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1.
Frontiers in Pediatrics ; 10, 2022.
Article in English | EMBASE | ID: covidwho-1822390

ABSTRACT

Background: With the outbreak of the COVID-19 pandemic, non-pharmaceutical interventions such as social distancing have been implemented worldwide, and a decrease in other infectious diseases has been reported as an unexpected benefit. However, to date, studies are lacking regarding the effects of the COVID-19 pandemic on neuroinfectious diseases;therefore, we aimed to determine the effects of the COVID-19 pandemic on the incidence of meningitis, which is the most common infectious disease in children. Methods: This retrospective study used electronic medical record data from five university hospitals located in the metropolitan cities in Korea. This study included patients aged <18 years who were diagnosed with meningitis between January 2017 and December 2020. We analyzed the clinical characteristics of patients with meningitis and changes in the incidence and causative pathogens of meningitis before and after the COVID-19 outbreak. Results: The study included 677 patients with meningitis. Following the outbreak of COVID-19 in Korea in January 2020, the incidence of childhood meningitis significantly decreased and seasonal changes noted yearly disappeared. There was a difference in the age distribution of patients with meningitis. The incidence of meningitis decreased significantly in children aged >5 years, and the incidence in children <5 years of age relatively increased (p < 0.001). In addition, there was a notable decrease in the cases of suspected meningitis (p < 0.001). The incidence of enteroviral meningitis, the most common cause of meningitis, significantly decreased. Conclusion: After the COVID-19 outbreak, the incidence of childhood meningitis significantly decreased with the implementation of non-pharmaceutical interventions. Absence of enteroviral meningitis and decrease in the proportion of patients aged ≥5 years with meningitis having mild symptoms were noted. Consequently, it can be concluded that the non-pharmaceutical interventions (NPIs) instituted to prevent the spread of COVID-19 had some effect on reducing the incidence of meningitis.

2.
Klimik Dergisi/Klimik Journal ; 35(1):21-25, 2022.
Article in Turkish | GIM | ID: covidwho-1819124

ABSTRACT

Objective: Coronavirus disease 2019 (COVID-19) pandemic is a global health emergency. Physicians are at high risk for COVID-19 due to their occupational exposure to infected patients. In this study, we aimed to evaluate the opinions of physicians, who are at the forefront of the fight against the COVID-19 pandemic, on prophylaxis and probable vaccination for SARS-CoV-2 infection through a questionnaire.

3.
Vaccines ; 10(3), 2022.
Article in English | EMBASE | ID: covidwho-1818228

ABSTRACT

Background: Several countries are implementing COVID-19 booster vaccination campaigns. The objective of this study was to model the impact of different primary and booster vaccination strategies. Methods: We used a compartmental model fitted to hospital admission data in France to analyze the impact of primary and booster vaccination strategies on morbidity and mortality, assuming waning of immunity and various levels of virus transmissibility during winter. Results: Strategies prioritizing primary vaccinations were systematically more effective than strategies prioritizing boosters. Regarding booster strategies targeting different age groups, their effectiveness varied with immunity and virus transmissibility levels. If the waning of immunity affects all adults, people aged 30 to 49 years should be boosted in priority, even for low transmissibility levels. Conclu-sions: Increasing the primary vaccination coverage should remain a priority. If a plateau has been reached, boosting the immunity of younger adults could be the most effective strategy, especially if SARS-CoV-2 transmissibility is high.

4.
Veterinary Quarterly ; 42(1):48-67, 2022.
Article in English | EMBASE | ID: covidwho-1815728

ABSTRACT

Natural antioxidants applied as feed additives can improve not only animals’ health and overall performance but also increase their resistance to environmental stress such as heat stress, bad housing conditions, diseases, etc. Marine organisms, for example seaweeds–red, brown, and green macroalgae contain a plethora of biologically active substances, including phenolic compounds, polysaccharides, pigments, vitamins, micro- and macroelements, and proteins known for their antioxidant activity, which can help in the maintenance of appropriate redox status in animals and show pleiotropic effects for enhancing good health, and productivity. The dysregulated production of free radicals is a marked characteristic of several clinical conditions, and antioxidant machinery plays a pivotal role in scavenging the excessive free radicals, thereby preventing and treating infections in animals. Supplementation of seaweeds to animal diet can boost antioxidant activity, immunity, and the gut environment. Dietary supplementation of seaweeds can also enhance meat quality due to the deposition of marine-derived antioxidant components in muscles. The use of natural antioxidants in the meat industry is a practical approach to minimize or prevent lipid oxidation. However, overconsumption of seaweeds, especially brown macroalgae, should be avoided because of their high iodine content. An important point to consider when including seaweeds in animal feed is their variable composition which depends on the species, habitat, location, harvest time, growing conditions such as nutrient concentration in water, light intensity, temperature, etc. This review highlights the beneficial applications of seaweeds and their extracted compounds, which have antioxidant properties as feed additives and impact animal health and production.

5.
Disease Surveillance ; 37(1):67-71, 2022.
Article in Chinese | GIM | ID: covidwho-1789474

ABSTRACT

Objective: To analyze the epidemiologic characteristics of common respiratory virus infection in hospitalized children in Wuhan Children's Hospital from January to December 2019, and provide evidence for clinical diagnosis and treatment.

6.
Journal of Clinical Oncology ; 40(6 SUPPL), 2022.
Article in English | EMBASE | ID: covidwho-1779696

ABSTRACT

Background: The COVID-19 pandemic has been associated with a significant disruption in healthcare services including cancer screening and diagnosis. Delays in cancer screening and treatment may lead to increased mortality. We aimed to analyze changes in screening, diagnosis and surgical treatment of common GU malignancies in relation to the COVID-19 pandemic. Methods: We evaluated screening, novel diagnoses, and surgical management modalities of prostate cancer (PCa), urothelial carcinoma (UC) and renal cell carcinoma (RCC) within Massachusetts General Brigham, the largest healthcare system in the Northeastern United States, over four 3-month time periods during the pandemic (March 2020- March 2021). The percentage change in screening, diagnoses and management modalities during pandemic periods as compared to the immediate pre-pandemic period (December 2019-March 2020) was calculated as (Nperiod - Ncontrol)/Ncontrol. The difference in "predicted" versus "observed" diagnoses in each pandemic period was compared to the average of the four preceding 3-month periods (March 2019-March 2020) to account for seasonal variation. Results: The first pandemic peak (March-June 2020) was associated with a significant decline across screening, diagnosis and treatment, ranging from -15.7 to -64.8%, followed by a progressive recovery, ranging from -5.9 to +25.1% in the latest period (December 2020-March 2021) (Table). Although 725 diagnoses were "missed" between March and June 2020 as compared to the previous 12 months, 971 diagnoses were "recovered" between June 2020 and March 2021. Conclusions: A substantial disruption in the screening, diagnosis and treatment of GU malignancies was observed early in the pandemic, followed by a progressive rebound and recovery. The highest declines were observed for PSA screening, and the lowest for cystectomy procedures, reflecting triaging of care based on severity during the pandemic.

7.
Annals of Parasitology ; 68(1):35-38, 2022.
Article in English | CAB Abstracts | ID: covidwho-1771929

ABSTRACT

Scabies is a highly contagious, parasitic infestation caused by Sarcoptes scabiei var. hominis. There are some reports which claim the incidence of scabies has increased during COVID-19 lockdown. In this study, we aimed to compare the prevalence of scabies between March to September 2020 - the first six months of the COVID-19 outbreak in Turkey - and March to September 2019 - the same period in the previous year. Case number percentages were compared month-over-month and by total numbers for each specified period. Pearson's chi-squared test was the comparison tool used. We checked the records of 36,469 patients who were admitted to Bezmialem Vakif University, Faculty of Medicine, Dermatology Department, a tertiary healthcare center, between March and September 2019, and out of this number, 258 patients had been diagnosed with scabies. The overall scabies case percentage was 0.71% and the range of monthly prevalence was 0.57%-0.83%. During the corresponding period in 2020, 26,219 dermatology patients were admitted, and 465 of those patients were diagnosed with scabies. The overall scabies case percentage was 1.77% and the range of monthly prevalence was 1.37%-3.46%. Scabies prevalence percentages were statistically significantly higher in all months and in the overall total in 2020 (P < 0.001). Our nine patients, who admitted in 2020, did not respond to permethrin treatment but responded well to an ivermectin and permethrin combination. Scabies incidence has increased during the COVID-19 pandemic according to our study. We believe there may be an underreported resistance to permethrin and that starting treatment with oral ivermectin in combination with topical permethrin in extraordinary times, such as a pandemic, may help to control outbreaks.

8.
Veterinary Practitioner ; 22(2):165-171, 2021.
Article in English | EMBASE | ID: covidwho-1766725

ABSTRACT

An attempt was made to analyze the impact of seasonal changes, disease scare situations and festivals on the prices of broilers across India. Prices of broilers were collected for the period from 2017 to 2021 from the various secondary sources like Karnataka Poultry Farmers and Breeders Association (KPFBA), TS AP Broiler Co-Ordination Committee (TSAPBCC), Poultry Bazaar etc. The seasonal index analysis for the last 10 years data revealed that the average broiler prices had grown significantly from 2011 to 2014, later prices gradually declined in 2015 due to the outbreak of Highly Pathogenic Avian Influenza (H5N1) in the month of February, 2015. Prices bounced back and increased from 2016 to 2019. Again there was decline of prices in the middle of January 2020 due to outbreak of Highly Pathogenic Avian Influenza (H5N1)) and Covid-19 pandemic. The prices of broilers have been recovering and gradually increasing since March, 2021 onwards. The consumption of chicken during winter season is high and this led to high prices in the market. Whereas the demand for chicken during hot climate months of March, April and May become slack in all the market centers of India resulting lowest price for chicken. Also, the increased demand on account of festivals viz., Christmas and New Year attributed to the rise in prices in the months of November and December.

9.
Reports ; 5(1):1, 2022.
Article in English | ProQuest Central | ID: covidwho-1760805

ABSTRACT

Vitamin D is known as an antirachitic factor, although it also plays a critical role in several nonskeletal diseases. In our study, we evaluated vitamin D status and sex, age and seasonal association in a general population cohort living in central Italy. Data from 1174 men and 2274 women aged 20–81 were analyzed, and stored serum samples were assayed for 25-hydroxyvitamin D (25(OH)D). Vitamin D was low in both sexes with values significantly lower in women than in men;furthermore, its deficiency was highly correlated with age. The younger men had just sufficient 25(OH)D levels (32.3 ng/mL ± 13.2), which decreased with increasing age. The younger women showed insufficient 25(OH)D levels (24.8 ng/mL ± 11.9) that, as with men, further decreased with increasing age. This study demonstrated that hypovitaminosis D may be a very frequent condition also in a rural central Italian area with remarkable solar irradiation throughout the year. Our data clearly indicated an evident seasonal trend: at the end of the winter, serum 25(OH)D levels of the examined cohort were below the official sufficient value for both adult sexes. Sufficient levels were just reached in summer for men and only at the end of summer for young women.

10.
Open Forum Infectious Diseases ; 8(SUPPL 1):S753-S754, 2021.
Article in English | EMBASE | ID: covidwho-1744148

ABSTRACT

Background. The four common human coronavirus (HCoV) types, including two alpha (NL63 and 229E) and two beta (HKU1 and OC43) coronaviruses, generally cause mild, upper respiratory illness. Common HCoV seroprevalence increases rapidly during the first five years of life and remains high throughout adulthood. HCoVs are known to have seasonal patterns, with variation in predominant types each year, but more defined measures of seasonality are needed. Methods. We describe laboratory detection, percent positivity, and seasonality of the four common HCoVs during July 2014 to May 2021 in the United States reported to the National Respiratory and Enteric Virus Surveillance System (NREVSS). We also describe age, sex, and co-detection with other respiratory viruses for a subset of specimens available through the Public Health Laboratory Interoperability Project (PHLIP). We used a method previously validated for respiratory syncytial virus, characterized by a centered 5-week moving average and normalization to peak, to define seasonal inflections, including season onset, peak, and offset. Results. Any HCoV type was detected in 96,336 (3.4%) of 2,487,736 specimens. Predominant common HCoV types fluctuated by surveillance year (Figure 1) and were generally consistent across geographic regions. In a subset of 4,576 specimens with a common HCoV detection, those with type 229E had a higher median age compared to other HCoV types (30.8 versus 24.8 years, p< 0.001), but there were no differences by sex. Influenza was the most commonly co-detected virus. In the last six complete HCoV seasons, onsets ranged from October to November, peaks from January to February, and offsets from April to June;>95% of all HCoV detections occurred within these ranges. The 2020-2021 common HCoV season onset, dominated by types NL63 and OC43, was delayed by approximately two months compared to prior seasons. Conclusion. Common HCoVs demonstrate relatively consistent seasonal patterns. The delayed onset of the 2020-2021 season may be attributable to mitigation measures implemented across the US including masking, improved hand hygiene, and social distancing. Better defining HCoV seasonality can inform clinical preparedness and testing practices and may provide insights into the behavior of emerging coronaviruses.

11.
Open Forum Infectious Diseases ; 8(SUPPL 1):S104-S106, 2021.
Article in English | EMBASE | ID: covidwho-1746765

ABSTRACT

Background. The COVID-19 pandemic was associated with a significant (28%) reduction of methicillin-resistant Staphylococcus aureus (MRSA) acquisition at UVA Hospital (P=0.016). This "natural experiment" allowed us to analyze 3 key mechanisms by which the pandemic may have influenced nosocomial transmission: 1) enhanced infection control measures (i.e., barrier precautions and hand hygiene), 2) patient-level risk factors, and 3) networks of healthcare personnel (HCP)-mediated contacts. Hospital MRSA acquisition was defined as a new clinical or surveillance positive in patients with prior unknown or negative MRSA status occurring >72h after admission. 10 month time periods pre- (5/6/2019 to 2/23/2020) and post-COVID-19 (5/4/2020 to 2/28/2021) were chosen to mitigate the effects of seasonality. A 6-week wash-in period was utilized coinciding with the onset of several major hospital-wide infection control measures (opening of 2 special pathogen units with universal contact/airborne precautions on 4/1/21 and 5/1/21, universal mask 4/10/21 and eye protection 4/20/20 policies instituted along with staff education efforts including the importance of standard precautions). Box and whisker plots depict quartile ranges, median (dotted line), and mean values. Mean MRSA acquisition rates pre- (0.92 events per 1,000 patient days) significantly declined post-COVD-19 (to 0.66;P=0.016). Independent-samples t tests were used (2-tailed) for statistical comparisons except for variables without a normal distribution (Shorr Scores), for which a Mann-Whitney U test was used. Methods. Census-adjusted hospital-acquired MRSA acquisition events were analyzed over 10 months pre- (5/6/2019 to 2/23/2020) and post-COVD-19 (5/4/2020 to 2/28/2021), with a 6-week wash-in period coinciding with hospital-wide intensification of infection control measures (e.g., universal masking). HCP hand hygiene compliance rates were examined to reflect adherence to infection control practices. To examine impacts of non-infection control measures on MRSA transmission, we analyzed pre/post-COVD-19 differences in individual risk profiles for MRSA acquisition as well as a broad suite of properties of the hospital social network using person-location and person-person interactions inferred from the electronic medical record. Figure 2. Social Network Construction We constructed a contact network of hospitalized patients and staff at University of Virginia Hospital to analyze the properties of both person-location and person-person networks and their changes pre- and post-COVID-19. Colocation data (inferred from shared patient rooms and healthcare personnel (HCP)-patient interactions recorded in the electronic health record, e.g., medication administration) were used to construct contact networks, with nodes representing patients and HCP, and edges representing contacts. The above schematic shows how the temporal networks are inferred. In the figure, circles represent patients and the small filled squares represent HCP, while the larger rectangles represent patient rooms. The first room is a shared room with two patients. At each time step, co-location is inferred from the EMR data, which specifies interactions between HCP and patients. This can be represented as the temporal network (t) at the bottom. Results. Hand hygiene compliance significantly improved post-COVD-19, in parallel with other infection control measures. Patient Shorr Scores (an index of individual MRSA risk) were statistically similar pre-/post-COVD-19. Analysis of various network properties demonstrated no trends to suggest a reduced outbreak threshold post-COVD-19. Figure 3. Hand Hygiene Compliance Rates Analysis of hospital-wide hand hygiene auditing data (anonymous auditors deployed to various units across UVA Hospital with an average 1,710 observations per month (range 340 - 7,187)) demonstrated a statistically significant (6%) improvement in average monthly hand hygiene compliance (86.9% pre- versus 93.1% post-COVD-19;P=0.008). Figure 4. Individual MRSA Risk Factors We calculated the Shorr Score (a validated tool to estimate individual risk for MRSA carriage in hospitalized patients;Shorr et al. Arch Intern Med. 2008;168(20):2205-10) for patients using data from the electronic health record to test the hypothesis that individual risk factors in aggregate did not change significantly in the post-COVD-19 period to explain changes in MRSA acquisition. Values for this score ranged from 0 to 10 with the following criteria: recent hospitalization (4), nursing home residence (3), hemodialysis (2), ICU admission (1). Pictured are frequency distributions of Shorr scores in the pre-COVID-19 and post-COVID-19 periods. The Mann-Whitney effect size (E), 0.53 (P=0.51), indicated that pre- and post-COVD-19 distributions were very similar. We analyzed three major types of network properties for this analysis: (1) Node properties of the pre- and post-COVID-19 networks consisted of all the edges in the pre- and post-COVID-19 periods, respectively. We considered a number of standard properties used in social network analysis to quantify opportunities for patient-patient transmission: degree centrality (links held by each node), betweenness centrality (times each node acts as the shortest 'bridge' between two other nodes), closeness centrality (how close each node is to other nodes in network), Eigenvector centrality (node's relative influence on the network), and clustering coefficient (degree to which nodes cluster together) in the first five panels (left to right, top to bottom);(Newman, Networks: An Introduction, 2010). Each panel shows the frequency distributions of these properties. These properties generally did not have a normal distribution and therefore we used a Mann Whitney U test on random subsets of nodes in these networks to compare pre- and post-COVID properties. The mean effect size (E) and P-values are shown for each metric in parenthesis. We concluded that all of these pre- versus post-COVID-19 network properties were statistically similar. (2) Properties of the ego networks (networks induced by each node and its 'one-hop' neighbors). We considered density (average number of neighbors for each node;higher density generally favors lower outbreak threshold) and degree centrality (number of links held by each node) of ego networks (middle right and bottom left panels). The mean effect size and p-values using the Mann Whitney test are shown in parenthesis;there were no statistically significant differences in these properties in the pre- and post-COVID networks. (3) Aggregate properties of the weekly networks, consisting of all the interactions within a week. We considered modularity (measure of how the community structure differs from a random network;higher modularity means a stronger community structure and lower likelihood of transmission) and density (average number of neighbors each node;higher density generally favors lower outbreak threshold) of the weekly networks (bottom middle and bottom right panels). The modularity in the post-COVID weekly networks was slightly lower (i.e., it has a weaker community structure, and the network is more well mixed), while density was slightly higher, the differences of which were statistically significant;a caveat is that these are relatively small datasets (about 40 weeks). These differences (higher density, and better connectivity) both increase the risk of transmission in the post-COVID networks. In summary, the post-COVID networks either have similar properties as the pre-COVID networks, or had changes which are unlikely to have played a role in reducing MRSA transmission. Conclusion. A significant reduction in post-COVD-19 MRSA transmission may have been an unintended positive effect of enhanced infection control measures, particularly hand hygiene and increased mask use. A modest (11.6%) post-COVD-19 reduction in surveillance testing may have also played a role. Despite pandemic-related cohorting and census fluctuations, most network properties were not significantly different post-COVID-19, except for aggregate density and modularity which varied in a directio that instead favored transmission;therefore, HCP-based networks did not play a significant role in reducing MRSA transmission. Multivariate modeling to isolate relative contributions of these factors is underway. Figure 6. Surveillance Testing and Clinical Culturing Post-COVD-19, there was a modest (11.6%) but statistically significant reduction in surveillance PCR testing (42.4 mean tests per 1,000 patient days pre- versus 37.5 post-COVD-19;P<0.002). There was not a statistically significant difference in rates of clinical cultures sent (2.48 cultures per 1,000 patient days pre- versus 2.23 post-COVD-19;P=0.288).

12.
Open Forum Infectious Diseases ; 8(SUPPL 1):S690-S691, 2021.
Article in English | EMBASE | ID: covidwho-1746314

ABSTRACT

Background. Non-pharmaceutical interventions (NPIs), such as sanitary measures and travel restrictions, aimed at controlling the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), may affect the transmission dynamics of human respiratory syncytial virus (HRSV). We aimed to quantify the contribution of the sales of hand hygiene products and the number of international and domestic airline passenger arrivals on HRSV epidemic in Japan. Methods. The monthly number of HRSV cases per sentinel site (HRSV activity) in 2020 was compared with the average of the corresponding period in the previous 6 years (from January 2014 to December 2020) using a monthly paired t-test. A generalized linear Poisson regression model was used to regress the time-series of the monthly HRSV activity against NPI indicators, including sale of hand hygiene products and the number of domestic and international airline passengers, while controlling for meteorological conditions (monthly average temperature and relative humidity) and seasonal variations between years (2014-2020). Results. The average number of monthly HRSV case notifications in 2020 decreased by approximately 85% (P < 0.001) compared to those in the preceding 6 years (2014-2019) (Figure 1A). For every average \1 billion (approximately $9,000,000/£6,800,00) spent on hand hygiene products during the current month and 1 month before (lag 0-1 months) there was a 0.22% (P = 0.02) decrease in HRSV infections (Table 1). An increase of average 1,000 domestic and international airline passenger arrivals during the previous 1-2 months (lag 1-2 months) was associated with a 4.6×10-4% (P < 0.001) and 1.1×10-3% (P = 0.007) increase in the monthly number of HRSV infections, respectively. Conclusion. This study suggests that there is an association between the decrease in the monthly number of HRSV cases and improved hygiene and sanitary measures and travel restrictions for COVID-19 in Japan, indicating that these public health interventions can contribute to the suppression of HRSV activity. These findings may help in public health policy and decision making.

13.
Indian Journal of Medical Microbiology ; 39:S127-S128, 2021.
Article in English | EMBASE | ID: covidwho-1734530

ABSTRACT

Background:Influenza is an important respiratory infection, causing 250,000 to 500,000 deaths annually. Influenza virus A is the most virulent and associated with winter epidemics in temperate regions, more persistent transmission in the tropics, and occasional large-scale global pandemics. But, there is variability in the pattern, and the H1N1 pandemic of 2009-2010 was unusually with a large spike in spring and a sharp decline continuing throughout winter. Varying in pattern is due to antigenic shift and drift and reassortment of the virus. Methods:A prospective study was carried out in Advance Basic Sciences & Clinical Research Lab, Department of Micro- biology in SMS Medical College & Hospital, Jaipur for diagnosis of Influenza A virus as well as subtyping was done using RT-PCR technique over 1 year period (July 2019 to June 2020) and demographic data was noted. Results:Total of 7213 samples were tested, out of which 498 (6.90%) were positive for Influenza A which is less from the previous year’s 22.46%. Out of total positive cases Influenza a (H1N1) pdm09 was 24.9% and InfA H3N2 was 75.10%. InfA H3N2 was the prominent circulating strain in all months while Influenza a (H1N1) pdm09 was prominent strain pre- vious year. Majority of positive cases were found in March 2020 (43.17%), September 2019 (28.51%). Most of these cases 36.14% were from age group between 20 to 40 years. Conclusions: A decline in the positivity of influenza infection compared to last year is seen which could be in part due to circulation of SARS COV 2 and measures of prevention undertaken by community to prevent it. Demographic parame- ters and seasonal variation of Influenza A virus give ideas to create awareness and to improve control strategies to mini- mize the morbidity, mortality and spread of disease.

14.
Working Paper Series National Bureau of Economic Research ; 36, 2021.
Article in English | GIM | ID: covidwho-1733025

ABSTRACT

I present a behavioral epidemiological model of the evolution of the COVID epidemic in the United States and the United Kingdom over the past 12 months. The model includes the introduction of a new, more contagious variant in the UK in early fall and the US in mid December. The model is behavioral in that activity, and thus transmission, responds endogenously to the daily death rate. I show that with only seasonal variation in the transmission rate and pandemic fatigue modeled as a one-time reduction in the semi-elasticity of the transmission rate to the daily death rate late in the year, the model can reproduce the evolution of daily and cumulative COVID deaths in the both countries from Feb 15, 2020 to the present remarkably well. I find that most of the end-of-year surge in deaths in both the US and the UK was generated by pandemic fatigue and not the new variant of the virus. I then generate forecasts for the evolution of the epidemic over the next two years with continuing seasonality, pandemic fatigue, and spread of the new variant.

15.
Diabetol Int ; : 1-7, 2022 Mar 08.
Article in English | MEDLINE | ID: covidwho-1734070

ABSTRACT

Aim: The purpose of the study was to investigate seasonal variations in HbA1c, GA and LDL-C and to examine the effects of the COVID-19 pandemic on these variations and on glycemic and lipid control themselves in patients with type 2 diabetes. Patients and methods: The subjects were outpatients with type 2 diabetes who had received standard treatment for glycemic control for more than 3 years. Data for patients who visited our hospital from January 2021 to March 2021 were retrospectively investigated based on electronic medical records. Results: HbA1c showed seasonal variation (high in winter-spring and low in summer-autumn), and this was similar during the COVID-19 pandemic. However, the mean HbA1c over 1 year was significantly elevated during the COVID-19 pandemic (7.53 ± 1.02% in 2020) compared with the previous 2 years: (7.34 ± 0.91 in 2018, 7.39 ± 0.93 in 2019; 2020 vs. 2018; 0.19%, P < 0.001; 2020 vs. 2019; 0.14%, P = 0.0013) and the difference was larger in winter. GA showed no apparent seasonal variation, but mean GA during the COVID-19 pandemic was elevated compared with earlier years (2020 vs. 2018, P < 0.001; 2020 vs. 2019, P < 0.001). LDL-C did not show apparent seasonal variation and was unaffected by COVID-19 pandemic. Conclusion: The COVID-19 pandemic influenced mean HbA1c and GA levels over 1 year, but did not affect seasonal variations, while LDL-C was not affected by COVID-19. Observation of these levels over a longer period is warranted to determine the longer-term influence of the COVID-19 pandemic.

16.
Annals of Actuarial Science ; : 23, 2022.
Article in English | Web of Science | ID: covidwho-1721375

ABSTRACT

The COVID-19 pandemic requires that actuaries track short-term mortality fluctuations in the portfolios they manage. This demands methods that not only operate over much shorter time periods than a year but that also deal with reporting delays. In this paper, we consider a semi-parametric approach for tracking portfolio mortality levels in continuous time. We identify both seasonal patterns and mortality shocks, thus providing a comparison benchmark for the impact of COVID-19 in terms of a portfolio's own past experience. A parametric model is presented to allow for the average impact of seasonal variation and also reporting delays. We find that an estimate of mortality reporting delays can be made from a single extract of experience data. This can be used to forecast unreported deaths and improve estimates of recent mortality levels. Results are given for annuity portfolios in France, the UK and the USA.

17.
Field Exchange Emergency Nutrition Network ENN ; 64:35-40, 2021.
Article in English | CAB Abstracts | ID: covidwho-1717258

ABSTRACT

GLOBAL. What we know: Demand for treatment services for childhood diseases (particularly malaria, diarrhoea and acute respiratory infection (ARI)) surge in response to seasonal changes and shocks. What this article adds: A broader Health Surge approach is emerging, prompted by health facility staff beginning to apply community-based management of acute malnutrition (CMAM) Surge principles to other childhood disease services. Lessons learned from implementing countries to date (Sierra Leone, Burkina Faso, Chad, Niger, Ethiopia and Mauritania), including during the COVID-19 response, have informed working definitions, key elements of a package and key principles of an approach currently modelled on the CMAM Surge steps. Health Surge can be viewed as a quality improvement approach that empowers health workers to better anticipate, prepare for and manage fluctuations in demand for essential nutrition and child health services at facility-level in real-time, in complement to wider disease surveillance and response mechanisms. Health facility staff set specific thresholds for single diseases of public health importance in their catchment area to inform decisions and action on health facility capacity;information can be aggregated at district or regional levels to reveal rising stress on the health system. Adaptability of the approach is key and should always consider the context, effectiveness, local and national ownership, process transparency and sustainability. Experiences indicate that the Health Surge approach should protect services for the most vulnerable and will benefit from local prioritisation of illnesses, the tailoring of threshold setting methods according to how local health services are organised and disease-specific surge actions. Digital monitoring approaches will help real-time monitoring. Existing global and regional technical working groups on CMAM Surge are now coordinating Health Surge efforts. Tools and guidance are currently being developed by Concern and will be piloted in Niger, Kenya and Mali by Concern and Save the Children from early 2021.

18.
Value in Health ; 25(1):S251, 2022.
Article in English | EMBASE | ID: covidwho-1650254

ABSTRACT

Objectives: The COVID-19 pandemic outbreak forced hospitals to postpone or cancel surgeries so staff and equipment could be reallocated to intensive care units. However, few studies have measured the impact of the pandemic on surgical activities. This study aimed at quantifying the impact of COVID-19 and lockdowns on surgical activity in a French university teaching hospital. Methods: All surgeries for the period between 01/2017 and 04/2021 were extracted. Seven specific surgeries were selected and classified as urgent (appendectomy, osteosynthesis [hip]) or non-urgent (forefoot & cataract surgery, cholecystectomy, arteriovenous fistula creation and total hip arthroplasty) based on expert opinion. We undertook time-series analyses of the weekly count of surgeries using negative binomial and Poisson regression models to measure the effect of COVID-19-related lockdowns (three lockdown periods: March-May 2020, October-December 2020 and April-May 2021). The effects of all lockdown periods combined were analyzed and we controlled for seasonality and year-related factors. Results: We observed a significant decrease by -24% (p<0.01) in overall surgical activity during lockdown periods. Significant reductions were also noticed for non-urgent surgeries such as total hip arthroplasty, forefoot surgery and cataract surgery, with -38% (p<0.05), -48% (p<0.01) and -64% (p<0.001) respectively. Inversely, a significant increase in urgent osteosynthesis [hip] activity was observed (+46%;p<0.05), while a non-significant augmentation in appendectomies was noted (+24%). Conclusions: Significant decreases in activity were observed for non-urgent surgeries, suggesting those operations were postponed or cancelled so that resources could be reallocated internally. Furthermore, ambulatory surgeries such as forefoot & cataract surgeries were considerably impacted. Conversely, surgeries labelled as urgent seemed unaffected, indicating emergencies were still carried on during lockdowns. Our results highlight the impact of the COVID-19 pandemic and associated lockdowns on surgical activities, but the consequences on patient opportunity losses should also be explored.

19.
Circulation ; 144(SUPPL 1), 2021.
Article in English | EMBASE | ID: covidwho-1631983

ABSTRACT

Introduction: TEE's are an essential component of cardiology fellowship education. At our institution, COVID peaked twice in 2020. The first peak showed a drop in total fellow TEE's. To counter this decline, the use of personal protective equipment (PPE) and COVID testing patients requiring TEE's were implemented to maintain patient care and ensure the safety of health personnel. We analyzed the differences in fellow TEE's during the second COVID wave compared to the first to determine if these interventions prevented a decline in fellow TEE's. Methods: The monthly number of TEE's performed by fellows on core TEE rotations was plotted for the year 2019, prior to the COVID pandemic. For the data set, a linear line was fit to account for the variation of studies read over the year. This linear variation was subtracted from the monthly totals to remove seasonal variation. The degree of variation was taken as the standard deviation (SD) for 2019. The 2020 data was processed using the predictions for 2019 and the upper and lower limits of variation were taken as three times the SD of the 2019 data. Results: Using the 2019 TEE data (Figure 1A), the linear seasonal variation line was created and used to account for variations in the 2020 TEE data (Figure 1B). After accounting for seasonal variation, a significant decline is noted, indicated by the red dot, in the number of fellow TEE'sduring the month of April, the first peak (Figure 1C). Institutional guidelines for PPE and COVID testing were put in place in June 2020 and December 2020. After implementation, fellow TEE numbers improve back to baseline and remain consistent even through the December peak (Figure 1C). Conclusions: Our data demonstrates the value of PPE and COVID testing prior to TEE's can help maintain fellow education during a pandemic while ensuring the safety of fellows, faculty, and technicians. COVID brings uncertainty to the healthcare field and these systems will allow for maintenance of both fellow education and patient care.

20.
British Actuarial Journal ; 27, 2022.
Article in English | ProQuest Central | ID: covidwho-1621186

ABSTRACT

The COVID-19 pandemic creates a challenge for actuaries analysing experience data that include mortality shocks. Without sufficient local flexibility in the time dimension, any analysis based on the most recent data will be biased by the temporarily higher mortality. Also, depending on where the shocks sit in the exposure period, any attempt to identify mortality trends will be distorted. We present a methodology for analysing portfolio mortality data that offer local flexibility in the time dimension. The approach permits the identification of seasonal variation, mortality shocks and occurred-but-not reported deaths (OBNR). The methodology also allows actuaries to measure portfolio-specific mortality improvements. Finally, the method assists actuaries in determining a representative mortality level for long-term applications like reserving and pricing, even in the presence of mortality shocks. Results are given for a mature annuity portfolio in the UK, which suggest that the Bayesian information criterion is better for actuarial model selection in this application than Akaike’s information criterion.

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