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1.
Lancet ; 396(10256): 946-947, 2020 10 03.
Artigo em Inglês | MEDLINE | ID: mdl-33010827
2.
Sci Adv ; 6(32): eabc1463, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32923613

RESUMO

Bacillus Calmette-Guérin (BCG) vaccination may reduce the risk of a range of infectious diseases, and if so, it could protect against coronavirus disease 2019 (COVID-19). Here, we compared countries that mandated BCG vaccination until at least 2000 with countries that did not. To minimize any systematic effects of reporting biases, we analyzed the rate of the day-by-day increase in both confirmed cases (134 countries) and deaths (135 countries) in the first 30-day period of country-wise outbreaks. The 30-day window was adjusted to begin at the country-wise onset of the pandemic. Linear mixed models revealed a significant effect of mandated BCG policies on the growth rate of both cases and deaths after controlling for median age, gross domestic product per capita, population density, population size, net migration rate, and various cultural dimensions (e.g., individualism). Our analysis suggests that mandated BCG vaccination can be effective in the fight against COVID-19.


Assuntos
Vacina BCG/imunologia , Betacoronavirus/imunologia , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/mortalidade , Pneumonia Viral/prevenção & controle , Infecções por Coronavirus/transmissão , Humanos , Pneumonia Viral/transmissão , Saúde Pública/legislação & jurisprudência , Vacinação/estatística & dados numéricos
3.
Pan Afr Med J ; 36: 179, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32952823

RESUMO

As SARS-CoV-2 rapidly spread across the globe, short-term modeling forecasts provided time-critical information for containment and mitigation strategies. Global projections had so far incorrectly predicted large numbers of COVID-19 cases in Africa and that its health systems would be overwhelmed. Significantly higher COVID-19-related mortality were expected in Africa mainly because of its poor socio-economic determinants that make it vulnerable to public health threats, including diseases of epidemic potential. Surprisingly as SARS-CoV-2 swept across the globe, causing tens of thousands of deaths and massive economic disruptions, Africa has so far been largely spared the impact that threw China, USA, and Europe into chaos. To date, 42 African countries imposed lockdowns on movements and activities. Experience from around the world suggests that such interventions effectively suppressed the spread of COVID-19. However, lockdown measures posed considerable economic costs that, in turn, threatened lives, put livelihoods at risk, exacerbated poverty and the deleterious effects on cultures, health and behaviours. Consequently, there has been great interest in lockdown exit strategies that preserve lives while protecting livelihoods. Nonetheless in the last few weeks, African countries have started easing restrictions imposed to curb the spread of SARS-CoV-2. WHO recommends lifting of lockdowns should depend on the ability to contain SARS-CoV-2 and protect the public once restrictions are lifted. Yet, the greatest challenge is the critical decision which must be made in this time of uncertainties. We propose simple strategies on how to ease lockdowns in Africa based on evidence, disease dynamics, situational analysis and ability of national governments to handle upsurges.


Assuntos
Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Saúde Pública/legislação & jurisprudência , Quarentena/legislação & jurisprudência , África/epidemiologia , Infecções por Coronavirus/economia , Infecções por Coronavirus/epidemiologia , Assistência à Saúde/organização & administração , Humanos , Pandemias/economia , Pneumonia Viral/economia , Pneumonia Viral/epidemiologia , Pobreza , Saúde Pública/economia , Quarentena/economia , Fatores Socioeconômicos
7.
S Afr Med J ; 110(6): 458-460, 2020 04 22.
Artigo em Inglês | MEDLINE | ID: mdl-32880551

RESUMO

In March 2020, two cases of attempted murder were opened against people who had tested positive for COVID-19 and had not remained in quarantine. Criminal law has previously been used to criminalise intentional transmission of HIV in both South Africa (SA) and other countries. However, it has been found that criminalisation laws undermine public health and measures to control outbreaks by stigmatising those infected and deterring testing. This article explores whether SA's existing HIV criminalisation laws can be applied to the transmission of SARS-CoV-2, and the potential effect such measures could have on efforts to control the COVID-19 epidemic.


Assuntos
Infecções por Coronavirus/transmissão , Surtos de Doenças/prevenção & controle , Pneumonia Viral/transmissão , Saúde Pública/legislação & jurisprudência , Quarentena/legislação & jurisprudência , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Comportamento Criminoso , Direito Penal/legislação & jurisprudência , Infecções por HIV/transmissão , Humanos , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , África do Sul/epidemiologia
8.
S Afr Med J ; 110(6): 469-472, 2020 04 22.
Artigo em Inglês | MEDLINE | ID: mdl-32880555

RESUMO

Quarantine is a very effective method for containing the spread of highly infectious diseases in large populations during a pandemic, but it is only effective if properly implemented. The co-operation and compliance of people entering quarantine are critical to its success. However, owing to the isolating and social distancing nature of quarantine, it often leads to extreme economic hardship and shortages in basic needs such as food, medicine, water and communication - and to the curtailment of certain universal social norms such as attending a parent's funeral. To escape these hardships, people often refuse to enter voluntary quarantine, or breach quarantine rules. In these circumstances, health authorities are obliged to act in the best interests of the public and obtain court orders to force some people into quarantine. In further extreme circumstances, when a national lockdown is ordered, non-compliance with quarantine measures may result in arrests and penalties. The scope of this article is limited to the period prior to and following such a lockdown, during which quarantine may still be vital for the containment of COVID-19. Because a quarantine order will deprive an individual of his or her freedom, this must be carefully balanced with the public interest. This article explains the legal and ethical considerations of this balancing exercise and provides practical guidance for obtaining quarantine orders.


Assuntos
Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Saúde Pública/legislação & jurisprudência , Quarentena/legislação & jurisprudência , Infecções por Coronavirus/epidemiologia , Humanos , Pneumonia Viral/epidemiologia , Saúde Pública/ética , Quarentena/ética , África do Sul/epidemiologia
9.
MMWR Morb Mortal Wkly Rep ; 69(35): 1198-1203, 2020 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-32881851

RESUMO

SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), is thought to spread from person to person primarily by the respiratory route and mainly through close contact (1). Community mitigation strategies can lower the risk for disease transmission by limiting or preventing person-to-person interactions (2). U.S. states and territories began implementing various community mitigation policies in March 2020. One widely implemented strategy was the issuance of orders requiring persons to stay home, resulting in decreased population movement in some jurisdictions (3). Each state or territory has authority to enact its own laws and policies to protect the public's health, and jurisdictions varied widely in the type and timing of orders issued related to stay-at-home requirements. To identify the broader impact of these stay-at-home orders, using publicly accessible, anonymized location data from mobile devices, CDC and the Georgia Tech Research Institute analyzed changes in population movement relative to stay-at-home orders issued during March 1-May 31, 2020, by all 50 states, the District of Columbia, and five U.S. territories.* During this period, 42 states and territories issued mandatory stay-at-home orders. When counties subject to mandatory state- and territory-issued stay-at-home orders were stratified along rural-urban categories, movement decreased significantly relative to the preorder baseline in all strata. Mandatory stay-at-home orders can help reduce activities associated with the spread of COVID-19, including population movement and close person-to-person contact outside the household.


Assuntos
Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Dinâmica Populacional/estatística & dados numéricos , Saúde Pública/legislação & jurisprudência , Infecções por Coronavirus/epidemiologia , Humanos , Pneumonia Viral/epidemiologia , Fatores de Tempo , Estados Unidos/epidemiologia
10.
J Korean Med Sci ; 35(34): e314, 2020 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-32864911

RESUMO

A 14-day quarantine is implemented in many countries in response to the coronavirus disease pandemic. Korea implemented a mandatory quarantine for those who had close contact with infected patients and those returning from abroad. The present study explored the implications of mandatory coronavirus disease 2019 testing before releasing individuals from the 14-day quarantine in Incheon, Korea. From February 11 to July 5, 2020, 19,296 people were self-quarantined, and 56 (0.3%) of them were confirmed cases of COVID-19. Twenty (35.7%) were identified through the reporting of symptoms during quarantine, and 32 (57.1%) were identified using mandatory pre-release RT-PCR tests. Among the 32, 14 (25%) individuals reported mild symptoms and 18 (32.1%) were asymptomatic. It is suggested that mandatory diagnostic testing prior to release and the symptom-based surveillance after the 14-day quarantine may help control delayed or asymptomatic COVID-19 cases.


Assuntos
Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Controle de Infecções/legislação & jurisprudência , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Saúde Pública/legislação & jurisprudência , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus/isolamento & purificação , Busca de Comunicante , Feminino , Humanos , Controle de Infecções/métodos , Masculino , Pessoa de Meia-Idade , Pandemias , Quarentena , República da Coreia/epidemiologia , Reação em Cadeia da Polimerase Via Transcriptase Reversa/métodos , Adulto Jovem
11.
J Int Med Res ; 48(8): 300060520938943, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32865095

RESUMO

BACKGROUND: The outbreak of coronavirus disease 2019 (COVID-19) began in December 2019 and continues to spread worldwide. Rapid and accurate identification of suspected cases is critical in slowing spread of the virus that causes the disease. We aimed to highlight discrepancies in the various criteria used by international agencies and highly impacted individual countries around the world. METHODS: We reviewed the criteria for identifying a suspected case of COVID-19 used by two international public health agencies and 10 countries across Asia, Europe, and North America. The criteria included information on the clinical causes of illness and epidemiological risk factors. Non-English language guidelines were translated into English by a co-author who is fluent in that particular language. RESULTS: Although most criteria are modifications of World Health Organization recommendations, the specific clinical features and epidemiological risks for triggering evaluation of patients with suspected COVID-19 differed widely among countries. The rationale for these differences may be related to each country's resources, politics, experience with previous outbreaks or pandemics, health insurance system, COVID-19 outbreak severity, and other undetermined factors. CONCLUSION: We found no consensus regarding the best diagnostic criteria for identifying a suspected case of COVID-19.


Assuntos
Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Regulamento Sanitário Internacional , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Saúde Pública/legislação & jurisprudência , Ásia/epidemiologia , Betacoronavirus , Centers for Disease Control and Prevention, U.S. , Europa (Continente)/epidemiologia , Humanos , Cooperação Internacional , América do Norte/epidemiologia , Pandemias , Estados Unidos , Organização Mundial da Saúde
12.
S Afr Med J ; 110(9): 858-863, 2020 08 13.
Artigo em Inglês | MEDLINE | ID: mdl-32880268

RESUMO

As COVID-19 spreads rapidly across Africa, causing havoc to economies and disruption to already fragile healthcare systems, it is becoming clear that despite standardised global health strategies, national and local government responses must be tailored to their individual settings. Some African countries have adopted stringent measures such as national lockdown, quarantine or isolation, in combination with good hand hygiene, mandatory wearing of masks and physical distancing, to prevent an impending healthcare crisis. The impact of stringent measures in low- to middle-income African countries has bought time for healthcare facilities to prepare for the onslaught of COVID-19 cases, but some measures have been challenging to implement. In some settings, public health measures have been associated with serious violations of individual rights owing to abuse of power and gaps in implementation of well-intentioned policy. Collateral damage with regard to non-COVID-19 diseases that were suboptimally managed in pre-pandemic times may mean that lives lost from other diseases could exceed those saved from COVID-19. While individuals complying with lockdown regulations have embraced an acceptance of the concept of the common good, at a broad community level many are finding the transition from individualism to collective thinking required during a pandemic difficult to navigate. In this article, we look at government responses to the pandemic in six African countries (Malawi, South Africa, Uganda, Zambia, Zimbabwe and Botswana), and highlight ethical concerns arising in these contexts.


Assuntos
Direitos Civis/ética , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Autonomia Pessoal , Pneumonia Viral/prevenção & controle , Saúde Pública/ética , África , Betacoronavirus , Botsuana , Direitos Civis/legislação & jurisprudência , Infecções por Coronavirus/epidemiologia , Liberdade , Humanos , Malaui , Pneumonia Viral/epidemiologia , Saúde Pública/legislação & jurisprudência , África do Sul , Uganda , Zâmbia , Zimbábue
13.
N Z Med J ; 133(1520): 99-103, 2020 08 21.
Artigo em Inglês | MEDLINE | ID: mdl-32994598

RESUMO

In this viewpoint we briefly review the evidence for smoke-free car legislation. We find that this legislation has been consistently associated with reduced secondhand exposure in cars with children/youth in all nine jurisdictions studied. Despite this, there are various aspects of this intervention that warrant further study-especially determining its impact on reducing tobacco-related ethnic inequalities. So we argue that the New Zealand Ministry of Health should invest in a thorough evaluation of this important upcoming public health intervention. This could both help the country in further refining the design of the law (if necessary) and would also be a valuable contribution to advancing the knowledge base for international tobacco control.


Assuntos
Automóveis/legislação & jurisprudência , Exposição Ambiental/prevenção & controle , Política Antifumo/legislação & jurisprudência , Poluição por Fumaça de Tabaco/legislação & jurisprudência , Adolescente , Automóveis/normas , Criança , Exposição Ambiental/efeitos adversos , Grupos Étnicos/estatística & dados numéricos , Humanos , Nova Zelândia/epidemiologia , Saúde Pública/economia , Saúde Pública/legislação & jurisprudência , Fatores Socioeconômicos , Tabaco/efeitos adversos , Poluição por Fumaça de Tabaco/efeitos adversos , Poluição por Fumaça de Tabaco/prevenção & controle
14.
Cuad Bioet ; 31(102): 167-182, 2020.
Artigo em Espanhol | MEDLINE | ID: mdl-32910670

RESUMO

In this paper present, from a bioethical perspective, a reflection on how to reconcile efforts to combat the COVID-19 pandemic with the safeguard of human rights. To do this, I develop three points. First, the regulatory framework that justifies the restriction or suspension of rights in the face of serious threats to public health. Second, the declarations of the international bioethics committees on the way in which human rights should be protected during public health crisis. And third, a review of the main rights threatened both by the public health crisis and by the means adopted to combat it. Before going into each of these points, I offer a preliminary note to clarify certain legal concepts and underline the need to overcome disjunctive approaches in considering human rights.


Assuntos
Betacoronavirus , Controle de Doenças Transmissíveis/legislação & jurisprudência , Direitos Humanos/ética , Pandemias/prevenção & controle , Saúde Pública/ética , Controle de Doenças Transmissíveis/métodos , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Comissão de Ética , União Europeia , Liberdade , Recursos em Saúde/ética , Recursos em Saúde/provisão & distribução , Acesso aos Serviços de Saúde/ética , Direitos Humanos/legislação & jurisprudência , Humanos , Pandemias/ética , Pandemias/legislação & jurisprudência , Direitos do Paciente/ética , Direitos do Paciente/legislação & jurisprudência , Autonomia Pessoal , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Guias de Prática Clínica como Assunto , Saúde Pública/legislação & jurisprudência , Quarentena/ética , Quarentena/legislação & jurisprudência , Sujeitos da Pesquisa , Alocação de Recursos/ética , Espanha , UNESCO
15.
Int J Law Psychiatry ; 71: 101602, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32768125

RESUMO

This article examines the changes made to mental health and capacity laws in Northern Ireland through temporary emergency legislation, known as the Coronavirus Act 2020. The purpose of the legislation was to respond to the emergency situation created by the COVID-19 pandemic, in particular the increase pressure placed on health services in the United Kingdom. An overview is provided of the government's rationale for the changes to Northern Ireland mental health and capacity laws, as well as exploring how they are likely to be operationalised in practice. Consideration is also given as to how such changes may impact upon existing human rights protections for persons assessed as lacking mental capacity. It is argued that it is important that regular parliamentary oversight is maintained in relation to the potential impact and consequences of such changes during the period they are in force. This should be done in order to assess whether they remain a necessary, proportionate and least restrictive response to the challenges faced in managing mental health and capacity issues in Northern Ireland during this public health emergency.


Assuntos
Infecções por Coronavirus/epidemiologia , Saúde Mental/legislação & jurisprudência , Pneumonia Viral/epidemiologia , Betacoronavirus , Internação Compulsória de Doente Mental/legislação & jurisprudência , Direitos Humanos/legislação & jurisprudência , Humanos , Competência Mental/legislação & jurisprudência , Irlanda do Norte/epidemiologia , Pandemias , Saúde Pública/legislação & jurisprudência
16.
Vopr Pitan ; 89(3): 6-13, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32790253

RESUMO

Currently, due to the wide spread of the new coronavirus infection COVID-19 and the need for anti-epidemic measures, medical science should integrate all efforts to ensure, on the one hand, at the global level - the fight against the spread of infection, on the other hand, at the individual level - increasing the adaptive capacity and immune response of the organism to protect against COVID-19. Nutrition is the most important factor determining human health and the functioning of all mechanisms to protect a person from negative environmental factors. For the prevention and treatment of new coronavirus infection COVID-19, a significant role is played by the correction of eating disorders, including vitamin and micronutrient deficiency. Federal Research Centre of Nutrition and Biotechnology, together with Russian Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor), prepared Recommendations on nutrition for children and adults, requiring a self-isolation regime or quarantine at home in connection with COVID-19. In order to promptly inform and advise the population on nutrition optimization in the early days of anti-epidemic measures, an information reference Contact Center was created and is continuously functioning on the basis of the Federal Research Centre of Nutrition and Biotechnology. Equally important is the implementation of measures aimed at the prevention of food contamination with COVID-19 agent. In this regard, the Federal Research Centre of Nutrition and Biotechnology, together with Rospotrebnadzor prepared guidelines on measures to prevent the transmission of a new coronavirus infection through foods. Another aspect that the medical community has faced in connection with the pandemic is the need to reorient specialized medical organizations that have not previously worked with patients with infectious diseases in order to create Clinical centers for the treatment of the new coronavirus infection COVID-19. Thus, in the context of the spread of the new coronavirus infection COVID-19, many areas of medicine are involved in the process of providing anti-epidemic measures. Successful completion of the tasks will significantly reduce the negative consequences of the COVID-19 pandemic for the state and citizens.


Assuntos
Betacoronavirus , Infecções por Coronavirus , Pandemias , Pneumonia Viral , Saúde Pública , Quarentena , Adulto , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Humanos , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Saúde Pública/legislação & jurisprudência , Saúde Pública/métodos , Saúde Pública/normas , Quarentena/legislação & jurisprudência , Quarentena/organização & administração , Quarentena/normas , Federação Russa
20.
Public Health Rep ; 135(5): 685-690, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32762633

RESUMO

OBJECTIVES: Racial/ethnic disparities in HIV diagnosis rates remain despite the availability of effective treatment and prevention tools in the United States. In 2019, President Trump announced the "Ending the HIV Epidemic: A Plan for America" (EHE) initiative to reduce new HIV infections in the United States at least 75% by 2025 and at least 90% by 2030. The objective of this study was to show the potential effect of the EHE initiative on racial/ethnic disparities in HIV diagnosis rates at the national level. METHODS: We used 2017 HIV diagnoses data from the Centers for Disease Control and Prevention National HIV Surveillance System. We developed a counterfactual scenario to determine changes in racial/ethnic disparities if the 2017 HIV diagnosis rates were reduced by 75% in the geographic regions targeted by the EHE initiative. We used 4 measures to calculate results: rate ratio, population-attributable proportion (PAP), Gini coefficient, and Index of Disparity. RESULTS: The relative measures of racial/ethnic disparity decreased by 9%-21% in the EHE scenario compared with the 2017 HIV diagnoses data. The largest decrease was in the Hispanic/Latino:white rate ratio (-20.6%) and in the black:white rate ratio (-18.2%). The PAP measure decreased by 11.5%. The absolute versions of the Index of Disparity (unweighted and weighted) were approximately 50% lower in the EHE scenario than in the 2017 HIV diagnoses data. CONCLUSIONS: EHE efforts could reduce but will not eliminate racial/ethnic disparities in HIV diagnosis rates. Efforts to address racial/ethnic disparities should continue, and innovative approaches, specifically those that focus on social and structural factors, should be developed and implemented for populations that are disproportionately affected by HIV in the United States.


Assuntos
Epidemias/prevenção & controle , Epidemias/estatística & dados numéricos , Grupos Étnicos/estatística & dados numéricos , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Disparidades nos Níveis de Saúde , Saúde Pública/legislação & jurisprudência , Saúde Pública/estatística & dados numéricos , Adolescente , Adulto , Afro-Americanos/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Grupos de Populações Continentais/estatística & dados numéricos , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Feminino , Hispano-Americanos/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos/epidemiologia , Adulto Jovem
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