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1.
Eur J Epidemiol ; 36(12): 1247-1251, 2021 12.
Article in English | MEDLINE | ID: covidwho-1588774
2.
Preprint in English | EuropePMC | ID: ppcovidwho-295641

ABSTRACT

Background: There is continuing uncertainty about the effectiveness of testing, tracing, isolation, and quarantine (TTIQ) policies during the pandemic.<br><br>Methods: We developed proxy indicators of the implementation of TTIQ policies at subnational and national (Republic of Korea), and international level (111 countries) from the beginning of 2020 to September 2021. These were: proportion of quarantined population (“Q-proportion”) among newly diagnosed COVID-19 cases/week, ratio of quarantined people to cases, and ratio of negative tests to new cases, with higher values suggesting more complete TTIQ. We used linear regression to analyze the association between TTIQ indicators and 1-week lagged cases and cumulative deaths, separating periods before and after vaccines becoming available.<br><br>Findings: We found consistently inverse associations between TTIQ indicators and COVID-19 outcomes, with gradual attenuation as vaccination coverage rose. Q-proportion overall (β= -0·091;p -value < 0·001) and log-transformed quarantined population per case (β ranges from -0·626;p < 0.001 to -0·288;p = 0·023) in each of 9 provinces were negatively associated with log-transformed 1-week lagged incidence in Korea overall. The strength of association decreased with greater vaccination coverage. The ratio of negative test results/new case was also inversely associated with incidence (β= -1·19;p -value < 0·001) in Korea. Globally, increasing negative test ratio was significantly associated with lower cumulative cases and deaths per capita, more so earlier in the pandemic. Jurisdictions with lower vaccination coverage showed the strongest association.<br><br>Interpretation: A real-world evaluation demonstrates an association between performance of testing, contact tracing, isolation, and quarantine and better disease outcomes.<br><br>Funding Information: Ministry of Foreign Affairs, Republic of Korea. <br><br>Declaration of Interests: None to declare.

4.
National Bureau of Economic Research Working Paper Series ; No. 27282, 2020.
Article in English | NBER, Grey literature | ID: grc-748417

ABSTRACT

We provide an interim report on the Indian lockdown provoked by the covid-19 pandemic. The main topics — ranging from the philosophy of lockdown to the provision of relief measures — transcend the Indian case. A recurrent theme is the enormous visibility of covid-19 deaths worldwide, with Governments everywhere propelled to respect this visibility, developing countries perhaps even more so. In advanced economies, the cost of achieving this reduction in visible deaths is “merely” a dramatic reduction in overall economic activity, coupled with far-reaching measures to compensate those who bear such losses. But for India, a developing country with great sectoral and occupational vulnerabilities, this dramatic reduction is more than economic: it means lives lost. These lost lives, through violence, starvation, indebtedness and extreme stress (both psychological and physiological) are invisible. It is this conjunction of visibility and invisibility that drives the Indian response. The lockdown meets all international standards so far;the relief package none.

5.
National Bureau of Economic Research Working Paper Series ; No. 27696, 2020.
Article in English | NBER, Grey literature | ID: grc-748252

ABSTRACT

India’s case fatality rate (CFR) under covid-19 is strikingly low, trending from 3% or more, to a current level of around 2.2%. The world average rate is far higher, at around 4%. Several observers have noted that this difference is at least partly due to India’s younger age distribution. In this paper, we use age-specific fatality rates from 14 comparison countries, coupled with India’s distribution of covid-19 cases to “predict" what India’s CFR would be with those age-specific rates. In most cases, those predictions are lower than India’s actual performance, suggesting that India’s CFR is, if anything, too high rather than too low. We supplement the prediction exercises with the application of a decomposition technique, and we additionally account for time lags between case incidence and death, for a more relevant cross-country perspective in the growth phase of the pandemic.

8.
Development Studies Research ; 8(1):236-243, 2021.
Article in English | Scopus | ID: covidwho-1393118

ABSTRACT

It is widely acknowledged that the distribution of Covid cases and that of Covid deaths by age constitute a factor that deserves to be taken into account in assessing and comparing quantitative indicators of Covid-related mortality. The single most widely employed measure of Covid mortality is the so-called Case Fatality Rate (CFR), which is just the ratio of Covid deaths to Covid cases. The CFR is essentially a measure of central tendency. The present note outlines a procedure, drawing on the standard literature on income inequality, for deriving a measure of Covid mortality which supplements information on average mortality with information on its dispersion across a population’s age cohorts. © 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

10.
Sci Rep ; 11(1): 13717, 2021 07 02.
Article in English | MEDLINE | ID: covidwho-1294481

ABSTRACT

Most countries have implemented restrictions on mobility to prevent the spread of Coronavirus disease-19 (COVID-19), entailing considerable societal costs but, at least initially, based on limited evidence of effectiveness. We asked whether mobility restrictions were associated with changes in the occurrence of COVID-19 in 34 OECD countries plus Singapore and Taiwan. Our data sources were the Google Global Mobility Data Source, which reports different types of mobility, and COVID-19 cases retrieved from the dataset curated by Our World in Data. Beginning at each country's 100th case, and incorporating a 14-day lag to account for the delay between exposure and illness, we examined the association between changes in mobility (with January 3 to February 6, 2020 as baseline) and the ratio of the number of newly confirmed cases on a given day to the total number of cases over the past 14 days from the index day (the potentially infective 'pool' in that population), per million population, using LOESS regression and logit regression. In two-thirds of examined countries, reductions of up to 40% in commuting mobility (to workplaces, transit stations, retailers, and recreation) were associated with decreased cases, especially early in the pandemic. Once both mobility and incidence had been brought down, further restrictions provided little additional benefit. These findings point to the importance of acting early and decisively in a pandemic.


Subject(s)
COVID-19/prevention & control , Communicable Disease Control , COVID-19/epidemiology , Humans , Incidence , Pandemics/prevention & control , Transportation , Travel , Travel-Related Illness , Workplace
12.
Soc Sci Med ; 278: 113948, 2021 06.
Article in English | MEDLINE | ID: covidwho-1193481

ABSTRACT

We use county level data from the United States to document the role of social capital the evolution of COVID-19 between January 2020 and January 2021. We find that social capital differentials in COVID-19 deaths and hospitalizations depend on the dimension of social capital and the timeframe considered. Communities with higher levels of relational and cognitive social capital were especially successful in lowering COVID-19 deaths and hospitalizations than communities with lower social capital between late March and early April. A difference of one standard deviation in relational social capital corresponded to a reduction of 30% in the number of COVID-19 deaths recorded. After April 2020, differentials in COVID-19 deaths related to relational social capital persisted although they became progressively less pronounced. By contrast, the period of March-April 2020, our estimates suggest that there was no statistically significant difference in the number of deaths recorded in areas with different levels of cognitive social capital. In fact, from late June-early July onwards the number of new deaths recorded as being due to COVID-19 was higher in communities with higher levels of cognitive social capital. The overall number of deaths recorded between January 2020 and January 2021 was lower in communities with higher levels of relational social capital. Our findings suggest that the association between social capital and public health outcomes can vary greatly over time and across indicators of social capital.


Subject(s)
COVID-19 , Social Capital , Hospitalization , Humans , SARS-CoV-2 , United States/epidemiology
13.
JAMA Netw Open ; 4(4): e217373, 2021 04 01.
Article in English | MEDLINE | ID: covidwho-1171508

ABSTRACT

Importance: An accurate understanding of the distributional implications of public health policies is critical for ensuring equitable responses to the COVID-19 pandemic and future public health threats. Objective: To identify and quantify the association of race/ethnicity-based, sex-based, and income-based inequities of state-specific lockdowns with 6 well-being dimensions in the United States. Design, Setting, and Participants: This pooled, repeated cross-sectional study used data from 14 187 762 households who participated in phase 1 of the population-representative US 2020 Household Pulse Survey (HPS). Households were invited to participate by email, text message, and/or telephone as many as 3 times. Data were collected via an online questionnaire from April 23 to July 21, 2020, and participants lived in all 50 US states and the District of Columbia. Exposures: Indicators of race/ethnicity, sex, and income and their intersections. Main Outcomes and Measures: Unemployment; food insufficiency; mental health problems; no medical care received for health problems; default on last month's rent or mortgage; and class cancellations with no distance learning. Race/ethnicity, sex, income, and their intersections were used to measure distributional implications across historically marginalized populations; state-specific, time-varying population mobility was used to measure lockdown intensity. Logistic regression models with pooled repeated cross-sections were used to estimate risk of dichotomous outcomes by social group, adjusted for confounding variables. Results: The 1 088 314 respondents (561 570 [51.6%; 95% CI, 51.4%-51.9%] women) were aged 18 to 88 years (mean [SD], 51.55 [15.74] years), and 826 039 (62.8%; 95% CI, 62.5%-63.1%) were non-Hispanic White individuals; 86 958 (12.5%; 95% CI, 12.4%-12.7%), African American individuals; 86 062 (15.2%; 95% CI, 15.0%-15.4%), Hispanic individuals; and 50 227 (5.6%; 95% CI, 5.5%-5.7%), Asian individuals. On average, every 10% reduction in mobility was associated with higher odds of unemployment (odds ratio [OR], 1.3; 95% CI, 1.2-1.4), food insufficiency (OR, 1.1; 95% CI, 1.1-1.2), mental health problems (OR, 1.04; 95% CI, 1.0-1.1), and class cancellations (OR, 1.1; 95% CI, 1.1-1.2). Across most dimensions compared with White men with high income, African American individuals with low income experienced the highest risks (eg, food insufficiency, men: OR, 3.3; 95% CI, 2.8-3.7; mental health problems, women: OR, 1.9; 95% CI, 1.8-2.1; medical care inaccessibility, women: OR, 1.7; 95% CI, 1.6-1.9; unemployment, men: OR, 2.8; 95% CI, 2.5-3.2; rent/mortgage defaults, men: OR, 5.7; 95% CI, 4.7-7.1). Other high-risk groups were Hispanic individuals (eg, unemployment, Hispanic men with low income: OR, 2.9; 95% CI, 2.5-3.4) and women with low income across all races/ethnicities (eg, medical care inaccessibility, non-Hispanic White women: OR, 1.8; 95% CI, 1.7-2.0). Conclusions and Relevance: In this cross-sectional study, African American and Hispanic individuals, women, and households with low income had higher odds of experiencing adverse outcomes associated with the COVID-19 pandemic and stay-at-home orders. Blanket public health policies ignoring existing distributions of risk to well-being may be associated with increased race/ethnicity-based, sex-based, and income-based inequities.


Subject(s)
COVID-19 , Communicable Disease Control/statistics & numerical data , Income/statistics & numerical data , Sex Factors , Adolescent , Adult , Aged , Aged, 80 and over , Cross-Sectional Studies , Family Characteristics , Female , Food Security/statistics & numerical data , Health Status Disparities , Humans , Male , Middle Aged , SARS-CoV-2 , Unemployment/statistics & numerical data , United States , Young Adult
14.
J Intern Med ; 289(1): 97-115, 2021 01.
Article in English | MEDLINE | ID: covidwho-1153555

ABSTRACT

BACKGROUND: SARS-CoV-2 coronavirus infection ranges from asymptomatic through to fatal COVID-19 characterized by a 'cytokine storm' and lung failure. Vitamin D deficiency has been postulated as a determinant of severity. OBJECTIVES: To review the evidence relevant to vitamin D and COVID-19. METHODS: Narrative review. RESULTS: Regression modelling shows that more northerly countries in the Northern Hemisphere are currently (May 2020) showing relatively high COVID-19 mortality, with an estimated 4.4% increase in mortality for each 1 degree latitude north of 28 degrees North (P = 0.031) after adjustment for age of population. This supports a role for ultraviolet B acting via vitamin D synthesis. Factors associated with worse COVID-19 prognosis include old age, ethnicity, male sex, obesity, diabetes and hypertension and these also associate with deficiency of vitamin D or its response. Vitamin D deficiency is also linked to severity of childhood respiratory illness. Experimentally, vitamin D increases the ratio of angiotensin-converting enzyme 2 (ACE2) to ACE, thus increasing angiotensin II hydrolysis and reducing subsequent inflammatory cytokine response to pathogens and lung injury. CONCLUSIONS: Substantial evidence supports a link between vitamin D deficiency and COVID-19 severity but it is all indirect. Community-based placebo-controlled trials of vitamin D supplementation may be difficult. Further evidence could come from study of COVID-19 outcomes in large cohorts with information on prescribing data for vitamin D supplementation or assay of serum unbound 25(OH) vitamin D levels. Meanwhile, vitamin D supplementation should be strongly advised for people likely to be deficient.


Subject(s)
Angiotensin-Converting Enzyme 2/metabolism , COVID-19/ethnology , SARS-CoV-2 , Thrombosis/etiology , Vitamin D Deficiency/ethnology , COVID-19/metabolism , Comorbidity , Global Health , Humans , Risk Factors , Thrombosis/ethnology , Thrombosis/metabolism , Vitamin D Deficiency/metabolism
15.
Lancet Global Health ; 8(12):E1464-E1464, 2020.
Article in English | Web of Science | ID: covidwho-1061704
16.
Journal of Human Development and Capabilities ; : 1-25, 2020.
Article in English | Taylor & Francis | ID: covidwho-1010267
17.
International Journal of Research in Pharmaceutical Sciences ; 11(Special Issue 1):1105-1109, 2020.
Article in English | EMBASE | ID: covidwho-995035

ABSTRACT

In past few years, multiple new viral diseases like SARS,MARS and Ebola are emerging all over the world. Due to global warming and pollution, people are becoming more susceptible to all infectious diseases. Recurrent mutations in these viruses make it difficult to create vaccine. So again there is need of safer and natural remedies which can help to sustain health of the present world and which can be used without potential hazards. The recent pandemic of Covid 19 is one of the example of a global crisis emerged by SARS-CoV-2 virus. It is causing acute as well as silent chronic damage to various systems in human body. Neem (Azadiracta indica) is found to have following properties as per various studies-It has Broad spectrum antiviral, antibacterial, antifun-gal, antiretroviral and antimalerial effect. It has proinflammatory cytokine inhibitor and immunomodulator effect. It has hepatoprotective and antioxi-dant effect. It has thrombolytic properties. It has ACE inhibitor action. As per its docking study, it has high inhibition against COVID-19 Main Protease. As Covid 19 is responsible for severe cytokine storm induced complications and coagulopathies, the Neem can be useful as a single Silver bullet in Covid 19 in both prophylactic and curative aspect. It can even be helpful in post Covid complications.

19.
International Journal of Nutrition, Pharmacology, Neurological Diseases ; 10(3):166-167, 2020.
Article in English | EMBASE | ID: covidwho-918298
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