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1.
Ethnography ; : 14661381221100532, 2022.
Article in English | Sage | ID: covidwho-1862022

ABSTRACT

Following the COVID-19 pandemic, migration was framed in Italy as ?the emergency within the emergency?, leading the Italian Government to declare that its ports were not ??safe places? for people rescued from boats flying a foreign flag to disembark.? As a result, under this guise of health and safety, in Italy migrants are now held in cruise ships repurposed as quarantine-ships for their sanitary isolation. We take this space as our analytic lens and draw on the experiences of the Elena Giacomelli whilst working as a caseworker for a humanitarian organization on board. In our analysis of the interactions of those working on board and the social relations produced therein, we unravel how these ships function as a form of Goffman?s totalitarian institution, where bio-political techniques are adopted that act on the body and mind of all on board, limiting access to asylum and functioning as a form of externalisation.

2.
BMJ Open ; 11(7), 2021.
Article in English | ProQuest Central | ID: covidwho-1843004

ABSTRACT

ObjectiveTo examine inequalities in COVID-19 vaccination rates among elderly adults in England.DesignCohort study.SettingPeople living in private households and communal establishments in England.Participants6 655 672 adults aged ≥70 years (mean 78.8 years, 55.2% women) who were alive on 15 March 2021.Main outcome measuresHaving received the first dose of a vaccine against COVID-19 by 15 March 2021. We calculated vaccination rates and estimated unadjusted and adjusted ORs using logistic regression models.ResultsBy 15 March 2021, 93.2% of people living in England aged 70 years and over had received at least one dose of a COVID-19 vaccine. While vaccination rates differed across all factors considered apart from sex, the greatest disparities were seen between ethnic and religious groups. The lowest rates were in people of black African and black Caribbean ethnic backgrounds, where only 67.2% and 73.8% had received a vaccine, with adjusted odds of not being vaccinated at 5.01 (95% CI 4.86 to 5.16) and 4.85 (4.75 to 4.96) times greater than the white British group. The proportion of individuals self-identifying as Muslim and Buddhist who had received a vaccine was 79.1% and 84.1%, respectively. Older age, greater area deprivation, less advantaged socioeconomic position (proxied by living in a rented home), being disabled and living either alone or in a multigenerational household were also associated with higher odds of not having received the vaccine.ConclusionResearch is now urgently needed to understand why disparities exist in these groups and how they can best be addressed through public health policy and community engagement.

3.
EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-329511

ABSTRACT

Background It is unclear whether receiving two COVID-19 vaccinations before SARS-CoV-2 infection reduces the risk of developing Long Covid symptoms. We examined whether the likelihood of symptoms 12 weeks after infection differed by vaccination status. Methods We included COVID-19 Infection Survey participants aged 18-69 years who tested positive for SARS-CoV-2 between 26 April 2020 and 30 November 2021;we excluded participants who, before their first test-confirmed infection, had suspected COVID-19 or Long Covid symptoms, or were single-vaccinated. Participants who were double-vaccinated ≥14 days before infection were 1:1 propensity-score matched, based on socio-demographic characteristics and time from infection to follow-up for Long Covid, to those unvaccinated at time of infection. We estimated adjusted odds ratios (aOR) of Long Covid symptoms ≥12 weeks post-infection, comparing double-vaccinated with unvaccinated (reference group) participants. Results The study sample comprised 3,090 double-vaccinated participants (mean age 49 years, 54% female, 92% white, median follow-up from infection 96 days) and matched control participants. Long Covid symptoms were reported by 294 double-vaccinated participants (prevalence 9.5%) compared with 452 unvaccinated participants (14.6%), corresponding to an aOR for Long Covid symptoms of 0.59 (95% CI: 0.50 to 0.69). There was no evidence of heterogeneity by adenovirus vector versus messenger ribonucleic acid vaccines (p=0.25). Conclusions COVID-19 vaccination is associated with reduced risk of Long Covid, emphasising the need for public health initiatives to increase population-level vaccine uptake. Longer follow-up is needed, as is the assessment of further vaccine doses and the Omicron variant.

4.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-312594

ABSTRACT

We investigate the distribution of numbers of secondary cases in households in the Office for National Statistics COVID-19 Infection Survey (ONS CIS), stratified by timing of vaccination and infection in the households. This shows a total effect of a statistically significant approximate halving of the secondary attack rate in households following vaccination.

5.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-312593

ABSTRACT

The response of many governments to the COVID-19 pandemic has involved measures to control within- and between-household transmission, providing motivation to improve understanding of the absolute and relative risks in these contexts. Here, we perform exploratory, residual-based, and transmission-dynamic household analysis of the Office for National Statistics (ONS) COVID-19 Infection Survey (CIS) data from 26 April 2020 to 8 March 2021 in England. This provides evidence for: (i) temporally varying rates of introduction of infection into households broadly following the trajectory of the overall epidemic;(ii) Susceptible-Infectious Transmission Probabilities (SITPs) of within-household transmission in the 15-35% range;(iii) the emergence of the B.1.1.7 variant, being around 50% more infectious within households;(iv) significantly (in the range 25-300%) more risk of bringing infection into the household for workers in patient-facing roles;(v) increased risk for secondary school-age children of bringing the infection into the household when schools are open (in the range 64-235%);(vi) increased risk for primary school-age children of bringing the infection into the household when schools were open in late autumn 2020 (around 40%).

6.
EuropePMC;
Preprint in English | EuropePMC | ID: ppcovidwho-326044

ABSTRACT

The response of many governments to the COVID-19 pandemic has involved measures to control within- and between-household transmission, providing motivation to improve understanding of the absolute and relative risks in these contexts. Here, we perform exploratory, residual-based, and transmission-dynamic household analysis of the Office for National Statistics (ONS) COVID-19 Infection Survey (CIS) data from 26 April 2020 to 15 July 2021 in England. This provides evidence for: (i) temporally varying rates of introduction of infection into households broadly following the trajectory of the overall epidemic and vaccination programme;(ii) Susceptible-Infectious Transmission Probabilities (SITPs) of within-household transmission in the 15-35% range;(iii) the emergence of the Alpha and Delta variants, with the former being around 50% more infectious than wildtype and 35% less infectious than Delta within households;(iv) significantly (in the range 25-300%) more risk of bringing infection into the household for workers in patient-facing roles pre-vaccine;(v) increased risk for secondary school-age children of bringing the infection into the household when schools are open;(vi) increased risk for primary school-age children of bringing the infection into the household when schools were open since the emergence of new variants.

7.
BMJ Open ; 12(2): e057408, 2022 02 07.
Article in English | MEDLINE | ID: covidwho-1673446

ABSTRACT

INTRODUCTION: Long COVID-19 is a distressing, disabling and heterogeneous syndrome often causing severe functional impairment. Predominant symptoms include fatigue, cognitive impairment ('brain fog'), breathlessness and anxiety or depression. These symptoms are amenable to rehabilitation delivered by skilled healthcare professionals, but COVID-19 has put severe strain on healthcare systems. This study aims to explore whether digitally enabled, remotely supported rehabilitation for people with long COVID-19 can enable healthcare systems to provide high quality care to large numbers of patients within the available resources. Specific objectives are to (1) develop and refine a digital health intervention (DHI) that supports patient assessment, monitoring and remote rehabilitation; (2) develop implementation models that support sustainable deployment at scale; (3) evaluate the impact of the DHI on recovery trajectories and (4) identify and mitigate health inequalities due to the digital divide. METHODS AND ANALYSIS: Mixed-methods, theoretically informed, single-arm prospective study, combining methods drawn from engineering/computer science with those from biomedicine. There are four work packages (WP), one for each objective. WP1 focuses on identifying user requirements and iteratively developing the intervention to meet them; WP2 combines qualitative data from users with learning from implementation science and normalisation process theory, to promote adoption, scale-up, spread and sustainability of the intervention; WP3 uses quantitative demographic, clinical and resource use data collected by the DHI to determine illness trajectories and how these are affected by use of the DHI; while WP4 focuses on identifying and mitigating health inequalities and overarches the other three WPs. ETHICS AND DISSEMINATION: Ethical approval obtained from East Midlands - Derby Research Ethics Committee (reference 288199). Our dissemination strategy targets three audiences: (1) Policy makers, Health service managers and clinicians responsible for delivering long COVID-19 services; (2) patients and the public; (3) academics. TRIAL REGISTRATION NUMBER: Research Registry number: researchregistry6173.


Subject(s)
COVID-19 , Anxiety , COVID-19/complications , Humans , Prospective Studies , SARS-CoV-2
8.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-296523

ABSTRACT

Objective To estimate associations between COVID-19 vaccination and Long Covid symptoms in adults who were infected with SARS-CoV-2 prior to vaccination. Design Observational cohort study using individual-level interrupted time series analysis. Setting Random sample from the community population of the UK. Participants 28,356 COVID-19 Infection Survey participants (mean age 46 years, 56% female, 89% white) aged 18 to 69 years who received at least their first vaccination after test-confirmed infection. Main outcome measures Presence of long Covid symptoms at least 12 weeks after infection over the follow-up period 3 February to 5 September 2021. Results Median follow-up was 141 days from first vaccination (among all participants) and 67 days from second vaccination (84% of participants). First vaccination was associated with an initial 12.8% decrease (95% confidence interval: −18.6% to −6.6%) in the odds of Long Covid, but increasing by 0.3% (−0.6% to +1.2%) per week after the first dose. Second vaccination was associated with an 8.8% decrease (−14.1% to −3.1%) in the odds of Long Covid, with the odds subsequently decreasing by 0.8% (−1.2% to −0.4%) per week. There was no statistical evidence of heterogeneity in associations between vaccination and Long Covid by socio-demographic characteristics, health status, whether hospitalised with acute COVID-19, vaccine type (adenovirus vector or mRNA), or duration from infection to vaccination. Conclusions The likelihood of Long Covid symptoms reduced after COVID-19 vaccination, and the improvement was sustained over the follow-up period after the second dose. Vaccination may contribute to a reduction in the population health burden of Long Covid, though longer follow-up time is needed. Summary box What is already known on this topic COVID-19 vaccines are effective at reducing rates of SARS-CoV-2 infection, transmission, hospitalisation, and death The incidence of Long Covid may be reduced if infected after vaccination, but the relationship between vaccination and pre-existing long COVID symptoms is unclear, as published studies are generally small and with self-selected participants What this study adds The likelihood of Long Covid symptoms reduced after COVID-19 vaccination, and the improvement was sustained over the follow-up period after the second dose There was no evidence of differences in this relationship by socio-demographic characteristics, health-related factors, vaccine type, or duration from infection to vaccination Although causality cannot be inferred from this observational evidence, vaccination may contribute to a reduction in the population health burden of Long Covid;further research is needed to understand the biological mechanisms that may ultimately contribute to the development of therapeutics for Long Covid

9.
2021.
Preprint in English | Other preprints | ID: ppcovidwho-296296

ABSTRACT

We investigated anti-spike IgG antibody responses and correlates of protection following second doses of ChAdOx1 or BNT162b2 SARS-CoV-2 vaccines in the UK general population. In 222,493 individuals, we found significant boosting of anti-spike IgG by second doses of both vaccines in all ages and using different dosing intervals, including the 3-week interval for BNT162b2. After second vaccination, BNT162b2 generated higher peak levels than ChAdOX1. Antibody levels declined faster at older ages and in males with BNT162b2, but declines were similar across ages and sexes with ChAdOX1. Prior infection significantly increased antibody half-life with both vaccines. Anti-spike IgG levels were associated with protection from infection after vaccination and, to an even greater degree, after prior infection. At least 67% protection against infection was estimated to last for 2-3 months after two ChAdOx1 doses and 6-15 months after two BNT162b2 doses in those without prior infection, and 1-2 years for those unvaccinated after natural infection. A third booster dose may be needed, prioritised to ChAdOx1 recipients and those more clinically vulnerable.

10.
2021.
Preprint in English | Other preprints | ID: ppcovidwho-295762

ABSTRACT

The effectiveness of COVID-19 vaccination in preventing new SARS-CoV-2 infections in the general community is still unclear. Here, we used the Office for National Statistics (ONS) COVID-19 Infection Survey, a large community-based survey of individuals living in randomly selected private households across the UK, to assess the effectiveness of BNT162b2 (Pfizer-BioNTech) and ChAdOx1 nCoV-19 (Oxford-AstraZeneca;ChAdOx1) vaccines against any new SARS-CoV-2 PCR-positive tests, split according to self-reported symptoms, cycle threshold value (<30 versus ≥30) as a surrogate for viral load, and gene positivity pattern (compatible with B.1.1.7 or not). Using 1,945,071 RT-PCR results from nose and throat swabs taken from 383,812 participants between 1 December 2020 and 8 May 2021, we found that vaccination with the ChAdOx1 or BNT162b2 vaccines already reduced SARS-CoV-2 infections ≥21 days after the first dose (61%, 95% CI 54 to 68% versus 66%, 95% CI 60 to 71%, respectively) with greater reductions observed after a second dose (79%, 95% CI 65 to 88% versus 80%, 95% CI 73 to 85%, respectively). Largest reductions were observed for symptomatic infections and/or infections with a higher viral burden. Overall, COVID-19 vaccination reduced the number of new SARS-CoV-2 infections, with the largest benefit received after two vaccinations and against symptomatic and high viral burden infections, and with no evidence of difference between the BNT162b2 and ChAdOx1 vaccines.

11.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-294332

ABSTRACT

The physiological effects of vaccination against SARS-CoV-2 (COVID-19) are well documented, yet the behavioural effects are largely unknown. Risk compensation suggests that gains in personal safety, as a result of vaccination, are offset by increases in risky behaviour, such as socialising, commuting and working outside the home. This is potentially problematic because transmission of SARS-CoV-2 is driven by contacts, which could be amplified by vaccine-related risk compensation behaviours. Here, we show that behaviours were overall unrelated to personal vaccination, but - adjusting for variation in mitigation policies - were responsive to the level of vaccination in the wider population: individuals in the UK were risk compensating when rates of vaccination were rising. This effect was observed across four nations of the UK, each of which varied policies autonomously.

12.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-294200

ABSTRACT

We combine data collected just prior to the unfolding of COVID-19 with follow-up data from July 2020 to document the adverse economic effects of the pandemic and resulting impact on parental and child mental well-being in rural and semi-urban Pakistan. 22% of the households in our sample are affected by job loss, with monthly income down 34% on average. Our difference-in-difference results show that job loss is associated with a 0.73 standard deviation (SD) reduction in adult mental health score (K10), a 0.55 SD reduction in a ‘Hope’ index of children’s aspirations, agency and future pathways, and a 0.33 SD increase in children’s depression symptoms. In addition, we observe higher levels of parental stress and anger reported by children, as well as an increase in reported prevalence of domestic violence. Overall, we document that the pandemic has disproportionately and negatively affected the economic and mental well-being of the most vulnerable households in our sample.

13.
Curr Res Food Sci ; 4: 598-602, 2021.
Article in English | MEDLINE | ID: covidwho-1442332

ABSTRACT

The COVID-19 pandemic has generated increased interest in potential transmission routes. In food retail settings, transmission from infected customers and workers and customers through surfaces has been deemed plausible. However, limited information exists on the presence and survival of SARS-CoV-2 on surfaces, particularly outside laboratory settings. Therefore, the purpose of this project was to assess the presence of the virus at commonly found surfaces at food retail stores and the potential role that these spaces play in virus transmission. Samples (n=957) were collected twice a week for a month in food-retail stores within Ontario, Canada. High-touch surfaces were identified and surveyed in 4 zones within the store (payment stations, deli counters, refrigerated food section and carts and baskets). The samples were analyzed using a molecular method, i.e., reverse transcriptase quantitative Polymerase Chain Reaction (RT-qPCR). Regardless of the store's location, the sampling day or time, the location of the surface within the store or the surface material, all samples tested negative for SARS-CoV-2. These results suggest that the risk of exposure from contaminated high-touch surfaces within a food retailer store is low if preventive measures and recommended sanitizing routines are maintained.

14.
BMJ Open ; 11(7): e053402, 2021 07 23.
Article in English | MEDLINE | ID: covidwho-1322829

ABSTRACT

OBJECTIVE: To examine inequalities in COVID-19 vaccination rates among elderly adults in England. DESIGN: Cohort study. SETTING: People living in private households and communal establishments in England. PARTICIPANTS: 6 655 672 adults aged ≥70 years (mean 78.8 years, 55.2% women) who were alive on 15 March 2021. MAIN OUTCOME MEASURES: Having received the first dose of a vaccine against COVID-19 by 15 March 2021. We calculated vaccination rates and estimated unadjusted and adjusted ORs using logistic regression models. RESULTS: By 15 March 2021, 93.2% of people living in England aged 70 years and over had received at least one dose of a COVID-19 vaccine. While vaccination rates differed across all factors considered apart from sex, the greatest disparities were seen between ethnic and religious groups. The lowest rates were in people of black African and black Caribbean ethnic backgrounds, where only 67.2% and 73.8% had received a vaccine, with adjusted odds of not being vaccinated at 5.01 (95% CI 4.86 to 5.16) and 4.85 (4.75 to 4.96) times greater than the white British group. The proportion of individuals self-identifying as Muslim and Buddhist who had received a vaccine was 79.1% and 84.1%, respectively. Older age, greater area deprivation, less advantaged socioeconomic position (proxied by living in a rented home), being disabled and living either alone or in a multigenerational household were also associated with higher odds of not having received the vaccine. CONCLUSION: Research is now urgently needed to understand why disparities exist in these groups and how they can best be addressed through public health policy and community engagement.


Subject(s)
COVID-19 Vaccines , COVID-19 , Adult , Aged , Aged, 80 and over , Cohort Studies , England , Female , Humans , Male , SARS-CoV-2 , Semantic Web , Vaccination , Vaccination Coverage
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