Vaccine access, equity and justice: COVID-19 vaccines and vaccination.

Although significant progress has been made in achieving goals for COVID-19 vaccine access, the quest for equity and justice remains an unfinished agenda. Vaccine nationalism has prompted calls for new approaches to achieve equitable access and justice not only for vaccines but also for vaccination. This includes ensuring country and community participation in global discussions and that local needs to strengthen health systems, address issues related to social determinants of health, build trust and leverage acceptance to vaccines, are addressed. Regional vaccine technology and manufacturing hubs are promising approaches to address access challenges and must be integrated with efforts to ensure demand. The current situation underlines the need for access, demand and system strengthening to be addressed along with local priorities for justice to be achieved. Innovations to improve accountability and leverage existing platforms are also needed. Sustained political will and investment is required to ensure ongoing production of non-pandemic vaccines and sustained demand, particularly when perceived threat of disease appears to be waning. Several recommendations are made to govern towards justice including codesigning the path forward with low-income and middle-income countries; establishing stronger accountability measures; establishing dedicated groups to engage with countries and manufacturing hubs to ensure that the affordable supply and predictable demand are in balance; addressing country needs for health system strengthening through leveraging existing health and development platforms and delivering on product presentations informed by country needs. Even if difficult, we must converge on a definition of justice well in advance of the next pandemic.

COVID-19 vaccines and the pandemic: lessons learnt for other neglected diseases and future threats.

Through the experiences gained by accelerating new vaccines for both Ebola virus infection and COVID-19 in a public health emergency, vaccine development has benefited from a 'multiple shots on goal' approach to new vaccine targets. This approach embraces simultaneous development of candidates with differing technologies, including, when feasible, vesicular stomatitis virus or adenovirus vectors, messenger RNA (mRNA), whole inactivated virus, nanoparticle and recombinant protein technologies, which led to multiple effective COVID-19 vaccines. The challenge of COVID-19 vaccine inequity, as COVID-19 spread globally, created a situation where cutting-edge mRNA technologies were preferentially supplied by multinational pharmaceutical companies to high-income countries while low and middle-income countries (LMICs) were pushed to the back of the queue and relied more heavily on adenoviral vector, inactivated virus and recombinant protein vaccines. To prevent this from occurring in future pandemics, it is essential to expand the scale-up capacity for both traditional and new vaccine technologies at individual or simultaneous hubs in LMICs. In parallel, a process of tech transfer of new technologies to LMIC producers needs to be facilitated and funded, while building LMIC national regulatory capacity, with the aim of several reaching 'stringent regulator' status. Access to doses is an essential start but is not sufficient, as healthcare infrastructure for vaccination and combating dangerous antivaccine programmes both require support. Finally, there is urgency to establish an international framework through a United Nations Pandemic Treaty to promote, support and harmonise a more robust, coordinated and effective global response.

Observed Mask Use in Kindergarten Through Grade 12 Schools in Georgia-Fall, 2021.

BACKGROUND: Universal masking, with additional layered prevention strategies, was an essential tool for limiting the transmission of SARS-CoV-2 and ensuring a safe return to in-person learning for kindergarten through 12th grade (K-12) students and staff. Few studies have examined mask adherence in this setting and none have described types of masks worn or locations of mask adherence. This project sought to assess mask adherence, types worn, and location of mask adherence in K-12 settings. METHODS: This study used direct in-person observations to measure the proportion of persons wearing masks correctly; type of masks worn; and location of mask adherence in 19 K-12 schools in Georgia. RESULTS: A total of 16,222 observations were conducted. Among those observed, 85.2% wore masks, with 80.3% wearing the mask correctly. Persons in high school were less likely to wear masks correctly. Correct mask use was most often observed among persons wearing N95-type masks. The prevalence of persons wearing masks correctly in transitional spaces was 5% higher than in congregate spaces. CONCLUSION: In K-12 schools with a universal masking policy, correct mask adherence was high among individuals. Examining adherence to recommended prevention measures can provide K-12 schools feedback to inform targeted messaging and policies during future disease outbreaks.

Pneumococcal Disease: Global Disease Prevention Strategies with a Focus on the Challenges in Iraq.

Pneumococcal disease is a global public health concern that significantly contributes to clinical disease burden and economic burden. Patients frequently afflicted are young children and older adults, as well as the immunocompromised population. Immunization is the most effective public health strategy to combat pneumococcal disease and several vaccine formulations have been developed in this regard. Although vaccines have had a significant global impact in reducing pneumococcal disease, there are several barriers to its success in Iraq. The war and conflict situation, increasing economic crises and poverty, poor vaccine accessibility in the public sector, and high vaccine costs are a few of the major obstacles that impede a successful immunization program. The last reported third dose pneumococcal conjugate vaccine coverage for Iraq was 37% in 2019, which is expected to reduce even further owing to the COVID-19 pandemic. Thus, strategies and policies to improve pneumococcal vaccine availability and coverage need to be strengthened to achieve maximum benefits of immunization. In the current review, we provide an overview of the existing knowledge on pneumococcal disease-prevention strategies across the globe. The main aim of this manuscript is to discuss the current status and challenges of pneumococcal vaccination in Iraq as well as the strategies to prevent pneumococcal infections.

Social carrying capacity and emotion dynamics in urban national parks during the COVID-19 pandemic

The COVID-19 pandemic has changed the mobility, accessibility, and behaviors of visitors dramatically. Under the impact of COVID-19, the social carrying capacity and emotion dynamics in parks and recreation areas are expected to change due to the uncertainty of health risks associated with visitors' behaviors. This study con-ducted an on-site visitor survey at Leiqiong Global Geological Park, a national park located in urban-proximate areas in Haikou, China. This study aims to examine factors impacting visitors' perceived crowding and emotions under varying levels of visitor use in urban national parks in the context of COVID-19. Study results suggest that visitors have the highest level of motivation for scenery and culture viewing and are generally satisfied with the environmental quality and design and COVID-19 prevention strategies and implementation efforts within the park. Moreover, this study suggests that the level of crowding and COVID-19 prevention strategies and imple-mentation can affect visitors' emotions in urban natioanl parks significantly. These findings highlight the importance of enforcing the social carrying capacity limits and COVID-19 prevention strategies for urban parks and protected areas to mitigate physical and mental health risks during the COVID-19 pandemic. Management implication: This study is one of the pilot studies that examines the social carrying capacity and emotion dynamics in urban national parks under the impact of the COVID-19 pandemic. Study results identify the thresholds of social carrying capacity and visitors' positive emotions based on the indicator of People Per View (PPV). Moreover, COVID-19 prevention strategies (e.g., mask-wearing and social distancing) can reduce visitors' perceived crowding and enhance positive emotions. These findings suggest that urban national parks should monitor visitor use levels based on the social carrying capacity framework to reduce visitors' perceived crowding and maintain positive emotions in the post-COVID-19 era.

Study on the Effectiveness of Prevention Strategies for the COVID-19 Pandemic: A Case Study in Ezhou, China

Background: Today, with the coronavirus disease 2019 (COVID-19) pandemic, the governments and international institutions are taking various approaches to control the infections. This study aims to propose an improved susceptible-exposed-infectious-removed (SEIR) model to predict the future trend of pandemic and assess the effectiveness of prevention and control strategies. Materials and Methods: A new SEIR model was developed by adding two Q1 and Q2 isolation parameters (at home and hospital) named "SEIR-Q1 Q2 ” to predict the future trend of pandemic, and assess the effectiveness of prevention and control strategies in Ezhou, Hubei province, China. The stimulation was conducted in Python by evaluating the effects of pandemic knowledge dissemination, medical supply, and both. Results: due to the lack of knowledge of the disease risk, there was no strong tendency towards self-isolation, and the outbreak time coincided with the start of the Spring Festival, China's major holiday, when many Chinse people are gathered and have close contact with each other. Therefore, it was not possible to disseminate the knowledge of pandemic, which let the virus kill many people. Conclusion: The SEIR-Q1 Q2 model can be used to predict the future trend of the COVID-19 pandemic by proposing the dissemination of the pandemic knowledge and increasing the supply of medical resources. © 2022, Negah Institute for Scientific Communication. All rights reserved.

Identifying Potential Super-Spreaders and Disease Transmission Hotspots Using White-Tailed Deer Scraping Networks.

White-tailed deer (Odocoileus virginianus, WTD) spread communicable diseases such the zoonotic coronavirus SARS-CoV-2, which is a major public health concern, and chronic wasting disease (CWD), a fatal, highly contagious prion disease occurring in cervids. Currently, it is not well understood how WTD are spreading these diseases. In this paper, we speculate that "super-spreaders" mediate disease transmission via direct social interactions and indirectly via body fluids exchanged at scrape sites. Super-spreaders are infected individuals that infect more contacts than other infectious individuals within a population. In this study, we used network analysis from scrape visitation data to identify potential super-spreaders among multiple communities of a rural WTD herd. We combined local network communities to form a large region-wide social network consisting of 96 male WTD. Analysis of WTD bachelor groups and random network modeling demonstrated that scraping networks depict real social networks, allowing detection of direct and indirect contacts, which could spread diseases. Using this regional network, we model three major types of potential super-spreaders of communicable disease: in-degree, out-degree, and betweenness potential super-spreaders. We found out-degree and betweenness potential super-spreaders to be critical for disease transmission across multiple communities. Analysis of age structure revealed that potential super-spreaders were mostly young males, less than 2.5 years of age. We also used social network analysis to measure the outbreak potential across the landscape using a new technique to locate disease transmission hotspots. To model indirect transmission risk, we developed the first scrape-to-scrape network model demonstrating connectivity of scrape sites. Comparing scrape betweenness scores allowed us to locate high-risk transmission crossroads between communities. We also monitored predator activity, hunting activity, and hunter harvests to better understand how predation influences social networks and potential disease transmission. We found that predator activity significantly influenced the age structure of scraping communities. We assessed disease-management strategies by social-network modeling using hunter harvests or removal of potential super-spreaders, which fragmented WTD social networks reducing the potential spread of disease. Overall, this study demonstrates a model capable of predicting potential super-spreaders of diseases, outlines methods to locate transmission hotspots and community crossroads, and provides new insight for disease management and outbreak prevention strategies.

'Just because something works doesn't mean it can't be improved': an ethnographic analysis of the health system in Black Panther's Wakanda.

The emergence of COVID-19 (SARS-CoV-2) has introduced significant global challenges for healthcare systems, healthcare professionals and patients. This current climate creates an opportunity to learn from equitable health systems and move toward making fundamental changes to healthcare systems. Our ethnographic analysis of Wakanda's healthcare system in Black Panther, from the Marvel Cinematic Universe, offers opportunities for system-level transformation across healthcare settings. We propose four healthcare system themes within the context of Wakandan identity: (1) technology as an instrument (blending bodies and technology, blending technology with tradition); (2) reimagining medication; (3) warfare and rehabilitation; and (4) preventative approaches to health (prioritising collective health, deprofessionalisation of healthcare services). The preceding themes represent core elements of Wakandan health systems that allow the people of Wakanda to thrive. Wakandans retain a strong identity and cultural traditions while embracing modern technologies. We found that effective upstream approaches to health for all are embedded in anti-colonial philosophies. Wakandans embrace innovation, embedding biomedical engineering and continuous improvement into care settings. For global health systems under strain, Wakanda's health system identifies equitable possibilities for system change, reminding us that culturally relevant prevention strategies can both decrease pressure on health services and allow all people to thrive.

Prevention strategies of panic buying during disaster

Panic buying is arguably an (ir)rational human behavior that is observed at times of emergencies. Although the phenomenon has been noted across the globe, very little evidence has been identified to prevent it. We aimed to identify, assess, and categorize the prevention strategies of panic buying during disasters. Sensible media reporting, psychological measures (online group counseling measures, promotion of kinship), (de)marketing (rationing, avoiding price hike), public health authority measures (assurance of the stock, raising awareness, subsidized goods sales, reduction of import duty, monitoring and punishment, psychosocial support, direct, clear, and sensible communication to the people), and supply chain management (assurance of the stock, sustainable supply, import from an alternative source, product substitution, resilient e-commerce, rapid replenishment) were the major identified domains of prevention for panic buying. This chapter identified and discussed importantly and perhaps preliminary strategies for the prevention of panic buying relating them to the different phases of disaster. Preparedness for controlling the panic among the population during future outbreaks should have an emphasis on these identified domains of preventive strategies. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Suicide in late life: A viewpoint.

Suicide in old age represents a sad public health concern. Despite the global decline in rates of suicide and the general amelioration of quality of life and access to health care for older adults, their rates of suicide remain the highest virtually in every part of the world. With the aging of the world population and the growing number of mononuclear families, the risk of an increase in isolation, loneliness and dependency does not appear ungrounded. The Covid-19 pandemic is claiming the life of many older persons and creating unprecedented conditions of distress, particularly for this segment of the population. This article briefly examines the main characteristics of suicidal behavior in late life, including observations deriving from the spread of the Sars-2 coronavirus and possible strategies for prevention.

A comprehensive and healthcare equity promoting response by a civil society-public partnership to COVID-19 in Chiapas, Mexico.

Following the first COVID-19 case in Chiapas, Mexico in March 2020, the non-governmental organisation Compañeros En Salud (CES) and the state's Ministry of Health (MOH) decided to join forces to respond to the global pandemic. The collaboration was built over 8 years of partnership to bring healthcare to underserved populations in the Sierra Madre region. The response consisted of a comprehensive SARS-CoV-2 infection prevention and control programme, which included prevention through communication campaigns to combat misinformation and stigma related to COVID-19, contact tracing of suspected and confirmed COVID-19 cases and their contacts, outpatient and inpatient care for patients with respiratory symptoms, and CES-MOH collaboration on anti-COVID-19 immunisation campaigns. In this article, we describe these interventions and their principal outcomes, as well as reflect on notable pitfalls identified during the collaboration, and we suggest a series of recommendations to prevent and mitigate their occurrence. As with many cities and towns across the globe, the poor preparedness of the local health system for a pandemic and pandemic response led to the collapse of the medical supply chain, the saturation of public medical facilities and the exhaustion of healthcare personnel, which had to be overcome through adaptation, collaboration and innovation. For our programme in particular, the lack of a formal definition of roles and clear lines of communication between CES and the MOH; thoughtful planning, monitoring and evaluation and active engagement of the communities served in the design and implementation of health interventions affected the outcomes of our efforts.

COVID-19 Workplace Mitigation Strategies and Employee Leave Policies Implemented during the Height of the Pandemic, United States, Fall 2020 and 2021.

COVID-19 workplace mitigation strategies implemented within US businesses have been effective at preventing disease and protecting workers, but the extent of their use is not well understood. We examined reported COVID-19 workplace mitigation strategies by business size, geographic region, and industry using internet panel survey data from US adult respondents working full- or part-time outside the home (fall 2020, N = 1168) andfull- or part-time, inside or outside the home (fall 2021, N = 1778). We used chi-square tests to assess the differences in the strategies used (e.g., masking and COVID-19 screening) and ANOVA tests to examine the group differences on a mitigation strategies summative score. Fewer COVID-19 mitigation strategies were reported by respondents in fall 2021 (compared to fall 2020) across businesses of different sizes and regions. The participants in microbusinesses (1-10 employees) reported significantly (p < 0.05) lower mitigation scores than all other business sizes, and the respondents in these businesses were significantly less likely (p < 0.05) to have paid leave than those in enterprises with >10 employees. The healthcare and education sectors had the highest reported mean score of COVID-19 workplace mitigation strategies. Small and essential businesses are critical to the US economy. Insight is needed on their use of mitigation strategies to protect workers during the current and future pandemics.

Post-Covid Workplace Scenario - Employer and Employee Health and Safety

The decreasing trend in the spread of the covid-19 infection has relaxed the restrictions imposed on the community, especially the working people. This working community, whether or not infected by the virus is now slowly turning back to work, along with the impacts of the lockdown. Though there is a decrease in the infection rate, there is always the possibility of infection at the workplace, as some percentage of the vaccinated people are also getting infected. It is necessary to follow the covid precautionary measures. Hence, it cannot be said that the normal situation has returned. The employer is in a state to manage a crowd comprising post-covid patients, caretakers of covid patients, and non-affected groups. The literature works reporting on post covid scenario, precautionary measures to be taken and workplace, benefits of workplace social distancing and sanitation, and medical care needed for workers were reviewed. This paper discusses the post-pandemic workplace scenario, health, and safety, sanitation among workers, awareness of precautionary measures, and their behavioral changes. © 2022 International Journal of Occupational Safety and Health (IJOSH). All rights reserved.

An early analysis of the World Bank's Pandemic Fund: a new fund for pandemic prevention, preparedness and response.

In response to shortcomings in epidemic preparedness and response that were revealed by the COVID-19 pandemic, there have been numerous proposals for ways to improve preparedness and response financing. Included among these is the World Bank's Pandemic Fund, formerly known as the Financial Intermediary Fund for Pandemic Prevention, Preparedness, and Response, which was launched in September 2022. This analysis piece examines the Pandemic Fund, where it fits into ongoing discussions surrounding financing for preparedness and response efforts and discusses emerging apprehensions about the new financing mechanism. Briefly, the Pandemic Fund is not the first time that the World Bank has hosted a financing mechanism to provide support for pandemic response. Notably the Pandemic Emergency Financing Facility (PEF)-which was launched in 2017 and closed in 2021-was criticised for generally failing to realise its potential. However, the Pandemic Fund seems to be addressing several of these critiques by placing a greater emphasis on prevention and preparedness financing, as opposed to response financing. Still, there is an important need for response funding mechanisms, and concerningly, the Pandemic Fund seems to support response efforts in name only. While it is clearly desirable to prepare for and prevent outbreaks for a multitude of reasons, it is also naive to assume that strengthening preparedness capacities will eliminate outbreaks and the need for response financing altogether. Accordingly, there is a need to complement this new financing mechanism with dedicated funding for responding to infectious disease outbreaks and to closely link this response financing with health security frameworks and instruments.

Transitioning the COVID-19 response in the WHO African region: a proposed framework for rethinking and rebuilding health systems.

The onset of the pandemic revealed the health system inequities and inadequate preparedness, especially in the African continent. Over the past months, African countries have ensured optimum pandemic response. However, there is still a need to build further resilient health systems that enhance response and transition from the acute phase of the pandemic to the recovery interpandemic/preparedness phase. Guided by the lessons learnt in the response and plausible pandemic scenarios, the WHO Regional Office for Africa has envisioned a transition framework that will optimise the response and enhance preparedness for future public health emergencies. The framework encompasses maintaining and consolidating the current response capacity but with a view to learning and reshaping them by harnessing the power of science, data and digital technologies, and research innovations. In addition, the framework reorients the health system towards primary healthcare and integrates response into routine care based on best practices/health system interventions. These elements are significant in building a resilient health system capable of addressing more effectively and more effectively future public health crises, all while maintaining an optimal level of essential public health functions. The key elements of the framework are possible with countries following three principles: equity (the protection of all vulnerable populations with no one left behind), inclusiveness (full engagement, equal participation, leadership, decision-making and ownership of all stakeholders using a multisectoral and transdisciplinary, One Health approach), and coherence (to reduce the fragmentation, competition and duplication and promote logical, consistent programmes aligned with international instruments).

Research progress on transmission routes of COVID-19

The COVID-19 (SARS-CoV-2) pandemic has become an urgent issue and attracted extensive attention all over the world due to its strong infectivity and high mortality. The outbreak of COVID-19 has a negative impact on the development of the world economy, brought inconvenience to people's daily life and threatened our health safety. Considering the global spread of COVID-19 disease with the tremendous number of infections and also deaths, understanding the transmission modes of this virus to formulate effective prevention and control strategies is of vital importance. This paper reviews three main transmission routes (contact, droplet and aerosol) and three possible transmission routes (maternal-infant, fecal-oral and cross-species) of COVID-19, which has reference value and guiding significance for the prevention and control of COVID-19 in the future. © 2022 ACM.

Resilience-Based Epidemic Strategy Evaluation Method Under Post-Covid-19

COVID-19 has heavily attacked the urban system and has continued to cause economic losses and human fatalities worldwide. Methodologies to properly evaluate the advantages and disadvantages of epidemic prevention strategies are urged, and to develop mitigation and improvement are required post-COVID. The urban system includes many elements;existing epidemic prevention and control strategy evaluation only focus on the effectiveness of containing confirmed cases. Therefore, a new resilience concept by combing multifaceted effectiveness is proposed for evaluating how epidemic prevention strategy influences urban system. The approach reflects the short-term factual effectiveness for epidemic mitigation and long-term value, including urban social and institutional resilience improvement and PDCA-cycle-based dynamic adjustability. An integrated model is used to evaluate prevention and control strategies in Shenzhen and Shanghai, China. The scores obtained are consistent with the facts and indicate that Shenzhen has more reasonable strategies for urban system than Shanghai. The strategy evaluation framework based on resilience proposed in this paper presents an innovative approach for assessing public health emergencies more comprehensively. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

Short-Term Safety and Psychosocial Impact of the BNT162b2 mRNA COVID-19 Vaccine in Cancer Patients-An Italian Single-Center Experience.

Safety data regarding BNT162b2 in cancer patients (CPs) are scarce. Herein we report the side effects (SEs), the adverse events (AEs), and the patient-reported outcomes (PROs) following BNT162b2 administration in CPs treated at the San Luigi Gonzaga University Hospital. All CPs who agreed to participate in our vaccination campaign received BNT162b2 and were included in the descriptive analysis. An anonymous questionnaire investigating the occurrence of SEs/AEs and PROs was administered to the study population 21 days after the first dose. Pearson's chi-squared test was used to estimate the risk of experiencing SEs/AEs according to selected variables. A total of 997 patients were included in the study: 62.0% had stage IV cancer, and 68.8% were receiving an active treatment, of whom 15.9% were receiving immunotherapy. SEs/AEs were recorded in 37.1% of cases after the first dose and in 48.5% of cases after the second dose. The most common SEs were muscle pain/local rash (27.9% and 28%, after the first and second dose, respectively). Patients older than 70 years showed lower risk of SEs/AEs, while women showed a higher risk. Before receiving the vaccine, 18.2% of patients felt fearful and/or insecure about the vaccination. After the first dose, 57.5% of patients changed their feelings positively. Our data support the short-term safety of BNT162b2 in CPs, regardless of disease stage and concurrent treatments. Overall, the vaccination showed a positive impact on quality of life.

Covid-19 Epidemic Trend Prediction Based on CNN-StackBiLSTM

In late 2019, the novel coronavirus (COVID-19) became a major health hazard around the world. Recently, the COVID-19 has spread widely in most countries and regions and the number of infected people continues to grow rapidly. Therefore, it is essential to research the development trend of the epidemic. The prediction of the number of infections and deaths is critical and helpful for developing health and epidemic prevention strategies and even curbing the epidemic. In this paper, a one-dimensional convolutional neural network combined with the stacked long-short-term-memory network model (CNN-StackBiLSTM) is proposed for the time-series prediction of cumulative cases and daily new cases. The local feature is extracted by CNN. The stacked BiLSTM captures the deeper characteristics of the time-series data. By combining the two networks, the proposed method simultaneously considers the information of temporal and spatial domains and can achieve accurate prediction results. Examples in Taiwan and Italy demonstrate the effectiveness of the proposed method. The proposed method is compared with LSTM, BiLSTM, and GRU. The mean absolute error, mean square error, R2 score, and root mean square error are calculated to quantificationally measure the different models. The results indicate the proposed method performs well in the prediction of both new daily confirmed cases and cumulative confirmed cases. © 2022 IEEE.