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1.
Commun Med (Lond) ; 2: 61, 2022.
Article in English | MEDLINE | ID: covidwho-1947556

ABSTRACT

Background: Public hesitancy towards Covid-19 vaccines remains a major hurdle for mass vaccination programs today. While mRNA vaccines are more efficacious than conventional vaccines, it is unknown how much the novelty of this technology increases hesitancy. Methods: We quantify this "novelty penalty" in a large online experiment with 35,173 adults in nine countries. Subjects were randomly selected and assigned to one of two vaccine groups (conventional or mRNA), and one of five hypothetical inoculation rate groups (0%, 20%, 40%, 60%, or 80%). Subjects reported their willingness to accept the Covid-19 vaccine on a five-point Likert scale. Results: The novelty of the mRNA vaccine technology reduces the odds of a higher level of vaccine acceptance by 14.2% (odds ratio 0.858; p < 0.001). On the other hand, we find that social conformity reduces vaccine hesitancy. At a 0% inoculation rate, 31.7% report that they are "very likely" to get a mRNA vaccine while at a 20% inoculation rate, willingness jumps to 49.6%. Conclusions: The novelty of the mRNA vaccine increases hesitancy, but social conformity reduces it. A small group of early adopters can provide momentum for vaccination.

2.
BMJ Glob Health ; 7(6)2022 06.
Article in English | MEDLINE | ID: covidwho-1909743
3.
Lancet ; 399(10326): 757-768, 2022 02 19.
Article in English | MEDLINE | ID: covidwho-1747476

ABSTRACT

Diagnostics have proven to be crucial to the COVID-19 pandemic response. There are three major methods for the detection of SARS-CoV-2 infection and their role has evolved during the course of the pandemic. Molecular tests such as PCR are highly sensitive and specific at detecting viral RNA, and are recommended by WHO for confirming diagnosis in individuals who are symptomatic and for activating public health measures. Antigen rapid detection tests detect viral proteins and, although they are less sensitive than molecular tests, have the advantages of being easier to do, giving a faster time to result, of being lower cost, and able to detect infection in those who are most likely to be at risk of transmitting the virus to others. Antigen rapid detection tests can be used as a public health tool for screening individuals at enhanced risk of infection, to protect people who are clinically vulnerable, to ensure safe travel and the resumption of schooling and social activities, and to enable economic recovery. With vaccine roll-out, antibody tests (which detect the host's response to infection or vaccination) can be useful surveillance tools to inform public policy, but should not be used to provide proof of immunity, as the correlates of protection remain unclear. All three types of COVID-19 test continue to have a crucial role in the transition from pandemic response to pandemic control.


Subject(s)
COVID-19 Testing/trends , COVID-19/diagnosis , Communicable Disease Control/organization & administration , Mass Screening/organization & administration , Pandemics/prevention & control , Antibodies, Viral/blood , Antigens, Viral/isolation & purification , COVID-19/epidemiology , COVID-19/transmission , COVID-19/virology , COVID-19 Testing/methods , COVID-19 Vaccines/administration & dosage , Communicable Disease Control/methods , Communicable Disease Control/trends , Humans , Mass Screening/trends , RNA, Viral/isolation & purification , SARS-CoV-2/genetics , SARS-CoV-2/immunology , SARS-CoV-2/isolation & purification
6.
Ann Acad Med Singap ; 49(8): 561-572, 2020 08.
Article in English | MEDLINE | ID: covidwho-934777

ABSTRACT

Singapore, an island country with 5.6 million population and a large volume of tourists from mainland China, was one of the first countries to report imported COVID-19 cases and had the highest number of cases outside mainland China for a time in February 2020. The government responded with a series of broadscale public health measures and managed to contain this first wave of infection. Notwithstanding that, an evolving pandemic situation in other countries eventually triggered a second, and much larger, wave of infection. This case study narrates the developments, influencing factors, and outcomes related to events starting from Singapore's first response to COVID-19 and up to the point of its entry into Circuit Breaker. It serves as a reference for the understanding and analysis of developments in an evolving pandemic and a nation's response from a systems level perspective.


Subject(s)
Betacoronavirus , Communicable Disease Control/organization & administration , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , COVID-19 , Coronavirus Infections/transmission , Humans , Pneumonia, Viral/transmission , SARS-CoV-2 , Singapore/epidemiology
7.
Annals Academy of Medicine Singapore ; 49(8):561-572, 2020.
Article in English | Web of Science | ID: covidwho-911155

ABSTRACT

Singapore, an island country with 5 6 million population and a large volume of tourists from mainland China, was one of the first countries to report imported COVID-19 cases and had the highest number of cases outside mainland China for a time in February 2020. The government responded with a series of broadscale public health measures and managed to contain this first wave of infection. Notwithstanding that, an evolving pandemic situation in other countries eventually triggered a second, and much larger, wave of infection. This case study narrates the developments, influencing factors, and outcomes related to events starting from Singapore's first response to COVID-19 and up to the point of its entry into Circuit Breaker. It serves as a reference for the understanding and analysis of developments in an evolving pandemic and a nation's response from a systems level perspective.

8.
Lancet ; 396(10261): 1525-1534, 2020 11 07.
Article in English | MEDLINE | ID: covidwho-792249

ABSTRACT

The COVID-19 pandemic is an unprecedented global crisis. Many countries have implemented restrictions on population movement to slow the spread of severe acute respiratory syndrome coronavirus 2 and prevent health systems from becoming overwhelmed; some have instituted full or partial lockdowns. However, lockdowns and other extreme restrictions cannot be sustained for the long term in the hope that there will be an effective vaccine or treatment for COVID-19. Governments worldwide now face the common challenge of easing lockdowns and restrictions while balancing various health, social, and economic concerns. To facilitate cross-country learning, this Health Policy paper uses an adapted framework to examine the approaches taken by nine high-income countries and regions that have started to ease COVID-19 restrictions: five in the Asia Pacific region (ie, Hong Kong [Special Administrative Region], Japan, New Zealand, Singapore, and South Korea) and four in Europe (ie, Germany, Norway, Spain, and the UK). This comparative analysis presents important lessons to be learnt from the experiences of these countries and regions. Although the future of the virus is unknown at present, countries should continue to share their experiences, shield populations who are at risk, and suppress transmission to save lives.


Subject(s)
Communicable Disease Control/economics , Communicable Disease Control/legislation & jurisprudence , Coronavirus Infections/prevention & control , Health Policy , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , COVID-19 , Commerce , Coronavirus Infections/economics , Coronavirus Infections/epidemiology , Europe , Far East , Humans , New Zealand , Pandemics/economics , Pneumonia, Viral/economics , Pneumonia, Viral/epidemiology
9.
BMJ Glob Health ; 5(9)2020 09.
Article in English | MEDLINE | ID: covidwho-772191

ABSTRACT

Singapore, one of the first countries affected by COVID-19, adopted a national strategy for the pandemic which emphasised preparedness through a whole-of-nation approach. The pandemic was well contained initially until early April 2020, when there was a surge in cases, attributed to Singapore residents returning from hotspots overseas, and more significantly, rapid transmission locally within migrant worker dormitories. In this paper, we present the response of Singapore to the COVID-19 pandemic based on core dimensions of health system resilience during outbreaks. We also discussed on the surge in cases in April 2020, highlighting efforts to mitigate it. There was: (1) clear leadership and governance which adopted flexible plans appropriate to the situation; (2) timely, accurate and transparent communication from the government; (3) public health measures to reduce imported cases, and detect as well as isolate cases early; (4) maintenance of health service delivery; (5) access to crisis financing; and (6) legal foundation to complement policy measures. Areas for improvement include understanding reasons for poor uptake of government initiatives, such as the mobile application for contact tracing and adopting a more inclusive response that protects all individuals, including at-risk populations. The experience in Singapore and lessons learnt will contribute to pandemic preparedness and mitigation in the future.


Subject(s)
Coronavirus Infections , Delivery of Health Care , Health Planning , Pandemics , Pneumonia, Viral , Betacoronavirus , COVID-19 , Coronavirus Infections/prevention & control , Coronavirus Infections/therapy , Humans , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Pneumonia, Viral/therapy , SARS-CoV-2 , Singapore , Transients and Migrants
12.
J Clin Med ; 9(3)2020 Feb 26.
Article in English | MEDLINE | ID: covidwho-2155

ABSTRACT

Rapid diagnostics, vaccines and therapeutics are important interventions for the management of the 2019 novel coronavirus (2019-nCoV) outbreak. It is timely to systematically review the potential of these interventions, including those for Middle East respiratory syndrome-Coronavirus (MERS-CoV) and severe acute respiratory syndrome (SARS)-CoV, to guide policymakers globally on their prioritization of resources for research and development. A systematic search was carried out in three major electronic databases (PubMed, Embase and Cochrane Library) to identify published studies in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Supplementary strategies through Google Search and personal communications were used. A total of 27 studies fulfilled the criteria for review. Several laboratory protocols for confirmation of suspected 2019-nCoV cases using real-time reverse transcription polymerase chain reaction (RT-PCR) have been published. A commercial RT-PCR kit developed by the Beijing Genomic Institute is currently widely used in China and likely in Asia. However, serological assays as well as point-of-care testing kits have not been developed but are likely in the near future. Several vaccine candidates are in the pipeline. The likely earliest Phase 1 vaccine trial is a synthetic DNA-based candidate. A number of novel compounds as well as therapeutics licensed for other conditions appear to have in vitro efficacy against the 2019-nCoV. Some are being tested in clinical trials against MERS-CoV and SARS-CoV, while others have been listed for clinical trials against 2019-nCoV. However, there are currently no effective specific antivirals or drug combinations supported by high-level evidence.

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