Subject(s)
COVID-19/prevention & control , Global Health/trends , International Health Regulations/organization & administration , Pandemics/prevention & control , COVID-19/epidemiology , Global Health/statistics & numerical data , Humans , International Health Regulations/statistics & numerical data , International Health Regulations/trends , World Health OrganizationSubject(s)
COVID-19 Vaccines/pharmacology , COVID-19 , Global Health/standards , Health Equity/organization & administration , International Health Regulations/organization & administration , COVID-19/epidemiology , COVID-19/prevention & control , Communicable Disease Control/legislation & jurisprudence , Humans , SARS-CoV-2ABSTRACT
AIMS: We developed a model, updated daily, to estimate undetected COVID-19 infections exiting quarantine following selectively opening New Zealand's borders to travellers from low-risk countries. METHODS: The prevalence of infectious COVID-19 cases by country was multiplied by expected monthly passenger volumes to predict the rate of arrivals. The rate of undetected infections entering the border following screening and quarantine was estimated. Level 1, Level 2 and Level 3 countries were defined as those with an active COVID-19 prevalence of up to 1/105, 10/105 and 100/105, respectively. RESULTS: With 65,272 travellers per month, the number of undetected COVID-19 infections exiting quarantine is 1 every 45, 15 and 31 months for Level 1, Level 2 and Level 3 countries, respectively. The overall rate of undetected active COVID-19 infections exiting quarantine is expected to increase from the current 0.40 to 0.50 per month, or an increase of one extra infection every 10 months. CONCLUSIONS: Loosening border restrictions results in a small increase in the rate of undetected COVID-19 infections exiting quarantine, which increases from the current baseline by one infection every 10 months. This information may be useful in guiding decision-making on selectively opening of borders in the COVID-19 era.
Subject(s)
COVID-19 , Communicable Disease Control , Communicable Diseases, Imported , Disease Transmission, Infectious , International Health Regulations , Quarantine , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/transmission , Communicable Disease Control/methods , Communicable Disease Control/organization & administration , Communicable Diseases, Imported/epidemiology , Communicable Diseases, Imported/prevention & control , Communicable Diseases, Imported/transmission , Disease Transmission, Infectious/prevention & control , Disease Transmission, Infectious/statistics & numerical data , Forecasting , Global Health , Humans , International Health Regulations/organization & administration , International Health Regulations/trends , New Zealand/epidemiology , Prevalence , Public Policy , Quarantine/organization & administration , Quarantine/statistics & numerical data , SARS-CoV-2 , Travel/legislation & jurisprudence , Travel/statistics & numerical dataSubject(s)
COVID-19 , Communicable Disease Control , Disease Transmission, Infectious , Immunization Programs , International Health Regulations/organization & administration , Public Health , COVID-19/epidemiology , COVID-19/prevention & control , Communicable Disease Control/methods , Communicable Disease Control/organization & administration , Disease Transmission, Infectious/legislation & jurisprudence , Disease Transmission, Infectious/prevention & control , Government Regulation , Humans , Immunization Programs/organization & administration , Immunization Programs/trends , Internationality , New Zealand/epidemiology , Policy Making , Public Health/legislation & jurisprudence , Public Health/methods , Public Health/trends , SARS-CoV-2ABSTRACT
OBJECTIVES: We examined if the WHO International Health Regulations (IHR) capacities were associated with better COVID-19 pandemic control. DESIGN: Observational study. SETTING: Population-based study of 114 countries. PARTICIPANTS: General population. MAIN OUTCOME MEASURES: For each country, we extracted: (1) the maximum rate of COVID-19 incidence increase per 100,000 population over any 5-day moving average period since the first 100 confirmed cases; (2) the maximum 14-day cumulative incidence rate since the first case; (3) the incidence and mortality within 30 days since the first case and first COVID-19-related death, respectively. We retrieved the 13 country-specific International Health Regulations capacities and constructed linear regression models to examine whether these capacities were associated with COVID-19 incidence and mortality, controlling for the Human Development Index, Gross Domestic Product, the population density, the Global Health Security index, prior exposure to SARS/MERS and Stringency Index. RESULTS: Countries with higher International Health Regulations score were significantly more likely to have lower incidence (ß coefficient -24, 95% CI -35 to -13) and mortality (ß coefficient -1.7, 95% CI -2.5 to -1.0) per 100,000 population within 30 days since the first COVID-19 diagnosis. A similar association was found for the other incidence outcomes. Analysis using different regression models controlling for various confounders showed a similarly significant association. CONCLUSIONS: The International Health Regulations score was significantly associated with reduction in rate of incidence and mortality of COVID-19. These findings inform design of pandemic control strategies, and validated the International Health Regulations capacities as important metrics for countries that warrant evaluation and improvement of their health security capabilities.
Subject(s)
COVID-19 , Communicable Disease Control , Disease Transmission, Infectious/prevention & control , International Health Regulations , World Health Organization , COVID-19/epidemiology , COVID-19/prevention & control , Communicable Disease Control/legislation & jurisprudence , Communicable Disease Control/organization & administration , Cross-Sectional Studies , Global Health/statistics & numerical data , Humans , Incidence , International Health Regulations/organization & administration , International Health Regulations/standards , Mortality , SARS-CoV-2 , Surge Capacity/statistics & numerical dataSubject(s)
Air Travel/statistics & numerical data , COVID-19 , Communicable Disease Control/methods , Epidemiological Monitoring , SARS-CoV-2/isolation & purification , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/transmission , COVID-19 Nucleic Acid Testing/methods , COVID-19 Nucleic Acid Testing/statistics & numerical data , China/epidemiology , Epidemiologic Measurements , Humans , International Health Regulations/organization & administration , Prevalence , Travel Medicine/methods , Travel Medicine/trends , United Kingdom/epidemiologyABSTRACT
The developed countries of the world were ill-prepared for the pandemic that they have suffered. When we compare developed to developing countries, the sophisticated parameters we use do not necessarily address the weaknesses in the healthcare systems of developed countries that make them susceptible to crises like the present pandemic. We strongly suggest that better preparation for such events is necessary for a country to be considered developed.