Lifting COVID-19 mitigation measures in Spain (May-June 2020).

Introduction: The state of alarm was declared in Spain due to the COVID-19 epidemic on March 14, 2020, and established population confinement measures. The objective is to describe the process of lifting these mitigation measures. Methods: The Plan for the Transition to a New Normality, approved on April 28, contained four sequential phases with progressive increase in socio-economic activities and population mobility. In parallel, a new strategy for early diagnosis, surveillance and control was implemented. A bilateral decision mechanism was established between the Spanish Government and the autonomous communities (AC), guided by a set of qualitative and quantitative indicators capturing the epidemiological situation and core capacities. The territorial units were established ad-hoc and could be from Basic Health Zones to entire AC. Results: The process run from May 4 to June 21, 2020. AC implemented plans for reinforcement of core capacities. Incidence decreased from a median (50% of territories) of 7.4 per 100,000 in 7 days at the beginning to 2.5 at the end. Median PCR testing increased from 53% to 89% of suspected cases and PCR total capacity from 4.5 to 9.8 per 1000 inhabitants weekly; positivity rate decreased from 3.5% to 1.8%. Median proportion of cases with traced contacts increased from 82% to 100%. Conclusion: Systematic data collection, analysis, and interterritorial dialogue allowed adequate process control. The epidemiological situation improved but, mostly, the process entailed a great reinforcement of core response capacities nation-wide, under common criteria. Maintaining and further reinforcing capacities remained crucial for responding to future waves.

Introducción: El 14 de marzo de 2020 España declaró el estado de alarma por la pandemia por COVID-19 incluyendo medidas de confinamiento. El objetivo es describir el proceso de desescalada de estas medidas. Métodos: Un plan de transición hacia una nueva normalidad, del 28 de abril, incluía 4 fases secuenciales incrementando progresivamente las actividades socioeconómicas y la movilidad. Concomitantemente, se implementó una nueva estrategia de diagnóstico precoz, vigilancia y control. Se estableció un mecanismo de decisión bilateral entre Gobierno central y comunidades autónomas (CCAA), guiado por un panel de indicadores cualitativos y cuantitativos de la situación epidemiológica y las capacidades básicas. Las unidades territoriales evaluadas comprendían desde zonas básicas de salud hasta CCAA. Resultados: El proceso se extendió del 4 de mayo al 21 de junio y se asoció a planes de refuerzo de las capacidades en las CCAA. La incidencia disminuyó de una mediana inicial de 7,4 por 100.000 en 7 días a 2,5 al final del proceso. La mediana de pruebas PCR aumentó del 53% al 89% de los casos sospechosos, y la capacidad total de 4,5 a 9,8 pruebas semanales por 1.000 habitantes; la positividad disminuyó del 3,5% al 1,8%. La mediana de casos con contactos trazados aumentó del 82% al 100%. Conclusión: La recogida y análisis sistemático de información y el diálogo interterritorial logaron un adecuado control del proceso. La situación epidemiológica mejoró, pero sobre todo, se aumentaron las capacidades, en todo el país y con criterios comunes, cuyo mantenimiento y refuerzo fue clave en olas sucesivas.

Lifting COVID-19 mitigation measures in Spain (May-June 2020).

INTRODUCTION: The state of alarm was declared in Spain due to the COVID-19 epidemic on March 14, 2020, and established population confinement measures. The objective is to describe the process of lifting these mitigation measures. METHODS: The Plan for the Transition to a New Normality, approved on April 28, contained four sequential phases with progressive increase in socio-economic activities and population mobility. In parallel, a new strategy for early diagnosis, surveillance and control was implemented. A bilateral decision mechanism was established between the Spanish Government and the autonomous communities (AC), guided by a set of qualitative and quantitative indicators capturing the epidemiological situation and core capacities. The territorial units were established ad-hoc and could be from Basic Health Zones to entire AC. RESULTS: The process run from May 4 to June 21, 2020. AC implemented plans for reinforcement of core capacities. Incidence decreased from a median (50% of territories) of 7.4 per 100,000 in 7 days at the beginning to 2.5 at the end. Median PCR testing increased from 53% to 89% of suspected cases and PCR total capacity from 4.5 to 9.8 per 1000 inhabitants weekly; positivity rate decreased from 3.5% to 1.8%. Median proportion of cases with traced contacts increased from 82% to 100%. CONCLUSION: Systematic data collection, analysis, and interterritorial dialogue allowed adequate process control. The epidemiological situation improved but, mostly, the process entailed a great reinforcement of core response capacities nation-wide, under common criteria. Maintaining and further reinforcing capacities remained crucial for responding to future waves.

Evaluación de la discapacidad sobrevenida estimada y los costes de la no promoción de la salud en una población laboral: metodología PoRT-9LSQ / Evaluation of estimated supervening disability and the costs of not promoting health in a working population: PoRT-9LSQ methodology

El aumento de la esperanza de vida es un éxito de la salud pública. Este incremento no ha implicado un aumento similar en la esperanza de vida libre de discapacidad (EVLD). España en 2018 la EVLD al nacer es de 68,0 años.Más 50% de los trabajadores de la UE dejan el trabajo prematuramente debido a la cronicidad, limitaciones en la realización de actividades o discapacidades, debido a la prevalencia de factores de riesgo como tabaquismo, sedentarismo, hipertensión arterial, diabetes, dislipemia y sobrepeso/obesidad.Calcular los años de discapacidad sobrevenida estimada (ADSE) y su coste estimado constituye un excelente indicador de impacto de eficacia de la promoción de la salud. Se plantea como objetivo la utilización de una metodología propia (herramienta de riesgo poblacional Poblational Risk Tool Nine Lifestyle Questionnaire-PoRT-9LSQ), que incluye datos sobre salud percibida/comparada, actividad física, alimentación, tabaquismo, tensión arterial, hipercolesterolemia, diabetes e IMC. Los datos corresponden a una muestra de 1.985 trabajadores de 45 empresas de diferentes sectores recogidos durante los reconocimientos médicos en 2021.Se realza un análisis descriptivo numérico y gráfico de las variables implicadas en el estudio (variable dependiente ADSE y las variables independientes, así como modelos de análisis de la varianza (ANOVA). Como resultados preliminares, destaca un total de 4.475 ADSE equivalente a 256.226.140€, esto es, 2,25 ADSE por cada trabajador y un coste de 129.081€.La utilidad y aplicabilidad de una herramienta para cuantificar el impacto de la no promoción de la salud, constituye un indicador innovador para justificar la implantación de un modelo de empresa saludable. (AU)

The increase in life expectancy is a public health success. This increase has not implied a similar increase in disability-free life expectancy (EVLD). Spain in 2018 the EVLD at birth is 68.0 years. More than 50% of workers in the EU leave work prematurely due to chronicity, limitations in carrying out activities or disabilities, due to the prevalence of risk factors such as smoking, sedentary lifestyle, high blood pressure, diabetes, dyslipidemia and overweight/obesity. Calculating the years of estimated supervening disability (ADSE) and its estimated cost is an excellent indicator of the impact of the effectiveness of health promotion. The objective is to use its own methodology (Population Risk Tool Nine Lifestyle Questionnaire-PoRT-9LSQ), which includes data on perceived/compared health, physical activity, diet, smoking, blood pressure, hypercholesterolemia, diabetes and BMI. The data corresponds to a sample of 1,985 workers from 45 companies from different sectors collected during medical examinations in 2021. A descriptive numerical and graphic analysis of the variables involved in the study (dependent variable ADSE and independent variables) will be carried out, as well as analysis of variance models (ANOVA). As preliminary results, a total of 4,475 ADSE equivalent to 256,226 stands out. €140, that is, 2.25 ADSE for each worker and a cost of €129,081. The usefulness and applicability of a tool to quantify the impact of not promoting health constitutes an innovative indicator to justify the implementation of a healthy business model. (AU)

Lifting COVID-19 mitigation measures in Spain (May-June 2020).

INTRODUCTION: The state of alarm was declared in Spain due to the COVID-19 epidemic on March 14, 2020, and established population confinement measures. The objective is to describe the process of lifting these mitigation measures. METHODS: The Plan for the Transition to a New Normality, approved on April 28, contained four sequential phases with progressive increase in socio-economic activities and population mobility. In parallel, a new strategy for early diagnosis, surveillance and control was implemented. A bilateral decision mechanism was established between the Spanish Government and the autonomous communities (AC), guided by a set of qualitative and quantitative indicators capturing the epidemiological situation and core capacities. The territorial units were established ad-hoc and could be from Basic Health Zones to entire AC. RESULTS: The process run from May 4 to June 21, 2020. AC implemented plans for reinforcement of core capacities. Incidence decreased from a median (50% of territories) of 7.4 per 100,000 in 7 days at the beginning to 2.5 at the end. Median PCR testing increased from 53% to 89% of suspected cases and PCR total capacity from 4.5 to 9.8 per 1000 inhabitants weekly; positivity rate decreased from 3.5% to 1.8%. Median proportion of cases with traced contacts increased from 82% to 100%. CONCLUSION: Systematic data collection, analysis, and interterritorial dialogue allowed adequate process control. The epidemiological situation improved but, mostly, the process entailed a great reinforcement of core response capacities nation-wide, under common criteria. Maintaining and further reinforcing capacities remained crucial for responding to future waves.

A pilot study of common health problems in smallholder pigs in Angónia and Boane districts, Mozambique.

A pilot survey was conducted in 2 districts in Mozambique to determine the most important health problems facing smallholder pig producers. While African swine fever is the most serious disease that affects pigs at all levels of production in Mozambique, it is likely that productivity is reduced by the presence of mange and gastrointestinal parasites, while in traditional systems the conditions are favourable for the development of porcine cysticercosis caused by the pork tapeworm Taenia solium, which poses a health risk to communities. Results of the pilot survey confirmed that, with the exception of African swine fever, ecto- and endoparasites are probably the most important health risks for producers. Porcine cysticercosis is more prevalent among pigs in traditional, free-ranging systems, while mange becomes a serious factor when pigs are permanently confined.

A survey on the occurrence of resistance to anthelmintics of gastrointestinal nematodes of goats in Mozambique.

A survey to study the extent of anthelmintic resistance was conducted in Maputo and Gaza, two of the ten provinces of Mozambique, during February and March, 1999. A total of 12 flocks, six in Maputo and six in Gaza, was surveyed. The faecal egg count reduction test was used to assess the efficacy of three anthelmintics most often used in Mozambique, namely albendazole, fenbendazole and levamisole. The degree of resistance was calculated using two different methods, and varied according to the method used. Using the formula of Coles, Bauer, Borgsteede, Geerts, Klei, Taylor & Waller (1992), resistance to the benzimidazoles was detected in one flock in Maputo and one in Gaza, and to levamisole in three flocks in Maputo and one in Gaza. When the formula of Dash, Hall & Barger (1988) was used, however, resistance to the benzimidazoles was detected in only one flock in Maputo, and no resistance to levamisole was detected. The 12 farms surveyed were too few for conclusions to be made on the prevalence of anthelmintic resistance in goats in Mozambique as a whole. Therefore, an extensive survey at national level is needed. This study gives evidence, however, that anthelmintic resistance in nematode parasites of goats is an emerging problem, to which special attention should be paid.