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1.
Global Health ; 17(1): 28, 2021 03 17.
Artigo em Inglês | MEDLINE | ID: mdl-33731178

RESUMO

BACKGROUND: Three months after the first reported cases, COVID-19 had spread to nearly 90% of World Health Organization (WHO) member states and only 24 countries had not reported cases as of 30 March 2020. This analysis aimed to 1) assess characteristics, capability to detect and monitor COVID-19, and disease control measures in these 24 countries, 2) understand potential factors for the reported delayed COVID-19 introduction, and 3) identify gaps and opportunities for outbreak preparedness, particularly in low and middle-income countries (LMICs). We collected and analyzed publicly available information on country characteristics, COVID-19 testing, influenza surveillance, border measures, and preparedness activities in these countries. We also assessed the association between the temporal spread of COVID-19 in all countries with reported cases with globalization indicator and geographic location. RESULTS: Temporal spreading of COVID-19 was strongly associated with countries' globalization indicator and geographic location. Most of the 24 countries with delayed COVID-19 introduction were LMICs; 88% were small island or landlocked developing countries. As of 30 March 2020, only 38% of these countries reported in-country COVID-19 testing capability, and 71% reported conducting influenza surveillance during the past year. All had implemented two or more border measures, (e.g., travel restrictions and border closures) and multiple preparedness activities (e.g., national preparedness plans and school closing). CONCLUSIONS: Limited testing capacity suggests that most of the 24 delayed countries may have lacked the capability to detect and identify cases early through sentinel and case-based surveillance. Low global connectedness, geographic isolation, and border measures were common among these countries and may have contributed to the delayed introduction of COVID-19 into these countries. This paper contributes to identifying opportunities for pandemic preparedness, such as increasing disease detection, surveillance, and international collaborations. As the global situation continues to evolve, it is essential for countries to improve and prioritize their capacities to rapidly prevent, detect, and respond, not only for COVID-19, but also for future outbreaks.


Assuntos
/epidemiologia , Surtos de Doenças/prevenção & controle , Saúde Global , Pandemias/prevenção & controle , Vigilância em Saúde Pública , /diagnóstico , /estatística & dados numéricos , Humanos , Influenza Humana/epidemiologia , Viagem/legislação & jurisprudência , Organização Mundial da Saúde
2.
PLoS One ; 16(2): e0246447, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33556117

RESUMO

COVID-19 has had a substantial impact on clinical care and lifestyles globally. The State of Michigan reports over 80,000 positive COVID-19 tests between March 1, 2020 and July 29, 2020. We surveyed 8,041 Michigan Medicine biorepository participants in late June 2020. We found that 55% of COVID-19 cases reported no known exposure to family members or to someone outside the house diagnosed with COVID-19. A significantly higher rate of COVID-19 cases were employed as essential workers (45% vs 19%, p = 9x10-12). COVID-19 cases reporting a fever were more likely to require hospitalization (categorized as severe; OR = 4.4 [95% CI: 1.6-12.5, p = 0.005]) whereas respondents reporting rhinorrhea was less likely to require hospitalization (categorized as mild-to-moderate; OR = 0.16 [95% CI: 0.04-0.73, p = 0.018]). African-Americans reported higher rates of being diagnosed with COVID-19 (OR = 4.0 [95% CI: 2.2-7.2, p = 5x10-6]), as well as higher rates of exposure to family or someone outside the household diagnosed with COVID-19, an annual household income < $40,000, living in rental housing, and chronic diseases. During the Executive Order in Michigan, African Americans, women, and the lowest income group reported worsening health behaviors and higher overall concern for the potential detrimental effects of the pandemic. The higher risk of contracting COVID-19 observed among African Americans may be due to the increased rates of working as essential employees, lower socioeconomic status, and exposure to known positive cases. Continued efforts should focus on COVID-19 prevention and mitigation strategies, as well as address the inequality gaps that result in higher risks for both short-term and long-term health outcomes.


Assuntos
/epidemiologia , Controle de Doenças Transmissíveis , Adulto , Afro-Americanos , Idoso , Comorbidade , Feminino , Humanos , Masculino , Michigan/epidemiologia , Pessoa de Meia-Idade , Fatores de Risco , Fatores Socioeconômicos , Inquéritos e Questionários , Viagem/legislação & jurisprudência
3.
Cell ; 184(5): 1127-1132, 2021 03 04.
Artigo em Inglês | MEDLINE | ID: mdl-33581746

RESUMO

Recent reports suggest that some SARS-CoV-2 genetic variants, such as B.1.1.7, might be more transmissible and are quickly spreading around the world. As the emergence of more transmissible variants could exacerbate the pandemic, we provide public health guidance for increased surveillance and measures to reduce community transmission.


Assuntos
/prevenção & controle , Controle de Doenças Transmissíveis , /genética , Fatores Etários , /virologia , Monitoramento Epidemiológico , Saúde Global , Humanos , Programas Obrigatórios , Pandemias , Viagem/legislação & jurisprudência , Reino Unido/epidemiologia , Populações Vulneráveis
5.
N Z Med J ; 134(1529): 10-25, 2021 02 05.
Artigo em Inglês | MEDLINE | ID: mdl-33582704

RESUMO

AIMS: We developed a model, updated daily, to estimate undetected COVID-19 infections exiting quarantine following selectively opening New Zealand's borders to travellers from low-risk countries. METHODS: The prevalence of infectious COVID-19 cases by country was multiplied by expected monthly passenger volumes to predict the rate of arrivals. The rate of undetected infections entering the border following screening and quarantine was estimated. Level 1, Level 2 and Level 3 countries were defined as those with an active COVID-19 prevalence of up to 1/105, 10/105 and 100/105, respectively. RESULTS: With 65,272 travellers per month, the number of undetected COVID-19 infections exiting quarantine is 1 every 45, 15 and 31 months for Level 1, Level 2 and Level 3 countries, respectively. The overall rate of undetected active COVID-19 infections exiting quarantine is expected to increase from the current 0.40 to 0.50 per month, or an increase of one extra infection every 10 months. CONCLUSIONS: Loosening border restrictions results in a small increase in the rate of undetected COVID-19 infections exiting quarantine, which increases from the current baseline by one infection every 10 months. This information may be useful in guiding decision-making on selectively opening of borders in the COVID-19 era.


Assuntos
Controle de Doenças Transmissíveis , Doenças Transmissíveis Importadas , Transmissão de Doença Infecciosa , Regulamento Sanitário Internacional , Quarentena , /epidemiologia , /transmissão , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/organização & administração , Doenças Transmissíveis Importadas/epidemiologia , Doenças Transmissíveis Importadas/prevenção & controle , Doenças Transmissíveis Importadas/transmissão , Transmissão de Doença Infecciosa/prevenção & controle , Transmissão de Doença Infecciosa/estatística & dados numéricos , Previsões , Saúde Global , Humanos , Regulamento Sanitário Internacional/organização & administração , Regulamento Sanitário Internacional/tendências , Nova Zelândia/epidemiologia , Prevalência , Política Pública , Quarentena/organização & administração , Quarentena/estatística & dados numéricos , Viagem/legislação & jurisprudência , Viagem/estatística & dados numéricos
6.
BMC Public Health ; 21(1): 226, 2021 01 27.
Artigo em Inglês | MEDLINE | ID: mdl-33504339

RESUMO

BACKGROUND: As COVID-19 continues to spread around the world, understanding how patterns of human mobility and connectivity affect outbreak dynamics, especially before outbreaks establish locally, is critical for informing response efforts. In Taiwan, most cases to date were imported or linked to imported cases. METHODS: In collaboration with Facebook Data for Good, we characterized changes in movement patterns in Taiwan since February 2020, and built metapopulation models that incorporate human movement data to identify the high risk areas of disease spread and assess the potential effects of local travel restrictions in Taiwan. RESULTS: We found that mobility changed with the number of local cases in Taiwan in the past few months. For each city, we identified the most highly connected areas that may serve as sources of importation during an outbreak. We showed that the risk of an outbreak in Taiwan is enhanced if initial infections occur around holidays. Intracity travel reductions have a higher impact on the risk of an outbreak than intercity travel reductions, while intercity travel reductions can narrow the scope of the outbreak and help target resources. The timing, duration, and level of travel reduction together determine the impact of travel reductions on the number of infections, and multiple combinations of these can result in similar impact. CONCLUSIONS: To prepare for the potential spread within Taiwan, we utilized Facebook's aggregated and anonymized movement and colocation data to identify cities with higher risk of infection and regional importation. We developed an interactive application that allows users to vary inputs and assumptions and shows the spatial spread of the disease and the impact of intercity and intracity travel reduction under different initial conditions. Our results can be used readily if local transmission occurs in Taiwan after relaxation of border control, providing important insights into future disease surveillance and policies for travel restrictions.


Assuntos
/epidemiologia , Doenças Transmissíveis Importadas/epidemiologia , Surtos de Doenças , Viagem/estatística & dados numéricos , Previsões , Humanos , Modelos Biológicos , Risco , Mídias Sociais , Taiwan/epidemiologia , Viagem/legislação & jurisprudência
9.
BMC Public Health ; 21(1): 225, 2021 01 27.
Artigo em Inglês | MEDLINE | ID: mdl-33504347

RESUMO

BACKGROUND: The first COVID-19 cases were diagnosed in Australia on 25 January 2020. Initial epidiemiology showed that the majority of cases were in returned travellers from overseas. One aspect of Public Health response was to introduce compulsory 14 day quarantine for all travellers returning to New South Wales (NSW) by air or sea in Special Health Accommodation (SHA). We aim to outline the establishment of a specialised health quarantine accommodation service in the context of the COVID-19 pandemic, and describe the first month of COVID-19 screening. METHODS: The SHA was established with a comprehensive governance structure, remote clinical management through Royal Prince Alfred Virtual Hospital (rpavirtual) and site management with health care workers, NSW Police and accommodation staff. RESULTS: From 29 March to 29 April 2020, 373 returning travellers were admitted to the SHA from Sydney Airport. 88 (26.1%) of those swabbed were positive for SARS-CoV 2. The day of diagnosis of COVID-19 varied from Day 1 to Day 13, with 63.6% (n = 56) of these in the first week of quarantine. 50% of the people in the SHA were referred to rpavirtual for ongoing clinical management. Seven people required admission to hospital for ongoing clinical care. CONCLUSION: The Public Health response to COVID-19 in Australia included early and increased case detection through testing, tracing of contacts of confirmed cases, social distancing and prohibition of gatherings. In addition to these measures, the introduction of mandated quarantine for travellers to Australia was integral to the successful containment of COVID-19 in NSW and Australia through the prevention of transmission locally and interstate from returning travellers.


Assuntos
/prevenção & controle , Doenças Transmissíveis Importadas/prevenção & controle , Serviços de Saúde , Saúde Pública , Quarentena/legislação & jurisprudência , Viagem/legislação & jurisprudência , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Austrália/epidemiologia , Criança , Pré-Escolar , Doenças Transmissíveis Importadas/epidemiologia , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , New South Wales/epidemiologia , Adulto Jovem
11.
J R Soc Interface ; 17(173): 20200344, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33323055

RESUMO

One approach to delaying the spread of the novel coronavirus (COVID-19) is to reduce human travel by imposing travel restriction policies. Understanding the actual human mobility response to such policies remains a challenge owing to the lack of an observed and large-scale dataset describing human mobility during the pandemic. This study uses an integrated dataset, consisting of anonymized and privacy-protected location data from over 150 million monthly active samples in the USA, COVID-19 case data and census population information, to uncover mobility changes during COVID-19 and under the stay-at-home state orders in the USA. The study successfully quantifies human mobility responses with three important metrics: daily average number of trips per person; daily average person-miles travelled; and daily percentage of residents staying at home. The data analytics reveal a spontaneous mobility reduction that occurred regardless of government actions and a 'floor' phenomenon, where human mobility reached a lower bound and stopped decreasing soon after each state announced the stay-at-home order. A set of longitudinal models is then developed and confirms that the states' stay-at-home policies have only led to about a 5% reduction in average daily human mobility. Lessons learned from the data analytics and longitudinal models offer valuable insights for government actions in preparation for another COVID-19 surge or another virus outbreak in the future.


Assuntos
/prevenção & controle , Computadores de Mão , Pandemias , Viagem , /epidemiologia , Interpretação Estatística de Dados , Sistemas de Informação Geográfica , Humanos , Estudos Longitudinais , Modelos Estatísticos , Pandemias/prevenção & controle , Viagem/legislação & jurisprudência , Viagem/estatística & dados numéricos , Viagem/tendências , Estados Unidos/epidemiologia
12.
J Prev Med Public Health ; 53(5): 293-301, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33070499

RESUMO

OBJECTIVES: At the beginning of the coronavirus disease 2019 (COVID-19) pandemic, some countries imposed entry bans against Chinese visitors. We sought to identify the effects of border shutdowns on the spread of the COVID-19 outbreak. METHODS: We used the synthetic control method to measure the effects of entry bans against Chinese visitors on the cumulative number of confirmed cases using World Health Organization situation reports as the data source. The synthetic control method constructs a synthetic country that did not shut down its borders, but is similar in all other aspects. RESULTS: Six countries that shut down their borders were evaluated. For Australia, the effects of the policy began to appear 4 days after implementation, and the number of COVID-19 cases dropped by 94.4%. The border shutdown policy took around 13.2 days to show positive effects and lowered COVID-19 cases by 91.7% on average by the end of February. CONCLUSIONS: The border shutdowns in early February significantly reduced the spread of the virus. Our findings are informative for future planning of public health policies.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Política de Saúde/legislação & jurisprudência , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Viagem/legislação & jurisprudência , Austrália/epidemiologia , Surtos de Doenças/legislação & jurisprudência , Surtos de Doenças/prevenção & controle , Hong Kong/epidemiologia , Humanos , Pandemias/legislação & jurisprudência , Singapura/epidemiologia , Taiwan/epidemiologia , Estados Unidos/epidemiologia , Vietnã/epidemiologia
13.
J Prev Med Public Health ; 53(5): 302-306, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33070500

RESUMO

OBJECTIVES: In this paper, we aimed to investigate the evolving debate over border closure in Korea during the coronavirus disease 2019 (COVID-19) pandemic, to address the main themes associated with border closure, and to discuss the factors that need to be considered when making such decisions. METHODS: We collated and reviewed previously conducted review studies on border closures during infectious disease outbreaks to derive relevant themes and factors. RESULTS: According to our systematic review on border closures and travel restrictions, the effects of such containment efforts are limited. We suggest considering the following factors when determining whether to impose border closure measures: (1) disease characteristics, (2) timeliness of implementation, (3) transmission delay and the basic reproduction number, (4) globalization and pandemics, and (5) social and economic costs. CONCLUSIONS: Our assessment indicates that the effects of border closures are at best temporary and limited. Alternative measures must be contemplated and implemented to suppress the spread of COVID-19 in particular and infectious diseases more broadly.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Política de Saúde/legislação & jurisprudência , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Viagem/legislação & jurisprudência , Infecções por Coronavirus/transmissão , Humanos , Pandemias/legislação & jurisprudência , Pneumonia Viral/transmissão , República da Coreia/epidemiologia
14.
J Prev Med Public Health ; 53(5): 307-310, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33070501

RESUMO

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has placed unprecedented pressure on healthcare systems, even in advanced economies. While the number of cases of SARS-CoV-2 in Africa compared to other continents has so far been low, there are concerns about under-reporting, inadequate diagnostic tools, and insufficient treatment facilities. Moreover, proactiveness on the part of African governments has been under scrutiny. For instance, issues have emerged regarding the responsiveness of African countries in closing international borders to limit trans-continental transmission of the virus. Overdependence on imported products and outsourced services could have contributed to African governments' hesitation to shut down international air and seaports. In this era of emerging and re-emerging pathogens, we recommend that African nations should consider self-sufficiency in the health sector as an urgent priority, as this will not be the last outbreak to occur. In addition to the Regional Disease Surveillance Systems Enhancement fund (US$600 million) provided by the World Bank for strengthening health systems and disease surveillance, each country should further establish an epidemic emergency fund for epidemic preparedness and response. We also recommend that epidemic surveillance units should create a secure database of previous and ongoing pandemics in terms of aetiology, spread, and treatment, as well as financial management records. Strategic collection and analysis of data should also be a central focus of these units to facilitate studies of disease trends and to estimate the scale of requirements in preparation and response to any future pandemic or epidemic.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Planejamento em Desastres/legislação & jurisprudência , Política de Saúde/legislação & jurisprudência , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Viagem/legislação & jurisprudência , África/epidemiologia , Infecções por Coronavirus/transmissão , Governo , Humanos , Pandemias/legislação & jurisprudência , Pneumonia Viral/transmissão
15.
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
16.
Public Health ; 187: 140-142, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32971478

RESUMO

OBJECTIVES: Coronavirus disease 2019 (COVID-19) is the most devastating pandemic to affect humanity in a century. In this article, we assessed tests as a policy instrument and policy enactment to contain COVID-19 and potentially reduce mortalities. STUDY DESIGN: A model was devised to estimate the factors that influenced the death rate across 121 nations and by income group. RESULTS: Nations with a higher proportion of people aged 65+ years had a higher fatality rate (P = 0.00014). Delaying policy enactment led to a higher case fatality rate (P = 0.0013). A 10% delay time to act resulted in a 3.7% higher case fatality rate. This study found that delaying policies for international travel restrictions, public information campaigns, and testing policies increased the fatality rate. Tests also impacted the case fatality rate, and nations with 10% more cumulative tests per million people showed a 2.8% lower mortality rate. Citizens of nations who can access more destinations without the need to have a prior visa have a significant higher mortality rate than those who need a visa to travel abroad (P = 0.0040). CONCLUSION: Tests, as a surrogate of policy action and earlier policy enactment, matter for saving lives from pandemics as such policies reduce the transmission rate of the pandemic.


Assuntos
Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/prevenção & controle , Saúde Global/estatística & dados numéricos , Pandemias/prevenção & controle , Pneumonia Viral/mortalidade , Pneumonia Viral/prevenção & controle , Política Pública , Idoso , Técnicas de Laboratório Clínico/estatística & dados numéricos , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Educação em Saúde , Humanos , Modelos Estatísticos , Pneumonia Viral/epidemiologia , Viagem/legislação & jurisprudência
17.
Occup Environ Med ; 77(11): 798-800, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32895319

RESUMO

OBJECTIVES: To examine the impact of COVID-19 lockdown restrictions in March/April 2020 on concentrations of nitrogen dioxide (NO2) and ambient fine particulate matter (PM2.5) air pollution measured at roadside monitors across Scotland by comparing data with previous years. METHODS: Publicly available data of PM2.5 concentrations from reference monitoring systems at sites across Scotland were extracted for the 31-day period immediately following the imposition of lockdown rules on 23 March 2020. Similar data for 2017, 2018 and 2019 were gathered for comparison. Mean period values were calculated from the hourly data and logged values compared using pairwise t-tests. Weather effects were corrected using meteorological normalisation. RESULTS: NO2 concentrations were significantly lower in the 2020 lockdown period than in the previous 3 years (p<0.001). Mean outdoor PM2.5 concentrations in 2020 were much lower than during the same period in 2019 (p<0.001). However, despite UK motor vehicle journeys reducing by 65%, concentrations in 2020 were within 1 µg/m3 of those measured in 2017 (p=0.66) and 2018 (p<0.001), suggesting that traffic-related emissions may not explain variability of PM2.5 in outdoor air in Scotland. CONCLUSIONS: The impact of reductions in motor vehicle journeys during COVID-19 lockdown restrictions may not have reduced ambient PM2.5 concentrations in some countries. There is also a need for work to better understand how movement restrictions may have impacted personal exposure to air pollutants generated within indoor environments.


Assuntos
Poluição do Ar/análise , Infecções por Coronavirus/prevenção & controle , Dióxido de Nitrogênio/análise , Pandemias/prevenção & controle , Material Particulado/análise , Pneumonia Viral/prevenção & controle , Quarentena , Poluentes Atmosféricos/análise , Infecções por Coronavirus/epidemiologia , Monitoramento Ambiental/métodos , Humanos , Pneumonia Viral/epidemiologia , Escócia , Viagem/legislação & jurisprudência , Emissões de Veículos/análise
18.
Public Health ; 187: 111-114, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32947252

RESUMO

OBJECTIVES: Non-pharmaceutical interventions (NPIs) are effective in curbing the spread of severe acute respiratory syndrome coronavirus 2. All US states have adopted NPI policies, but the compliance to these measures and influence of sociopolitical factors on NPI adherence is unknown. NPI adherence may be approximated by personal mobility in a population that is tracked by anonymous mobile phone data. STUDY DESIGN: This is a cross-sectional study of state-level mobility changes across the US. METHODS: State-level mobility was based on anonymous mobile phone data from multiple participating carriers collected by the University of Washington's Institute for Health Metrics and Evaluation (http://www.healthdata.org). Pearson's correlation coefficient was used to examine the strength and direction of the relationship between political affiliations and mobility restriction across states. Multivariable linear regression analyses were used to assess other factors that may impact personal travel. RESULTS: All states experienced a decline in personal mobility but had varying nadirs ranging from a 34% to a 69% reduction in mobility, which was not temporally related to the timing of state-level NPI measures. There was a statistically significant linear and negative correlation (r = -0.79) between the proportion of Republicans/leaning Republicans and NPI adherence across US states. The negative association between Republicans and NPI adherence was significant even when adjusting for urbanization, proportion of essential workers, population, Gini index, and poverty rates. CONCLUSIONS: Political orientation affects risk perception, which may contribute to the unwillingness of some individuals to perceive the coronavirus disease 2019 pandemic as a risk and to comply with NPIs. Our results highlight the importance of sociopolitical factors in disease control and emphasize the importance of bipartisan efforts in fighting the pandemic. These results may have implications for the development, dissemination, and communication of public health policies.


Assuntos
Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Política , Viagem/legislação & jurisprudência , Infecções por Coronavirus/epidemiologia , Estudos Transversais , Fidelidade a Diretrizes/estatística & dados numéricos , Humanos , Pneumonia Viral/epidemiologia , Medição de Risco , Estados Unidos/epidemiologia
19.
Bull World Health Organ ; 98(8): 518-529, 2020 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-32773897

RESUMO

Objective: To estimate the effect of airline travel restrictions on the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) importation. Methods: We extracted passenger volume data for the entire global airline network, as well as the dates of the implementation of travel restrictions and the observation of the first case of coronavirus disease (COVID-19) in each country or territory, from publicly available sources. We calculated effective distance between every airport and the city of Wuhan, China. We modelled the risk of SARS-CoV-2 importation by estimating survival probability, expressing median time of importation as a function of effective distance. We calculated the relative change in importation risk under three different hypothetical scenarios that all resulted in different passenger volumes. Findings: We identified 28 countries with imported cases of COVID-19 as at 26 February 2020. The arrival time of the virus at these countries ranged from 39 to 80 days since identification of the first case in Wuhan. Our analysis of relative change in risk indicated that strategies of reducing global passenger volume and imposing travel restrictions at a further 10 hub airports would be equally effective in reducing the risk of importation of SARS-CoV-2; however, this reduction is very limited with a close-to-zero median relative change in risk. Conclusion: The hypothetical variations in observed travel restrictions were not sufficient to prevent the global spread of SARS-CoV-2; further research should also consider travel by land and sea. Our study highlights the importance of strengthening local capacities for disease monitoring and control.


Assuntos
Controle de Doenças Transmissíveis/métodos , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Viagem/legislação & jurisprudência , Aeronaves/legislação & jurisprudência , Aeroportos/normas , Betacoronavirus , Infecções por Coronavirus/transmissão , Humanos , Modelos Estatísticos , Pneumonia Viral/transmissão , Medição de Risco , Fatores de Tempo
20.
J Infect Dev Ctries ; 14(7): 732-736, 2020 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-32794462

RESUMO

Bangladesh reported the first three laboratory-confirmed COVID-19 cases on March 8, 2020 in Dhaka and Narayanganj cities. As of April 8, 2020, 218 confirmed cases across the country, they have mostly detected from Dhaka (56.4%) and Narayanganj (21%) cities where the hotspots of an outbreak of COVID-19 disease. There were 6 cases in Dhaka district excluding metropolitan areas and rest of 43 (20%) cases in the 19 other regions. Local government-enforced completely shut down the hotspots areas on April 8 2020. However, peoples from hotspots travelled openly to the other districts. We aimed to understand the risk of open movement from hotspots. We studied 40 individuals who were infected with SARS-CoV-2 virus later at their destination. We developed a route map and density maps using Geographic Information System (GIS). Among the studied people, the average distance was 140.1 (75.1) kilometers (Km), and the range of distance was from 20.3 to 321.7 kilometers. Among them, 42.5% traveled <100 Km, 40.0% traveled between 100 and 200 Km and 17.5% traveled above 200 Km. Case numbers were increased 13.5 times more on April 20 than the cases as of April 8, 2020. Our analysis suggests that relaxed travel restriction could play an important role to spread COVID-19 transmission domestically. To reduce further spread of COVID-19, the government should closely monitor the public health intervention to stop the casual movement.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Viagem/legislação & jurisprudência , Bangladesh/epidemiologia , Infecções por Coronavirus/prevenção & controle , Surtos de Doenças , Sistemas de Informação Geográfica , Humanos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Migrantes , Doença Relacionada a Viagens
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