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1.
Cien Saude Colet ; 25(9): 3557-3562, 2020 Sep.
Article in Spanish | MEDLINE | ID: covidwho-740440

ABSTRACT

Thinking about the SARS-CoV-2 pandemic implies the study of general and unique dimensions for the historical evolution of Latin America and the Caribbean. From the individual to the collective, from biomedical sciences to social sciences and collective health, from risk groups to exclusive societies and the inequities constituting the colonial, patriarchal, modern capitalist heritage in the State and societies. The objective of this article is to review what are called the three intersections for Latin American critical health thinking. Seeking to analyze and reflect on the assumptions and logic present in the responses to the health emergency with reference to: 1. Critical health theory and its intersections with Latin American critical thinking; 2. The decolonial implications of problematizing the State and public health systems; and 3. The geopolitics of global health security as a roadmap for the global North. They outline approaches on the risks of capitalism's acceleration of the post-pandemic disaster and the alternative ways of addressing creative tensions in the reconstruction of emancipatory processes for regional health sovereignty and Health from the South.


Subject(s)
Coronavirus Infections/epidemiology , Pneumonia, Viral/epidemiology , Public Health , Capitalism , Caribbean Region/epidemiology , Family Characteristics , Global Health , Health Status Disparities , Humans , Latin America/epidemiology , Pandemics , Thinking
2.
PLoS One ; 15(8): e0238090, 2020.
Article in English | MEDLINE | ID: covidwho-733001

ABSTRACT

In the article a virus transmission model is constructed on a simplified social network. The social network consists of more than 2 million nodes, each representing an inhabitant of Slovenia. The nodes are organised and interconnected according to the real household and elderly-care center distribution, while their connections outside these clusters are semi-randomly distributed and undirected. The virus spread model is coupled to the disease progression model. The ensemble approach with the perturbed transmission and disease parameters is used to quantify the ensemble spread, a proxy for the forecast uncertainty. The presented ongoing forecasts of COVID-19 epidemic in Slovenia are compared with the collected Slovenian data. Results show that at the end of the first epidemic wave, the infection was twice more likely to transmit within households/elderly care centers than outside them. We use an ensemble of simulations (N = 1000) and data assimilation approach to estimate the COVID-19 forecast uncertainty and to inversely obtain posterior distributions of model parameters. We found that in the uncontrolled epidemic, the intrinsic uncertainty mostly originates from the uncertainty of the virus biology, i.e. its reproduction number. In the controlled epidemic with low ratio of infected population, the randomness of the social network becomes the major source of forecast uncertainty, particularly for the short-range forecasts. Virus transmission models with accurate social network models are thus essential for improving epidemics forecasting.


Subject(s)
Computer Simulation , Coronavirus Infections/transmission , Pneumonia, Viral/transmission , Social Networking , Basic Reproduction Number , Betacoronavirus , Coronavirus Infections/epidemiology , Disease Progression , Family Characteristics , Forecasting , Humans , Models, Theoretical , Pandemics , Pneumonia, Viral/epidemiology , Slovenia/epidemiology , Uncertainty
3.
J Infect Dev Ctries ; 14(7): 713-720, 2020 Jul 31.
Article in English | MEDLINE | ID: covidwho-721539

ABSTRACT

INTRODUCTION: There are significant differences in the active cases and fatality rates of Covid-19 for different European countries. METHODOLOGY: The present study employs Monte Carlo based transmission growth simulations for Italy, Germany and Turkey. The probabilities of transmission at home, work and social networks and the number of initial cases have been calibrated to match the basic reproduction number and the reported fatality curves. Parametric studies were conducted to observe the effect of social distancing, work closure, testing and quarantine of the family and colleagues of positively tested individuals. RESULTS: It is observed that estimates of the number of initial cases in Italy compared to Turkey and Germany are higher. Turkey will probably experience about 30% less number of fatalities than Germany due its smaller elderly population. If social distancing and work contacts are limited to 25% of daily routines, Germany and Turkey may limit the number of fatalities to a few thousands as the reproduction number decreases to about 1.3 from 2.8. Random testing may reduce the number of fatalities by 10% upon testing least 5/1000 of the population. Quarantining of family and workmates of positively tested individuals may reduce the total number of fatalities by about 50%. CONCLUSIONS: The fatality rate of Covid-19 is estimated to be about 1.5% based on the simulation results. This may further be reduced by limiting the number of non-family contacts to two, conducting tests more than 0.5% of the population and immediate quarantine of the contacts for positively tested individuals.


Subject(s)
Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Quarantine , Adolescent , Adult , Age Distribution , Aged , Basic Reproduction Number , Child , Clinical Laboratory Techniques/statistics & numerical data , Coronavirus Infections/diagnosis , Coronavirus Infections/mortality , Family Characteristics , Germany/epidemiology , Humans , Italy/epidemiology , Middle Aged , Monte Carlo Method , Pandemics , Pneumonia, Viral/diagnosis , Pneumonia, Viral/mortality , Social Isolation , Social Networking , Turkey/epidemiology , Young Adult
4.
PLoS One ; 15(8): e0237833, 2020.
Article in English | MEDLINE | ID: covidwho-717610

ABSTRACT

OBJECTIVE: Serological testing is needed to investigate the extent of transmission of SARS-CoV-2 from front-line essential workers to their household members. However, the requirement for serum/plasma limits serological testing to clinical settings where it is feasible to collect and process venous blood. To address this problem we developed a serological test for SARS-CoV-2 IgG antibodies that requires only a single drop of finger stick capillary whole blood, collected in the home and dried on filter paper (dried blood spot, DBS). We describe assay performance and demonstrate its utility for remote sampling with results from a community-based study. METHODS: An ELISA to the receptor binding domain of the SARS-CoV-2 spike protein was optimized to quantify IgG antibodies in DBS. Samples were self-collected from a community sample of 232 participants enriched with health care workers, including 30 known COVID-19 cases and their household members. RESULTS: Among 30 individuals sharing a household with a virus-confirmed case of COVID-19, 80% were seropositive. Of 202 community individuals without prior confirmed acute COVID-19 diagnoses, 36% were seropositive. Of documented convalescent COVID-19 cases from the community, 29 of 30 (97%) were seropositive for IgG antibodies to the receptor binding domain. CONCLUSION: DBS ELISA provides a minimally-invasive alternative to venous blood collection. Early analysis suggests a high rate of transmission among household members. High rates of seroconversion were also noted following recovery from infection. Serological testing for SARS-CoV-2 IgG antibodies in DBS samples can facilitate seroprevalence assessment in community settings to address epidemiological questions, monitor duration of antibody responses, and assess if antibodies against the spike protein correlate with protection from reinfection.


Subject(s)
Betacoronavirus/immunology , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Dried Blood Spot Testing , Family Characteristics , Health Personnel , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Serologic Tests/methods , Adolescent , Adult , Aged , Antibodies, Viral/blood , Coronavirus Infections/transmission , Coronavirus Infections/virology , Enzyme-Linked Immunosorbent Assay , Female , Humans , Immunoglobulin G/blood , Male , Middle Aged , Pandemics , Pneumonia, Viral/transmission , Pneumonia, Viral/virology , Seroepidemiologic Studies , Spike Glycoprotein, Coronavirus/immunology , Young Adult
6.
Proc Biol Sci ; 287(1932): 20201405, 2020 08 12.
Article in English | MEDLINE | ID: covidwho-711780

ABSTRACT

Combinations of intense non-pharmaceutical interventions (lockdowns) were introduced worldwide to reduce SARS-CoV-2 transmission. Many governments have begun to implement exit strategies that relax restrictions while attempting to control the risk of a surge in cases. Mathematical modelling has played a central role in guiding interventions, but the challenge of designing optimal exit strategies in the face of ongoing transmission is unprecedented. Here, we report discussions from the Isaac Newton Institute 'Models for an exit strategy' workshop (11-15 May 2020). A diverse community of modellers who are providing evidence to governments worldwide were asked to identify the main questions that, if answered, would allow for more accurate predictions of the effects of different exit strategies. Based on these questions, we propose a roadmap to facilitate the development of reliable models to guide exit strategies. This roadmap requires a global collaborative effort from the scientific community and policymakers, and has three parts: (i) improve estimation of key epidemiological parameters; (ii) understand sources of heterogeneity in populations; and (iii) focus on requirements for data collection, particularly in low-to-middle-income countries. This will provide important information for planning exit strategies that balance socio-economic benefits with public health.


Subject(s)
Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Immunity, Herd , Models, Theoretical , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Child , Coronavirus Infections/immunology , Coronavirus Infections/prevention & control , Disease Eradication , Family Characteristics , Humans , Pandemics/prevention & control , Pneumonia, Viral/immunology , Pneumonia, Viral/prevention & control , Schools , Seroepidemiologic Studies
7.
J Prim Care Community Health ; 11: 2150132720946951, 2020.
Article in English | MEDLINE | ID: covidwho-680376

ABSTRACT

The coronavirus disease (COVID-19) pandemic and subsequent public health interventions have disrupted food systems all over the world. In the Philippines, where stringent lockdown rules have been implemented, households living in poverty have had to rely largely on food aid in the form of food packs distributed by local governments and private donors. An evaluation of the commonly distributed food items reveals a diet that addresses acute hunger but does not contain sufficient nutrients to promote and maintain health. Such a diet puts low-income households at a greater risk of acute and chronic disease. The negative health impact of commonly distributed food packs on food aid-dependent households shine a light on how the COVID-19 pandemic and public health policies exacerbate health inequities. A primary care perspective is essential in creating food security policies that can effectively address acute hunger and malnutrition without contributing to the long-term deleterious effects of inadequate nutrition on the health of indigent communities.


Subject(s)
Coronavirus Infections/epidemiology , Food Supply , Pandemics , Pneumonia, Viral/epidemiology , Vulnerable Populations , Coronavirus Infections/prevention & control , Diet/adverse effects , Family Characteristics , Food Assistance , Humans , Pandemics/prevention & control , Philippines/epidemiology , Pneumonia, Viral/prevention & control , Poverty , Primary Health Care , Public Policy
8.
Int J Behav Nutr Phys Act ; 17(1): 85, 2020 07 06.
Article in English | MEDLINE | ID: covidwho-656557

ABSTRACT

BACKGROUND: Healthy childhood development is fostered through sufficient physical activity (PA; including time outdoors), limiting sedentary behaviours (SB), and adequate sleep; collectively known as movement behaviours. Though the COVID-19 virus outbreak has changed the daily lives of children and youth, it is unknown to what extent related restrictions may compromise the ability to play and meet movement behaviour recommendations. This secondary data analysis examined the immediate impacts of COVID-19 restrictions on movement and play behaviours in children and youth. METHODS: A national sample of Canadian parents (n = 1472) of children (5-11 years) or youth (12-17 years) (54% girls) completed an online survey that assessed immediate changes in child movement and play behaviours during the COVID-19 outbreak. Behaviours included PA and play, SB, and sleep. Family demographics and parental factors that may influence movement behaviours were assessed. Correlations between behaviours and demographic and parental factors were determined. For open-ended questions, word frequency distributions were reported. RESULTS: Only 4.8% (2.8% girls, 6.5% boys) of children and 0.6% (0.8% girls, 0.5% boys) of youth were meeting combined movement behaviour guidelines during COVID-19 restrictions. Children and youth had lower PA levels, less outside time, higher SB (including leisure screen time), and more sleep during the outbreak. Parental encouragement and support, parental engagement in PA, and family dog ownership were positively associated with healthy movement behaviours. Although families spent less time in PA and more time in SB, several parents reported adopting new hobbies or accessing new resources. CONCLUSIONS: This study provides evidence of immediate collateral consequences of the COVID-19 outbreak, demonstrating an adverse impact on the movement and play behaviours of Canadian children and youth. These findings can guide efforts to preserve and promote child health during the COVID-19 outbreak and crisis recovery period, and to inform strategies to mitigate potential harm during future pandemics.


Subject(s)
Coronavirus Infections/epidemiology , Exercise , Play and Playthings , Pneumonia, Viral/epidemiology , Sedentary Behavior , Sleep , Adolescent , Betacoronavirus , Canada/epidemiology , Child , Child, Preschool , Cross-Sectional Studies , Family Characteristics , Female , Health Behavior , Health Status , Humans , Male , Pandemics , Parents , Surveys and Questionnaires
9.
BMC Infect Dis ; 20(1): 526, 2020 Jul 20.
Article in English | MEDLINE | ID: covidwho-655328

ABSTRACT

BACKGROUND: With the spread of SARS-CoV-2 worldwide, understanding the basic epidemiological parameter values of COVID-19 from real-world data in mega-cities is essential for disease prevention and control. METHODS: To investigate the epidemiological parameters in SARS-CoV-2 infected cases in Beijing, we studied all confirmed cases and close contacts in Beijing from Jan 1st to Apr 3rd 2020. The epidemiological and virological characteristics of SARS-CoV-2 were analyzed. RESULTS: A total of 602 cases were positive for SARS-CoV-2, including 585 confirmed patients and 17 asymptomatic infections. The imported cases were mainly from Wuhan initially and then from abroad. Among 585 confirmed case-patients, the median age was 39 years old. The mean incubation period was 6.3 days. The secondary attack rate among households was higher than social contacts (15.6 vs 4.6%). The secondary attack rate of healthcare workers (HCWs) was higher than non-HCWs' (7.3 vs 4.2%). The basic reproduction number was 2.0, and the average serial interval was 7.6 days. No significant genetic variant was identified. CONCLUSIONS: The transmissibility of SARS-CoV-2 was relatively high, especially among households and from HCWs, which draws specific public health attention. So far, no evidence of widespread circulation of SARS-CoV-2 in communities in Beijing was found.


Subject(s)
Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Adult , Asymptomatic Infections/epidemiology , Basic Reproduction Number/statistics & numerical data , Beijing/epidemiology , Betacoronavirus/genetics , Betacoronavirus/isolation & purification , Cities/statistics & numerical data , Coronavirus Infections/transmission , Coronavirus Infections/virology , Family Characteristics , Family Health/statistics & numerical data , Female , Health Personnel/statistics & numerical data , Humans , Male , Pandemics , Pneumonia, Viral/transmission , Pneumonia, Viral/virology , Time Factors
10.
Commun Dis Intell (2018) ; 442020 Jul 02.
Article in English | MEDLINE | ID: covidwho-630611

ABSTRACT

The Northern Territory (NT) Centre for Disease Control (CDC) undertook contact tracing of all notified cases of coronavirus disease 2019 (COVID-19) within the Territory. There were 28 cases of COVID-19 notified in the NT between 1 March and 30 April 2020. In total 527 people were identified as close contacts over the same period; 493 were successfully contacted; 445 were located in the NT and were subsequently quarantined and monitored for disease symptoms daily for 14 days after contact with a confirmed COVID-19 case. Of these 445 close contacts, 4 tested positive for COVID-19 after developing symptoms; 2/46 contacts who were cruise ship passengers (4.3%, 95% CI 0.5-14.8%) and 2/51 household contacts (3.9%, 95% CI 0.5-13.5%). None of the 326 aircraft passengers or 4 healthcare workers who were being monitored in the NT as close contacts became cases.


Subject(s)
Betacoronavirus , Contact Tracing , Coronavirus Infections/epidemiology , Pneumonia, Viral/epidemiology , Family Characteristics , Humans , Northern Territory/epidemiology , Pandemics , Public Health , Risk Factors , Time Factors , Travel
11.
Proc Natl Acad Sci U S A ; 117(28): 16118-16120, 2020 07 14.
Article in English | MEDLINE | ID: covidwho-612671

ABSTRACT

Based on harmonized census data from 81 countries, we estimate how age and coresidence patterns shape the vulnerability of countries' populations to outbreaks of coronavirus disease 2019 (COVID-19). We estimate variation in deaths arising due to a simulated random infection of 10% of the population living in private households and subsequent within-household transmission of the virus. The age structures of European and North American countries increase their vulnerability to COVID-related deaths in general. The coresidence patterns of elderly persons in Africa and parts of Asia increase these countries' vulnerability to deaths induced by within-household transmission of COVID-19. Southern European countries, which have aged populations and relatively high levels of intergenerational coresidence, are, all else equal, the most vulnerable to outbreaks of COVID-19. In a second step, we estimate to what extent avoiding primary infections for specific age groups would prevent subsequent deaths due to within-household transmission of the virus. Preventing primary infections among the elderly is the most effective in countries with small households and little intergenerational coresidence, such as France, whereas confining younger age groups can have a greater impact in countries with large and intergenerational households, such as Bangladesh.


Subject(s)
Coronavirus Infections/mortality , Coronavirus Infections/transmission , Family Characteristics , Pneumonia, Viral/mortality , Pneumonia, Viral/transmission , Adolescent , Adult , Age Factors , Aged , Betacoronavirus , Child , Child, Preschool , Humans , Infant , Infant, Newborn , Internationality , Middle Aged , Pandemics , Residence Characteristics , Young Adult
12.
J Glob Health ; 10(1): 011007, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-611488

ABSTRACT

Background: The presence of COVID-19 in low- and middle-income countries (LMICs) is raising important concerns about effective pandemic response and preparedness in the context of fragile health systems and the pervasiveness of misinformation. The objective of this study was to gain an understanding of how COVID-19 was perceived by households experiencing extreme poverty in the Philippines. Methods: This study was conducted in partnership with International Care Ministries (ICM), a Philippine-based non-governmental organization (NGO) that runs a poverty-alleviation program called Transform targeted towards extreme low-income households. We integrated knowledge, attitudes, and practices (KAP) questions into ICM's cross-sectional program monitoring and evaluation systems from February 20 through March 13, 2020. Frequencies and proportions were calculated to describe the respondents' responses, and the Kruskal-Wallis test and binomial logistic regression were undertaken to determine the socio-demographic characteristics associated with COVID-19 KAPs. Results: In total, 2224 respondents from 166 communities in rural, urban and coastal settings were surveyed. Although the survey was administered during the earlier stages of the pandemic, 94.0% of respondents had already heard of COVID-19. Traditional media sources such as television (85.5%) and radio (56.1%) were reported as the main sources of information about the virus. Coughing and sneezing were identified as a transmission route by 89.5% of respondents, while indirect hand contact was the least commonly identified transmission route, recognized by 72.6% of respondents. Handwashing was identified by 82.2% of respondents as a preventive measure against the virus, but social distancing and avoiding crowds were only identified by 32.4% and 40.6%, respectively. Handwashing was the most common preventive practice in response to COVID-19, adopted by 89.9% of respondents. A greater number of preventive measures were taken by those with more knowledge of potential transmission routes. Conclusions: There is a need for targeted health education as a response strategy to COVID-19 in low-income settings, and it is important that strategies are contextually relevant. Understanding KAPs among populations experiencing extreme poverty will be important as tailored guidance for public health response and communication strategies are developed for LMICs.


Subject(s)
Coronavirus Infections/prevention & control , Family Characteristics , Health Knowledge, Attitudes, Practice , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Poverty , Adult , Coronavirus Infections/epidemiology , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Philippines/epidemiology , Pneumonia, Viral/epidemiology , Surveys and Questionnaires , Young Adult
13.
Am J Clin Nutr ; 112(2): 251-256, 2020 08 01.
Article in English | MEDLINE | ID: covidwho-608368

ABSTRACT

Coronavirus disease 2019 (COVID-19) continues to ravage health and economic metrics globally, including progress in maternal and child nutrition. Although there has been focus on rising rates of childhood wasting in the short term, maternal and child undernutrition rates are also likely to increase as a consequence of COVID-19 and its impacts on poverty, coverage of essential interventions, and access to appropriate nutritious foods. Key sectors at particular risk of collapse or reduced efficiency in the wake of COVID-19 include food systems, incomes, and social protection, health care services for women and children, and services and access to clean water and sanitation. This review highlights key areas of concern for maternal and child nutrition during and in the aftermath of COVID-19 while providing strategic guidance for countries in their efforts to reduce maternal and child undernutrition. Rooted in learnings from the exemplars in Global Health's Stunting Reduction Exemplars project, we provide a set of recommendations that span investments in sectors that have sustained direct and indirect impact on nutrition. These include interventions to strengthen the food-supply chain and reducing food insecurity to assist those at immediate risk of food shortages. Other strategies could include targeted social safety net programs, payment deferrals, or tax breaks as well as suitable cash-support programs for the most vulnerable. Targeting the most marginalized households in rural populations and urban slums could be achieved through deploying community health workers and supporting women and community members. Community-led sanitation programs could be key to ensuring healthy household environments and reducing undernutrition. Additionally, several COVID-19 response measures such as contact tracing and self-isolation could also be exploited for nutrition protection. Global health and improvements in undernutrition will require governments, donors, and development partners to restrategize and reprioritize investments for the COVID-19 era, and will necessitate data-driven decision making, political will and commitment, and international unity.


Subject(s)
Child Health , Coronavirus Infections , Infant Health , Infant, Newborn , Malnutrition , Maternal Health , Nutritional Status , Pandemics , Pneumonia, Viral , Child , Child Nutrition Disorders/prevention & control , Child, Preschool , Coronavirus , Coronavirus Infections/complications , Family Characteristics , Food Supply , Global Health , Growth Disorders/prevention & control , Humans , Infant , Malnutrition/complications , Malnutrition/prevention & control , Pneumonia, Viral/complications , Poverty
14.
Elife ; 92020 06 19.
Article in English | MEDLINE | ID: covidwho-607959

ABSTRACT

Previously, we showed that 3% (31/1032)of asymptomatic healthcare workers (HCWs) from a large teaching hospital in Cambridge, UK, tested positive for SARS-CoV-2 in April 2020. About 15% (26/169) HCWs with symptoms of coronavirus disease 2019 (COVID-19) also tested positive for SARS-CoV-2 (Rivett et al., 2020). Here, we show that the proportion of both asymptomatic and symptomatic HCWs testing positive for SARS-CoV-2 rapidly declined to near-zero between 25th April and 24th May 2020, corresponding to a decline in patient admissions with COVID-19 during the ongoing UK 'lockdown'. These data demonstrate how infection prevention and control measures including staff testing may help prevent hospitals from becoming independent 'hubs' of SARS-CoV-2 transmission, and illustrate how, with appropriate precautions, organizations in other sectors may be able to resume on-site work safely.


Subject(s)
Clinical Laboratory Techniques/statistics & numerical data , Coronavirus Infections/transmission , Health Personnel , Mass Screening/statistics & numerical data , Occupational Diseases/prevention & control , Pandemics , Pneumonia, Viral/transmission , Adult , Asymptomatic Diseases , Betacoronavirus/genetics , Betacoronavirus/isolation & purification , Community-Acquired Infections/transmission , Contact Tracing , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Disease Transmission, Infectious/prevention & control , England/epidemiology , Family Characteristics , Female , Hospital Units , Hospitals, Teaching/organization & administration , Hospitals, Teaching/statistics & numerical data , Hospitals, University/organization & administration , Hospitals, University/statistics & numerical data , Humans , Infection Control , Infectious Disease Transmission, Patient-to-Professional/statistics & numerical data , Male , Mass Screening/organization & administration , Middle Aged , Nasopharynx/virology , Occupational Diseases/epidemiology , Pandemics/prevention & control , Patient Admission/statistics & numerical data , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Prevalence , Program Evaluation , Real-Time Polymerase Chain Reaction , Symptom Assessment
15.
Cad Saude Publica ; 36(5): e00099920, 2020.
Article in English | MEDLINE | ID: covidwho-594378

ABSTRACT

We sought to evaluate contact rate reduction goals for household and close contacts and to provide preventive recommendations during the coronavirus pandemic. We applied an agent-based model to simulate the transmission dynamics of SARS-CoV-2 within household or close contacts through a social network of 150 nodes. there is no great difference in total infected people within modifications in number of links per node for networks with average number of links per node greater than three. For six nodes, total infected people are 149.85; for five nodes, 148.97; and for four nodes, 141.57. On the other hand, for three nodes, total infected are 82.39, for two nodes, 13.95; and for one node, 2.96. This model indicates a possible pitfall if social distancing measures are not stepwise suspended and close surveillance of cases are not provided, since the relationship between average links per node and number of infected people seems to be s-shaped, and not linear.


Subject(s)
Betacoronavirus , Communicable Disease Control , Coronavirus Infections/transmission , Family Characteristics , Pneumonia, Viral/transmission , Brazil/epidemiology , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Humans , Models, Biological , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Social Isolation
16.
Pediatr Infect Dis J ; 39(8): e202-e204, 2020 08.
Article in English | MEDLINE | ID: covidwho-526108

ABSTRACT

We examined the dynamics of coronavirus 2019 (COVID-19) transmission within families. Our investigation demonstrated significantly lower rates of COVID-19 positivity in children compared with adults residing in the same household. Children of 5-17 years of age were 61% and children of 0-4 years of age were 47% less likely to have positive polymerase chain reaction results compared with adults residing in the same household.


Subject(s)
Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Pandemics/statistics & numerical data , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Adolescent , Adult , Betacoronavirus , Child , Child, Preschool , Coronavirus , Coronavirus Infections/diagnosis , Disease Outbreaks , Family Characteristics , Female , Humans , Infant , Israel/epidemiology , Male , Middle Aged , Pneumonia, Viral/diagnosis , Polymerase Chain Reaction , Young Adult
17.
Nutrients ; 12(6)2020 Jun 02.
Article in English | MEDLINE | ID: covidwho-459147

ABSTRACT

The COVID-19 pandemic has dramatically increased food insecurity in the United States (US). The objective of this study was to understand the early effects of the COVID-19 pandemic among low-income adults in the US as social distancing measures began to be implemented. On 19-24 March 2020 we fielded a national, web-based survey (53% response rate) among adults with <250% of the federal poverty line in the US (N = 1478). Measures included household food security status and COVID-19-related basic needs challenges. Overall, 36% of low-income adults in the US were food secure, 20% had marginal food security, and 44% were food insecure. Less than one in five (18.8%) of adults with very low food security reported being able to comply with public health recommendations to purchase two weeks of food at a time. For every basic needs challenge, food-insecure adults were significantly more likely to report facing that challenge, with a clear gradient effect based on severity of food security. The short-term effects of the COVID-19 pandemic are magnifying existing disparities and disproportionately affecting low-income, food-insecure households that already struggle to meet basic needs. A robust, comprehensive policy response is needed to mitigate food insecurity as the pandemic progresses.


Subject(s)
Coronavirus Infections/epidemiology , Food Supply/statistics & numerical data , Pneumonia, Viral/epidemiology , Adolescent , Adult , Betacoronavirus , Family Characteristics , Female , Humans , Male , Middle Aged , Pandemics , Poverty , Surveys and Questionnaires , United States/epidemiology , Young Adult
18.
Int J Infect Dis ; 96: 631-633, 2020 Jul.
Article in English | MEDLINE | ID: covidwho-457279

ABSTRACT

There are few published data on the efficacy of masks or respirators against coronavirus infections. This is an important research question to inform the response to the COVID-19 epidemic. The transmission modes of human coronaviruses are similar, thought to be by droplet, contact, and sometimes airborne routes. There are several randomized clinical trials of masks and respirators, but most used clinical endpoints or tested only for influenza. In four trials that we conducted, we tested for human coronaviruses, but only composite viral endpoints were reported in the trials. We reviewed and analyzed the coronavirus data from four of our trials. Laboratory-confirmed coronavirus infections were identified in our community household trial (one case), health worker trials (eight cases), and trial of mask use by sick patients (19 cases). No coronavirus infections were transmitted in households to parents who wore P2 or surgical masks, but one child with coronavirus infection transmitted infection to a parent in the control arm. No transmissions to close contacts occurred when worn by sick patients with coronavirus infections. There was a higher risk of coronavirus infection in HCWs who wore a mask compared to a respirator, but the difference was not statistically significant. These are the only available clinical trial data on coronavirus infections associated with mask or respirator use. More clinical trials are needed to assess the efficacy of respiratory protection against coronavirus infections.


Subject(s)
Coronavirus Infections/prevention & control , Infection Control/instrumentation , Masks , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Respiratory Protective Devices , Betacoronavirus , Family Characteristics , Health Personnel , Humans , Randomized Controlled Trials as Topic
20.
Emerg Infect Dis ; 26(8): 1924-1926, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-378186

ABSTRACT

We explored the secondary attack rate in different types of contact with persons presymptomatic for coronavirus disease (COVID-19). Close contacts who lived with or had frequent contact with an index case-patient had a higher risk for COVID-19. Our findings provide population-based evidence for transmission from persons with presymptomatic COVID-19 infections.


Subject(s)
Betacoronavirus/pathogenicity , Contact Tracing/statistics & numerical data , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Adolescent , Adult , Aged , Aged, 80 and over , Asymptomatic Diseases , Child , Child, Preschool , China/epidemiology , Coronavirus Infections/diagnosis , Family Characteristics , Female , Humans , Incidence , Infant , Infant, Newborn , Male , Middle Aged , Pneumonia, Viral/diagnosis , Risk Factors , Severity of Illness Index , Time Factors
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