Socioeconomic Disadvantage and Youth Mental Health During the COVID-19 Pandemic Lockdown.

Importance: Adolescence is a period in which mental health problems emerge. Research suggests that the COVID-19 lockdown may have worsened emotional and behavioral health. Objective: To examine whether socioeconomic status was associated with mental health outcomes among youths during the COVID-19 pandemic. Design, Setting, and Participants: The Adolescent Brain Cognitive Development (ABCD) Study is a multisite 10-year longitudinal study of youth neurocognitive development in the US. Recruitment was staggered where the baseline visit (ages 9 to 10 years) occurred from 2016 to 2018, and visits occurred yearly. The COVID-19 lockdown halted research collection during the 2-year follow-up visits (ages 11 to 12 years), but eventually resumed. As some youths already underwent their 2-year visits prior to lockdown, this allowed for a natural experiment-like design to compare prepandemic and intrapandemic groups. Thus, data were gathered from the 1-year follow-up (pre-COVID-19 lockdown for all youths) and the 2-year follow-up, of which a portion of youths had data collected after the lockdown began, to compare whether a period of near social isolation was associated with mental health symptoms in youths. The prepandemic group consisted of youths with a 2-year follow-up visit collected prior to March 11, 2020, and the intrapandemic group had their 2-year follow-up visit after lockdown restrictions were lifted. Main Outcomes and Measures: Assessments included measures on income-to-needs ratio (INR; derived from total household income), the Child Behavior Checklist (a measure of mental health symptomology), and the Family Environmental Scale. Results: The final sample included 10 399 youths; 3947 (52.3%) were male; 2084 (20.3%) were Latinx/Hispanic; 6765 (66.0%) were White; 4600 (44.2%) reported caregiver education levels below a 4-year college degree; and 2475 (26.2%) had INR either below 100% (indicating poverty) or between 100% and less than 200% (near poverty). Among youths in the intrapandemic group, worse mental health symptoms (eg, more total problems, greater depression, and greater anxiety) over time were associated with being from a household with higher socioeconomic status (eg, when comparing individuals who differed by 1 unit on INR between prepandemic and intrapandemic groups from 1-year to 2-year follow-up, their expected difference in total problems score was 0.79 [95% CI, 0.37-1.22]; false discovery rate-corrected P < .001). Conclusions and Relevance: This cohort study found that the COVID-19 lockdown was associated with disproportionately negative mental health outcomes among youths from higher socioeconomic status backgrounds. Although this study does not shed light on the direct mechanisms driving these associations, it does provide some support for positive outcomes for youths. Future studies are needed to understand whether these associations persist over longer periods of time.

Harnessing technology for infectious disease response in conflict zones: Challenges, innovations, and policy implications.

Epidemic outbreaks of infectious diseases in conflict zones are complex threats to public health and humanitarian activities that require creativity approaches of reducing their damage. This narrative review focuses on the technology intersection with infectious disease response in conflict zones, and complexity of healthcare infrastructure, population displacement, and security risks. This narrative review explores how conflict-related destruction is harmful towards healthcare systems and the impediments to disease surveillance and response activities. In this regards, the review also considered the contributions of technological innovations, such as the improvement of epidemiological surveillance, mobile health (mHealth) technologies, genomic sequencing, and surveillance technologies, in strengthening infectious disease management in conflict settings. Ethical issues related to data privacy, security and fairness are also covered. By advisement on policy that focuses on investment in surveillance systems, diagnostic capacity, capacity building, collaboration, and even ethical governance, stakeholders can leverage technology to enhance the response to infectious disease in conflict settings and, thus, protect the global health security. This review is full of information for researchers, policymakers, and practitioners who are dealing with the issues of infectious disease outbreaks in conflicts worn areas.

The effect of COVID-19 public health measures on nationally notifiable diseases in Australia during 2020 and 2021.

Abstract: The novel coronavirus disease 2019 (COVID-19) pandemic prompted Australia to implement large-scale domestic lockdowns and halted international travel. However, the impact of these measures on national notifiable diseases is yet to been fully examined. In this paper, we expand on a preliminary analysis conducted in 2020, and conducted a retrospective, observational study using nationally notifiable disease surveillance system (NNDSS) data to examine if the changes identified in the first half of 2020 continued in Australia through wide-scale public health measures. We found that there was an overall reduction in most of Australia's nationally notifiable diseases over the two pandemic years during which wide-scale public health measures remained in operation, particularly for 23 social and imported diseases. We observed an increase in notifications for psittacosis, leptospirosis and legionellosis during these years. The public health measures implemented in 2020 and 2021 (including lockdowns, mask mandates, and increased hand and respiratory hygiene) may have contributed to the observed notification reductions. The outcomes of these measures' implementation provide insights into broader communicable disease control for mass outbreaks and pandemic responses.

The Lagos State COVID-19 Think-tank, a Potential Framework for Decision-making in a Pandemic Era.

Lagos state remains the epicenter of COVID-19 infection in Nigeria. To facilitate the emergency preparedness and response to COVID-19, the State Governor and Incident Commander constituted a Think Tank comprising 13 experts from various disciplines committed to the health of the public. The Think Tank assisted the government with decision-making strategies and supported the emergency operation centre (EOC) for the COVID-19 response. Their main achievements were developing frameworks for decision-making and strategies for phased easing of the State-wide lockdown. The challenges encountered were that it was often viewed as a parallel structure to the EOC and separated from the traditional civil service structure; causing some reluctance to implement ideas generated by the Think Tank. Nevertheless, the Think Tank played an important role during the COVID-19 pandemic; the lessons learned might help other states and resource-limited countries wishing to adopt this approach to emergency response.

RésuméL'État de Lagos reste l'épicentre de l'infection au COVID-19 au Nigeria. Pour faciliter la préparation et la réponse aux situations d'urgence (EPR) face au COVID-19, le gouverneur de l'État a constitué un groupe de réflexion composé de 13 experts de diverses disciplines. Le concept du groupe de réflexion était d'impliquer le secteur privé et le milieu universitaire dans la réponse COVID de l'État de Lagos, reconnaissant qu'un résultat réussi de l'EPR nécessite une expertise dont certaines n'existaient pas au sein de la fonction publique. Le Think Tank a aidé le gouvernement à élaborer des stratégies de prise de décision et a soutenu le centre des opérations d'urgence (COU) pour la réponse à la COVID-19. Leurs principales réalisations ont été l'élaboration de cadres de prise de décision et de stratégies d'assouplissement progressif du confinement à l'échelle de l'État. Les défis rencontrés étaient qu'il était souvent considéré comme une structure parallèle à l'EOC et séparé de la structure traditionnelle de la fonction publique; provoquant une certaine réticence à mettre en œuvre les idées générées. Le groupe de réflexion de l'État de Lagos a démontré un modèle réussi de partenariat public-privé dans le domaine de la santé mis en œuvre par une diversité d'acteurs dans des secteurs critiques. Cela pourrait être considéré comme un modèle utile pour faire face à une myriade de crises similaires auxquelles le secteur de la santé est souvent confronté. Les enseignements tirés pourraient aider d'autres États et pays aux ressources limitées souhaitant adopter cette approche dans les interventions d'urgence.

The effects of occupational disruption during COVID-19 lockdowns on health: a cross-sectional study.

The disruption in daily activity performance during COVID-19 lockdowns is widely understood to have impacted health, but a better understanding of how restricted performance of specific activities are associated with health is needed. This cross-sectional study answers the following question: How were changes in the performance of 16 daily activities associated with health during COVID-19 lockdowns? A total of 116 participants completed an online survey rating their health before and during COVID-19 lockdowns and comparing their recollection of the performance of 16 activities before COVID-19 with their performance during lockdowns. Multiple stepwise linear regression analysis was used to estimate the relationship between self-reported changes in activities during lockdowns and concurrent (during-lockdown) health status, while controlling for pre-COVID-19 health status. Only changes in activities that were uniquely and significantly associated with lockdown health status were retained in the final model. Health before COVID-19 accounted for 3.7% (P = 0.039) of the variance in health during COVID-19 lockdowns. After controlling for health before COVID-19, five types of activity were significantly and uniquely predictive of health during lockdowns, together accounting for 48.3% of the variance. These activities and the variances they accounted for were rest and sleep (29.5%, P < 0.001), play and recreational activities (8%, P < 0.001), work (4.8%, P = 0.002), personal hygiene (3.2%, P = 0.01), and healthy eating (2.8%, P = 0.013). The study suggests that these five types of activity should be prioritized in policy or interventions when participation in activity is constrained by lockdowns or comparable factors.

[Progress of schistosomiasis control in People's Republic of China in 2023].

To understand the progress of national schistosomiasis elimination program of China in 2023 and summarize the lessons and experiences, data on the endemic status of schistosomiasis and national schistosomiasis surveillance results in the People's Republic of China were collected and analyzed at a national level. By the end of 2023, Shanghai Municipality, Zhejiang Province, Fujian Province, Guangdong Province and Guangxi Zhuang Autonomous Region continued to consolidate the achievements of schistosomiasis elimination, and Sichuan and Jiangsu provinces maintained the criteria of transmission interruption, while Yunnan and Hubei provinces were identified to achieve the criteria of transmission interruption in 2020, and Anhui, Jiangxi and Hunan provinces achieved the criteria of transmission interruption in 2023. A total of 451 counties (cites, districts) were found to be endemic for schistosomiasis in China in 2023, including 26 250 endemic villages covering 73 034 500 residents at risk of infections. Among the 451 endemic counties (cities, districts), 78.49% (354/451) achieved the criteria of schistosomiasis elimination and 21.51% (97/451) achieved the criteria of transmission interruption, respectively. In 2023, a total of 4 216 643 individuals received immunological tests, with 47 794 sero-positives identified, and a total of 184 216 individuals received parasitological examinations, with 4 egg-positives detected. A total of 27 768 cases with advanced schistosomiasis were documented in China by the end of 2023. In 2023, 539 548 bovines were raised in schistosomiasis-endemic areas of China, and 125 440 bovines received immunological tests, with 124 sero-positives detected, while no egg-positives were identified among the 133 508 bovines receiving parasitological examinations. In 2023, snail survey was performed at an area of 641 339.53 hm2 and 184 819.77 hm2 snail habitats were identified, including 51.53 hm2 emerging snail habitats and 642.25 hm2 reemerging snail habitats. In 2023, there were 20 198 schistosomiasis patients receiving praziquantel chemotherapy, and 598 183 person-time individuals and 283 954 herdtime bovines were given expanded chemotherapy. In 2023, snail control with chemical treatment was performed in 116 347.95 hm2 snail habitats, and the actual area of chemical treatment was 65 690.89 hm2, while environmental improvements were performed in snail habitats covering an area of 1 334.62 hm2. The national schistosomiasis surveillance results showed that the mean prevalence of Schistosoma japonicum infections were both zero among humans and bovines in 2023, and no S. japonicum infection was detected in snails. These data demonstrated that transmission interruption of schistosomiasis had been achieved across all endemic provinces in China in 2023, and the endemic status of schistosomiasis tended to be stable, while advanced cases were predominant among all schistosomiasis cases. However, the areas of snail habitats remained high and cattle re-raising was very common in some regions. Intensified schistosomiasis surveillance and forecast and snail control in high-risk areas are needed.

Plan de acción para fortalecer la vigilancia y el control de las leishmaniasis en las Américas 2023-2030

Con el fin de actualizar, sistematizar y monitorear las acciones relacionadas con la leishmaniasis en el nivel operativo, la Organización Panamericana de la Salud ha elaborado esta nueva versión del Plan para el período 2023-2030, que contiene las principales líneas de acción para la vigilancia, la asistencia y el control de las leishmaniasis en la Región. En estas páginas se abordan la evidencia, el costo, la costo-efectividad de las intervenciones disponibles, el acceso y los análisis de los datos epidemiológicos y de procesos, entre otras cuestiones esenciales, así como la organización de los servicios de salud en los países de las Américas. Para preparar las metas y los indicadores del Plan se consideraron discusiones técnicas, puntos de consenso, orientaciones y sugerencias provenientes de expertos, investigadores y profesionales responsables de las acciones de lucha contra la enfermedad en los países endémicos. Las acciones propuestas se formularon a partir del diagnóstico de la situación en la Región, lo cual implicó definir los indicadores de procesos, epidemiológicos y operativos, a fin de valorar los avances y hacer un seguimiento de la enfermedad con miras a alcanzar mejoras palpables. Estas acciones se enfocan en el diagnóstico temprano, el tratamiento y el seguimiento adecuados de las personas afectadas, y toman en cuenta la vigilancia, la prevención y el control de los casos humanos, de los vectores y de los reservorios, cuando se requiera, todo lo cual debe sumarse a las labores de educación y comunicación. Las metas para el control de las leishmaniasis en la Región son ambiciosas y exigirán que los países y los socios interesados en proporcionar su apoyo trabajen con mucho empeño para alcanzarlas.

Use of a toll-free call center for COVID-19 response and continuity of essential services during the lockdown, Greater Kampala, Uganda, 2020: a descriptive study.

Introduction: on March 21, 2020, the first case of COVID-19 was confirmed in Uganda. A total lockdown was initiated on March 30 which was gradually lifted May 5-June 30. On March 25, a toll-free call center was organized at the Kampala Capital City Authority to respond to public concerns about COVID-19 and the lockdown. We documented the set-up and use of the call center and analyzed key concerns raised by the public. Methods: two hotlines were established and disseminated through media platforms in Greater Kampala. The call center was open 24 hours a day and 7 days a week. We abstracted data on incoming calls from March 25 to June 30, 2020. We summarized call data into categories and conducted descriptive analyses of public concerns raised during the lockdown. Results: among 10,167 calls, two-thirds (6,578; 64.7%) involved access to health services, 1,565 (15.4%) were about social services, and 1,375 (13.5%) involved COVID-19-related issues. Approximately one-third (2,152; 32.7%) of calls about access to health services were requests for ambulances for patients with non-COVID-19-related emergencies. About three-quarters of calls about social services were requests for food and relief items (1,184; 75.7%). Half of the calls about COVID-19 (730; 53.1%) sought disease-related information. Conclusion: the toll-free call center was used by the public during the COVID-19 lockdown in Kampala. Callers were more concerned about access to essential health services, non-related to COVID-19 disease. It is important to plan for continuity of essential services before a public health emergency-related lockdown.

An innovative fractional-order evolutionary game theoretical study of personal protection, quarantine, and isolation policies for combating epidemic diseases.

This study uses imposed control techniques and vaccination game theory to study disease dynamics with transitory or diminishing immunity. Our model uses the ABC fractional-order derivative mechanism to show the effect of non-pharmaceutical interventions such as personal protection or awareness, quarantine, and isolation to simulate the essential control strategies against an infectious disease spread in an infinite and uniformly distributed population. A comprehensive evolutionary game theory study quantified the significant influence of people's vaccination choices, with government forces participating in vaccination programs to improve obligatory control measures to reduce epidemic spread. This model uses the intervention options described above as a control strategy to reduce disease prevalence in human societies. Again, our simulated results show that a combined control strategy works exquisitely when the disease spreads even faster. A sluggish dissemination rate slows an epidemic outbreak, but modest control techniques can reestablish a disease-free equilibrium. Preventive vaccination regulates the border between the three phases, while personal protection, quarantine, and isolation methods reduce disease transmission in existing places. Thus, successfully combining these three intervention measures reduces epidemic or pandemic size, as represented by line graphs and 3D surface diagrams. For the first time, we use a fractional-order derivate to display the phase-portrayed trajectory graph to show the model's dynamics if immunity wanes at a specific pace, considering various vaccination cost and effectiveness settings.

Assessing the instantaneous social dilemma on social distancing attitudes and vaccine behavior in disease control.

In the face of infectious disease outbreaks, the collective behavior of a society can has a profound impact on the course of the epidemic. This study investigates the instantaneous social dilemma presented by individuals' attitudes toward vaccine behavior and its influence on social distancing as a critical component in disease control strategies. The research employs a multifaceted approach, combining modeling techniques and simulation to comprehensively assess the dynamics between social distancing attitudes and vaccine uptake during disease outbreaks. With respect to modeling, we introduce a new vaccination game (VG) where, unlike conventional VG models, a 2-player and 2-strategy payoff structure is aptly embedded in the individual behavior dynamics. Individuals' willingness to adhere to social distancing measures, such as mask-wearing and physical distancing, is strongly associated with their inclination to receive vaccines. The study reveals that a positive attitude towards social distancing tends to align with a higher likelihood of vaccine acceptance, ultimately contributing to more effective disease control. As the COVID-19 pandemic has demonstrated, swift and coordinated public health measures are essential to curbing the spread of infectious diseases. This study underscores the urgency of addressing the instantaneous social dilemma posed by individuals' attitudes. By understanding the intricate relationship between these factors, policymakers, and healthcare professionals can develop tailored strategies to promote both social distancing compliance and vaccine acceptance, thereby enhancing our ability to control and mitigate the impact of disease outbreaks in the future.

Agent-based modeling to estimate the impact of lockdown scenarios and events on a pandemic exemplified on SARS-CoV-2.

In actual pandemic situations like COVID-19, it is important to understand the influence of single mitigation measures as well as combinations to create most dynamic impact for lockdown scenarios. Therefore we created an agent-based model (ABM) to simulate the spread of SARS-CoV-2 in an abstract city model with several types of places and agents. In comparison to infection numbers in Germany our ABM could be shown to behave similarly during the first wave. In our model, we implemented the possibility to test the effectiveness of mitigation measures and lockdown scenarios on the course of the pandemic. In this context, we focused on parameters of local events as possible mitigation measures and ran simulations, including varying size, duration, frequency and the proportion of events. The majority of changes to single event parameters, with the exception of frequency, showed only a small influence on the overall course of the pandemic. By applying different lockdown scenarios in our simulations, we could observe drastic changes in the number of infections per day. Depending on the lockdown strategy, we even observed a delayed peak in infection numbers of the second wave. As an advantage of the developed ABM, it is possible to analyze the individual risk of single agents during the pandemic. In contrast to standard or adjusted ODEs, we observed a 21% (with masks) / 48% (without masks) increased risk for single reappearing participants on local events, with a linearly increasing risk based on the length of the events.

The "supercompensation" effect of children's lockdown during COVID-19: based on the analysis of changes in physical activity, sleep, and psychology.

OBJECTIVE: To investigate the "supercompensation" effect of preschoolers during the coronavirus disease 2019 lockdown by comparing the changes in physical activity (PA), psychological, and sleep indicators before and after the lockdown. METHODS: A total of 127 children (aged 3-6 years) were recruited. Before and after the lockdown, the children's PA levels were measured using the ActiGraph GT3X+, and their psychological and sleep indicators were measured using the Strengths and Difficulties Questionnaire (SDQ) and Child Sleep Habit Questionnaire (CSHQ), respectively. RESULTS: Regarding PA, the children's total physical activity, low-intensity physical activity, and medium-intensity physical activity (MVPA) were higher after the lockdown than before the lockdown, with significant differences in MVPA (p < 0.05). Regarding psychology, the children's SDQ and multidimensional scores were better after the lockdown than before the lockdown, with a significant difference in SDQ scores (p < 0.05). Regarding sleep, the children's CSHQ scores were better after the lockdown than before the lockdown, with a highly significant difference in CSHQ scores (p < 0.01). CONCLUSION: After lockdown, children's PA, psychological, and sleep effects were "supercompensated." In particular, the PA of preschoolers before, during, and after the lockdown may show a "baseline-inhibition-supercompensation" process.

Evaluating infectious disease outbreak potential and mitigation effectiveness on cruise ships.

The cruise ship sector is a major part of the tourism industry, and an estimated over 30 million passengers are transformed worldwide each year. Cruise ships bring diverse populations into proximity for many days, facilitating the transmission of respiratory illnesses. The objective of this study is to develop a modeling framework to inform the development of viable disease risk management policies and measures to control disease outbreaks on cruises. Our model, parameterized and calibrated using the data of the COVID-19 outbreak on the Diamond Princess cruise ship in 2020, is used to assess the impact of the mitigation measures such as mask wearing, vaccination, on-board and pre-traveling testing measures. Our results indicate mask wearing in public places as the cheapest and most affordable measure can drop the number of cumulative confirmed cases by almost 50%. This measure along with the vaccination by declining the number of the cumulative confirmed cases by more than 94% is the most effective measure to control outbreaks on cruises. According to our findings, outbreaks are more predominant in the passenger population than the crew members, however, the protection measures are more beneficial if they are applied by both crew members and passengers. Regarding the testing measure, pre-traveling testing is more functional than the on-board testing to control outbreaks on cruises.

Mathematical Assessment of the Role of Human Behavior Changes on SARS-CoV-2 Transmission Dynamics in the United States.

The COVID-19 pandemic has not only presented a major global public health and socio-economic crisis, but has also significantly impacted human behavior towards adherence (or lack thereof) to public health intervention and mitigation measures implemented in communities worldwide. This study is based on the use of mathematical modeling approaches to assess the extent to which SARS-CoV-2 transmission dynamics is impacted by population-level changes of human behavior due to factors such as (a) the severity of transmission (such as disease-induced mortality and level of symptomatic transmission), (b) fatigue due to the implementation of mitigation interventions measures (e.g., lockdowns) over a long (extended) period of time, (c) social peer-pressure, among others. A novel behavior-epidemiology model, which takes the form of a deterministic system of nonlinear differential equations, is developed and fitted using observed cumulative SARS-CoV-2 mortality data during the first wave in the United States. The model fits the observed data, as well as makes a more accurate prediction of the observed daily SARS-CoV-2 mortality during the first wave (March 2020-June 2020), in comparison to the equivalent model which does not explicitly account for changes in human behavior. This study suggests that, as more newly-infected individuals become asymptomatically-infectious, the overall level of positive behavior change can be expected to significantly decrease (while new cases may rise, particularly if asymptomatic individuals have higher contact rate, in comparison to symptomatic individuals).

Core health system measures response to COVID-19 among East Asian countries.

Objective: The purpose of this study is to summarize the health system response to COVID-19 in four East Asian countries, analyze the effectiveness of their health system response, and provide lessons for other countries to control the epidemic and optimize their health system response. Methods: This study investigated and summarized COVID-19 data and health system response in four East Asian countries, China, Japan, Mongolia, and South Korea from national governments and ministries of health, WHO country offices, and official websites of international organizations, to assess the effectiveness of health system measures. Result: As of June 30, 2022, all four countries are in a declining portion of COVID-19. China has two waves, and new cases increased slowly, with the total cases per million remaining within 4, indicating a low level. Japan has experienced six waves, with case growth at an all-time high, total cases per million of 250.994. Mongolia started the epidemic later, but also experienced four waves, with total cases per million of 632.658, the highest of the four countries. South Korea has seen an increasing number of new cases per wave, with a total case per million of 473.759. Conclusion: In containment strategies adopted by China and Mongolia, and mitigation strategies adopted by Japan and South Korea, health systems have played important roles in COVID-19 prevention and control. While promoting vaccination, countries should pay attention to non-pharmaceutical health system measures, as evidenced by: focusing on public information campaigns to lead public minds; strengthening detection capabilities for early detection and identification; using technical ways to participate in contact tracing, and promoting precise judging isolation.

Effects of the COVID-19 associated United Kingdom lockdown on physical activity in older adults at high risk of cardiovascular disease: a mixed methods perspective from the MedEx-UK multicenter trial.

Introduction: Physical inactivity and sedentary behaviour are linked to increased risk of cardiovascular disease, infections and dementia, as well as placing a significant economic burden on healthcare systems. The implementation of COVID-19 pandemic lockdown measures aimed at reducing virus transmission posed challenges to the opportunity to be physically active. This study investigates how the first UK COVID-19 lockdown affected objectively measured physical activity in older adults at higher risk of cardiovascular disease. Methods: We studied 48 individuals aged 55-74 years (81.3% female) with self-reported PA levels < 90 min/week and a QRISK2 score ≥ 10 (indicative of a ≥ 10% risk of a major cardiovascular event in the next 10 years) without mild cognitive impairment or dementia. Physical activity data was collected using objective wrist-based activity monitors and analysed across three time periods, usual activity (pre-pandemic), the precautionary phase when the UK began advising on limiting social contact and finally during the first UK lockdown period was collected (27 January 2020 and 07 June 2020). Data was analysed using linear mixed effects model was used to investigate PA levels over the measured 12-week period. Effects of BMI, age, deprivation score and baseline PA levels on PA across the three measurement periods were also examined. Focus-group and individual interviews were conducted, and data were thematically analysed. Results: Average daily step count (-34% lower, p < 0.001) and active energy expenditure (-26% lower, p < 0.001) were significantly lower during the precautionary period compared with the usual activity period. Physical activity remained low during the UK lockdown period. Participants with a lower BMI engaged in significantly more (+45% higher daily steps p < 0.001) physical activity and those over 70 years old were more physically active than those under 70 years across the 12-week period (+23% higher daily steps p < 0.007). The risk of COVID-19 infection and restrictions because of lockdown measures meant some individuals had to find alternative methods to staying physical active. Participants described a lack of access to facilities and concerns over health related to COVID-19 as barriers to engaging in physical activity during lockdown. For some, this resulted in a shift towards less structured activities such as gardening or going for a walk. Discussion: The data presented shows that lockdown measures during the COVID-19 pandemic significantly reduced physical activity among older individuals at risk of cardiovascular disease, particularly those with a higher body mass index. To support this population group in staying active during future lockdowns, a multifaceted strategy is needed, emphasizing psychosocial benefits and home-based physical activity. The MedEx-UK study was pre-registered with ClinicalTrials.gov (NCT03673722).

Utilizing disease transmission and response capacities to optimize covid-19 control in Malaysia.

OBJECTIVES: Public Health Social Measures (PHSM) such as movement restriction movement needed to be adjusted accordingly during the COVID-19 pandemic to ensure low disease transmission alongside adequate health system capacities based on the COVID-19 situational matrix proposed by the World Health Organization (WHO). This paper aims to develop a mechanism to determine the COVID-19 situational matrix to adjust movement restriction intensity for the control of COVID-19 in Malaysia. METHODS: Several epidemiological indicators were selected based on the WHO PHSM interim guidance report and validated individually and in several combinations to estimate the community transmission level (CT) and health system response capacity (RC) variables. Correlation analysis between CT and RC with COVID-19 cases was performed to determine the most appropriate CT and RC variables. Subsequently, the CT and RC variables were combined to form a composite COVID-19 situational matrix (SL). The SL matrix was validated using correlation analysis with COVID-19 case trends. Subsequently, an automated web-based system that generated daily CT, RC, and SL was developed. RESULTS: CT and RC variables were estimated using case incidence and hospitalization rate; Hospital bed capacity and COVID-19 ICU occupancy respectively. The estimated CT and RC were strongly correlated [ρ = 0.806 (95% CI 0.752, 0.848); and ρ = 0.814 (95% CI 0.778, 0.839), p < 0.001] with the COVID-19 cases. The estimated SL was strongly correlated with COVID-19 cases (ρ = 0.845, p < 0.001) and responded well to the various COVID-19 case trends during the pandemic. SL changes occurred earlier during the increase of cases but slower during the decrease, indicating a conservative response. The automated web-based system developed produced daily real-time CT, RC, and SL for the COVID-19 pandemic. CONCLUSIONS: The indicators selected and combinations formed were able to generate validated daily CT and RC levels for Malaysia. Subsequently, the CT and RC levels were able to provide accurate and sensitive information for the estimation of SL which provided valuable evidence on the progression of the pandemic and movement restriction adjustment for the control of Malaysia.

Diagnostics for Public Health - Infectious Disease Surveillance and Control.

AbstractAccurate diagnostics are critical in public health to ensure successful disease tracking, prevention, and control. Many of the same characteristics are desirable for diagnostic procedures in both medicine and public health: for example, low cost, high speed, low invasiveness, ease of use and interpretation, day-to-day consistency, and high accuracy. This review lays out five principles that are salient when the goal of diagnosis is to improve the overall health of a population rather than that of a particular patient, and it applies them in two important use cases: pandemic infectious disease and antimicrobial resistance.