Modelling the spread of serotype-2 vaccine derived-poliovirus outbreak in Pakistan and Afghanistan to inform outbreak control strategies in the context of the COVID-19 pandemic.

BACKGROUND: Since July 2019, Pakistan and Afghanistan have been facing an outbreak of serotype-2 circulating vaccine derived poliovirus (cVDPV2) in addition to continued transmission of serotype-1 wild poliovirus (WPV1) and SARS-CoV-2 in 2020. Understanding the risks of cVDPV2 transmission due to pause of global vaccination efforts and the impact of potential vaccination response strategies in the current context of COVID-19 mitigation measures is critical. METHODS: We developed a stochastic, geographically structured mathematical model of cVDPV2 transmission which captures both mucosal and humoral immunity separately and allows for reversion of serotype-2 oral polio vaccine (OPV2) virus to cVDPV2 following vaccine administration. The model includes geographic heterogeneities in vaccination coverage, population immunity and population movement. The model was fitted to historic cVDPV2 cases in Pakistan and Afghanistan between January 2010-April 2016 and July 2019-March 2020 using iterated particle filtering. The model was used to simulate spread of cVDPV2 infection from July 2019 to explore impact of various proposed vaccination responses on stopping transmission and risk of spread of reverted Sabin-2 under varying assumptions of impacts from COVID-19 lockdown measures on movement patterns as well as declines in vaccination coverage. RESULTS: Simulated monthly incidence of cVDPV2 from the best-fit model demonstrated general spatio-temporal alignment with observed cVDPV2 cases. The model predicted substantial spread of cVDPV2 infection, with widespread transmission through 2020 in the absence of any vaccination activities. Vaccination responses were predicted to substantially reduce transmission and case burden, with a greater impact from earlier responses and those with larger geographic scope. While the greatest risk of seeding reverted Sabin-2 was predicted in areas targeted with OPV2, subsequent spread was greatest in areas with no or delayed response. The proposed vaccination strategy demonstrated ability to stop the cVDPV2 outbreak (with low risk of reverted Sabin-2 spread) by February 2021. CONCLUSION: Outbreak response vaccination campaigns against cVDPV2 will be challenging throughout the COVID-19 pandemic but must be implemented urgently when feasible to stop transmission of cVDPV2.

Consecutive Waves of COVID-19 in Iran: Various Dimensions and Probable Causes.

OBJECTIVE: The coronavirus disease (COVID-19) pandemic has somehow affected the lives of 80% of the world's population. Iran has also experienced numerous outbreaks of this disease. The fifth wave having occurred in August 2021 was one of the most agonizing incidences of the pandemic in the country. METHOD: We reviewed all of publications and govermental statistics about COVID-19 pandemic In Iran between 2019 to 2021. RESULTS: The current study discusses the possible dimensions and causes of successive waves of COVID-19 in Iran, namely, the consequences of a significant delay in vaccination administration in due time, the collective overwhelming fallacy toward immunization, the polypharmacy controversy, inadequate community-based participation in risk reduction, and noticeable decrease in the public's resilience. CONCLUSION: A variety of strategies have been recommended in the article to modify the principal challenges in order to help control the pandemic in the country.

Last mile practices in e-commerce: framework development and empirical analysis of Swedish firms

Purpose>In light of the recent dynamics, this paper aims to explore the last mile (LM) of e-commerce retailers. Two research questions are developed (1) What firm characteristics are critical in LM practices? and (2) How do LM practices differ based on the identified critical firm characteristics?Design/methodology/approach>Data were collected via 10 interviews with e-commerce executives, as well as a survey on 200 e-commerce firms in different retail sectors in Sweden.Findings>“Firm Size” and “Sales Channel-Mix” appear to be the top critical firm characteristics in LM practices. While last mile delivery (LMDe) was found to vary more based on sales channel mix than firm size, the opposite occurs for last mile back-end fulfilment (LMBF). Moreover, last mile consumer steering (LMCS) was found to vary only with sales channel-mix. Unexpectedly, primarily store-based retailers capitalize on their stores while offering competitive remote services;they hence compete indirectly with their existing store network.Originality/value>While most prior work has focused on LMBF and LMDe for strategizing, the consumer-steering aspect seems to have been a missing link. This study develops an integrated framework for LM strategy planning, incorporating LMCS, LMBF and LMDe. New aspects such as the environment, specialization and inventory management are included. The findings provide insights for executives when strategizing, undertaking competition analysis and positioning the firm.

Cultural-Religious Approach: An Effective Community-Based Disaster Management Strategy for Reducing the Mortality and Morbidity of the Fourth Wave of Coronavirus Pandemic Caused by the Lineage B.1.1.7 (the British Variant) in Iran (Spring 2021).

Lineage B.1.1.7 (the British variant) is a new variant of SARS-CoV-2. The virus was first identified in the UK in October 2020. Since Iran is one of the most disaster risk countries in the world, disaster management is one of the most important issues. One of the effective approaches of this field is community-based disaster management (CBDM). Altogether, planning and policy-making through using various cultural-religious role models with emphasis on the cultural points can be useful to reduce the mortality and morbidity rate caused by the fourth wave of coronavirus in Iran.

Progress Toward Poliomyelitis Eradication - Pakistan, January 2020-July 2021.

When the Global Polio Eradication Initiative began in 1988, wild poliovirus (WPV) transmission was occurring in 125 countries; currently, only WPV type 1 (WPV1) transmission continues, and as of August 2021, WPV1 transmission persists in only two countries (1,2). This report describes Pakistan's progress toward polio eradication during January 2020-July 2021 and updates previous reports (3,4). In 2020, Pakistan reported 84 WPV1 cases, a 43% reduction from 2019; as of August 25, 2021, Pakistan has reported one WPV1 case in 2021. Circulating vaccine-derived poliovirus (cVDPV) emerges as a result of attenuated oral poliovirus vaccine (OPV) virus regaining neurovirulence after prolonged circulation in underimmunized populations and can lead to paralysis. In 2019, 22 cases of cVDPV type 2 (cVDPV2) were reported in Pakistan, 135 cases were reported in 2020, and eight cases have been reported as of August 25, 2021. Because of the COVID-19 pandemic, planned supplementary immunization activities (SIAs)* were suspended during mid-March-June 2020 (3,5). Seven SIAs were implemented during July 2020-July 2021 without substantial decreases in SIA quality. Improving the quality of polio SIAs, vaccinating immigrants from Afghanistan, and implementing changes to enhance program accountability and performance would help the Pakistan polio program achieve its goal of interrupting WPV1 transmission by the end of 2022.

Progress Toward Poliomyelitis Eradication - Pakistan, January 2019-September 2020.

Pakistan and Afghanistan are the only countries where wild poliovirus type 1 (WPV1) is endemic (1,2). In 2019, Pakistan reported 147 WPV1 cases, approximately 12 times the number reported in 2018. As of September 15, 72 cases had been reported in 2020. Since 2019, WPV1 transmission has also spread from Pakistan's core poliovirus reservoirs (Karachi, Peshawar, and Quetta block) to southern districts of Khyber Pakhtunkhwa (KP), Punjab, and Sindh provinces. Further, an outbreak of circulating vaccine-derived poliovirus type 2 (cVDPV2), first detected in July 2019, has caused 22 paralytic cases in 2019 and 59 as of September 15, 2020, throughout the country. The coronavirus disease 2019 (COVID-19) pandemic has substantially reduced delivery of polio vaccines through essential immunization (formerly routine immunization) and prevented implementation of polio supplementary immunization activities (SIAs)* during March-July 2020. This report describes Pakistan's progress in polio eradication during January 2019-September 2020 and updates previous reports (1,3,4). The Pakistan polio program has reinitiated SIAs and will need large, intensive, high-quality campaigns with strategic use of available oral poliovirus vaccines (OPVs)† to control the surge and widespread transmission of WPV1 and cVDPV2.