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2.
J Racial Ethn Health Disparities ; 10(4): 1597-1604, 2023 08.
Article in English | MEDLINE | ID: mdl-35689156

ABSTRACT

Black Americans are more likely to be essential workers due to racial capitalism. Because of the COVID-19 pandemic, essential workers are less able to adhere to social distancing and stay-at-home guidelines due to the nature of their work, because they are more likely to occupy crowded households, and are more likely to possess pre-existing health conditions. To assist Black essential workers in preventing infection or reducing the intensity of symptoms if contracted, vaccination against the virus is essential. Unfortunately, Black essential workers face considerable barriers to accessing vaccinations and are hesitant to receive the vaccine due to widespread misinformation and justified historical mistrust of the American medical system. The purpose of this work is to (1) describe the disproportionate impact of COVID-19 on Black essential workers due to racial capitalism, (2) outline the socioeconomic and racial barriers related to vaccination within this population, and (3) to suggest policy-related approaches to facilitate vaccination such as access to on-site vaccination opportunities, the funding of community outreach efforts, and the mandating of increased employee benefits.


Subject(s)
Black People , COVID-19 , Capitalism , Communicable Disease Control , Health Equity , Systemic Racism , Humans , COVID-19/economics , COVID-19/epidemiology , COVID-19/ethnology , COVID-19/prevention & control , Pandemics/economics , Policy , Health Policy/economics , COVID-19 Vaccines/economics , COVID-19 Vaccines/supply & distribution , Health Services Accessibility/economics , Health Equity/economics , Systemic Racism/economics , Systemic Racism/ethnology , Communicable Disease Control/economics , Communicable Disease Control/methods
4.
PLoS One ; 17(1): e0261759, 2022.
Article in English | MEDLINE | ID: mdl-35061722

ABSTRACT

In the beginning of the COVID-19 US epidemic in March 2020, sweeping lockdowns and other aggressive measures were put in place and retained in many states until end of August of 2020; the ensuing economic downturn has led many to question the wisdom of the early COVID-19 policy measures in the US. This study's objective was to evaluate the cost and benefit of the US COVID-19-mitigating policy intervention during the first six month of the pandemic in terms of COVID-19 mortality potentially averted, versus mortality potentially attributable to the economic downturn. We conducted a synthesis-based retrospective cost-benefit analysis of the full complex of US federal, state, and local COVID-19-mitigating measures, including lockdowns and all other COVID-19-mitigating measures, against the counterfactual scenario involving no public health intervention. We derived parameter estimates from a rapid review and synthesis of recent epidemiologic studies and economic literature on regulation-attributable mortality. According to our estimates, the policy intervention saved 866,350-1,711,150 lives (4,886,214-9,650,886 quality-adjusted life-years), while mortality attributable to the economic downturn was 57,922-245,055 lives (2,093,811-8,858,444 life-years). We conclude that the number of lives saved by the spring-summer lockdowns and other COVID-19-mitigation was greater than the number of lives potentially lost due to the economic downturn. However, the net impact on quality-adjusted life expectancy is ambiguous.


Subject(s)
COVID-19/epidemiology , Cost-Benefit Analysis/statistics & numerical data , Models, Statistical , Public Health/economics , Quality-Adjusted Life Years , Quarantine/economics , COVID-19/economics , Communicable Disease Control/economics , Communicable Disease Control/methods , Humans , Public Health/statistics & numerical data , Quality of Life/psychology , Quarantine/ethics , Retrospective Studies , SARS-CoV-2/pathogenicity , United States/epidemiology
5.
PLoS Negl Trop Dis ; 15(12): e0009904, 2021 12.
Article in English | MEDLINE | ID: mdl-34928945

ABSTRACT

Since its early spread in early 2020, the disease caused by the novel Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Coronavirus Disease 2019 (COVID-19) has caused mass disruptions to health services. These have included interruptions to programs that aimed to prevent, control, and eliminate neglected tropical diseases (NTDs). In March 2020, the World Health Organization (WHO) released interim guidelines recommending the temporary cessation of mass drug administration (MDA), community-based surveys, and case detection, while encouraging continuation of morbidity management and vector control where possible. Over the course of the following months, national programs and implementing partners contributed to COVID-19 response efforts, while also beginning to plan for resumption of NTD control activities. To understand the challenges, opportunities, and recommendations for maximizing continuity of disease control during public health emergencies, we sought perspectives from Nigeria and Guinea on the process of restarting NTD control efforts during the COVID-19 pandemic. Through semistructured interviews with individuals involved with NTD control at the local and national levels, we identified key themes and common perspectives between the 2 countries, as well as observations that were specific to each. Overall, interviewees stressed the challenges posed by COVID-19 interruptions, particularly with respect to delays to activities and related knock-on impacts, such as drug expiry and prolonged elimination timelines, as well as concerns related to funding. However, respondents in both countries also highlighted the benefits of a formal risk assessment approach, particularly in terms of encouraging information sharing and increasing coordination and advocacy. Recommendations included ensuring greater availability of historical data to allow better monitoring of how future emergencies affect NTD control progress; continuing to use risk assessment approaches in the future; and identifying mechanisms for sharing lessons learned and innovations between countries as a means of advancing postpandemic health systems and disease control capacity strengthening.


Subject(s)
COVID-19 , Communicable Disease Control/organization & administration , Neglected Diseases/prevention & control , Communicable Disease Control/economics , Government Programs/economics , Government Programs/organization & administration , Guinea , Humans , Mass Drug Administration , Nigeria , SARS-CoV-2 , Tropical Medicine/methods
7.
Sci Rep ; 11(1): 22855, 2021 11 24.
Article in English | MEDLINE | ID: mdl-34819577

ABSTRACT

Policymakers commonly employ non-pharmaceutical interventions to reduce the scale and severity of pandemics. Of non-pharmaceutical interventions, physical distancing policies-designed to reduce person-to-person pathogenic spread - have risen to recent prominence. In particular, stay-at-home policies of the sort widely implemented around the globe in response to the COVID-19 pandemic have proven to be markedly effective at slowing pandemic growth. However, such blunt policy instruments, while effective, produce numerous unintended consequences, including potentially dramatic reductions in economic productivity. In this study, we develop methods to investigate the potential to simultaneously contain pandemic spread while also minimizing economic disruptions. We do so by incorporating both occupational and contact network information contained within an urban environment, information that is commonly excluded from typical pandemic control policy design. The results of our methods suggest that large gains in both economic productivity and pandemic control might be had by the incorporation and consideration of simple-to-measure characteristics of the occupational contact network. We find evidence that more sophisticated, and more privacy invasive, measures of this network do not drastically increase performance.


Subject(s)
COVID-19/prevention & control , Communicable Disease Control/economics , Communicable Disease Control/methods , Contact Tracing/economics , Contact Tracing/methods , Disease Transmission, Infectious/prevention & control , Humans , Occupations/classification , Pandemics , Physical Distancing , Policy , Principal Component Analysis , Quarantine/economics , Quarantine/methods , Quarantine/trends , SARS-CoV-2/pathogenicity
8.
Sci Rep ; 11(1): 21174, 2021 10 27.
Article in English | MEDLINE | ID: mdl-34707187

ABSTRACT

Lockdowns implemented to address the COVID-19 pandemic have disrupted human mobility flows around the globe to an unprecedented extent and with economic consequences which are unevenly distributed across territories, firms and individuals. Here we study socioeconomic determinants of mobility disruption during both the lockdown and the recovery phases in Italy. For this purpose, we analyze a massive data set on Italian mobility from February to October 2020 and we combine it with detailed data on pre-existing local socioeconomic features of Italian administrative units. Using a set of unsupervised and supervised learning techniques, we reliably show that the least and the most affected areas persistently belong to two different clusters. Notably, the former cluster features significantly higher income per capita and lower income inequality than the latter. This distinction persists once the lockdown is lifted. The least affected areas display a swift (V-shaped) recovery in mobility patterns, while poorer, most affected areas experience a much slower (U-shaped) recovery: as of October 2020, their mobility was still significantly lower than pre-lockdown levels. These results are then detailed and confirmed with a quantile regression analysis. Our findings show that economic segregation has, thus, strengthened during the pandemic.


Subject(s)
COVID-19/epidemiology , Pandemics , SARS-CoV-2 , COVID-19/economics , Communicable Disease Control/economics , Communicable Disease Control/methods , Humans , Income , Italy/epidemiology , Machine Learning , Pandemics/economics , Poverty , Quarantine/economics , Regression Analysis , Socioeconomic Factors , Travel
9.
J Prim Health Care ; 13(2): 116-120, 2021 Jun.
Article in English | MEDLINE | ID: mdl-34620292

ABSTRACT

During the first months of the coronavirus disease 2019 (COVID-19) pandemic in early 2020, South Korea stood as one of the most successful in preventing a nationwide outbreak. The country was unique in that it did so without enforcing massive border restrictions and tight social distancing measures, instead focusing on maximal testing, contact tracing, and treatment. But as the year 2020 went on, the country has suffered second and third waves, each one being larger and harder to combat than the last. The Korean government, however, has been unwilling to impose stringent measures due to potential economic consequences and has still relied on its initial strategies in an attempt to prevent further disease transmission. It is therefore crucial to revisit their position beyond their early successes to re-evaluate the effectiveness of their strategy, and to finally decide if it is time to move on to more drastic measures.


Subject(s)
COVID-19/prevention & control , Communicable Disease Control , Pandemics/prevention & control , COVID-19 Testing , Communicable Disease Control/economics , Communicable Disease Control/methods , Contact Tracing , Federal Government , Humans , Physical Distancing , Republic of Korea
10.
PLoS One ; 16(9): e0256921, 2021.
Article in English | MEDLINE | ID: mdl-34525120

ABSTRACT

Using a nationwide survey of primary grocery shoppers conducted in August 2020, we examine household food spending when the economy had partially reopened and consumers had different spending opportunities in comparison to when the Covid-19 lockdown began. We estimate the impact of Covid-19 on household spending using interval and Order Probit regressions. Income levels, age, access to grocery stores and farmers markets, household demographic information, along with other independent variables are controlled in the model. Findings show that middle-class households (with income below $50,000, or with income between $50,000 and $99,999) are less likely to increase their grocery expenditures during the pandemic. Households with children or elderlies that usually require higher food quality and nutrition intakes had a higher probability of increasing their spending during Covid-19 than before. Furthermore, consumers' spending behaviors were also significantly affected by their safe handing levels and the Covid-19 severity and food accessibility in their residences.


Subject(s)
COVID-19/prevention & control , Communicable Disease Control/economics , Family Characteristics , Food/statistics & numerical data , Surveys and Questionnaires/statistics & numerical data , Aged , COVID-19/epidemiology , COVID-19/virology , Child , Consumer Behavior/statistics & numerical data , Costs and Cost Analysis , Epidemics/prevention & control , Housing/standards , Housing/statistics & numerical data , Humans , Income/statistics & numerical data , SARS-CoV-2/physiology , Time Factors , United States
11.
PLoS One ; 16(9): e0256103, 2021.
Article in English | MEDLINE | ID: mdl-34516549

ABSTRACT

How do people balance concerns for general health and economic outcomes during a pandemic? And, how does the communication of this trade-off affect individual preferences? We address these questions using a field experiment involving around 2000 students enrolled in a large university in Italy. We design four treatments where the trade-off is communicated using different combinations of a positive framing that focuses on protective strategies and a negative framing which refers to potential costs. We find that positive framing on the health side induces students to give greater relevance to the health dimension. The effect is sizeable and highly effective among many different audiences, especially females. Importantly, this triggers a higher level of intention to adhere to social distancing and precautionary behaviors. Moreover, irrespective of the framing, we find a large heterogeneity in students' preferences over the trade-off. Economics students and students who have directly experienced the economic impact of the pandemic are found to give greater value to economic outcomes.


Subject(s)
COVID-19/psychology , Communicable Disease Control/economics , Costs and Cost Analysis , Persuasive Communication , Attitude , COVID-19/economics , COVID-19/prevention & control , Decision Making , Health Education/methods , Humans
15.
PLoS One ; 16(4): e0248818, 2021.
Article in English | MEDLINE | ID: mdl-33852593

ABSTRACT

The implementation of large-scale containment measures by governments to contain the spread of the COVID-19 virus has resulted in large impacts to the global economy. Here, we derive a new high-frequency indicator of economic activity using empirical vessel tracking data, and use it to estimate the global maritime trade losses during the first eight months of the pandemic. We go on to use this high-frequency dataset to infer the effect of individual non-pharmaceutical interventions on maritime exports, which we use as a proxy of economic activity. Our results show widespread port-level trade losses, with the largest absolute losses found for ports in China, the Middle-East and Western Europe, associated with the collapse of specific supply-chains (e.g. oil, vehicle manufacturing). In total, we estimate that global maritime trade reduced by -7.0% to -9.6% during the first eight months of 2020, which is equal to around 206-286 million tonnes in volume losses and up to 225-412 billion USD in value losses. We find large sectoral and geographical disparities in impacts. Manufacturing sectors are hit hardest, with losses up to 11.8%, whilst some small islands developing states and low-income economies suffered the largest relative trade losses. Moreover, we find a clear negative impact of COVID-19 related school and public transport closures on country-wide exports. Overall, we show how real-time indicators of economic activity can inform policy-makers about the impacts of individual policies on the economy, and can support economic recovery efforts by allocating funds to the hardest hit economies and sectors.


Subject(s)
COVID-19/economics , Commerce/economics , Quarantine/economics , COVID-19/epidemiology , China/epidemiology , Communicable Disease Control/economics , Communicable Disease Control/methods , Economics , Europe/epidemiology , Government , Humans , Middle East/epidemiology , Pandemics/economics , SARS-CoV-2/isolation & purification , Ships/economics
17.
J Gerontol Soc Work ; 64(6): 613-628, 2021 Sep.
Article in English | MEDLINE | ID: mdl-33882781

ABSTRACT

The novel COVID-19 pandemic and its containment measures such as lockdown and physical distancing are remarkedly affecting older adults' economic activities and well-being in ways deserving of urgent attention. To strengthen caregiving and promote targeted care for older adults during and after the pandemic, this paper investigates the impact of the coronavirus on the economic activities and well-being of older adults in Enugu and Anambra states, Nigeria. Hermeneutic phenomenology was adopted and 16 older adults aged between 60 and 81 years, with a majority of them still working as farmers and traders were phone-interviewed. Findings highlighted four key lessons for gerontological social workers including 1) the fear that impact of the containment measures could kill the older adults faster than the virus; 2) the measures generate a feeling of neglect and marginalization of healthcare needs among older adults; 3) altered positive health-seeking behavior among the older adults; 4) and concern about the absence of functional policy and plan to address the welfare of older adults. Therefore, the central focus of the gerontological social workers and Nigerian polity should not be on how to reduce the spread of the disease alone, but on an application of caution in instituting and implementing the measures.


Subject(s)
COVID-19/economics , COVID-19/epidemiology , Communicable Disease Control/economics , Aged , Aged, 80 and over , Fear , Female , Food Insecurity , Humans , Interviews as Topic , Male , Mental Health , Middle Aged , Nigeria/epidemiology , Pandemics , Patient Acceptance of Health Care/psychology , Public Assistance/organization & administration , Qualitative Research , SARS-CoV-2 , Social Workers/education , Socioeconomic Factors
18.
Hosp Pract (1995) ; 49(4): 232-239, 2021 Oct.
Article in English | MEDLINE | ID: mdl-33866912

ABSTRACT

The COVID-19 pandemic caused the United States to hit record numbers of COVID-19 cases: peak unemployment of 14.7%, an increase in $4 trillion in national debt, and an estimated 3.4% GDP decline. The current socio-economic environment the pandemic created is just an earthquake that can create a tsunami that is bound to hit the healthcare system and can be felt around the globe. This tsunami is composed of a post-pandemic increase in healthcare facilities admission of indigent patients, decrease in medical reimbursement, and high operating costs to maintain healthcare workers, which can cause a synergistic effect that can lead to healthcare facilities experiencing significant negative total revenue. Time is of the essence, and it is imperative to make a collective effort from all healthcare professionals and legislatures to shift the nation's attention to the issue at hand that can threaten the closure of many healthcare facilities post-pandemic.


Subject(s)
COVID-19/economics , COVID-19/epidemiology , Health Care Sector/organization & administration , COVID-19/prevention & control , COVID-19 Vaccines/supply & distribution , Communicable Disease Control/economics , Economic Recession/statistics & numerical data , Health Care Sector/economics , Health Expenditures/statistics & numerical data , Humans , Pandemics , Poverty , SARS-CoV-2 , Socioeconomic Factors , United States/epidemiology
19.
Front Public Health ; 9: 620770, 2021.
Article in English | MEDLINE | ID: mdl-33748065

ABSTRACT

Various measures have been taken in different countries to mitigate the Covid-19 epidemic. But, throughout the world, many citizens don't understand well how these measures are taken and even question the decisions taken by their government. Should the measures be more (or less) restrictive? Are they taken for a too long (or too short) period of time? To provide some quantitative elements of response to these questions, we consider the well-known SEIR model for the Covid-19 epidemic propagation and propose a pragmatic model of the government decision-making operation. Although simple and obviously improvable, the proposed model allows us to study the tradeoff between health and economic aspects in a pragmatic and insightful way. Assuming a given number of phases for the epidemic (namely, 4 in this paper) and a desired tradeoff between health and economic aspects, it is then possible to determine the optimal duration of each phase and the optimal severity level (i.e., the target transmission rate) for each of them. The numerical analysis is performed for the case of France but the adopted approach can be applied to any country. One of the takeaway messages of this analysis is that being able to implement the optimal 4-phase epidemic management strategy in France would have led to 1.05 million of infected people and a GDP loss of 231 billions € instead of 6.88 millions of infected and a loss of 241 billions €. This indicates that, seen from the proposed model perspective, the effectively implemented epidemic management strategy is good economically, whereas substantial improvements might have been obtained in terms of health impact. Our analysis indicates that the lockdown/severe phase should have been more severe but shorter, and the adjustment phase occurred earlier. Due to the natural tendency of people to deviate from the official rules, updating measures every month over the whole epidemic episode seems to be more appropriate.


Subject(s)
COVID-19 , Communicable Disease Control/economics , Cost-Benefit Analysis/economics , Decision Making , Government , Models, Statistical , COVID-19/economics , COVID-19/epidemiology , France/epidemiology , Health Status , Humans , Quarantine , Time Factors
20.
Malar J ; 20(1): 128, 2021 Mar 04.
Article in English | MEDLINE | ID: mdl-33663488

ABSTRACT

BACKGROUND: Seasonal malaria chemoprevention (SMC) is a strategy for malaria control recommended by the World Health Organization (WHO) since 2012 for Sahelian countries. The Mali National Malaria Control Programme adopted a plan for pilot implementation and nationwide scale-up by 2016. Given that SMC is a relatively new approach, there is an urgent need to assess the costs and cost effectiveness of SMC when implemented through the routine health system to inform decisions on resource allocation. METHODS: Cost data were collected from pilot implementation of SMC in Kita district, which targeted 77,497 children aged 3-59 months. Starting in August 2014, SMC was delivered by fixed point distribution in villages with the first dose observed each month. Treatment consisted of sulfadoxine-pyrimethamine and amodiaquine once a month for four consecutive months, or rounds. Economic and financial costs were collected from the provider perspective using an ingredients approach. Effectiveness estimates were based upon a published mathematical transmission model calibrated to local epidemiology, rainfall patterns and scale-up of interventions. Incremental cost effectiveness ratios were calculated for the cost per malaria episode averted, cost per disability adjusted life years (DALYs) averted, and cost per death averted. RESULTS: The total economic cost of the intervention in the district of Kita was US $357,494. Drug costs and personnel costs accounted for 34% and 31%, respectively. Incentives (payment other than salary for efforts beyond routine activities) accounted for 25% of total implementation costs. Average financial and economic unit costs per child per round were US $0.73 and US $0.86, respectively; total annual financial and economic costs per child receiving SMC were US $2.92 and US $3.43, respectively. Accounting for coverage, the economic cost per child fully adherent (receiving all four rounds) was US $6.38 and US $4.69, if weighted highly adherent, (receiving 3 or 4 rounds of SMC). When costs were combined with modelled effects, the economic cost per malaria episode averted in children was US $4.26 (uncertainty bound 2.83-7.17), US $144 (135-153) per DALY averted and US $ 14,503 (13,604-15,402) per death averted. CONCLUSIONS: When implemented at fixed point distribution through the routine health system in Mali, SMC was highly cost-effective. As in previous SMC implementation studies, financial incentives were a large cost component.


Subject(s)
Amodiaquine/therapeutic use , Antimalarials/therapeutic use , Communicable Disease Control/economics , Cost-Benefit Analysis/statistics & numerical data , Malaria/prevention & control , Pyrimethamine/therapeutic use , Sulfadoxine/therapeutic use , Chemoprevention/economics , Child, Preschool , Drug Combinations , Humans , Infant , Mali , Seasons
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