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2.
Sci Rep ; 11(1): 22871, 2021 11 25.
Article in English | MEDLINE | ID: covidwho-1537332

ABSTRACT

The COVID-19 pandemic has posed novel risks related to the indoor mixing of individuals from different households and challenged policymakers to adequately regulate this behaviour. While in many cases household visits are necessary for the purpose of social care, they have been linked to broadening community transmission of the virus. In this study we propose a novel, privacy-preserving framework for the measurement of household visitation at national and regional scales, making use of passively collected mobility data. We implement this approach in England from January 2020 to May 2021. The measures expose significant spatial and temporal variation in household visitation patterns, impacted by both national and regional lockdown policies, and the rollout of the vaccination programme. The findings point to complex social processes unfolding differently over space and time, likely informed by variations in policy adherence, vaccine relaxation, and regional interventions.


Subject(s)
COVID-19/psychology , Communicable Disease Control/methods , Social Support/psychology , COVID-19/prevention & control , Communicable Disease Control/trends , England , Family Characteristics , Health Policy/trends , Humans , Immunization Programs/methods , Models, Statistical , Models, Theoretical , Pandemics , Physical Distancing , Public Policy/trends , SARS-CoV-2/pathogenicity , Social Interaction/classification , Social Support/methods , Vaccines
3.
Sci Rep ; 11(1): 22427, 2021 11 17.
Article in English | MEDLINE | ID: covidwho-1521769

ABSTRACT

The United Nations' (UN) Sustainable Development Goals (SDGs) are heterogeneous and interdependent, comprising 169 targets and 231 indicators of sustainable development in such diverse areas as health, the environment, and human rights. Existing efforts to map relationships among SDGs are either theoretical investigations of sustainability concepts, or empirical analyses of development indicators and policy simulations. We present an alternative approach, which describes and quantifies the complex network of SDG interdependencies by applying computational methods to policy and scientific documents. Methods of Natural Language Processing are used to measure overlaps in international policy discourse around SDGs, as represented by the corpus of all existing UN progress reports about each goal (N = 85 reports). We then examine if SDG interdependencies emerging from UN discourse are reflected in patterns of integration and collaboration in SDG-related science, by analyzing data on all scientific articles addressing relevant SDGs in the past two decades (N = 779,901 articles). Results identify a strong discursive divide between environmental goals and all other SDGs, and unexpected interdependencies between SDGs in different areas. While UN discourse partially aligns with integration patterns in SDG-related science, important differences are also observed between priorities emerging in UN and global scientific discourse. We discuss implications and insights for scientific research and policy on sustainable development after COVID-19.


Subject(s)
Conservation of Natural Resources/methods , Natural Language Processing , Sustainable Development/trends , COVID-19 , Global Health , Goals , Human Rights , Humans , Public Policy/economics , Public Policy/trends , SARS-CoV-2 , Sustainable Development/economics , United Nations
4.
Nihon Eiseigaku Zasshi ; 76(0)2021.
Article in Japanese | MEDLINE | ID: covidwho-1506199

ABSTRACT

OBJECTIVE: In this study, we aimed to clarify the transition to the implementation of smoking prohibition at eating and drinking establishments one year before and after April 2020, the time when they became "nonsmoking" in principle following the implementation of the amendment bill for the Health Promotion Act of Japan. METHODS: The total number of nonsmoking/smoking eating and drinking establishments by industry were obtained using the data from "Tabelog®." The number of people who tested positive for COVID-19 by the polymerase chain reaction test on the day of the survey nationwide and the bankruptcy status of the companies (eating and drinking establishments, etc.) for each month were ascertained. RESULTS: In 2020, a state of emergency was declared owing to the increase in the number of people positive for COVID-19, and many eating and drinking establishments went bankrupt. Despite these circumstances, the number of nonsmoking eating and drinking establishments exceeded that of smoking establishments in March 2020 and continued to increase thereafter. Additionally, the number of nonsmoking "restaurants" increased and exceeded that of smoking restaurants in June 2020. The number of nonsmoking "cafes" already exceeded that of smoking "cafes" at the beginning of this survey and continued to increase. The number of nonsmoking "bars" increased, but that of smoking "bars" remained high. CONCLUSION: It is necessary to promote measures against passive smoking while paying attention to the trends for different types of eating and drinking establishments, rather than considering all establishments together.


Subject(s)
Public Policy/legislation & jurisprudence , Restaurants/legislation & jurisprudence , Smoking/legislation & jurisprudence , Tobacco Smoke Pollution/prevention & control , COVID-19 , Health Promotion , Humans , Japan , Public Policy/trends , Restaurants/statistics & numerical data , SARS-CoV-2 , Smoking Prevention/statistics & numerical data
5.
Sci Rep ; 11(1): 21700, 2021 11 04.
Article in English | MEDLINE | ID: covidwho-1504478

ABSTRACT

With recurring waves of the Covid-19 pandemic, a dilemma facing public health leadership is whether to provide public advice that is medically optimal (e.g., most protective against infection if followed), but unlikely to be adhered to, or advice that is less protective but is more likely to be followed. To provide insight about this dilemma, we examined and quantified public perceptions about the tradeoff between (a) the stand-alone value of health behavior advice, and (b) the advice's adherence likelihood. In a series of studies about preference for public health leadership advice, we asked 1061 participants to choose between (5) strict advice that is medically optimal if adhered to but which is less likely to be broadly followed, and (2) relaxed advice, which is less medically effective but more likely to gain adherence-given varying infection expectancies. Participants' preference was consistent with risk aversion. Offering an informed choice alternative that shifts volition to advice recipients only strengthened risk aversion, but also demonstrated that informed choice was preferred as much or more than the risk-averse strict advice.


Subject(s)
COVID-19/psychology , Guideline Adherence/trends , Information Dissemination/methods , Adolescent , Adult , Aged , Female , Health Behavior , Humans , Male , Middle Aged , Pandemics/prevention & control , Public Health/trends , Public Policy/trends , Risk Reduction Behavior , SARS-CoV-2/pathogenicity
6.
PLoS One ; 16(10): e0258840, 2021.
Article in English | MEDLINE | ID: covidwho-1496515

ABSTRACT

BACKGROUND: Despite the development and enforcement of preventive guidelines by governments, COVID-19 continues to spread across nations, causing unprecedented economic losses and mortality. Public places remain hotspots for COVID-19 transmission due to large numbers of people present; however preventive measures are poorly enforced. Supermarkets are among the high-risk establishments due to the high interactions involved, which makes compliance with the COVID-19 preventive guidelines of paramount importance. However, until now, there has been limited evidence on compliance with the set COVID-19 prevention guidelines. Therefore, this study aimed to measure compliance with the COVID-19 prevention guidelines among supermarkets in Kampala Capital City and Mukono Municipality Uganda. METHODS: A cross-sectional study was conducted among selected supermarkets in Kampala Capital City and Mukono Municipality in September 2020. A total of 229 supermarkets (195 in Kampala City and 34 in Mukono Municipality) were randomly selected for the study. Data were collected through structured observations on the status of compliance with COVID-19 prevention guidelines, and entered using the KoboCollect software, which was preinstalled on mobile devices (smart phones and tablets). Descriptive statistics were generated to measure compliance to the set COVID-19 Ministry of Health prevention guidelines using Stata 14 software. RESULTS: Only 16.6% (38/229) of the supermarkets complied with the COVID-19 prevention and control guidelines. In line with the specific measures, almost all supermarkets 95.2% (218/229) had hand washing facilities placed at strategic points such as the entrance, and 59.8% (137/229) of the supermarkets surveyed regularly disinfected commonly touched surfaces. Only 40.6% and 30.6% of the supermarkets enforced mandatory hand washing and use of face masks respectively for all customers accessing the premises. Slightly more than half, 52.4% (120/229) of the supermarkets had someone or a team in charge of enforcing compliance to COVID-19 measures and more than half, 55.5% (127/229) of the supermarkets had not provided their staff with job-specific training/mentorship on infection prevention and control for COVID-19. Less than a third, 26.2% (60/229) of the supermarkets had an infrared temperature gun for screening every customer, and only 5.7% (13/229) of the supermarkets captured details of clients accessing the supermarket as a measure to ease follow-up. CONCLUSION: This study revealed low compliance with COVID-19 guidelines, which required mandatory preventive measures such as face masking, regular disinfection, social distancing, and hand hygiene. This study suggests the need for health authorities to strengthen enforcement of these guidelines, and to sensitise the supermarket managers on COVID-19 in order to increase the uptake of the different measures.


Subject(s)
COVID-19/psychology , Guideline Adherence/statistics & numerical data , Guideline Adherence/trends , COVID-19/prevention & control , Cross-Sectional Studies , Hand Disinfection , Hand Hygiene , Humans , Masks , Physical Distancing , Public Policy/trends , SARS-CoV-2/pathogenicity , Supermarkets , Surveys and Questionnaires , Uganda
7.
Viruses ; 13(7)2021 07 13.
Article in English | MEDLINE | ID: covidwho-1323824

ABSTRACT

Many of the world's most pressing issues, such as the emergence of zoonotic diseases, can only be addressed through interdisciplinary research. However, the findings of interdisciplinary research are susceptible to miscommunication among both professional and non-professional audiences due to differences in training, language, experience, and understanding. Such miscommunication contributes to the misunderstanding of key concepts or processes and hinders the development of effective research agendas and public policy. These misunderstandings can also provoke unnecessary fear in the public and have devastating effects for wildlife conservation. For example, inaccurate communication and subsequent misunderstanding of the potential associations between certain bats and zoonoses has led to persecution of diverse bats worldwide and even government calls to cull them. Here, we identify four types of miscommunication driven by the use of terminology regarding bats and the emergence of zoonotic diseases that we have categorized based on their root causes: (1) incorrect or overly broad use of terms; (2) terms that have unstable usage within a discipline, or different usages among disciplines; (3) terms that are used correctly but spark incorrect inferences about biological processes or significance in the audience; (4) incorrect inference drawn from the evidence presented. We illustrate each type of miscommunication with commonly misused or misinterpreted terms, providing a definition, caveats and common misconceptions, and suggest alternatives as appropriate. While we focus on terms specific to bats and disease ecology, we present a more general framework for addressing miscommunication that can be applied to other topics and disciplines to facilitate more effective research, problem-solving, and public policy.


Subject(s)
Communication , Information Dissemination/methods , Therapeutic Misconception/psychology , Animals , Chiroptera , Communicable Diseases, Emerging , Conservation of Natural Resources , Disease Reservoirs , Humans , Language , Public Health , Public Policy/trends , Zoonoses/transmission
8.
Sci Rep ; 11(1): 14523, 2021 07 15.
Article in English | MEDLINE | ID: covidwho-1315610

ABSTRACT

The COVID-19 pandemic (SARS-CoV-2) has revealed the need for proactive protocols to react and act, imposing preventive and restrictive countermeasures on time in any society. The extent to which confirmed cases can predict the morbidity and mortality in a society remains an unresolved issue. The research objective is therefore to test a generic model's predictability through time, based on percentage of confirmed cases on hospitalized patients, ICU patients and deceased. This study reports the explanatory and predictive ability of COVID-19-related healthcare data, such as whether there is a spread of a contagious and virulent virus in a society, and if so, whether the morbidity and mortality can be estimated in advance in the population. The model estimations stress the implementation of a pandemic strategy containing a proactive protocol entailing what, when, where, who and how countermeasures should be in place when a virulent virus (e.g. SARS-CoV-1, SARS-CoV-2 and MERS) or pandemic strikes next time. Several lessons for the future can be learnt from the reported model estimations. One lesson is that COVID-19-related morbidity and mortality in a population is indeed predictable. Another lesson is to have a proactive protocol of countermeasures in place.


Subject(s)
COVID-19/epidemiology , COVID-19/mortality , Forecasting/methods , Hospitalization/statistics & numerical data , Hospitalization/trends , Humans , Intensive Care Units/statistics & numerical data , Intensive Care Units/trends , Models, Statistical , Morbidity , Pandemics , Public Health/statistics & numerical data , Public Policy/trends , SARS-CoV-2/isolation & purification
9.
Am J Public Health ; 110(12): 1811-1813, 2020 12.
Article in English | MEDLINE | ID: covidwho-1067489

ABSTRACT

Objectives. To examine public support for health insurance, income support, and unemployment policies during the initial phase of disease transmission and economic distress following the coronavirus disease 2019 (COVID-19) outbreak and to assess varying public support based on beliefs about the role of government.Methods. We fielded a nationally representative survey of US adults (n = 1468) from April 7, 2020, to April 13, 2020.Results. Of US adults, 77% supported paid sick leave, and a majority also supported universal health insurance, an increased minimum wage, and various unemployment support policies. Public support for an active government role in society to improve citizens' lives increased by 10 percentage points during this initial pandemic response relative to September 2019. Belief in a strong governmental role in society was associated with greater support for social safety-net policies.Conclusions. During the initial phase of the COVID-19 pandemic in early April 2020, most US adults favored a range of safety-net policies to ameliorate its negative health and economic consequences. For most safety-net policies, public support was highest among those favoring a stronger governmental role in society.


Subject(s)
COVID-19/epidemiology , Public Assistance/trends , Public Policy/trends , Humans , Pandemics , SARS-CoV-2 , Sick Leave/economics , United States/epidemiology
12.
Acad Med ; 95(12): 1831-1833, 2020 12.
Article in English | MEDLINE | ID: covidwho-975348

ABSTRACT

The COVID-19 pandemic has exacerbated the flaws in the U.S. employer-based health insurance system, magnified racial disparities in health and health care, and overwhelmed the country's underfunded public health infrastructure. These are the same systematic failures that have always harmed and killed the nation's most vulnerable. While everyone wishes for an end to this national tragedy, the authors believe a new normal must be defined for the postpandemic period.In the postpandemic period, policies that were once labeled radical and impossible will be urgent and necessary. Examples of such policies include providing universal health care, dismantling the structures that propagate racism and injustice, and reinvesting in public health. Previous research by the authors has shown that their medical student colleagues recognize that it is their responsibility to address policies that harm patients and to support reforms at the scale the authors propose. This commitment to a better future is reflected in the widespread mobilization of medical students seen across the United States. Recognizing that the old normal is unsustainable, the authors call on those who previously benefited from the status quo to instead seek a new postpandemic normal that works for all.


Subject(s)
COVID-19 , Forecasting , Health Services Accessibility/trends , Healthcare Disparities/trends , Public Policy/trends , Health Status Disparities , Humans , Insurance, Health/trends , Racism/trends , SARS-CoV-2 , Students, Medical , United States/epidemiology
13.
Risk Anal ; 40(S1): 2272-2299, 2020 11.
Article in English | MEDLINE | ID: covidwho-948522

ABSTRACT

One-fifth of the way through the 21st century, a commonality of factors with those of the last 50 years may offer the opportunity to address unfinished business and current challenges. The recommendations include: (1) Resisting the tendency to oversimplify scientific assessments by reliance on single disciplines in lieu of clear weight-of-evidence expressions, and on single quantitative point estimates of health protective values for policy decisions; (2) Improving the separation of science and judgment in risk assessment through the use of clear expressions of the range of judgments that bracket protective quantitative levels for public health protection; (3) Use of comparative risk to achieve the greatest gains in health and the environment; and (4) Where applicable, reversal of the risk assessment and risk management steps to facilitate timely and substantive improvements in public health and the environment. Lessons learned and improvements in the risk assessment process are applied to the unprecedented challenges of the 21st century such as, pandemics and climate change. The beneficial application of the risk assessment and risk management paradigm to ensure timely research with consistency and transparency of assessments is presented. Institutions with mandated stability and leadership roles at the national and international levels are essential to ensure timely interdisciplinary scientific assessment at the interface with public policy as a basis for organized policy decisions, to meet time sensitive goals, and to inform the public.


Subject(s)
Public Health , Risk Assessment , Risk Management , COVID-19/prevention & control , COVID-19/transmission , Climate Change/history , Environmental Health , Evidence-Based Medicine , History, 20th Century , History, 21st Century , Humans , Pandemics/prevention & control , Policy Making , Public Health/history , Public Health/trends , Public Policy/history , Public Policy/trends , Risk Assessment/history , Risk Assessment/trends , Risk Management/history , Risk Management/trends , SARS-CoV-2 , United States , United States Government Agencies
14.
Nat Med ; 26(12): 1829-1834, 2020 12.
Article in English | MEDLINE | ID: covidwho-834900

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic is straining public health systems worldwide, and major non-pharmaceutical interventions have been implemented to slow its spread1-4. During the initial phase of the outbreak, dissemination of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was primarily determined by human mobility from Wuhan, China5,6. Yet empirical evidence on the effect of key geographic factors on local epidemic transmission is lacking7. In this study, we analyzed highly resolved spatial variables in cities, together with case count data, to investigate the role of climate, urbanization and variation in interventions. We show that the degree to which cases of COVID-19 are compressed into a short period of time (peakedness of the epidemic) is strongly shaped by population aggregation and heterogeneity, such that epidemics in crowded cities are more spread over time, and crowded cities have larger total attack rates than less populated cities. Observed differences in the peakedness of epidemics are consistent with a meta-population model of COVID-19 that explicitly accounts for spatial hierarchies. We paired our estimates with globally comprehensive data on human mobility and predict that crowded cities worldwide could experience more prolonged epidemics.


Subject(s)
COVID-19/epidemiology , COVID-19/etiology , Crowding , Pandemics , China/epidemiology , Cities/epidemiology , Contact Tracing , Demography/standards , Demography/statistics & numerical data , Disease Outbreaks , Forecasting/methods , Geography , Human Activities/statistics & numerical data , Humans , Physical Distancing , Population Density , Public Policy/trends , SARS-CoV-2/physiology , Travel/statistics & numerical data
15.
Transl Behav Med ; 10(4): 850-856, 2020 10 08.
Article in English | MEDLINE | ID: covidwho-756965

ABSTRACT

Conspiracy theories have been proliferating during the COVID-19 pandemic. Evidence suggests that belief in conspiracy theories undermines engagement in pro-health behaviors and support for public health policies. Moreover, previous work suggests that inoculating messages from opinion leaders that expose conspiracy theories as false before people are exposed to them can help to prevent belief in new conspiracies. Goals of this study were to: (a) explore associations between COVID-19 conspiracy beliefs with SARS-CoV-2 vaccine intentions, cooperation with public health recommendations, and support for public health policies among U.S. adults and (b) investigate trusted sources of COVID-19 information to inform strategies to address conspiracy beliefs. A cross-sectional, online survey was conducted with 845 U.S. adults in April 2020. Data were analyzed using analyses of variance and multivariable regressions. One-third (33%) of participants believed one or more conspiracies about COVID-19. Participants who believed conspiracies reported that their intentions to vaccinate were 3.9 times lower and indicated less support for COVID-19 public health policies than participants who disbelieved conspiracies. There were no differences in cooperation with public health recommendations by conspiracy belief endorsement in the multivariable regression analysis. Although there were some key differences in trusted sources of COVID-19 information, doctor(s) were the most trusted source of information about COVID-19 overall with 90% of participants trusting doctor(s). Doctor(s) may play a role in addressing COVID-19 conspiracy theories before people are exposed to them to promote COVID-19 prevention efforts.


Subject(s)
Cooperative Behavior , Coronavirus Infections , Health Behavior , Pandemics , Pneumonia, Viral , Public Policy/trends , Trust/psychology , Vaccination/psychology , Adult , Betacoronavirus , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Coronavirus Infections/psychology , Cross-Sectional Studies , Culture , Female , Humans , Intention , Male , Pandemics/prevention & control , Physician's Role , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Pneumonia, Viral/psychology , Psychology , Public Health Practice , SARS-CoV-2 , United States/epidemiology
16.
J Theor Biol ; 507: 110469, 2020 12 21.
Article in English | MEDLINE | ID: covidwho-733724

ABSTRACT

After diagnosed in Wuhan, COVID-19 spread quickly in mainland China. Though the epidemic in regions outside Hubei in mainland China has maintained a degree of control, evaluating the effectiveness and timeliness of intervention strategies, and predicting the transmission risk of work resumption as well as lifting the lockdown in Hubei province remain urgent. A patch model reflecting the mobility of population between Hubei and regions outside Hubei is formulated, and parameterized based on multiple source data for Hubei and regions outside Hubei. The effective reproduction numbers for Hubei and regions outside Hubei are estimated as 3.59 and 3.26 before Jan 23rd, 2020, but decrease quickly since then and drop below 1 after Jan 31st and Jan 28th, 2020. It is predicted that the new infections in Hubei province will decrease to very low level in mid-March, and the final size is estimated to be about 68,500 cases. The simulations reveal that contact rate after work resumption or lifting the lockdown in Hubei plays a critical role in affecting the epidemic. If the contact rate could be kept at a relatively low level, work resumption starting as early as on March 2nd in Hubei province may not induce the secondary outbreak, and the daily new infectious cases can be controlled at a low level if the lockdown in Hubei is liftted after March 9th, otherwise both work resumption and lifting the lockdown in Hubei should be postponed.


Subject(s)
Betacoronavirus , Coronavirus Infections/transmission , Models, Theoretical , Pneumonia, Viral/transmission , Social Isolation , COVID-19 , China/epidemiology , Contact Tracing , Coronavirus Infections/prevention & control , Forecasting , Humans , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Public Policy/trends , SARS-CoV-2
18.
J Addict Med ; 14(4): e4-e5, 2020.
Article in English | MEDLINE | ID: covidwho-327256

ABSTRACT

: The United States is currently in the midst of 2 public health emergencies: COVID-19 and the ongoing opioid crisis. In an attempt to reduce preventable harm to individuals with opioid use disorder (OUD), federal, state, and local governments have temporarily modified law and policy to increase access to OUD treatment and divert some individuals at high risk away from the correctional system. In this Commentary, we briefly describe how people with OUD are at increased risk for COVID-19, discuss existing policy barriers to evidence-based prevention and treatment for individuals with OUD, explain the temporary rollbacks of those barriers, and argue that these changes should be made permanent. We also suggest several additional steps that federal and state governments can urgently take to reduce barriers to care for individuals with OUD, both during the current crisis and beyond.


Subject(s)
Communicable Disease Control , Coronavirus Infections , Disease Transmission, Infectious/prevention & control , Opioid-Related Disorders , Pandemics , Pneumonia, Viral , Public Policy , Social Control, Formal/methods , COVID-19 , Communicable Disease Control/legislation & jurisprudence , Communicable Disease Control/methods , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Coronavirus Infections/psychology , Government Regulation , Humans , Opioid-Related Disorders/epidemiology , Opioid-Related Disorders/psychology , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Pneumonia, Viral/psychology , Public Policy/legislation & jurisprudence , Public Policy/trends , United States/epidemiology
19.
J Appl Gerontol ; 39(7): 690-699, 2020 07.
Article in English | MEDLINE | ID: covidwho-209740

ABSTRACT

New York City is currently experiencing an outbreak of COVID-19, a highly contagious and potentially deadly virus, which is particularly dangerous for older adults. This pandemic has led to public health policies including social distancing and stay-at-home orders. We explore here the impact of this unique crisis on victims of elder mistreatment and people at risk of victimization. The COVID-19 outbreak has also had a profound impact on the organizations from many sectors that typically respond to protect and serve victims of elder mistreatment. We examine this impact and describe creative solutions developed by these organizations and initial lessons learned in New York City to help inform other communities facing this pandemic and provide guidance for future crises.


Subject(s)
Coronavirus Infections , Crime Victims/psychology , Health Services for the Aged , Pandemics , Pneumonia, Viral , Public Policy , Social Isolation/psychology , Aged , Betacoronavirus/isolation & purification , Betacoronavirus/pathogenicity , COVID-19 , Chronic Disease/epidemiology , Communicable Disease Control/methods , Coronavirus Infections/diagnosis , Coronavirus Infections/mortality , Coronavirus Infections/physiopathology , Coronavirus Infections/psychology , Elder Abuse/economics , Elder Abuse/legislation & jurisprudence , Elder Abuse/prevention & control , Elder Abuse/psychology , Female , Health Services for the Aged/standards , Health Services for the Aged/trends , Humans , Male , Mortality , New York City/epidemiology , Pneumonia, Viral/diagnosis , Pneumonia, Viral/mortality , Pneumonia, Viral/physiopathology , Pneumonia, Viral/psychology , Public Policy/legislation & jurisprudence , Public Policy/trends , Risk Assessment , SARS-CoV-2
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