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1.
PLoS One ; 17(11): e0277201, 2022.
Article in English | MEDLINE | ID: covidwho-2197029

ABSTRACT

OBJECTIVES: Respiratory tract infection (RTI) incidence varies between people, but little is known about why. The aim of this study is therefore to identify risk factors for acquiring RTIs. METHODS: We conducted a secondary analysis of 16,908 participants in the PRIMIT study, a pre-pandemic randomised trial showing handwashing reduced incidence of RTIs in the community. Data was analysed using multivariable logistic regression analyses of self-reported RTI acquisition. RESULTS: After controlling for handwashing, RTI in the previous year (1 to 2 RTIs: adjusted OR 1.96, 95% CI 1.79 to 2.13, p<0.001; 3 to 5 RTIs: aOR 3.89, 95% CI 3.49 to 4.33, p<0.001; ≥6 RTIs: OR 5.52, 95% CI 4.37 to 6.97, p<0.001); skin conditions that prevent handwashing (aOR 1.39, 95% CI 1.24 to 1.55, p<0.001); children under 16 years in the household (aOR 1.27, 95% CI 1.12, 1.43, p<0.001); chronic lung condition (aOR 1.16, 95% CI 1.02 to 1.32, p = 0.026); female sex (aOR 1.10, 95% CI 1.03 to 1.18, p = 0.005), and post-secondary education (aOR 1.09, 95% CI 1.02 to 1.17, p = 0.01) increased the likelihood of RTI. Those over the age of 65 years were less likely to develop an infection (aOR 0.89, 95% CI 0.82 to 0.97, p = 0.009). Household crowding and influenza vaccination do not influence RTI acquisition. A post-hoc exploratory analysis found no evidence these subgroups differentially benefited from handwashing. CONCLUSIONS: Previous RTIs, chronic lung conditions, skin conditions that prevent handwashing, and the presence of household children predispose to RTI acquisition. Further research is needed to understand how host and microbial factors explain the relationship between previous and future RTIs.


Subject(s)
Community-Acquired Infections , Respiratory Tract Infections , Aged , Child , Female , Humans , Community-Acquired Infections/epidemiology , Community-Acquired Infections/prevention & control , Crowding , Family Characteristics , Respiratory System , Respiratory Tract Infections/epidemiology , Respiratory Tract Infections/prevention & control , Risk Factors
2.
Scand J Trauma Resusc Emerg Med ; 28(1): 107, 2020 Oct 28.
Article in English | MEDLINE | ID: covidwho-2098376

ABSTRACT

OBJECTIVES: COVID-19 presents challenges to the emergency care system that could lead to emergency department (ED) crowding. The Huddinge site at the Karolinska university hospital (KH) responded through a rapid transformation of inpatient care capacity together with changing working methods in the ED. The aim is to describe the KH response to the COVID-19 crisis, and how ED crowding, and important input, throughput and output factors for ED crowding developed at KH during a 30-day baseline period followed by the first 60 days of the COVID-19 outbreak in Stockholm Region. METHODS: Different phases in the development of the crisis were described and identified retrospectively based on major events that changed the conditions for the ED. Results were presented for each phase separately. The outcome ED length of stay (ED LOS) was calculated with mean and 95% confidence intervals. Input, throughput, output and demographic factors were described using distributions, proportions and means. Pearson correlation between ED LOS and emergency ward occupancy by phase was estimated with 95% confidence interval. RESULTS: As new working methods were introduced between phase 2 and 3, ED LOS declined from mean (95% CI) 386 (373-399) minutes to 307 (297-317). Imaging proportion was reduced from 29 to 18% and admission rate increased from 34 to 43%. Correlation (95% CI) between emergency ward occupancy and ED LOS by phase was 0.94 (0.55-0.99). CONCLUSIONS: It is possible to avoid ED crowding, even during extreme and quickly changing conditions by leveraging previously known input, throughput and output factors. One key factor was the change in working methods in the ED with higher competence, less diagnostics and increased focus on rapid clinical admission decisions. Another important factor was the reduction in bed occupancy in emergency wards that enabled a timely admission to inpatient care. A key limitation was the retrospective study design.


Subject(s)
Betacoronavirus , Coronavirus Infections/epidemiology , Coronavirus Infections/therapy , Crowding , Emergency Service, Hospital , Pneumonia, Viral/epidemiology , Pneumonia, Viral/therapy , Adult , Aged , Aged, 80 and over , Bed Occupancy , COVID-19 , Female , Hospitalization , Hospitals, University , Humans , Male , Middle Aged , Pandemics , Retrospective Studies , SARS-CoV-2 , Sweden
4.
Int J Environ Res Public Health ; 19(16)2022 08 17.
Article in English | MEDLINE | ID: covidwho-2023661

ABSTRACT

Environmental factors including household crowding and inadequate washing facilities underpin recurrent streptococcal infections in childhood that cause acute rheumatic fever (ARF) and subsequent rheumatic heart disease (RHD). No community-based 'primordial'-level interventions to reduce streptococcal infection and ARF rates have been reported from Australia previously. We conducted a study at three Australian Aboriginal communities aiming to reduce infections including skin sores and sore throats, usually caused by Group A Streptococci, and ARF. Data were collected for primary care diagnoses consistent with likely or potential streptococcal infection, relating to ARF or RHD or related to environmental living conditions. Rates of these diagnoses during a one-year Baseline Phase were compared with a three-year Activity Phase. Participants were children or adults receiving penicillin prophylaxis for ARF. Aboriginal community members were trained and employed to share knowledge about ARF prevention, support reporting and repairs of faulty health-hardware including showers and provide healthcare navigation for families focusing on skin sores, sore throat and ARF. We hypothesized that infection-related diagnoses would increase through greater recognition, then decrease. We enrolled 29 participants and their families. Overall infection-related diagnosis rates increased from Baseline (mean rate per-person-year 1.69 [95% CI 1.10-2.28]) to Year One (2.12 [95% CI 1.17-3.07]) then decreased (Year Three: 0.72 [95% CI 0.29-1.15]) but this was not statistically significant (p = 0.064). Annual numbers of first-known ARF decreased, but numbers were small: there were six cases of first-known ARF during Baseline, then five, 1, 0 over the next three years respectively. There was a relationship between household occupancy and numbers (p = 0.018), but not rates (p = 0.447) of infections. This first Australian ARF primordial prevention study provides a feasible model with encouraging findings.


Subject(s)
Pharyngitis , Rheumatic Fever , Rheumatic Heart Disease , Streptococcal Infections , Adult , Australia/epidemiology , Child , Crowding , Family Characteristics , Humans , Native Hawaiian or Other Pacific Islander , Primary Prevention , Rheumatic Fever/epidemiology , Rheumatic Fever/prevention & control , Rheumatic Heart Disease/epidemiology , Rheumatic Heart Disease/prevention & control , Streptococcal Infections/complications
5.
BMJ ; 378: e072884, 2022 08 26.
Article in English | MEDLINE | ID: covidwho-2019974
7.
J Formos Med Assoc ; 120 Suppl 1: S57-S68, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1972177

ABSTRACT

BACKGROUND: The COVID-19 outbreaks associated with mass religious gatherings which have the potential of invoking epidemics at large scale have been a great concern. This study aimed to evaluate the risk of outbreak in mass religious gathering and further to assess the preparedness of non-pharmaceutical interventions (NPIs) for preventing COVID-19 outbreak in this context. METHODS: The risk of COVID-19 outbreak in mass religious gathering was evaluated by using secondary COVID-19 cases and reproductive numbers. The preparedness of a series of NPIs for preventing COVID-19 outbreak in mass religious gathering was then assessed by using a density-dependent model. This approach was first illustrated by the Mazu Pilgrimage in Taiwan and validated by using the COVID-19 outbreak in the Shincheonji Church of Jesus (SCJ) religious gathering in South Korea. RESULTS: Through the strict implementation of 80% NPIs in the Mazu Pilgrimage, the number of secondary cases can be substantially reduced from 1508 (95% CI: 900-2176) to 294 (95% CI: 169-420) with the reproductive number (R) significantly below one (0.54, 95% CI: 0.31-0.78), indicating an effective containment of outbreak. The expected number of secondary COVID-19 cases in the SCJ gathering was estimated as 232 (basic reproductive number (R0) = 6.02) and 579 (R0 = 2.50) for the first and second outbreak, respectively, with a total expected cases (833) close to the observed data on high infection of COVID-19 cases (887, R0 = 3.00). CONCLUSION: We provided the evidence on the preparedness of NPIs for preventing COVID-19 outbreak in the context of mass religious gathering by using a density-dependent model.


Subject(s)
COVID-19 , Communicable Disease Control/methods , Crowding , Disease Outbreaks , COVID-19/prevention & control , Disease Outbreaks/prevention & control , Humans , Religion , Republic of Korea/epidemiology , SARS-CoV-2 , Taiwan/epidemiology
8.
PLoS One ; 17(7): e0271786, 2022.
Article in English | MEDLINE | ID: covidwho-1951561

ABSTRACT

OBJECTIVE: To investigate the role of children in the home and household crowding as risk factors for severe COVID-19 disease. METHODS: We used interview data from 6,831 U.S. adults screened for the Communities, Households and SARS/CoV-2 Epidemiology (CHASING) COVID Cohort Study in April 2020. RESULTS: In logistic regression models, the adjusted odds ratio [aOR] of hospitalization due to COVID-19 for having (versus not having) children in the home was 10.5 (95% CI:5.7-19.1) among study participants living in multi-unit dwellings and 2.2 (95% CI:1.2-6.5) among those living in single unit dwellings. Among participants living in multi-unit dwellings, the aOR for COVID-19 hospitalization among participants with more than 4 persons in their household (versus 1 person) was 2.5 (95% CI:1.0-6.1), and 0.8 (95% CI:0.15-4.1) among those living in single unit dwellings. CONCLUSION: Early in the US SARS-CoV-2 pandemic, certain household exposures likely increased the risk of both SARS-CoV-2 acquisition and the risk of severe COVID-19 disease.


Subject(s)
COVID-19 , Pandemics , Adult , COVID-19/epidemiology , Child , Cohort Studies , Crowding , Family Characteristics , Humans , Risk Factors , SARS-CoV-2
9.
BMJ Open ; 12(7): e058239, 2022 07 12.
Article in English | MEDLINE | ID: covidwho-1932739

ABSTRACT

OBJECTIVE: As mass gathering events resume in the wake of the COVID-19 pandemic, there is a pressing need to understand (a) engagement in COVID-safe behaviour at these events and (b) how attending a mass gathering impacts subsequent behaviours. This study examined anticipated COVID-safe behaviour before, during, and after a youth mass gathering event. DESIGN: Longitudinal cohort study. SETTING: Self-report data were collected online at five timepoints from secondary-school graduates participating in celebrations linked to an annual week-long youth mass gathering event in Australia. PARTICIPANTS: Australian secondary-school graduates completed surveys before the event (N=397), on days 1 (N=183), 3 (N=158) and 5 (N=163) of the event, and 3 weeks after the event (N=140). Of those who completed the first survey, 72 indicated they would attend a primary mass gathering site where the largest mass gathering of graduates in Australia occurs in a typical (non-pandemic) year; 325 indicated they would be celebrating at other locations (ie, secondary sites). PRIMARY OUTCOME MEASURES: Anticipated COVID-safe behaviour: physical distancing from friends and strangers and additional protective behaviours (hand hygiene and mask wearing). RESULTS: At all timepoints, participants anticipated maintaining appropriate (>1.5 m) physical distance from strangers, but not from friends (<0.5 m). Attendees at the primary site reported less physical distancing from friends over time throughout the mass gathering, χ2(4)=16.89, p=0.002. Physical distancing from strangers, χ2(4)=26.93, p<0.001, and additional protective behaviours, χ2(4)=221.23, p<0.001, also declined across the mass gathering among both groups. These reductions in COVID-safe behaviour were significant and enduring, with all declines persisting at follow-up. CONCLUSION: It is critical that public health messaging and interventions emphasise the risks of disease transmission arising from other attendees who are known to us during mass gathering events, and that such messaging is sustained during and following the event to combat reductions in COVID-safe behaviour.


Subject(s)
COVID-19 , Mass Gatherings , Adolescent , Australia/epidemiology , COVID-19/epidemiology , COVID-19/prevention & control , Crowding , Humans , Longitudinal Studies , Pandemics/prevention & control
11.
Pan Afr Med J ; 42: 87, 2022.
Article in English | MEDLINE | ID: covidwho-1928885

Subject(s)
COVID-19 , Crowding , Humans , Pandemics
12.
Sensors (Basel) ; 22(13)2022 Jun 25.
Article in English | MEDLINE | ID: covidwho-1911520

ABSTRACT

At present, the COVID-19 pandemic still presents with outbreaks occasionally, and pedestrians in public areas are at risk of being infected by the viruses. In order to reduce the risk of cross-infection, an advanced pedestrian state sensing method for automated patrol vehicles based on multi-sensor fusion is proposed to sense pedestrian state. Firstly, the pedestrian data output by the Euclidean clustering algorithm and the YOLO V4 network are obtained, and a decision-level fusion method is adopted to improve the accuracy of pedestrian detection. Then, combined with the pedestrian detection results, we calculate the crowd density distribution based on multi-layer fusion and estimate the crowd density in the scenario according to the density distribution. In addition, once the crowd aggregates, the body temperature of the aggregated crowd is detected by a thermal infrared camera. Finally, based on the proposed method, an experiment with an automated patrol vehicle is designed to verify the accuracy and feasibility. The experimental results have shown that the mean accuracy of pedestrian detection is increased by 17.1% compared with using a single sensor. The area of crowd aggregation is divided, and the mean error of the crowd density estimation is 3.74%. The maximum error between the body temperature detection results and thermometer measurement results is less than 0.8°, and the abnormal temperature targets can be determined in the scenario, which can provide an efficient advanced pedestrian state sensing technique for the prevention and control area of an epidemic.


Subject(s)
Biosensing Techniques , COVID-19 , Pedestrians , COVID-19/epidemiology , COVID-19/prevention & control , Crowding , Humans , Pandemics/prevention & control
13.
Environ Res ; 213: 113604, 2022 10.
Article in English | MEDLINE | ID: covidwho-1881986

ABSTRACT

Crowd gatherings are an important cause of COVID-19 outbreaks. However, how the scale, scene and other factors of gatherings affect the spread of the epidemic remains unclear. A total of 184 gathering events worldwide were collected to construct a database, and 99 of them with a clear gathering scale were used for statistical analysis of the impact of these factors on the disease incidence among the crowd in the study. The results showed that the impact of small-scale (less than 100 people) gathering events on the spread of COVID-19 in the city is also not to be underestimated due to their characteristics of more frequent occurrence and less detection and control. In our dataset, 22.22% of small-scale events have an incidence of more than 0.8. In contrast, the incidence of most large-scale events is less than 0.4. Gathering scenes such as "Meal" and "Family" occur in densely populated private or small public places have the highest incidence. We further designed a model of epidemic transmission triggered by crowd gathering events and simulated the impact of crowd gathering events on the overall epidemic situation in the city. The simulation results showed that the number of patients will be drastically reduced if the scale and the density of crowds gathering are halved. It indicated that crowd gatherings should be strictly controlled on a small scale. In addition, it showed that the model well reproduce the epidemic spread after crowd gathering events better than does the original SIER model and could be applied to epidemic prediction after sudden gathering events.


Subject(s)
COVID-19 , Epidemics , COVID-19/epidemiology , Computer Simulation , Crowding , Disease Outbreaks , Humans
14.
BMC Infect Dis ; 22(1): 527, 2022 Jun 07.
Article in English | MEDLINE | ID: covidwho-1879224

ABSTRACT

BACKGROUND: Latinos have had higher case counts, hospitalization rates and deaths during the COVID-19 pandemic nationally and in the state of California. Meanwhile, Latino vaccination rates remain lower than those of non-Hispanic Whites. COVID-19 vaccine nonintent, defined as intent to not vaccinate against COVID-19, among Latino individuals continues to be an issue in the state of California. METHODS: Families from three Latino longitudinal mother-child cohorts previously recruited in the San Francisco Bay Area were surveyed telephonically from February to June 2021 to assess attitudes towards vaccination against COVID-19 and prior vaccination, in general, for themselves and their children. Risk for vaccine nonintent was assessed using the Mann-Whitney rank sum non-parametric test for continuous predictors and chi-squared tests for categorical ones. RESULTS: Three hundred and nineteen families were surveyed from the Telomere at Birth (TAB), Hispanic Eating and Nutrition (HEN) and Latino Eating and Diabetes Cohort (LEAD). Approximately 36% from TAB and 28% from HEN/LEAD indicated COVID-19 vaccine nonintent for themselves and/or their children. Risk factors for vaccine nonintent included lower maternal age (p = 0.01), concern about vaccine side effects (p < 0.01) and prior history of a household members being infected with SARS-CoV-2 (p < 0.01) and indexes of household crowding including number of people sharing a bathroom (p = 0.048). Vaccine intent was also associated with receiving vaccine input from friends (p = 0.03), family (p < 0.01) and/or coworkers (p = 0.02) compared with those who were not planning on getting vaccinated against COVID-19. CONCLUSIONS: Latino families living in crowded living situations who may not have received any COVID-19 advice from family, coworkers or friends are at particular risk for nonintent for vaccinatation against COVID-19. Community-based grassroots or promotor/a based interventions centered on trusted individuals with close community ties and counseling concerning vaccination against COVID-19 could help boost vaccination rates in this population group.


Subject(s)
COVID-19 , Vaccines , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines , Crowding , Family Characteristics , Hispanic or Latino , Humans , Pandemics , SARS-CoV-2 , San Francisco/epidemiology , Vaccination/psychology
16.
Sensors (Basel) ; 22(9)2022 Apr 26.
Article in English | MEDLINE | ID: covidwho-1810113

ABSTRACT

Managing citizen and community safety is one of the most essential services that future cities will require. Crowd analysis and monitoring are also a high priority in the current COVID-19 pandemic scenario, especially because large-scale gatherings can significantly increase the risk of infection transmission. However, crowd tracking presents several complex technical challenges, including accurate people counting and privacy preservation. In this study, using a tile-map-based method, a new intelligent method is proposed which is integrated with the cloud of things and data analytics to provide intelligent monitoring of outdoor crowd density. The proposed system can detect and intelligently analyze the pattern of crowd activity to implement contingency plans, reducing accidents, ensuring public safety, and establishing a smart city. The experimental results demonstrate the feasibility of the proposed model in detecting crowd density status in real-time. It can effectively assist with crowd management tasks such as monitoring, guiding, and managing crowds to ensure safety. In addition, the proposed algorithm provides acceptable performance.


Subject(s)
COVID-19 , Algorithms , Crowding , Engineering , Humans , Pandemics/prevention & control
17.
BMJ Open ; 12(4): e058580, 2022 04 13.
Article in English | MEDLINE | ID: covidwho-1788965

ABSTRACT

OBJECTIVES: COVID-19 lockdown measures have challenged people's mental health, especially among economically vulnerable households. The objective of this study was to investigate the impact of exposure to COVID-19 shocks (defined as job loss, living cost pressures and changing housing conditions throughout the lockdown period) and double precarity (defined as precarity in housing and employment) on mental health outcomes for members of share households as well as the mediating effects of a range of resources. DESIGN: We conducted a two-wave survey of occupants of share housing in June and October 2020 during a prolonged period of population lockdown. Research design involved fixed effects ordered logit regression models to assess the mental health consequences of baseline precarity and COVID-related shocks. SETTING: Victoria, Australia. PARTICIPANTS: We surveyed 293 occupants of share houses (mean age 34 SD 11.5, 56% female). Members of share houses (where individuals are unrelated adults and not in a romantic relationship) are more likely to be young, casually employed, visa-holders and low-income. OUTCOME MEASURES: We measured household composition, housing and employment precarity, access to government support, household crowding, social networks and COVID-19 shocks. We used a self-reported measure of mental health. RESULTS: Those exposed to COVID-19 shocks reported a 2.7 times higher odds of mental health deterioration (OR 2.7, 95% CI 1.53 to 4.85). People exposed to double precarity (precarity in both housing and employment) reported 2.4 times higher odds of mental health deterioration (OR 2.4, 95% CI 0.99 to 5.69). Housing inadequacy and lack of access to sufficient government payments explained 14.7% and 7% of the total effect of double precarity on mental health, respectively. CONCLUSIONS: Results indicate that residents of group households characterised by pre-existing precarity were vulnerable to negative mental health effects during lockdown. Access to sufficient government payments and adequate housing buffered this negative effect.


Subject(s)
COVID-19 , Shock , Adult , COVID-19/epidemiology , Communicable Disease Control , Crowding , Family Characteristics , Female , Housing , Humans , Male , Mental Health , Victoria/epidemiology
18.
Sci Rep ; 12(1): 5612, 2022 04 04.
Article in English | MEDLINE | ID: covidwho-1773993

ABSTRACT

Many studies have investigated the impact of the COVID-19 pandemic on mental health. Throughout the pandemic, time spent at home increased to a great extent due to restrictive measures. Here we set out to investigate the relationship between housing conditions and the mental health of populations across European countries. We analyzed survey data collected during spring 2020 from 69,136 individuals from four cohorts from Denmark, France, and the UK. The investigated housing conditions included household density, composition, and crowding, access to outdoor facilities, dwelling type, and urbanicity. The outcomes were loneliness, anxiety, and life satisfaction. Logistic regression models were used, and results were pooled using random-effects meta-analysis. In the meta-analysis, living alone was associated with higher levels of loneliness (OR = 3.08, 95% CI 1.87-5.07), and lower life satisfaction (OR = 1.27, 95% CI 1.05-0.55), compared to living with others. Not having access to an outdoor space and household crowding were suggestively associated with worse outcomes. Living in crowded households, living alone, or lacking access to outdoor facilities may be particularly important in contributing to poor mental health during a lockdown. Addressing the observed fundamental issues related to housing conditions within society will likely have positive effects in reducing social inequalities, as well as improving preparedness for future pandemics.


Subject(s)
COVID-19 , Pandemics , COVID-19/epidemiology , Communicable Disease Control , Crowding , Family Characteristics , Housing , Humans , Mental Health
19.
Travel Med Infect Dis ; 37: 101692, 2020.
Article in English | MEDLINE | ID: covidwho-1764004

ABSTRACT

Social distancing at its various levels has been a key measure to mitigate the transmission of COVID-19. The implementation of strict measures for social distancing is challenging, including in the Kingdom of Saudi Arabia (KSA) due to its level of urbanization, its social and religious norms and its annual hosting of high visibility international religious mass gatherings. KSA started introducing decisive social distancing measures early before the first case of COVID-19 was confirmed in the Kingdom. These ranged from suspension or cancelations of religious, entertainment and sporting mass gatherings and events such as the Umrah, temporary closure of educational establishments and mosques and postponing all non-essential gatherings, to imposing a curfew. These measures were taken in spite of their socio-economic, political and religious challenges in the interest of public and global health. The effect of these actions on the epidemic curve of the Kingdom and on the global fight against COVID-19 remains to be seen. However, given the current COVID-19 situation, further bold and probably unpopular measures are likely to be introduced in the future.


Subject(s)
Coronavirus Infections/prevention & control , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Betacoronavirus , COVID-19 , Crowding , Humans , Islam , SARS-CoV-2 , Saudi Arabia , Social Isolation , Travel
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