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1.
Pediatr Infect Dis J ; 40(11): 955-961, 2021 11 01.
Article in English | MEDLINE | ID: covidwho-1758891

ABSTRACT

BACKGROUND: We analyzed contagions of coronavirus disease 2019 inside school bubble groups in Catalonia, Spain, in the presence of strong nonpharmaceutical interventions from September to December 2020. More than 1 million students were organized in bubble groups and monitored and analyzed by the Health and the Educational departments. METHODS: We had access to 2 data sources, and both were employed for the analysis, one is the Catalan school surveillance system and the other of the educational department. As soon as a positive index case is detected by the health system, isolation is required for all members of the bubble group, in addition to a mandatory proactive systematic screening of each individual. All infected cases are reported. It permits the calculation of the average reproductive number (R*), corresponding to the average number of infected individuals per index case. RESULTS: We found that propagation inside of the bubble group was small. Among 75% index cases, there was no transmission to other members in the classroom, with an average R* across all ages inside the bubble of R* = 0.4. We found a significant age trend in the secondary attack rates, with the R* going from 0.2 in preschool to 0.6 in high school youth. CONCLUSIONS: The secondary attack rate depends on the school level and therefore on the age. Super-spreading events (outbreaks of 5 cases or more) in childhood were rare, only occurring in 2.5% of all infections triggered from a pediatric index case.


Subject(s)
COVID-19/epidemiology , COVID-19/virology , SARS-CoV-2 , Schools , Students , Adolescent , Age Factors , Algorithms , Child , Child, Preschool , Disease Outbreaks , Female , Humans , Male , Models, Statistical , Population Surveillance , Spain/epidemiology
2.
SSRN; 2022.
Preprint in English | SSRN | ID: ppcovidwho-329997

ABSTRACT

Background: Mandatory use of face covering masks (FCM) had been established for children aged six and above in Catalonia (Spain), as one of the non-pharmaceutical interventions aimed at mitigating SARS-CoV-2 transmission within schools. To date, the effectiveness of this mandate has not been well established. The quasi-experimental comparison between 5 year-old children, as a control group, and 6 year-old children, as an interventional group, provides us with the appropriate research conditions for addressing this issue. Methods: We performed a retrospective population-based study among 599,314 children aged 3 to 11 years attending preschool (3-5 years, without FCM mandate) and primary education (6-11 years, with FCM mandate) with the aim of calculating the incidence of SARS-CoV-2, secondary attack rates (SAR) and the effective reproductive number (R*) for each grade during the first trimester of the 2021-2022 academic year, and analysing the differences between 5-year-old, without FCM, and 6 year-old children, with FCM. Findings: SARS-CoV-2 incidence was significantly lower in preschool than in primary education, and an age-dependent trend was observed. Children aged 3 and 4 showed lower outcomes for all the analysed epidemiological variables, while children aged 11 had the higher values. Six-year-old children showed higher incidence than 5 year-olds (3·54% vs 3·1%;OR: 1·15 [95%CI: 1·08-1·22]) and slightly lower but not statistically significant SAR and R*: SAR were 4·36% in 6 year-old children, and 4·59% in 5 year-old (IRR: 0·96 [95%CI: 0·82-1·11]);and R* was 0·9 and 0·93 (OR: 0·96 [95%CI: 0·87-1·09]), respectively. Interpretation: FCM mandates in schools were not associated with lower SARS-CoV-2 incidence or transmission, suggesting that this intervention was not effective. Instead, age-dependency was the most important factor in explaining the transmission risk for children attending school. Funding Information: CP and SA received funding from Ministerio de Ciencia, Innovación y Universidades and FEDER, with the project PGC2018-095456-B-I00. Declaration of Interests: The authors declare that they have no conflict of interests. Ethics Approval Statement: The study was evaluated and approved by the Clinical Research Ethics Committee of the IDIAP Jordi Gol, Reference 21/018-PCV. This research was based on the agreement established in Regulation 2016/679 of the European Parliament and the Council of Europe of 27 April 2016 on Data Protection, and Organic Law 3/2018 of December 5 on the protection of personal data and the guarantee of digital rights.

3.
PLoS One ; 17(2): e0263741, 2022.
Article in English | MEDLINE | ID: covidwho-1690714

ABSTRACT

BACKGROUND: Despite their clear lesser vulnerability to COVID-19, the extent by which children are susceptible to getting infected by SARS-CoV-2 and their capacity to transmit the infection to other people remains inadequately characterized. We aimed to evaluate the role of school reopening and the preventive strategies in place at schools in terms of overall risk for children and community transmission, by comparing transmission rates in children as detected by a COVID-19 surveillance platform in place in Catalonian Schools to the incidence at the community level. METHODS AND FINDINGS: Infections detected in Catalan schools during the entire first trimester of classes (September-December 2020) were analysed and compared with the ongoing community transmission and with the modelled predicted number of infections. There were 30.486 infections (2.12%) documented among the circa 1.5M pupils, with cases detected in 54.0% and 97.5% of the primary and secondary centres, respectively. During the entire first term, the proportion of "bubble groups" (stable groups of children doing activities together) that were forced to undergo confinement ranged between 1 and 5%, with scarce evidence of substantial intraschool transmission in the form of chains of infections, and with ~75% of all detected infections not leading to secondary cases. Mathematical models were also used to evaluate the effect of different parameters related to the defined preventive strategies (size of the bubble group, number of days of confinement required by contacts of an index case). The effective reproduction number inside the bubble groups in schools (R*), defined as the average number of schoolmates infected by each primary case within the bubble, was calculated, yielding a value of 0.35 for primary schools and 0.55 for secondary schools, and compared with the outcomes of the mathematical model, implying decreased transmissibility for children in the context of the applied measures. Relative homogenized monthly cumulative incidence ([Formula: see text]) was assessed to compare the epidemiological dynamics among different age groups and this analysis suggested the limited impact of infections in school-aged children in the context of the overall community incidence. CONCLUSIONS: During the fall of 2020, SARS-CoV-2 infections and COVID-19 cases detected in Catalan schools closely mirrored the underlying community transmission from the neighbourhoods where they were set and maintaining schools open appeared to be safe irrespective of underlying community transmission. Preventive measures in place in those schools appeared to be working for the early detection and rapid containment of transmission and should be maintained for the adequate and safe functioning of normal academic and face-to-face school activities.


Subject(s)
COVID-19 , Residence Characteristics , Schools , Basic Reproduction Number , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/transmission , Humans , Incidence , Models, Theoretical , Spain/epidemiology
4.
Clin Infect Dis ; 74(1): 66-73, 2022 01 07.
Article in English | MEDLINE | ID: covidwho-1633721

ABSTRACT

BACKGROUND: Understanding the role of children in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission is critical to guide decision-making for schools in the pandemic. We aimed to describe the transmission of SARS-CoV-2 among children and adult staff in summer schools. METHODS: During July 2020, we prospectively recruited children and adult staff attending summer schools in Barcelona who had SARS-CoV-2 infection. Primary SARS-CoV-2 infections were identified through (1) a surveillance program in 22 summer schools of 1905 participants, involving weekly saliva sampling for SARS-CoV-2 reverse-transcription polymerase chain reaction (RT-PCR) during 2-5 weeks; and (2) cases identified through the Catalonian Health Surveillance System of children diagnosed with SARS-CoV-2 infection by nasopharyngeal RT-PCR. All centers followed prevention protocols: bubble groups, handwashing, face masks, and conducting activities mostly outdoors. Contacts of a primary case within the same bubble were evaluated by nasopharyngeal RT-PCR. Secondary attack rates and the effective reproduction number in summer schools (Re*) were calculated. RESULTS: Among the >2000 repeatedly screened participants, 30 children and 9 adults were identified as primary cases. A total of 253 close contacts of these primary cases were studied (median, 9 [interquartile range, 5-10] for each primary case), among which 12 new cases (4.7%) were positive for SARS-CoV-2. The Re* was 0.3, whereas the contemporary rate in the general population from the same areas in Barcelona was 1.9. CONCLUSIONS: The transmission rate of SARS-CoV-2 infection among children attending school-like facilities under strict prevention measures was lower than that reported for the general population. This suggests that under preventive measures schools are unlikely amplifiers of SARS-CoV-2 transmission, supporting current recommendations for school opening.


Subject(s)
COVID-19 , Adult , Child , Humans , Pandemics , SARS-CoV-2 , Schools , Spain/epidemiology
5.
Risks ; 10(2):23, 2022.
Article in English | MDPI | ID: covidwho-1625156

ABSTRACT

Central banks have been pursuing an expansionary monetary policy since before the pandemic, although the health and economic crisis of COVID-19 has boosted asset purchase programmes. After the Great Recession, a new phase began, characterised by low interest rates and liquidity injections. These policies spilled over into financial markets and are leading to higher inflation. These policies stabilised the situation in the short term, but if they continue indefinitely there is a risk of debt overhang, investment mistakes and high inflation in the future. The aim of this article is to analyse monetary policy developments from the Great Recession to the COVID-19 crisis. Correlations between different macroeconomic variables will be shown through IBM SPSS Statistics. For this purpose, bi-variate correlations were used. For the predictions and confidence of the model data, Tableau Desktop Edition was used, which in turn was used for the generation of the graphs. There is a strong correlation between the growth of monetary aggregates and public debt and stock market capitalisation for the selected indicators. The main contribution of this research is the analysis of the long-term effects of a monetary policy.

7.
Pediatr Infect Dis J ; 40(11): 955-961, 2021 11 01.
Article in English | MEDLINE | ID: covidwho-1331604

ABSTRACT

BACKGROUND: We analyzed contagions of coronavirus disease 2019 inside school bubble groups in Catalonia, Spain, in the presence of strong nonpharmaceutical interventions from September to December 2020. More than 1 million students were organized in bubble groups and monitored and analyzed by the Health and the Educational departments. METHODS: We had access to 2 data sources, and both were employed for the analysis, one is the Catalan school surveillance system and the other of the educational department. As soon as a positive index case is detected by the health system, isolation is required for all members of the bubble group, in addition to a mandatory proactive systematic screening of each individual. All infected cases are reported. It permits the calculation of the average reproductive number (R*), corresponding to the average number of infected individuals per index case. RESULTS: We found that propagation inside of the bubble group was small. Among 75% index cases, there was no transmission to other members in the classroom, with an average R* across all ages inside the bubble of R* = 0.4. We found a significant age trend in the secondary attack rates, with the R* going from 0.2 in preschool to 0.6 in high school youth. CONCLUSIONS: The secondary attack rate depends on the school level and therefore on the age. Super-spreading events (outbreaks of 5 cases or more) in childhood were rare, only occurring in 2.5% of all infections triggered from a pediatric index case.


Subject(s)
COVID-19/epidemiology , COVID-19/virology , SARS-CoV-2 , Schools , Students , Adolescent , Age Factors , Algorithms , Child , Child, Preschool , Disease Outbreaks , Female , Humans , Male , Models, Statistical , Population Surveillance , Spain/epidemiology
8.
Front Public Health ; 9: 633123, 2021.
Article in English | MEDLINE | ID: covidwho-1325582

ABSTRACT

The current worldwide pandemic produced by coronavirus disease 2019 (COVID-19) has changed the paradigm of mathematical epidemiology due to the high number of unknowns of this new disease. Thus, the empirical approach has emerged as a robust tool to analyze the actual situation carried by the countries and also allows us to predict the incoming scenarios. In this paper, we propose three empirical indexes to estimate the state of the pandemic. These indexes quantify both the propagation and the number of estimated cases, allowing us to accurately determine the real risk of a country. We have calculated these indexes' evolution for several European countries. Risk diagrams are introduced as a tool to visualize the evolution of a country and evaluate its current risk as a function of the number of contagious individuals and the empiric reproduction number. Risk diagrams at the regional level are useful to observe heterogeneity on COVID-19 penetration and spreading in some countries, which is essential during deconfinement processes. During the pandemic, there have been significant differences seen in countries reporting case criterion and detection capacity. Therefore, we have introduced estimations about the real number of infectious cases that allows us to have a broader view and to better estimate the risk. These diagrams and indexes have been successfully used for the monitoring of European countries and regions during the COVID-19 pandemic.


Subject(s)
COVID-19 , Pandemics , Europe , Humans , SARS-CoV-2
9.
Front Public Health ; 9: 693956, 2021.
Article in English | MEDLINE | ID: covidwho-1320593

ABSTRACT

Monitoring transmission is a prerequisite for containing COVID-19. We report on effective potential growth (EPG) as a novel measure for the early identification of local outbreaks based on primary care electronic medical records (EMR) and PCR-confirmed cases. Secondly, we studied whether increasing EPG precedes local hospital and intensive care (ICU) admissions and mortality. Population-based cohort including all Catalan citizens' PCR tests, hospitalization, intensive care (ICU) and mortality between 1/07/2020 and 13/09/2020; linked EMR covering 88.6% of the Catalan population was obtained. Nursing home residents were excluded. COVID-19 counts were ascertained based on EMR and PCRs separately. Weekly empirical propagation (ρ7) and 14-day cumulative incidence (A14) and 95% confidence intervals were estimated at care management area (CMA) level, and combined as EPG = ρ7 × A14. Overall, 7,607,201 and 6,798,994 people in 43 CMAs were included for PCR and EMR measures, respectively. A14, ρ7, and EPG increased in numerous CMAs during summer 2020. EMR identified 2.70-fold more cases than PCRs, with similar trends, a median (interquartile range) 2 (1) days earlier, and better precision. Upticks in EPG preceded increases in local hospital admissions, ICU occupancy, and mortality. Increasing EPG identified localized outbreaks in Catalonia, and preceded local hospital and ICU admissions and subsequent mortality. EMRs provided similar estimates to PCR, but some days earlier and with better precision. EPG is a useful tool for the monitoring of community transmission and for the early identification of COVID-19 local outbreaks.


Subject(s)
COVID-19 , Disease Outbreaks , Electronic Health Records , Humans , Primary Health Care , Prospective Studies , Real-Time Polymerase Chain Reaction , SARS-CoV-2 , Spain/epidemiology
10.
Sustainability ; 13(8):4242, 2021.
Article in English | MDPI | ID: covidwho-1178421

ABSTRACT

This article analyzes the monetary policy of major central banks during the economic crisis generated by the COVID-19 pandemic. Rising public debt in many countries is being financed through asset purchases by monetary authorities. Although these stimulus policies predate the pandemic, they have been significantly boosted as many governments face large financing needs. We have been in a low interest rate environment for years and some governments have issued debt securities at negative rates. In addition, the rise of decentralized cryptocurrencies, based on blockchain technology, has created greater competition in the international monetary system and many governments have considered the creation of centralized virtual currencies, known as central bank digital currencies (CBDCs). We will analyze some relevant cases, with an emphasis on the digital euro project. The methodology is based on the analysis of the evolution of monetary variables. Pearson’s correlation will be used to establish some relationships between them. There is a strong similarity in the expansionary monetary policies of central banks. Although the growth of the money supply has not been passed on to the CPI, it has been passed on to the financial markets and the price of assets such as Bitcoin or gold.

11.
PLoS One ; 16(1): e0243701, 2021.
Article in English | MEDLINE | ID: covidwho-1060187

ABSTRACT

Policymakers need clear, fast assessment of the real spread of the COVID-19 epidemic in each of their respective countries. Standard measures of the situation provided by the governments include reported positive cases and total deaths. While total deaths indicate immediately that countries like Italy and Spain had the worst situation as of mid-April, 2020, reported cases alone do not provide a complete picture of the situation. Different countries diagnose differently and present very distinctive reported case fatality ratios. Similar levels of reported incidence and mortality might hide a very different underlying pictures. Here we present a straightforward and robust estimation of the diagnostic rate in each European country. From that estimation we obtain a uniform, unbiased incidence of the epidemic. The method to obtain the diagnostic rate is transparent and empirical. The key assumption of the method is that the infection fatality ratio of COVID-19 in Europe is not strongly country-dependent. We show that this number is not expected to be biased due to demography nor to the way total deaths are reported. The estimation protocol is dynamic, and it has been yielding converging numbers for diagnostic rates in all European countries as from mid-April, 2020. Using this diagnostic rate, policy makers can obtain Effective Potential Growth updated every day, providing an unbiased assessment of the countries at greater risk of experiencing an uncontrolled situation. The method developed has been and will be used to track possible improvements in the diagnostic rate in European countries as the epidemic evolves.


Subject(s)
COVID-19/epidemiology , Basic Reproduction Number , COVID-19/diagnosis , COVID-19/mortality , COVID-19/prevention & control , Communicable Disease Control , Europe/epidemiology , European Union , Health Policy , Humans , Incidence
12.
PLoS One ; 16(1): e0243701, 2021.
Article in English | MEDLINE | ID: covidwho-1013207

ABSTRACT

Policymakers need clear, fast assessment of the real spread of the COVID-19 epidemic in each of their respective countries. Standard measures of the situation provided by the governments include reported positive cases and total deaths. While total deaths indicate immediately that countries like Italy and Spain had the worst situation as of mid-April, 2020, reported cases alone do not provide a complete picture of the situation. Different countries diagnose differently and present very distinctive reported case fatality ratios. Similar levels of reported incidence and mortality might hide a very different underlying pictures. Here we present a straightforward and robust estimation of the diagnostic rate in each European country. From that estimation we obtain a uniform, unbiased incidence of the epidemic. The method to obtain the diagnostic rate is transparent and empirical. The key assumption of the method is that the infection fatality ratio of COVID-19 in Europe is not strongly country-dependent. We show that this number is not expected to be biased due to demography nor to the way total deaths are reported. The estimation protocol is dynamic, and it has been yielding converging numbers for diagnostic rates in all European countries as from mid-April, 2020. Using this diagnostic rate, policy makers can obtain Effective Potential Growth updated every day, providing an unbiased assessment of the countries at greater risk of experiencing an uncontrolled situation. The method developed has been and will be used to track possible improvements in the diagnostic rate in European countries as the epidemic evolves.


Subject(s)
COVID-19/epidemiology , Basic Reproduction Number , COVID-19/diagnosis , COVID-19/mortality , COVID-19/prevention & control , Communicable Disease Control , Europe/epidemiology , European Union , Health Policy , Humans , Incidence
13.
PLoS Comput Biol ; 16(12): e1008431, 2020 12.
Article in English | MEDLINE | ID: covidwho-965902

ABSTRACT

The appearance and fast spreading of Covid-19 took the international community by surprise. Collaboration between researchers, public health workers, and politicians has been established to deal with the epidemic. One important contribution from researchers in epidemiology is the analysis of trends so that both the current state and short-term future trends can be carefully evaluated. Gompertz model has been shown to correctly describe the dynamics of cumulative confirmed cases, since it is characterized by a decrease in growth rate showing the effect of control measures. Thus, it provides a way to systematically quantify the Covid-19 spreading velocity and it allows short-term predictions and longer-term estimations. This model has been employed to fit the cumulative cases of Covid-19 from several European countries. Results show that there are systematic differences in spreading velocity among countries. The model predictions provide a reliable picture of the short-term evolution in countries that are in the initial stages of the Covid-19 outbreak, and may permit researchers to uncover some characteristics of the long-term evolution. These predictions can also be generalized to calculate short-term hospital and intensive care units (ICU) requirements.


Subject(s)
COVID-19 , Models, Statistical , COVID-19/epidemiology , COVID-19/transmission , Computational Biology , Europe , Humans , Public Health , SARS-CoV-2
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