Analyzing the impact of the covid epidemic on beach access traffic

The covid 19 epidemic has been marking the pace of life around the world for the last two years, and it left clear marks on economic activity, our social life and even the pollution associated with human activity. One of the consequences is related to the decrease in car traffic, especially in the months of mandatory social confinement. This work analyzes the impact of the epidemic on traffic regarding access to the beaches of Barra and Costa Nova in the region of Aveiro, Portugal, through the infrastructure of the PASMO project. Therefore, the weekly and weekend traffic profiles evolution were analyzed over the various months of 2020. The work also compared the evolution of infections with the evolution of road traffic, as well as the impact of the various events related to the epidemic in road traffic.

Seroprevalence and SARS-CoV-2 antibodies distribution in Portugal following mass vaccination campaign : Irina Kislaya

Introduction Information on post-infection and vaccine-induced SARS-CoV-2 seroprevalence is important for public health policies. A 3rd wave of National Serological Survey (ISN3COVID-19) was conducted to measure SARS-CoV-2 seroprevalence and characterize specific antibodies distribution in Portuguese population in September - November 2021, following a mass vaccination campaign. Methods ISN3COVID-19 was a cross-sectional epidemiological study that collected serum samples and questionnaire data on a sample of Portuguese residents aged 1 year or older (n = 4545). SARS-CoV-2 IgG anti-nucleoprotein and anti-spike antibody levels were measured using Abbott Chemiluminescent Microparticle Immunoassays. Seroprevalence was estimated for the overall sample and stratified by age group, sex, region and self-reported chronic conditions. Medians and respective 95% confidence intervals (95%CI) were used to describe the distribution of SARS-CoV-2 antibodies in specific population subgroups. Results The overall seroprevalence of SARS-CoV-2 (post-infection or vaccine-induced) was 86.4% (95%CI: 85.2 to 87.6%), post-infection seroprevalence was 7.5% (95%CI: 6.6 to 8.5). Higher seroprevalence was observed among 50-59 years-old (96.5%), women (88.3%), and those with two or more self-reported chronic conditions (90.8%). Higher IgG (anti-Spike) levels were estimated for individuals vaccinated with the booster dose (median=12601.3 AU/ml;95%CI: 4127.5 to 19089.1) and for those vaccinated with two doses of Spikevax® vaccine (median=7012.7 AU/ml, 95%CI: 5568.8 to 8456.6). Conclusions The SARS-CoV-2 seroprevalence was high and consistent with vaccine coverage in Portugal. Seropositivity was associated with sex, age and previous chronic conditions. The anti-SARS-CoV-2 anti-spike IgG levels varied according to vaccine brand and number of doses. These results show that monitoring seroprevalence and SARS-CoV-2 antibody distribution is of paramount importance to guide public health policies. Key messages • Significant increase in SARS-CoV-2 seroprevalence following the mass vaccination campaign consistent with the high vaccine coverage achieved in Portugal. • Continuous monitoring of the population‐level IgG response after vaccination remains important to guide further public health measures.

COVID-19 Impacts and Mitigation Strategies on Food Supply Chains: A Survey to the Brazilian Context

The COVID-19 pandemic has significantly affected Food Supply Chains (FSCs), causing impacts that interfere with the normal flow of operations. This paper analyzes the COVID-19 impacts on FSCs and the main strategies to minimize their adverse effects. The research adopts a scoping review to identify impacts and strategies and an empirical study consisting of a survey with professionals operating in Brazilian SCs to discuss and validate the results. Impacts are categorized into final consumer, internal environment, and external environment. The policies are also divided into COVID-19 prevention policies and FSCs operational policies. The survey presents 45 complete responses to identify the major impacts and implementation of mitigation policies in FSCs during the COVID-19 pandemic. The main impacts are increased demand, increased operating costs, and price instability. The main mitigation policies are isolation of employees with suspicious cases (COVID-19 prevention) and strong and focused leadership (Operational policy). The results provide a first validation of the research, and the authors suggest as future research the development of studies deepening other types of supply chains. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Analyzing the impact of the covid epidemic on beach access traffic

The covid 19 epidemic has been marking the pace of life around the world for the last two years, and it left clear marks on economic activity, our social life and even the pollution associated with human activity. One of the consequences is related to the decrease in car traffic, especially in the months of mandatory social confinement. This work analyzes the impact of the epidemic on traffic regarding access to the beaches of Barra and Costa Nova in the region of Aveiro, Portugal, through the infrastructure of the PASMO project. Therefore, the weekly and weekend traffic profiles evolution were analyzed over the various months of 2020. The work also compared the evolution of infections with the evolution of road traffic, as well as the impact of the various events related to the epidemic in road traffic.

LONGITUDINAL FOLLOW-UP of HUMORAL RESPONSE AGAINST SARS-COV-2 and VIRAL PERSISTENCE in 96 DMARDS-TREATED PATIENTS with PREVIOUS COVID-19 INFECTION

Background: Although it prevents severe forms of the disease, vaccination does not completely protect against the occurrence of COVID19 disease. If, DMARDs used have been associated with variable humoral response to SARS-CoV-2 vaccination, the impact of their use after SARS-CoV-2 natural infection have been poorly studied. Objectives: To characterize humoral response after SARS-CoV-2 infection and viral persistence in the nasopharyngeal sphere (NP), stools and blood of patients with rheumatic disease under DMARDs, and compared to healthy controls. Methods: Prospective monocentric longitudinal study including patients with rheumatoid arthritis or spondyloarthritis under DMARDs and with a confrmed SARS-CoV-2 infection (positive NP PCR and/or positive serology and/or pathognomonic thoracic tomography (CT)) during the frst or second wave of the COVID pandemic. Patients were followed up until one year after infection and humoral response was assessed before vaccination. Serum IgG and IgA antibodies against spike (S) and nucleocapsid (N) proteins were measured at every visit. Viral persistence was assessed at the early visit in the NP and stools using conventional RT-PCR and in the blood using a high sensitive technique (droplet digital PCR). Results: Between June 2020 and July 2021, we include 96 patients (50 SpA and 46 RA) with a mean age of 53 +/-14 years and 20 healthy controls (mean age 49 ± 16 years) corresponding to relatives of patients (spouses, children) living together and infected at the same time. The immune responses were analyzed according to 6 treatment groups: methotrexate (MTX)/salazopyrine (SLZ) monotherapy (n=17/2);anti-TNF monotherapy (n=24), anti-TNF + MTX (n=23);rituximab (RTX) (n=11);anti-IL17 or-23 (n=8);others (n=11). Visits were made at 1 month (29 ±13 days;n=18), 3 months (110 ±23 days;n=67), 6 months (231 ±35 days;n=48) and 12 months (368 ± 19 days;n=19) after infection. The anti-S and anti-N IgG Ab titers were not signifcantly different in the 6 treatment groups and the control population at 3 months. A signifcant decrease in anti-S IgA Ab titers was noted in the group treated with RTX (p=0.007) and with molecules targeting the IL17/23 pathway (p=0.007). A similar but non-signifcant trend was observed in these same treatment groups for anti-N IgA Ab (p=0.07). The titers of anti-SARS-CoV-2 antibodies at M3, was not associated with a severe COVID disease. Detection of SARS-Cov-2 RNA in stools and serum was negative for all samples taken at 1 month or 3 months. 4 patients (2 RA treated with abatacept/RTX and 2 SpA treated with anti-TNF/secukinumab) had a positive RT-PCR NP with low to very low viral load at the 1-month visit (mean Ct 36). None of these 4 patients had had a severe form of COVID19 infection. Conclusion: DMARDs-treated patients with previous proven COVID-19 did not seem to alter IgG Ab response but RTX and anti-IL17/-IL-23 might alter IgA humoral response. This lower immune response was not associated with a more severe disease. In these patients, new infection may not be considered as a full boost for the immune system. DMARDs did not induce viral persistence in the serum, the NP or in the stool.

Analyzing the impact of the covid epidemic on beach access traffic

The covid 19 epidemic has been marking the pace of life around the world for the last two years, and it left clear marks on economic activity, our social life and even the pollution associated with human activity. One of the consequences is related to the decrease in car traffic, especially in the months of mandatory social confinement. This work analyzes the impact of the epidemic on traffic regarding access to the beaches of Barra and Costa Nova in the region of Aveiro, Portugal, through the infrastructure of the PASMO project. Therefore, the weekly and weekend traffic profiles evolution were analyzed over the various months of 2020. The work also compared the evolution of infections with the evolution of road traffic, as well as the impact of the various events related to the epidemic in road traffic. © 2022 IEEE Computer Society. All rights reserved.

COMPARAÇÃO DOS GASTOS EM SAÚDE POR LINFOMA NÃO-HODGKIN ANTES E DURANTE A PANDEMIA DO COVID-19

Objetivos: Analisar comparativamente as características relativas aos gastos dispensados em saúde para tratamento de pacientes internados por Linfoma não-Hodgkin antes e durante a pandemia de Covid-19. Material e métodos: Este estudo possui caráter transversal, descritivo e retrospectivo. Os dados utilizados foram obtidos mediante o Departamento de Informática do Sistema Único de Saúde (DATASUS), em que foi analisado o perfil de internações ocasionadas por Linfoma não-hodgkin, bem como os gastos empreendidos com tais pacientes no período de janeiro de 2019 a dezembro de 2020, por região no país. Resultados: Durante a pandemia, houve redução de 9,84% no número de internações (17.443 em 2019 e 15.725 em 2020) e de 9,46% no valor total gasto com pacientes portadores de Linfoma não-hodgkin (R$ 35.083.926,83 em 2019 e R$ 31.761.600,24 em 2020). Em contrapartida, houve um aumento de 0,42% no valor médio gasto por paciente (R$2.011,35 em 2019 e R$2.019,82 em 2020). A média de permanência em 2019 foi de 7,6 dias, enquanto que no período de pandemia reduziu para 7 dias. A taxa de mortalidade também obteve queda de 1,01% quando comparado ao ano anterior da pandemia de Covid-19 (8,82% em 2019 e 7,87% em 2020). Discussão: Diante de tais resultados, observa-se que há uma redução significativa no número de internações relacionadas ao Linfoma não-hodgkin, contrastando, com o relatório de 2020 do INCA, no qual, o estado o Rio de Janeiro apresentou uma queda na quantidade de internações por causas oncológicas (13.438 em 2019 e 10.384 em 2020). Tal fato, relaciona-se com a separação de leitos para pacientes com suspeita ou contaminados por Covid-19, o que acarretou na diminuição da disponibilidade de leitos para internação. Ademais, o mesmo relatório apresentou uma redução na quantidade de consultas médicas, quimioterapias, transplante de medula óssea, consultas multiprofissionais e outros, pela implantação de uma política de cancelamento das consultas de acompanhamento dos pacientes, uma vez que o risco relacionado ao deslocamento e à eventual contaminação por Covid-19 trariam maiores prejuízos para esses pacientes, tal feito, pode ter corroborado para redução do valor total gasto. Além disso, notou-se aumento dos gastos por paciente, concordando com outros estudos, onde notou-se o aumento dos custos por baixa produtividade de medicamentos, equipamentos, entre outros. Todavia, a diferença entre a média de permanência dos pacientes analisados neste estudo, difere do relatório do INCA, haja vista, que o tempo médio de permanência dos pacientes oncológicos do relatório, manteve-se estável, em cerca de 7,63 dias e do estudo reduziu para 7 dias. Sobre a redução da taxa de morte, pode-se relacionar-se também a redução do número de internações. É válido salientar também, que estes resultados podem denotar uma redução da assistência à saúde. Conclusão: Pode-se concluir que durante o período avaliado na pesquisa, houve redução significativa no número de internações de pacientes portadores de Linfoma não-Hodgkin. No entanto, ocorreu discreto aumento nos gastos com esses pacientes, o que pode-se inferir relação com a realocação de leitos em hospitais, para destinação exclusiva para pacientes com Covid-19. Ademais, observou-se redução na média de tempo de permanência e também na taxa de mortalidade.

Model-informed health system reorganization during emergencies

The COVID-19 pandemic presented the world to a novel class of problems highlighting distinctive features that rendered standard academic research and participatory processes less effective in properly informing public health interventions in a timely way. The urgency and rapidity of the emergency required tight integration of novel and high-quality simulation modeling with public health policy implementation. By introducing flexibility and agility into standard participatory processes, we aligned the modeling effort with the imposed reality of the emergency to rapidly develop a regional system dynamics (SD) model integrating diverse streams of data that could reliably inform both health system restructuring and public health policy. Using Lombardy data, our SD model was able to generate early projections for the diffusion of the pandemic in neighbor Ticino. Later, it projected the timing and size of peak patient demand. Our work also supported the need for reorganization of the healthcare system and volume flexibility strategies increasing hospital capacity (e.g., intensive care unit [ICU] and ward beds, medical and nursing staff, and oxygen supply) in Ticino. Counterfactual analyses quantify the impact of the decisions supported by our interventions. Our research contributes to our understanding of volume flexibility strategies used by healthcare organizations during emergencies, highlighting the critical role played by available response time in the deployment of strategies that either prioritize critical services or leverage available resources. It also contributes to the literature on participatory systems modeling by describing a flexible and agile participatory process that was successfully deployed in a rapidly evolving high-stakes emergency.

Do Managers Overreact When in Backlog? Evidence of Scope Neglect from a Supply Chain Experiment

Problem definition: We empirically examine a complementary behavioral source of the bullwhip effect that has been previously overlooked in the literature: that individuals order more aggressively (i.e., overreact) when they face shortages than when they hold inventory. Methodology/Results: We conduct a behavioral experiment using the beer distribution game. We estimate decision rules using multilevel modeling approaches that overcome several drawbacks of the estimation methods used in the earlier literature. We find robust evidence that, contrary to the overreaction when in backlog hypothesis and reports from popular press, decision makers order less aggressively and become insensitive to the scope of the problem when in backlog-a scope neglect phenomenon. Managerial implications: We propose a dual-process theoretical account predicated on affective reactions to explain this scope neglect. Our results suggest that affective reactions under novel operating conditions or dramatic events in supply chains, such as the COVID-19 pandemic, can overwhelm cognitive processing of managers and make them fail to recognize the full scope of the problems faced and update decision models accordingly. Understanding the cognitive-affective drivers of ordering behaviors that generate supply chain instability is important in designing interventions to mitigate their negative effects.

Impact of COVID-19 pandemic on ST-elevation myocardial infarction: data from two Portuguese centers

Introduction: Recently during the COVID-19 pandemic there was a general belief in a reduction of hospital admissions due to non-infectious causes, namely cardiovascular diseases. Objectives: To evaluate the impact of the pandemic in the admissions by ST elevation acute myocardial infarction (STEMI), during the first pandemic wave. Methods: Multicentric and retrospective analysis of consecutive patients presenting in two Portuguese hospital centers with STEMI in two sequential periods - P1 (1st March to 30th April) and P2 (1st May to 30th June). A comparison of patient's clinical and hospital outcomes data was performed between the year 2020 and 2017 to 2019 for both periods. Results: A total of 347 consecutive STEMI patients were included in this study. The patient's baseline characteristics and cardiovascular risk factors were similar across the considered periods. During P1 of 2020, in comparison with previous years, a reduction in the number of STEMI patients was observed (26.0±4.2 vs 16.5±4.9 cases per month;p=0.033), contrary to what was observed during P2 (19.5±0.7 vs 20.5±0.7 cases per month;p=0.500). Percutaneous coronary interventions in the setting of failed thrombolysis were more frequent (1.9% vs 9.1%;p=0.033). A global trend in longer delays in time-key bundles of STEMI care was noted, namely pain to first medical contact, door to needle, door to wire crossing and symptoms to wire crossing times, however without statistical significance. Mortality rate was six-fold higher during P1 comparing to previous years (1.9% vs 12.1%;p=0.005), and also an increase in the number of mechanical complications (0.0% vs 3.0%;p=0.029) was observed. Conclusions: During the first COVID-19 pandemic wave there were fewer patients presenting with STEMI at catheterization laboratory for coronary angioplasty. These patients presented more mechanical complications and higher mortality rates.

Étude de la réponse humorale anti-SARS-CoV-2 et de la persistance virale dans une cohorte de 96 patients avec rhumatisme inflammatoire chronique (PR et SpA) sous immunomodulateurs, infectés par le SARS-CoV-2

Introduction L’impact des traitements immunomodulateurs utilisés dans les rhumatismes inflammatoires chroniques sur la réponse humorale anti-SARS-coV-2 et sur la persistance virale dans la sphère nasopharyngée (NP), les selles et le sang a été peu étudié à ce jour. L’objectif était de caractériser la réponse humorale anti-SARS-CoV-2 ainsi que la persistance virale NP, sérique et fécale de patients sous immunomodulateurs (DMARDs) pour un rhumatisme inflammatoire chronique, comparativement à une population témoin sans rhumatisme inflammatoire chronique et non immunodéprimée. Patients et méthodes Étude longitudinale prospective (inclusions de juin 2020 à maintenant) de patients sous DMARDs synthétiques et/ou biologiques pour une spondyloarthrite (SpA) ou une polyarthrite rhumatoïde (PR). Les titres d’Ac anti-Spike (S) et anti-Nucleocapside (N) en IgG et IgA ont été déterminés dans le sérum et sur l’écouvillonnage NP. La persistance virale NP, fécale et sérique a été déterminée par RT-PCR. L’ARNémie plasmatique du SARS-CoV-2 a été déterminée par RT-PCR numérique ultrasensible sur gouttelettes (BioRad®). Résultats Un total de 96 patients (50 SpA et 46 PR) d’âge moyen 53±14 ans ont été inclus dans l’étude COVIRIC après une infection confirmée à SARS-CoV-2 (RT-PCR et/ou sérologie positive et/ou tomodensitométrie (TDM) thoracique compatible). 20 témoins (âge moyen 49±16 ans) correspondant à des collatéraux de ces patients (conjoints, enfants majeurs) vivants sous le même toit et infectés au même moment ont été inclus comme population contrôle. Les réponses immunes ont été analysées selon 6 groupes de traitement : méthotrexate (MTX)/salazopyrine (SLZ) monothérapie (n=17/2) ;anti-TNF monothérapie (n=24), anti-TNF+MTX (n=23) ;rituximab (RTX) (n=11) ;traitements ciblant la voie IL17/23 (n=8) ;autres (n=11). Les visites étaient effectuées à 1 mois (29±13jours ;n=18), 3 mois (110±23jours ;n=67), 6 mois (231±35jours ;n=48) et 12 mois (368±19jours ;n=19) après l’infection. Aucune des visites n’était post-vaccinale. La distribution des titres d’Ac IgG anti-S et anti-N n’était pas significativement différente dans les 6 groupes de traitement et la population témoin à 3 mois. En revanche, on notait une diminution significative des IgA anti-S dans les groupes de traitement par RTX (p=0,007) et par molécules ciblant la voie IL17/23 (p=0,007). On observait une tendance similaire mais non significative dans ces mêmes groupes de traitement pour les IgA anti-N (p=0,07) dans le sérum et pour la quantification des IgA anti-S anti-SARS-CoV-2 dans les prélèvements NP du groupe RTX comparativement aux témoins (p=0,07). Les titres des Ac anti-SARS-CoV-2 à M3, quel que soit leur sous-type, ne conditionnaient pas la sévérité de l’infection COVID-19. La détection de l’ARN SARS-Cov-2 dans les selles et le sérum était négative pour l’ensemble des prélèvements réalisés à 1 mois et 3 mois. 4 patients (2 PR ;traitement par abatacept (ABA)/RTX ;2 SpA traitement par ADA/sécukinumab) avaient une RT-PCR NP positive avec charge virale faible à très faible à la visite de 1 mois (Ct moyen 36). Aucun de ces 4 patients n’avaient eu une forme sévère d’infection COVID19. Conclusion Les traitements analysés dans cette étude n’ont pas eu d’impact significatif sur les titres d’IgG anti-N et anti-S. En revanche, les traitements par RTX et ceux ciblant la voie IL17/23 semblent impacter la réponse humorale IgA mais sans lien avec la sévérité de l’infection dans la population étudiée. Les différents traitements analysés n’induisaient pas de persistance virale sérique ou dans les selles.

Patients with head & neck cancer with COVID-19 in Brazil

Introduction: With the emergence of SARS-CoV-2 infection, concern for the most vulnerable populations has become an urgency. Several studies warn of the weakness of patients with head & neck cancer (HNC). The objective is to describe the sociodemographic and clinical profile of patients with HNC with a positive diagnosis for COVID-19 who required hospitalization. Method: In this prospective observational study, carried out from March to May 2020, we included individuals of both sexes, enrolled in the Head and Neck Surgery Department of the Brazilian National Cancer Institute and diagnosed with COVID-19 who needed hospitalization. Results: A total of 1153 patients were attended in this period;30 patients required hospitalization and tested positive for COVID-19. The group had a mean age of 62.4 years, with a prevalence of male patients (n = 20;66.67%). There was a predominance of elderly (63.33%), self-declared White (73.32), married (53.32), with low education (56.58%), and smokers (56.67%). Most patients had advanced clinical oncological staging (III-IV;53.33%), approximately. The larynx was the site with the highest prevalence of individuals (n = 7), followed by the thyroid (n = 5) and the oral cavity (n = 5). Systemic arterial hypertension and diabetes mellitus were the most prevalent comorbidities. It was observed that 60% of patients delayed the start of cancer treatment due to a positive diagnosis for COVID-19. Ten deaths had been confirmed, for a mortality rate of 33.3% in the sample. Conclusion: The present study describes a group of patients with HNC at increased risk for hospitalization infected by COVID-19: elderly individuals, with advanced tumors, economically disadvantaged, and undergoing cancer diagnosis and treatment who were not in social isolation.

Exploratory study on the psychological impact of COVID-19 on the general Brazilian population

The COVID-19 pandemic has become one of the main international concerns regarding its impact on mental health. The present study aims to investigate the prevalence of depression, anxiety, and stress symptoms, and behavioral aspects amidst the COVID-19 pandemic in a Brazilian population. An online survey was administered from May 22 to June 5, 2020 using a questionnaire comprising of sociodemographic information, the Depression, Anxiety, and Stress Scale (DASS-21), and the Coping Strategies Inventory. Participants comprised 3,000 people from Brazil's 26 states and the Federal District, with an average age of 39.8 years, women (83%), married (50.6%), graduates (70.1%) and employees (46.7%). Some contracted the virus (6.4%) and had dead friends or relatives (22.7%). There was more consumption of drugs, tobacco, medication, and food (40.8%). Almost half of participants expressed symptoms of depression (46.4%), anxiety (39.7%), and stress (42.2%). These were higher in women, people without children, students, patients with chronic diseases, and people who had contact with others diagnosed with COVID-19. The existence of a group more vulnerable to situations with a high stress burden requires greater attention regarding mental health during and after the pandemic. That said, it should be emphasized that these findings are preliminary and portray a moment still being faced by many people amid the pandemic and quarantine measures. Therefore, we understand that the magnitude of the impacts on mental health will only be more specific with continuous studies after total relaxation of the quarantine.

Causal impacts of epidemics and pandemics on food supply chains: A systematic review

The epidemics and pandemics can severely affect food supply chains, including producers, retailers, wholesalers, and customers. To minimize their impacts, it is fundamental to implement effective policies that ensure continuity in the provision, affordability, and distribution of basic food items. This research identifies the main impacts of pandemics and epidemics on food supply chains and policies that can minimize these impacts. Based on a systematic literature review (SLR), 173 documents are analysed to propose a taxonomy of impacts on four supply chain links: demand-side, supply-side, logistics and infrastructure, and management and operation. The taxonomy presents the main impacts and respective mitigation policies. In addition, the literature review leads to the development of a comprehensive causal loop diagram (CLD) with the identification of main variables and their relationship with food supply chains. Finally, a specific research agenda is proposed by identifying the main research gaps. These findings provide a structured method for evaluating policies that ensure the functioning of food supply chains, particularly in disruptions such as epidemics and pandemics. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.