ABSTRACT
Background: Cancer care in French Polynesia has been deprioritized during severe acute respiratory syndrome coronavirus 2 (SARS CoV2) pandemic due to the urgent necessity to reorganize health care systems to fight this crisis and patients (pts) were more reluctant to visit medical doctors, fearful about exposure to the virus or not wanting to disturb a saturated health system. Method(s): We aimed to assess the incidence of cancer diagnosis and cancer care during the Covid-19 period compared to the same period in 2019 (before covid) and in 2021 (after covid). We retrospectively collected data from January 2019 to Sept 2021 regarding pts visits, treatments (ttt) administrations in oncology and radiotherapy outpatient wards, at the Taaone university hospital center of French Polynesia. Result(s): Regarding the newly diagnosed pts, we observed a decreased of 13.6% on oncology visits from January to Sept 2020 compared to the same period in 2019 and an increase of oncology visits after the first wave with +14.2%, from January to Sept 2021 compared to 2020. We did not observe any major impact of the crisis on ttt administrations in oncology outpatients. There was a +1.3% of activity from January to Sept 2020 compared to 2019 and a +1.5% from January to Sept 2021 compare to 2020. Regarding the radiotherapy activity, the newly diagnosed pts visits increased of +2.5% from January to Sept 2020 compared to the same period in 2019 and +21% from January to Sept 2021 compared to the same period in 2020. The ttts in radiotherapy outpatient wards decreased of -11% in 2020 (from January to Sept 2020 compared to 2019) and increased of +11% in 2021. Conclusion(s): The covid 19 crisis had an impact in French Polynesia on the oncology and radiotherapy visit of the newly diagnosed patients, with more patients diagnosed after covid;while ttt administrations in oncology and radiotherapy stayed stable. Legal entity responsible for the study: The authors. Funding(s): Has not received any funding. Disclosure: All authors have declared no conflicts of interest. Copyright © 2022
ABSTRACT
This article presents the main findings and recommendations of a socioeconomic assessment of the impacts of the COVID-19 pandemic on Tonga's coastal fisheries sector which was conducted by means of a national survey targeting households that benefit from subsistence and artisanal fishing and focus group discussions targeting registered commercial small-scale fishers. The assessment aimed to (1) better understand the effects of COVID-19 on coastal small-scale fishers and fishing households;(2) examine how they have coped and recovered from the effects of COVID-19;and (3) identify the types of support that they would find helpful to cope with and recover from the effects of COVID-19, as well as future crises.
ABSTRACT
A mixed-methods study was performed to identify the physical and emotional needs of Hawai'i health care workers during the COVID-19 pandemic, and the degree to which these needs are being met by their clinic or hospital. Qualitative interviews and demographic surveys were conducted with two cohorts of health care workers. Cohort 1 (N=15) was interviewed between July 20 - August 7, 2020, and Cohort 2 (N=16) between September 28 - October 9, 2020. A thematic analysis of the interview data was then performed. Participants' primary concern was contracting the illness at work and transmitting it to their families. Solo practitioners working in outpatient clinics reported more financial challenges and greater difficulty obtaining PPE than those employed by hospitals or group practices. While telehealth visits increased for both inpatient and out-patient settings, the new visit type introduced new barriers to entry for patients. The study findings may serve to better understand the effect of COVID-19 on health care workers and support the development of hospital and clinic procedures. Further research into the impacts of COVID-19 on nurses in Hawai'i is recommended.
ABSTRACT
Utilizing 11 waves of data from the Household Pulse Survey collected between April and November 2020, this study examines disparities in psychological distress (defined as having symptoms of anxiety/depression) among adult residents of Hawai'i during the COVID-19 pandemic. Results showed that 36.4% of the respondents reported symptoms of distress. Younger age, female, and lower household income were associated with higher levels of psychological distress than older age, male, and higher household income. The prevalence ratios of distress for those aged 18-24, 25-34, 35-44 and females were 43.1%, 47.3%, 44.1%, and 39.3% respectively. Asians experienced lower prevalence compared to other racial/ethnic groups. Two practical implications are offered. First, the economic sequelae of COVID-19 impact psychological distress even when the community infection rate is stable. Second, disparities in psychosocial distress demonstrate that social and economic resources are needed by social groups such as young adults, females, and racial/ethnic minorities that have experienced the highest impact. Strategies need to be developed to mitigate the unavoidable local consequences of a pandemic.
ABSTRACT
Hawai'i's Pacific Islander (PI) population has suffered a higher burden of coronavirus disease 2019 (COVID-19) infections, hospitalizations, and deaths compared to other groups in the state. The Hawai'i Emergency Management Agency Community Care Outreach Unit conducted an assessment across the state to gain an understanding of the impact of the COVID-19 pandemic on the health and social welfare of households. Survey data was collected from individuals across the state during a period of 3 weeks (August 12-September 5, 2020). The following are resulting recommendations from the Pacific Island community to mitigate the impact and disparities of the pandemic as immediate and medium-term structural requests: (1) ensure that Pacific Island communities are proactively represented in state and county committees that develop health interventions to ensure that relevant language and culturally tailored communications and strategies are included, (2) provide consistent funding and community centered support to ensure consistent COVID-19 impact services for the Pacific Island families, (3) enhance the capacity of PI health care navigators and interpreters through increased funding and program support, and (4) engage state policy makers immediately to understand and address the systemic structural barriers to health care and social services for Pacific Islanders in Hawai'i. These recommendations were developed to address the generational inequities and disparities that exist for Pacific islanders in Hawai'i which were exacerbated by the COVID-19 pandemic.
ABSTRACT
The Republic of the Marshall Islands, American Samoa, the Federated States of Micronesia, and the Republic of Palau have been without any COVID-19 community transmission since the beginning of the global pandemic. The Commonwealth of the Northern Mariana Islands has experienced modest community transmission, and Guam has had significant COVID-19 community transmission and morbidity. Although several of these United States Affiliated Pacific Island jurisdictions made difficult strategic choices to prevent the spread of COVID-19 which have been largely successful, the built environment and the population density in the urban areas of the Pacific remain inherently conducive to rapid COVID-19 transmission. Rapid transmission could result in devastating health and economic consequences in the absence of continued vigilance and long-term strategic measures. The unique COVID-19 vulnerability of islands in the Pacific can be modeled through examination of recent outbreaks onboard several United States Naval ships and other marine vessels. The environmental characteristics that pose challenges to infection control on an isolated naval ship are analogous to the environmental characteristics of these Pacific island communities. Considering a collection of case studies of COVID-19 transmission on ships and applying to Pacific Island environments, provides a heuristic, easily accessible epidemiologic framework to identify methods for interventions that are practical and reliable towards COVID-19 containment, prevention, and control. Using accessible evidence based public health policies, infection risk can be decreased with the objective of maintaining in-country health and social stability. These case studies have also been examined for their relevance to current discussions of health care infrastructure and policy in the Pacific Islands, especially that of vaccination and repatriation of citizens marooned in other countries. The need for aggressive preparation on the parts of territories and nations not yet heavily exposed to the virus is critical to avoid a rapid "burn-through" of disease across the islands, which would likely result in catastrophic consequences.
ABSTRACT
In small islands, the potential for new coastal activities and management options are often spatially limited. To reduce dependence on external factors and increase the resilience of populations to global changes and fluctuations in international markets, a recommended pathway is to diversify activities. We used a systematic prioritization tool with single and multiobjective zoning to explore the feasibility of scenarios at various levels of spatial diversification in the Gambier lagoon (French Polynesia), where black pearl culture is economically and spatially dominant. Local managers are committed to economic, livelihood, and environmental sustainability and agree that prioritizing both artisanal fisheries, which provide local food security, and ecosystem conservation should also be considered. Diversification options included the optimized reallocation of farming concessions and the identification of different types of conservation areas while taking into account traditional management areas. The scenarios were set to minimize surface areas and loss of access to existing fishing grounds. The solutions were compared between the scenarios with different cost metrics, allowing further discussions with stakeholders and managers. The Gambier case study shows that exploring diversification options in small islands using systematic prioritization tools can provide local managers with tailor-made plans adapted to island development questions.
ABSTRACT
Having been affected by the highest increase in COVID-19 cases since the start of the pandemic, Honolulu and Maui counties in Hawai'i implemented vaccine passport mandates for select industries in September 2021. Herein, we describe the effects of these mandates on three areas: (1) changes in foot traffic for businesses affected by mandates in comparison to businesses unaffected by the mandates;(2) changes in the number of COVID-19 cases per 100,000 and (3) COVID-19 vaccination rate increases across counties affected by mandates in comparison to counties that were unaffected by the mandates. Although businesses affected by mandates experienced a 4.0% decrease of foot traffic in the 10 weeks after the mandates were implemented, the number of COVID-19 cases significantly decreased (47.3%, p < 0.01), and the vaccination rate significantly increased (1.47%, p < 0.05) in counties that implemented mandates. As the trend of foot traffic towards the end of this period indicates impacted businesses converging towards the levels of non-impacted businesses, the trade-off in temporary losses during the adjustment period is met with significant gains in public health and safety.
ABSTRACT
In French Polynesia, following the emergence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in March 2020, several control measures were implemented to prevent virus spread, including a population lockdown and the interruption of international air traffic. SARS-CoV-2 local transmission rapidly stopped, and circulation of dengue virus serotypes 1 and 2, the only arboviruses being detected at that time, decreased. After the borders re-opened, a surveillance strategy consisting of the testing by SARS-CoV-2 RT-PCR of travelers entering French Polynesia, and isolating those with ongoing infection, was implemented. This strategy proved efficient to limit the introduction of SARS-CoV-2, and should be considered to prevent the importation of other pathogens, including mosquito-borne viruses, in geographically isolated areas such as French Polynesia.
Subject(s)
Arboviruses , COVID-19 , Vector Borne Diseases , Animals , COVID-19/epidemiology , COVID-19/prevention & control , Communicable Disease Control , SARS-CoV-2/geneticsABSTRACT
The COVID-19 pandemic has severely hit the United States of America (USA) with tourism being one of the most directly affected sectors. The effect is even more striking in Hawaii, which has been one of the most popular tourist destinations in the United States since the 1950s. While the state government's early reaction has resulted in a decrease in COVID cases in this state, travel restrictions established in response to the pandemic have wreaked havoc on the state's tourist economy. To quantitatively measure this impact, this paper investigates the nexus between the international tourist arrivals, COVID-19 spread, and air quality in Hawaii. Using the daily data from March 2020 to August 2020, the study employs the robust methodology comprising Wavelet coherence, partial and multiple Wavelet coherence methods. The empirical results reveal a significant coherence between international tourists, COVID-19 cases, and air quality at different time-frequency compositions.
ABSTRACT
This paper studies the economic impact of COVID-19 in Fiji, Tonga, and Vanuatu. The UNWTO's International Tourism 2020 Scenarios and the World Bank's projected decline in remittance flows are treated as negative COVID-19 led shocks in the nonlinear autoregressive distributed lag (NARDL) model. Negative tourism shocks are significant for all three countries, whereas negative remittance shocks are significant for Tonga only. Thus, the economic effects of COVID-19 are propagated by tourism for all three countries, whilst remittance is a COVID-19 transmission channel for Tonga only. Simulations with the projected declines in tourism and remittances suggest that Vanuatu would experience the greatest decline in growth and highest uncertainty, whilst Tonga would face the lowest decline and uncertainty.
ABSTRACT
Reducing Coronavirus disease 2019 (COVID-19) transmission relies on people quarantining after exposure to COVID-19 or if they experience COVID-19 symptoms, and isolating from others if COVID-19 positive. Quarantine and isolation last 10 to 14 days and can be state-mandated;however, the level of compliance is unknown. The University of Hawai'i Department of Family Medicine clinic called patients instructed by our physicians to quarantine for exposure risk or symptoms of potential COVID-19 infection between March 15, 2020, and April 15, 2020. None of the patients tested positive for COVID-19. Sixty-nine of 90 (77%) patients completed follow-up calls and self-reported whether they had stayed home. Of these 69 patients, 32 (46%) broke quarantine to buy groceries (36%), work (9%), visit others (6%), or for other reasons (12%). For patients living alone, 8 of 11 (73%) left home to buy groceries. For employed patients, 6 of 39 (15%) returned to work during their quarantine period. Nearly half of our patients did not quarantine for the entire period. Many persons left home to buy food or to work. Strong public health messaging is needed to educate communities about the requirement to quarantine. Clinicians can help by asking patients about social and financial ability to quarantine, schedule follow-up appointments to remind patients to stay home, and link patients to food programs, financial assistance, and other community resources to successfully quarantine and prevent COVID-19 transmission.
ABSTRACT
Nationwide shortages of tests that detect severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and diagnose coronavirus disease 2019 (COVID- 19) have led the US Food and Drug Administration (FDA) to significantly relax regulations regarding COVID-19 diagnostic testing. To date the FDA has given emergency use authorization (EUA) to 48 COVID-19 in vitro diagnostic tests and 21 high complexity molecular-based laboratory developed tests, as well as implemented policies that give broad authority to clinical laboratories and commercial manufacturers in the development, distribution, and use of COVID-19 diagnostic tests. Currently, there are 2 types of diagnostic tests available for the detection of SARS-CoV-2: (1) molecular and (2) serological tests. Molecular detection of nucleic acid (RNA or DNA) sequences relating to the suspected pathogen is indicative of an active infection with the suspected pathogen. Serological tests detect antibodies against the suspected pathogen, which are produced by an individual's immune system. A positive serological test result indicates recent exposure to the suspected pathogen but cannot be used to determine if the individual is actively infected with the pathogen or immune to reinfection. In this article, the SARS-CoV-2 diagnostic tests currently approved by the FDA under EUA are reviewed, and other diagnostic tests that researchers are developing to detect SARS-CoV-2 infection are discussed.
ABSTRACT
The finding of 0 positive for COVID-19 suggests that these patients and their families should be congratulated for keeping the prevalence of COVID-19 so low in our hospital pediatric population, including young children. children from diverse racial and socioeconomic backgrounds, as well as in the broader community. For example, 0-17 year olds statewide, there were an average of 0 and 6 new coronavirus cases in the weeks ending May 16 and July 25, respectively. During this 10-week period, and across all ages, the total number of cases increased from 637 to 1,490 (1.2% positivity rate based on 73,009 tests) and related deaths increased from 17-26. Additionally, more than 45% of the patients examined were of Hawaiian/Pacific Islander descent, whose subgroup will be disproportionately affected by COVID-19, unlike other racial groups in Hawaii. However, the incidence found here is much lower and the infectivity seems to be similar, if not non-existent, in these pediatric patients despite racial differences. Previous studies of patients from other pediatric hospitals located in the continental United States reported highly geographically variable COVID-19 prevalence, with a mean prevalence of 0.65%. Comparative data from other hospitals located in states with very high rates of COVID-19 will be analysed based on geographic differences or the likelihood that pediatric patients (and their families) are unique in local in the same way. From a public health perspective, Hawaii's overall response to COVID-19 has been proactive thanks to the state government's timely issuance of restrictions (e.g., mask wearing, social distancing, no/restrictive social gatherings and travel surveillance) and civilian membership of Hawaii residents, due to increased COVID-19 positivity rates statewide and the evolving pandemic in the United States. In the area of control and prevention that has emerged in response to the COVID-19 pandemic, it is conceivable that some regions and/or groups will differ in approving and complying with government-imposed restrictions. The zero positivity rate has supported the effectiveness of public health initiatives authorized by local governments to respond to COVID-19, which is, in turn, dependent on state community approval. Comparable information on the general pediatric patient population of Hawaii or of other children's hospitals is limited and/or unavailable, which reduces contrast with current data. This 0-positive result may simply be due to the fact that children present for elective surgery at SHC HON during this time were an exception in terms of their compliance with COVID-19 precautions. Or, it may simply be a reflection of these children's cautious behavior, or more so, their parents' protective efforts against a vulnerable health condition (usually a debilitating illness).
ABSTRACT
BACKGROUND: During cruises, the management of coronavirus disease 2019 (COVID-19) infections poses serious organizational problems such as those encountered in 2020 by the Zaandam, the aircraft carrier Charles de Gaulle or the Diamond Princess. In French Polynesia, the mixed cargo ship Aranui 5 transports both tourists and freight to the Marquesas Islands. The purpose of this article is to show how COVID-19 infections were diagnosed and contained before and after passengers boarded a cruise. MATERIALS AND METHODS: On October 15, 2020, 161 passengers including 80 crew members embarked for a 13-day voyage from Papeete to the Marquesas Islands. Prior to boarding, all passengers underwent a reverse transcriptase-polymerase chain reaction (RT-PCR) test; the tests results were all negative. On Day 0, 3, 5, 8 and 11, Biosynex® rapid antigen diagnostic tests were carried out on all or some of the crew members and tourists who may have had contact with new positive cases. Each day, forehead or temporal temperatures were measured using an infrared thermometer and questions were asked concerning the subjects' health status. When a subject was positive, the person and their contacts were isolated in individual cabins. The infected person then left the vessel to be received in a communal reception centre on the nearest island. RESULTS: A total of 9 positive cases were observed, including two before departure (a tourist and a crew member). During the trip, 7 crew members tested positive. The patients and their contacts were isolated and then disembarked at the earliest opportunity. At the time of sampling, the subjects were asymptomatic. The patients and their contacts all became symptomatic within 24 to 48 hours after sampling. CONCLUSIONS: In total, the voyage could be completed without any transmission on board among the tourists and with a minimum transmission among the crew members, thus maintaining the tourist and economic activity of the islands during the times of COVID-19 pandemic.
Subject(s)
COVID-19/diagnosis , COVID-19/prevention & control , Naval Medicine/methods , Body Temperature , COVID-19/epidemiology , COVID-19 Testing , Contact Tracing/methods , Humans , Occupational Exposure , Polynesia , Quarantine/methods , SARS-CoV-2 , Ships , TravelABSTRACT
OBJECTIVE: To analyse the epidemiological data on suicide in French Polynesia (FP). METHODS: Data on suicides were collected from the Public Health Direction, Judicial Police Investigations Court of Justice records, the Centre d'Opérations et de Renseignements de la Gendarmerie, patient records for those hospitalized in psychiatry and from psychological autopsies. RESULTS: The dataset consisted of 316 suicide cases in FP over 25 years (1992-2016). In FP, suicide was more frequent in men (sex ratio 3.2:1), young people (mean age, 34.4 years) and individuals with previously diagnosed psychiatric disorders (100 of 316; 31.6%) The most common method of suicide was hanging (276 of 316; 87.3%). A history of previous suicide attempts was found in 25 of 56 (44.6%) of suicide cases, when documented. The most common potential triggering factors for suicide were emotional problems. The suicide rates have remained stable during 1992-2016 (mean 10.6/100 000 inhabitants per year), with periods of economic crises increasing suicide rates. CONCLUSIONS: These results provide valuable information to enable the effective targeting of suicide prevention strategies toward those at high risk. Economic crises had larger impacts in the French overseas territories than mainland France. Given the unprecedented economic impact of the Covid-19 pandemic in FP, there is an urgent need to implement suicide epidemiological surveillance and prevention programmes.
Subject(s)
COVID-19 , Pandemics , Adolescent , Adult , Humans , Male , Retrospective Studies , SARS-CoV-2 , Suicide, AttemptedABSTRACT
BACKGROUND: The COVID-19 pandemic has had a profound global impact on governments, health care systems, economies, and populations around the world. Within the East Asia and Pacific region, some countries have mitigated the spread of the novel coronavirus effectively and largely avoided severe negative consequences, while others still struggle with containment. As the second wave reaches East Asia and the Pacific, it becomes more evident that additional SARS-CoV-2 surveillance is needed to track recent shifts, rates of increase, and persistence associated with the pandemic. OBJECTIVE: The goal of this study is to provide advanced surveillance metrics for COVID-19 transmission that account for speed, acceleration, jerk, persistence, and weekly shifts, to better understand country risk for explosive growth and those countries who are managing the pandemic successfully. Existing surveillance coupled with our dynamic metrics of transmission will inform health policy to control the COVID-19 pandemic until an effective vaccine is developed. We provide novel indicators to measure disease transmission. METHODS: Using a longitudinal trend analysis study design, we extracted 330 days of COVID-19 data from public health registries. We used an empirical difference equation to measure the daily number of cases in East Asia and the Pacific as a function of the prior number of cases, the level of testing, and weekly shift variables based on a dynamic panel model that was estimated using the generalized method of moments approach by implementing the Arellano-Bond estimator in R. RESULTS: The standard surveillance metrics for Indonesia, the Philippines, and Myanmar were concerning as they had the largest new caseloads at 4301, 2588, and 1387, respectively. When looking at the acceleration of new COVID-19 infections, we found that French Polynesia, Malaysia, and the Philippines had rates at 3.17, 0.22, and 0.06 per 100,000. These three countries also ranked highest in terms of jerk at 15.45, 0.10, and 0.04, respectively. CONCLUSIONS: Two of the most populous countries in East Asia and the Pacific, Indonesia and the Philippines, have alarming surveillance metrics. These two countries rank highest in new infections in the region. The highest rates of speed, acceleration, and positive upwards jerk belong to French Polynesia, Malaysia, and the Philippines, and may result in explosive growth. While all countries in East Asia and the Pacific need to be cautious about reopening their countries since outbreaks are likely to occur in the second wave of COVID-19, the country of greatest concern is the Philippines. Based on standard and enhanced surveillance, the Philippines has not gained control of the COVID-19 epidemic, which is particularly troubling because the country ranks 4th in population in the region. Without extreme and rigid social distancing, quarantines, hygiene, and masking to reverse trends, the Philippines will remain on the global top 5 list of worst COVID-19 outbreaks resulting in high morbidity and mortality. The second wave will only exacerbate existing conditions and increase COVID-19 transmissions.