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ImportanceCOVID-19 continues to cause significant hospitalizations and deaths in the United States. Its continued burden and the impact of annually reformulated vaccines remain unclear. ObjectiveTo project COVID-19 hospitalizations and deaths from April 2023-April 2025 under two plausible assumptions about immune escape (20% per year and 50% per year) and three possible CDC recommendations for the use of annually reformulated vaccines (no vaccine recommendation, vaccination for those aged 65+, vaccination for all eligible groups). DesignThe COVID-19 Scenario Modeling Hub solicited projections of COVID-19 hospitalization and deaths between April 15, 2023-April 15, 2025 under six scenarios representing the intersection of considered levels of immune escape and vaccination. State and national projections from eight modeling teams were ensembled to produce projections for each scenario. SettingThe entire United States. ParticipantsNone. ExposureAnnually reformulated vaccines assumed to be 65% effective against strains circulating on June 15 of each year and to become available on September 1. Age and state specific coverage in recommended groups was assumed to match that seen for the first (fall 2021) COVID-19 booster. Main outcomes and measuresEnsemble estimates of weekly and cumulative COVID-19 hospitalizations and deaths. Expected relative and absolute reductions in hospitalizations and deaths due to vaccination over the projection period. ResultsFrom April 15, 2023-April 15, 2025, COVID-19 is projected to cause annual epidemics peaking November-January. In the most pessimistic scenario (high immune escape, no vaccination recommendation), we project 2.1 million (90% PI: 1,438,000-4,270,000) hospitalizations and 209,000 (90% PI: 139,000-461,000) deaths, exceeding pre-pandemic mortality of influenza and pneumonia. In high immune escape scenarios, vaccination of those aged 65+ results in 230,000 (95% CI: 104,000-355,000) fewer hospitalizations and 33,000 (95% CI: 12,000-54,000) fewer deaths, while vaccination of all eligible individuals results in 431,000 (95% CI: 264,000-598,000) fewer hospitalizations and 49,000 (95% CI: 29,000-69,000) fewer deaths. Conclusion and RelevanceCOVID-19 is projected to be a significant public health threat over the coming two years. Broad vaccination has the potential to substantially reduce the burden of this disease. Key pointsO_ST_ABSQuestionC_ST_ABSWhat is the likely impact of COVID-19 from April 2023-April 2025 and to what extent can vaccination reduce hospitalizations and deaths? FindingsUnder plausible assumptions about viral evolution and waning immunity, COVID-19 will likely cause annual epidemics peaking in November-January over the two-year projection period. Though significant, hospitalizations and deaths are unlikely to reach levels seen in previous winters. The projected health impacts of COVID-19 are reduced by 10-20% through moderate use of reformulated vaccines. MeaningCOVID-19 is projected to remain a significant public health threat. Annual vaccination can reduce morbidity, mortality, and strain on health systems.
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COVID-19Résumé
Our ability to forecast epidemics more than a few weeks into the future is constrained by the complexity of disease systems, our limited ability to measure the current state of an epidemic, and uncertainties in how human action will affect transmission. Realistic longer-term projections (spanning more than a few weeks) may, however, be possible under defined scenarios that specify the future state of critical epidemic drivers, with the additional benefit that such scenarios can be used to anticipate the comparative effect of control measures. Since December 2020, the U.S. COVID-19 Scenario Modeling Hub (SMH) has convened multiple modeling teams to make 6-month ahead projections of the number of SARS-CoV-2 cases, hospitalizations and deaths. The SMH released nearly 1.8 million national and state-level projections between February 2021 and November 2022. SMH performance varied widely as a function of both scenario validity and model calibration. Scenario assumptions were periodically invalidated by the arrival of unanticipated SARS-CoV-2 variants, but SMH still provided projections on average 22 weeks before changes in assumptions (such as virus transmissibility) invalidated scenarios and their corresponding projections. During these periods, before emergence of a novel variant, a linear opinion pool ensemble of contributed models was consistently more reliable than any single model, and projection interval coverage was near target levels for the most plausible scenarios (e.g., 79% coverage for 95% projection interval). SMH projections were used operationally to guide planning and policy at different stages of the pandemic, illustrating the value of the hub approach for long-term scenario projections.
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COVID-19Résumé
This workshop will provide health science librarians and information professionals at any level/context with an overview of the best practices in finding and identifying the best scientific evidence during novel public health emergencies. Attendees will be presented with an overview of a best practices statement developed by the Librarian Reserve Corps. Attendees will then apply the recommendations from the best practices statement in designing a plan to respond to real-life case study/information request during a public health emergency. A discussion period will follow on how to apply the best practices in other contexts, environments, and cultures. Attendees will also be invited to share their own experiences and best practices during the discussion session. Through hands-on learning and discussion, librarians and information professionals at any level/context will develop strategies to find and critically appraise the best evidence in any novel public health emergency situation. Introduction: To inform the design of a consumer health strategy for a provincial health library system, the library sought to understand patient challenges and barriers in accessing quality sources of health information. Description: Over a period of three months in the winter of 2020-2021, the library engaged in semi-structured interviews with relevant clinical and corporate stakeholders. Program leads were asked about their role in consumer health information provision and support, and where they saw gaps and opportunities within the organization. Answers were themed and analyzed, and an internal report was produced to guide next steps in developing a consumer health strategy. Outcomes: The environmental scan showed that there are clear challenges and barriers for patients in accessing quality health information. Barriers include the duration of interaction with a healthcare practitioner;the specificity of patient information needs;and the organizational emphasis on a single enterprise-wide patient information resource. More significant challenges include language;lack of health information literacy skills;and low digital literacy among certain populations. Discussion: The environmental scan results provided strong rationale for developing a cohesive consumer health strategy for the library. They highlighted valuable but disjointed resources and programs throughout the organization. A Consumer Health Framework was drafted to guide the library in setting achievable goals and leveraging existing supports. Due to the Covid-19 pandemic it was not possible to engage directly with patients for the initial scan, however consultation with patient advisory groups is now being planned to check and validate the library’s direction.
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This study draws on the tradition of transdisciplinarity to extend the boundaries of interdisciplinary educational work. In this paper, we apply the concepts of liminality and third space to examine a case of a professional immersive experience (PIEx), designed in response to the catastrophic disruption of work-integrated learning opportunities by the COVID-19 pandemic. The study uses a participatory reflexive methodology to interrogate the range of ways liminality was manifest in PIEx. First, we examine liminal learning in the virtual environment, which facilitated the unfolding of connections between different spaces, locations and people. Second, we seek to understand the PIEx experience through the concept of third space, highlighting the fluidity of roles, where educators, students and industry partners generate new knowledge and practices together. Lastly, we examine the experience through the boundary-crossing lens of transdisciplinarity. We conclude by gesturing towards a new understanding of work integrated learning, as it could take place in the future, well beyond the walls of the university.
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The current study examined whether perceived disruption to bereavement via suppression of sociocultural death rite traditions could be linked to core bereavement and post-traumatic stress disorder (PTSD) symptoms in Turkish individuals who lost their close relatives to COVID-19. The sample included patients who consulted the clinic, presenting with self-reported bereavement issues related to coping, sleep, and eating, as well as individuals who sought general grief counselling. Participants (n=52) completed a Demographic Information and Bereavement Experience (DIBEF) form with items probing participants’ demographics, experience of attending rituals, and receiving social support. The final item inquired the rating of perceived disruption to bereavement due to COVID-19 restrictions (perceived disruption score-PDS). The Core Bereavement Items (CBI) scale and the Post-traumatic Stress Disorder Checklist-Civilian Version (PCL-C) were also used to measure symptomology. The results revealed that 92.3% of the participants did not receive condolence visitors, 98.1% did not get to say goodbye, and 78.8% were unable to practice their religious duties. Regression analysis suggested that PDS was a significant predictor of the CBI scores while it was not associated with PCL-C scores. The potential role of perceived disruption to bereavement in aggravating the grief response is discussed regarding the dual process model of coping with bereavement. Health authorities should thus introduce additional support mechanisms such as technology-based grief counselling, tailored to cultural values and individual needs. Relevant bodies should also ensure the accessibility of virtual platforms through which individuals could connect with others and participate in rituals during future pandemics or other humanitarian crises.
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COVID-19 , Troubles de stress traumatique , Troubles de stress post-traumatiqueRésumé
Background: SARS-CoV-2 vaccination of persons aged 12 years and older has reduced disease burden in the United States. The COVID-19 Scenario Modeling Hub convened multiple modeling teams in September 2021 to project the impact of expanding vaccine administration to children 5-11 years old on anticipated COVID-19 burden and resilience against variant strains. Methods: Nine modeling teams contributed state- and national-level projections for weekly counts of cases, hospitalizations, and deaths in the United States for the period September 12, 2021 to March 12, 2022. Four scenarios covered all combinations of: 1) presence vs. absence of vaccination of children ages 5-11 years starting on November 1, 2021; and 2) continued dominance of the Delta variant vs. emergence of a hypothetical more transmissible variant on November 15, 2021. Individual team projections were combined using linear pooling. The effect of childhood vaccination on overall and age-specific outcomes was estimated by meta-analysis approaches. Findings: Absent a new variant, COVID-19 cases, hospitalizations, and deaths among all ages were projected to decrease nationally through mid-March 2022. Under a set of specific assumptions, models projected that vaccination of children 5-11 years old was associated with reductions in all-age cumulative cases (7.2%, mean incidence ratio [IR] 0.928, 95% confidence interval [CI] 0.880-0.977), hospitalizations (8.7%, mean IR 0.913, 95% CI 0.834-0.992), and deaths (9.2%, mean IR 0.908, 95% CI 0.797-1.020) compared with scenarios where children were not vaccinated. This projected effect of vaccinating children 5-11 years old increased in the presence of a more transmissible variant, assuming no change in vaccine effectiveness by variant. Larger relative reductions in cumulative cases, hospitalizations, and deaths were observed for children than for the entire U.S. population. Substantial state-level variation was projected in epidemic trajectories, vaccine benefits, and variant impacts. Conclusions: Results from this multi-model aggregation study suggest that, under a specific set of scenario assumptions, expanding vaccination to children 5-11 years old would provide measurable direct benefits to this age group and indirect benefits to the all-age U.S. population, including resilience to more transmissible variants.