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2.
Public Health Res Pract ; 31(3)2021 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-34494077

RESUMO

OBJECTIVES: To describe local operational aspects of the coronavirus disease 2019 (COVID-19) response during the first three waves of outbreaks in New South Wales (NSW), Australia, which began in January, July and December 2020. Type of program or service: Public health outbreak response. METHODS: Narrative with epidemiological linking and genomic testing. RESULTS: Epidemiological linking and genomic testing found that during the first wave of COVID-19 in NSW, a large number of community transmissions went undetected because of limited testing for the virus and limited contact tracing of cases. The second wave of COVID-19 in NSW emerged following reintroduction from the second wave in Victoria, Australia in July 2020, and the third wave followed undetected introduction from overseas. By the second and third waves, cases could be more effectively detected and isolated through an increased ability to test and contact trace, and to rapidly genomic sequence severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) isolates, allowing most cases to be identified and epidemiologically linked. This greater certainty in understanding chains of transmission resulted in control of the outbreaks despite less stringent restrictions on the community, by using a refined strategy of targeted shutdown, restrictions on cases, their close contacts, identified hotspots and venues of concern rather than a whole of community lockdown. Risk assessments of potential transmission sites were constantly updated through our evolving experience with transmission events. However, this refined strategy did leave the potential for large point source outbreaks should any cases go undetected. [Addendum] A fourth wave that began in Sydney in June 2021 challenged this strategy due to the more transmissible nature of the Delta variant of SARS-CoV-2. LESSONS LEARNT: A wave of COVID-19 infections can develop quickly from one infected person. The community needs to remain vigilant, adhering to physical distancing measures, signing in to venues they visit, and getting tested if they have any symptoms. Signing out of venues on exit allows public health resources to be used more efficiently to respond to outbreaks.


Assuntos
COVID-19/epidemiologia , COVID-19/prevenção & controle , Controle de Doenças Transmissíveis/métodos , Surtos de Doenças/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19/diagnóstico , Teste para COVID-19/métodos , Criança , Pré-Escolar , Controle de Doenças Transmissíveis/organização & administração , Busca de Comunicante/métodos , Surtos de Doenças/prevenção & controle , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , New South Wales/epidemiologia , Distanciamento Físico , Saúde Pública , Quarentena/métodos , SARS-CoV-2/isolamento & purificação , Vitória/epidemiologia , Adulto Jovem
3.
MMWR Morb Mortal Wkly Rep ; 70(34): 1129-1135, 2021 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-34437527

RESUMO

In 1988, when the Global Polio Eradication Initiative (GPEI) began, polio paralyzed >350,000 children across 125 countries. Today, only one of three wild poliovirus serotypes, type 1 (WPV1), remains in circulation in only two countries, Afghanistan and Pakistan. This report summarizes progress toward global polio eradication during January 1, 2019-June 30, 2021 and updates previous reports (1,2). In 2020, 140 cases of WPV1 were reported, including 56 in Afghanistan (a 93% increase from 29 cases in 2019) and 84 in Pakistan (a 43% decrease from 147 cases in 2019). As GPEI focuses on the last endemic WPV reservoirs, poliomyelitis outbreaks caused by circulating vaccine-derived poliovirus (cVDPV) have emerged as a result of attenuated oral poliovirus vaccine (OPV) virus regaining neurovirulence after prolonged circulation in underimmunized populations (3). In 2020, 32 countries reported cVDPV outbreaks (four type 1 [cVDPV1], 26 type 2 [cVDPV2] and two with outbreaks of both); 13 of these countries reported new outbreaks. The updated GPEI Polio Eradication Strategy 2022-2026 (4) includes expanded use of the type 2 novel oral poliovirus vaccine (nOPV2) to avoid new emergences of cVDPV2 during outbreak responses (3). The new strategy deploys other tactics, such as increased national accountability, and focused investments for overcoming the remaining barriers to eradication, including program disruptions and setbacks caused by the COVID-19 pandemic.


Assuntos
Erradicação de Doenças , Saúde Global/estatística & dados numéricos , Poliomielite/prevenção & controle , Vigilância da População , Surtos de Doenças/estatística & dados numéricos , Doenças Endêmicas/estatística & dados numéricos , Humanos , Programas de Imunização , Poliomielite/epidemiologia , Vacinas contra Poliovirus/administração & dosagem
5.
Sci Rep ; 11(1): 16945, 2021 08 20.
Artigo em Inglês | MEDLINE | ID: mdl-34417513

RESUMO

The patterns of respiratory virus illness are expressed differently between temperate and tropical climates. Tropical outbreaks often peak in wet seasons. Temperate outbreaks typically peak during the winter. The prevailing causal hypotheses focus on sunlight, temperature and humidity variations. Yet no consistent factors have been identified to sufficiently explain seasonal virus emergence and decline at any latitude. Here we demonstrate close connections among global-scale atmospheric circulations, IgE antibody enhancement through seasonal pollen inhalation, and respiratory virus patterns at any populated latitude, with a focus on the US. Pollens emerge each Spring, and the renewed IgE titers in the population are argued to terminate each winter peak of respiratory illness. Globally circulated airborne viruses are postulated to subsequently deposit across the Southern US during lower zonal geostrophic winds each late Summer. This seasonally refreshed viral load is postulated to trigger a new influenza outbreak, once the existing IgE antibodies diminish to a critical value each Fall. Our study offers a new and consistent explanation for the seasonal diminishment of respiratory viral illnesses in temperate climates, the subdued seasonal signature in the tropics, the annually circulated virus phenotypes, and the northerly migration of influenza across the US every year. Our integrated geospatial and IgE hypothesis provides a new perspective for prediction, mitigation and prevention of the outbreak and spread of seasonal respiratory viruses including Covid-19 pandemic.


Assuntos
COVID-19/epidemiologia , Surtos de Doenças/estatística & dados numéricos , Influenza Humana/epidemiologia , Infecções por Vírus Respiratório Sincicial/epidemiologia , Doenças Respiratórias/epidemiologia , SARS-CoV-2/fisiologia , Antígenos de Plantas , Atmosfera , Humanos , Imunoglobulina E/metabolismo , Pandemias , Pólen , Estações do Ano , Estados Unidos/epidemiologia
6.
Elife ; 102021 08 24.
Artigo em Inglês | MEDLINE | ID: mdl-34425938

RESUMO

SARS-CoV-2 is notable both for its rapid spread, and for the heterogeneity of its patterns of transmission, with multiple published incidences of superspreading behaviour. Here, we applied a novel network reconstruction algorithm to infer patterns of viral transmission occurring between patients and health care workers (HCWs) in the largest clusters of COVID-19 infection identified during the first wave of the epidemic at Cambridge University Hospitals NHS Foundation Trust, UK. Based upon dates of individuals reporting symptoms, recorded individual locations, and viral genome sequence data, we show an uneven pattern of transmission between individuals, with patients being much more likely to be infected by other patients than by HCWs. Further, the data were consistent with a pattern of superspreading, whereby 21% of individuals caused 80% of transmission events. Our study provides a detailed retrospective analysis of nosocomial SARS-CoV-2 transmission, and sheds light on the need for intensive and pervasive infection control procedures.


Assuntos
COVID-19/epidemiologia , COVID-19/transmissão , Surtos de Doenças/estatística & dados numéricos , Hospitais/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
8.
PLoS One ; 16(8): e0253843, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34407073

RESUMO

BACKGROUND: Knowing the true infected and symptomatic case fatality ratios (IFR and CFR) for COVID-19 is of high importance for epidemiological model projections. Early in the pandemic many locations had limited testing and reporting, so that standard methods for determining IFR and CFR required large adjustments for missed cases. We present an alternate approach, based on results from the countries at the time that had a high test to positive case ratio to estimate symptomatic CFR. METHODS: We calculated age specific (0-69, 70-79, 80+ years old) time corrected crude symptomatic CFR values from 7 countries using two independent time to fatality correction methods. Data was obtained through May 7, 2020. We applied linear regression to determine whether the mean of these coefficients had converged to the true symptomatic CFR values. We then tested these coefficients against values derived in later studies as well as a large random serological study in NYC at that time. RESULTS: The age dependent symptomatic CFR values accurately predicted the percentage of the population infected as reported by two random testing studies in NYC. They also were in good agreement with later studies that estimated age specific IFR and CFR values from serological studies and more extensive data sets available later in the pandemic. CONCLUSIONS: We found that for regions with extensive testing it is possible to get early accurate symptomatic CFR coefficients. These values, in combination with an estimate of the age dependence of infection, allows symptomatic CFR values and percentage of the population that is infected to be determined in similar regions with limited testing.


Assuntos
COVID-19/epidemiologia , Surtos de Doenças/estatística & dados numéricos , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , COVID-19/mortalidade , Causas de Morte , Criança , Pré-Escolar , Europa (Continente)/epidemiologia , Feminino , Humanos , Lactente , Recém-Nascido , Israel/epidemiologia , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Modelos Estatísticos , Mortalidade , Nova Zelândia/epidemiologia , República da Coreia/epidemiologia , Adulto Jovem
10.
Epidemiol Infect ; 149: e153, 2021 06 24.
Artigo em Inglês | MEDLINE | ID: mdl-34372950

RESUMO

Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) pandemic is still ongoing along with the global vaccination efforts against it. Here, we aimed to understand the longevity and strength of anti-SARS-CoV-2 IgG responses in a small community (n = 283) six months following local SARS-COV-2 outbreak in March 2020. Three serological assays were compared and neutralisation capability was also determined. Overall 16.6% (47/283) of the participants were seropositive and 89.4% (42/47) of the IgG positives had neutralising antibodies. Most of the symptomatic individuals confirmed as polymerase chain reaction (PCR) positive during the outbreak were seropositive (30/32, 93.8%) and 33.3% of the individuals who quarantined with a PCR confirmed patient had antibodies. Serological assays comparison revealed that Architect (Abbott) targeting the N protein LIASON® (DiaSorin) targeting the S protein and enzyme-linked immunosorbent assay (ELISA) targeting receptor binding domain detected 9.5% (27/283), 17.3% (49/283) and 17% (48/283), respectively, as IgG positives. The latter two assays highly agreed (kappa = 0.89) between each other. In addition, 95%, (19/20, by ELISA) and 90.9% (20/22, with LIASON) and only 71.4% (15/21, by Architect) of individuals that were seropositive in May 2020 were found positive also in September. The unexpected low rate of overall immunity indicates the absence of un-noticed, asymptomatic infections. Lack of overall high correlation between the assays is attributed mainly to target-mediated antibody responses and suggests that using a single serological assay may be misleading.


Assuntos
Anticorpos Antivirais/imunologia , COVID-19/epidemiologia , Surtos de Doenças , Imunoglobulina G/imunologia , SARS-CoV-2/imunologia , Adolescente , Adulto , Fatores Etários , Anticorpos Neutralizantes/imunologia , COVID-19/imunologia , Criança , Pré-Escolar , Surtos de Doenças/estatística & dados numéricos , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Imunidade Coletiva/imunologia , Lactente , Recém-Nascido , Israel/epidemiologia , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Características de Residência/estatística & dados numéricos , Estudos Soroepidemiológicos , Fatores de Tempo , Adulto Jovem
11.
Int J Prison Health ; ahead-of-print(ahead-of-print)2021 08 03.
Artigo em Inglês | MEDLINE | ID: mdl-34339114

RESUMO

PURPOSE: In this work, the authors present some of the key results found during early efforts to model the COVID-19 outbreak inside a UK prison. In particular, this study describes outputs from an idealised disease model that simulates the dynamics of a COVID-19 outbreak in a prison setting when varying levels of social interventions are in place, and a Monte Carlo-based model that assesses the reduction in risk of case importation, resulting from a process that requires incoming prisoners to undergo a period of self-isolation prior to admission into the general prison population. DESIGN/METHODOLOGY/APPROACH: Prisons, typically containing large populations confined in a small space with high degrees of mixing, have long been known to be especially susceptible to disease outbreaks. In an attempt to meet rising pressures from the emerging COVID-19 situation in early 2020, modellers for Public Health England's Joint Modelling Cell were asked to produce some rapid response work that sought to inform the approaches that Her Majesty's Prison and Probation Service (HMPPS) might take to reduce the risk of case importation and sustained transmission in prison environments. FINDINGS: Key results show that deploying social interventions has the potential to considerably reduce the total number of infections, while such actions could also reduce the probability that an initial infection will propagate into a prison-wide outbreak. For example, modelling showed that a 50% reduction in the risk of transmission (compared to an unmitigated outbreak) could deliver a 98% decrease in total number of cases, while this reduction could also result in 86.8% of outbreaks subsiding before more than five persons have become infected. Furthermore, this study also found that requiring new arrivals to self-isolate for 10 and 14 days prior to admission could detect up to 98% and 99% of incoming infections, respectively. RESEARCH LIMITATIONS/IMPLICATIONS: In this paper we have presented models which allow for the studying of COVID-19 in a prison scenario, while also allowing for the assessment of proposed social interventions. By publishing these works, the authors hope these methods might aid in the management of prisoners across additional scenarios and even during subsequent disease outbreaks. Such methods as described may also be readily applied use in other closed community settings. ORIGINALITY/VALUE: These works went towards informing HMPPS on the impacts that the described strategies might have during COVID-19 outbreaks inside UK prisons. The works described herein are readily amendable to the study of a range of addition outbreak scenarios. There is also room for these methods to be further developed and built upon which the timeliness of the original project did not permit.


Assuntos
COVID-19/prevenção & controle , Planejamento em Desastres/organização & administração , Surtos de Doenças/prevenção & controle , Prisioneiros/estatística & dados numéricos , Prisões/organização & administração , COVID-19/epidemiologia , Surtos de Doenças/estatística & dados numéricos , Previsões , Pessoal de Saúde/educação , Humanos , Reino Unido
13.
Am J Public Health ; 111(8): 1534-1541, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34260262

RESUMO

Objectives. To empirically evaluate the relationship between presence of a state or federal prison and COVID-19 case and death counts. Methods. We merged data on locations of federal and state prisons and of local and county jails with daily case and death counts in the United States. We used a selection-on-observables design to estimate the correlation between prisons and COVID-19 spread, controlling for known correlates of COVID-19. Results. We found empirical evidence that the presence and capacities of prisons are strong correlates of county-level COVID-19 case counts. The presence of a state or federal prison in a county corresponded with a 9% increase in the COVID-19 case count during the first wave of the pandemic, ending July 1, 2020. Conclusions. Our results suggest that the public health implications of these facilities extend beyond the health of employees and incarcerated individuals, and policymakers should explicitly consider the public health concerns posed by these facilities when developing pandemic-response policy.


Assuntos
COVID-19/epidemiologia , COVID-19/transmissão , Controle de Doenças Transmissíveis/organização & administração , Surtos de Doenças/estatística & dados numéricos , Prisioneiros/estatística & dados numéricos , Prisões/estatística & dados numéricos , Humanos , Estados Unidos
14.
Epidemiol Infect ; 149: e197, 2021 07 19.
Artigo em Inglês | MEDLINE | ID: mdl-34278986

RESUMO

Estimating the case fatality ratio (CFR) for COVID-19 is an important aspect of public health. However, calculating CFR accurately is problematic early in a novel disease outbreak, due to uncertainties regarding the time course of disease and difficulties in diagnosis and reporting of cases. In this work, we present a simple method for calculating the CFR using only public case and death data over time by exploiting the correspondence between the time distributions of cases and deaths. The time-shifted distribution (TSD) analysis generates two parameters of interest: the delay time between reporting of cases and deaths and the CFR. These parameters converge reliably over time once the exponential growth phase has finished. Analysis is performed for early COVID-19 outbreaks in many countries, and we discuss corrections to CFR values using excess-death and seroprevalence data to estimate the infection fatality ratio (IFR). While CFR values range from 0.2% to 20% in different countries, estimates for IFR are mostly around 0.5-0.8% for countries that experienced moderate outbreaks and 1-3% for severe outbreaks. The simplicity and transparency of TSD analysis enhance its usefulness in characterizing a new disease as well as the state of the health and reporting systems.


Assuntos
COVID-19/mortalidade , Surtos de Doenças/estatística & dados numéricos , Saúde Pública/métodos , SARS-CoV-2/fisiologia , Humanos , Mortalidade
15.
Am J Public Health ; 111(S2): S149-S155, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34314202

RESUMO

Objectives. To test whether distortions in the age structure of mortality during the 1918 influenza pandemic in Michigan tracked the severity of the pandemic. Methods. We calculated monthly excess deaths during the period of 1918 to 1920 by using monthly data on all-cause deaths for the period of 1912 to 1920 in Michigan. Next, we measured distortions in the age distribution of deaths by using the Kuiper goodness-of-fit test statistic comparing the monthly distribution of deaths by age in 1918 to 1920 with the baseline distribution for the corresponding month for 1912 to 1917. Results. Monthly distortions in the age distribution of deaths were correlated with excess deaths for the period of 1918 to 1920 in Michigan (r = 0.83; P < .001). Conclusions. Distortions in the age distribution of deaths tracked variations in the severity of the 1918 influenza pandemic. Public Health Implications. It may be possible to track the severity of pandemic activity with age-at-death data by identifying distortions in the age distribution of deaths. Public health authorities should explore the application of this approach to tracking the COVID-19 pandemic in the absence of complete data coverage or accurate cause-of-death data.


Assuntos
COVID-19/história , Surtos de Doenças/estatística & dados numéricos , Influenza Pandêmica, 1918-1919/história , COVID-19/mortalidade , Teste para COVID-19/história , Causas de Morte , História do Século XX , História do Século XXI , Humanos , Influenza Pandêmica, 1918-1919/mortalidade , Michigan , Estações do Ano
16.
Am J Public Health ; 111(S2): S93-S100, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34314219

RESUMO

Timely and accurate data on COVID-19 cases and COVID-19‒related deaths are essential for making decisions with significant health, economic, and policy implications. A new report from the National Academies of Sciences, Engineering, and Medicine proposes a uniform national framework for data collection to more accurately quantify disaster-related deaths, injuries, and illnesses. This article describes how following the report's recommendations could help improve the quality and timeliness of public health surveillance data during pandemics, with special attention to addressing gaps in the data necessary to understand pandemic-related health disparities.


Assuntos
COVID-19/prevenção & controle , Planejamento em Desastres/organização & administração , Desastres/prevenção & controle , Surtos de Doenças/prevenção & controle , Vigilância da População/métodos , COVID-19/epidemiologia , Controle de Doenças Transmissíveis/organização & administração , Desastres/estatística & dados numéricos , Surtos de Doenças/estatística & dados numéricos , Registros Eletrônicos de Saúde/estatística & dados numéricos , Humanos
17.
Viruses ; 13(6)2021 06 16.
Artigo em Inglês | MEDLINE | ID: mdl-34208620

RESUMO

We describe the impact of COVID-19 mitigation measures on mosquito-borne diseases in Queensland, Australia, during the first half of 2020. Implementation of restrictions coincided with an atypical late season outbreak of Ross River virus (RRV) characterized by a peak in notifications in April (1173) and May (955) which were greater than 3-fold the mean observed for the previous four years. We propose that limitations on human movement likely resulted in the majority of RRV infections being acquired at or near the place of residence, and that an increase in outdoor activities, such as gardening and bushwalking in the local household vicinity, increased risk of exposure to RRV-infected mosquitoes. In contrast, the precipitous decline in international passenger flights led to a reduction in the number of imported dengue and malaria cases of over 70% and 60%, respectively, compared with the previous five years. This substantial reduction in flights also reduced a risk pathway for importation of exotic mosquitoes, but the risk posed by importation via sea cargo was not affected. Overall, the emergence of COVID-19 has had a varied impact on mosquito-borne disease epidemiology in Queensland, but the need for mosquito surveillance and control, together with encouragement of personal protective measures, remains unchanged.


Assuntos
COVID-19/prevenção & controle , Surtos de Doenças/prevenção & controle , Vigilância da População , Doenças Transmitidas por Vetores/epidemiologia , Infecções por Alphavirus/epidemiologia , Infecções por Alphavirus/transmissão , Animais , COVID-19/epidemiologia , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/estatística & dados numéricos , Culicidae/virologia , Surtos de Doenças/estatística & dados numéricos , Humanos , Movimento , Queensland/epidemiologia , Viagem , Doenças Transmitidas por Vetores/prevenção & controle , Doenças Transmitidas por Vetores/transmissão
18.
Medicine (Baltimore) ; 100(28): e26634, 2021 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-34260556

RESUMO

ABSTRACT: Emergency departments (EDs) are on the frontline of the coronavirus disease (COVID-19) outbreak. To resolve the abrupt overloading of COVID-19-suspected patients in a community, each ED needs to respond in various ways. In our hospital, we increased the isolation beds through temporary remodeling and by performing in-hospital COVID-19 polymerase chain reaction testing rather than outsourcing them. The aim of this study was to verify the effects of our response to the newly developed viral outbreak.The medical records of patients who presented to an ED were analyzed retrospectively. We divided the study period into 3: pre-COVID-19, transition period of response (the period before fully implementing the response measures), and post-response (the period after complete response). We compared the parameters of the National Emergency Department Information System and information about isolation and COVID-19.The number of daily ED patients was 86.8 ±â€Š15.4 in the pre-COVID-19, 36.3 ±â€Š13.6 in the transition period, and 67.2 ±â€Š10.0 in the post-response period (P < .001). The lengths of stay in the ED were significantly higher in transition period than in the other periods [pre-COVID-19 period, 219.0 (121.0-378.0) min; transition period, 301 (150.0-766.5) min; post-response period, 281.0 (114.0-575.0) min; P < .001]. The ratios of use of an isolation room and fever (≥37.5°C) were highest in the post-response period [use of isolation room: pre-COVID-19 period, 0.6 (0.7%); transition period, 1.2 (3.3%); post-response period, 16.1 (24.0%); P < .001; fever: pre-COVID-19 period, 14.8(17.3%); transition period, 6.8 (19.1%); post-response period, 14.5 (21.9%), P < .001].During an outbreak of a novel infectious disease, increasing the number of isolation rooms in the ED and applying a rapid confirmation test would enable the accommodation of more suspected patients, which could help reduce the risk posed to the community and thus prevent strain on the local emergency medical system.


Assuntos
COVID-19 , Surtos de Doenças/estatística & dados numéricos , Serviços Médicos de Emergência/estatística & dados numéricos , Serviço Hospitalar de Emergência/estatística & dados numéricos , Controle de Infecções/estatística & dados numéricos , Adulto , Idoso , Continuidade da Assistência ao Paciente/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Isolamento de Pacientes/estatística & dados numéricos , República da Coreia , Estudos Retrospectivos , SARS-CoV-2
19.
Value Health ; 24(7): 917-924, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34243834

RESUMO

OBJECTIVES: Throughout the coronavirus disease 2019 pandemic, susceptible-infectious-recovered (SIR) modeling has been the preeminent modeling method to inform policy making worldwide. Nevertheless, the usefulness of such models has been subject to controversy. An evolution in the epidemiological modeling field is urgently needed, beginning with an agreed-upon set of modeling standards for policy recommendations. The objective of this article is to propose a set of modeling standards to support policy decision making. METHODS: We identify and describe 5 broad standards: transparency, heterogeneity, calibration and validation, cost-benefit analysis, and model obsolescence and recalibration. We give methodological recommendations and provide examples in the literature that employ these standards well. We also develop and demonstrate a modeling practices checklist using existing coronavirus disease 2019 literature that can be employed by readers, authors, and reviewers to evaluate and compare policy modeling literature along our formulated standards. RESULTS: We graded 16 articles using our checklist. On average, the articles met 6.81 of our 19 categories (36.7%). No articles contained any cost-benefit analyses and few were adequately transparent. CONCLUSIONS: There is significant room for improvement in modeling pandemic policy. Issues often arise from a lack of transparency, poor modeling assumptions, lack of a system-wide perspective in modeling, and lack of flexibility in the academic system to rapidly iterate modeling as new information becomes available. In anticipation of future challenges, we encourage the modeling community at large to contribute toward the refinement and consensus of a shared set of standards for infectious disease policy modeling.


Assuntos
Doenças Transmissíveis Emergentes/tratamento farmacológico , Doenças Transmissíveis Emergentes/prevenção & controle , Métodos Epidemiológicos , Análise Custo-Benefício , Surtos de Doenças/prevenção & controle , Surtos de Doenças/estatística & dados numéricos , Previsões/métodos , Humanos , Formulação de Políticas , Padrões de Referência
20.
Sci Rep ; 11(1): 15297, 2021 07 27.
Artigo em Inglês | MEDLINE | ID: mdl-34315928

RESUMO

Starting with a handful of SARS-CoV-2 infections in dormitory residents in late March 2020, rapid transmission in their dense living environments ensued and by October 2020, more than 50,000 acute infections were identified across various dormitories in Singapore. The aim of the study is to identify combination of factors facilitating SARS-CoV-2 transmission and the impact of control measures in a dormitory through extensive epidemiological, serological and phylogenetic investigations, supported by simulation models. Our findings showed that asymptomatic cases and symptomatic cases who did not seek medical attention were major drivers of the outbreak. Furthermore, each resident had about 30 close contacts and each infected resident spread to 4.4 (IQR 3.5-5.3) others at the start of the outbreak. The final attack rate of the current outbreak was 76.2% (IQR 70.6-98.0%) and could be reduced by further 10% under a modified dormitory housing condition. These findings are important when designing living environments in a post COVID-19 future to reduce disease spread and facilitate rapid implementation of outbreak control measures.


Assuntos
COVID-19/prevenção & controle , COVID-19/transmissão , Surtos de Doenças/prevenção & controle , Densidade Demográfica , SARS-CoV-2/fisiologia , COVID-19/epidemiologia , Surtos de Doenças/estatística & dados numéricos , Humanos , Filogenia
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