Equity in the Pandemic Treaty: Access and Benefit-Sharing as a Policy Device or a Rhetorical Device?

Equity is a foundational concept for the new World Health Organization (WHO) Pandemic Treaty. WHO Member States are currently negotiating to turn this undefined concept into tangible outcomes by borrowing a policy mechanism from international environmental law: "access and benefit-sharing" (ABS).

Circulation of respiratory viruses during the COVID-19 pandemic in The Gambia

Background: In many countries, non-pharmaceutical interventions to limit severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission resulted in significant reductions in other respiratory viruses. However, similar data from Africa are limited. We explored the extent to which viruses such as influenza and rhinovirus co-circulated with SARS-CoV-2 in The Gambia during the COVID-19 pandemic. Methods: Between April 2020 and March 2022, respiratory viruses were detected using RT-PCR in nasopharyngeal swabs from 1397 participants with influenza-like illness. An assay to detect SARS-CoV-2 and a viral multiplex RT-PCR assay was used as previously described to detect influenza A and B, respiratory syncytial virus (RSV) A and B, parainfluenza viruses 1-4, human metapneumovirus (HMPV), adenovirus, seasonal coronaviruses (229E, OC43, NL63) and human rhinovirus. Result(s): Overall virus positivity was 44.2%, with prevalence higher in children <5 years (80%) compared to children aged 5-17 years (53.1%), adults aged 18-50 (39.5%) and >50 years (39.9%), p<0.0001. After SARS-CoV-2 (18.3%), rhinoviruses (10.5%) and influenza viruses (5.5%) were the most prevalent. SARS-CoV-2 positivity was lower in children <5 (4.3%) and 5-17 years (12.7%) than in adults aged 18-50 (19.3%) and >50 years (24.3%), p<0.0001. In contrast, rhinoviruses were most prevalent in children <5 years (28.7%), followed by children aged 5-17 (15.8%), adults aged 18-50 (8.3%) and >50 years (6.3%), p<0.0001. Four SARS-CoV-2 waves occurred, with 36.1%-52.4% SARS-CoV-2 positivity during peak months. Influenza infections were observed in both 2020 and 2021 during the rainy season as expected (peak positivity 16.4%-23.5%). Peaks of rhinovirus were asynchronous to the months when SARS-CoV-2 and influenza peaked. Conclusion(s): Our data show that many respiratory viruses continued to circulate during the COVID-19 pandemic in The Gambia, including human rhinoviruses, despite the presence of NPIs during the early stages of the pandemic, and influenza peaks during expected months.Copyright: © 2023 Jarju S et al.

Decreasing rates of ambulatory and hospitalized exacerbations of COPD during COVID-19 pandemic

Introduction Acute exacerbation of COPD (AECOPD) is a significant event in COPD associated with worse outcome and progressive lung disease. Infectious agents are thought to play an important role in causing AECOPD. Prevention of an exacerbation is an important therapeutic aim in COPD. Methods In order to gain insight into the relationship of ambulatory and hospitalized AECOPD cases we requested anonymized data from the largest local health care insurance including 4.5 Mio insurants of saxony and saxony-anhalt. Between 2016-2021 there were 516.591 ambulatory (466.841) and hospitalized (49.750) patients with an AECOPD (including J44.0 or J44.1;ICD-10). From 2016 to 2019 an average of 81.628 ambulatory and 9.378 hospitalized ECOPD cases per year were documented. Results AECOPD diagnoses in ambulatory care were decreased by 9,7 % (73.702) in 2020 and 18,4 % (66.629) in 2021. AECOPD cases in hospitals were reduced by 27,6 % in 2020 (6.791) and 41,9 % (5.447) in 2021. The percental diagnosis per insurant dropped from a mean of 0,28 % (2016 to 2019) to 0,18 % in 2020 and 0,12 % in 2021. During previous years there was a seasonal peak within the first quarter of the year, more pronounced during the influenza pandemic 2018. In 2021 this seasonal peak was not detectable (*Figure 1). The reduction in hospitalized AECOPD was more significant than that seen in practicing doctor sector. Discussion To our knowledge here we provide the biggest data set regarding information about decline of AECOPD in ambulatory care and hospital. Clearly the observed fall in case numbers of in and out patient AECOPD cases is related to preventive COVID-19 measures such as wearing masks, social isolation, improved hand hygiene, keeping distances, closure of public spaces and restaurants, testing and possibly also due to vaccination strategies. All together, these preventive measures showed effective in eliminating the usual seasonal peak.

Mask Use During COVID-19: A Social-Ecological Analysis.

To limit the spread of coronavirus disease 2019 (COVID-19), the Centers for Disease Control and Prevention issued recommendations that individuals wear face masks in public. Despite these recommendations, the individual decision to adhere and wear a mask may not be a simple decision. In this article, we examine the decision to wear a mask from a social-ecological perspective. Through critical analysis of societal, interpersonal and community, and intrapersonal influences, it is clear that the decision to wear a mask is multifaceted and influenced by constructs including public health recommendations and government mandates, racism and cultural norms, geography, household income, age, and personal attitudes. Understanding the multifactorial influences on mask wearing during COVID-19 is crucial for informing the creation and distribution of inclusive public health messaging regarding mask wearing now in the midst of an unprecedented health crisis, and in future unforeseen public health emergencies.

THE IMPACT OF COVID-19 ON SMES IN HUNGARY

Apart from the Spanish flu after World War I, the biggest global natural disaster of the past 100 years has been the coronavirus epidemic, which has had a serious impact on the Hungarian economy and society. Mathias Corvinus Collegium and IFKA Public Benefit Nonprofit Ltd. have examined the impact of the COVID-19 crisis on Hungarian SMEs, with a focus on their crisis resilience and adaptation strategies. The results indicated that it was mainly the impact on demand that has determined which business did better or worse during the pandemic. The adaptation strategies of enterprises have primarily been based on flexibility, cost reduction and cautious entrepreneurial behaviour. Their reaction shows that the pandemic may strengthen entrepreneurs' strategic thinking, as well as the crisis resilience and increased initiative of businesses. (English) [ABSTRACT FROM AUTHOR] Az első világháborút követő spanyolnáthán kívül az elmúlt száz év legnagyobb világméretű természeti katasztrófája a koronavírus-járvány volt, amely a magyar társadalomra és gazdaságra is súlyos hatással volt. A Mathias Corvinus Collegium és az IFKA Közhasznú Nonprofit Kft. közös kutatásában a koronavírus-járvány és a válság magyar kis- és középvállalkozásokra gyakorolt hatását vizsgálta, azok válságálló- és reagálóképessége, valamint alkalmazkodási stratégiái vonatkozásában. A kutatás megállapította, hogy elsősorban a járvány keresletre gyakorolt hatásán múlt, melyik vállalkozás járt jobban vagy rosszabbul koronavírus miatt. A bizonytalanság és a járvány generálta helyzet önmagában is megnövelte a vállalkozók költségeit. Az alkalmazkodás leginkább a rugalmasságon, a költségcsökkentésen és az óvatosságon alapult. A vállalkozók reagálása azt mutatja, hogy a járvány hatására erősödhet a vállalkozások stratégiai gondolkozása, melynek fontos elemei a válságállóság és a kezdeményezési képesség megerősítése. (Hungarian) [ABSTRACT FROM AUTHOR] Copyright of Vezetéstudomány / Budapest Management Review is the property of Corvinus University of Budapest and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Circulation of respiratory viruses during the COVID-19 pandemic in The Gambia

Background: In many countries, non-pharmaceutical interventions to limit severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission resulted in significant reductions in other respiratory viruses. However, similar data from Africa are limited. We explored the extent to which viruses such as influenza and rhinovirus co-circulated with SARS-CoV-2 in The Gambia during the COVID-19 pandemic. Method(s): Between April 2020 and March 2022, respiratory viruses were detected using RT-PCR in nasopharyngeal swabs from 1397 participants with influenza-like illness. An assay to detect SARS-CoV-2 and a viral multiplex RT-PCR assay was used as previously described to detect influenza A and B, respiratory syncytial virus (RSV) A and B, parainfluenza viruses 1-4, human metapneumovirus (HMPV), adenovirus, seasonal coronaviruses (229E, OC43, NL63) and human rhinovirus. Result(s): Overall virus positivity was 44.2%, with prevalence higher in children <5 years (80%) compared to children aged 5-17 years (53.1%), adults aged 18-50 (39.5%) and >50 years (39.9%), p<0.0001. After SARS-CoV-2 (18.3%), rhinoviruses (10.5%) and influenza viruses (5.5%) were the most prevalent. SARS-CoV-2 positivity was lower in children <5 (4.3%) and 5-17 years (12.7%) than in adults aged 18-50 (19.3%) and >50 years (24.3%), p<0.0001. In contrast, rhinoviruses were most prevalent in children <5 years (28.7%), followed by children aged 5-17 (15.8%), adults aged 18-50 (8.3%) and >50 years (6.3%), p<0.0001. Four SARS-CoV-2 waves occurred, with 36.1%-52.4% SARS-CoV-2 positivity during peak months. Influenza infections were observed in both 2020 and 2021 during the rainy season as expected (peak positivity 16.4%-23.5%). Peaks of rhinovirus were asynchronous to the months when SARS-CoV-2 and influenza peaked. Conclusion(s): Our data show that many respiratory viruses continued to circulate during the COVID-19 pandemic in The Gambia, including human rhinoviruses, despite the presence of NPIs during the early stages of the pandemic, and influenza peaks during expected months.Copyright © 2022 Jarju S et al.

Clinical support during covid-19: An opportunity for service and learning? A cross-sectional survey of UK medical students.

PURPOSE: Medical students providing support to clinical teams during Covid-19 may have been an opportunity for service and learning. We aimed to understand why the reported educational impact has been mixed to inform future placements. METHODS: We conducted a cross-sectional survey of medical students at UK medical schools during the first Covid-19 'lockdown' period in the UK (March-July 2020). Analysis was informed by the conceptual framework of service and learning. RESULTS: 1245 medical students from 37 UK medical schools responded. 57% of respondents provided clinical support across a variety of roles and reported benefits including increased preparedness for foundation year one compared to those who did not (p < 0.0001). However, not every individual's experience was equal. For some, roles complemented the curriculum and provided opportunities for clinical skill development, reflection, and meaningful contribution to the health service. For others, the relevance of their role to their education was limited; these roles typically focused on service provision, with few opportunities to develop. CONCLUSION: The conceptual framework of service and learning can help explain why student experiences have been heterogeneous. We highlight how this conceptual framework can be used to inform clinical placements in the future, in particular the risks, benefits, and structures.[Box: see text].

Differential Leukocyte Expression of IFITM1 and IFITM3 in Patients with Severe Pandemic Influenza A(H1N1) and COVID-19.

Interferon-induced transmembrane (IFITM) proteins mediate protection against enveloped viruses by blocking membrane fusion at endosomes. IFITM1 and IFITM3 are crucial for protection against influenza, and various single nucleotide polymorphisms altering their function have been linked to disease susceptibility. However, bulk IFITM1 and IFITM3 mRNA expression dynamics and their correlation with clinical outcomes have not been extensively addressed in patients with respiratory infections. In this study, we evaluated the expression of IFITM1 and IFITM3 in peripheral leukocytes from healthy controls and individuals with severe pandemic influenza A(H1N1) or coronavirus disease 2019 (COVID-19). Comparisons between participants grouped according to their clinical characteristics, underlying disease, and outcomes showed that the downregulation of IFITM1 was a distinctive characteristic of severe pandemic influenza A(H1N1) that correlated with outcomes, including mortality. Conversely, increased IFITM3 expression was a common feature of severe pandemic influenza A(H1N1) and COVID-19. Using a high-dose murine model of infection, we confirmed not only the downregulation of IFITM1 but also of IFITM3 in the lungs of mice with severe influenza, as opposed to humans. Analyses in the comparative cohort also indicate the possible participation of IFITM3 in COVID-19. Our results add to the evidence supporting a protective function of IFITM proteins against viral respiratory infections in humans.

Economic evaluations of antivirals for pandemic influenza viruses

Background: The coronavirus, COVID-19, has caused a global pandemic of an unprecedented scale. The efficacy of antivirals and other drugs, considered for repurposing, is assessed in clinical trials. It is not clear, however, whether these treatments, when available, will be cost effective. Purpose(s): To systematically review published economic evaluations of antivirals for the management of pandemic influenza. Method(s): The following databases were searched from inception to 26 March 2020: Medline (EBSCO HOST), EMBASE (OVID), EconLit (OVID), NHS EED (OVID) and HTA (OVID). Citation tracking and reference checking were also used. Only full economic evaluations published in the last ten years were included. Studies were quality assessed using NICE economic evaluation checklist. Data were extracted into standard data extraction tables and narratively summarised. Result(s): Of 709 records identified, 14 studies were included. These were mostly conducted in high income countries. They were seven (50.0%) cost-utility analyses, four (28.6%) cost-effectiveness analyses, two (14.3%) cost-consequences analyses, and one (7.1%) cost-benefit analysis. Antiviral treatment-containing strategies were found to be either cost saving or cost effective. Empirical treatment was more cost effective than test-guided treatment for young adults but less for older adults. Infection rate, prevalence, antiviral efficacy and costs were the key drivers of cost effectiveness Conclusion(s): Antiviral treatment for managing pandemic influenza viruses that have high case fatality rate, similar to the COVID-19 pandemic, has shown to be cost effective, either as standalone intervention or part of a multifaceted strategy.

Estimating R 0 from early exponential growth: parallels between 1918 influenza and 2020 SARS-CoV-2 pandemics.

The large spatial scale, geographical overlap, and similarities in transmission mode between the 1918 H1N1 influenza and 2020 SARS-CoV-2 pandemics together provide a novel opportunity to investigate relationships between transmission of two different diseases in the same location. To this end, we use initial exponential growth rates in a Bayesian hierarchical framework to estimate the basic reproductive number, R 0, of both disease outbreaks in a common set of 43 cities in the United States. By leveraging multiple epidemic time series across a large spatial area, we are able to better characterize the variation in R 0 across the United States. Additionally, we provide one of the first city-level comparisons of R 0 between these two pandemics and explore how demography and outbreak timing are related to R 0. Despite similarities in transmission modes and a common set of locations, R 0 estimates for COVID-19 were uncorrelated with estimates of pandemic influenza R 0 in the same cities. Also, the relationships between R 0 and key population or epidemic traits differed between diseases. For example, epidemics that started later tended to be less severe for COVID-19, while influenza epidemics exhibited an opposite pattern. Our results suggest that despite similarities between diseases, epidemics starting in the same location may differ markedly in their initial progression.

Wastewater Surveillance for SARS-CoV-2 RNA in Canada

Wastewater surveillance for SARS-CoV-2 RNA is a relatively recent adaptation of long-standing wastewater surveillance for infectious and other harmful agents. Individuals infected with COVID-19 were found to shed SARS-CoV-2 in their faeces. Researchers around the world confirmed that SARS-CoV-2 RNA fragments could be detected and quantified in community wastewater. Canadian academic researchers, largely as volunteer initiatives, reported proof-of-concept by April 2020. National collaboration was initially facilitated by the Canadian Water Network.Many public health officials were initially skeptical about actionable information being provided by wastewater surveillance even though experience has shown that public health surveillance for a pandemic has no single, perfect approach. Rather, different approaches provide different insights, each with its own strengths and limitations. Public health science must triangulate among different forms of evidence to maximize understanding of what is happening or may be expected. Well-conceived, resourced, and implemented wastewater-based platforms can provide a cost-effective approach to support other conventional lines of evidence. Sustaining wastewater monitoring platforms for future surveillance of other disease targets and health states is a challenge. Canada can benefit from taking lessons learned from the COVID-19 pandemic to develop forward-looking interpretive frameworks and capacity to implement, adapt, and expand such public health surveil-lance capabilities.

CSR in major European football leagues in the age of COVID-19: financial vulnerability, mental health and domestic violence

PurposeCOVID-19 pandemic has significantly impacted the lives of people and businesses around the world in different ways. France, Spain, Italy and the UK are among the worst affected countries by this pandemic. The purpose of this paper is to identify and compare different corporate social responsibility (CSR) activities taken by the clubs and player of the major football leagues of these four countries to develop a more comprehensive model of intervention. Design/methodology/approachThis paper has analyzed the initiatives taken by these football clubs and players to address financial vulnerabilities, mental health problems and domestic violence among the stakeholders and compared them with the existing CSR and humanitarian models. A case study approach has been used to collect and analyze data related to the CSR activities taken by the players and club management. Official websites of the clubs, newspaper and journal articles were among the major sources used to collect data for the paper. FindingsFootball clubs and players of the four major leagues have raised funds through different campaigns and delivered foods and essential medical supplies to the communities and hospitals to address financial vulnerabilities, mental health issues and domestic violence within their communities during the COVID-19 pandemic. They have provided guidance to their followers using social and television media to improve their physical and mental health during the pandemic. Online competitions, quizzes or virtual hangouts have also been used by the players to engage the stakeholders on a frequent basis. Football clubs have also initiated campaigns to raise awareness within the community on available medical services for the victims of domestic violence and also provided them with shelter, food, medical, legal and online counseling services. Originality/valueFootball clubs and players of the major leagues were always at the forefront to help the communities and hospitals to address issues related to mental health problems, financial vulnerabilities and domestic violence during the COVID-19 pandemic. The findings of this paper could help and guide other entities in designing a more comprehensive model of CSR interventions during pandemics or crisis situations to address financial vulnerabilities, mental health problems and domestic violence within their communities.

Vaccine Preparedness for the Next Influenza Pandemic: A Regulatory Perspective.

The response to SARS-CoV-2 demonstrated the tremendous potential of investments in vaccine research and development to impact a global pandemic, resulting in the rapid development and deployment of lifesaving vaccines. However, this unprecedented speed was insufficient to either effectively combat initial waves of the pandemic or adapt in real time to new variants. This review focuses on opportunities from a public health oriented regulatory perspective for enhancing research, development, evaluation, production, and monitoring of safety and effectiveness to facilitate more rapid availability of pandemic influenza vaccines. We briefly review regulatory pathways and processes relevant to pandemic influenza, including how they can be strengthened and globally coordinated. We then focus on what we believe are critical opportunities to provide better approaches, tools, and methods to accelerate and improve vaccine development and evaluation and thus greatly enhance pandemic preparedness. In particular, for the improved vaccines needed to respond to a future influenza pandemic better and more rapidly, moving as much of the development and evaluation process as possible into the pre-pandemic period is critical, including through approval and use of analogous seasonal influenza vaccines with defined immune correlates of protection.

Navajo Nation Stores Show Resilience During COVID-19 Pandemic.

On April 8, 2020, the Navajo Nation issued an administrative order limiting business operations. Facing high coronavirus disease 2019 (COVID-19) rates and limited food infrastructure, a survey was conducted among Navajo Nation store managers to assess: (1) COVID-19 adaptations; (2) challenges; (3) changes in customer volume and purchasing; and (4) suggestions for additional support. Purposive sampling identified 29 stores in Navajo communities. Representatives from 20 stores (19 store managers/owners, 1 other; 7 grocery, and 13 convenience/other stores) were interviewed by phone or in-person to reach saturation (new information threshold < 5%). Responses were coded using frequencies and inductive thematic analysis. All 20 stores implemented COVID-19 guidelines (Centers for Disease Control and Prevention [CDC]/Navajo Nation) and most received orientation/support from local chapters, community organizations, or health centers. Stores implemented staff policies (50%, handwashing, vaccinations, protective personal equipment (PPE), sick leave, temperature checks), environmental changes (50%, hand sanitizer, checkout dividers), customer protocols (40%, limit customers, mask requirements, closed restrooms), and deep cleaning (40%). Most stores (65%) reported challenges including stress/anxiety, changing guidelines, supply chain and customer compliance; 30% reported infection or loss of staff. Weekday customer volume was slightly higher vs. pre-COVID, but weekend lower. Stores reported consistent or more healthy food purchases (50%), more nonfood essentials (20%), or shelf-stable foods (10%). Desired support included further orientation (30%), leadership support (20%), overtime/time to learn guidelines (20%), and signage/handouts (15%). Despite a high COVID-19 burden and limited food store infrastructure, Navajo Nation stores adapted by implementing staff, environmental and customer policies. Local support, staffing, and small store offerings were key factors in healthy food access.

Using Data Mining to Estimate Patterns of Contagion-Risk Interactions in an Intercity Public Road Transport System

The COVID-19 pandemic has had very negative effects on public transport systems. These effects have compromised the role they should play as enablers of social equity and environmentally sustainable mobility and have caused serious economic losses for public transport operators. For this reason, in the context of pandemics, meaningful epidemiological information gathered in the specific framework of these systems is of great interest. This article presents the findings of an investigation into the risk of transmission of a respiratory infectious disease in an intercity road transport system that carries millions of passengers annually. To achieve this objective, a data mining methodology was used to generate the data required to ascertain the level of risk. Using this methodology, the occupancy of vehicle seats by passengers was simulated using two different strategies. The first is an empirical approach to the behaviour of passengers when occupying a free seat and the second attempts to minimise the risk of contagion. For each of these strategies, the interactions with risk of infection between passengers were estimated, the patterns of these interactions on the different routes of the transport system were obtained using k-means clustering technique, and the impact of the strategies was analysed.

Risk of herpes zoster ophthalmicus following COVID-19 vaccination in a large US claims database

Purpose : To determine whether there is an increased risk of herpes zoster ophthalmicus (HZO) following COVID-19 vaccination. Methods : Retrospective observational study utilizing OptumLabs® Data Warehouse, a longitudinal, real-world data asset with de- identified administrative claims and electronic health record data. A cohort study design and a self-controlled design were both utilized to investigate HZO following vaccination, defined by an ICD-10 diagnosis code within 30 days after vaccine administration (or up to the second dose if a second dose was administered), plus a new prescription or dose escalation of antivirals within 5 days of HZO diagnosis. Using a cohort design, COVID-19 vaccinated individuals from 12/11/2020- 6/30/2021 were compared to two influenza-vaccinated cohorts: a pre-pandemic group (1/1/2018-12/13/2019) and an early pandemic group (3/1/2020-11/1/2020). Cox proportional hazard models were used to identify unadjusted and adjusted hazard ratios for HZO. Using a self-controlled design, the incidence rate ratio comparing the risk of HZO in the risk intervals following COVID-19 vaccination to a control interval 60 to 90 days prior to the first dose was estimated using conditional Poisson regression. Results : Among 3,567,715 patients in the COVID-19 vaccinated cohort, there were 60 post-vaccine HZO cases. Patients vaccinated against COVID-19 were not at increased risk of HZO compared to pre-pandemic influenza vaccinated patients (N= 5,101,709;HR= 0.84;95% CI: 0.61-1.16;p= 0.29) and early pandemic influenza vaccinated patients (N= 4,060,412;HR= 0.93;95% CI: 0.64-1.34;p= 0.69) after adjustment for demographics, comorbidities, zoster vaccine, and medication use. Additionally, HZO cases post-COVID-19 vaccination were less likely to be prescribed ophthalmic steroids compared to cases following pre-pandemic and early pandemic influenza vaccination (18.3% vs 29.6% vs 41.4%, respectively). In the self-controlled design, patients were not at increased risk of HZO after COVID-19 vaccination compared to their control interval (IRR= 0.74;95% CI: 0.49-1.12;p= 0.15). Conclusions : There is not an increased risk of HZO following COVID-19 vaccination. These results provide reassurance for the safety of the COVID-19 vaccine from an ophthalmic standpoint.

Household Structure Projection: A Monte-Carlo based Approach

The kernel of an agent based simulation system for spreading of infectious disease needs a so called household structure (HSD) of the area being simulated which contains a list of households with the age of each member in the household being recorded. Such a household structure is available in a Census that is usually released every 10 years. Previous researches have shown the changing of the household structure has a great impact on disease spreading patterns. It is observed that the changing of the household structure e.g., the average citizen ages and household size, is at a faster speed. However, serious infectious diseases, such as SARS (year 2002), H1N1 (year 2009) and COVID-19 (year 2019), occur with a higher frequency now than previous eras. For example, it would be bad to use HSD2010 built using Census 2010 to simulate COVID-19. In view of this situation, we need a better way to obtain a good household structure in between the Census years in order for an agent-based simulation system to be effective. Note that though a detailed Census is not available every year, aggregated information such as the number of households with a particular size, and the number of people of a particular age are usually available almost monthly. Given HSDx, the household structure for year x, and the aggregated information from year y where y > x, we propose a Monte-Carlo based approach "patching" HSDx to get an approximated HSDy. To validate our algorithm, we pick x and y - x + 10 which both Censuses are available and find out the root-mean-square error (RMSE) between Census's HSDy and generated HSDy is fairly small for x = 1990 and 2000. The spreading patterns obtained by our simulation system have good matches. We hence obtain HSD2020 to be used in your system for studying the spreading of COVID-19.

Risk perception research informing recommendations for COVID-19 preventative health measures and public messaging.

OBJECTIVE: To provide a commentary on evidence-based recommendations for COVID-19 pandemic risk communication for more effective public health measures. METHOD: We apply the principles of risk communication to address key issues in the COVID-19 pandemic. RESULTS: Risk perception and communication research usefully informs preventative health education and public messaging during disease outbreaks such as the current COVID-19 pandemic, especially for those with severe mental illness. CONCLUSIONS: Key recommendations for pandemic public health risk communication are: clear, timely and balanced information from a reputable source; accurate and non-sensationalised depiction of infection, morbidity and mortality rates; awareness of fear as a powerful motivator for adoption of protective measures against the causative virus; promotion of self-efficacy and sense of control in terms of mitigating the health threats associated with a pandemic; correction of mis- and disinformation regarding the pandemic and associated protective measures; and messaging may need to be modified for people with a mental illness to avoid exacerbations of depressive and anxiety symptoms.

Evidenced-based natural therapies and immune-enhancing strategies to control, prevent, and treat co-morbidities COVID-19 and cancer

The purpose of this research is to provide evidence-based natural therapies and foods that will enhance the immune system to fight the virus SARS CoV-2 and cancer. Minority populations that include Black African Americans and Hispanics are experiencing higher mortality rates due to both socioeconomic and lifestyle factors in the US and globally. Successful lessons learned from controlling previous 1918 pandemic flu will be discussed. Hypotheses: We hypothesize that targeting lifestyle factors such as diet, exercise, and hydrothermal therapy that enhance the immune system can effectively control and reduce the risk to COVID-19 disease and cancer simultaneously. The target cells for the SARS CoV-2 virus contain the ACE2 and TMPRSS2 receptors which serve as portals of entry. They are expressed throughout the body including the nose, lungs, heart, bladder, pancreas, kidneys and brain found on the epithelial and vascular tissue cells of these organs. Covid-19 affects multiple organs in the body and disrupts the innate immune system, especially the natural killer cells, monocytes, and neutrophils. Studies have shown that countries where BCG was used have less than 10% of COVID-19 cases and countries that do not use the BCG vaccine such as the US and Italy had high cases. It was also seen that people who had higher natural killer cell activity had 100% survival rates. Enhancing the innate immune system through natural therapies has shown to enhance immune cells to fight COVID-19 as well as cancer and destroy it. Methodology: Our research is exploratory and is based on recently published literature on COVID-19 diseases. The following databases were searched: CINAHL, Web of Science, PubMed, EBSCOHost, Google Scholar, Academic Search Complete, AccessMedicine, MedlinePlus, Nutrition Care Manuel, JSTOR and Publons. Results: During the Spanish flu pandemic death rates of those who received the best medical care was 6.7% compared with those who received hydrotherapy at 1.34%. Hydrotherapy will increase the body temperature and stimulate the activity of the immune cells, which can kill the viruses. Increasing the body temperature to 39.5 degrees centigrade was shown to kill the virus. Following the hot water bath with cold treatment was shown to be even more effective. Many foods have been found to enhance the immune system and to fight the flu virus. Foods such as blueberries, garlic, and probiotics were shown to improve natural killer activity. Vitamin C, Vitamin D, Zinc, and selenium play a role in immunity. Foods rich in antioxidants such as kale, blueberries, red bell peppers, and all citrus fruits also help enhance the immune system. During the 1918 flu pandemic that received hydrotherapy and other natural remedies, out of the 120 students and staff exposed, there were 90 patients, none very sick, and there were no deaths. Natural remedies used in the Spanish flu pandemic and should be instituted to help enhance immunity and lessen the deadly impact of COVID-19 cancer patients.