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2.
N Engl J Med ; 387(21): 1935-1946, 2022 11 24.
Article in English | MEDLINE | ID: covidwho-2106628

ABSTRACT

BACKGROUND: In February 2022, Massachusetts rescinded a statewide universal masking policy in public schools, and many Massachusetts school districts lifted masking requirements during the subsequent weeks. In the greater Boston area, only two school districts - the Boston and neighboring Chelsea districts - sustained masking requirements through June 2022. The staggered lifting of masking requirements provided an opportunity to examine the effect of universal masking policies on the incidence of coronavirus disease 2019 (Covid-19) in schools. METHODS: We used a difference-in-differences analysis for staggered policy implementation to compare the incidence of Covid-19 among students and staff in school districts in the greater Boston area that lifted masking requirements with the incidence in districts that sustained masking requirements during the 2021-2022 school year. Characteristics of the school districts were also compared. RESULTS: Before the statewide masking policy was rescinded, trends in the incidence of Covid-19 were similar across school districts. During the 15 weeks after the statewide masking policy was rescinded, the lifting of masking requirements was associated with an additional 44.9 cases per 1000 students and staff (95% confidence interval, 32.6 to 57.1), which corresponded to an estimated 11,901 cases and to 29.4% of the cases in all districts during that time. Districts that chose to sustain masking requirements longer tended to have school buildings that were older and in worse condition and to have more students per classroom than districts that chose to lift masking requirements earlier. In addition, these districts had higher percentages of low-income students, students with disabilities, and students who were English-language learners, as well as higher percentages of Black and Latinx students and staff. Our results support universal masking as an important strategy for reducing Covid-19 incidence in schools and loss of in-person school days. As such, we believe that universal masking may be especially useful for mitigating effects of structural racism in schools, including potential deepening of educational inequities. CONCLUSIONS: Among school districts in the greater Boston area, the lifting of masking requirements was associated with an additional 44.9 Covid-19 cases per 1000 students and staff during the 15 weeks after the statewide masking policy was rescinded.


Subject(s)
COVID-19 , Health Policy , Masks , School Health Services , Universal Precautions , Humans , COVID-19/epidemiology , COVID-19/prevention & control , Incidence , Poverty/statistics & numerical data , Schools/legislation & jurisprudence , Schools/statistics & numerical data , Students/legislation & jurisprudence , Students/statistics & numerical data , Health Policy/legislation & jurisprudence , Masks/statistics & numerical data , School Health Services/legislation & jurisprudence , School Health Services/statistics & numerical data , Occupational Groups/legislation & jurisprudence , Occupational Groups/statistics & numerical data , Universal Precautions/legislation & jurisprudence , Universal Precautions/statistics & numerical data , Massachusetts/epidemiology , Communicable Disease Control/legislation & jurisprudence , Communicable Disease Control/statistics & numerical data
3.
BMC Public Health ; 22(1): 1594, 2022 08 22.
Article in English | MEDLINE | ID: covidwho-2002144

ABSTRACT

BACKGROUND: The outbreak of Coronavirus disease, which originated in Wuhan, China in 2019, has affected the lives of billions of people globally. Throughout 2020, the reproduction number of COVID-19 was widely used by decision-makers to explain their strategies to control the pandemic. METHODS: In this work, we deduce and analyze both initial and effective reproduction numbers for 12 diverse world regions between February and December of 2020. We consider mobility reductions, mask wearing and compliance with masks, mask efficacy values alongside other non-pharmaceutical interventions (NPIs) in each region to get further insights in how each of the above factored into each region's SARS-COV-2 transmission dynamic. RESULTS: We quantify in each region the following reductions in the observed effective reproduction numbers of the pandemic: i) reduction due to decrease in mobility (as captured in Google mobility reports); ii) reduction due to mask wearing and mask compliance; iii) reduction due to other NPI's, over and above the ones identified in i) and ii). CONCLUSION: In most cases mobility reduction coming from nationwide lockdown measures has helped stave off the initial wave in countries who took these types of measures. Beyond the first waves, mask mandates and compliance, together with social-distancing measures (which we refer to as other NPI's) have allowed some control of subsequent disease spread. The methodology we propose here is novel and can be applied to other respiratory diseases such as influenza or RSV.


Subject(s)
COVID-19 , Communicable Disease Control , Global Health , Pandemics , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/transmission , Communicable Disease Control/methods , Global Health/statistics & numerical data , Health Behavior , Humans , Masks/statistics & numerical data , Pandemics/prevention & control , Travel/statistics & numerical data
4.
PLoS One ; 17(3): e0265328, 2022.
Article in English | MEDLINE | ID: covidwho-1938431

ABSTRACT

BACKGROUND: In the era of COVID-19 where there is emphasis on the importance of wearing a mask, wearing it rightly is equally important. Therefore, the purpose of this study was to assess the knowledge, attitude and practice of wearing a mask in the general population of a developing country at three major tertiary care hospital. MATERIALS AND METHODS: Participants of this cross-sectional study were patients and attendants at three major tertiary care hospital of Karachi Pakistan. Selected participants, through non-probability convenient sampling technique, were interviewed regarding knowledge, attitude, and practice of wearing mask using an Urdu translated version of a questionnaire used in an earlier study. Three summary scores (0 to 100) were computed to indicate participants' mask wearing practice, technique of putting it on, and technique of taking if off. Collected data were analyzed with the help of IBM SPSS version 19. RESULTS: A total of 370 selected individuals were interviewed, out of which 51.9% were male and mean age was 37.65±11.94 years. For more than 90% of the participants, wearing a face mask was a routine practicing during the pandemic. The mean practice score was 65.69±25.51, score for technique of putting on a face mask was 67.77±23.03, and score of technique of taking off a face mask was 51.01±29.23. Education level of participant tends to have positive relationship with all three scores, while presence of asthma or chronic obstructive pulmonary disease (COPD) as co-morbid had negative impact on mask wearing practice. CONCLUSION: We have observed suboptimal knowledge, attitude and practice of wearing mask among the selected individuals. There is a continued need to spread awareness and educate general population about the importance of using a face mask, as well as the proper technique of wearing and taking off a face mask.


Subject(s)
COVID-19/prevention & control , Masks/trends , Adult , Cross-Sectional Studies , Developing Countries/statistics & numerical data , Female , Health Knowledge, Attitudes, Practice , Humans , Knowledge , Male , Masks/statistics & numerical data , Middle Aged , Pakistan/epidemiology , Pandemics , SARS-CoV-2/pathogenicity , Surveys and Questionnaires , Tertiary Care Centers
5.
PLoS One ; 17(2): e0263820, 2022.
Article in English | MEDLINE | ID: covidwho-1793524

ABSTRACT

Many factors play a role in outcomes of an emerging highly contagious disease such as COVID-19. Identification and better understanding of these factors are critical in planning and implementation of effective response strategies during such public health crises. The objective of this study is to examine the impact of factors related to social distancing, human mobility, enforcement strategies, hospital capacity, and testing capacity on COVID-19 outcomes within counties located in District of Columbia as well as the states of Maryland and Virginia. Longitudinal data have been used in the analysis to model county-level COVID-19 infection and mortality rates. These data include big location-based service data, which were collected from anonymized mobile devices and characterize various social distancing and human mobility measures within the study area during the pandemic. The results provide empirical evidence that lower rates of COVID-19 infection and mortality are linked with increased levels of social distancing and reduced levels of travel-particularly by public transit modes. Other preventive strategies and polices also prove to be influential in COVID-19 outcomes. Most notably, lower COVID-19 infection and mortality rates are linked with stricter enforcement policies and more severe penalties for violating stay-at-home orders. Further, policies that allow gradual relaxation of social distancing measures and travel restrictions as well as those requiring usage of a face mask are related to lower rates of COVID-19 infections and deaths. Additionally, increased access to ventilators and Intensive Care Unit (ICU) beds, which represent hospital capacity, are linked with lower COVID-19 mortality rates. On the other hand, gaps in testing capacity are related to higher rates of COVID-19 infection. The results also provide empirical evidence for reports suggesting that certain minority groups such as African Americans and Hispanics are disproportionately affected by the COVID-19 pandemic.


Subject(s)
Big Data , COVID-19/prevention & control , Physical Distancing , Public Health , Travel/statistics & numerical data , COVID-19/epidemiology , COVID-19/virology , District of Columbia/epidemiology , Female , Humans , Male , Maryland/epidemiology , Masks/statistics & numerical data , Middle Aged , Quarantine , SARS-CoV-2/isolation & purification , Virginia/epidemiology
6.
Anesth Analg ; 134(3): 524-531, 2022 03 01.
Article in English | MEDLINE | ID: covidwho-1709740

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) cases continue to surge in the United States with the emergence of new variants. Statewide variability and inconsistency in implementing risk mitigation strategies are widespread, particularly in regards to enforcing mask mandates and encouraging the public to become fully vaccinated. METHODS: This is a cross-sectional study conducted on July 31, 2021, utilizing publicly available data from the Wisconsin Department of Health Services. The authors abstracted data on total COVID-19-related cases, hospitalizations, and deaths in the state of Wisconsin. The primary objective was comparison of total COVID-19-related cases, hospitalizations, and deaths in vaccinated versus unvaccinated people in the state of Wisconsin over a 31-day period (July 2021). Furthermore, we also performed a narrative review of the literature on COVID-19-related outcomes based on mask use and vaccination status. RESULTS: In the state of Wisconsin during July 2021, total COVID-19 cases was 125.4 per 100,000 fully vaccinated people versus 369.2 per 100,000 not fully vaccinated people (odds ratio [OR] = 0.34, 95% confidence interval [CI], 0.33-0.35; P < .001). Total COVID-19 hospitalizations was 4.9 per 100,000 fully vaccinated people versus 18.2 per 100,000 not fully vaccinated people (OR = 0.27, 98% CI, 0.22-0.32; P < .001). Total COVID-19 deaths was 0.1 per 100,000 fully vaccinated people versus 1.1 per 100,000 not fully vaccinated people (OR = 0.09, 95% CI, 0.03-0.29; P < .001). Narrative review of the literature demonstrated high vaccine effectiveness against COVID-19 infection prevention (79%-100% among fully vaccinated people), COVID-19-related hospitalization (87%-98% among fully vaccinated people), and COVID-19-related death (96.7%-98% among fully vaccinated people). Studies have also generally reported that mask use was associated with increased effectiveness in preventing COVID-19 infection ≤70%. CONCLUSIONS: Strict adherence to public mask use and fully vaccinated status are associated with improved COVID-19-related outcomes and can mitigate the spread, morbidity, and mortality of COVID-19. Anesthesiologists and intensivists should adhere to evidence-based guidelines in their approach and management of patients to help mitigate spread.


Subject(s)
COVID-19/mortality , Cost of Illness , Hospitalization/trends , Mandatory Programs/trends , Masks/trends , Vaccination/trends , COVID-19/prevention & control , Cross-Sectional Studies , Data Interpretation, Statistical , Hospitalization/statistics & numerical data , Humans , Mandatory Programs/statistics & numerical data , Masks/statistics & numerical data , Mortality/trends , Vaccination/statistics & numerical data , Wisconsin/epidemiology
7.
JAMA Netw Open ; 5(1): e2141227, 2022 01 04.
Article in English | MEDLINE | ID: covidwho-1653127

ABSTRACT

Importance: It is not known how effective child masking is in childcare settings in preventing the transmission of SARS-CoV-2. This question is critical to inform health policy and safe childcare practices. Objective: To assess the association between masking children 2 years and older and subsequent childcare closure because of COVID-19. Design, Setting, and Participants: A prospective, 1-year, longitudinal electronic survey study of 6654 childcare professionals at home- and center-based childcare programs in all 50 states was conducted at baseline (May 22 to June 8, 2020) and follow-up (May 26 to June 23, 2021). Using a generalized linear model (log-binomial model) with robust SEs, this study evaluated the association between childcare program closure because of a confirmed or suspected COVID-19 case in either children or staff during the study period and child masking in both early adoption (endorsed at baseline) and continued masking (endorsed at baseline and follow-up), while controlling for physical distancing, other risk mitigation strategies, and program and community characteristics. Exposures: Child masking in childcare programs as reported by childcare professionals at baseline and both baseline and follow-up. Main Outcomes and Measures: Childcare program closure because of a suspected or confirmed COVID-19 case in either children or staff as reported in the May 26 to June 23, 2021, end survey. Results: This survey study of 6654 childcare professionals (mean [SD] age, 46.9 [11.3] years; 750 [11.3%] were African American, 57 [0.9%] American Indian/Alaska Native, 158 [2.4%] Asian, 860 [12.9%] Hispanic, 135 [2.0%] multiracial [anyone who selected >1 race on the survey], 18 [0.3%] Native Hawaiian/Pacific Islander, and 5020 [75.4%] White) found that early adoption (baseline) of child masking was associated with a 13% lower risk of childcare program closure because of a COVID-19 case (adjusted relative risk, 0.87; 95% CI, 0.77-0.99), and continued masking for 1 year was associated with a 14% lower risk (adjusted relative risk, 0.86; 95% CI, 0.74-1.00). Conclusions and Relevance: This survey study of childcare professionals suggests that masking young children is associated with fewer childcare program closures, enabling in-person education. This finding has important public health policy implications for families that rely on childcare to sustain employment.


Subject(s)
COVID-19/prevention & control , Child Care/statistics & numerical data , Child Care/standards , Child Day Care Centers/statistics & numerical data , Child Day Care Centers/standards , Masks/statistics & numerical data , Masks/standards , Adult , COVID-19/epidemiology , Child , Child, Preschool , Cross-Sectional Studies , Female , Humans , Longitudinal Studies , Male , Middle Aged , Prospective Studies , SARS-CoV-2 , United States/epidemiology
8.
PLoS One ; 17(1): e0261398, 2022.
Article in English | MEDLINE | ID: covidwho-1631249

ABSTRACT

OBJECTIVES: To quantify changes in adherence to mask and distancing guidelines in outdoor settings in Philadelphia, PA before and after President Trump announced he was infected with COVID-19. METHODS: We used Systematic Observation of Masking Adherence and Distancing (SOMAD) to assess mask adherence in parks, playgrounds, and commercial streets in the 10 City Council districts in Philadelphia PA. We compared adherence rates between August and September 2020 and after October 2, 2020. RESULTS: Disparities in mask adherence existed by age group, gender, and race/ethnicity, with females wearing masks correctly more often than males, seniors having higher mask use than other age groups, and Asians having higher adherence than other race/ethnicities. Correct mask use did not increase after the City released additional mask guidance in September but did after Oct 2. Incorrect mask use also decreased, but the percentage not having masks at all was unchanged. CONCLUSIONS: Vulnerability of leadership appears to influence population behavior. Public health departments likely need more resources to effectively and persuasively communicate critical safety messages related to COVID-19 transmission.


Subject(s)
COVID-19/epidemiology , Masks/trends , Adolescent , Adult , Aged , COVID-19/virology , Child , Child, Preschool , Female , Guideline Adherence/trends , Humans , Male , Masks/statistics & numerical data , Middle Aged , Philadelphia , Physical Distancing , Public Health , SARS-CoV-2/isolation & purification , Young Adult
9.
PLoS One ; 16(12): e0261321, 2021.
Article in English | MEDLINE | ID: covidwho-1639116

ABSTRACT

By September 2020, COVID-19 had claimed the lives of almost 1 million people worldwide, including more than 400,000 in the U.S. and Europe [1] To slow the spread of the virus, health officials advised social distancing, regular handwashing, and wearing a face covering [2]. We hypothesized that public adherence to the health guidance would be influenced by prevailing social norms, and the prevalence of these behaviors among others. We focused on mask-wearing behavior during fall 2020, and coded livestream public webcam footage of 1,200 individuals across seven cities. Results showed that only 50% of participants were correctly wearing a mask in public, and that this percentage varied as a function of the mask-wearing behavior of close and distant others in the immediate physical vicinity. How social normative information might be used to increase mask-wearing behavior is discussed. "Cloth face coverings are one of the most powerful weapons we have to slow and stop the spread of the virus-particularly when used universally within a community setting" CDC Director Dr. Robert Redfield in July 2020.


Subject(s)
COVID-19 , Masks/statistics & numerical data , Pandemics/statistics & numerical data , Social Behavior , Adult , COVID-19/epidemiology , COVID-19/psychology , Female , Humans , Male , Middle Aged
10.
PLoS One ; 16(12): e0261330, 2021.
Article in English | MEDLINE | ID: covidwho-1638355

ABSTRACT

Coronavirus disease 2019 (COVID-19) is an infectious disease of humans caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Since the first case was identified in China in December 2019 the disease has spread worldwide, leading to an ongoing pandemic. In this article, we present an agent-based model of COVID-19 in Luxembourg, and use it to estimate the impact, on cases and deaths, of interventions including testing, contact tracing, lockdown, curfew and vaccination. Our model is based on collation, with agents performing activities and moving between locations accordingly. The model is highly heterogeneous, featuring spatial clustering, over 2000 behavioural types and a 10 minute time resolution. The model is validated against COVID-19 clinical monitoring data collected in Luxembourg in 2020. Our model predicts far fewer cases and deaths than the equivalent equation-based SEIR model. In particular, with R0 = 2.45, the SEIR model infects 87% of the resident population while our agent-based model infects only around 23% of the resident population. Our simulations suggest that testing and contract tracing reduce cases substantially, but are less effective at reducing deaths. Lockdowns are very effective although costly, while the impact of an 11pm-6am curfew is relatively small. When vaccinating against a future outbreak, our results suggest that herd immunity can be achieved at relatively low coverage, with substantial levels of protection achieved with only 30% of the population fully immune. When vaccinating in the midst of an outbreak, the challenge is more difficult. In this context, we investigate the impact of vaccine efficacy, capacity, hesitancy and strategy. We conclude that, short of a permanent lockdown, vaccination is by far the most effective way to suppress and ultimately control the spread of COVID-19.


Subject(s)
COVID-19/epidemiology , Pandemics/prevention & control , Quarantine/statistics & numerical data , Vaccination/statistics & numerical data , Adolescent , Adult , Aged , Child , Child, Preschool , Contact Tracing/statistics & numerical data , Humans , Immunity, Herd , Infant , Infant, Newborn , Luxembourg/epidemiology , Masks/statistics & numerical data , Middle Aged , Young Adult
11.
J Child Neurol ; 37(2): 127-132, 2022 02.
Article in English | MEDLINE | ID: covidwho-1602856

ABSTRACT

INTRODUCTION: This study was designed to assess current recommendations from child neurologists and epileptologists on masking for school-age children with epilepsy. METHODS: A 7-item survey was created and sent out to members of the Child Neurology Society and Pediatric Epilepsy Research Consortium in August of 2021 to assess current practice and provider recommendations on masking. RESULTS: One hundred four individuals participated with representation from all regions of the United States. Masking was recommended by 95.1%, with 63.4% (n = 66) noting exception of those with severe intellectual disability, autism, and behavioral problems. Of those who write exemption letters, 54% write these <5% of the time. Only 3% reported potential adverse events associated with masking. CONCLUSION: Nearly all respondents recommended masking for school-age children with epilepsy. Potential risks of masking and adverse events were low. Improved guidance on masking is needed to ensure academic success of our patients with epilepsy.


Subject(s)
COVID-19/prevention & control , Epilepsy/physiopathology , Health Care Surveys/statistics & numerical data , Masks/statistics & numerical data , Child , Consensus , Humans , Neurologists/statistics & numerical data , SARS Virus , United States
13.
Neurol Neuroimmunol Neuroinflamm ; 9(1)2022 01.
Article in English | MEDLINE | ID: covidwho-1596607

ABSTRACT

BACKGROUND AND OBJECTIVES: To investigate whether children receiving immunosuppressive therapies for neuroimmunologic disorders had (1) increased susceptibility to SARS-CoV2 infection or to develop more severe forms of COVID-19; (2) increased relapses or autoimmune complications if infected; and (3) changes in health care delivery during the pandemic. METHODS: Patients with and without immunosuppressive treatment were recruited to participate in a retrospective survey evaluating the period from March 14, 2020, to March 30, 2021. Demographics, clinical features, type of immunosuppressive treatment, suspected or confirmed COVID-19 in the patients or cohabitants, and changes in care delivery were recorded. RESULTS: One hundred fifty-three children were included: 84 (55%) female, median age 13 years (interquartile range [8-16] years), 79 (52%) on immunosuppressive treatment. COVID-19 was suspected or confirmed in 17 (11%) (all mild), with a frequency similar in patients with and without immunosuppressive treatment (11/79 [14%] vs 6/74 [8%], p = 0.3085). The frequency of neurologic relapses was similar in patients with (18%) and without (21%) COVID-19. Factors associated with COVID-19 included having cohabitants with COVID-19 (p < 0.001) and lower blood levels of vitamin D (p = 0.039). Return to face-to-face schooling or mask type did not influence the risk of infection, although 43(28%) children had contact with a classmate with COVID-19. Clinic visits changed from face to face to remote for 120 (79%) patients; 110 (92%) were satisfied with the change. DISCUSSION: In this cohort of children with neuroimmunologic disorders, the frequency of COVID-19 was low and not affected by immunosuppressive therapies. The main risk factors for developing COVID-19 were having cohabitants with COVID-19 and low vitamin D levels.


Subject(s)
COVID-19/complications , COVID-19/immunology , Immunocompromised Host , Immunosuppressive Agents/adverse effects , Nervous System Diseases/complications , Nervous System Diseases/immunology , SARS-CoV-2/immunology , Adolescent , COVID-19/prevention & control , COVID-19/virology , Child , Delivery of Health Care/organization & administration , Delivery of Health Care/statistics & numerical data , Female , Humans , Immunosuppressive Agents/therapeutic use , Male , Masks/statistics & numerical data , Masks/virology , Nervous System Diseases/virology , Pandemics , Recurrence , Retrospective Studies , Vitamin D/blood
14.
Sci Rep ; 11(1): 24490, 2021 12 29.
Article in English | MEDLINE | ID: covidwho-1594104

ABSTRACT

During the first wave of Covid-19 infections in Germany in April 2020, clinics reported a shortage of filtering face masks with aerosol retention> 94% (FFP2 & 3, KN95, N95). Companies all over the world increased their production capacities, but quality control of once-certified materials and masks came up short. To help identify falsely labeled masks and ensure safe protection equipment, we tested 101 different batches of masks in 993 measurements with a self-made setup based on DIN standards. An aerosol generator provided a NaCl test aerosol which was applied to the mask. A laser aerosol spectrometer measured the aerosol concentration in a range from 90 to 500 nm to quantify the masks' retention. Of 101 tested mask batches, only 31 batches kept what their label promised. Especially in the initial phase of the pandemic in Germany, we observed fluctuating mask qualities. Many batches show very high variability in aerosol retention. In addition, by measuring with a laser aerosol spectrometer, we were able to show that not all masks filter small and large particles equally well. In this study we demonstrate how important internal and independent quality controls are, especially in times of need and shortage of personal protection equipment.


Subject(s)
COVID-19/prevention & control , COVID-19/transmission , Masks/statistics & numerical data , Aerosols , Filtration/instrumentation , Germany , Humans , Masks/standards , Masks/trends , N95 Respirators/standards , N95 Respirators/statistics & numerical data , Occupational Exposure/prevention & control , Pandemics/prevention & control , Personal Protective Equipment/standards , Quality Control , Respiratory Protective Devices/standards , SARS-CoV-2/pathogenicity
15.
Gac Med Mex ; 157(3): 277-283, 2021.
Article in English | MEDLINE | ID: covidwho-1535085

ABSTRACT

INTRODUCTION: Currently, the face mask represents an incomparable symbol whose value went from clinical work to impacting the containment of the spread of SARS-CoV-2, although it has become an element of discord in the general population. OBJECTIVE: To establish the impact of face mask use policies on COVID-19 morbidity and mortality. METHODS: Face mask use policy variables, obtained from the website of the #Masks4All scientific movement, were associated with the number of infections, deaths and flattening of the curve published by the Johns Hopkins University resource center and EndCoronavirus.org. RESULTS: Face mask use policies were universal (required in shops, restaurants, public transport), partial (recommended, required in any public place) and absent. Associations of the face mask use policy with total cases (p = 0.01), cases per million (p = 0.04) and deaths per million population (p = 0.02) were statistically significant. Associations of the variables with the epidemiological curve trend were also statistically significant (p = 0.00). CONCLUSION: The recommendation for face mask widespread use is a measure with sufficient scientific support to reduce the number of COVID-19-related infections and deaths.


INTRODUCCIÓN: Actualmente, la mascarilla representa un símbolo incomparable cuyo valor pasó del trabajo clínico a impactar en la contención de la propagación del virus SARS-CoV-2; se convirtió en un elemento de discordia en la población general. OBJETIVO: Establecer el impacto de las políticas de uso de mascarilla en la morbimortalidad por COVID-19. MÉTODOS: Se asociaron las variables de política de uso de cubrebocas, obtenidas de la página web del movimiento científico #Masks4All, con el número de contagios, muertes y aplanamiento de la curva publicados por el centro de recursos de la Universidad Johns Hopkins y EndCoronavirus.org. RESULTADOS: Las políticas de uso de mascarilla fueron de tipo universal (requerido en tiendas, restaurantes, transporte público), parcial (recomendado, requerido en cualquier lugar público) y ausente. Las asociaciones de la política de uso de mascarilla con casos totales (p = 0.01), casos por millón (p = 0.04) y muertes por millón de habitantes (p = 0.02) resultaron estadísticamente significativas. Las asociaciones de las variables con la tendencia de la curva epidemiológica también resultaron estadísticamente significativas (p = 0.00). CONCLUSIÓN: La recomendación del uso generalizado de mascarilla es una medida con suficiente respaldo científico para reducir el número de contagios y muertes por COVID-19.


Subject(s)
COVID-19/prevention & control , Health Policy , Masks/statistics & numerical data , COVID-19/epidemiology , COVID-19/mortality , Cross-Sectional Studies , Global Health , Humans
16.
PLoS One ; 16(11): e0260287, 2021.
Article in English | MEDLINE | ID: covidwho-1528728

ABSTRACT

Coronavirus disease 2019 (COVID-19) pandemic has become a major public health issue globally. Preventive health measures against COVID-19 can reduce the health burden significantly by containing the transmission. A few research have been undertaken on the effectiveness of preventive strategies such as mask use, hand washing, and keeping social distance in preventing COVID-19 transmission. The main aim of this study was to determine the association of the preventive measures with the reduction of transmission of COVID-19 among people. Data was collected during January 06, 2021 to May 10, 2021 from 1690 participants in Bangladesh. A validated questionnaire was used to collect both the online and offline data. Chi-square test and logistic regression analyses were performed to determine the association among the variables. The prevalence of COVID-19 was 11.5% (195 of 1690) among the population. Age, gender, occupation and monthly income of the participants were significantly associated with the likelihood of following the preventive measures. The risk of infection and death reduced significantly among the participants following preventive measures (p = .001). The odds of incidence was lower among the participants using masks properly (OR: 0.02, 95% CI: 0.01-0.43), maintaining social distances (OR: 0.04, 95% CI: 0.01-0.33), avoiding crowded places (OR: 0.07, 95% CI: 0.02-0.19) and hand shaking (OR: 0.17, 95% CI: 0.09-0.41). This study suggests that preventive health measures are significantly associated with the reduction of the risk of infection of COVID-19. Findings from this study will help the policymakers to take appropriate steps to curb the health burden of COVID-19.


Subject(s)
Basic Reproduction Number , COVID-19/prevention & control , Physical Distancing , Respiratory Protective Devices/statistics & numerical data , Adolescent , Adult , Bangladesh , COVID-19/epidemiology , COVID-19/transmission , Child , Female , Humans , Male , Masks/statistics & numerical data , Middle Aged
17.
JAMA Netw Open ; 4(11): e2135386, 2021 11 01.
Article in English | MEDLINE | ID: covidwho-1527392

ABSTRACT

Importance: Adoption of mask wearing in response to the COVID-19 pandemic alters daily communication. Objective: To assess communication barriers associated with mask wearing in patient-clinician interactions and individuals who are deaf and hard of hearing. Design, Setting, and Participants: This pilot cross-sectional survey study included the general population, health care workers, and health care workers who are deaf or hard of hearing in the United States. Volunteers were sampled via an opt-in survey panel and nonrandomized convenience sampling. The general population survey was conducted between January 5 and January 8, 2021. The health care worker surveys were conducted between December 3, 2020, and January 3, 2021. Respondents viewed 2 short videos of a study author wearing both a standard and transparent N95 mask and answered questions regarding mask use, communication, preference, and fit. Surveys took 15 to 20 minutes to complete. Main Outcomes and Measures: Participants' perceptions were assessed surrounding the use of both mask types related to communication and the ability to express emotions. Results: The national survey consisted of 1000 participants (mean [SD] age, 48.7 [18.5] years; 496 [49.6%] women) with a response rate of 92.25%. The survey of general health care workers consisted of 123 participants (mean [SD] age, 49.5 [9.0] years; 84 [68.3%] women), with a response rate of 11.14%. The survey of health care workers who are deaf or hard of hearing consisted of 45 participants (mean [SD] age, 54.5 [9.0] years; 30 [66.7%] women) with a response rate of 23.95%. After viewing a video demonstrating a study author wearing a transparent N95 mask, 781 (78.1%) in the general population, 109 general health care workers (88.6%), and 38 health care workers who are deaf or hard of hearing (84.4%) were able to identify the emotion being expressed, in contrast with 201 (20.1%), 25 (20.5%), and 11 (24.4%) for the standard opaque N95 mask. In the general population, 450 (45.0%) felt positively about interacting with a health care worker wearing a transparent mask; 76 general health care workers (61.8%) and 37 health care workers who are deaf or hard of hearing (82.2%) felt positively about wearing a transparent mask to communicate with patients. Conclusions and Relevance: The findings of this study suggest that transparent masks could help improve communication during the COVID-19 pandemic, particularly for individuals who are deaf and hard of hearing.


Subject(s)
COVID-19/prevention & control , Communication Barriers , Health Personnel/statistics & numerical data , Masks/statistics & numerical data , Professional-Patient Relations , Adult , Communication , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , United States , Young Adult
18.
Sci Rep ; 11(1): 21675, 2021 11 04.
Article in English | MEDLINE | ID: covidwho-1504246

ABSTRACT

The recent outbreak of the COVID-19 led to death of millions of people worldwide. To stave off the spread of the virus, the authorities in the US employed different strategies, including the mask mandate order issued by the states' governors. In the current work, we defined a parameter called average death ratio as the monthly average of the number of daily deaths to the monthly average number of daily cases. We utilized survey data to quantify people's abidance by the mask mandate order. Additionally, we implicitly addressed the extent to which people abide by the mask mandate order, which may depend on some parameters such as population, income, and education level. Using different machine learning classification algorithms, we investigated how the decrease or increase in death ratio for the counties in the US West Coast correlates with the input parameters. The results showed that for the majority of counties, the mask mandate order decreased the death ratio, reflecting the effectiveness of such a preventive measure on the West Coast. Additionally, the changes in the death ratio demonstrated a noticeable correlation with the socio-economic condition of each county. Moreover, the results showed a promising classification accuracy score as high as 90%.


Subject(s)
COVID-19/mortality , COVID-19/prevention & control , Masks/trends , California , Guideline Adherence/trends , Health Policy , Humans , Machine Learning , Masks/statistics & numerical data , Oregon , SARS-CoV-2/pathogenicity , Washington
20.
Biomedica ; 41(Sp. 2): 48-61, 2021 10 15.
Article in English, Spanish | MEDLINE | ID: covidwho-1478423

ABSTRACT

INTRODUCTION: The studies on knowledge, attitudes, and practices (KAP) regarding COVID-19 help to identify erroneous concepts and inadequate practices related to the disease. This baseline information is essential to design effective strategies and improve adherence to prevention measures. OBJECTIVE: To identify the COVID-19-related KAP in Venezuelan patients screened at the Hospital Universitario de Caracas triage tent. MATERIALS AND METHODS: We conducted a cross-sectional study among 215 patients between April 25th and May 25th, 2020, with in-person interviews using a KAP survey. RESULTS: Most surveyed patients (53.5%) were asymptomatic. Most of them, both from the symptomatic and the asymptomatic groups, had adequate knowledge about the symptoms and transmission of the disease and the majority said they were practicing quarantine, frequent handwashing, and the use of face masks in public areas. However, the daily replacement of cloth face masks was more frequent in the asymptomatic group whereas replacement every three days was more frequent in the symptomatic group. Finally, more than half of the participants admitted having been in crowded places, a common practice among the symptomatic compared to the asymptomatic patients. CONCLUSIONS: This is the first KAP study in Venezuela about COVID-19. Knowledge and practices among Venezuelans could be improved by strengthening education and training programs. This information from the early phase of the pandemic in Venezuela may contribute to the design of COVID-19 promotion and prevention strategies.


Introducción: Los estudios sobre conocimientos, actitudes y prácticas (CAP) sobre COVID-19 ayudan a identificar conceptos erróneos y prácticas inadecuadas relacionadas con la enfermedad. Esta información de referencia es fundamental para diseñar estrategias efectivas y mejorar la adherencia a las medidas de prevención. Objetivo: Identificar la CAP relacionada con COVID-19 en pacientes venezolanos cribados en la carpa de triaje del Hospital Universitario de Caracas. Materiales y métodos: Realizamos un estudio transversal entre 215 pacientes entre el 25 de abril y el 25 de mayo de 2020, con entrevistas en persona utilizando una encuesta KAP. Resultados: La mayoría de los pacientes encuestados (53,5%) se encontraban asintomáticos. La mayoría de ellos, tanto del grupo sintomático como asintomático, tenían un conocimiento adecuado sobre los síntomas y la transmisión de la enfermedad y la mayoría dijo que practicaban la cuarentena, el lavado frecuente de manos y el uso de mascarillas en las áreas públicas. Sin embargo, el reemplazo diario de mascarillas de tela fue más frecuente en el grupo asintomático, mientras que el reemplazo cada tres días fue más frecuente en el grupo sintomático. Finalmente, más de la mitad de los participantes admitieron haber estado en lugares concurridos, una práctica común entre los sintomáticos en comparación con los asintomáticos. Conclusiones: Este es el primer estudio CAP en Venezuela sobre COVID-19. El conocimiento y las prácticas entre los venezolanos podrían mejorarse fortaleciendo los programas de educación y capacitación. Esta información de la fase inicial de la pandemia en Venezuela puede contribuir al diseño de estrategias de promoción y prevención del COVID-19.


Subject(s)
COVID-19/prevention & control , COVID-19/transmission , Health Knowledge, Attitudes, Practice , Adult , Asymptomatic Infections/epidemiology , Cross-Sectional Studies , Crowding , Female , Hand Disinfection , Health Surveys/methods , Health Surveys/statistics & numerical data , Humans , Male , Masks/statistics & numerical data , Physical Distancing , Symptom Assessment , Triage , Venezuela/epidemiology
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