Nowcasting epidemics of novel pathogens: lessons from COVID-19.

Epidemic nowcasting broadly refers to assessing the current state by understanding key pathogenic, epidemiologic, clinical and socio-behavioral characteristics of an ongoing outbreak. Its primary objective is to provide situational awareness and inform decisions on control responses. In the event of large-scale sustained emergencies, such as the COVID-19 pandemic, scientists need to constantly update their aims and analytics with respect to the rapidly evolving emergence of new questions, data and findings in order to synthesize real-time evidence for policy decisions. In this Perspective, we share our views on the functional aims, rationale, data requirements and challenges of nowcasting at different stages of an epidemic, drawing on the ongoing COVID-19 experience. We highlight how recent advances in the computational and laboratory sciences could be harnessed to complement traditional approaches to enhance the scope, timeliness, reliability and utility of epidemic nowcasting.

Changes in characteristics and case-severity in patients hospitalised with influenza A (H1N1) pdm09 infection between two epidemic waves-England, 2009-2010.

BACKGROUND: During 2009-2010, pandemic influenza A (H1N1) pdm09 virus (pH1N1) infections in England occurred in two epidemic waves. Reasons for a reported increase in case-severity during the second wave are unclear. METHODS: We analysed hospital-based surveillance for patients with pH1N1 infections in England during 2009-2010 and linked national data sets to estimate ethnicity, socio-economic status and death within 28 days of admission. We used multivariable logistic regression to assess whether changes in demographic, clinical and management characteristics of patients could explain an increase in ICU admission or death, and accounted for missing values using multiple imputation. RESULTS: During the first wave, 54/960 (6%) hospitalised patients required intensive care and 21/960 (2%) died; during the second wave 143/1420 (10%) required intensive care and 55/1420 (4%) died. In a multivariable model, during the second wave patients were less likely to be from an ethnic minority (OR 0.33, 95% CI 0.26-0.42), have an elevated deprivation score (OR 0.75, 95% CI 0.68-0.83), have known comorbidity (OR 0.78, 95% CI 0.63-0.97) or receive antiviral therapy ≤2 days before onset (OR 0.72, 95% CI 0.56-0.92). Increased case-severity during the second wave was not explained by changes in demographic, clinical or management characteristics. CONCLUSIONS: Monitoring changes in patient characteristics could help target interventions during multiple waves of COVID-19 or a future influenza pandemic. To understand and respond to changes in case-severity, surveillance is needed that includes additional factors such as admission thresholds and seasonal coinfections.

Anti-Epidemic Emergency Regimes under Polish Law in Comparative, Historical and Jurisprudential Perspective.

The SARS-CoV-2 crisis of 2020 triggered a number of unprecedented reactions of European states, in particular in the form of either constitutional emergency measures or statutory anti-epidemic emergency measures. Poland chose to deal with the crisis by delegating powers to the executive by ordinary legislative means and declared a nationwide state of epidemic emergency on 13 March 2020 and a week later a state of epidemic on the basis of the Act of 5 December 2008 on preventing and combating infections and infectious diseases. For a century, Poland has been dealing with epidemics by delegating powers to the executive by ordinary legislative means. Anti-epidemic emergency measures were developed under the relevant acts of 1919, 1935, 1963, 2001, 2008 and now form an autonomous normative model authorised directly by Article 68 (4) of the Constitution of the Republic of Poland of 2 April 1997. The Constitution of 2 April 1997 authorises also extraordinary measures in situations of particular danger, "if ordinary constitutional measures are inadequate". This article analyses anti-epidemic emergency regimes under Polish law in a comparative, historical and jurisprudential perspective.

Revisiting "What Is an Epidemic?" in the Time of COVID-19: Lessons from the History of Latin American Public Health.

This essay considers what thirty years of scholarship on the history of epidemics in Latin America and the larger hemisphere can bring to a current reading of Charles Rosenberg's influential 1989 essay, "What Is an Epidemic? AIDS in Historical Perspective." It advocates that taking a broader geographical view is valuable to understanding better the arc of an epidemic in society. In addition, it proposes that, to see the ways in which the United States is experiencing the COVID-19 pandemic, we need to place the United States alongside the experiences of other countries of the Americas rather than making comparisons to Europe.

Spectacles of Difference: The Racial Scripting of Epidemic Disparities.

This essay explores how epidemics in the past and present give rise to distinctive, recurring racial scripts about bodies and identities, with sweeping racial effects beyond the Black experience. Using examples from cholera, influenza, tuberculosis, AIDS, and COVID-19, the essay provides a dramaturgical analysis of race and epidemics in four acts, moving from Act I, racial revelation; to Act II, the staging of bodies and places; to Act III, where race and disease is made into spectacle; and finally, Act IV, in which racial boundaries are fixed, repaired, or made anew in the response to the racial dynamics revealed by epidemics. Focusing primarily on North America but touching on global racial narratives, the essay concludes with reflections on the writers and producers of these racialized dramas, and a discussion of why these racialized repertoires have endured.

Sinophobic Epidemics in America: Historical Discontinuity in Disease-related Yellow Peril Imaginaries of the Past and Present.

Modern scholarship has drawn hasty and numerous parallels between the Yellow Peril discourses of the 19th- and 20th-century plagues and the recent racialization of infectious disease in the 21st-century. While highlighting these similarities is politically useful against Sinophobic epidemic narratives, Michel Foucault argues that truly understanding the past's continuity in the present requires a more rigorous genealogical approach. Employing this premise in a comparative analysis, this work demonstrates a critical discontinuity in the epidemic imaginary that framed the Chinese as pathogenic. Consequently, those seeking to prevent future disease racialization must understand modern Sinophobia as fundamentally distinct from that of the past.

The nurse COVID and historical epidemics literature repository: Development, description, and summary.

BACKGROUND: During COVID-19, a Kaggle challenge was issued to data scientists to leverage text mining to provide high-level summaries of full-text articles in the COVID-19 Open Research Dataset (CORD-19) data set, a data set containing articles around COVID-19 and other epidemics. A question was asked: "What if nursing had something similar?" PURPOSE: Describe the development and function of the Nursing COVID and Historical Epidemic Literature and describe high-level summaries of abstracts within the repository. METHOD: Nurse-specific literature was abstracted from two data sets: CORD-19 and LitCOVID. LitCOVID is a data set containing the most up-to-date literature around COVID-19. Multiple text mining algorithms were utilized to provide summaries of the articles. DISCUSSION: As of July 2020, the repository contains 760 articles. Summaries indicate the importance of psychological support for nurses and of high-impact rapid education. CONCLUSION: To our knowledge, this repository is the only repository specific for nursing that utilizes text mining to provide summaries.

Invisible epidemics: ethics and asymptomatic infection.

Interactions between microbes and human hosts can lead to a wide variety of possible outcomes including benefits to the host, asymptomatic infection, disease (which can be more or less severe), and/or death. Whether or not they themselves eventually develop disease, asymptomatic carriers can often transmit disease-causing pathogens to others. This phenomenon has a range of ethical implications for clinical medicine, public health, and infectious disease research. The implications of asymptomatic infection are especially significant in situations where, and/or to the extent that, the microbe in question is transmissible, potentially harmful, and/or untreatable. This article reviews the history and concept of asymptomatic infection, and relevant ethical issues associated with this phenomenon. It illustrates the role and ethical significance of asymptomatic infection in outbreaks, epidemics, and pandemics-including recent crises involving drug resistance, Zika, and Covid19. Serving as the Introduction to this Special Issue of Monash Bioethics Review, it also provides brief summaries of the other articles comprising this collection.

Legislative preparedness for the control of pandemics - using Taiwan as an example.

At the early stage of an emerging disease, information is often insufficient for governments to determine what actions are necessary to contain its transmission. Taiwanese society was not prepared when the SARS epidemic hit in 2003. After the SARS epidemic, Taiwan began to overhaul its Communicable Disease Control Act authorising the government to act in a murky situation without the fear of violating due process. In hindsight, the new law has contributed a large part to the effective containment of Covid-19 in Taiwan. However, a new issue emerged concerning the conflict between an individual's freedom of confidential communication and the government's use of cell phone positioning to monitor self-quarantine. Although Taiwan's Council of Grand Justices previously resolved the concern over potential breaching of due-process, the legislature may have to strike a balance between public health emergency and the use of an electronic footprint to trace individual activities.

Confidence vanished or impaired until distrust in the doctor-patient relationship because of COVID-19: Confidence vanished or impaired until distrust: "COVID" in relationship.

Since Hippocrates, the cornerstone of medical practice has been the doctor-patient relationship. The question here is whether these basic principles are still compatible with this unusual COVID-period. This pandemic represents a serious threat to human health, leading to profound changes in behavior in daily life but also in health care. Because of limited resources, health-managers must choose well-balanced solutions able to protect patients and citizens on the one hand and to provide maximal benefit for the society on the other hand. We are going through a moment of rupture that we must acknowledge. Here, we discussed how the doctor-patient relationship could be compromised. Doctors are focused on cares whereas patients are focused on scare. Profound changes occur presently, from the way we present ourselves to each other (including the masks), the poor conditions for physical examination, the mental suffering of both patient and caregiver until sometimes terrible end-of-life conditions. The historical point-of-view helps us to keep in mind previous experiences, and the philosophical perspective helps to contextualize this unedited situation. We should stop briefly our daily rush to put these considerations into perspective to overcome these challenges. Nothing is as effective as trust: let's rebuild it.

[Epidemics: lessons from History]. / Épidémies: Leçons d'Histoire.

TITLE: Épidémies: Leçons d'Histoire. ABSTRACT: Jusqu'au milieu du XVIIIe siècle, l'espérance de vie était de 25 ans dans les pays d'Europe, proche alors de celle de la préhistoire. À cette époque, nos ancêtres succombaient, pour la plupart, à une infection bactérienne ou virale, quand la mort n'était pas le résultat d'un épisode critique, comme la guerre ou la famine. Un seul microbe suffisait à terrasser de nombreuses victimes. L'épidémie de SARS-CoV-2 est là pour nous rappeler que ce risque est désormais à nouveau d'actualité. Si son origine zoonotique par la chauve-souris est probable, la contamination interhumaine montre son adaptation rapide à l'homme et permet d'évoquer ainsi la transmission des épidémies, qu'elle soit ou non liée à des vecteurs, ces derniers pouvant représenter dans d'autres occasions un des maillons de la chaîne.

Fatal Infectious Epidemics in Iran in the Last Two Centuries; What Lessons Can We Learn from Preceding Outbreaks? A Brief Historical Review.

In the past two centuries, several fatal infectious outbreaks have arisen in Iran. Presented here is a brief historical account of four fatal epidemics including cholera, plague, Spanish influenza of 1918 and smallpox between1796 and 1979. The lessons from these outbreaks could be helpful for better combatting other deadly epidemics including the present-day disastrous COVID-19 pandemic.

A brief introduction of Xiangya's anti-epidemic history in a century. / ç™¾å¹´æ¹˜é› æŠ—ç–«ç®€å².

Based on archival materials, the Xiangya's anti-epidemic history in a century from its establishment to 2020 is divided into 4 stages. The first stage (1906-1926), Edward Hicks Hume and YAN Fuqing, the founders of Xiangya, prevented and controlled smallpox and plague. The second stage (1929-1953), during the resumption of Xiangya, students prevented and controlled cholera, plague, dysentery, typhus, and other infectious diseases. In the third stage (1953-1999), in a peacetime, Xiangya actively fought against schistosomiasis, hydatidosis, malaria, leprosy, tuberculosis and other epidemics. The fourth stage (2000-2020), the era of Central South University. Medical staff in Xiangya fight SARS, influenza A (H1N1) flu, Ebola hemorrhagic fever, coronavirus disease 2019, etc. Over the past hundred years, Xiangya people joined together to spread benevolence and love, apply medical knowledge and skills, combat the epidemic and rescue people in difficulties, which made a great contribution to the motherland and the people.

Demographic perspectives on the mortality of COVID-19 and other epidemics.

To put estimates of COVID-19 mortality into perspective, we estimate age-specific mortality for an epidemic claiming for illustrative purposes 1 million US lives, with results approximately scalable over a broad range of deaths. We calculate the impact on period life expectancy (down 2.94 y) and remaining life years (11.7 y per death). Avoiding 1.75 million deaths or 20.5 trillion person years of life lost would be valued at $10.2 to $17.5 trillion. The age patterns of COVID-19 mortality in other countries are quite similar and increase at rates close to each country's rate for all-cause mortality. The scenario of 1 million COVID-19 deaths is similar in scale to that of the decades-long HIV/AIDS and opioid-overdose epidemics but considerably smaller than that of the Spanish flu of 1918. Unlike HIV/AIDS and opioid epidemics, the COVID-19 deaths are concentrated in a period of months rather than spread out over decades.