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2.
Nat Commun ; 11(1): 5012, 2020 10 06.
Artigo em Inglês | MEDLINE | ID: mdl-33024096

RESUMO

Understanding changes in human mobility in the early stages of the COVID-19 pandemic is crucial for assessing the impacts of travel restrictions designed to reduce disease spread. Here, relying on data from mainland China, we investigate the spatio-temporal characteristics of human mobility between 1st January and 1st March 2020, and discuss their public health implications. An outbound travel surge from Wuhan before travel restrictions were implemented was also observed across China due to the Lunar New Year, indicating that holiday travel may have played a larger role in mobility changes compared to impending travel restrictions. Holiday travel also shifted healthcare pressure related to COVID-19 towards locations with lower healthcare capacity. Network analyses showed no sign of major changes in the transportation network after Lunar New Year. Changes observed were temporary and did not lead to structural reorganisation of the transportation network during the study period.


Assuntos
Infecções por Coronavirus/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Viagem/tendências , Betacoronavirus , China/epidemiologia , Assistência à Saúde , Férias e Feriados , Humanos , Densidade Demográfica , Saúde Pública , Fatores de Tempo , Transportes
3.
Cad Saude Publica ; 36(9): e00184820, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33027475

RESUMO

The inter-cities mobility network is of great importance in understanding outbreaks, especially in Brazil, a continental-dimension country. We adopt the data from the Brazilian Ministry of Health and the terrestrial flow of people between cities from the Brazilian Institute of Geography and Statistics database in two scales: cities from Brazil, without the North region, and from the São Paulo State. Grounded on the complex networks approach, and considering that the mobility network serves as a proxy for the SARS-CoV-2 spreading, the nodes and edges represent cities and flows, respectively. Network centrality measures such as strength and degree are ranked and compared to the list of cities, ordered according to the day that they confirmed the first case of COVID-19. The strength measure captures the cities with a higher vulnerability of receiving new cases. Besides, it follows the interiorization process of SARS-CoV-2 in the São Paulo State when the network flows are above specific thresholds. Some countryside cities such as Feira de Santana (Bahia State), Ribeirão Preto (São Paulo State), and Caruaru (Pernambuco State) have strength comparable to states' capitals. Our analysis offers additional tools for understanding and decision support to inter-cities mobility interventions regarding the SARS-CoV-2 and other epidemics.


Assuntos
Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Viagem , Betacoronavirus , Brasil/epidemiologia , Cidades , Humanos , Pandemias
5.
Rev Prat ; 70(3): 329-332, 2020 Mar.
Artigo em Francês | MEDLINE | ID: mdl-32877071

RESUMO

Zika virus infection: what advice in post-epidemic situation? Zika virus transmission is vector-borne, but it can also be sexual. The Zika disease contracted by an adult or child is most often mild but infection of the woman during pregnancy can lead to severe neurological congenital lesions. The Zika virus continues to circulate in many parts of the world. Risk of infection during travel is low but cannot be overlooked. An infected man can be infectious, during sexual intercourse, up to 3 months after contracting the disease. Information of pregnant women and couples with a child project is warranted if at least one of the two trips or has travelled in Zika virus transmission zone. Laboratory serologic tests can be used to determine if the partners have been infected and to verify, through the investigation of the virus in the semen, that there is no risk of sexual transmission.


Assuntos
Epidemias , Complicações Infecciosas na Gravidez , Infecção por Zika virus , Zika virus , Adulto , Criança , Feminino , Humanos , Masculino , Gravidez , Viagem , Infecção por Zika virus/epidemiologia , Infecção por Zika virus/prevenção & controle , Infecção por Zika virus/transmissão
6.
BMC Infect Dis ; 20(1): 649, 2020 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-32883213

RESUMO

BACKGROUND: More than 80,000 dengue cases including 215 deaths were reported nationally in less than 7 months between 2016 and 2017, a fourfold increase in the number of reported cases compared to the average number over 2010-2016. The region of Negombo, located in the Western province, experienced the greatest number of dengue cases in the country and is the focus area of our study, where we aim to capture the spatial-temporal dynamics of dengue transmission. METHODS: We present a statistical modeling framework to evaluate the spatial-temporal dynamics of the 2016-2017 dengue outbreak in the Negombo region of Sri Lanka as a function of human mobility, land-use, and climate patterns. The analysis was conducted at a 1 km × 1 km spatial resolution and a weekly temporal resolution. RESULTS: Our results indicate human mobility to be a stronger indicator for local outbreak clusters than land-use or climate variables. The minimum daily temperature was identified as the most influential climate variable on dengue cases in the region; while among the set of land-use patterns considered, urban areas were found to be most prone to dengue outbreak, followed by areas with stagnant water and then coastal areas. The results are shown to be robust across spatial resolutions. CONCLUSIONS: Our study highlights the potential value of using travel data to target vector control within a region. In addition to illustrating the relative relationship between various potential risk factors for dengue outbreaks, the results of our study can be used to inform where and when new cases of dengue are likely to occur within a region, and thus help more effectively and innovatively, plan for disease surveillance and vector control.


Assuntos
Dengue/epidemiologia , Clima , Surtos de Doenças , Humanos , Modelos Estatísticos , Fatores de Risco , Sri Lanka/epidemiologia , Temperatura , Viagem
7.
J Med Internet Res ; 22(9): e22469, 2020 09 17.
Artigo em Inglês | MEDLINE | ID: mdl-32886622

RESUMO

BACKGROUND: Implementing and lifting social distancing (LSD) is an urgent global issue during the COVID-19 pandemic, particularly when the travel ban is lifted to revive international businesses and economies. However, when and whether LSD can be considered is subject to the spread of SARS-CoV-2, the recovery rate, and the case-fatality rate. It is imperative to provide real-time assessment of three factors to guide LSD. OBJECTIVE: A simple LSD index was developed for health decision makers to do real-time assessment of COVID-19 at the global, country, region, and community level. METHODS: Data on the retrospective cohort of 186 countries with three factors were retrieved from a publicly available repository from January to early July. A simple index for guiding LSD was measured by the cumulative number of COVID-19 cases and recoveries, and the case-fatality rate was envisaged. If the LSD index was less than 1, LSD can be considered. The dynamic changes of the COVID-19 pandemic were evaluated to assess whether and when health decision makers allowed for LSD and when to reimplement social distancing after resurgences of the epidemic. RESULTS: After large-scale outbreaks in a few countries before mid-March (prepandemic phase), the global weekly LSD index peaked at 4.27 in March and lasted until mid-June (pandemic phase), during which most countries were affected and needed to take various social distancing measures. Since, the value of LSD has gradually declined to 0.99 on July 5 (postpandemic phase), at which 64.7% (120/186) of countries and regions had an LSD<1 with the decile between 0 and 1 to refine risk stratification by countries. The LSD index decreased to 1 in about 115 days. In addition, we present the results of dynamic changes of the LSD index for the world and for each country and region with different time windows from January to July 5. The results of the LSD index on the resurgence of the COVID-19 epidemic in certain regions and validation by other emerging infectious diseases are presented. CONCLUSIONS: This simple LSD index provides a quantitative assessment of whether and when to ease or implement social distancing to provide advice for health decision makers and travelers.


Assuntos
Algoritmos , Infecções por Coronavirus/prevenção & controle , Política de Saúde , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Formulação de Políticas , Isolamento Social , Betacoronavirus , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/transmissão , Humanos , Pneumonia Viral/mortalidade , Pneumonia Viral/transmissão , Estudos Retrospectivos , Viagem
8.
Infect Dis Poverty ; 9(1): 131, 2020 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-32938497

RESUMO

BACKGROUND: The coronavirus disease 2019 (COVID-19) has emerged as a global health and economic security threat with staggering cumulative incidence worldwide. Given the severity of projections, hospitals across the globe are creating additional critical care surge capacity and limiting patient routine access to care for other diseases like tuberculosis (TB). The outbreak fuels panic in sub-Saharan Africa where the healthcare system is fragile in withstanding the disease. Here, we looked over the COVID-19 containment measures in Ethiopia in context from reliable sources and put forth recommendations that leverage the health system response to COVID-19 and TB. MAIN TEXT: Ethiopia shares a major proportion of the global burden of infectious diseases, while the patterns of COVID-19 are still at an earlier stage of the epidemiology curve. The Ethiopian government exerted tremendous efforts to curb the disease. It limited public gatherings, ordered school closures, directed high-risk civil servants to work from home, and closed borders. It suspended flights to 120 countries and restricted mass transports. It declared a five-month national state of emergency and granted a pardon for 20 402 prisoners. It officially postponed parliamentary and presidential elections. It launched the 'PM Abiy-Jack Ma initiative', which supports African countries with COVID-19 diagnostics and infection prevention and control commodities. It expanded its COVID-19 testing capacity to 38 countrywide laboratories. Many institutions are made available to provide clinical care and quarantine. However, the outbreak still has the potential for greater loss of life in Ethiopia if the community is unable to shape the regular behavioral and sociocultural norms that would facilitate the spread of the disease. The government needs to keep cautious that irregular migrants would fuel the disease. A robust testing capacity is needed to figure out the actual status of the disease. The pandemic has reduced TB care and research activities significantly and these need due attention. CONCLUSIONS: Ethiopia took several steps to detect, manage, and control COVID-19. More efforts are needed to increase testing capacity and bring about behavioral changes in the community. The country needs to put in place alternative options to mitigate interruptions of essential healthcare services and scientific researches of significant impact.


Assuntos
Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Tuberculose/terapia , Betacoronavirus/isolamento & purificação , Técnicas de Laboratório Clínico , Comorbidade , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Assistência à Saúde , Monitoramento Epidemiológico , Etiópia/epidemiologia , Feminino , Humanos , Masculino , Assistência ao Paciente , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Quarentena , Viagem/estatística & dados numéricos , Tuberculose/diagnóstico , Tuberculose/epidemiologia
9.
Rev Prat ; 70(2): 201-205, 2020 Feb.
Artigo em Francês | MEDLINE | ID: mdl-32877141

RESUMO

Rickettsioses. Rickettsioses are caused by intracellular bacteria from order of rickettsiales. They are transmitted by arthropods, mainly ticks, lice, fleas or other species close to chiggers, mainly in tropical areas. Some rickettsioses are endemic in France and others can be seen in patients returning from travel, including those presenting with "fever of unknown origin". Rickettsiae can't be isolated by conventional blood cultures in the laboratory. The diagnosis of rickettsial diseases is often made by serology, but specific PCR based on the swab of an inoculation eschar when it is present is a simple and rapid tool. The standard treatment for rickettsioses is doxycycline, that should be started as soon as clinical suspicion occurs, before diagnostic confirmation since some rickettsial diseases can be fatal.


Assuntos
Infecções por Rickettsia , Rickettsia , Febre , França , Humanos , Viagem
10.
Artigo em Inglês | MEDLINE | ID: mdl-32899942

RESUMO

The tourism industry has been seriously suffering from the coronavirus disease (COVID-19) crisis ever since its outbreak. Given this pandemic situation, the major aim of this study is to develop a conceptual framework that clearly explains the US international tourists' post-pandemic travel behaviors by expanding the theory of planned behavior (TPB). By utilizing a quantitative process, the TPB was successfully broadened by incorporating the travelers' perceived knowledge of COVID-19, and it has been deepened by integrating the psychological risk. Our theoretical framework sufficiently accounted for the US tourists' post-pandemic travel intentions for safer international destinations. In addition, the perceived knowledge of COVID-19 contributed to boosting the prediction power for the intentions. The associations among the subjective norm, the attitude, and the intentions are under the significant influence of the tourists' psychological risks regarding international traveling. The comparative criticality of the subjective norm is found. Overall, the findings of this study considerably enhanced our understanding of US overseas tourists' post-pandemic travel decision-making processes and behaviors.


Assuntos
Comportamento de Escolha , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Viagem , Betacoronavirus , Humanos , Pandemias , Teoria Psicológica
11.
Proc Natl Acad Sci U S A ; 117(39): 24144-24153, 2020 09 29.
Artigo em Inglês | MEDLINE | ID: mdl-32934147

RESUMO

Voluntary physical distancing is essential for preventing the spread of COVID-19. We assessed the role of political partisanship in individuals' compliance with physical distancing recommendations of political leaders using data on mobility from a sample of mobile phones in 3,100 counties in the United States during March 2020, county-level partisan preferences, information about the political affiliation of state governors, and the timing of their communications about COVID-19 prevention. Regression analyses examined how political preferences influenced the association between governors' COVID-19 communications and residents' mobility patterns. Governors' recommendations for residents to stay at home preceded stay-at-home orders and led to a significant reduction in mobility that was comparable to the effect of the orders themselves. Effects were larger in Democratic- than in Republican-leaning counties, a pattern more pronounced under Republican governors. Democratic-leaning counties also responded more strongly to recommendations from Republican than from Democratic governors. Political partisanship influences citizens' decisions to voluntarily engage in physical distancing in response to communications by their governor.


Assuntos
Infecções por Coronavirus/prevenção & controle , Fidelidade a Diretrizes , Liderança , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Política , Betacoronavirus , Comunicação , Infecções por Coronavirus/epidemiologia , Governo , Fidelidade a Diretrizes/estatística & dados numéricos , Humanos , Pneumonia Viral/epidemiologia , Política Pública , Fatores de Tempo , Viagem/estatística & dados numéricos , Estados Unidos/epidemiologia
12.
Math Biosci Eng ; 17(4): 3710-3720, 2020 05 21.
Artigo em Inglês | MEDLINE | ID: mdl-32987551

RESUMO

Since December 2019, an outbreak of a novel coronavirus pneumonia (WHO named COVID-19) swept across China. In Shanxi Province, the cumulative confirmed cases finally reached 133 since the first confirmed case appeared on January 22, 2020, and most of which were imported cases from Hubei Province. Reasons for this ongoing surge in Shanxi province, both imported and autochthonous infected cases, are currently unclear and demand urgent investigation. In this paper, we developed a SEIQR difference-equation model of COVID-19 that took into account the transmission with discrete time imported cases, to perform assessment and risk analysis. Our findings suggest that if the lock-down date in Wuhan is earlier, the infectious cases are fewer. Moreover, we reveal the effects of city lock-down date on the final scale of cases: if the date is advanced two days, the cases may decrease one half (67, 95% CI: 66-68); if the date is delayed for two days, the cases may reach about 196 (95% CI: 193-199). Our investigation model could be potentially helpful to study the transmission of COVID-19, in other provinces of China except Hubei. Especially, the method may also be used in countries with the first confirmed case is imported.


Assuntos
Betacoronavirus , Infecções por Coronavirus/transmissão , Modelos Biológicos , Pandemias , Pneumonia Viral/transmissão , Número Básico de Reprodução/estatística & dados numéricos , China/epidemiologia , Simulação por Computador , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Humanos , Cadeias de Markov , Conceitos Matemáticos , Método de Monte Carlo , Pandemias/prevenção & controle , Pandemias/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Quarentena/estatística & dados numéricos , Fatores de Tempo , Viagem/estatística & dados numéricos
14.
JAMA Netw Open ; 3(9): e2020485, 2020 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-32897373

RESUMO

Importance: A stay-at-home social distancing mandate is a key nonpharmacological measure to reduce the transmission rate of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), but a high rate of adherence is needed. Objective: To examine the association between the rate of human mobility changes and the rate of confirmed cases of SARS-CoV-2 infection. Design, Setting, and Participants: This cross-sectional study used daily travel distance and home dwell time derived from millions of anonymous mobile phone location data from March 11 to April 10, 2020, provided by the Descartes Labs and SafeGraph to quantify the degree to which social distancing mandates were followed in the 50 US states and District of Columbia and the association of mobility changes with rates of coronavirus disease 2019 (COVID-19) cases. Exposure: State-level stay-at-home orders during the COVID-19 pandemic. Main Outcomes and Measures: The main outcome was the association of state-specific rates of COVID-19 confirmed cases with the change rates of median travel distance and median home dwell time of anonymous mobile phone users. The increase rates are measured by the exponent in curve fitting of the COVID-19 cumulative confirmed cases, while the mobility change (increase or decrease) rates were measured by the slope coefficient in curve fitting of median travel distance and median home dwell time for each state. Results: Data from more than 45 million anonymous mobile phone devices were analyzed. The correlation between the COVID-19 increase rate and travel distance decrease rate was -0.586 (95% CI, -0.742 to -0.370) and the correlation between COVID-19 increase rate and home dwell time increase rate was 0.526 (95% CI, 0.293 to 0.700). Increases in state-specific doubling time of total cases ranged from 1.0 to 6.9 days (median [interquartile range], 2.7 [2.3-3.3] days) before stay-at-home orders were enacted to 3.7 to 30.3 days (median [interquartile range], 6.0 [4.8-7.1] days) after stay-at-home social distancing orders were put in place, consistent with pandemic modeling results. Conclusions and Relevance: These findings suggest that stay-at-home social distancing mandates, when they were followed by measurable mobility changes, were associated with reduction in COVID-19 spread. These results come at a particularly critical period when US states are beginning to relax social distancing policies and reopen their economies. These findings support the efficacy of social distancing and could help inform future implementation of social distancing policies should they need to be reinstated during later periods of COVID-19 reemergence.


Assuntos
Telefone Celular , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Viagem/estatística & dados numéricos , Betacoronavirus , Infecções por Coronavirus/transmissão , Estudos Transversais , Sistemas de Informação Geográfica , Humanos , Modelos Lineares , Pandemias , Pneumonia Viral/transmissão , Estados Unidos/epidemiologia
15.
An Acad Bras Cienc ; 92(4): e20201139, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32965306

RESUMO

The spread of SARS-CoV-2 and the distribution of cases worldwide followed no clear biogeographic, climatic, or cultural trend. Conversely, the internationally busiest cities in all countries tended to be the hardest hit, suggesting a basic, mathematically neutral pattern of the new coronavirus early dissemination. We tested whether the number of flight passengers per time and the number of international frontiers could explain the number of cases of COVID-19 worldwide by a stepwise regression. Analysis were taken by 22 May 2020, a period when one would claim that early patterns of the pandemic establishment were still detectable, despite of community transmission in various places. The number of passengers arriving in a country and the number of international borders explained significantly 49% of the variance in the distribution of the number of cases of COVID-19, and number of passengers explained significantly 14.2% of data variance for cases per million inhabitants. Ecological neutral theory may explain a considerable part of the early distribution of SARS-CoV-2 and should be taken into consideration to define preventive international actions before a next pandemic.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Viagem , Aeronaves , Betacoronavirus , Cidades , Humanos , Modelos Teóricos , Pandemias
17.
Global Health ; 16(1): 85, 2020 09 23.
Artigo em Inglês | MEDLINE | ID: mdl-32967691

RESUMO

OBJECTIVES: Restricting mobility is a central aim for lowering contact rates and preventing COVID-19 transmission. Yet the impact on mobility of different non-pharmaceutical countermeasures in the earlier stages of the pandemic is not well-understood. DESIGN: Trends were evaluated using Citymapper's mobility index covering 2nd to 26th March 2020, expressed as percentages of typical usage periods from 0% as the lowest and 100% as normal. China and India were not covered. Multivariate fixed effects models were used to estimate the association of policies restricting movement on mobility before and after their introduction. Policy restrictions were assessed using the Oxford COVID-19 Government Response Stringency Index as well as measures coding the timing and degree of school and workplace closures, transport restrictions, and cancellation of mass gatherings. SETTING: 41 cities worldwide. MAIN OUTCOME MEASURES: Citymapper's mobility index. RESULTS: Mobility declined in all major cities throughout March. Larger declines were seen in European than Asian cities. The COVID-19 Government Response Stringency Index was strongly associated with declines in mobility (r = - 0.75, p < 0.001). After adjusting for time-trends, we observed that implementing non-pharmaceutical countermeasures was associated with a decline of mobility of 10.0% for school closures (95% CI: 4.36 to 15.7%), 15.0% for workplace closures (95% CI: 10.2 to 19.8%), 7.09% for cancelling public events (95% CI: 1.98 to 12.2%), 18.0% for closing public transport (95% CI: 6.74 to 29.2%), 13.3% for restricting internal movements (95% CI: 8.85 to 17.8%) and 5.30% for international travel controls (95% CI: 1.69 to 8.90). In contrast, as expected, there was no association between population mobility changes and fiscal or monetary measures or emergency healthcare investment. CONCLUSIONS: Understanding the effect of public policy on mobility in the early stages is crucial to slowing and reducing COVID-19 transmission. By using Citymapper's mobility index, this work provides the first evidence about trends in mobility and the impacts of different policy interventions, suggesting that closure of public transport, workplaces and schools are particularly impactful.


Assuntos
Infecções por Coronavirus/prevenção & controle , Saúde Global , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Viagem/estatística & dados numéricos , Cidades/epidemiologia , Infecções por Coronavirus/epidemiologia , Sistemas de Informação Geográfica , Humanos , Pneumonia Viral/epidemiologia , Política Pública , Fatores de Tempo , Viagem/legislação & jurisprudência , Voluntários
18.
Nat Commun ; 11(1): 4376, 2020 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-32873808

RESUMO

Genomic sequencing has significant potential to inform public health management for SARS-CoV-2. Here we report high-throughput genomics for SARS-CoV-2, sequencing 80% of cases in Victoria, Australia (population 6.24 million) between 6 January and 14 April 2020 (total 1,333 COVID-19 cases). We integrate epidemiological, genomic and phylodynamic data to identify clusters and impact of interventions. The global diversity of SARS-CoV-2 is represented, consistent with multiple importations. Seventy-six distinct genomic clusters were identified, including large clusters associated with social venues, healthcare and cruise ships. Sequencing sequential samples from 98 patients reveals minimal intra-patient SARS-CoV-2 genomic diversity. Phylodynamic modelling indicates a significant reduction in the effective viral reproductive number (Re) from 1.63 to 0.48 after implementing travel restrictions and physical distancing. Our data provide a concrete framework for the use of SARS-CoV-2 genomics in public health responses, including its use to rapidly identify SARS-CoV-2 transmission chains, increasingly important as social restrictions ease globally.


Assuntos
Betacoronavirus/genética , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Adulto , Austrália/epidemiologia , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/transmissão , Feminino , Genoma Viral , Genômica/métodos , Pessoal de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Epidemiologia Molecular , Pandemias , Filogenia , Pneumonia Viral/transmissão , Saúde Pública , Estudos Retrospectivos , Viagem
19.
Artigo em Inglês | MEDLINE | ID: mdl-32947859

RESUMO

The current COVID-19 pandemic has evolved to unprecedented proportions. This research aimed to gain a deeper understanding of the psychological effects of the COVID-19 pandemic on cruise ship employees stuck at sea. Using an inductive qualitative approach, a synchronous online focus group was conducted with nine cruise ship employees who were stuck at sea during COVID-19 pandemic. The findings revealed that COVID-19 pandemic has managed to erase the feeling of joy from cruise ship employees who were stuck at sea while exposing weakness of cruise line companies such as poor human resource management leadership. Moreover, COVID-19 pandemic demonstrated that it is of paramount importance that cruise line companies create a comprehensive strategy in assisting their employees who are experiencing an anxiety disorder and depression. The managerial implications are outlined.


Assuntos
Infecções por Coronavirus/psicologia , Medo , Pneumonia Viral/psicologia , Navios , Recursos Humanos , Betacoronavirus , Humanos , Pandemias , Viagem
20.
J Public Health Manag Pract ; 26(6): 622-631, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32969952

RESUMO

OBJECTIVE: To evaluate predictors of stay-at-home order adoption among US states, as well as associations between order enactment and residents' mobility. DESIGN: We assess associations between state characteristics and adoption timing. We also assess associations between enactment and aggregate state-level measures of residents' mobility (Google COVID-19 Community Mobility Reports). SETTING: The United States. PARTICIPANTS: Adoption population: 50 US states and District of Columbia. Mobility population: state residents using devices with GPS tracking accessible by Google. INTERVENTION AND EXPOSURES: State characteristics: COVID-19 diagnoses per capita, 2016 Trump vote share, Republican governor, Medicaid expansion status, hospital beds per capita, public health funding per capita, state and local tax revenue per capita, median household income, population, percent residents 65 years or older, and percent urban residents. Mobility exposure: indicator of order enactment by March 29, 2020 (date of mobility data collection). MAIN OUTCOME MEASURES: Order adoption timing: days since adoption of first order. Mobility: changes in mobility to 6 locations from February 6 to March 29, 2020. RESULTS: In bivariate models, order adoption was associated with COVID-19 diagnoses (hazard ratio [HR] = 1.01; 95% confidence interval [CI], 1.00 to 1.01), Republican governor (HR = 0.24; 95% CI, 0.13 to 0.44), Medicaid expansion (HR = 2.50; 95% CI, 1.40 to 4.48), and hospital capacity (HR = 0.43; 95% CI, 0.26 to 0.70), consistent with findings in the multivariate models. Order enactment was positively associated with time at home (beta (B) = 1.31; 95% CI, 0.35 to 2.28) and negatively associated with time at retail and recreation (B = -7.17; 95% CI, -10.89 to -3.46) and grocery and pharmacy (B = -8.28; 95% CI, -11.97 to -4.59) locations. Trump vote share was associated with increased mobility for 4 of 6 mobility measures. CONCLUSIONS AND RELEVANCE: While politics influenced order adoption, public health considerations were equally influential. While orders were associated with decreased mobility, political ideology was associated with increased mobility under social distancing policies.


Assuntos
Infecções por Coronavirus/epidemiologia , Sistemas de Informação Geográfica , Pneumonia Viral/epidemiologia , Política Pública , Quarentena , Viagem , Betacoronavirus , Feminino , Humanos , Masculino , Pandemias , Distância Social , Estados Unidos/epidemiologia
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