The Impact of the COVID-19 Pandemic on Suicide Rate Trends in the Tsunami-Disaster-Affected Area Following the Great East Japan Earthquake.

Background: People who experienced the Great East Japan Earthquake (GEJE) were expected to have additional levels of psychological burden resulting from the stressful conditions imposed during the coronavirus disease 2019 (COVID-19) pandemic; consequently, suicide rates may increase. Aim: We aimed to carry out continuous monitoring of suicide rates in the affected area following the GEJE under COVID-19 pandemic conditions. Method: This descriptive study monitored the suicide rates of the coastal area of Miyagi Prefecture, where disaster-related mental health activities have been continuing following severe damage caused by the tsunami disaster. An exponential smoothing time-series analysis that converted suicide rates into a smooth trend was conducted. Results: Although the suicide rate in the affected area was higher than the national average in February 2020, it showed a declining trend during the COVID-19 pandemic, while showing an increase trend in the national and non-affected areas. Limitations: Uncertainty about the direct reasons for suicide and the short time-scale observation are the limitations of this study. Conclusion: Although the national suicide rate increased, this was not the case for the affected area. Our findings may provide important lessons for suicide prevention during the COVID-19 pandemic, which needs careful regional monitoring of the state of suicide and of high-risk approaches such as disaster-related mental health activities.

Trends in emergency department visits for suicide attempts before and during the COVID-19 pandemic in Korea: A nationwide study, 2016-2021.

BACKGROUND: There is increasing concern that the effects of the COVID-19 pandemic will result in excess suicides by increasing known risk factors, such as suicide attempts. However, evidence on the long-term impacts of COVID-19 on suicide attempts is lacking. We aimed to assess the short- and long-term effects of the COVID-19 pandemic on patients with suicide attempts in emergency departments (EDs) and to evaluate age- and sex-specific differences. METHOD: We conducted nationwide cross-sectional study among patients with suicide attempts in the ED from 2016 to 2021. The trend test were used to determine whether study subjects were affected by changes in ED visits for suicide attempts. We estimated the average annual percentage change (APC) stratified by sex and age groups. RESULTS: The number of ED visits related to suicide attempts increased from 27,581 in 2016 to 37,719 in 2021. In particular, it decreased immediately after the COVID-19 pandemic but increased again in 2021. We identified that the average APC increased by 6.8 % overall, 1.6 % among males, and 10.8 % among females. Moreover, the APC of trend sharply increased in patients aged 10s and 20s. The in-hospital mortality was 3.6 % for females, compared to 9.5 % for males, which showed sex differences. LIMITATIONS: This study was limited to confirming causal relationship based on a descriptive study. CONCLUSIONS: The incidence of suicide attempts in ED has increased in Korea. In particular, there was a sharp increase among women, adolescents and young adults. Patient-tailored treatment and preventive medical system for suicide attempts is important.

Impact of COVID-19 pandemic on notifiable diseases in Northern Brazil / Impacto da COVID-19 em doenças de notificação compulsória no Norte do Brasil / Impacto de la COVID-19 en las enfermedades de notificación compulsoria del Norte de Brasil

Objetivo: Avaliar o impacto da pandemia COVID-19 em doenças de notificação compulsória no Norte do Brasil. Métodos: Estudo descritivo e retrospectivo realizado com dados das bases Sinan (Sistema de Informação de Agravos de Notificação) e SIH/SUS (Sistema de Informações Hospitalares do SUS) sobre meningite bacteriana e viral, dengue, febre hemorrágica da dengue, arboviroses, sífilis, tuberculose, hanseníase e hepatites virais. Utilizou-se estatística descritiva para avaliação da variação nos números absolutos das notificações e internações do período de 2015 a 2020 e suas variações médias. Resultados: As notificações e internações de meningite, arboviroses não-dengue, hanseníase, leptospirose e hepatites virais, em geral, demonstraram redução de 50 até 80% em relação a períodos anteriores. Houve variabilidade regional com dengue e febre hemorrágica da dengue, com aumentos e reduções independentes. As sífilis adquirida, gestacional e congênita demonstraram queda de até 60% nas notificações e nas internações, exceto sífilis congênita, que se manteve em estabilidade. As notificações e as internações de tuberculose se mantiveram estáveis em toda a região. Conclusão: Houve redução geral de mais da metade das notificações e das internações hospitalares, apresentando um impacto variável, dependendo do Estado e do processo de endemia de cada sub-região.

Objective: To assess the impact of the COVID-19 pandemic on notifiable diseases in Northern Brazil. Methods: A descriptive retrospective study was conducted using data from the Notifiable Disease Information System (Sistema de Informação de Agravos de Notificação ­ Sinan) and SUS Hospital Information System (Sistema de Informações Hospitalares do SUS ­ SIH/SUS) on bacterial and viral meningitis, dengue, dengue hemorrhagic fever, arboviruses, syphilis, tuberculosis, leprosy, and viral hepatitis. Descriptive statistics was used to assess the variation in absolute numbers of notifications and hospitalizations from 2015 to 2020 and their average variations. Results: Notifications and hospitalizations for meningitis, non-dengue arboviruses, leprosy, leptospirosis, and viral hepatitis exhibited a general decrease of 50 to 80% compared to previous years. There was regional variation in dengue and dengue hemorrhagic fever, with independent increases and decreases. Acquired, gestational and congenital syphilis presented a 60% decrease in notifications and hospitalizations, except for congenital syphilis, which remained stable. Tuberculosis notifications and hospitalizations remained stable in the entire region. Conclusion: There was an overall decrease of more than a half of notifications and hospitalizations, representing a variable impact depending on the state and the endemic process of each subregion.

Objetivo: Evaluar el impacto de la pandemia de la COVID-19 en las enfermedades de notificación compulsoria del Norte de Brasil. Métodos: Estudio descriptivo y retrospectivo realizado con datos de las bases SINAN (Sistema de Información de Agravios de Notificación) y SIH/SUS (Sistema de Informaciones Hospitalarias del SUS) sobre la meningitis bacteriana y viral, el dengue, la fiebre hemorrágica del dengue, las arbovirosis, la sífilis, la tuberculosis, la lepra y las hepatitis virales. Se utilizó de la estadística descriptiva para la evaluación de la variación de los números absolutos de las notificaciones y los ingresos del periodo entre 2015 y 2020 y sus variaciones medias. Resultados: Las notificaciones y los ingresos de meningitis, arbovirosis no-dengue,la lepra, la leptospirosis y las hepatitis virales, en general, han demostrado una disminución del 50 hasta el 80% respecto los periodos anteriores. Hubo variabilidad por región respecto el dengue y fiebre hemorrágica del dengue con subidas y bajadas independientes. Las sífilis adquirida, gestacional y congénita han demostrado caída hasta el 60% de las notificaciones e ingresos excepto la sífilis congénita que se mantuvo estable. Las notificaciones y los ingresos por tuberculosis se mantuvieron estables em toda la región. Conclusión: Hubo una disminución general de más de la mitad de las notificaciones y los ingresos hospitalarios, presentando un impacto variable, a depender del Estado y del proceso de endemia de cada sub-región.

Impact of Public Health and Social Measures on the COVID-19 Pandemic in the United States and Other Countries: Descriptive Analysis.

BACKGROUND: The United States of America has the highest global number of COVID-19 cases and deaths, which may be due in part to delays and inconsistencies in implementing public health and social measures (PHSMs). OBJECTIVE: In this descriptive analysis, we analyzed the epidemiological evidence for the impact of PHSMs on COVID-19 transmission in the United States and compared these data to those for 10 other countries of varying income levels, population sizes, and geographies. METHODS: We compared PHSM implementation timing and stringency against COVID-19 daily case counts in the United States and against those in Canada, China, Ethiopia, Japan, Kazakhstan, New Zealand, Singapore, South Korea, Vietnam, and Zimbabwe from January 1 to November 25, 2020. We descriptively analyzed the impact of border closures, contact tracing, household confinement, mandated face masks, quarantine and isolation, school closures, limited gatherings, and states of emergency on COVID-19 case counts. We also compared the relationship between global socioeconomic indicators and national pandemic trajectories across the 11 countries. PHSMs and case count data were derived from various surveillance systems, including the Health Intervention Tracking for COVID-19 database, the World Health Organization PHSM database, and the European Centre for Disease Prevention and Control. RESULTS: Implementing a specific package of 4 PHSMs (quarantine and isolation, school closures, household confinement, and the limiting of social gatherings) early and stringently was observed to coincide with lower case counts and transmission durations in Vietnam, Zimbabwe, New Zealand, South Korea, Ethiopia, and Kazakhstan. In contrast, the United States implemented few PHSMs stringently or early and did not use this successful package. Across the 11 countries, national income positively correlated (r=0.624) with cumulative COVID-19 incidence. CONCLUSIONS: Our findings suggest that early implementation, consistent execution, adequate duration, and high adherence to PHSMs represent key factors of reducing the spread of COVID-19. Although national income may be related to COVID-19 progression, a country's wealth appears to be less important in controlling the pandemic and more important in taking rapid, centralized, and consistent public health action.

Characteristics of the population affected by COVID-19 at an urban Primary Care Centre in Zaragoza

Objective: to analyse the sociodemographic characteristics of the urban population of Zaragoza affected by COVID-19. Specific objectives: to describe said population according to age, gender, origin, socioeconomic level, and destination after consultation;to describe the characteristics of COVID-19 contagions;and to analyse the association between the origin of the population, their socioeconomic level, and infection by close contact. Method: a cross-sectional study with the cases of COVID-19 contagion between February and September 2020, from an urban Primary Care Centre in Zaragoza, (N= 1,277). Data were retrieved from the Primary Care database, the public bases from Aragon, the Public Health Surveillance Service, and the epidemiological screening surveys. Square Chi tests were conducted, and statistical significance was p< 0.05. Results: the study included 1,277 cases (100%);54.74% were female with a median age of 39 years, 62.02% were of foreign origin, 62.96% had an income <18,000 euros per year, and 91.3% went back home after the consultation. 67.80% of them had contact with an infected person, mainly at home (62.63%). An association was found between the origin of the population and their income level, which was lower for foreigners (p< 0.001), who also presented a higher number of contagions due to close contact (p= 0.009), particularly in the home setting vs. the social setting for the native population (p= 0.039). Conclusions: the COVID-19 pandemic had a higher impact on vulnerable populations, particularly the foreign population with lower income. Health education strategies must be promoted, which are adapted to the community. © 2022 DAE Editorial, Grupo Paradigma. All rights reserved.

COVID-19 in Japan, January-March 2020: insights from the first three months of the epidemic.

BACKGROUND: Understanding the characteristics and natural history of novel pathogens is crucial to inform successful control measures. Japan was one of the first affected countries in the COVID-19 pandemic reporting their first case on 14 January 2020. Interventions including airport screening, contact tracing, and cluster investigations were quickly implemented. Here we present insights from the first 3 months of the epidemic in Japan based on detailed case data. METHODS: We conducted descriptive analyses based on information systematically extracted from individual case reports from 13 January to 31 March 2020 including patient demographics, date of report and symptom onset, symptom progression, travel history, and contact type. We analysed symptom progression and estimated the time-varying reproduction number, Rt, correcting for epidemic growth using an established Bayesian framework. Key delays and the age-specific probability of transmission were estimated using data on exposures and transmission pairs. RESULTS: The corrected fitted mean onset-to-reporting delay after the peak was 4 days (standard deviation: ± 2 days). Early transmission was driven primarily by returning travellers with Rt peaking at 2.4 (95% CrI: 1.6, 3.3) nationally. In the final week of the trusted period (16-23 March 2020), Rt accounting for importations diverged from overall Rt at 1.1 (95% CrI: 1.0, 1.2) compared to 1.5 (95% CrI: 1.3, 1.6), respectively. Household (39.0%) and workplace (11.6%) exposures were the most frequently reported potential source of infection. The estimated probability of transmission was assortative by age with individuals more likely to infect, and be infected by, contacts in a similar age group to them. Across all age groups, cases most frequently onset with cough, fever, and fatigue. There were no reported cases of patients < 20 years old developing pneumonia or severe respiratory symptoms. CONCLUSIONS: Information collected in the early phases of an outbreak are important in characterising any novel pathogen. The availability of timely and detailed data and appropriate analyses is critical to estimate and understand a pathogen's transmissibility, high-risk settings for transmission, and key symptoms. These insights can help to inform urgent response strategies.

COVID-19 outbreak in a long-term care facility in Kelowna, British Columbia after rollout of COVID-19 vaccine in March 2021.

BACKGROUND: In March 2021, a coronavirus disease 2019 (COVID-19) outbreak was declared at a large long-term care and short stay facility in British Columbia, Canada-well after introduction of the vaccination program in long-term care facilities that resulted in a dramatic decline in the number of outbreaks in this type of setting. The objective of this study is to provide the descriptive epidemiology of this outbreak, in the context of partial immunization of both residents and staff at the facility. METHODS: The cases' information was extracted from a provincial information system (Panorama). Descriptive analysis was performed using Microsoft Excel and SAS. Outbreak management controls included, but were not limited to, asymptomatic testing and efforts to increase vaccination. RESULTS: Twenty-six cases among the 241 resident and three cases among the 418 staff (corresponding to attack rates of 10% and less than 1%, respectively) were identified. The attack rate in residents was considerably lower than the average attack rate for COVID-19 outbreaks in long-term care facilities before the vaccine rollout. Seventeen resident cases were either partially or fully immunized. Four of the eight hospitalized cases and two of the three deceased cases were partially immunized. Seventeen cases were temporary stay residents. The three staff cases were not vaccinated. Ten cases were identified as part of asymptomatic testing. CONCLUSION: Introduction of vaccination at facilities contributed to lower attack rates and higher numbers of asymptomatic cases in this outbreak. Screening asymptomatic individuals identified additional cases among vaccinated residents. Findings underscore the importance of achieving high vaccine coverage, including among temporary stay residents, to prevent virus introduction and subsequent unrecognized transmission opportunities.

Epidemiology of coronavirus disease 2019 (COVID-19) in Japan during the first and second waves.

Following the emergence and worldwide spread of coronavirus disease 2019 (COVID-19), each country has attempted to control the disease in different ways. The first patient with COVID-19 in Japan was diagnosed on 15 January 2020, and until 31 October 2020, the epidemic was characterized by two large waves. To prevent the first wave, the Japanese government imposed several control measures such as advising the public to avoid the 3Cs (closed spaces with poor ventilation, crowded places with many people nearby, and close-contact settings such as close-range conversations) and implementation of "cluster buster" strategies. After a major epidemic occurred in April 2020 (the first wave), Japan asked its citizens to limit their numbers of physical contacts and announced a non-legally binding state of emergency. Following a drop in the number of diagnosed cases, the state of emergency was gradually relaxed and then lifted in all prefectures of Japan by 25 May 2020. However, the development of another major epidemic (the second wave) could not be prevented because of continued chains of transmission, especially in urban locations. The present study aimed to descriptively examine propagation of the COVID-19 epidemic in Japan with respect to time, age, space, and interventions implemented during the first and second waves. Using publicly available data, we calculated the effective reproduction number and its associations with the timing of measures imposed to suppress transmission. Finally, we crudely calculated the proportions of severe and fatal COVID-19 cases during the first and second waves. Our analysis identified key characteristics of COVID-19, including density dependence and also the age dependence in the risk of severe outcomes. We also identified that the effective reproduction number during the state of emergency was maintained below the value of 1 during the first wave.

Unraveling COVID-19: A Large-Scale Characterization of 4.5 Million COVID-19 Cases Using CHARYBDIS.

Purpose: Routinely collected real world data (RWD) have great utility in aiding the novel coronavirus disease (COVID-19) pandemic response. Here we present the international Observational Health Data Sciences and Informatics (OHDSI) Characterizing Health Associated Risks and Your Baseline Disease In SARS-COV-2 (CHARYBDIS) framework for standardisation and analysis of COVID-19 RWD. Patients and Methods: We conducted a descriptive retrospective database study using a federated network of data partners in the United States, Europe (the Netherlands, Spain, the UK, Germany, France and Italy) and Asia (South Korea and China). The study protocol and analytical package were released on 11th June 2020 and are iteratively updated via GitHub. We identified three non-mutually exclusive cohorts of 4,537,153 individuals with a clinical COVID-19 diagnosis or positive test, 886,193 hospitalized with COVID-19, and 113,627 hospitalized with COVID-19 requiring intensive services. Results: We aggregated over 22,000 unique characteristics describing patients with COVID-19. All comorbidities, symptoms, medications, and outcomes are described by cohort in aggregate counts and are readily available online. Globally, we observed similarities in the USA and Europe: more women diagnosed than men but more men hospitalized than women, most diagnosed cases between 25 and 60 years of age versus most hospitalized cases between 60 and 80 years of age. South Korea differed with more women than men hospitalized. Common comorbidities included type 2 diabetes, hypertension, chronic kidney disease and heart disease. Common presenting symptoms were dyspnea, cough and fever. Symptom data availability was more common in hospitalized cohorts than diagnosed. Conclusion: We constructed a global, multi-centre view to describe trends in COVID-19 progression, management and evolution over time. By characterising baseline variability in patients and geography, our work provides critical context that may otherwise be misconstrued as data quality issues. This is important as we perform studies on adverse events of special interest in COVID-19 vaccine surveillance.

On the Need to Revitalize Descriptive Epidemiology.

Nearly every introductory epidemiology course begins with a focus on person, place, and time, the key components of descriptive epidemiology. And yet in our experience, introductory epidemiology courses were the last time we spent any significant amount of training time focused on descriptive epidemiology. This gave us the impression that descriptive epidemiology does not suffer from bias and is less impactful than causal epidemiology. Descriptive epidemiology may also suffer from a lack of prestige in academia and may be more difficult to fund. We believe this does a disservice to the field and slows progress towards goals of improving population health and ensuring equity in health. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak and subsequent coronavirus disease 2019 pandemic have highlighted the importance of descriptive epidemiology in responding to serious public health crises. In this commentary, we make the case for renewed focus on the importance of descriptive epidemiology in the epidemiology curriculum using SARS-CoV-2 as a motivating example. The framework for error we use in etiological research can be applied in descriptive research to focus on both systematic and random error. We use the current pandemic to illustrate differences between causal and descriptive epidemiology and areas where descriptive epidemiology can have an important impact.

Changes in Numbers of COVID-19 Cases among Residents of Tourist Resort Areas before and during the "Go To Travel" Campaign: Descriptive Epidemiology in Gunma Prefecture.

The "Go To Travel" campaign in Japan, which encouraged people to travel throughout the country, was implemented in July 2020 to revitalize economic activity that was sluggish due to COVID-19. Although the risk of the spread of infection has been reported for tourists crossing prefectural borders, the spread of infection among residents living in tourist areas is unclear. The present study evaluated the number of COVID-19 cases among residents of tourist resort areas in Gunma Prefecture using a descriptive epidemiological method. Data regarding infected individuals were obtained from public data available on the prefecture's official homepage. Evaluation of epidemic curves showed that the number of cases increased slightly after the start of the campaign, with numbers affected by the occurrence of clusters. Toward the end of 2020, the number of cases increased in both resort and non-resort areas, although the increase was smaller in resort areas. Thus, the increased transmission of cases during the campaign suggested a need to take additional preventive measures, more-so for tourists than for resort area residents.

Epidemiology of Coronavirus Disease 2019 in Japan: Descriptive Findings and Lessons Learned through Surveillance during the First Three Waves.

INTRODUCTION: Coronavirus disease 2019 (COVID-19) has caused unprecedented global morbidity and mortality. Japan has faced three epidemic "waves" of COVID-19 from early 2020 through early 2021. Here we narratively review the three waves in Japan, describe the key epidemiologic features of COVID-19, and discuss lessons learned. METHODS: We assessed publicly available surveillance data, routine surveillance reports, and other relevant sources-multiple indicators were monitored to improve interpretation of surveillance data. Weekly trends for each wave were described based on the number of case notifications; number of tests performed; proportion of those tests that were positive for the novel coronavirus; the prevalent number of COVID-19 hospitalizations (total hospitalizations and those categorized as severe); and number of COVID-19 deaths. For each indicator and wave, we recorded the first calendar week to show an increase over two consecutive previous weeks, along with the peak week. RESULTS: The spring wave was characterized by detection of cases imported from China, followed by notifications of sporadic cases without travel history, clusters, and mild/asymptomatic cases. The summer wave saw a large increase in notifications and a younger age distribution, but in the context of increased testing with lower test positivity. The winter wave brought considerable morbidity and mortality, surpassing the cumulative case counts and fatalities from the earlier waves, with high peak values. Overall, relative to the first wave, the burden of severe outcomes was lower in the second and higher in the third wave, but varied by prefecture. In all three waves, severe outcomes peaked after notification counts and test positivity peaked; severe outcomes were also consistently skewed toward the elderly. CONCLUSIONS: Important lessons were learned from each wave and across waves-some aspects remained constant, while others changed over time. In order to rapidly detect an increase in incidence, continuous, timely, and sensitive surveillance-using multiple information sources with careful interpretations-will be key in COVID-19 control.

Differences in COVID-19 Testing and Test Positivity Among Veterans, United States, 2020.

OBJECTIVE: COVID-19 disproportionately affects racial/ethnic minority groups in the United States. We evaluated characteristics associated with obtaining a COVID-19 test from the Veterans Health Administration (VHA) and receiving a positive test result for COVID-19. METHODS: We conducted a retrospective cohort analysis of 6 292 800 veterans in VHA care at 130 VHA medical facilities. We assessed the number of tests for SARS-CoV-2 administered by the VHA (n = 822 934) and the number of positive test results (n = 82 094) from February 8 through December 28, 2020. We evaluated associations of COVID-19 testing and test positivity with demographic characteristics of veterans, adjusting for facility characteristics, comorbidities, and county-level area-based socioeconomic measures using nested generalized linear models. RESULTS: In fully adjusted models, veterans who were female, Black/African American, Hispanic/Latino, urban, and low income and had a disability had an increased likelihood of obtaining a COVID-19 test, and veterans who were Asian had a decreased likelihood of obtaining a COVID-19 test. Compared with veterans who were White, veterans who were Black/African American (risk ratio [RR] = 1.23; 95% CI, 1.19-1.27) and Native Hawaiian/Other Pacific Islander (RR = 1.13; 95% CI, 1.05-1.21) had an increased likelihood of receiving a positive test result. Hispanic/Latino veterans had a 43% higher likelihood of receiving a positive test result than non-Hispanic/Latino veterans did. CONCLUSIONS: Although veterans have access to subsidized health care at the VHA, the increased risk of receiving a positive test result for COVID-19 among Black and Hispanic/Latino veterans, despite receiving more tests than White and non-Hispanic/Latino veterans, suggests that other factors (eg, social inequities) are driving disparities in COVID-19 prevalence.

The Relationship Between the Global Burden of Influenza From 2017 to 2019 and COVID-19: Descriptive Epidemiological Assessment.

BACKGROUND: SARS-CoV-2 and influenza are lipid-enveloped viruses with differential morbidity and mortality but shared modes of transmission. OBJECTIVE: With a descriptive epidemiological framing, we assessed whether recent historical patterns of regional influenza burden are reflected in the observed heterogeneity in COVID-19 cases across regions of the world. METHODS: Weekly surveillance data reported by the World Health Organization from January 2017 to December 2019 for influenza and from January 1, 2020 through October 31, 2020, for COVID-19 were used to assess seasonal and temporal trends for influenza and COVID-19 cases across the seven World Bank regions. RESULTS: In regions with more pronounced influenza seasonality, COVID-19 epidemics have largely followed trends similar to those seen for influenza from 2017 to 2019. COVID-19 epidemics in countries across Europe, Central Asia, and North America have been marked by a first peak during the spring, followed by significant reductions in COVID-19 cases in the summer months and a second wave in the fall. In Latin America and the Caribbean, COVID-19 epidemics in several countries peaked in the summer, corresponding to months with the highest influenza activity in the region. Countries from regions with less pronounced influenza activity, including South Asia and sub-Saharan Africa, showed more heterogeneity in COVID-19 epidemics seen to date. However, similarities in COVID-19 and influenza trends were evident within select countries irrespective of region. CONCLUSIONS: Ecological consistency in COVID-19 trends seen to date with influenza trends suggests the potential for shared individual, structural, and environmental determinants of transmission. Using a descriptive epidemiological framework to assess shared regional trends for rapidly emerging respiratory pathogens with better studied respiratory infections may provide further insights into the differential impacts of nonpharmacologic interventions and intersections with environmental conditions. Ultimately, forecasting trends and informing interventions for novel respiratory pathogens like COVID-19 should leverage epidemiologic patterns in the relative burden of past respiratory pathogens as prior information.

Epidemiological characteristics of COVID-19 cases and estimates of the reproductive numbers 1 month into the epidemic, Italy, 28 January to 31 March 2020.

BackgroundOn 20 February 2020, a locally acquired coronavirus disease (COVID-19) case was detected in Lombardy, Italy. This was the first signal of ongoing transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the country. The number of cases in Italy increased rapidly and the country became the first in Europe to experience a SARS-CoV-2 outbreak.AimOur aim was to describe the epidemiology and transmission dynamics of the first COVID-19 cases in Italy amid ongoing control measures.MethodsWe analysed all RT-PCR-confirmed COVID-19 cases reported to the national integrated surveillance system until 31 March 2020. We provide a descriptive epidemiological summary and estimate the basic and net reproductive numbers by region.ResultsOf the 98,716 cases of COVID-19 analysed, 9,512 were healthcare workers. Of the 10,943 reported COVID-19-associated deaths (crude case fatality ratio: 11.1%) 49.5% occurred in cases older than 80 years. Male sex and age were independent risk factors for COVID-19 death. Estimates of R0 varied between 2.50 (95% confidence interval (CI): 2.18-2.83) in Tuscany and 3.00 (95% CI: 2.68-3.33) in Lazio. The net reproduction number Rt in northern regions started decreasing immediately after the first detection.ConclusionThe COVID-19 outbreak in Italy showed a clustering onset similar to the one in Wuhan, China. R0 at 2.96 in Lombardy combined with delayed detection explains the high case load and rapid geographical spread. Overall, Rt in Italian regions showed early signs of decrease, with large diversity in incidence, supporting the importance of combined non-pharmacological control measures.

Cluster of Severe Acute Respiratory Syndrome Coronavirus 2 Infections Linked to Music Clubs in Osaka, Japan.

BACKGROUND: It is important to understand the mode of transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) for disease control. We aimed to clarify how soon SARS-CoV-2 transmission can occur after infection by asymptomatically infected individuals. METHODS: We analyzed the publicly available epidemiological information for a cluster of 108 cases of coronavirus disease 2019 (COVID-19) cases in Osaka, Japan. RESULTS: Among cases, 51 cases attended a live music club only once and were considered to have a single visit. Ten remained asymptomatic at the time of COVID-19 diagnosis by reverse-transcription polymerase chain reaction, which was on average 20 days after exposure. Three routes of secondary transmission were identified, with 2-4 days from infection to transmission. All index cases for secondary transmission were asymptomatic at the time of contact with other people. Based on the date of symptom onset in the remaining 41 cases, the period from exposure to illness ranged from 2 to 17 days. CONCLUSIONS: Seemingly healthy people could spread SARS-CoV-2 during intense activities in enclosed environments without sufficient ventilation. Asymptomatically infected persons can transmit the virus as soon as 2 days after infection. Continuous efforts to avoid crowding and to maintain personal hygiene are needed for effective control of COVID-19.

Firearm purchasing and storage during the COVID-19 pandemic.

To better understand motivations behind purchase and storage of firearms during the COVID-19 pandemic, we used Amazon Mechanical Turk to conduct an online survey of individuals who did and did not purchase a firearm since 1 January 2020 in response to COVID-19. The survey was fielded between 1 and 5 May 2020. We asked about motivations for purchase, changes in storage practices and concern for themselves or others due to COVID-19. There were 1105 survey respondents. Most people who purchased a firearm did so to protect themselves from people. Among respondents who had purchased a firearm in response to COVID-19 without prior household firearm ownership, 39.7% reported at least one firearm was stored unlocked. Public health efforts to improve firearm-related safety during COVID-19 should consider increasing access to training and framing messages around the concerns motivating new firearm purchase.

Changes in intimate partner violence during the early stages of the COVID-19 pandemic in the USA.

The objective of this study is to describe intimate partner violence (IPV) severity and types of victimization during the early states of the COVID19 pandemic. A survey was distributed through social media and email distribution lists. The survey was open for 14 days in April 2020 and 2441 participated. Information on IPV, COVID19-related IPV severity, sociodemographics, and COVID19-related behaviors (eg, job loss) were collected. Regression models were used to evaluate COVID19-related IPV severity across victimization types and sociodemographics. 18% screened positive for IPV. Among the respondents that screened positive, 54% stated the victimization remained the same since the COVID19 outbreak, while 17% stated it worsened and 30% stated it got better. The odds of worsening victimization during the pandemic was significantly higher among physical and sexual violence. While the majority of IPV participants reported victimization to remain the same, sexual and physical violence was exacerbated during the early stages of the pandemic. Addressing victimization during the pandemic (and beyond) must be multi-sectorial.

Ancestral origin, antigenic resemblance and epidemiological insights of novel coronavirus (SARS-CoV-2): Global burden and Bangladesh perspective.

SARS-CoV-2, a new coronavirus strain responsible for COVID-19, has emerged in Wuhan City, China, and continuing its global pandemic nature. The availability of the complete gene sequences of the virus helps to know about the origin and molecular characteristics of this virus. In the present study, we performed bioinformatic analysis of the available gene sequence data of SARS-CoV-2 for the understanding of evolution and molecular characteristics and immunogenic resemblance of the circulating viruses. Phylogenetic analysis was performed for four types of representative viral proteins (spike, membrane, envelope and nucleoprotein) of SARS-CoV-2, HCoV-229E, HCoV-OC43, SARS-CoV, HCoV-NL63, HKU1, MERS-CoV, HKU4, HKU5 and BufCoV-HKU26. The findings demonstrated that SARS-CoV-2 exhibited convergent evolutionary relation with previously reported SARS-CoV. It was also depicted that SARS-CoV-2 proteins were highly similar and identical to SARS-CoV proteins, though proteins from other coronaviruses showed a lower level of resemblance. The cross-checked conservancy analysis of SARS-CoV-2 antigenic epitopes showed significant conservancy with antigenic epitopes derived from SARS-CoV. Descriptive epidemiological analysis on several epidemiological indices was performed on available epidemiological outbreak information from several open databases on COVID-19 (SARS-CoV-2). Satellite-derived imaging data have been employed to understand the role of temperature in the environmental persistence of the virus. Findings of the descriptive analysis were used to describe the global impact of newly emerged SARS-CoV-2, and the risk of an epidemic in Bangladesh.

Laboratory surveillance for SARS-CoV-2 in India: Performance of testing & descriptive epidemiology of detected COVID-19, January 22 - April 30, 2020.

BACKGROUND & OBJECTIVES: India has been reporting the cases of coronavirus disease 2019 (COVID-19) since January 30, 2020. The Indian Council of Medical Research (ICMR) formulated and established laboratory surveillance for COVID-19. In this study, an analysis of the surveillance data was done to describe the testing performance and descriptive epidemiology of COVID-19 cases by time, place and person. METHODS: The data were extracted from January 22 to April 30, 2020. The frequencies of testing performance were described over time and by place. We described cases by time (epidemic curve by date of specimen collection; seven-day moving average), place (area map) and person (attack rate by age, sex and contact status), and trends were represented along with public health measures and events. RESULTS: Between January 22 and April 30, 2020, a total of 1,021,518 individuals were tested for severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). Testing increased from about 250 individuals per day in the beginning of March to 50,000 specimens per day by the end of April 2020. Overall, 40,184 (3.9%) tests were reported positive. The proportion of positive cases was highest among symptomatic and asymptomatic contacts, 2-3-fold higher than among those with severe acute respiratory infection, or those with an international travel history or healthcare workers. The attack rate (per million) by age was highest among those aged 50-69 yr (63.3) and was lowest among those under 10 yr (6.1). The attack rate was higher among males (41.6) than females (24.3). The secondary attack rate was 6.0 per cent. Overall, 99.0 per cent of 736 districts reported testing and 71.1 per cent reported COVID-19 cases. INTERPRETATION & CONCLUSIONS: The coverage and frequency of ICMR's laboratory surveillance for SARS-CoV-2 improved over time. COVID-19 was reported from most parts of India, and the attack rate was more among men and the elderly and common among close contacts. Analysis of the data indicates that for further insight, additional surveillance tools and strategies at the national and sub-national levels are needed.