The response of local governments and public health centers to COVID-19: looking for infectious disease control due to the change of trend and mutations of the virus

Public Health Centers of Japan. of which there are 468 across the country as of April 2022. are at the core of health crisis management. responding to natural disasters and infectious diseases according to the Community Health Act (1994). Under the Infectious Diseases Control La these centers have made repeated efforts to respond to COV1D-19 from the first to the seventh waves while epidemic dynamics changed. variants emerged. and pathogenicity fluctuated. All centers essentially play a common role in infectious disease control (answering questions and consultations. testing, registering cases, coordinating healthcare. transporting confirmed patients, following up with patients and close contacts. carrying out epidemiological investigations. issuing notifications for recommendations on hospital stays and work restrictions. etc.). 'forever, due to the varying number of cases and healthcare resources depending on the region, the actual work was not identical, and local governments. which operate the centers. took different appreoclws. Looking back on the epidemic, the first, second, and third waves saw travel restrictions implemented across the country, and were characterized by a demand for testing that exceeded capacity. At that time. COVID-19 was a threat to the respiratory system, no effective treatment or vaccination was available. and the number of healthcare institutions diagnosing and treating cases was inadequate. The fourth wave saw the Alpha variant ripping through nursing homes putting a significant burden on healthcare. while the fifth wave saw the Delta variant spreading mainly from Tokyo after the Olympics. The sixth and seventh waves came with the highly. Contagious Omicron variant. leading to skyrocketing patient numbers and the public health capacity quickly being overwhelmed. Local governments considered ways to reduce the burden on Public Health Centers, including outsourcing. Over this 2.5 year period, numerous advisories were issued by the Ministry of Health, Labor, and Welfare (MHLW), and the Japanese Association of Public Health Center Directors has advocated actively on behalf of the centers. Given that Japan is a disaster-prone country, Public Health Centers in Japan are expected to play a pivotal role in crisis preparedness, responses to, and recovery from natural disasters and infectious diseases. As a coordination hub to protect lives and maintain health, here we strongly suggest that public health centers implement the lessons learned from COVID-19 to collaborate with healthcare institutions and long-term care facilities, and evolve into a sustainable social framework to advance pandemic preparedness in their respective communities.

Hawkes process marked with topics and its application to Twitter data analysis

On Twitter, complex networks of information propagation are observed. In this article, we propose a method to model the time interval of user's tweets by combining the marked Hawkes process and the Latent Dirichlet Allocation method. We also propose a method that quantifies how individual topics in tweets excite future tweets and visualize the results as a topic-wise Hawkes graph. As an application to actual data, we analyze the tweets from the American, Chinese, and British embassies from February 1, 2020, to September 27, 2020, a period that roughly corresponds to the initial outbreak of the COVID-19 pandemic.

A numerical method to calculate multiple epidemic waves in COVID-19 with a realistic total number of people involved

We use the total number of individuals involved in the coronavirus disease-2019 (COVID-19), namely, N, inside a specific region as a parameter in the susceptible-infected-quarantined-recovery (SIQR) model of Odagaki. Public data on the number of newly detected individuals are fitted by the numerical results of the SIQR model with optimized parameters. As a result of the optimization, we can determine the total number of individuals involved in COVID-19 inside a specific region and call such an SIQR model with a realistic total number of people involved the SIQR-N model. We then propose two methods to simulate multiple epidemic waves (MEWs), which appear in the time evolution of the number of the newly detected individuals. One is a decomposition of MEWs into independent epidemic waves that can be approximated by multiple time-derivative logistic functions (MTLF). Once the decomposition of the MEWs is completed, we fit the solution of the SIQR-N model to each MTLF using optimized parameters. Finally, we superpose the solutions obtained by multiple SIQR-N (MSIQR-N) models with the optimized parameters to fit the MEWs. The other is a set of N in the SIQR-N model as a function of time, namely, N(t), now called the SIQR-N ( t ) model. Numerical results indicate that a logistic functional approximation of N(t) fits MEWs with good accuracy. Finally, we confirm the availability of the MSIQR-N model with effects of vaccination using the recent data in Israel.

Three coronavirus disease 2019 cases with acute progression of respiratory failure were improved after methylprednisolone therapy

The main target of anti-inflammatory drug therapies for coronavirus disease 2019 (COVID-19) is reducing the risk of acute respiratory distress syndrome (ARDS), an important risk factor for acute death. In the RECOVERY trial, 6 mg/day of dexamethasone for up to 10 days improved 28-day mortality compared with those who received usual care alone. Here, we present three COVID-19 cases who improved after treatment with methylprednisolone (MPSL) and/or following prednisolone (PSL) for acute progression of respiratory failure. Three male COVID-19 patients, aged 56, 84, and 49 years old, developed acute respiratory failure after admission. MPSL therapy (500 mg/day for 3 days) was started for these patients at 4, 4, and, 2 days after admission, respectively, when oxygen administration was required. Following this therapy, two of the three present cases received 30 or 40 mg/day of PSL for an additional 6 and 8 days, respectively. The remaining case discontinued corticosteroid after MPSL therapy. All three cases survived, had fever reduction at 6, 2, and 1 days after start of MPSL therapy, could discontinue oxygen therapy at 6, 6, and 11 days after start of MPSL therapy, and showed negative results for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction at 8, 6, and 22 days after start of MPSL therapy, respectively. No serious side effects due to drug discontinuation of treatment for COVID-19 were observed. MPSL is a candidate drug for corticosteroid therapy for COVID-19. Corticosteroid therapy should be started in the early stage of respiratory failure. Optimal drug selection, timing of intervention, dose, and duration of corticosteroid therapy for COVID-19 should be analyzed in the further studies. © Journal of Xiangya Medicine. All rights reserved.