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1.
Int J Environ Res Public Health ; 19(7)2022 04 01.
Article in English | MEDLINE | ID: covidwho-1785647

ABSTRACT

Following alerts about the diminishing role of health risk assessment (HRA) in informing public health decisions, this study examines specific HRA topics with the aim of identifying possible solutions for addressing this compelling situation. The study administered a survey among different groups of stakeholders involved in HRA or decision-making, or both. The responses show various understandings of HRA in the decision-making context-including confusion with the health impact assessment (HIA)-and confirm recurring foundational issues within the risk analysis field that contribute to the growth of inconsistency in the HRA praxis. This inconsistency lowers the effectiveness of HRA to perform its primary purpose of informing public health decisions. Opportunities for improving this situation come at the beginning of the assessment process, where greater attention should be given to defining the assessment and decision-making contexts. Both must reflect the concerns and expectations of the stakeholders regarding the needs and purpose of an HRA on one side, and the methodological and procedural topics relevant for the decision case at hand on the other. The HRA process should end with a decision follow-up step with targeted auditing and the participation of stakeholders to measure its success.


Subject(s)
Health Impact Assessment , Public Health , Risk Assessment , Surveys and Questionnaires
2.
Ciênc. Saúde Colet ; 25(supl.1): 2447-2456, Mar. 2020. tab, graf
Article in Spanish | WHO COVID, LILACS (Americas) | ID: covidwho-1725047

ABSTRACT

Resumen El objetivo de este trabajo es explorar los sentimientos y expectativas que genera el COVID-19 en Argentina durante la primera etapa de la pandemia. Se aplicó una encuesta de la Organización Mundial de la Salud adaptada al contexto local. Se incluyeron preguntas abiertas para indagar sentimientos de las personas frente al COVID-19, y se realizó un análisis de contenido. Como resultados se advierte que la población encuestada siente incertidumbre, miedo y angustia, pero también emerge un sentimiento de responsabilidad y cuidado frente al COVID-19. Así mismo se destacan sentimientos positivos para la sociedad como una valoración de la interdependencia social. Los resultados arribados señalan que el impacto en la salud mental es desigual según el género, el nivel educativo alcanzado y el confort percibido en el hogar. El estudio permite concluir que las dimensiones emocionales y vinculares de las personas resultan aspectos centrales ante la pandemia del COVID-19 en Argentina. Es recomendable que estas dimensiones, así como y su impacto subjetivo y social diferencial entre los diversos grupos poblacionales, sean consideradas en la planificación de políticas para afrontar el COVID-19.


Abstract The scope of this work is to explore the feelings and expectations that COVID-19 has generated in Argentina during the first stage of the pandemic. A survey of the World Health Organization adapted to the local context was applied. Open-ended questions were included to study people's feelings about COVID-19, and content analysis was subsequently conducted. In terms of results, it is revealed that the population surveyed feels uncertainty, fear and anguish, albeit a feeling of responsibility and care in the face of COVID-19 also emerges. Moreover, positive feelings regarding society stand out as an achievement of social interdependence. The results obtained show that the impact on mental health differs in accordance with gender, educational level, and perceived comfort in the home. The study concludes that the emotional and bonding dimensions of people are central to confronting the COVID-19 pandemic in Argentina. It is recommended that these dimensions, as well as their subjective and differential social impact among the different population groups, should be considered in the planning of policies to address the COVID-19 pandemic.


Subject(s)
Humans , Male , Female , Adult , Aged , Pneumonia, Viral/psychology , Pneumonia, Viral/epidemiology , Coronavirus Infections/psychology , Coronavirus Infections/epidemiology , Emotions , Pandemics/prevention & control , Betacoronavirus , Anxiety/epidemiology , Argentina/epidemiology , Pneumonia, Viral/prevention & control , Mental Health , Cross-Sectional Studies , Age Factors , Coronavirus Infections , Coronavirus Infections/prevention & control , Health Care Surveys/statistics & numerical data , Uncertainty , Vulnerable Populations/psychology , Educational Status , Fear , Health Impact Assessment/statistics & numerical data , Middle Aged
3.
Nat Commun ; 13(1): 1012, 2022 02 23.
Article in English | MEDLINE | ID: covidwho-1709629

ABSTRACT

Mitigation of SARS-CoV-2 transmission from international travel is a priority. We evaluated the effectiveness of travellers being required to quarantine for 14-days on return to England in Summer 2020. We identified 4,207 travel-related SARS-CoV-2 cases and their contacts, and identified 827 associated SARS-CoV-2 genomes. Overall, quarantine was associated with a lower rate of contacts, and the impact of quarantine was greatest in the 16-20 age-group. 186 SARS-CoV-2 genomes were sufficiently unique to identify travel-related clusters. Fewer genomically-linked cases were observed for index cases who returned from countries with quarantine requirement compared to countries with no quarantine requirement. This difference was explained by fewer importation events per identified genome for these cases, as opposed to fewer onward contacts per case. Overall, our study demonstrates that a 14-day quarantine period reduces, but does not completely eliminate, the onward transmission of imported cases, mainly by dissuading travel to countries with a quarantine requirement.


Subject(s)
COVID-19/prevention & control , Communicable Diseases, Imported/prevention & control , Quarantine/legislation & jurisprudence , SARS-CoV-2/genetics , COVID-19/epidemiology , COVID-19/transmission , Communicable Diseases, Imported/epidemiology , Communicable Diseases, Imported/transmission , Contact Tracing , England/epidemiology , Genome, Viral/genetics , Genomics , Health Impact Assessment , Humans , SARS-CoV-2/classification , Travel/legislation & jurisprudence , Travel-Related Illness
4.
Int J Mol Sci ; 23(2)2022 Jan 12.
Article in English | MEDLINE | ID: covidwho-1638520

ABSTRACT

The selenium field expanded at a rapid rate for about 45 years, from the mid-1970's until about 2015 (see [...].


Subject(s)
Disease Susceptibility , Health Impact Assessment , Homeostasis , Selenium/metabolism , Selenoproteins/metabolism , Humans , Selenium/adverse effects
5.
PLoS Negl Trop Dis ; 15(12): e0010064, 2021 12.
Article in English | MEDLINE | ID: covidwho-1581898

ABSTRACT

BACKGROUND: Among the many collaterals of the COVID-19 pandemic is the disruption of health services and vital clinical research. COVID-19 has magnified the challenges faced in research and threatens to slow research for urgently needed therapeutics for Neglected Tropical Diseases (NTDs) and diseases affecting the most vulnerable populations. Here we explore the impact of the pandemic on a clinical trial for plague therapeutics and strategies that have been considered to ensure research efforts continue. METHODS: To understand the impact of the COVID-19 pandemic on the trial accrual rate, we documented changes in patterns of all-cause consultations that took place before and during the pandemic at health centres in two districts of the Amoron'I Mania region of Madagascar where the trial is underway. We also considered trends in plague reporting and other external factors that may have contributed to slow recruitment. RESULTS: During the pandemic, we found a 27% decrease in consultations at the referral hospital, compared to an 11% increase at peripheral health centres, as well as an overall drop during the months of lockdown. We also found a nation-wide trend towards reduced number of reported plague cases. DISCUSSION: COVID-19 outbreaks are unlikely to dissipate in the near future. Declining NTD case numbers recorded during the pandemic period should not be viewed in isolation or taken as a marker of things to come. It is vitally important that researchers are prepared for a rebound in cases and, most importantly, that research continues to avoid NTDs becoming even more neglected.


Subject(s)
COVID-19 , Health Impact Assessment , Neglected Diseases/drug therapy , Plague/drug therapy , Randomized Controlled Trials as Topic , Research , Tropical Medicine/trends , Disease Notification , Epidemiological Monitoring , Humans , Madagascar/epidemiology , Pandemics , Patient Acceptance of Health Care , Patient Selection , Plague/epidemiology , Referral and Consultation/trends
6.
PLoS One ; 16(12): e0260486, 2021.
Article in English | MEDLINE | ID: covidwho-1581782

ABSTRACT

INTRODUCTION: Worldwide, children with disabilities are a vulnerable population and at high risk for COVID-19 morbidity and mortality. There is little information on the impact that COVID-19 had on children with disabilities and their families, particularly in low-income settings. This assessment describes the extent to which the pandemic impacted seven indicators of well-being in three low-income communities in Lusaka, Zambia. METHODS: Interviews were conducted with a random selection of families participating in an existing program (n = 39), community health workers (n = 6), healthcare workers (n = 7) and government officials (n = 2). Descriptive data was summarized and qualitative responses reviewed for themes. RESULTS: Most families reported a major loss of income resulting in food insecurity (79%), housing instability (67%), stress (36%), and increased risk of child separation and neglect (18%). Most families did not report receiving governmental financial assistance and reported loss of access to health services for their child such as physiotherapy (33%). Stakeholders interviewed reported that COVID-19 information was widely available although few specific interventions for children. Families were seen to have greater food insecurity, more poverty, more crowding, less healthcare services and children left alone or on the streets to beg. DISCUSSION: COVID-19 and related containment measures have impacted the lives of children with disabilities and their families to a great extent. There is an urgent need for disability-inclusive responses that deliberately address the needs of children with disabilities and their families, notably uninterrupted access to adequate food, inclusive education, rehabilitation therapy, and income-generating activities.


Subject(s)
COVID-19 , Health Impact Assessment , Zambia
7.
CMAJ Open ; 9(4): E1175-E1180, 2021.
Article in English | MEDLINE | ID: covidwho-1575909

ABSTRACT

BACKGROUND: Reliable reports on hand hygiene performance throughout the COVID-19 pandemic are lacking as most hospitals continue to rely on direct observation to measure this quality indicator. Using group electronic hand hygiene monitoring, we sought to assess the impact of COVID-19 on adherence to hand hygiene. METHODS: Across 12 Ontario hospitals (5 university and 7 community teaching hospitals), a group electronic hand hygiene monitoring system was installed before the pandemic to provide continuous measurement of hand hygiene adherence across 978 ward and 367 critical care beds. We performed an interrupted time-series study of institutional hand hygiene adherence in association with a COVID-19 inpatient census and the Ontario daily count of COVID-19 cases during a baseline period (Nov. 1, 2019, to Feb. 29, 2020), the pre-peak period of the first wave of the pandemic (Mar. 1 to Apr. 24, 2020), and the post-peak period of the first wave (Apr. 25 to July 5, 2020). We used a Poisson regression model to assess the association between the hospital COVID-19 census and institutional hand hygiene adherence while adjusting for the correlation within inpatient units. RESULTS: At baseline, the rate of hand hygiene adherence was 46.0% (6 325 401 of 13 750 968 opportunities) and this improved beginning in March 2020 to a daily peak of 79.3% (66 640 of 84 026 opportunities) on Mar. 30, 2020. Each patient admitted with COVID-19 was associated with improved hand hygiene adherence (incidence rate ratio [IRR] 1.0621, 95% confidence interval [CI] 1.0619-1.0623). Increasing Ontario daily case count was similarly associated with improved hand hygiene (IRR 1.0026, 95% CI 1.0021-1.0032). After peak COVID-19 community and inpatient numbers, hand hygiene adherence declined and returned to baseline. INTERPRETATION: The first wave of the COVID-19 pandemic was associated with significant improvement in hand hygiene adherence, measured using a group electronic monitoring system. Future research should seek to determine whether strategies that focus on health care worker perception of personal risk can achieve sustainable improvements in hand hygiene performance.


Subject(s)
COVID-19/epidemiology , Hand Hygiene , Health Personnel , Hospitals , Infection Control/statistics & numerical data , COVID-19/virology , Hand Hygiene/methods , Health Impact Assessment , Humans , Infection Control/methods , Public Health Surveillance
8.
Int Heart J ; 62(6): 1230-1234, 2021.
Article in English | MEDLINE | ID: covidwho-1542216

ABSTRACT

During the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, patients with ST-elevation myocardial infarction (STEMI) should be treated as possibly infected individuals. Therefore, more time is considered necessary to conduct primary percutaneous coronary intervention (PCI). In this study, we sought to evaluate the impact of the SARS-CoV-2 pandemic on primary PCI for STEMI. Between March 2019 and March 2021, 259 patients with STEMI underwent primary PCI. Patients were divided into 2 groups: the pre-pandemic group (March 2019-February 2020) and the pandemic group (March 2020-February 2021). The patient demographics, reperfusion time including onset-to-door time, door-to-balloon time (DTBT), computed tomography (CT), peak creatinine phosphokinase (CPK), and 30-day mortality rate were investigated. The mean age of the patients was 70.4 ± 12.9 years, and 71.6% were male. There were 117 patients before the pandemic and 142 during the pandemic. The median DTBT was 29 (21.25-41.25) minutes before the pandemic and 48 minutes (31-73 minutes) during the pandemic (P < 0.001). The median door-to-catheter-laboratory time was 13.5 (10-18.75) minutes before the pandemic and 29.5 (18-47.25) minutes during the pandemic (P < 0.001). CT evaluation was performed before PCI in 39 (33.3%) patients and 63 (44.4%) patients (P = 0.08); their peak CPK levels were 1480 (358-2737.5) IU and 1363 (621-2722.75) IU (P = 0.56), and the 30-day mortality rates were 4.3% and 2.1% (P = 0.48), respectively. The SARS-CoV-2 pandemic changed the diagnostic procedure in the emergency department and affected the DTBT in patients with STEMI. Nonetheless, no adverse effects on the 30-day mortality rate were observed.


Subject(s)
COVID-19/complications , Creatine Kinase/blood , Percutaneous Coronary Intervention/statistics & numerical data , ST Elevation Myocardial Infarction/surgery , Aged , Aged, 80 and over , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/virology , Female , Health Impact Assessment/statistics & numerical data , Humans , Japan/epidemiology , Male , Middle Aged , Mortality/trends , Percutaneous Coronary Intervention/methods , Percutaneous Coronary Intervention/mortality , Retrospective Studies , SARS-CoV-2/genetics , ST Elevation Myocardial Infarction/epidemiology , ST Elevation Myocardial Infarction/mortality , ST Elevation Myocardial Infarction/virology , Time Factors , Time-to-Treatment/trends
9.
PLoS Med ; 18(10): e1003815, 2021 10.
Article in English | MEDLINE | ID: covidwho-1450724

ABSTRACT

BACKGROUND: Multiple Coronavirus Disease 2019 (COVID-19) vaccines appear to be safe and efficacious, but only high-income countries have the resources to procure sufficient vaccine doses for most of their eligible populations. The World Health Organization has published guidelines for vaccine prioritisation, but most vaccine impact projections have focused on high-income countries, and few incorporate economic considerations. To address this evidence gap, we projected the health and economic impact of different vaccination scenarios in Sindh Province, Pakistan (population: 48 million). METHODS AND FINDINGS: We fitted a compartmental transmission model to COVID-19 cases and deaths in Sindh from 30 April to 15 September 2020. We then projected cases, deaths, and hospitalisation outcomes over 10 years under different vaccine scenarios. Finally, we combined these projections with a detailed economic model to estimate incremental costs (from healthcare and partial societal perspectives), disability-adjusted life years (DALYs), and incremental cost-effectiveness ratio (ICER) for each scenario. We project that 1 year of vaccine distribution, at delivery rates consistent with COVAX projections, using an infection-blocking vaccine at $3/dose with 70% efficacy and 2.5-year duration of protection is likely to avert around 0.9 (95% credible interval (CrI): 0.9, 1.0) million cases, 10.1 (95% CrI: 10.1, 10.3) thousand deaths, and 70.1 (95% CrI: 69.9, 70.6) thousand DALYs, with an ICER of $27.9 per DALY averted from the health system perspective. Under a broad range of alternative scenarios, we find that initially prioritising the older (65+) population generally prevents more deaths. However, unprioritised distribution has almost the same cost-effectiveness when considering all outcomes, and both prioritised and unprioritised programmes can be cost-effective for low per-dose costs. High vaccine prices ($10/dose), however, may not be cost-effective, depending on the specifics of vaccine performance, distribution programme, and future pandemic trends. The principal drivers of the health outcomes are the fitted values for the overall transmission scaling parameter and disease natural history parameters from other studies, particularly age-specific probabilities of infection and symptomatic disease, as well as social contact rates. Other parameters are investigated in sensitivity analyses. This study is limited by model approximations, available data, and future uncertainty. Because the model is a single-population compartmental model, detailed impacts of nonpharmaceutical interventions (NPIs) such as household isolation cannot be practically represented or evaluated in combination with vaccine programmes. Similarly, the model cannot consider prioritising groups like healthcare or other essential workers. The model is only fitted to the reported case and death data, which are incomplete and not disaggregated by, e.g., age. Finally, because the future impact and implementation cost of NPIs are uncertain, how these would interact with vaccination remains an open question. CONCLUSIONS: COVID-19 vaccination can have a considerable health impact and is likely to be cost-effective if more optimistic vaccine scenarios apply. Preventing severe disease is an important contributor to this impact. However, the advantage of prioritising older, high-risk populations is smaller in generally younger populations. This reduction is especially true in populations with more past transmission, and if the vaccine is likely to further impede transmission rather than just disease. Those conditions are typical of many low- and middle-income countries.


Subject(s)
COVID-19 Vaccines/economics , COVID-19/economics , Cost-Benefit Analysis/methods , Health Impact Assessment/economics , Models, Economic , Vaccination/economics , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines/administration & dosage , Cost-Benefit Analysis/trends , Health Impact Assessment/methods , Health Impact Assessment/trends , Humans , Pakistan/epidemiology , Quality-Adjusted Life Years , Vaccination/trends
10.
Acta Paul. Enferm. (Online) ; 34: eAPE02523, 2021. graf
Article in Portuguese | WHO COVID, LILACS (Americas) | ID: covidwho-1342176

ABSTRACT

Resumo Objetivo: Apreender os impactos na saúde mental de profissionais de Enfermagem face às interações com o 'novo' da pandemia da Covid-19. Métodos: Recorte qualitativo, da macropesquisa "Estudo VidaMenta/Covid-19", realizado com 719 profissionais de Enfermagem residentes no Brasil. A coleta de dados foi realizada em ambiente virtual com a aplicação da técnica bola de neve . Para a análise metodológica utilizou-se o Discurso do Sujeito Coletivo e para interpretação teórica e filosófica recorreu-se a elementos do Interacionismo Simbólico. Resultados: O discurso coletivo evidenciou que a saúde mental de profissionais de Enfermagem foi afetada pelas: interações com o 'novo' com elaboração de significados atribuídos à pandemia; interações com o cuidado de Enfermagem relacionadas com os atendimentos aos pacientes; e interações com o trabalho demarcadas pelas relações profissionais e institucionais. Conclusão: Os achados confirmam que há impactos na saúde mental de profissionais de Enfermagem no contexto da pandemia Covid-19 que se manifestam a partir da interação com o 'novo'. Nessa interação trazem o advento de um 'cuidado de Enfermagem pandêmico', permeado por especificidades que emergiram e apresenta uma possibilidade de mudança de paradigma para as diretrizes de formação em Enfermagem, nos avanços tecnológicos de ensino-aprendizagem e na prática profissional.


Resumen Objetivo: Comprender los impactos en la salud mental de profesionales de enfermería frente a las interacciones cono lo "nuevo" de la pandemia de COVID-19. Métodos: Recorte cualitativo, de la macroinvestigación "Estudo VidaMenta/Covid-19", realizado con 719 profesionales de enfermería residentes en Brasil. La recolección de datos fue realizada en ambiente virtual con la aplicación de la técnica bola de nieve . Para el análisis metodológico se utilizó el Discurso del Sujeto Colectivo, y para la interpretación teórica y filosófica se recurrió a elementos del Interaccionismo Simbólico. Resultados: El discurso colectivo evidenció que la salud mental de profesionales de enfermería estuvo afectada por: interacciones con lo "nuevo" con elaboración de significados atribuidos a la pandemia; interacciones con el cuidado de enfermería relacionadas con la atención a pacientes, e interacciones con el trabajo determinadas por las relaciones profesionales e institucionales. Conclusión: Los resultados confirman que hay impactos en la salud mental de profesionales de enfermería en el contexto de la pandemia de COVID-19, que se manifiestan a partir de la interacción con lo "nuevo". Esta interacción trae consigo el advenimiento de un "cuidado de enfermería pandémico", impregnado de especificidades que surgieron, y presenta una posibilidad de cambio de paradigma de las directrices de formación en enfermería, en los avances tecnológicos de enseñanza-aprendizaje y en la práctica profesional.


Abstract Objective: To understand mental health impacts on nursing professionals in the face of interactions with the novel COVID-19 pandemic. Methods: This is a qualitative cut, from the macrosearch " Estudo VidaMenta/Covid-19 ", carried out with 719 nursing professionals residing in Brazil. Data collection was performed in a virtual environment using the snowball technique. For methodological analysis, the Discourse of the Collective Subject was used and for theoretical and philosophical interpretation, Symbolic Interactionism elements were used. Results: The collective discourse showed that nursing professionals' mental health was affected by: interactions with the 'new' with the elaboration of meanings attributed to the pandemic; interactions with nursing care related to patient care; interactions with work demarcated by professional and institutional relationships. Conclusion: The findings confirm that there are impacts on nursing professionals' mental health in the COVID-19 pandemic context that manifest themselves through the interaction with the 'new'. In this interaction, they bring the advent of 'pandemic nursing care', permeated by specificities that have emerged and presents a possibility of changing the paradigm for nursing training guidelines, in technological advances in teaching and learning and in professional practice.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Mental Health , Pandemics , Health Impact Assessment , COVID-19 , Nurse Practitioners , Address , Evaluation Studies as Topic , Nurse-Patient Relations
11.
BMC Public Health ; 21(1): 1456, 2021 07 27.
Article in English | MEDLINE | ID: covidwho-1329111

ABSTRACT

BACKGROUND: Health Impact Assessment (HIA) is promoted as a decision-informing tool by public health and governmental agencies. HIA is beneficial when carried out as part of policy development but is also valuable as a methodology when a policy is being implemented to identify and understand the wider health and well-being impacts of policy decisions, particularly when a decision needs to be taken rapidly to protect the population. This paper focusses on a HIA of the 'Staying at Home and Social Distancing Policy' or 'lockdown' in response to the COVID-19 pandemic in Wales conducted by the Welsh national public health institute. It describes the process and findings, captures the learning and discusses how the process has been used to better understand the wider health and well-being impacts of policy decisions beyond direct health harm. It also examines the role of public health institutes in promoting and using HIA. METHODS: A HIA was conducted following a standard HIA five step process. A literature review was undertaken alongside 15 qualitative semi-structured interviews with key stakeholders, and relevant health and demographic data were collated. The results were triangulated and analysed to form a holistic assessment of the policy decision and its impacts. RESULTS: A wide range of major health and well-being impacts of the lockdown in Wales were identified across the determinants of health, which included positive and negative social, economic, environmental and mental well-being impacts beyond the impact on direct health. Populations affected included children and young people, those on low incomes and women as well as those whose health has been directly impacted by COVID-19 such as older people. The work highlighted the benefit that HIA can bring in emphasizing impacts which can inform policy and shared learning with others. CONCLUSION: HIA is a largely underused tool to understand the impact of policy and political decisions, particularly when a decision has been taken at speed. This case study highlights how HIA provide evidence and information for advocacy and further work by public health institutes, health agencies and policy makers.


Subject(s)
COVID-19 , Health Impact Assessment , Adolescent , Aged , Child , Communicable Disease Control , Female , Health Policy , Humans , Pandemics , Physical Distancing , Policy , SARS-CoV-2 , Wales
13.
Pediatr Infect Dis J ; 39(12): e452-e454, 2020 12.
Article in English | MEDLINE | ID: covidwho-762166

ABSTRACT

In this birth cohort, coronavirus acute respiratory infection was detected in 6.5% of the episodes; the commonest strain was OC43, followed by NL63, HKU1, and 229E. Children with coronavirus acute respiratory infection during infancy had significantly decreased forced expiratory volume in 0.5 seconds, forced expiratory flow between 25% and 75% of forced vital capacity, and peak expiratory flow at 3 years of age.


Subject(s)
Coronavirus Infections/epidemiology , Coronavirus Infections/physiopathology , Coronavirus , Health Impact Assessment , Lung/physiopathology , Respiratory Tract Infections/epidemiology , Respiratory Tract Infections/physiopathology , Child, Preschool , Cohort Studies , Coronavirus Infections/diagnosis , Coronavirus Infections/virology , Female , Follow-Up Studies , Humans , India/epidemiology , Infant , Infant, Newborn , Lung/virology , Male , Public Health Surveillance , Recurrence , Respiratory Tract Infections/diagnosis , Respiratory Tract Infections/virology , Symptom Assessment
14.
Int J Occup Med Environ Health ; 34(2): 223-237, 2021 May 27.
Article in English | MEDLINE | ID: covidwho-1168184

ABSTRACT

OBJECTIVES: The objective of this research is to determine the change in outdoor air quality during the COVID­19 related state of emergency resulting in a lockdown and the potential health benefits for the urban population. MATERIAL AND METHODS: During 53 days of the COVID­19 related state of emergency with a lockdown (March 15-May 6, 2020) in the Republic of Serbia, as well as in the corresponding periods of 2018 and 2019, data on the daily sulfur dioxide (SO2), nitrogen dioxide (NO2), ground-level ozone (O3) and particulate matter (PM10 and PM2.5) concentrations were analyzed. The total mortality data were analyzed to estimate the impact of the COVID­19 related lockdown measures on the burden of health in a given population, attributed to the outdoor air quality in the City of Novi Sad, using AirQ+ software. RESULTS: The average daily concentrations of PM2.5, NO2, PM10 and SO2 were reduced by 35%, 34%, 23% and 18%, respectively. In contrast, the average daily concentration of O3 increased by 8%, even if the primary precursors were reducing, thus representing a challenge for air quality management. In the City of Novi Sad, a reduction in the average daily PM2.5 concentration of 11.23 µg/m³ was significant, which resulted in a quantified number of avoided deaths. CONCLUSIONS: Air pollution in the City of Novi Sad had a chance to be improved due to some preventive measures related to the infectious disease (the COVID­19 related lockdown), which in turn was the mitigation measure to air pollution with positive public health effects. The confirmed positive effects of the improved air quality on public health could also include raising collective resistance to mass non-communicable and infectious diseases such as COVID­19 and reducing economic costs. Int J Occup Med Environ Health. 2021;34(2):223-37.


Subject(s)
Air Pollution/statistics & numerical data , COVID-19/epidemiology , Air Pollutants/analysis , Air Pollution/adverse effects , Air Pollution/analysis , COVID-19/prevention & control , Cause of Death , Cities , Health Impact Assessment , Humans , Nitrogen Dioxide/analysis , Ozone/analysis , Particulate Matter/analysis , Public Health , SARS-CoV-2 , Serbia/epidemiology , Sulfur Dioxide/analysis
15.
Environ Sci Pollut Res Int ; 28(31): 41843-41850, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1159993

ABSTRACT

Studies around the world have revealed reduced levels of atmospheric particulate matter in periods of greatest human mobility restriction to contain the spread of SARS-CoV-2 during the COVID-19 pandemic. The present study aimed to carry out a health impact assessment in Recife, Brazil, hypothesizing a scenario in which the levels of PM10 and PM2.5 remained, throughout the year, as in the most restrictive period of human mobility. Particular material data (PM10 and PM2.5) were measured during the pandemic and population and health (mortality, hospital admissions for heart and respiratory problems) data from 2018 were used. We observed a reduction in the concentration of PM2.5 in up to 43.7% and PM10 up to 29.5% during the period of social isolation in the city of Recife. The reduction in PM2.5 would avoid 106 annual deaths from non-external causes and 58 annual deaths from cardiovascular diseases. In this scenario, $ 294.88 million would be saved ($ 114.88 million from heart problems and $ 180 million from non-external causes). When considering hospitalizations avoided by the decrease in PM10, we observed 57 fewer hospitalizations for respiratory diseases, 42 for heart diseases and a reduction of 37 deaths due to non-external causes. The reduction in spending on respiratory and cardiovascular hospitalizations would exceed $ 330,000. Therefore, the reduction of particulate matter could prevent hospital admissions, deaths and consequently there would be a reduction in disease burden in developing countries where economic resources are scarce. In this sense, governments should seek to reduce levels of pollution in order to improve the life quality and health of the population.


Subject(s)
Air Pollutants , Air Pollution , COVID-19 , Air Pollutants/analysis , Air Pollution/analysis , Brazil , Cities , Environmental Exposure/analysis , Health Impact Assessment , Humans , Pandemics , Particulate Matter/analysis , SARS-CoV-2
16.
Acta Med Port ; 34(5): 355-361, 2021 May 02.
Article in English | MEDLINE | ID: covidwho-1156228

ABSTRACT

INTRODUCTION: The COVID-19 pandemic poses unprecedented challenges for healthcare services and has led to changes in the usage pattern of the pediatric population. We aimed to describe the impact of COVID-19 on children's health, wellbeing, and access to medical care in Portugal. MATERIAL AND METHODS: We conducted a cross-sectional study through an anonymous online survey via social media. The collected data refers to a period between the 16th of March and the 17th of May 2020. RESULTS: We obtained responses to the survey on 19 745 children. Of the previously scheduled outpatient consultations, 54.2% were postponed by healthcare institutions and 21.6% of planned vaccinations were missed. Parents expressed concerns regarding psychological, social, and physical consequences for their children due to the pandemic. DISCUSSION: The observed reduction of pediatric emergency department visits and the postponement of outpatient consultations and vaccine administrations are potentially harmful for non-COVID patients. The current pandemic and the imposed social distance might have an important negative impact on the mental health of children. CONCLUSION: Further studies are necessary to fully comprehend the outcomes of the decreased access to medical care, as well as the collateral damage for children beyond the clinical aspects of the pandemic. Defining strategies regarding the urge to vaccinate children and not postpone urgent evaluations should be a public health priority.


Introdução: A pandemia COVID-19 constitui um desafio sem precedentes para os serviços de saúde e conduziu a alterações no padrão de utilização dos recursos pela população pediátrica. Procurámos descrever o impacto da pandemia COVID-19 na saúde infantil e no acesso à saúde em Portugal. Material e Métodos: Realizámos um estudo retrospetivo, recolhendo dados através da aplicação de um inquérito anónimo online nas redes sociais. Os dados referem-se ao período entre 16 de março e 17 de maio de 2020. Resultados: Obtivemos respostas ao inquérito relativas a 19 745 crianças. Da análise às respostas, concluímos que 54,2% das consultas previamente agendadas foram adiadas pelas instituições de saúde e 21,6% das vacinações previstas não se realizaram. Os pais expressaram preocupação quanto às consequências psicológicas, sociais e físicas da pandemia nos seus filhos. Discussão: A reduzida utilização dos serviços de urgência pediátricos, bem como a não realização de consultas e vacinações previamente agendadas é potencialmente lesiva para os doentes não-COVID. A pandemia e o isolamento social imposto poderão causar um impacto negativo na saúde mental das crianças. Conclusão: Estudos adicionais são necessários para melhor compreender as consequências da diminuição do acesso à saúde, bem como os efeitos psicológicos, sociais e físicos nas crianças. A definição de estratégias para incentivar a vacinação e o não adiamento de avaliações médicas urgentes deveriam ser prioridades de Saúde Pública.


Subject(s)
COVID-19 , Child Health , Health Impact Assessment/methods , Pandemics , Pediatrics , COVID-19/epidemiology , COVID-19/psychology , Child , Cross-Sectional Studies , Health Services Accessibility , Humans , Parents , Portugal , Quality of Health Care , SARS-CoV-2
17.
J Clin Immunol ; 41(2): 324-334, 2021 02.
Article in English | MEDLINE | ID: covidwho-1064553

ABSTRACT

PURPOSE: The influenza vaccine is essential in reducing the influenza burden, especially among healthcare workers (HCW). Experimental studies suggest both coronaviruses and influenza viruses engage with the angiotensin-converting enzyme 2 (ACE 2) and tetraspanin antibodies, and that ACE 2 tetraspanin antibodies in turn may inhibit both coronavirus and low-pathogenicity influenza A viruses (LP IAV) infections. This study aims to investigate the potential clinical association between receiving the 2019 influenza vaccine and the incidence of COVID-19 among HCW. METHODS: We designed a case-control study within a hospital setting in Iran when it became a center for treating COVID-19 patients. We collected data and calculated relevant incidence and associative measures among HCW who had received the 2019 influenza vaccine as compared to HCW who had not received the vaccine. RESULTS: Our total sample size was 261 HCW. Of 80 COVID-19 incident cases, three cases had received the influenza vaccine, while 87 of 181 controls had received the vaccine. The odds ratio (OR) and confidence interval (CI) of being vaccinated were 0.04 (95% CI: 0.01 to 0.14) among COVID-19 cases as compared to controls. CONCLUSIONS: Significant findings suggest that the 2019 influenza vaccine may have a protective association against COVID-19 among HCW.


Subject(s)
COVID-19/epidemiology , Influenza Vaccines/immunology , SARS-CoV-2 , Adult , COVID-19/virology , Female , Health Impact Assessment , Health Personnel , Humans , Incidence , Influenza Vaccines/administration & dosage , Influenza Vaccines/adverse effects , Iran/epidemiology , Male , Middle Aged , Outcome Assessment, Health Care , Public Health Surveillance , Vaccination , Young Adult
18.
J Occup Health ; 63(1): e12198, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-1059413

ABSTRACT

OBJECTIVES: The health effects of telework, which was introduced extensively in the immediate context of the COVID-19 pandemic crisis in Japan, on teleworkers, their families, and non-teleworkers, are unknown. Accordingly, we developed a rapid health impact assessment (HIA) to evaluate positive and negative health effects of telework on these groups and recommended easily implementable countermeasures. METHODS: Immediately after an emergency was declared in Japan, we implemented a rapid, five-step HIA. We screened and categorized health effects of telework for the three above-mentioned groups, extracting their content, directionality, and likelihood. Following a scoping exercise to determine the HIA's overall implementation, five experienced occupational health physicians appraised and prioritized the screened items and added new items. We outlined specific countermeasures and disseminated the results on our website. A short-term evaluation was conducted by three external occupational health physicians and three nurses. RESULTS: Following screening and appraisal, 59, 29, and 27 items were listed for teleworkers, non-teleworkers, and family members of teleworkers, respectively, covering work, lifestyle, disease and medical care, and home and community. Targeted countermeasures focused on the work environment, business management, communications, and lifestyles for teleworkers; safety and medical guidelines, work prioritization, and regular communication for non-teleworkers; and shared responsibilities within families and communication outside families for family members of teleworkers. CONCLUSION: The HIA's validity and the countermeasures' practical applicability were confirmed by the external evaluators. They can be easily applied and adapted across diverse industries to mitigate the wider negative effects of telework and enhance its positive effects.


Subject(s)
COVID-19 , Health Impact Assessment , Occupational Health , Teleworking , Attitude of Health Personnel , COVID-19/prevention & control , Communication , Computer Security , Exercise , Family , Health Impact Assessment/methods , Health Status , Humans , Japan , Life Style , SARS-CoV-2 , Safety , Time Management , Work/psychology , Workplace/organization & administration
19.
Front Immunol ; 11: 614086, 2020.
Article in English | MEDLINE | ID: covidwho-1058417

ABSTRACT

In the last few months the world has witnessed a global pandemic due to severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection causing coronavirus disease 2019 (COVID-19). Obviously, this pandemic affected individuals differently, with a significant impact on populations considered to be at high-risk. One such population, was assumed to be patients with primary genetic defect involving components or pathways of the immune system. While human immunity against COVID-19 is not fully understood, it is, so far, well documented, that both adaptive and innate cells have a critical role in protection against SARS-CoV-2. Here, we aimed to summarize the clinical and laboratory data on primary immunodeficiency (PID) patients in Israel, who were tested positive for SARS-CoV-2, in order to estimate the impact of COVID-19 on such patients. Data was collected from mid-February to end-September. During this time Israel experienced two "waves" of COVID-19 diseases; the first, from mid-February to mid-May and the second from mid-June and still ongoing at the end of data collection. A total of 20 PID patients, aged 4 months to 60 years, were tested positive for SARS-CoV-2, all but one, were detected during the second wave. Fourteen of the patients were on routine monthly IVIG replacement therapy at the time of virus detection. None of the patients displayed severe illness and none required hospitalization; moreover, 7/20 patients were completely asymptomatic. Possible explanations for the minimal clinical impact of COVID-19 pandemic observed in our PID patients include high level of awareness, extra-precautions, and even self-isolation. It is also possible that only specific immune pathways (e.g. type I interferon signaling), may increase the risk for a more severe course of disease and these are not affected in many of the PID patients. In some cases, lack of an immune response actually may be a protective measure against the development of COVID-19 sequelae.


Subject(s)
COVID-19/complications , COVID-19/epidemiology , Primary Immunodeficiency Diseases/complications , Primary Immunodeficiency Diseases/epidemiology , SARS-CoV-2 , Adolescent , Adult , Child , Child, Preschool , Female , Health Impact Assessment , Humans , Infant , Israel/epidemiology , Male , Middle Aged , Public Health Surveillance , Young Adult
20.
PLoS One ; 15(12): e0243299, 2020.
Article in English | MEDLINE | ID: covidwho-999823

ABSTRACT

BACKGROUND: The novel Coronavirus Disease 2019 (COVID-19) pandemic is having a profound impact on global healthcare. Shortages in staff, operating theatre space and intensive care beds has led to a significant reduction in the provision of surgical care. Even vascular surgery, often insulated from resource scarcity due to its status as an urgent specialty, has limited capacity due to the pandemic. Furthermore, many vascular surgical patients are elderly with multiple comorbidities putting them at increased risk of COVID-19 and its complications. There is an urgent need to investigate the impact on patients presenting to vascular surgeons during the COVID-19 pandemic. METHODS AND ANALYSIS: The COvid-19 Vascular sERvice (COVER) study has been designed to investigate the worldwide impact of the COVID-19 pandemic on vascular surgery, at both service provision and individual patient level. COVER is running as a collaborative study through the Vascular and Endovascular Research Network (VERN), an independent, international vascular research collaborative with the support of numerous national and international organisations). The study has 3 'Tiers': Tier 1 is a survey of vascular surgeons to capture longitudinal changes to the provision of vascular services within their hospital; Tier 2 captures data on vascular and endovascular procedures performed during the pandemic; and Tier 3 will capture any deviations to patient management strategies from pre-pandemic best practice. Data submission and collection will be electronic using online survey tools (Tier 1: SurveyMonkey® for service provision data) and encrypted data capture forms (Tiers 2 and 3: REDCap® for patient level data). Tier 1 data will undergo real-time serial analysis to determine longitudinal changes in practice, with country-specific analyses also performed. The analysis of Tier 2 and Tier 3 data will occur on completion of the study as per the pre-specified statistical analysis plan.


Subject(s)
COVID-19/epidemiology , Endovascular Procedures/statistics & numerical data , Health Impact Assessment/statistics & numerical data , Humans , Internet , Operating Rooms/statistics & numerical data , SARS-CoV-2 , Specialties, Surgical/statistics & numerical data , Surgeons , Surveys and Questionnaires , Vascular Surgical Procedures/statistics & numerical data
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