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1.
Front Immunol ; 13: 1025884, 2022.
Article in English | MEDLINE | ID: covidwho-2109769

ABSTRACT

Since the first outbreak in the 19th century influenza virus has remained emergent owing to the huge pandemic potential. Only the pandemic of 1918 caused more deaths than any war in world history. Although two types of influenza- A (IAV) and B (IBV) cause epidemics annually, influenza A deserves more attention as its nature is much wilier. IAVs have a large animal reservoir and cause the infection manifestation not only in the human population but in poultry and domestic pigs as well. This many-sided characteristic of IAV along with the segmented genome gives rise to the antigenic drift and shift that allows evolving the new strains and new subtypes, respectively. As a result, the immune system of the body is unable to recognize them. Importantly, several highly pathogenic avian IAVs have already caused sporadic human infections with a high fatality rate (~60%). The current review discusses the promising strategy of using a potentially universal IAV mRNA vaccine based on conserved elements for humans, poultry, and pigs. This will better aid in averting the outbreaks in different susceptible species, thus, reduce the adverse impact on agriculture, and economics, and ultimately, prevent deadly pandemics in the human population.


Subject(s)
Influenza Vaccines , Influenza, Human , Humans , Animals , Swine , Influenza, Human/epidemiology , Influenza, Human/prevention & control , Poultry , RNA, Messenger
2.
J Prim Care Community Health ; 13: 21501319221134851, 2022.
Article in English | MEDLINE | ID: covidwho-2108670

ABSTRACT

BACKGROUND: Our study aimed to describe the variation in the frequency of correct mask use among pedestrians in the first and second waves of the COVID-19 pandemic in high-flow indoor public spaces from different geographic and social settings in Peru. METHODS: We carried out a cross-sectional exploratory study among pedestrians in Lima (the capital city) and other coastal and highland cities in Peru. Pedestrians were directly observed by trained medical students in 2 high-flow indoor areas at different times in November 2020 (first wave) and October 2021 (second wave). Primary outcomes included the frequencies of mask use and correct use. We applied multinomial logistic models and estimated crude and adjusted relative prevalence ratios for sex, age, obesity, and location. Additionally, we used binomial generalized linear models to estimate prevalence ratios in crude and adjusted models. RESULTS: We included 1996 participants. The frequency of mask use was similar in both years: 96.9% in 2020 and 95.5% in 2021. However, the frequency of correct mask use significantly decreased from 81.9% (95% CI, 79.4-84.3) in 2020 to 60.3% (95% CI, 57.2-67.3) in 2021. In 2020, we observed an increase in the probability of misuse in the cities of Lima (aRP: 1.42; P = .021) and Chiclayo (aPR: 1.62, P = .001), whereas, in 2021, we noted an increase in the probability of misuse in the cities of Lima (aRP: 1.72; P < .001) and Piura (aPR: 1.44; P < .001). CONCLUSIONS: The correct mask use decreased during the second wave, although no significant overall variations were observed in mask use in pedestrians between both periods. Also, we found regional differences in correct mask use in both periods.


Subject(s)
COVID-19 , Pedestrians , Humans , COVID-19/epidemiology , Pandemics , Cross-Sectional Studies , Peru/epidemiology
3.
Palliat Med ; : 2692163221133665, 2022 Nov 06.
Article in English | MEDLINE | ID: covidwho-2108533

ABSTRACT

BACKGROUND: Voluntary and community sector bereavement services are central to bereavement support in the UK. AIM: To determine service providers' perspectives on access to their support before and during the COVID-19 pandemic. DESIGN: Mixed methods study using an explanatory sequential design: (1) Cross-sectional online survey of UK bereavement services; (2) Qualitative interviews with staff and volunteers at selected services. SETTINGS/PARTICIPANTS: 147 services participated in the survey; 24 interviews were conducted across 14 services. RESULTS: 67.3% of services reported there were groups with unmet needs not accessing their services before the pandemic; most frequently people from minoritised ethnic communities (49%), sexual minority groups (26.5%), deprived areas (24.5%) and men (23.8%). Compared with before the pandemic, 3.4% of services were seeing more people from minoritised ethnic groups, while 6.1% were seeing fewer. 25.2% of services did not collect ethnicity data. Qualitative findings demonstrated the disproportionate impact of the pandemic on minoritised ethnic communities, including disruption to care/mourning practices, and the need for culturally appropriate support. During the pandemic outreach activities were sometimes deprioritised; however, increased collaboration was also reported. Online provision improved access but excluded some. Positive interventions to increase equity included collecting client demographic data; improving outreach, language accessibility and staff representation; supporting other professionals to provide bereavement support; local collaboration and co-production. CONCLUSIONS: Service providers report inequities in access to bereavement support. Attention needs to be paid to identifying, assessing and meeting unmet needs for appropriate bereavement support. Identified positive interventions can inform service provision and research.

4.
Computer ; 55(11):16-28, 2022.
Article in English | Web of Science | ID: covidwho-2107838

ABSTRACT

With the COVID-19 pandemic, online university education assumed greater importance. We propose a practical e-learning model with suggestions to augment online education of all forms to support effective technical education. We also share our experiences of implementations of some of these suggestions in online teaching.

5.
Transp Res Interdiscip Perspect ; 16: 100718, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-2106082

ABSTRACT

The COVID-19 pandemic can be considered an unparalleled disruption to the aviation industry in the last century. Starting with an at-that-time inconceivable reduction in the number of flights from March 2020 to May 2020, the aviation industry has been trying to navigate through and out of the crisis. This process is accompanied with a significant number of scientific studies, reporting on the direct and indirect impact of the COVID-19 pandemic on aviation and vice versa. This paper reviews the impacts in context of the recent literature. We have collected nearly 200 well-published papers on the subject in the years 2021/2022 and dissected them into a framework of eight categories, built around: airlines, airports, passengers, workforce, markets, contagion, sustainability, and economics. We highlight the essence of findings in the literature and derive a set of future research directions and policy considerations which we deem important on the way towards pandemic-resilient aviation.

6.
Soc Sci Med ; 315: 115511, 2022 Nov 07.
Article in English | MEDLINE | ID: covidwho-2105993

ABSTRACT

Pandemic preparedness and COVID-19 response indicators focus on public health outcomes (such as infections, case fatalities, and vaccination rates), health system capacity, and/or the effects of the pandemic on the economy, yet this avoids more political questions regarding how responses were mobilized. Pandemic preparedness country rankings have been called into question due to their inability to predict COVID-19 response and outcomes, and COVID-19 response indicators have ignored one of the most well documented secondary effects of the pandemic - its disproportionate effects on women. This paper analyzes pandemic preparedness and response indicators from a feminist perspective to understand how indicators might consider the secondary effects of the pandemic on women and other equity deserving groups. Following a discussion of the tensions that exist between feminist methodologies and the reliance on indicators by policymakers in preparing and responding to health emergencies, we assess the strengths and weakness of current pandemic preparedness and COVID-19 response indicators. The risk with existing pandemic preparedness and response indicators is that they give only limited attention to secondary effects of pandemics and inequities in terms of who is disproportionately affected. There is an urgent need to reconceptualize what 'successful' pandemic preparedness and response entails, moving beyond epidemiological and economic measurements. We suggest how efforts to design COVID response indicators on gender inclusion could inform pandemic preparedness and associated indicators.

7.
Cities ; 131: 103909, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-2104560

ABSTRACT

In this paper we derive a theoretical model of the spread of a viral infection which we use as basis for an estimation strategy to test four interrelated hypotheses on the relationship between country-level COVID-19 mortality rates and the extent of urban development. Using data covering 81 countries we find evidence that countries with a higher population density, a higher share of the urban population living in the largest city, and countries with a higher urbanization rate had on average the same or fewer COVID-19 fatalities compared to less urbanized countries in 2020. Even though COVID-19 spreads faster in cities, fatalities may be lower, conditional on economic development, trust in government, and a well-functioning health care system. Generally, urbanization and city development are associated with economic development: with the resources urbanized countries have, it is easier for them to manage and maintain stricter lockdowns, and to roll out effective pharmaceutical interventions.

8.
Economics & Human Biology ; : 101198, 2022.
Article in English | ScienceDirect | ID: covidwho-2104833

ABSTRACT

Decisions on public health measures to contain a pandemic are often based on parameters such as expected disease burden and additional mortality due to the pandemic. Both pandemics and non-pharmaceutical interventions to fight pandemics, however, produce economic, social, and medical costs. The costs are, for example, caused by changes in access to healthcare, social distancing, and restrictions on economic activity. These factors indirectly influence health outcomes in the short- and long-term perspective. In a narrative review based on targeted literature searches, we develop a comprehensive perspective on the concepts available as well as the challenges of estimating the overall disease burden and the direct and indirect effects of COVID-19 interventions from both epidemiological and economic perspectives, particularly during the early part of a pandemic. We review the literature and discuss relevant components that need to be included when estimating the direct and indirect effects of the COVID-19 pandemic. The review presents data sources and different forms of death counts, and discusses empirical findings on direct and indirect effects of the pandemic and interventions on disease burden as well as the distribution of health risks.

9.
Int J Environ Health Res ; : 1-10, 2021 Oct 24.
Article in English | MEDLINE | ID: covidwho-2106932

ABSTRACT

Brazil has become the epicenter of coronavirus disease, and the São Paulo State has the worst scenario. This study evaluated the effect of the COVID-19 in dentists of São Paulo State, Brazil. A self-administered web-based survey with 33 multiple-choice questions was sent to dentists. Descriptive statistics were used to assess the 302 valid responses. Data were analyzed by Chi-square, McNemar and Wilcoxon tests (α = 0.05). Most of the participants aged until 34 years (61.6%) and were female (74.5%). They reduced work to less than 20 h per week. Monthly remuneration was reduced (86.8%). Personal protective equipment at the office was changed (p < 0.05). A few dentists (7.6%) had COVID-19, and more than 99% were aware of the disease. Most of the participants (90.2%) were insecure about being contaminated. The dentists of São Paulo State had coronavirus knowledge and have adopted strict biosafety protocols, but the pandemic affected their financial and psychological features.

10.
Aust Crit Care ; 2022 Nov 09.
Article in English | MEDLINE | ID: covidwho-2104403

ABSTRACT

BACKGROUND: Intensive care unit (ICU) nurses experience high levels of burnout during the COVID-19 pandemic due to multiple stressors. It has long been known that burnout is negatively associated with patient and staff outcomes. Understanding the triggers for intensive care nurses' burnout during the pandemic can help to develop appropriate mitigation measures. OBJECTIVE: The objective of this study was to examine intensive care nurses' experiences during the COVID-19 pandemic in Saudi Arabia to develop insights into the factors that influenced burnout. METHODS: The study was informed by a constructivist grounded theory design. The study was conducted in an adult ICU in a tertiary hospital in the Makkah province in the Kingdom of Saudi Arabia. All participants were registered nurses with at least 6 months' experience in intensive care and experienced caring for COVID-19 patients. FINDINGS: This paper reports on preliminary findings from interviews with 22 intensive care nurses. A core category 'pandemic pervasiveness' was identified from the interview data, which makes reference to the ever-present nature of the pandemic beyond the ICU context. Family, work, and the wider world context are the three groups of contextual factors that influenced nurses' experience and perception of burnout. CONCLUSION: Many issues identified from the findings in this study can be attributed to shortages in the intensive care nursing workforce. Thus, we join others in calling for healthcare organisations and policymakers to be creative in finding new ways to meet nurses' needs, motivate, and empower them to maintain and sustain the nursing workforce in highly demanding areas, such as ICUs. Nursing managers can play a crucial role in mitigating nurses' burnout by identifying and tackling sources of stress that exist among their staff, specifically team conflict, workplace harassment, and discrimination.

11.
Acta Diabetol ; 2022 Nov 08.
Article in English | MEDLINE | ID: covidwho-2103916

ABSTRACT

AIMS: We assessed the impact of Covid-19 on gestational diabetes rates in Quebec, the pandemic epicenter of Canada. METHODS: We conducted a population-based study of 569,686 deliveries in Quebec between 2014 and 2021. We measured gestational diabetes rates in wave 1 (March 1, 2020-August 22, 2020) and wave 2 (August 23, 2020-March 31, 2021), compared with the prepandemic period. We used interrupted time series regression to assess changes in gestational diabetes rates during each wave, and log-binomial regression models to estimate adjusted risk ratios (RR) and 95% confidence intervals (CI) for the association of the pandemic with gestational diabetes. We identified the types of patients that contributed to the change in gestational diabetes rates using Kitagawa's decomposition. RESULTS: Gestational diabetes rates were higher during the first (13.2 per 100 deliveries) and second waves (14.3 per 100 deliveries) than during the prepandemic period (12.4 per 100 deliveries). Risk of gestational diabetes increased both in wave 1 (RR 1.05, 95% CI 1.02-1.09) and wave 2 (RR 1.14, 95% CI 1.10-1.18), compared with the prepandemic period. However, most of the increase in gestational diabetes rates was driven by low-risk women without Covid-19 infections who were socioeconomically advantaged, had no comorbidity, and were 25-34 years of age. CONCLUSIONS: Gestational diabetes rates increased during the pandemic, mainly among women traditionally at low risk of hyperglycemia who did not have Covid-19 infections. Sudden widespread changes in screening or lifestyle can have a large impact on gestational diabetes rates in a population.

12.
Rev Panam Salud Publica ; 46: e23, 2022.
Article in Spanish | MEDLINE | ID: covidwho-2100871

ABSTRACT

Objective: Assess the impact of interventions introduced in Costa Rica during 2020 and 2021 to control the COVID-19 pandemic. Methods: A Bayesian Poisson regression model was used, incorporating control or intervention measures as independent variables in the changes in reported case numbers per epidemiological week. Results: The results showed the relative and combined impact of containment policies and measures on the reduction of cases: mainly vehicular traffic restrictions, use of masks, and implementation of health guidelines and protocols. Evidence of impact was optimized and made available for decision-making by the country's health and emergency authorities. Several iterations were generated for constant monitoring of variations in impact at four different moments in the pandemic's spread. Conclusion: The simultaneous implementation of different mitigation measures in Costa Rica has been a driving force in reducing the number of COVID-19 cases.


Objetivo: Avaliar o impacto das intervenções realizadas na Costa Rica durante 2020 e 2021 para o controle da pandemia de COVID-19. Método: Foi utilizado um modelo Bayesiano de regressão de Poisson que incorporou as medidas de controle ou intervenção como variáveis independentes sobre a variação do número de casos por semana epidemiológica. Resultados: Os resultados evidenciaram o efeito relativo e conjunto que as políticas ou medidas de contenção tiveram na redução de casos, principalmente as restrições a veículos, o uso de máscaras e a implementação de diretrizes e protocolos de saúde. As evidências dos efeitos foram otimizadas e disponibilizadas às autoridades sanitárias e de emergência do país para auxiliar na tomada de decisão. Diversas iterações foram geradas para o monitoramento constante da variação nos efeitos em quatro momentos distintos do avanço da pandemia. Conclusão: A aplicação simultânea de diferentes medidas de mitigação na Costa Rica tem sido um agente promotor da diminuição de casos de COVID-19.

13.
Biomedica ; 42(Sp. 2): 14-18, 2022 10 31.
Article in English, Spanish | MEDLINE | ID: covidwho-2100344

ABSTRACT

Durante dos años y medio, tanto en Colombia como en el resto del mundo, hemos enfrentado la pandemia generada por el SARS-CoV-2, agudizando los múltiples problemas de salud pública que venían cursando a manera de sindemias. Tal es el caso de las enfermedades crónicas no transmisibles asociadas, entre otros factores, a los malos hábitos alimenticios, especialmente por el gran consumo de alimentos ultraprocesados y bebidas azucaradas. En julio del 2021, se aprobó la Ley 2120, por medio de la cual se adoptaron medidas para fomentar entornos alimentarios saludables. Entre estas medidas, también se promueve que los alimentos empacados, procesados y que afectan negativamente la salud humana, tengan un sello que identifique sus componentes y valor nutricional para informar a los consumidores sobre el producto que están comprando o consumiendo. Entre las enfermedades más prevalentes en Colombia que afectan la salud bucal, se encuentran las caries y las periodontitis, ambas con factores de riesgo comunes con las enfermedades crónicas no transmisibles. Dados sus costos y prevalencia, dichas enfermedades crónicas no transmisibles resultan primordiales desde un enfoque de gestión del riesgo en salud pública, siendo, quizá, su gravedad mayor durante la pandemia generada por el SARS CoV-2. Asimismo, se especula que la población confinada pudo llegar a consumir más comida chatarra durante la pandemia del COVID-19 en comparación con otros períodos, además, porque en aquellos con enfermedades crónicas no transmisibles, el confinamiento obligado se asocia con mayor sedentarismo y con un menor número de controles médicos regulares, asuntos que se han reportado previamente. La promulgación de la ley de comida chatarra no va a cambiar los hábitos de alimentación de los colombianos "de la noche a la mañana" y, por esto, se necesita con urgencia implementar procesos de educación y sensibilización frente a los efectos adversos de los alimentos procesados y ultraprocesados en la salud.


Durante dos años y medio, tanto en Colombia como en el resto del mundo, hemos enfrentado la pandemia generada por el SARS-CoV-2, agudizando los múltiples problemas de salud pública que venían cursando a manera de sindemias. Tal es el caso de las enfermedades crónicas no transmisibles asociadas, entre otros factores, a los malos hábitos alimenticios, especialmente por el gran consumo de alimentos ultraprocesados y bebidas azucaradas. En julio del 2021, se aprobó la Ley 2120, por medio de la cual se adoptaron medidas para fomentar entornos alimentarios saludables. Entre estas medidas, también se promueve que los alimentos empacados, procesados y que afectan negativamente la salud humana, tengan un sello que identifique sus componentes y valor nutricional para informar a los consumidores sobre el producto que están comprando o consumiendo. Entre las enfermedades más prevalentes en Colombia que afectan la salud bucal, se encuentran las caries y las periodontitis, ambas con factores de riesgo comunes con las enfermedades crónicas no transmisibles. Dados sus costos y prevalencia, dichas enfermedades crónicas no transmisibles resultan primordiales desde un enfoque de gestión del riesgo en salud pública, siendo, quizá, su gravedad mayor durante la pandemia generada por el SARS CoV-2. Asimismo, se especula que la población confinada pudo llegar a consumir más comida chatarra durante la pandemia del COVID-19 en comparación con otros períodos, además, porque en aquellos con enfermedades crónicas no transmisibles, el confinamiento obligado se asocia con mayor sedentarismo y con un menor número de controles médicos regulares, asuntos que se han reportado previamente. La promulgación de la ley de comida chatarra no va a cambiar los hábitos de alimentación de los colombianos "de la noche a la mañana" y, por esto, se necesita con urgencia implementar procesos de educación y sensibilización frente a los efectos adversos de los alimentos procesados y ultraprocesados en la salud.


Subject(s)
COVID-19 , Humans , Colombia/epidemiology , SARS-CoV-2 , Retrospective Studies
14.
Korean J Women Health Nurs ; 26(2): 106-108, 2020 Jun 30.
Article in English | MEDLINE | ID: covidwho-2099985
15.
World J Gastroenterol ; 28(39): 5723-5730, 2022 Oct 21.
Article in English | MEDLINE | ID: covidwho-2099934

ABSTRACT

The novel coronavirus disease 2019 is an infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and was declared a global pandemic with more than 500 million reported cases and more than 6 million deaths worldwide to date. Although it has transitioned into the endemic phase in many countries, the mortality rate and overall prognosis of the disease are still abysmal and need further improvement. There has been evidence that shows the significance of SARS-CoV-2-related liver injury. Here, we review the literature on the various spectrum of SARS-CoV-2 infection-induced liver injury and the possible mechanisms of damage to the hepatobiliary system. This review aimed to illustrate the latest understanding regarding SARS-CoV-2-induced liver injury including the high-risk populations, the characteristic clinical manifestations, the possible pathogenic mechanism, the pathological changes, the current suggestions for clinical treatment for various spectrum of populations, and the prognosis of the condition. In conclusion, SARS-CoV-2 patients with a liver injury warrant close monitoring as it is associated with the more severe and poorer outcome of the infection.


Subject(s)
COVID-19 , Chemical and Drug Induced Liver Injury, Chronic , Humans , SARS-CoV-2 , COVID-19/complications , Pandemics
16.
Rev. Cuerpo Méd. Hosp. Nac. Almanzor Aguinaga Asenjo ; 15(2): 247-251, Abr. 01, 2022.
Article in Spanish | WHO COVID, LILACS (Americas) | ID: covidwho-2101012

ABSTRACT

Objetivo: Determinar las variables asociadas a la mortalidad por COVID 19 en población adulta mayor. El estudio: estudio observacional, 521 pacientes de 60 a más años con diagnóstico clínico/laboratorial de COVID -19; incluyó variables edad, sexo, prioridad de atención, procedencia, comorbilidades, estancia, frecuencia respiratoria y cardiaca, SO2, temperatura y signos/síntomas. Hallazgos: fallecidos, mayor frecuencia en julio (50.7%), 91,9% prioridad I/II, edad 70.1 ± 7.5 años, masculinos (71,0%), FC 103,7 ± 18,1 lat./min, FR 29,4 ± 6,4 resp./min (p<0,001), SO2 75,1% ± 14,35 y estancia 6,9 días ± 5,7; tos (68,3%), fiebre (38,0%) y cefalea (23,3%) signos/síntomas más frecuentes. El asma se asoció a la mortalidad (p=0,049). Conclusiones: El adulto mayor es una prioridad para los sistemas de salud pública; a mayor edad, masculino, que presente fiebre, tos y asma tendría mal pronóstico frente a la COVID-19.


Objetive:to determine the variables associated with mortality from COVID 19 in the older adult population. : observational study, 521 patients The studyaged 60 years and over with a clinical/laboratory diagnosis of COVID -19; variables included age, sex, priority of care, origin, comorbidities, stay, respiratory and heart rate, SO2, temperature and signs/symptoms. Findings: deaths, higher frequency in July (50.7%), 91.9% priority I/II, age 70.1 ± 7.5 years, male (71.0%), HR 103.7 ± 18.1 beats/min, RF 29.4 ± 6.4 breaths/min (p<0.001), SO2 75.1% ± 14.35 and stay 6.9 days ± 5.7; cough (68.3%), fever (38.0%) and headache (23.3%) most frequent signs/symptoms. Asthma was associated with mortality (p=0.049). The elderly is a priority for Conclusions:public health systems; older, male, with fever, cough and asthma have a poor prognosis against COVID-19.

17.
Snapshot series on alcohol control policies and practice|Brief 7, July 2022 ; 2022.
Article in English | WHOIRIS | ID: covidwho-2101137
18.
Work ; 2022 Oct 27.
Article in English | MEDLINE | ID: covidwho-2099077

ABSTRACT

BACKGROUND: The COVID-19 pandemic has led to widespread changes in the way people work. Some of these changes represent the same kinds of work modifications or adjustments that have often been requested as workplace accommodations, and which may improve labour market and employment outcomes for people with disabilities. OBJECTIVE: The aim of this scoping review was to examine the literature on workplace accommodations in the pandemic and their impacts and implications for people with disabilities. METHODS: Following a search of six international databases, articles were selected by two reviewers, and data were abstracted in accordance with scoping review methodology. A thematic analysis was used to report the relevant findings. RESULTS: Thirty-seven articles met the inclusion criteria, and three main themes were identified: positive impacts of pandemic-related workplace accommodations on people with disabilities (e.g., improved accessibility, reduced stigma around workplace accommodations, rapid implementation of workplace accommodations, opportunities for advocacy); negative impacts (e.g., worsened physical and mental health, new accommodation needs); and action needed and recommendations (e.g., revisit legislation and policy on accommodations, ensure representation of people with disabilities). Overall, our review identified a mixed assessment of the impacts of pandemic-related accommodations on people with disabilities. However, there was a broader consensus regarding the importance of learning from the experiences of the pandemic to improve workplace accommodation policies in the future. CONCLUSIONS: The pandemic may present opportunities for improving workplace accommodation policies, but our review also highlights the need for more research examining how workplace changes due to the COVID-19 pandemic have impacted people with disabilities.

19.
Hypertension ; 79(12): 2733-2742, 2022 12.
Article in English | MEDLINE | ID: covidwho-2098093

ABSTRACT

BACKGROUND: The COVID-19 pandemic may have negatively affected medical care for and self-management of chronic hypertension. We sought to examine the impact of the pandemic on blood pressure (BP) among individuals with hypertension. METHODS: Using an interrupted time series analysis, we compared the level and trend (slope) of BP outcomes before the public health emergency declaration (prepandemic period: August 2018 through January 2020) versus after the stay-at-home orders (pandemic period: April 2020 through November 2020) among adults with hypertension followed at 3 large health systems (n=137 593). Outcomes include systolic and diastolic BP recorded in electronic health records and the proportion of individuals with BP <140/90 mm Hg. RESULTS: The number of BP measurements substantially dropped early in the pandemic and then gradually increased. During the pandemic period, systolic and diastolic BP increased by 1.79 mm Hg (95% CI, 1.57-2.01; P<0.001) and 1.30 mm Hg (95% CI, 1.18-1.42; P<0.001), respectively, compared with the prepandemic period. Similarly, the proportion of patients with controlled BP decreased by 3.43 percentage points (95% CI, -3.97 to -2.90; P<0.001). A trend showing increasing control in the prepandemic period (+3.19 percentage points per year [95% CI, +2.96 to +3.42]; P<0.001) flattened during the pandemic period (+0.27 percentage points per year [95% CI, -0.81 to -1.37]; P=0.62). CONCLUSIONS: The first 8 months of the pandemic were associated with worsening BP outcomes among individuals with hypertension. Opportunities to ensure ongoing access to health care with telemedicine and home BP monitoring may mitigate adverse impacts on BP control for future disasters/emergencies.


Subject(s)
COVID-19 , Hypertension , Telemedicine , Adult , Humans , Blood Pressure/physiology , Pandemics , COVID-19/epidemiology , Time Factors , Hypertension/epidemiology , Blood Pressure Monitoring, Ambulatory
20.
The International Journal of High Performance Computing Applications ; 2022.
Article in English | Web of Science | ID: covidwho-2098239

ABSTRACT

This paper describes an integrated, data-driven operational pipeline based on national agent-based models to support federal and state-level pandemic planning and response. The pipeline consists of (i) an automatic semantic-aware scheduling method that coordinates jobs across two separate high performance computing systems;(ii) a data pipeline to collect, integrate and organize national and county-level disaggregated data for initialization and post-simulation analysis;(iii) a digital twin of national social contact networks made up of 288 Million individuals and 12.6 Billion time-varying interactions covering the US states and DC;(iv) an extension of a parallel agent-based simulation model to study epidemic dynamics and associated interventions. This pipeline can run 400 replicates of national runs in less than 33 h, and reduces the need for human intervention, resulting in faster turnaround times and higher reliability and accuracy of the results. Scientifically, the work has led to significant advances in real-time epidemic sciences.

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