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1.
Gesundheitswesen ; 82(11): 829-835, 2020 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-33187002

RESUMO

The COVID 19 crisis offers unique opportunities and poses special challenges for practical and theoretical public health. Management of the pandemic was initially dominated by virologists, supported by epidemiologists who did not always exercise the necessary scientific rigour. Expertise in interdisciplinary health sciences and complex considerations from a broader public health perspective, however, did not have noticeable impact on the COVID 19 debate and even less on the strategies for containing the pandemic. Public health is universal and more than health security or health protection. As an explicitly political discipline, public health takes a far-reaching socio-political approach and must not be reduced to biomedical aspects. Medical and biotechnological solutions alone will not meet the challenges of the corona crisis. The analysis of the political, economic, social and ecological determinants that led to the crisis is indispensable for the sustainable management of the pandemic. In order to improve population health and reduce the risk of future outbreaks of dangerous infections, a comprehensive policy is needed that also addresses hegemonies and power relations.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Saúde Pública/tendências , Betacoronavirus , Alemanha/epidemiologia , Humanos , Saúde Pública/métodos
3.
PLoS Negl Trop Dis ; 14(11): e0008828, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33147222

RESUMO

Since the beginning of the year, the world's attention has rightly been focused on the spread of the Coronavirus Disease 2019 (COVID-19) pandemic and the implementation of drastic mitigation strategies to limit disease transmission. However, public health information campaigns tailored to children are very rare. Now more than ever, at a time when some governments are taking populations out of lockdown and youth are returning to schools, children around the world need to fully grasp the modes of transmission of the disease, the health risks, the scientific notions of the immune system, the value of barrier measures, and the progress of scientific research. In the context of the COVID-19 pandemic, comics can be very useful for communicating quickly and effectively abstract and important information to children who might be under the influence of a large amount of sometimes contradictory information. Conveying precise, reliable, and accessible information to children is key in a world overwhelmingly impacted by the outbreak. This should be the role and the responsibility of world health official leaders and governments in compliance with the United Nations Convention on the Rights of the Child. In partnership with mainstream medias, consortia of scientists, communication experts, and education specialists, it is urgent that world leaders engage children in this worldwide public health fight.


Assuntos
Infecções por Coronavirus/prevenção & controle , Histórias em Quadrinhos como Assunto , Educação em Saúde/métodos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Criança , Saúde da Criança , Humanos , Saúde Pública/métodos , Mídias Sociais
7.
PLoS One ; 15(10): e0241166, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33119721

RESUMO

BACKGROUND: The spread of coronavirus in the United States with nearly five and half million confirmed cases and over 170,000 deaths has strained public health and health care systems. While many have focused on clinical outcomes, less attention has been paid to vulnerability and risk of infection. In this study, we developed a planning tool that examines factors that affect vulnerability to COVID-19. METHODS: Across 46 variables, we defined five broad categories: 1) access to medical services, 2) underlying health conditions, 3) environmental exposures, 4) vulnerability to natural disasters, and 5) sociodemographic, behavioral, and lifestyle factors. The developed tool was validated by comparing the estimated overall vulnerability with the real-time reported normalized confirmed cases of COVID-19. ANALYSIS: A principal component analysis was undertaken to reduce the dimensions. In order to identify vulnerable census tracts, we conducted rank-based exceedance and K-means cluster analyses. RESULTS: All of the 5 vulnerability categories, as well as the overall vulnerability, showed significant (P-values <<0.05) and relatively strong correlations (0.203<ρ<0.57) with the normalized confirmed cases of COVID-19 at the census tract level. Our study showed a total of 722,357 (~17% of the County population) people, including 171,403 between the ages of 45-65 (~4% of County's population), and 76,719 seniors (~2% of County population), are at a higher risk based on the aforementioned categories. The exceedance and K-means cluster analysis demonstrated that census tracts in the northeastern, eastern, southeastern and northwestern regions of the County are at highest risk. CONCLUSION: Policymakers can use this planning tool to identify neighborhoods at high risk for becoming hot spots; efficiently match community resources with needs, and ensure that the most vulnerable have access to equipment, personnel, and medical interventions.


Assuntos
Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Medição de Risco , Populações Vulneráveis , Adulto , Idoso , Betacoronavirus , Análise por Conglomerados , Humanos , Pessoa de Meia-Idade , Pandemias , Prevalência , Saúde Pública/métodos , Características de Residência , Análise Espacial , Texas/epidemiologia
8.
Ann Glob Health ; 86(1): 133, 2020 10 08.
Artigo em Inglês | MEDLINE | ID: mdl-33102153

RESUMO

The COVID-19 pandemic has highlighted vast differences across countries in their responses to the emergency and their capacities to implement public health measures that could slow the progression of the disease. As public health systems are the first line of defense during pandemics, it has become clear that sustained investment in strengthening public health infrastructure is a major need in all countries, irrespective of income levels. Drawing on the successful experiences of Switzerland, Georgia, and New Zealand in dealing with COVID-19, we suggest prioritizing core public health capacities with links to the International Health Regulations, improving international cooperation, coordination, and multisectoral action, addressing health inequities by targeting vulnerable groups, and enhancing health literacy, including through sophisticated and sustained communication campaigns to build resilience. These measures will ensure that health systems and communities will be better prepared for the disruptions that future disease outbreaks will inevitably bring.


Assuntos
Controle de Doenças Transmissíveis , Infecções por Coronavirus , Assistência à Saúde , Saúde Global/normas , Pandemias/prevenção & controle , Pneumonia Viral , Saúde Pública/métodos , Betacoronavirus , Defesa Civil , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/organização & administração , Controle de Doenças Transmissíveis/normas , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Assistência à Saúde/organização & administração , Assistência à Saúde/normas , Humanos , Cooperação Internacional , Colaboração Intersetorial , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Melhoria de Qualidade , Fatores Socioeconômicos
12.
Infect Dis Poverty ; 9(1): 141, 2020 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-33046120

RESUMO

In the past five months, success in control the national epidemic of coronavirus disease 2019 (COVID-19) has been witnessed in China. The implementation of public health measures accounts for the success which include different interventions in the early or later stages of the outbreak. It is clear that although not all measures were universally effective worldwide, their achievements have been significant. More solidarity is needed to deal with this global pandemic with more learning and understanding. Understanding which of the public health interventions implemented in China were effective may provide ideas for international epidemic control.


Assuntos
Infecções por Coronavirus/prevenção & controle , Controle de Infecções/métodos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Saúde Pública/métodos , Betacoronavirus/isolamento & purificação , China/epidemiologia , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Transmissão de Doença Infecciosa/prevenção & controle , Diagnóstico Precoce , Humanos , Controle de Infecções/normas , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Saúde Pública/normas
13.
PLoS One ; 15(10): e0240011, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33022023

RESUMO

BACKGROUND: Understanding public perceptions of government responses to COVID-19 may foster improved public cooperation. Trust in government and population risk of exposure may influence public perception of the response. Other population-level characteristics, such as country socio-economic development, COVID-19 morbidity and mortality, and degree of democratic government, may influence perception. METHODS AND FINDINGS: We developed a novel ten-item instrument that asks respondents to rate key aspects of their government's response to the pandemic (COVID-SCORE). We examined whether the results varied by gender, age group, education level, and monthly income. We also examined the internal and external validity of the index using appropriate predefined variables. To test for dimensionality of the results, we used a principal component analysis (PCA) for the ten survey items. We found that Cronbach's alpha was 0.92 and that the first component of the PCA explained 60% of variance with the remaining factors having eigenvalues below 1, strongly indicating that the tool is both reliable and unidimensional. Based on responses from 13,426 people randomly selected from the general population in 19 countries, the mean national scores ranged from 35.76 (Ecuador) to 80.48 (China) out of a maximum of 100 points. Heterogeneity in responses was observed across age, gender, education and income with the greatest amount of heterogeneity observed between countries. National scores correlated with respondents' reported levels of trust in government and with country-level COVID-19 mortality rates. CONCLUSIONS: The COVID-SCORE survey instrument demonstrated satisfactory validity. It may help governments more effectively engage constituents in current and future efforts to control COVID-19. Additional country-specific assessment should be undertaken to measure trends over time and the public perceptions of key aspects of government responses in other countries.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Governo , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Opinião Pública , Projetos de Pesquisa , Inquéritos e Questionários , Adolescente , Adulto , Idoso , China/epidemiologia , Infecções por Coronavirus/virologia , Estudos Transversais , Equador/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/virologia , Análise de Componente Principal , Saúde Pública/métodos , Quarentena/métodos , Confiança , Adulto Jovem
15.
Sci Rep ; 10(1): 16950, 2020 10 12.
Artigo em Inglês | MEDLINE | ID: mdl-33046737

RESUMO

The spread of SARS-COV-2 has affected many economic and social systems. This paper aims at estimating the impact on regional productive systems in Italy of the interplay between the epidemic and the mobility restriction measures put in place to contain the contagion. We focus then on the economic consequences of alternative lockdown lifting schemes. We leverage a massive dataset of human mobility which describes daily movements of over four million individuals in Italy and we model the epidemic spreading through a metapopulation SIR model, which provides the fraction of infected individuals in each Italian district. To quantify economic backslashes this information is combined with socio-economic data. We then carry out a scenario analysis to model the transition to a post-lockdown phase and analyze the economic outcomes derived from the interplay between (a) the timing and intensity of the release of mobility restrictions and (b) the corresponding scenarios on the severity of virus transmission rates. Using a simple model for the spreading disease and parsimonious assumptions on the relationship between the infection and the associated economic backlashes, we show how different policy schemes tend to induce heterogeneous distributions of losses at the regional level depending on mobility restrictions. Our work shed lights on how recovery policies need to balance the interplay between mobility flows of disposable workers and the diffusion of contagion.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Dinâmica Populacional , Saúde Pública/métodos , Betacoronavirus , Humanos , Modelos Biológicos , Movimento , Pandemias , Quarentena/métodos , Viagem
18.
Rev Esp Salud Publica ; 942020 Oct 30.
Artigo em Espanhol | MEDLINE | ID: mdl-33124619

RESUMO

This paper aims to share the reflections related to the community actions in which the Agència de Salut Pública de Barcelona has been involved during the emergency of COVID-19. The tasks carried out can be arranged in three stages, frequently overlapping: detection of needs and problems; contact with key stakeholders to assess what to do and how to do it; adaptation of the interventions to the "new normal" and generation of new responses. The emerging problems included: not being able to do the confinement (due to homelessness, material conditions, living in a situation of violence); digital gap (lack of knowledge, devices, access to Wifi); greater exposure to COVID-19 in the essential but precarious, feminized and racialized jobs (care, cleaning, food shops) that are the most frequent in the neighborhoods in where we work; language and cultural barriers that preclude to follow recommendations; to lose employment; insufficient income to cover basic needs; social isolation; and the deterioration of emotional health caused by the situation. During the process, some interventions were adapted to be delivered on-line. Solidarity networks and local resources were key to meet basic needs, but also other needs related to lack of digital knowledge or device. Community action in health, from a critical, intersectional and local perspective, and with intersectoral work and community participation, can contribute to: facilitate a contextualized response in the event of a health crisis; mitigate the effects derived from its economic and social crisis.


Assuntos
Betacoronavirus , Serviços de Saúde Comunitária/métodos , Infecções por Coronavirus/prevenção & controle , Política de Saúde , Promoção da Saúde/métodos , Determinação de Necessidades de Cuidados de Saúde , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Saúde Pública/métodos , Serviços de Saúde Comunitária/organização & administração , Participação da Comunidade , Promoção da Saúde/organização & administração , Humanos , Espanha
19.
BMJ Open ; 10(10): e041383, 2020 10 22.
Artigo em Inglês | MEDLINE | ID: mdl-33093038

RESUMO

INTRODUCTION: Implementing non-pharmaceutical interventions (NPIs) protect the public from COVID-19. However, the impact of NPIs has been inconsistent and remains unclear. This study, therefore, aims to measure the impact of major NPIs (social distancing, social isolation and quarantine) on reducing COVID-19 transmission. METHODS AND ANALYSIS: We will conduct a systematic review and meta-analysis research of both randomised and non-randomised controlled trials. We will undertake a systematic search of: MEDLINE, Embase, Allied & Complementary Medicine, COVID-19 Research, WHO database on COVID-19, ClinicalTrails.Gov for clinical trials on COVID-19, Cochrane Resources on Coronavirus (COVID-19), Oxford COVID-19 Evidence Service and Google Scholar for published and unpublished literatures on COVID-19 including preprint engines such as medRxiv, bioRxiv, Litcovid and SSRN for unpublished studies on COVID-19 and will be reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Outcomes of interest for impact analysis will include the reduction of COVID-19 transmission, avoiding crowds and restricting movement, isolating ill and psychological impacts. The Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols checklist has been used for this protocol. For quality of included studies, we will use the Cochrane Collaboration's tool for assessing risk of bias for randomised controlled trials and the Newcastle-Ottawa Scale for observational studies. The Grading of Recommendations Assessment, Development and Evaluation approach will grade the certainty of the evidence for all outcome measures across studies. Random-effects model for meta-analysis will measure the effect size of NPIs or the strengths of relationships. For quantitative data, risk ratio or OR, absolute risk difference (for dichotomous outcome data), or mean difference or standardised mean difference (for continuous data) and their 95% CIs will be calculated. Where statistical pooling is not possible, a narrative synthesis will be conducted for the included studies. To assess the heterogeneity of effects, I2 together with the observed effects will be evaluated to provide the true effects in the analysis. ETHICS AND DISSEMINATION: Formal ethical approval from an institutional review board or research ethics committee is not required as primary data will not be collected. The final results of this study will be published in an open-access peer-reviewed journal, and abstract will be presented at suitable national/international conferences or workshops. We will also share important information with public health authorities as well as with the WHO. In addition, we may post the submitted manuscript under review to medRxiv, or other relevant preprint servers. TRIAL REGISTRATION NUMBER: CRD42020207338.


Assuntos
Infecções por Coronavirus , Transmissão de Doença Infecciosa/prevenção & controle , Pandemias , Pneumonia Viral , Quarentena/métodos , Isolamento Social , Betacoronavirus , Controle de Doenças Transmissíveis/métodos , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Humanos , Metanálise como Assunto , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Saúde Pública/métodos , Saúde Pública/estatística & dados numéricos , Projetos de Pesquisa , Revisões Sistemáticas como Assunto
20.
BMJ Open ; 10(10): e043763, 2020 10 05.
Artigo em Inglês | MEDLINE | ID: mdl-33020109

RESUMO

OBJECTIVES: We evaluated whether implementation of lockdown orders in South Africa affected ambulatory clinic visitation in rural Kwa-Zulu Natal (KZN). DESIGN: Observational cohort SETTING: Data were analysed from 11 primary healthcare clinics in northern KZN. PARTICIPANTS: A total of 46 523 individuals made 89 476 clinic visits during the observation period. EXPOSURE OF INTEREST: We conducted an interrupted time series analysis to estimate changes in clinic visitation with a focus on transitions from the prelockdown to the level 5, 4 and 3 lockdown periods. OUTCOME MEASURES: Daily clinic visitation at ambulatory clinics. In stratified analyses, we assessed visitation for the following subcategories: child health, perinatal care and family planning, HIV services, non-communicable diseases and by age and sex strata. RESULTS: We found no change in total clinic visits/clinic/day at the time of implementation of the level 5 lockdown (change from 90.3 to 84.6 mean visits/clinic/day, 95% CI -16.5 to 3.1), or at the transitions to less stringent level 4 and 3 lockdown levels. We did detect a >50% reduction in child healthcare visits at the start of the level 5 lockdown from 11.9 to 4.7 visits/day (-7.1 visits/clinic/day, 95% CI -8.9 to 5.3), both for children aged <1 year and 1-5 years, with a gradual return to prelockdown within 3 months after the first lockdown measure. In contrast, we found no drop in clinic visitation in adults at the start of the level 5 lockdown, or related to HIV care (from 37.5 to 45.6, 8.0 visits/clinic/day, 95% CI 2.1 to 13.8). CONCLUSIONS: In rural KZN, we identified a significant, although temporary, reduction in child healthcare visitation but general resilience of adult ambulatory care provision during the first 4 months of the lockdown. Future work should explore the impacts of the circulating epidemic on primary care provision and long-term impacts of reduced child visitation on outcomes in the region.


Assuntos
Assistência Ambulatorial/estatística & dados numéricos , Infecções por Coronavirus/epidemiologia , Acesso aos Serviços de Saúde/estatística & dados numéricos , Acesso aos Serviços de Saúde/tendências , Pneumonia Viral/epidemiologia , Atenção Primária à Saúde , Saúde Pública , Adulto , Fatores Etários , Betacoronavirus , Serviços de Planejamento Familiar/estatística & dados numéricos , Feminino , Infecções por HIV/epidemiologia , Humanos , Masculino , Pandemias , Pediatria/estatística & dados numéricos , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde/estatística & dados numéricos , Saúde Pública/métodos , Saúde Pública/estatística & dados numéricos , População Rural
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