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2.
SSRN; 2022.
Preprint in English | SSRN | ID: ppcovidwho-337967

ABSTRACT

Background: The ongoing Omicron wave of the COVID-19 pandemic has resulted in unprecedented levels of population transmission due to the variant’s high level of infectiousness. We have seen repeatedly that the epidemiological characteristics of new variants can have profound impacts on global health outcomes, and while the characteristics of these new variants are difficult to predict ahead of their emergence, considering the impact of potential future scenarios is of critical importance for planning and policy making. This paper samples across a range of potential variant-level characteristics to provide global forecasts of infections, hospitalisations, and deaths in the face of high (but waning) levels of past immunity, and evaluates a range of interventions that may diminish the impact of future waves. Methods: We created a susceptible-exposed-infectious dynamic model that accounts for vaccine uptake and effectiveness, new variants, and waning protection from both infection- and vaccine-derived immunity. Using this model, we first estimated past infections, hospitalisations, and deaths by variant, location, and day. We used these findings to more fully understand the global progression of the COVID-19 pandemic through May 31, 2022. Second, we forecasted these same outcome measures for five different scenarios based on future emergence of variants, and then four sub-scenarios within each potential variant scenario, to evaluate the impact of available intervention strategies through November 30, 2022. Findings: We estimated that from November 15, 2021, through May 31, 2022, there were 3.83 billion (95% uncertainty interval [UI] 2.99–4.67) SARS-CoV-2 infections, 10.4 million (8.26–13.4) hospitalisations, and 2.44 million (2.06–2.89) deaths, the majority of which were attributable to the Omicron variant (96.3% (92.5-97.6) of infections, 74.7% (59.7-82.3) of hospitalisations, and 61.9% (46.9-67.8) of deaths). Compared to the pre-Omicron pandemic period from January 1, 2020, to November 14, 2021, we estimated that there were approximately the same number of infections globally from November 15, 2021, to May 31, 2022, but only 23.6% (18.0-25.9) of the estimated deaths. The massive Omicron wave and relatively high vaccination rates in many high-income countries have together contributed to high levels of partial or full immunity against SARS-CoV-2 infection, leaving only 4.48% (3.15–6.21) of the global population with no protection as of May 31, 2022. Under the future scenario we consider most plausible (a scenario with a new Omicron-like variant emerging and reference levels of the drivers of transmission), we estimated there will be an additional 3.45 billion (1.67–5.34) infections, 3.57 million (1.69–6.33) hospitalisations, and 816,000 (367,000–1,420,000) deaths between June 1, 2022, and November 30, 2022, with the Americas and European WHO regions projected to sustain the highest rates of additional deaths. If we consider a variant that combines the high infectiousness of Omicron with the high severity of Delta, we again estimate 3.45 billion (1.67–5.34) new infections, but due to the presumed increase in severe outcomes, we estimate 4.62 million (1.47– 8.61) deaths over the forecasted period. We estimate that resumed mask usage (to 80% of the population in each location, or the current level, whichever is higher) would, on average, reduce the number of deaths by at least 50% across all the potential variant futures we considered, while a delayed but eventual global scale-up of antivirals would reduce deaths, on average, by at least 20% across variant scenarios. Interpretation: As infection-derived and conferred protection wanes, we expect infections to rise, but given the large proportion of the population that had some level of immunity to SARS-CoV-2 as of June 1, 2022, all but the most pessimistic forecasts in this analysis do not predict a massive global surge by November 30, 2022. All signs point towards COVID-19 transitioning into a more endemic transmission regime (lower, but sustained disease burden), and with the introduction and proliferation of novel therapeutic interventions expected in mid- to late 2022, the likelihood of returning to past levels of COVID-19 mortality is low. The characteristics of future COVID-19 variants are difficult to predict, and our forecasts do show some considerable variation in outcomes as a function of variant properties. Given the uncertainty surrounding what type of variant will next emerge, we must remain vigilant as we move to the next phase of the COVID-19 pandemic. Despite the very important role of vaccines and the potential role of new therapeutics, the contribution of mask usage to the prevention of infection and death cannot be understated. Masks are a simple and effective COVID-19 reduction strategy that—under a scenario in which an Omicron-like variant emerges on approximately June 1, 2022—could prevent about 433,000 deaths (223,000–712,130) between June 1 and November 30, 2022, if worn universally. Under our worst-case variant scenario, high mask use could prevent an estimated 2.33 million (0.836–4.08) deaths.

3.
Wulf Hanson, Sarah, Abbafati, Cristiana, Aerts, Joachim, Al-Aly, Ziyad, Ashbaugh, Charlie, Ballouz, Tala, Blyuss, Oleg, Bobkova, Polina, Bonsel, Gouke, Borzakova, Svetlana, Buonsenso, Danilo, Butnaru, Denis, Carter, Austin, Chu, Helen, De Rose, Cristina, Diab, Mohamed Mustafa, Ekbom, Emil, El Tantawi, Maha, Fomin, Victor, Frithiof, Robert, Gamirova, Aysylu, Glybochko, Petr, Haagsma, Juanita, Javanmard, Shaghayegh Haghjooy, Hamilton, Erin, Harris, Gabrielle, Heijenbrok-Kal, Majanka, Helbok, Raimund, Hellemons, Merel, Hillus, David, Huijts, Susanne, Hultström, Michael, Jassat, Waasila, Kurth, Florian, Larsson, Ing-Marie, Lipcsey, Miklós, Liu, Chelsea, Loflin, Callan, Malinovschi, Andrei, Mao, Wenhui, Mazankova, Lyudmila, McCulloch, Denise, Menges, Dominik, Mohammadifard, Noushin, Munblit, Daniel, Nekliudov, Nikita, Ogbuoji, Osondu, Osmanov, Ismail, Peñalvo, José, Petersen, Maria Skaalum, Puhan, Milo, Rahman, Mujibur, Rass, Verena, Reinig, Nickolas, Ribbers, Gerard, Ricchiuto, Antonia, Rubertsson, Sten, Samitova, Elmira, Sarrafzadegan, Nizal, Shikhaleva, Anastasia, Simpson, Kyle, Sinatti, Dario, Soriano, Joan, Spiridonova, Ekaterina, Steinbeis, Fridolin, Svistunov, Andrey, Valentini, Piero, van de Water, Brittney, van den Berg-Emons, Rita, Wallin, Ewa, Witzenrath, Martin, Wu, Yifan, Xu, Hanzhang, Zoller, Thomas, Adolph, Christopher, Albright, James, Amlag, Joanne, Aravkin, Aleksandr, Bang-Jensen, Bree, Bisignano, Catherine, Castellano, Rachel, Castro, Emma, Chakrabarti, Suman, Collins, James, Dai, Xiaochen, Daoud, Farah, Dapper, Carolyn, Deen, Amanda, Duncan, Bruce, Erickson, Megan, Ewald, Samuel, Ferrari, Alize, Flaxman, Abraham, Fullman, Nancy, Gamkrelidze, Amiran, Giles, John, Guo, Gaorui, Hay, Simon, He, Jiawei, Helak, Monika, Hulland, Erin, Kereselidze, Maia, Krohn, Kris, Lazzar-Atwood, Alice, Lindstrom, Akiaja, Lozano, Rafael, Magistro, Beatrice, Malta, Deborah Carvalho, Månsson, Johan, Mantilla Herrera, Ana, Mokdad, Ali, Monasta, Lorenzo, Nomura, Shuhei, Pasovic, Maja, Pigott, David, Reiner, Robert, Reinke, Grace, Ribeiro, Antonio Luiz, Santomauro, Damian Francesco, Sholokhov, Aleksei, Spurlock, Emma Elizabeth, Walcott, Rebecca, Walker, Ally, Wiysonge, Charles Shey, Zheng, Peng, Bettger, Janet Prvu, Murray, Christopher J. L.; Vos, Theo.
EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-337680

ABSTRACT

Importance While much of the attention on the COVID-19 pandemic was directed at the daily counts of cases and those with serious disease overwhelming health services, increasingly, reports have appeared of people who experience debilitating symptoms after the initial infection. This is popularly known as long COVID. Objective To estimate by country and territory of the number of patients affected by long COVID in 2020 and 2021, the severity of their symptoms and expected pattern of recovery Design We jointly analyzed ten ongoing cohort studies in ten countries for the occurrence of three major symptom clusters of long COVID among representative COVID cases. The defining symptoms of the three clusters (fatigue, cognitive problems, and shortness of breath) are explicitly mentioned in the WHO clinical case definition. For incidence of long COVID, we adopted the minimum duration after infection of three months from the WHO case definition. We pooled data from the contributing studies, two large medical record databases in the United States, and findings from 44 published studies using a Bayesian meta-regression tool. We separately estimated occurrence and pattern of recovery in patients with milder acute infections and those hospitalized. We estimated the incidence and prevalence of long COVID globally and by country in 2020 and 2021 as well as the severity-weighted prevalence using disability weights from the Global Burden of Disease study. Results Analyses are based on detailed information for 1906 community infections and 10526 hospitalized patients from the ten collaborating cohorts, three of which included children. We added published data on 37262 community infections and 9540 hospitalized patients as well as ICD-coded medical record data concerning 1.3 million infections. Globally, in 2020 and 2021, 144.7 million (95% uncertainty interval [UI] 54.8–312.9) people suffered from any of the three symptom clusters of long COVID. This corresponds to 3.69% (1.38–7.96) of all infections. The fatigue, respiratory, and cognitive clusters occurred in 51.0% (16.9–92.4), 60.4% (18.9–89.1), and 35.4% (9.4–75.1) of long COVID cases, respectively. Those with milder acute COVID-19 cases had a quicker estimated recovery (median duration 3.99 months [IQR 3.84–4.20]) than those admitted for the acute infection (median duration 8.84 months [IQR 8.10–9.78]). At twelve months, 15.1% (10.3–21.1) continued to experience long COVID symptoms. Conclusions and relevance The occurrence of debilitating ongoing symptoms of COVID-19 is common. Knowing how many people are affected, and for how long, is important to plan for rehabilitative services and support to return to social activities, places of learning, and the workplace when symptoms start to wane. Key Points Question What are the extent and nature of the most common long COVID symptoms by country in 2020 and 2021? Findings Globally, 144.7 million people experienced one or more of three symptom clusters (fatigue;cognitive problems;and ongoing respiratory problems) of long COVID three months after infection, in 2020 and 2021. Most cases arose from milder infections. At 12 months after infection, 15.1% of these cases had not yet recovered. Meaning The substantial number of people with long COVID are in need of rehabilitative care and support to transition back into the workplace or education when symptoms start to wane.

4.
Lancet ; 398(10301): 685-697, 2021 08 21.
Article in English | MEDLINE | ID: covidwho-1815297

ABSTRACT

BACKGROUND: Associations between high and low temperatures and increases in mortality and morbidity have been previously reported, yet no comprehensive assessment of disease burden has been done. Therefore, we aimed to estimate the global and regional burden due to non-optimal temperature exposure. METHODS: In part 1 of this study, we linked deaths to daily temperature estimates from the ERA5 reanalysis dataset. We modelled the cause-specific relative risks for 176 individual causes of death along daily temperature and 23 mean temperature zones using a two-dimensional spline within a Bayesian meta-regression framework. We then calculated the cause-specific and total temperature-attributable burden for the countries for which daily mortality data were available. In part 2, we applied cause-specific relative risks from part 1 to all locations globally. We combined exposure-response curves with daily gridded temperature and calculated the cause-specific burden based on the underlying burden of disease from the Global Burden of Diseases, Injuries, and Risk Factors Study, for the years 1990-2019. Uncertainty from all components of the modelling chain, including risks, temperature exposure, and theoretical minimum risk exposure levels, defined as the temperature of minimum mortality across all included causes, was propagated using posterior simulation of 1000 draws. FINDINGS: We included 64·9 million individual International Classification of Diseases-coded deaths from nine different countries, occurring between Jan 1, 1980, and Dec 31, 2016. 17 causes of death met the inclusion criteria. Ischaemic heart disease, stroke, cardiomyopathy and myocarditis, hypertensive heart disease, diabetes, chronic kidney disease, lower respiratory infection, and chronic obstructive pulmonary disease showed J-shaped relationships with daily temperature, whereas the risk of external causes (eg, homicide, suicide, drowning, and related to disasters, mechanical, transport, and other unintentional injuries) increased monotonically with temperature. The theoretical minimum risk exposure levels varied by location and year as a function of the underlying cause of death composition. Estimates for non-optimal temperature ranged from 7·98 deaths (95% uncertainty interval 7·10-8·85) per 100 000 and a population attributable fraction (PAF) of 1·2% (1·1-1·4) in Brazil to 35·1 deaths (29·9-40·3) per 100 000 and a PAF of 4·7% (4·3-5·1) in China. In 2019, the average cold-attributable mortality exceeded heat-attributable mortality in all countries for which data were available. Cold effects were most pronounced in China with PAFs of 4·3% (3·9-4·7) and attributable rates of 32·0 deaths (27·2-36·8) per 100 000 and in New Zealand with 3·4% (2·9-3·9) and 26·4 deaths (22·1-30·2). Heat effects were most pronounced in China with PAFs of 0·4% (0·3-0·6) and attributable rates of 3·25 deaths (2·39-4·24) per 100 000 and in Brazil with 0·4% (0·3-0·5) and 2·71 deaths (2·15-3·37). When applying our framework to all countries globally, we estimated that 1·69 million (1·52-1·83) deaths were attributable to non-optimal temperature globally in 2019. The highest heat-attributable burdens were observed in south and southeast Asia, sub-Saharan Africa, and North Africa and the Middle East, and the highest cold-attributable burdens in eastern and central Europe, and central Asia. INTERPRETATION: Acute heat and cold exposure can increase or decrease the risk of mortality for a diverse set of causes of death. Although in most regions cold effects dominate, locations with high prevailing temperatures can exhibit substantial heat effects far exceeding cold-attributable burden. Particularly, a high burden of external causes of death contributed to strong heat impacts, but cardiorespiratory diseases and metabolic diseases could also be substantial contributors. Changes in both exposures and the composition of causes of death drove changes in risk over time. Steady increases in exposure to the risk of high temperature are of increasing concern for health. FUNDING: Bill & Melinda Gates Foundation.


Subject(s)
Cause of Death/trends , Cold Temperature/adverse effects , Global Burden of Disease/statistics & numerical data , Global Health/statistics & numerical data , Hot Temperature/adverse effects , Mortality/trends , Bayes Theorem , Heart Diseases/epidemiology , Humans , Metabolic Diseases/epidemiology
5.
Lancet ; 399(10344): 2381-2397, 2022 06 25.
Article in English | MEDLINE | ID: covidwho-1713034

ABSTRACT

BACKGROUND: Gender is emerging as a significant factor in the social, economic, and health effects of COVID-19. However, most existing studies have focused on its direct impact on health. Here, we aimed to explore the indirect effects of COVID-19 on gender disparities globally. METHODS: We reviewed publicly available datasets with information on indicators related to vaccine hesitancy and uptake, health care services, economic and work-related concerns, education, and safety at home and in the community. We used mixed effects regression, Gaussian process regression, and bootstrapping to synthesise all data sources. We accounted for uncertainty in the underlying data and modelling process. We then used mixed effects logistic regression to explore gender gaps globally and by region. FINDINGS: Between March, 2020, and September, 2021, women were more likely to report employment loss (26·0% [95% uncertainty interval 23·8-28·8, by September, 2021) than men (20·4% [18·2-22·9], by September, 2021), as well as forgoing work to care for others (ratio of women to men: 1·8 by March, 2020, and 2·4 by September, 2021). Women and girls were 1·21 times (1·20-1·21) more likely than men and boys to report dropping out of school for reasons other than school closures. Women were also 1·23 (1·22-1·23) times more likely than men to report that gender-based violence had increased during the pandemic. By September 2021, women and men did not differ significantly in vaccine hesitancy or uptake. INTERPRETATION: The most significant gender gaps identified in our study show intensified levels of pre-existing widespread inequalities between women and men during the COVID-19 pandemic. Political and social leaders should prioritise policies that enable and encourage women to participate in the labour force and continue their education, thereby equipping and enabling them with greater ability to overcome the barriers they face. FUNDING: The Bill & Melinda Gates Foundation.


Subject(s)
COVID-19 , COVID-19/epidemiology , COVID-19/prevention & control , Educational Status , Employment , Female , Gender Equity , Humans , Male , Pandemics/prevention & control
6.
J Epidemiol Community Health ; 2022 Jan 19.
Article in English | MEDLINE | ID: covidwho-1629386

ABSTRACT

BACKGROUND: Over the last 30 years, South Africa has experienced four 'colliding epidemics' of HIV and tuberculosis, chronic illness and mental health, injury and violence, and maternal, neonatal, and child mortality, which have had substantial effects on health and well-being. Using data from the 2019 Global Burden of Diseases, Injuries and Risk Factors Study (GBD 2019), we evaluated national and provincial health trends and progress towards important Sustainable Development Goal targets from 1990 to 2019. METHODS: We analysed GBD 2019 estimates of mortality, non-fatal health loss, summary health measures and risk factor burden, comparing trends over 1990-2007 and 2007-2019. Additionally, we decomposed changes in life expectancy by cause of death and assessed healthcare system performance. RESULTS: Across the nine provinces, inequalities in mortality and life expectancy increased over 1990-2007, largely due to differences in HIV/AIDS, then decreased over 2007-2019. Demographic change and increases in non-communicable diseases nearly doubled the number of years lived with disability between 1990 and 2019. From 1990 to 2019, risk factor burdens generally shifted from communicable and nutritional disease risks to non-communicable disease and injury risks; unsafe sex remained the top risk factor. Despite widespread improvements in healthcare system performance, the greatest gains were generally in economically advantaged provinces. CONCLUSIONS: Reductions in HIV/AIDS and related conditions have led to improved health since 2007, though most provinces still lag in key areas. To achieve health targets, provincial governments should enhance health investments and exchange of knowledge, resources and best practices alongside populations that have been left behind, especially following the COVID-19 pandemic.

7.
Lancet ; 399(10323): 417-419, 2022 01 29.
Article in English | MEDLINE | ID: covidwho-1625553
8.
JAMA ; 326(7): 649-659, 2021 08 17.
Article in English | MEDLINE | ID: covidwho-1359741

ABSTRACT

Importance: Measuring health care spending by race and ethnicity is important for understanding patterns in utilization and treatment. Objective: To estimate, identify, and account for differences in health care spending by race and ethnicity from 2002 through 2016 in the US. Design, Setting, and Participants: This exploratory study included data from 7.3 million health system visits, admissions, or prescriptions captured in the Medical Expenditure Panel Survey (2002-2016) and the Medicare Current Beneficiary Survey (2002-2012), which were combined with the insured population and notified case estimates from the National Health Interview Survey (2002; 2016) and health care spending estimates from the Disease Expenditure project (1996-2016). Exposure: Six mutually exclusive self-reported race and ethnicity groups. Main Outcomes and Measures: Total and age-standardized health care spending per person by race and ethnicity for each year from 2002 through 2016 by type of care. Health care spending per notified case by race and ethnicity for key diseases in 2016. Differences in health care spending across race and ethnicity groups were decomposed into differences in utilization rate vs differences in price and intensity of care. Results: In 2016, an estimated $2.4 trillion (95% uncertainty interval [UI], $2.4 trillion-$2.4 trillion) was spent on health care across the 6 types of care included in this study. The estimated age-standardized total health care spending per person in 2016 was $7649 (95% UI, $6129-$8814) for American Indian and Alaska Native (non-Hispanic) individuals; $4692 (95% UI, $4068-$5202) for Asian, Native Hawaiian, and Pacific Islander (non-Hispanic) individuals; $7361 (95% UI, $6917-$7797) for Black (non-Hispanic) individuals; $6025 (95% UI, $5703-$6373) for Hispanic individuals; $9276 (95% UI, $8066-$10 601) for individuals categorized as multiple races (non-Hispanic); and $8141 (95% UI, $8038-$8258) for White (non-Hispanic) individuals, who accounted for an estimated 72% (95% UI, 71%-73%) of health care spending. After adjusting for population size and age, White individuals received an estimated 15% (95% UI, 13%-17%; P < .001) more spending on ambulatory care than the all-population mean. Black (non-Hispanic) individuals received an estimated 26% (95% UI, 19%-32%; P < .001) less spending than the all-population mean on ambulatory care but received 19% (95% UI, 3%-32%; P = .02) more on inpatient and 12% (95% UI, 4%-24%; P = .04) more on emergency department care. Hispanic individuals received an estimated 33% (95% UI, 26%-37%; P < .001) less spending per person on ambulatory care than the all-population mean. Asian, Native Hawaiian, and Pacific Islander (non-Hispanic) individuals received less spending than the all-population mean on all types of care except dental (all P < .001), while American Indian and Alaska Native (non-Hispanic) individuals had more spending on emergency department care than the all-population mean (estimated 90% more; 95% UI, 11%-165%; P = .04), and multiple-race (non-Hispanic) individuals had more spending on emergency department care than the all-population mean (estimated 40% more; 95% UI, 19%-63%; P = .006). All 18 of the statistically significant race and ethnicity spending differences by type of care corresponded with differences in utilization. These differences persisted when controlling for underlying disease burden. Conclusions and Relevance: In the US from 2002 through 2016, health care spending varied by race and ethnicity across different types of care even after adjusting for age and health conditions. Further research is needed to determine current health care spending by race and ethnicity, including spending related to the COVID-19 pandemic.


Subject(s)
/statistics & numerical data , Health Expenditures/statistics & numerical data , Healthcare Disparities/ethnology , /statistics & numerical data , Health Care Surveys , Humans , United States
9.
BMJ Glob Health ; 6(8)2021 08.
Article in English | MEDLINE | ID: covidwho-1356932

ABSTRACT

INTRODUCTION: As the world responds to COVID-19 and aims for the Sustainable Development Goals, the potential for primary healthcare (PHC) is substantial, although the trends and effectiveness of PHC expenditure are unknown. We estimate PHC expenditure for each low-income and middle-income country between 2000 and 2017 and test which health outputs and outcomes were associated with PHC expenditure. METHODS: We used three data sources to estimate PHC expenditures: recently published health expenditure estimates for each low-income and middle-income country, which were constructed using 1662 country-reported National Health Accounts; proprietary data from IQVIA to estimate expenditure of prescribed pharmaceuticals for PHC; and household surveys and costing estimates to estimate inpatient vaginal delivery expenditures. We employed regression analyses to measure the association between PHC expenditures and 15 health outcomes and intermediate health outputs. RESULTS: PHC expenditures in low-income and middle-income countries increased between 2000 and 2017, from $41 per capita (95% uncertainty interval $33-$49) to $90 ($73-$105). Expenditures for low-income countries plateaued since 2014 at $17 per capita ($15-$19). As national income increased, the proportion of health expenditures on PHC generally decrease; however, the fraction of PHC expenditures spent via ambulatory care providers grew. Increases in the fraction of health expenditures on PHC was associated with lower maternal mortality rate (p value≤0.001), improved coverage of antenatal care visits (p value≤0.001), measles vaccination (p value≤0.001) and an increase in the Health Access and Quality index (p value≤0.05). PHC expenditure was not systematically associated with all-age mortality, communicable and non-communicable disease (NCD) burden. CONCLUSION: PHC expenditures were associated with maternal and child health but were not associated with reduction in health burden for other key causes of disability, such as NCDs. To combat changing disease burdens, policy-makers and health professionals need to adapt primary healthcare to ensure continued impact on emerging health challenges.


Subject(s)
COVID-19 , Health Expenditures , Child , Developing Countries , Female , Humans , Pregnancy , Primary Health Care , SARS-CoV-2
11.
Nat Commun ; 12(1): 2609, 2021 05 10.
Article in English | MEDLINE | ID: covidwho-1223089

ABSTRACT

Forecasts and alternative scenarios of COVID-19 mortality have been critical inputs for pandemic response efforts, and decision-makers need information about predictive performance. We screen n = 386 public COVID-19 forecasting models, identifying n = 7 that are global in scope and provide public, date-versioned forecasts. We examine their predictive performance for mortality by weeks of extrapolation, world region, and estimation month. We additionally assess prediction of the timing of peak daily mortality. Globally, models released in October show a median absolute percent error (MAPE) of 7 to 13% at six weeks, reflecting surprisingly good performance despite the complexities of modelling human behavioural responses and government interventions. Median absolute error for peak timing increased from 8 days at one week of forecasting to 29 days at eight weeks and is similar for first and subsequent peaks. The framework and public codebase ( https://github.com/pyliu47/covidcompare ) can be used to compare predictions and evaluate predictive performance going forward.


Subject(s)
COVID-19/mortality , Models, Statistical , Forecasting , Humans , SARS-CoV-2 , Time Factors
12.
JAMA ; 325(13):1249, 2021.
Article in English | ProQuest Central | ID: covidwho-1190876

ABSTRACT

This Viewpoint discusses the prospect that COVID-19 could become a recurrent seasonal disease like influenza and proposes strategies to mitigate the consequences for communities and health systems, including changes in surveillance, medical and public health response, and socioeconomic programs.

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