ABSTRACT
Traditional contact tracing tests the direct contacts of those who test positive. But, by the time an infected individual is tested, the infection starting from the person may have infected a chain of individuals. Hence, why should the testing stop at direct contacts, and not test secondary, tertiary contacts or even contacts further down? One deterrent in testing long chains of individuals right away may be that it substantially increases the testing load, or does it? We investigate the costs and benefits of such multi-hop contact tracing for different number of hops. Considering diverse contact networks, we show that the cost-benefit trade-off can be characterized in terms of a single measurable attribute, the initial epidemic growth rate. Once this growth rate crosses a threshold, multi-hop contact tracing substantially reduces the outbreak size compared with traditional tracing. Multi-hop even incurs a lower cost compared with the traditional tracing for a large range of values of the growth rate. The cost-benefit trade-offs can be classified into three phases depending on the value of the growth rate. The need for choosing a larger number of hops becomes greater as the growth rate increases or the environment becomes less conducive toward containing the disease.
ABSTRACT
INTRODUCTION: Novel coronavirus disease 2019 (COVID 19) has usurped human peace and mobility. The confinement of the population and the rising epidemic has disrupted the routine care for non-COVID-19 patients. Telehealth is a growing field, and its application in palliative care is seen as a solution to serve the population in this difficult crisis. METHODOLOGY: A exploratory survey was designed to assess the changes in the hospital-based practice of palliative care in the COVID-19 pandemic and patient/caregiver's perception about the provision of telehealth services to palliative care patients of a tertiary care cancer hospital of eastern India. RESULTS: There was a dramatic reduction in the outpatient clinic footfalls by 51% with teleconsultation. Although there was no change in the number of emergency visits, the inpatient admissions reduced by 44%. Nearly 82% of patient/caregivers gave a positive feedback about telemedicine care provided by the department and mentioned that the service provided them with support and connectedness. Almost 64% of the patients and caregivers reported that the service helped allay the fear and reassured them that there was a someone to support them. As high as 76% of the participants felt that they would prefer teleconsultation in future and were ready to pay for teleconsultations if charges were to be applied in the future. CONCLUSION: Telemedicine is an important tool and an essential service to care for palliative care patients in the community especially when the patient and health-care professionals are separated by a pandemic or natural disaster.
ABSTRACT
OBJECTIVES: Eradicated infectious diseases like smallpox can re-emerge through accident or the designs of bioterrorists, and cause heavy casualties. Presently, the populace is largely susceptible as only a small percentage is vaccinated, and their immunity is likely to have waned. And when the disease re-emerges, the susceptible individuals may be manipulated by disinformation on Social Media to refuse vaccines. Thus, a combination of countermeasures consisting of antiviral drugs and vaccines and a range of policies for their application need to be investigated. Opinions regarding whether to receive vaccines evolve over time through social exchanges via networks that overlap with but are not identical to the disease propagation networks. These couple the spread of the biological and information contagion and necessitate a joint investigation of the two. METHODS: We develop a computationally tractable metapopulation epidemiological model that captures the joint spatio-temporal evolution of an infectious disease (e.g., smallpox, COVID-19) and opinion dynamics. RESULTS: Considering smallpox, the computations based on the model show that opinion dynamics have a substantial impact on the fatality count. Towards understanding how perpetrators are likely to seed the infection, we identify a) the initial distribution of infected individuals that maximize the overall fatality count; and b) which habitation structures are more vulnerable to outbreaks. We assess the relative efficacy of different countermeasures and conclude that a combination of vaccines and drugs minimize the fatalities, and by itself, drugs reduce fatalities more than the vaccine. Accordingly, we assess the impact of increase in the supply of drugs and identify the most effective among a collection of policies for administering of drugs for various parameter combinations. Many of the observed patterns are stable to variations of a diverse set of parameters. CONCLUSIONS: Our findings provide a quantitative foundation for various important elements of public health discourse that have largely been conducted qualitatively.