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1.
BMJ Health Care Inform ; 28(1)2021 Mar.
Article in English | MEDLINE | ID: covidwho-1147326

ABSTRACT

INTRODUCTION: Telehealth became the most practical option for general practice consultations in Aotearoa New Zealand (NZ) as a result of the national lockdowns in response to the COVID-19 pandemic. What is the consumer experience of access to telehealth and how do consumers and providers perceive this mode of care delivery going forward? METHODS AND ANALYSIS: A national survey of general practice consumers and providers who used telehealth services since the national lockdowns in 2020 will be distributed. It is based on the Unified Theory of Acceptance and Use of Technology framework of technology acceptance and the access to care framework. The data will be statistically analysed to create a foundation for in-depth research on the use of telehealth services in NZ general practice services, with a specific focus on consumer experiences and health outcomes. ETHICS AND DISSEMINATION: Ethics approval was granted by the Auckland Health Research Ethics Committee on 13/11/2020, reference AH2539. The survey will be disseminated online.


Subject(s)
/epidemiology , General Practice/organization & administration , Telemedicine/organization & administration , Attitude to Computers , Humans , New Zealand/epidemiology , Pandemics , Prospective Studies , Research Design , Surveys and Questionnaires , Telephone , Videoconferencing
2.
PLoS One ; 16(3): e0248176, 2021.
Article in English | MEDLINE | ID: covidwho-1119476

ABSTRACT

Testing and case identification are key strategies in controlling the COVID-19 pandemic. Contact tracing and isolation are only possible if cases have been identified. The effectiveness of testing should be assessed, but a single comprehensive metric is not available to assess testing effectiveness, and no timely estimates of case detection rate are available globally, making inter-country comparisons difficult. The purpose of this paper was to propose a single, comprehensive metric, called the COVID-19 Testing Index (CovTI) scaled from 0 to 100, derived from epidemiological indicators of testing, and to identify factors associated with this outcome. The index was based on case-fatality rate, test positivity rate, active cases, and an estimate of the detection rate. It used parsimonious modeling to estimate the true total number of COVID-19 cases based on deaths, testing, health system capacity, and government transparency. Publicly reported data from 165 countries and territories that had reported at least 100 confirmed cases by June 3, 2020 were included in the index. Estimates of detection rates aligned satisfactorily with previous estimates in literature (R2 = 0.44). As of June 3, 2020, the states with the highest CovTI included Hong Kong (93.7), Australia (93.5), Iceland (91.8), Cambodia (91.3), New Zealand (90.6), Vietnam (90.2), and Taiwan (89.9). Bivariate analyses showed the mean CovTI in countries with open public testing policies (66.9, 95% CI 61.0-72.8) was significantly higher than in countries with no testing policy (29.7, 95% CI 17.6-41.9) (p<0.0001). A multiple linear regression model assessed the association of independent grouping variables with CovTI. Open public testing and extensive contact tracing were shown to significantly increase CovTI, after adjusting for extrinsic factors, including geographic isolation and centralized forms of government. The correlation of testing and contact tracing policies with improved outcomes demonstrates the validity of this model to assess testing effectiveness and also suggests these policies were effective at improving health outcomes. This tool can be combined with other databases to identify other factors or may be useful as a standalone tool to help inform policymakers.


Subject(s)
/diagnosis , /epidemiology , Australia/epidemiology , Cambodia/epidemiology , Contact Tracing , Health Policy , Hong Kong/epidemiology , Humans , Iceland/epidemiology , Linear Models , New Zealand/epidemiology , Taiwan/epidemiology , Vietnam/epidemiology
3.
PLoS One ; 16(3): e0248075, 2021.
Article in English | MEDLINE | ID: covidwho-1117473

ABSTRACT

The world is facing the coronavirus pandemic (COVID-19), which began in China. By August 18, 2020, the United States, Brazil, and India were the most affected countries. Health infrastructure and socioeconomic vulnerabilities may be affecting the response capacities of these countries. We compared official indicators to identify which vulnerabilities better determined the exposure risk to COVID-19 in both the most and least affected countries. To achieve this purpose, we collected indicators from the Infectious Disease Vulnerability Index (IDVI), the World Health Organization (WHO), the World Bank, and the Brazilian Geography and Statistics Institute (IBGE). All indicators were normalized to facilitate comparisons. Speed, incidence, and population were used to identify the groups of countries with the highest and lowest risks of infection. Countries' response capacities were determined based on socioeconomic, political, and health infrastructure conditions. Vulnerabilities were identified based on the indicator sensitivity. The highest-risk group included the U.S., Brazil, and India, whereas the lowest-risk group (with the largest population by continent) consisted of China, New Zealand, and Germany. The high-sensitivity cluster had 18 indicators (50% extra IDVI), such as merchandise trade, immunization, public services, maternal mortality, life expectancy at birth, hospital beds, GINI index, adolescent fertility, governance, political stability, transparency/corruption, industry, and water supply. The greatest vulnerability of the highest-risk group was related first to economic factors (merchandise trade), followed by public health (immunization), highlighting global dependence on Chinese trade, such as protective materials, equipment, and diagnostic tests. However, domestic political factors had more indicators, beginning with high sensitivity and followed by healthcare and economic conditions, which signified a lesser capacity to guide, coordinate, and supply the population with protective measures, such as social distancing.


Subject(s)
/epidemiology , Brazil/epidemiology , China/epidemiology , Delivery of Health Care , Germany/epidemiology , Humans , India/epidemiology , New Zealand/epidemiology , Pandemics , Political Systems , Risk Assessment , Socioeconomic Factors , United States/epidemiology , World Health Organization
4.
Int J Environ Res Public Health ; 18(4)2021 02 10.
Article in English | MEDLINE | ID: covidwho-1112722

ABSTRACT

This study describes self-reported physical activity (PA), motivation to exercise, physical and mental health and feelings towards PA during the March-May 2020 COVID-19 lockdown in New Zealand. Adults over the age of 18 years (n = 238; 80.2% female) completed the International Physical Activity Questionnaire (IPAQ), the Behavioural Regulation in Exercise Questionnaire 3, the Short Form-36 and open-ended questions about PA through an anonymous online survey. Regular exercise was undertaken by 85% of respondents prior to lockdown, but only 49.8% were able to maintain their usual level of PA. Although respondents were considered sufficiently physically active from the IPAQ, 51.5% reported not being able to maintain their usual level of PA primarily due to the closure of their gym facilities. Sixty percent of respondents reported that PA had a positive effect on their overall wellbeing. When asked to specify which aspects of wellbeing were affected, the effect on mental health was reported the most while the effect on body image or fitness was reported the least. Strategies to increase or maintain engagement in physical activity during lockdowns should be encouraged to promote positive mental health during the COVID-19 pandemic.


Subject(s)
/psychology , Exercise , Mental Health , Pandemics , Adolescent , Adult , Aged , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , New Zealand/epidemiology , Self Report , Young Adult
5.
Aust Crit Care ; 34(2): 146-154, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-1103716

ABSTRACT

AIM: The aim of the study was to determine levels of depression, anxiety, and stress symptoms and factors associated with psychological burden amongst critical care healthcare workers in the early stages of the coronavirus disease 2019 pandemic. METHODS: An anonymous Web-based survey distributed in April 2020. All healthcare workers employed in a critical care setting were eligible to participate. Invitations to the survey were distributed through Australian and New Zealand critical care societies and social media platforms. The primary outcome was the proportion of healthcare workers who reported moderate to extremely severe scores on the Depression, Anxiety, and Stress Scale-21 (DASS-21). RESULTS: Of the 3770 complete responses, 3039 (80.6%) were from Australia. A total of 2871 respondents (76.2%) were women; the median age was 41 years. Nurses made up 2269 (60.2%) of respondents, with most (2029 [53.8%]) working in intensive care units. Overall, 813 (21.6%) respondents reported moderate to extremely severe depression, 1078 (28.6%) reported moderate to extremely severe anxiety, and 1057 (28.0%) reported moderate to extremely severe stress scores. Mean ± standard deviation values of DASS-21 depression, anxiety, and stress scores amongst woman vs men was as follows: 8.0 ± 8.2 vs 7.1 ± 8.2 (p = 0.003), 7.2 ± 7.5 vs 5.0 ± 6.7 (p < 0.001), and 14.4 ± 9.6 vs 12.5 ± 9.4 (p < 0.001), respectively. After adjusting for significant confounders, clinical concerns associated with higher DASS-21 scores included not being clinically prepared (ß = 4.2, p < 0.001), an inadequate workforce (ß = 2.4, p = 0.001), having to triage patients owing to lack of beds and/or equipment (ß = 2.6, p = 0.001), virus transmission to friends and family (ß = 2.1, p = 0.009), contracting coronavirus disease 2019 (ß = 2.8, p = 0.011), being responsible for other staff members (ß = 3.1, p < 0.001), and being asked to work in an area that was not in the respondents' expertise (ß = 5.7, p < 0.001). CONCLUSION: In this survey of critical care healthcare workers, between 22 and 29% of respondents reported moderate to extremely severe depression, anxiety, and stress symptoms, with women reporting higher scores than men. Although female gender appears to play a role, modifiable factors also contribute to psychological burden and should be studied further.


Subject(s)
Anxiety/psychology , Depression/psychology , Health Personnel/psychology , Stress, Psychological/psychology , Adult , Australia/epidemiology , Female , Humans , Male , New Zealand/epidemiology , Pandemics , Surveys and Questionnaires
7.
Nat Commun ; 12(1): 1001, 2021 02 12.
Article in English | MEDLINE | ID: covidwho-1082056

ABSTRACT

Stringent nonpharmaceutical interventions (NPIs) such as lockdowns and border closures are not currently recommended for pandemic influenza control. New Zealand used these NPIs to eliminate coronavirus disease 2019 during its first wave. Using multiple surveillance systems, we observed a parallel and unprecedented reduction of influenza and other respiratory viral infections in 2020. This finding supports the use of these NPIs for controlling pandemic influenza and other severe respiratory viral threats.


Subject(s)
/epidemiology , Influenza, Human/epidemiology , Respiratory Tract Infections/epidemiology , /prevention & control , Communicable Disease Control , Epidemiological Monitoring , Hospitalization/statistics & numerical data , Humans , Influenza, Human/prevention & control , Influenza, Human/virology , New Zealand/epidemiology , Pandemics , Public Health , Respiratory Tract Infections/prevention & control , Respiratory Tract Infections/virology , /isolation & purification
8.
N Z Med J ; 134(1529): 26-38, 2021 02 05.
Article in English | MEDLINE | ID: covidwho-1080082

ABSTRACT

AIM: We aimed to estimate the risk of COVID-19 outbreaks in a COVID-19-free destination country (New Zealand) associated with shore leave by merchant ship crews who were infected prior to their departure or on their ship. METHODS: We used a stochastic version of the SEIR model CovidSIM v1.1 designed specifically for COVID-19. It was populated with parameters for SARS-CoV-2 transmission, shipping characteristics and plausible control measures. RESULTS: When no control interventions were in place, we estimated that an outbreak of COVID-19 in New Zealand would occur after a median time of 23 days (assuming a global average for source country incidence of 2.66 new infections per 1,000 population per week, crews of 20 with a voyage length of 10 days and 1 day of shore leave per crew member both in New Zealand and abroad, and 108 port visits by international merchant ships per week). For this example, the uncertainty around when outbreaks occur is wide (an outbreak occurs with 95% probability between 1 and 124 days). The combination of PCR testing on arrival, self-reporting of symptoms with contact tracing and mask use during shore leave increased this median time to 1.0 year (14 days to 5.4 years, or a 49% probability within a year). Scenario analyses found that onboard infection chains could persist for well over 4 weeks, even with crews of only 5 members. CONCLUSION: This modelling work suggests that the introduction of SARS-CoV-2 through shore leave from international shipping crews is likely, even after long voyages. But the risk can be substantially mitigated by control measures such as PCR testing and mask use.


Subject(s)
Communicable Diseases, Imported/prevention & control , Disease Transmission, Infectious , Naval Medicine , Quarantine/methods , Ships , /diagnosis , /prevention & control , /methods , Communicable Disease Control/instrumentation , Communicable Disease Control/methods , Computer Simulation , Disease Transmission, Infectious/prevention & control , Disease Transmission, Infectious/statistics & numerical data , Humans , Masks , Naval Medicine/methods , Naval Medicine/statistics & numerical data , New Zealand/epidemiology
9.
N Z Med J ; 134(1529): 10-25, 2021 02 05.
Article in English | MEDLINE | ID: covidwho-1080064

ABSTRACT

AIMS: We developed a model, updated daily, to estimate undetected COVID-19 infections exiting quarantine following selectively opening New Zealand's borders to travellers from low-risk countries. METHODS: The prevalence of infectious COVID-19 cases by country was multiplied by expected monthly passenger volumes to predict the rate of arrivals. The rate of undetected infections entering the border following screening and quarantine was estimated. Level 1, Level 2 and Level 3 countries were defined as those with an active COVID-19 prevalence of up to 1/105, 10/105 and 100/105, respectively. RESULTS: With 65,272 travellers per month, the number of undetected COVID-19 infections exiting quarantine is 1 every 45, 15 and 31 months for Level 1, Level 2 and Level 3 countries, respectively. The overall rate of undetected active COVID-19 infections exiting quarantine is expected to increase from the current 0.40 to 0.50 per month, or an increase of one extra infection every 10 months. CONCLUSIONS: Loosening border restrictions results in a small increase in the rate of undetected COVID-19 infections exiting quarantine, which increases from the current baseline by one infection every 10 months. This information may be useful in guiding decision-making on selectively opening of borders in the COVID-19 era.


Subject(s)
Communicable Disease Control , Communicable Diseases, Imported , Disease Transmission, Infectious , International Health Regulations , Quarantine , /epidemiology , /transmission , Communicable Disease Control/methods , Communicable Disease Control/organization & administration , Communicable Diseases, Imported/epidemiology , Communicable Diseases, Imported/prevention & control , Communicable Diseases, Imported/transmission , Disease Transmission, Infectious/prevention & control , Disease Transmission, Infectious/statistics & numerical data , Forecasting , Global Health , Humans , International Health Regulations/organization & administration , International Health Regulations/trends , New Zealand/epidemiology , Prevalence , Public Policy , Quarantine/organization & administration , Quarantine/statistics & numerical data , Travel/legislation & jurisprudence , Travel/statistics & numerical data
11.
J Gen Intern Med ; 36(3): 746-752, 2021 03.
Article in English | MEDLINE | ID: covidwho-1064586

ABSTRACT

BACKGROUND: To date, the risk/benefit balance of lockdown in controlling severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) epidemic is controversial. OBJECTIVE: We aimed to investigate the effectiveness of lockdown on SARS-CoV-2 epidemic progression in nine different countries (New Zealand, France, Spain, Germany, the Netherlands, Italy, the UK, Sweden, and the USA). DESIGN: We conducted a cross-country comparative evaluation using a susceptible-infected-recovered (SIR)-based model completed with pharmacokinetic approaches. MAIN MEASURES: The rate of new daily SARS-CoV-2 cases in the nine countries was calculated from the World Health Organization's published data. Using a SIR-based model, we determined the infection (ß) and recovery (γ) rate constants; their corresponding half-lives (t1/2ß and t1/2γ); the basic reproduction numbers (R0 as ß/γ); the rates of susceptible S(t), infected I(t), and recovered R(t) compartments; and the effectiveness of lockdown. Since this approach requires the epidemic termination to build the (I) compartment, we determined S(t) at an early epidemic stage using simple linear regressions. KEY RESULTS: In New Zealand, France, Spain, Germany, the Netherlands, Italy, and the UK, early-onset stay-at-home orders and restrictions followed by gradual deconfinement allowed rapid reduction in SARS-CoV-2-infected individuals (t1/2ß ≤ 14 days) with R0 ≤ 1.5 and rapid recovery (t1/2γ ≤ 18 days). By contrast, in Sweden (no lockdown) and the USA (heterogeneous state-dependent lockdown followed by abrupt deconfinement scenarios), a prolonged plateau of SARS-CoV-2-infected individuals (terminal t1/2ß of 23 and 40 days, respectively) with elevated R0 (4.9 and 4.4, respectively) and non-ending recovery (terminal t1/2γ of 112 and 179 days, respectively) was observed. CONCLUSIONS: Early-onset lockdown with gradual deconfinement allowed shortening the SARS-CoV-2 epidemic and reducing contaminations. Lockdown should be considered as an effective public health intervention to halt epidemic progression.


Subject(s)
/epidemiology , Communicable Disease Control/organization & administration , Quarantine/statistics & numerical data , France/epidemiology , Global Health , Humans , Italy/epidemiology , Netherlands/epidemiology , New Zealand/epidemiology , Outcome Assessment, Health Care , Social Isolation , Spain/epidemiology , Sweden/epidemiology , United States/epidemiology
12.
BMJ Open ; 11(1): e042464, 2021 01 28.
Article in English | MEDLINE | ID: covidwho-1054681

ABSTRACT

OBJECTIVE: To characterise the self-isolating household units (bubbles) during the COVID-19 Alert Level 4 lockdown in New Zealand. DESIGN, SETTING AND PARTICIPANTS: In this cross-sectional study, an online survey was distributed to a convenience sample via Facebook advertising and the Medical Research Institute of New Zealand's social media platforms and mailing list. Respondents were able to share a link to the survey via their own social media platforms and by email. Results were collected over 6 days during Alert Level 4 from respondents living in New Zealand, aged 16 years and over. MAIN OUTCOMES MEASURES: The primary outcome was the mean size of a self-isolating household unit or bubble. Secondary outcomes included the mean number of households in each bubble, the proportion of bubbles containing essential workers and/or vulnerable people, and the mean number of times the home was left each week. RESULTS: 14 876 surveys were included in the analysis. The mean (SD) bubble size was 3.58 (4.63) people, with mean (SD) number of households 1.26 (0.77). The proportion of bubbles containing one or more essential workers, or one or more vulnerable persons was 45.3% and 42.1%, respectively. The mean number of times individual bubble members left their home in the previous week was 12.9 (12.4). Bubbles that contained at least one vulnerable individual had fewer outings over the previous week compared with bubbles that did not contain a vulnerable person. The bubble sizes were similar by respondent ethnicity. CONCLUSION: In this New Zealand convenience sample, bubble sizes were small, mostly limited to one household, and a high proportion contained essential workers and/or vulnerable people. Understanding these characteristics from a country which achieved a low COVID-19 infection rate may help inform public health interventions during this and future pandemics.


Subject(s)
/epidemiology , Family Characteristics , Residence Characteristics/statistics & numerical data , Adult , Cross-Sectional Studies , European Continental Ancestry Group/statistics & numerical data , Family Characteristics/ethnology , Female , Humans , Male , Middle Aged , New Zealand/epidemiology , Oceanic Ancestry Group/statistics & numerical data , Surveys and Questionnaires , Vulnerable Populations/statistics & numerical data
13.
ANZ J Surg ; 91(3): 329-334, 2021 03.
Article in English | MEDLINE | ID: covidwho-1039799

ABSTRACT

BACKGROUND: The New Zealand government instituted escalating public health interventions to prevent the spread of COVID-19. There was concern this would affect health seeking behaviour leading to delayed presentation and worse outcomes. The aim of this study was to examine the effects of these interventions on rate and severity of acute general surgical admissions in Northland, New Zealand. METHODS: A retrospective comparative cohort study was performed. Two cohorts were identified: 28 February to 8 June 2020 and same period in 2019. Data for surgical admissions and operations and emergency department (ED) presentation were obtained from the hospital data warehouse. Three index diagnoses were assessed for severity. RESULTS: There were 650 acute general surgical admissions in 2019 and 627 in 2020 (P 0.353). Operations were performed in 226 and 224 patients respectively (P 0.829). ED presentations decreased from 11 398 to 8743 (P < 0.001). No difference in severity of acute appendicitis (P 0.970), acute diverticulitis (P 0.333) or acute pancreatitis (P 0.803) was detected. Median length-of-stay, 30-day mortality and admission diagnosis were comparable. CONCLUSION: Despite a significant reduction in ED presentations, interventions for COVID-19 did not result in a difference in the rate or severity of acute general surgical admissions.


Subject(s)
/epidemiology , Emergencies , Public Health , Surgical Procedures, Operative/statistics & numerical data , Adult , Female , Humans , Male , Middle Aged , New Zealand/epidemiology , Retrospective Studies , Severity of Illness Index
14.
Viruses ; 13(1)2021 Jan 08.
Article in English | MEDLINE | ID: covidwho-1016259

ABSTRACT

Phylodynamic inference is a pivotal tool in understanding transmission dynamics of viral outbreaks. These analyses are strongly guided by the input of an epidemiological model as well as sequence data that must contain sufficient intersequence variability in order to be informative. These criteria, however, may not be met during the early stages of an outbreak. Here we investigate the impact of low diversity sequence data on phylodynamic inference using the birth-death and coalescent exponential models. Through our simulation study, estimating the molecular evolutionary rate required enough sequence diversity and is an essential first step for any phylodynamic inference. Following this, the birth-death model outperforms the coalescent exponential model in estimating epidemiological parameters, when faced with low diversity sequence data due to explicitly exploiting the sampling times. In contrast, the coalescent model requires additional samples and therefore variability in sequence data before accurate estimates can be obtained. These findings were also supported through our empirical data analyses of an Australian and a New Zealand cluster outbreaks of SARS-CoV-2. Overall, the birth-death model is more robust when applied to datasets with low sequence diversity given sampling is specified and this should be considered for future viral outbreak investigations.


Subject(s)
/epidemiology , /genetics , Australia/epidemiology , Bayes Theorem , Computer Simulation , Evolution, Molecular , Humans , Models, Statistical , New Zealand/epidemiology , Pandemics , Phylogeny , /isolation & purification
15.
BMJ Open ; 10(12): e044726, 2020 12 23.
Article in English | MEDLINE | ID: covidwho-999264

ABSTRACT

OBJECTIVE: To examine the impact of a 5-week national lockdown on ambulance service demand during the COVID-19 pandemic in New Zealand. DESIGN: A descriptive cross-sectional, observational study. SETTING: High-quality data from ambulance electronic clinical records, New Zealand. PARTICIPANTS: Ambulance records were obtained from 588 690 attendances during pre-lockdown (prior to 17 February 2020) and from 36 238 records during the lockdown period (23 March to 26 April 2020). MAIN OUTCOME MEASURES: Ambulance service utilisation during lockdown was compared with pre-lockdown: (a) descriptive analyses of ambulance events and proportions of event types for each period, (b) absolute rates of ambulance attendance (event types/week) for each period. RESULTS: During lockdown, ambulance patients were more likely to be attended at home and less likely to be aged between 16 and 25 years. There was a significant increase in the proportion of lower acuity patients (Status 3 and Status 4) attended (p<0.001) and a corresponding increase in patients not transported from scene (p<0.001). Road traffic crashes (p<0.001) and alcohol-related incidents (p<0.001) significantly decreased. There was a decrease in the absolute number of weekly ambulance attendances (ratio (95% CI), 0.89 (0.87 to 0.91), p<0.001), attendances to respiratory conditions (0.74 (0.61 to 0.86), p=0.01), and trauma (0.81 (0.77 to 0.85), p<0.001). However, there was a significant increase in ambulance attendances for mental health conditions (1.37 (1.22 to 1.51), p=0.005). CONCLUSIONS: Despite the relative absence of COVID-19 in the community during the 5-week nationwide lockdown, there were significant differences in ambulance utilisation during this period. The lockdown was associated with an increase in ambulance attendances for mental health conditions and is of concern. In considering future lockdowns, the potential implications on a population's mental well-being will need to be seriously considered against the benefits of elimination of virus transmission.


Subject(s)
Ambulances/standards , Communicable Disease Control/methods , Emergency Service, Hospital , Pandemics/prevention & control , Quarantine , Adolescent , Adult , Aged , Child , Child, Preschool , Cross-Sectional Studies , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , New Zealand/epidemiology , Patient Acuity , Retrospective Studies , Young Adult
16.
Biomed Res Int ; 2020: 8850199, 2020.
Article in English | MEDLINE | ID: covidwho-991973

ABSTRACT

COVID-19 is a pandemic which has spread to more than 200 countries. Its high transmission rate makes it difficult to control. To date, no specific treatment has been found as a cure for the disease. Therefore, prediction of COVID-19 cases provides a useful insight to mitigate the disease. This study aims to model and predict COVID-19 cases. Eight countries: Italy, New Zealand, the USA, Brazil, India, Pakistan, Spain, and South Africa which are in different phases of COVID-19 distribution as well as in different socioeconomic and geographical characteristics were selected as test cases. The Alpha-Sutte Indicator approach was utilized as the modelling strategy. The capability of the approach in modelling COVID-19 cases over the ARIMA method was tested in the study. Data consist of accumulated COVID-19 cases present in the selected countries from the first day of the presence of cases to September 26, 2020. Ten percent of the data were used to validate the modelling approach. The analysis disclosed that the Alpha-Sutte modelling approach is appropriate in modelling cumulative COVID-19 cases over ARIMA by reporting 0.11%, 0.33%, 0.08%, 0.72%, 0.12%, 0.03%, 1.28%, and 0.08% of the mean absolute percentage error (MAPE) for the USA, Brazil, Italy, India, New Zealand, Pakistan, Spain, and South Africa, respectively. Differences between forecasted and real cases of COVID-19 in the validation set were tested using the paired t-test. The differences were not statistically significant, revealing the effectiveness of the modelling approach. Thus, predictions were generated using the Alpha-Sutte approach for each country. Therefore, the Alpha-Sutte method can be recommended for short-term forecasting of cumulative COVID-19 incidences. The authorities in the health care sector and other administrators may use the predictions to control and manage the COVID-19 cases.


Subject(s)
/epidemiology , Pandemics , Aged , Brazil/epidemiology , Female , Forecasting , Health Services , Humans , Incidence , India/epidemiology , Italy/epidemiology , Male , Models, Statistical , New Zealand/epidemiology , Pakistan/epidemiology , South Africa/epidemiology , Spain/epidemiology
17.
J Virol Methods ; 289: 114042, 2021 03.
Article in English | MEDLINE | ID: covidwho-988684

ABSTRACT

Utilising diverse molecular platforms has formed a solid foundation in New Zealand's COVID-19 response. We evaluated multiple extraction and PCR assays for the detection of SARS-CoV-2. We included 65 positive samples which were run on the Panther Fusion using a laboratory developed test (LDT, E gene target). Where viral RNA was extracted by MagNA Pure (MP) 96 extraction platform or EpMotion 5075/Geneaid extraction kit, SARS-CoV-2 detection was performed on Light Cycler (LC) 480 using a LDT (E gene) or 3 commercial assays; Certest Viasure (Orf1ab, N genes) GenePro (E, RdRp genes) and A* Star Fortitude (proprietary target). Median Cts on LC 480 LDT for specimens (n = 9) extracted on MP 96 (26.6) were lower than on EpMotion (31.6) whereas median Cts for specimens (n = 10) extracted on the Panther Fusion LDT (23.1) were comparable with MP 96 /LC480 LDT (23.6). Specimens tested on Panther Fusion LDT (n = 28), extracted by MP 96, and amplified using commercial assays showed good concordance with a few exceptions; lower median Ct values were seen for 2 targets on GenePro (16.9, 21.5) and Viasure (19.5, 21.1) than for the Panther Fusion LDT (24.2) and A* Star Fortitude (25.6). Specimens tested on MP 96 (n = 18) had comparable results using commercial assays, with lower median Cts for Viasure (22.2, 23.7) compared with the LC 480 LDT (24.7), GenePro (24.7,25.7) and A*Fortitude (25.1) assays. The study provides an early assessment of the performance characteristics of 3 extraction methods for viral RNA and 5 PCR assays for the detection of SARS-CoV-2.


Subject(s)
/methods , Polymerase Chain Reaction/methods , RNA, Viral/analysis , /isolation & purification , Disease Outbreaks , Humans , New Zealand/epidemiology , Sensitivity and Specificity , Specimen Handling
18.
N Z Med J ; 133(1527): 95-103, 2020 12 18.
Article in English | MEDLINE | ID: covidwho-979363

ABSTRACT

AIM: To evaluate rates of unplanned ICU admissions before, during and after New Zealand's COVID-19 Alert Level 4/3 lockdown, and to describe the characteristics and outcomes of patients admitted to Wellington ICU during lockdown in comparison to historical controls. METHOD: We conducted a retrospective cohort study using the Wellington Hospital ICU database and included patients with an unplanned ICU admission during the first 35 weeks of the year from 2015 to 2020 inclusive. The primary variable of interest was the rate of unplanned ICU admission in 2020 compared with historical controls. We also described the characteristics and outcomes of patients with unplanned admissions to ICU during the 2020 COVID-19 lockdown compared to historical controls. RESULTS: During the five weeks of Alert Level Four, and the subsequent two weeks of Alert Level Three, the number of unplanned ICU admissions per day fell to 1.65±1.52 compared to a historical average of 2.56±1.52 ICU unplanned ICU admissions per day (P<0.0001). The observed reduction in ICU admission rates appeared to occur for most categories of ICU admission diagnosis but was not evident for patients with neurologic disorders. The characteristics and outcomes of patients who had unplanned admissions to Wellington ICU during the COVID-19 lockdown were broadly similar to historical controls. The rate of unplanned ICU admissions in 2020 before and after the lockdown period were similar to historical controls. CONCLUSION: In this study, we observed a reduction in unplanned admissions to Wellington Hospital ICU associated with New Zealand's initial COVID-19 lockdown.


Subject(s)
/epidemiology , Communicable Disease Control/methods , Intensive Care Units/statistics & numerical data , Patient Admission/trends , Quarantine , Female , Follow-Up Studies , Hospital Mortality/trends , Humans , Male , Middle Aged , New Zealand/epidemiology , Retrospective Studies
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