Cuidado infantil, aislamiento y virtualización educativa durante la pandemia del COVID-19 en la Argentina

La pandemia de COVID-19 iniciada a finales de 2019 tuvo un impacto en la salud colectiva, aunque diferencial en función de la vulneración de derechos básicos de vastos sectores de la población y de las dificultades para el acceso a la atención en salud. Interpeló a los Estados y a las sociedades respecto de los obstáculos y las posibilidades de las políticas sanitarias integrales, las políticas del cuidado y la salud comunitaria. Asimismo, la complejidad socio-sistémica que evidenció la pandemia puso de manifiesto los límites del enfoque biomédico para afrontar la crisis sanitaria y la necesidad de considerar la perspectiva de la determinación social de la salud para la generación de respuestas adecuadas para garantizar los derechos de la población. Dentro de las poblaciones especialmente afectadas se encuentra la población infantil. En Argentina, INDEC determinó que, a fines del 2020, más de la mitad (57,7%) de las personas de 0 a 14 años eran pobres. Asimismo, durante la pandemia se profundizaron las brechas educativas, digitales y nutricionales y la exposición a situaciones de violencia. En este escenario, ante las recomendaciones de diversos organismos acerca del cuidado infantil en el período de cuarentena surgen interrogantes sobre las posibilidades y obstáculos para su desenvolvimiento. (AU)

Evaluating the impact of curfews and other measures on SARS-CoV-2 transmission in French Guiana.

While general lockdowns have proven effective to control SARS-CoV-2 epidemics, they come with enormous costs for society. It is therefore essential to identify control strategies with lower social and economic impact. Here, we report and evaluate the control strategy implemented during a large SARS-CoV-2 epidemic in June-July 2020 in French Guiana that relied on curfews, targeted lockdowns, and other measures. We find that the combination of these interventions coincided with a reduction in the basic reproduction number of SARS-CoV-2 from 1.7 to 1.1, which was sufficient to avoid hospital saturation. We estimate that thanks to the young demographics, the risk of hospitalisation following infection was 0.3 times that of metropolitan France and that about 20% of the population was infected by July. Our model projections are consistent with a recent seroprevalence study. The study showcases how mathematical modelling can be used to support healthcare planning in a context of high uncertainty.

Reduction of roadway noise in a coastal city underwater soundscape during COVID-19 confinement.

Confinement due to the COVID-19 pandemic drastically reduced human activities. Underwater soundscape variations are discussed in this study, comparing a typical and confinement day in a coastal lagoon near a popular tourist city in Mexico. Recording devices were located at 2 m in depth and 430 m away from the main promenade-a two-way avenue for light vehicle traffic-where main tourist infrastructure is located. The nearby marine environment is habitat to birds and dolphins as well as fish and invertebrates of commercial importance. Medium and small boats usually transit the area. The main underwater sound level reduction was measured at low frequencies (10-2000 Hz) because of the decrease in roadway noise. Vessel traffic also decreased by almost three quarters, although the level reduction due to this source was less noticeable. As typical day levels in the roadway noise band can potentially mask fish sounds and affect other low frequency noise-sensitive marine taxa, this study suggests that comprehensive noise analysis in coastal marine environments should consider the contribution from nearby land sources.

[Prediction of end of lockdown post-peak of cases in first wave of the COVID-19 pandemic in Chile]. / Predicción del fin del confinamiento después del máximo de casos en la primera ola de la pandemia COVID-19 en Chile.

INTRODUCTION: The results of mandatory confinement have been detrimental in several respects. Nonetheless, they have resulted in reducing the number of active cases of COVID-19. Chile has begun the de-escalation and needs to know the best time to end the restrictions. OBJECTIVE: We discuss the best conditions and guarantees for the end of compulsory confinement. METHODS: This study is based on a trend model with prediction estimation. The data of the variables of interest were subjected to linear regression studies to determine the curve that best explained the data. The coefficient of determination, the standard deviation of y in x, and the confidence interval of the observed curve were estimated. The trend curve was chosen in accordance with the regression estimates. OUTCOMES: It was found that all dependent variables tended to decrease over time in a quadratic fashion, except for the new cases variable. In general, the R2 and MAPE estimates are satisfactory, except for the variable number of PCR tests per day. CONCLUSIONS: Gradual and cautious steps should be taken before ending mandatory confinement. In the current de-escalator, daily PCR tests should be increased, maintaining vigilance on indicators of incidence, prevalence, and positivity of PCR tests. Evidence suggests with some degree of confidence that mandatory confinement could be safely lifted as of August 30, 2020. Long-term preparations must be made to contain future waves of new cases.

INTRODUCCIÓN: Los resultados del confinamiento obligatorio han sido perjudiciales en varios aspectos. No obstante, han surtido efecto en lograr el descenso de casos activos de COVID-19. Chile ha comenzado la desescalada y precisa conocer el mejor momento para poner fin a las restricciones. OBJETIVOS: Discutir las mejores condiciones y garantías para el fin del confinamiento obligatorio sobre la base de los casos nuevos, casos activos y positividad de exámenes de reacción en cadena de la polimerasa. MÉTODOS: Estudio basado en un modelo de tendencia con estimación de predicciones. Los datos de las variables de interés fueron sometidas a estudios de regresión lineal, con el objeto de determinar la curva que mejor explicaba los datos. Se estimó el coeficiente de determinación, la desviación estándar de y en x y el intervalo de confianza de la curva observada. Posteriormente, fue escogida la curva de tendencia en concordancia con las estimaciones de regresión. RESULTADOS: Se encontró que todas las variables dependientes tendían a disminuir con el tiempo de forma cuadrática, con excepción de la variable casos nuevos. En general, las estimaciones de coeficiente de determinación (R2) y error porcentual absoluto medio son satisfactorias, con excepción de la variable: número de exámenes de reacción en cadena de la polimerasa por día. CONCLUSIONES: Se deben tomar medidas graduales y cautelosas antes de poner fin al confinamiento obligatorio. En la actual desescalada, se deben aumentar los exámenes de reacción en cadena de la polimerasa diarios y mantener vigilancia en los indicadores de incidencia, prevalencia y positividad de dichos exámenes. La evidencia sugiere con cierto grado de confiabilidad que el confinamiento obligatorio podría levantarse de forma segura a contar del día 30 de agosto de 2020. Se deben hacer preparativos a largo plazo en contención de las futuras olas, es decir, una nueva alza de casos nuevos y activos luego del descenso.

Decentralized COVID-19 measures in Brazil were ineffective to protect people with diabetes.

BACKGROUND AND AIMS: COVID-19 severity and mortality are elevated in individuals with diabetes. During the pandemic, interventions recommended globally for people with diabetes were to keep blood glucose on target whilst staying at home to curb the spread of the virus. In Brazil, similar measures were proposed. The aim of our observational study was to assess whether these measures achieved their objectives. METHODS: An anonymous and untraceable survey was shared from April 22nd to May 4th. States with more than 30 respondents were included in the analysis and Fisher's exact test was performed to identify associations, with p < 0.05 considered significant. RESULTS: Type 1 diabetes and female participants were prevalent, 60.76% and 76.12% respectively. 10 out of 26 states were included, in addition to the Federal District (1562 responses). Only in three states (Bahia, Goiás and Pernambuco) less than 50% of the respondents experienced higher glycemia or higher variability during the pandemic. Goiás state, where almost half of the respondents (49.12%) have private insurance, presented the highest percentage of individuals receiving medicines for three months (35.48%) and one of the lowest percentages of blood glucose deterioration (47.17%). In the large states of Minas Gerais, Rio de Janeiro and São Paulo, consultations and/or lab exams were postponed by 37.14%, 34.33% and 40.88%, respectively. CONCLUSIONS: The decentralized measures implemented by states in Brazil left most people with diabetes unprotected. Many were forced to venture outside to collect or to purchase their medical supplies monthly and reported increased glycemic levels and/or variability.

COVID-19 and the social safety net around children and youth at risk of abuse, and youth protection practices

CONTEXT: This document and the findings it sets out were prepared in response to an inquiry from the Ministry of Health and Social Services (MSSS) in the context of the coronavirus (COVID-19) health emergency in Quebec. The aim was to conduct a summary review of the published data and to mobilize key knowledge in order to provide information to policy makers and to health and social service professionals. Since this response had to be provided rapidly, the resultant findings are not based on a comprehensive search of the published data and a systematic assessment of the response quality, or on a highly developed consultation process. During this public health emergency, INESSS is keeping a watchful eye for new data that might warrant an update of this response. METHODOLOGY: Literature Review: Selection criteria: Children and families, with no limits in terms of time or document type. Literature review methods: The scientific documentation and grey literature were briefly reviewed, and a narrative synthesis based on a comprehensive reading of the documents reviewed was produced. The quality assessment of the documents was not performed. Literature search: The Scientific Information Adviser developed a search strategy to identify all documents related to the youth-in-difficulty activity sector as well as to coronavirus and other situations that might raise similar issues (e.g., SARS, Ebola, pandemics, epidemics, health crises, disasters). The goal was to create a master data bank for this sector. The data bank was then searched for answers to the questions of interest discussed in this document. A SUMMARY OF THE LITERATURE CONSULTED: 1. Maintaining the community social safety net around children and youth at risk of abuse. 1.1 Impact of Covid-19 and associated control measures on children, youth and families. According to the literature consulted, the control measures implemented to curb the spread of Covid-19 (e.g., closure of schools, child care centres and daycare centres, travel restrictions) can have a significant negative impact on children, youth and families, weaken the social safety net around children and increase the risks of abuse. Of the negative consequences identified among children, youth and parents, those most often reported relate to the closure of schools, child care centres and daycare centres. 1.2 Conditions conducive to implementing a community social safety net for children and youth at risk of abuse. As noted above, the pandemic context is likely to negatively impact the social safety net for children and youth in Quebec. It therefore seems important to specify the conditions that would be conducive to maintaining or even strengthening this safety net. ADJUSTING ORGANIZATIONAL AND CLINICAL PRACTICES TO ENSURE THE SAFETY OF CHILDREN AND YOUTH: The mission of ensuring the safety and development of children remains a core concern of child protection services. Given their essentiality, all youth services should be maintained during the current COVID-19 pandemic. Children and youth receiving child protection services are considered a vulnerable population because of the abuse they have suffered. Beyond this vulnerability, the pandemic context can significantly limit the ability of youth protection services to provide services to this population. It then becomes especially important for those services responsible for vulnerable children to ensure continuity of their services during this period. Various organizational and clinical practices identified in the literature review can be implemented by the institutions, managers and youth workers to ensure that children receiving youth protection services continue to do so. THESE PRACTICES ARE SUMMARIZED IN THE SECTIONS THAT FOLLOW. IN CASES OF SUPERVISED VISITS: Inform parents if their access rights have been suspended and suggest other means of communication to maintain contact. Encourage and create opportunities to foster regular contact between children and family members from whom they are physically separated because of the pandemic: If the use of video makes the conversation between the child and parent difficult, suggest a game that can be played at a distance to maintain the bond remotely. During supervised in-person visits: ask questions about the health of visitors prior to their visit and ensure compliance with sanitary hygiene measures (e.g., frequent cleaning of supervised visiting rooms). Answer the child's questions and reassure him or her that the situation is temporary.

COVID-19 et filet de sécurité social autour des enfants et des jeunes à risques de subir de mauvais traitements et pratiques de la protection de la jeunesse / COVID-19 and social safety net around children and youth at risk of abuse and youth protection practices

CONTEXTE: Le présent document ainsi que les constats qu'il énonce ont été rédigés en réponse à une interpellation du ministère de la Santé et des Services sociaux dans le contexte de l'urgence sanitaire liée à la maladie à coronavirus (COVID-19) au Québec. L'objectif est de réaliser une recension sommaire des données publiées et de mobiliser les savoirs clés afin d'informer les décideurs publics et les professionnels de la santé et des services sociaux. Vu la nature rapide de cette réponse, les constats qui en découlent ne reposent pas sur une recherche exhaustive des données publiées et une évaluation de sa qualité avec une méthode systématique ou sur un processus de consultation élaboré. Dans les circonstances d'une telle urgence de santé publique, l'INESSS reste à l'affût de toutes nouvelles données susceptibles de lui faire modifier cette réponse rapide. MÉTHODOLOGIE: Revue de la littérature: Critères de sélection: Enfants et familles, sans limite de temps ou de type de document. Méthodes d'examen de la documentation: La documentation scientifique et la littérature grise ont été brièvement passées en revue et une synthèse narrative basée sur une lecture complète des documents examinés a été produite. L'évaluation de la qualité des documents n'a pas été effectuée. Recherche documentaire: le conseiller en information scientifique a élaboré une stratégie de recherche pour identifier tous les documents liés au secteur d'activité des jeunes en difficulté ainsi que les coronavirus et d'autres situations susceptibles de soulever des problèmes similaires (par exemple, SRAS, Ebola, pandémies, épidémies, santé). crises, catastrophes). L'objectif était de créer une banque de données maître pour ce secteur. La banque de données a ensuite été recherchée pour trouver des réponses aux questions d'intérêt abordées dans ce document. UN RÉSUMÉ DE LA LITTÉRATURE CONSULTÉE: 1. Maintenir le filet de sécurité sociale communautaire autour des enfants et des jeunes à risque d'abus. 1.1 Impact de Covid-19 et des mesures de contrôle associées sur les enfants, les jeunes et les familles. Selon la littérature consultée, les mesures de contrôle mises en œuvre pour freiner la propagation de Covid-19 (par exemple, fermeture d'écoles, de garderies et de garderies, restrictions de voyage) peuvent avoir un impact négatif significatif sur les enfants, les jeunes et les familles, affaiblir le filet de sécurité sociale autour des enfants et augmenter les risques d'abus. Parmi les conséquences négatives identifiées chez les enfants, les jeunes et les parents, celles le plus souvent signalées concernent la fermeture des écoles, des crèches et des garderies. 1.2 Conditions propices à la mise en place d'un filet de sécurité sociale communautaire pour les enfants et les jeunes à risque d'abus. Tel que mentionné ci-dessus, le contexte pandémique est susceptible d'avoir un impact négatif sur le filet de sécurité sociale pour les enfants et les jeunes du Québec. Il semble donc important de préciser les conditions qui seraient propices au maintien voire au renforcement de ce filet de sécurité. AJUSTER LES PRATIQUES ORGANISATIONNELLES ET CLINIQUES POUR ASSURER LA SÉCURITÉ DES ENFANTS ET DES JEUNES: La mission d'assurer la sécurité et le développement des enfants reste une préoccupation centrale des services de protection de l'enfance. Étant donné leur caractère essentiel, tous les services aux jeunes devraient être maintenus pendant la pandémie actuelle de COVID-19. Les enfants et les jeunes bénéficiant de services de protection de l'enfance sont considérés comme une population vulnérable en raison des sévices qu'ils ont subis. Au-delà de cette vulnérabilité, le contexte pandémique peut limiter considérablement la capacité des services de protection de la jeunesse à fournir des services à cette population. Il devient alors particulièrement important pour les services chargés des enfants vulnérables d'assurer la continuité de leurs services pendant cette période. Diverses pratiques organisationnelles et cliniques identifiées dans la revue de la littérature peuvent être mises en œuvre par les institutions, les gestionnaires et les animateurs de jeunesse pour garantir que les enfants recevant des services de protection de la jeunesse continuent de le faire. CES PRATIQUES SONT RÉSUMÉES DANS LES SECTIONS SUIVANTES. EN CAS DE VISITES SUPERVISÉES: Informez les parents si leurs droits d'accès ont été suspendus et proposez d'autres moyens de communication pour maintenir le contact. Encouragez et créez des occasions de favoriser des contacts réguliers entre les enfants et les membres de la famille dont ils sont physiquement séparés en raison de la pandémie: si l'utilisation de la vidéo rend la conversation entre l'enfant et les parents difficile, proposez un jeu qui peut être joué à distance pour maintenir le lien à distance. Pendant les visites supervisées en personne: posez des questions sur la santé des visiteurs avant leur visite et assurez-vous du respect des mesures d'hygiène sanitaire (par exemple, nettoyage fréquent des salles de visite surveillées). Répondez aux questions de l'enfant et rassurez-le que la situation est temporaire.

Intervenciones no farmacológicas para la contención, mitigación y supresión de la infección por COVID-19. Sintésis rápida / Non-pharmacological interventions for containment, mitigation and suppression of COVID-19 infection. Rapid Synthesis

La enfermedad respiratoria aguda COVID-19 es la causante de la pandemia que actualmente amenaza la salud de los seres humanos. La infección se ha propagado a 199 paísesy territorios, se han reportado 621.636 casos confirmados de la infección, 28,658 muertes y 135,752 pacientes recuperados. En Colombia, a 28 de marzo, se reportan 539 casos confirmados, seis muertes, 10 recuperados y 523 casos activos. Dada la situación global, en donde algunos países ya están controlando la infección y otros por el contrario están enfrentando situaciones cada vez mas difíciles, es importante identificar y aprender de las experiencias y estrategias que han adoptado otros países. En esta síntesis rápida se incluyeron, la ciudad de Wuhan y los siguientes países: Canadá, Estados Unidos, México Cuba, Colombia, Brasil, Chile, Argentina, Reino Unido, España, Italia, Alemania, Australia, Rusia, China, Japón, Noruega, Corea del Sur, Irán. Todos los países, han implementado diferentes estrategias para controlar la infección del COVID-19. Sin embargo, hay variabilidad en la cantidad y el tipo de intervenciones. Algunos países están enfocados principalmente en establecer restricciones de viajes, aislamiento de los casos identificados y de las personas de alto riesgo. Otros tienen una combinación más intensa de medidas obligatorias de cuarentena para toda la población, cierre de todos los centros educativos,

U.S. county level analysis to determine If social distancing slowed the spread of COVID-19 / Análisis a nivel de condado para determinar si el distanciamiento social ralentizó la propagación de la COVID-19 en los Estados Unidos

ABSTRACT Objective. To analyze the effectiveness of social distancing in the United States (U.S.). Methods. A novel cell-phone ping data was used to quantify the measures of social distancing by all U.S. counties. Results. Using a difference-in-difference approach results show that social distancing has been effective in slowing the spread of COVID-19. Conclusions. As policymakers face the very difficult question of the necessity and effectiveness of social distancing across the U.S., counties where the policies have been imposed have effectively increased social distancing and have seen slowing the spread of COVID-19. These results might help policymakers to make the public understand the risks and benefits of the lockdown.(AU)

RESUMEN Objetivo. Analizar la efectividad del distanciamiento social en los Estados Unidos. Métodos. Se empleó un método novedoso de contacto con teléfonos celulares (ping) para cuantificar las medidas de distanciamiento social de todos los condados de EE.UU. Resultados. Usando un enfoque de diferencia en diferencias los resultados indicaron que el distanciamiento social ha sido efectivo para reducir la propagación de la COVID-19. Conclusiones. A medida que los responsables de la formulación de políticas se enfrentan a la muy difícil cuestión de la necesidad y la eficacia del distanciamiento social en Estados Unidos, los condados en los que se han impuesto las políticas han aumentado efectivamente el distanciamiento social y en ellos se ha enlentecido la propagación de la COVID-19. Estos resultados pueden ayudar a los responsables de las políticas a hacer comprender a la población los riesgos y beneficios de las restricciones.(AU)