Impact of the COVID-19 pandemic on cardiovascular mortality and catherization activity during the lockdown in central Germany: an observational study

Abstract Aims During the COVID-19 pandemic, hospital admissions for cardiac care have declined. However, effects on mortality are unclear. Thus, we sought to evaluate the impact of the lockdown period in central Germany on overall and cardiovascular deaths. Simultaneously we looked at catheterization activities in the same region. Methods and results Data from 22 of 24 public health-authorities in central Germany were aggregated during the pandemic related lockdown period and compared to the same time period in 2019. Information on the total number of deaths and causes of death, including cardiovascular mortality, were collected. Additionally, we compared rates of hospitalization (n = 5178) for chronic coronary syndrome (CCS), acute coronary syndrome (ACS), and out of hospital cardiac arrest (OHCA) in 26 hospitals in this area. Data on 5,984 deaths occurring between March 23, 2020 and April 26, 2020 were evaluated. In comparison to the reference non-pandemic period in 2019 (deaths: n = 5832), there was a non-significant increase in all-cause mortality of 2.6% [incidence rate ratio (IRR) 1.03, 95% confidence interval (CI) 0.99–1.06; p = 0.16]. Cardiovascular and cardiac mortality increased significantly by 7.6% (IRR 1.08, 95%-CI 1.01–1.14; p = 0.02) and by 11.8% (IRR 1.12, 95%-CI 1.05–1.19; p < 0.001), respectively. During the same period, our data revealed a drop in cardiac catherization procedures. Conclusion During the COVID-19-related lockdown a significant increase in cardiovascular mortality was observed in central Germany, whereas catherization activities were reduced. The mechanisms underlying both of these observations should be investigated further in order to better understand the effects of a pandemic-related lockdown and social-distancing restrictions on cardiovascular care and mortality. Graphic abstract

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Decline in hospitalization for all medical conditions during the COVID-19 pandemic

Romanian Journal of Orthopaedic Surgery and Traumatology ◽

10.2478/rojost-2020-0016 ◽

2020 ◽

Vol 3 (2) ◽

pp. 103-110

Author(s):

Alin Cristinel Cotigă ◽

Claudiu Ivan ◽

Silvia Nica ◽

Mirela Zivari

Keyword(s):

Hospital Admissions ◽

Hospitalization Rate ◽

Medical Emergency ◽

Medical Services ◽

Emergency Hospital ◽

Admission Rates ◽

Health Authorities ◽

Public Health Authorities ◽

The University ◽

The Impact

AbstractIntroduction: Hospital admissions fell dramatically in Romania during the COVID-19 pandemic partially due to urgent legislation for controlling the infection rates that influenced the selection criteria for hospitalization and also due to fear of infection with SARS-CoV-2 which resulted in avoiding medical services.Aim: This study aimed to assess the impact of COVID-19 pandemic on the population availability to access medical services by comparing the admission rates for all departments of the University Emergency Hospital, Bucharest, from March to August 2019 and March to August 2020.Methods: A cohort of 38.730 patients was analyzed according to hospitalization rate from March to August 2019 and March to August 2020.Results: From March to August 2020 patients were hospitalized as a result of a medical emergency rather than an appointment, as outpatient and hospitalization rates changed dramatically. Thus, 67.4% accessed hospitalization from March to August 2019 and 32.6% accessed hospitalization from March to August 2020. The proportion of the patients admitted from the Ambulatory Care Unit decreased significantly from 44.2% in 2019 to 32.7% in 2020. Also, the structure of the patients’ profile has been affected.Discussion: The COVID-19 pandemic period in 2020 (March-September) affected the hospitalization rate and the structure of the patients’ profile that came to the University Emergency Hospital in Bucharest, Romania.Conclusion: The patients who would have accessed the medical health services that might have resulted in hospitalization could have resulted in out-of-hospital deaths and this should also be the focus of the public health authorities.

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XarxaSalut, network of municipalities for health, Valencia Region (Spain): policy process evaluation

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.235 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

R Peiró Pérez ◽

E Pérez Sanz ◽

E Legaz Sanchez ◽

J Quiles Izquierdo ◽

Grupo XarxaSalut

Keyword(s):

Process Evaluation ◽

Citizen Participation ◽

Policy Process ◽

Local Level ◽

Common Language ◽

Health Authorities ◽

Open Questions ◽

Economic Support ◽

Public Health Authorities ◽

The Impact

Abstract “XarxaSalut” started in 2017, with the municipalities that have taken the commitment to boost the Promotion of Health (HP) at the local level through community participation, intersectorality and equity perspective. The objective is to present a policy process evaluation (2'5 years) of the implementation of XarxaSalut. Different approaches have been used; a questionnaire addressed to the municipalities at the time of adhesion including data on intersectorality, participation, HP actions and open questions; description of instruments that Regional Public Health Authorities (RPHA) has mobilized and an analysis of barriers and strengths made by the coordination office. In 2017, 17 municipalities were joined, being 197 in February 2020 (70% of the population). 65% are in a process of an organizational change through the intersectoral, decision making and participative working group. 35% are doing analysis of determinants and /or health situation, assets maps and a prioritization of HP actions. The main barriers identified by municipalities are lack of economic and personal resources, and difficulties in achieve citizen participation. The main benefits were the optimization of resources, the exchange of experiences, training, or economic support from the RPHA. Some support instruments develop for RPHA are a collection of guides for community development, funds that the municipalities can apply to support actions related with training, HP action on vulnerable population, on asset maps, participation processes, vulnerable neighborhoods, etc.; Community actions have been included in the “Health Observatory” to give visibility and social support to XarxaSalut. Interdisciplinary training processes with health and municipal professionals have been made in order to develop a common language and strength the competences for HP. Lesson learned: The need to improve coordination and a common language between different types of participants and professionals Key messages The decision makers and professionals in the municipalities understand the impact in health of the policies developed at local level but needs guide and support to deal with it. The coordination between different administrations and primary health at local level and the misunderstandings about health and their determinants are the main aspect to reinforce.

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The Impact of Covid-19 Public Health Policies on Persons with Disability and their Caregivers in Malta

International Journal of Social Science Research and Review ◽

10.47814/ijssrr.v4i2.88 ◽

2021 ◽

Vol 4 (2) ◽

pp. 25-37

Author(s):

Andrew Camilleri ◽

Samantha Pace Gasan ◽

Andrew Azzopardi

Keyword(s):

Public Health ◽

World Health Organisation ◽

World Health ◽

Persons With Disabilities ◽

Health Authorities ◽

Essential Services ◽

Public Health Authorities ◽

Novel Coronavirus ◽

Restrictive Measures ◽

The Impact

On March 11, 2020, the World Health Organisation (WHO) declared a global health pandemic, due to the spread of a novel coronavirus, later named “Covid-19”. The spread of Covid-19 led to social isolation, distancing and a number of restrictive measures in Malta. The aim of this paper is to analyse the impact of Covid-19 and the subsequent restrictive measures on persons with disability and their caregivers and families in Malta. Using thematic analysis, the study found that a variety of impacts ranging from a sense of isolation, lack of essential services being provided, additional difficulties encountered at the place of work and education and measures that were not sufficiently tailored for persons with disability issued by public health authorities. Underlying the additional difficulties brought about by Covid-19, structural difficulties to access essential services as well as ignorance from policy makers and politicians and the added “vulnerable-ization” of persons with disabilities were found to be highly impacting factors that pervade the experience of persons with disabilities and their caregivers.

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Geospatial Analysis and Mapping Strategies for Fine Grained and Detailed COVID-19 Data With Geographic Information Systems

10.21203/rs.3.rs-273514/v1 ◽

2021 ◽

Author(s):

ÁNGEL MIRAMONTES CARBALLADA ◽

JOSE BALSA-BARREIRO

Keyword(s):

Geographic Location ◽

Social Contact ◽

Temporal Behaviour ◽

Fine Grained ◽

Health Authorities ◽

Public Health Authorities ◽

Spatio Temporal ◽

Media Reports ◽

Predictive Risk ◽

The Impact

Abstract The CoVID-19 pandemic is showing a dramatic impact across the world. To the tragedy of the loss of human lives, we must add the great uncertainty that the new coronavirus is causing to our lives. Governments and public health authorities must be able to respond this emergency by taking the appropriate decisions for minimizing the impact of the virus. In the absence of an immediate solution, governments have concentrated their efforts on adopting non-pharmaceutical interventions for restricting the mobility of people and reducing the social contact. Health authorities are publishing most of data for supporting their interventions and policies. The geographic location of the cases is a vital information with exceptional value for analysing the spatio-temporal behaviour of the virus, doing feasible to anticipate potential outbreaks and to elaborate predictive risk mapping. In fact, a great number of media reports, research papers, and web-browsers have presented the COVID-19 disease spreading by using maps. However, processing and visualization of this sort of data presents some aspects that must be carefully reviewed. Based on our experience with fine-grained and detailed data related to COVID-19 in a Spanish region, we present a bunch of mapping strategies and good practices using geospatial tools. The ultimate goal is create appropriate maps at any spatial scale while avoiding conflicts with data such as those related to patients’ privacy.

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Electronic Sentinel Surveillance of Influenza-like Illness

Applied Clinical Informatics ◽

10.4338/aci-2016-06-ra-0103 ◽

2017 ◽

Vol 26 (01) ◽

pp. 97-107

Author(s):

Mehnaz Adnan ◽

Donald Peterkin ◽

Liza Lopez ◽

Graham Mackereth

Keyword(s):

Information Transfer ◽

National Database ◽

Influenza Like Illness ◽

Electronic Reporting ◽

Health Authorities ◽

Time Period ◽

Public Health Authorities ◽

Manual Methods ◽

User Friendly ◽

Transactional Data

SummaryBackground: Electronic reporting of Influenza-like illness (eILI) from primary care was implemented and evaluated in three general medical practices in New Zealand during May to September 2015.Objective: To measure the uptake of eILI and to identify the system’s strength and limitations. Methods: Analysis of transactional data from the eILI system; comparative study of influenza-like illness cases reported using manual methods and eILI; questionnaire administered to clinical and operational stakeholders.Results: Over the study period 66% of total ILI cases were reported using eILI. Reporting timeliness improved significantly compared to manual reporting with an average of 24 minutes from submission by the clinician to processing in the national database. Users found the system to be user-friendly.Conclusion: eILI assists clinicians to report ILI cases to public health authorities within a stipulated time period and is associated with faster, more reliable and improved information transfer.

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Impact of data accuracy on the evaluation of COVID-19 mitigation policies

Data & Policy ◽

10.1017/dap.2021.25 ◽

2021 ◽

Vol 3 ◽

Author(s):

Michele Starnini ◽

Alberto Aleta ◽

Michele Tizzoni ◽

Yamir Moreno

Keyword(s):

Epidemiological Data ◽

Surveillance Data ◽

Inaccurate Data ◽

Health Authorities ◽

The Social ◽

Containment Measures ◽

Public Health Authorities ◽

Nonpharmaceutical Interventions ◽

The Impact ◽

Extreme Care

Abstract Evaluating the effectiveness of nonpharmaceutical interventions (NPIs) to mitigate the COVID-19 pandemic is crucial to maximize the epidemic containment while minimizing the social and economic impact of these measures. However, this endeavor crucially relies on surveillance data publicly released by health authorities that can hide several limitations. In this article, we quantify the impact of inaccurate data on the estimation of the time-varying reproduction number $ R(t) $ , a pivotal quantity to gauge the variation of the transmissibility originated by the implementation of different NPIs. We focus on Italy and Spain, two European countries among the most severely hit by the COVID-19 pandemic. For these two countries, we highlight several biases of case-based surveillance data and temporal and spatial limitations in the data regarding the implementation of NPIs. We also demonstrate that a nonbiased estimation of $ R(t) $ could have had direct consequences on the decisions taken by the Spanish and Italian governments during the first wave of the pandemic. Our study shows that extreme care should be taken when evaluating intervention policies through publicly available epidemiological data and call for an improvement in the process of COVID-19 data collection, management, storage, and release. Better data policies will allow a more precise evaluation of the effects of containment measures, empowering public health authorities to take more informed decisions.

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The importance of sustained compliance with physical distancing during COVID-19 vaccination rollout

10.21203/rs.3.rs-390037/v1 ◽

2021 ◽

Author(s):

Alexandra Teslya ◽

Ganna Rozhnova ◽

Thi Mui Pham ◽

Daphne van Wees ◽

Hendrik Nunner ◽

...

Keyword(s):

Vaccination Coverage ◽

Vaccine Coverage ◽

Transmission Model ◽

Cumulative Number ◽

Vaccination Rates ◽

Contact Rates ◽

Health Authorities ◽

Public Health Authorities ◽

Vaccination Campaigns ◽

The Impact

Abstract Mass vaccination campaigns against SARS-CoV-2 are under way in many countries with the hope that increasing vaccination coverage will enable reducing current physical distancing measures. Compliance with these measures is waning, while more transmissible virus variants such as B.1.1.7 have emerged. Using SARS-CoV-2 transmission model we investigated the impact of the feedback between compliance, the incidence of infection, and vaccination coverage on the success of a vaccination programme in the population where waning of compliance depends on vaccine coverage. Our results suggest that the combination of fast waning compliance, slow vaccination rates, and more transmissible variants may result in a higher cumulative number of infections than in a situation without vaccination. These adverse effects can be alleviated if vaccinated individuals do not revert to pre-pandemic contact rates, and if non-vaccinated individuals remain compliant with physical distancing measures. Both require convincing, clear and appropriately targeted communication strategies by public health authorities.

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Calidad de vida en un adulto joven insuficiente cardíaco en Manta

Revista Científica Sinapsis ◽

10.37117/s.v1i12.133 ◽

2018 ◽

Vol 1 (12) ◽

Author(s):

Yadira Flores ◽

Karina Ortiz

Keyword(s):

Heart Failure ◽

Structural Damage ◽

Hospital Admissions ◽

Health Sector ◽

Clinical History ◽

Functional Class ◽

Coronary Syndrome ◽

Calidad De Vida ◽

Insuficiencia Cardiaca ◽

The Impact

El problema identificado por las autoras es la insuficiencia cardíaca de origen isquémico-necrótico, que es más frecuente en la actualidad en adultos jóvenes en pleno desenvolvimiento de su existencia, afectando todos los aspectos de calidad de vida, desde el punto de vista de la enfermedad, y sus afectaciones a nivel psicológico y social. El objetivo fue evaluar los tratamientos efectivos, aspectos físicos, psíquicos, sociales y económicos que influyen en un paciente adulto joven con insuficiencia cardiaca. La metodología utilizada fue el estudio de caso, se tomó como referencia la historia clínica de un paciente que inició tempranamente con síndrome coronario agudo, consecuentemente presentó deterioro de su función cardíaca y a pesar de los tratamientos asignados, ha incurrido en la progresión del daño estructural y funcional del miocardio. Se utilizó como instrumento la historia clínica y exámenes complementarios. Los resultados no fueron los mejores, porque continuó la evolución natural de la enfermedad, pese al tratamiento instaurado por el impacto de diversos factores. Se concluyó que la atención de una patología tan compleja como la insuficiencia cardiaca en un hombre que inicio su enfermedad a los 40 años de edad, que tiene en la actualidad cinco décadas de vida, debió ser integral desde sus inicios, con la incorporación a equipos multidisciplinarios en el sector salud. Lo que incentiva a recomendar significativos ajustes en las políticas de salud, para tratar a estos grupos de pacientes que constituyen motivo de ingresos hospitalarios frecuentes en las casas de salud. Palabras clave: Atención integral de salud, aspectos psicológicos, aspectos socioeconómicos, sexualidad, clase funcional. Abstratc o sumary The problem identified by the authors is heart failure of ischemic-necrotic origin, which is currently more frequent in young adults who are in full development of their existence, affecting all aspects of their quality of life, from the point of view of view of the disease, and its effects at the psychological and social level. The objective was to evaluate the effective treatments, physical, psychic, social and economic aspects that influence a young adult patient with heart failure. The methodology used was the case study, the clinical history of a patient who started early with acute coronary syndrome was taken as a reference, consequently he presented deterioration of his cardiac function and despite the assigned treatments, he has incurred in the progression of the structural damage and functional myocardium The clinical history, complementary tests were used as an instrument. The results were not the best, because the natural evolution of the disease continued, despite the treatment established by the impact of various factors. It was concluded that the treatment of a pathology as complex as heart failure in a man who started his illness at 40 years of age and who currently has five decades of life, should have been comprehensive since its inception, with his incorporation into teams multidisciplinary in the health sector. This encourages us to recommend better adjustments in the health policies that are involved in treating these groups of patients that are a reason for frequent hospital admissions in health centers. Keys Words: Comprehensive health care, psychological aspects, socioeconomic aspects, sexuality, functional class. PARTICIPACIÓN EN LA PUBLICACIÓN: Autor: Yadira Flores, Cardiólogo. Co – Autores: Karina Ortiz, Cardiólogo.

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Examining trends in gun violence injuries before and during the COVID-19 pandemic across six trauma centers

Trauma Surgery & Acute Care Open ◽

10.1136/tsaco-2021-000801 ◽

2022 ◽

Vol 7 (1) ◽

pp. e000801

Author(s):

Constance McGraw ◽

Stephanie Jarvis ◽

Matthew Carrick ◽

Mark Lieser ◽

Robert M Madayag ◽

...

Keyword(s):

Mental Illness ◽

Substance Use ◽

Trauma Centers ◽

National Guidelines ◽

Level Of Evidence ◽

Health Authorities ◽

Public Health Authorities ◽

Level I ◽

The Impact ◽

At Home

ObjectivesThe onset of the national stay-at-home orders accompanied by a surge in firearm sales has elevated the concerns of clinicians and public health authorities. The purpose of this study was to examine the impact of the stay-at-home orders among gunshot wound (GSW) trauma admissions.MethodsThis was a retrospective cohort study at six level I trauma centers across four states. Patients admitted after the onset of COVID-19 restrictions (March 16, 2020–June 30, 2020) were compared with those admitted during the same period in 2019. We compared (1) rate of patients with GSW and (2) characteristics of patients with GSW, by period using Χ2 tests or Fisher’s exact tests, as appropriate.ResultsThere were 6996 trauma admissions across the study period; 3707 (53%) in 2019 and 3289 (47%) in 2020. From 2019 to 2020, there was a significant increase in GSW admissions (4% vs. 6%, p=0.001); 4 weeks specifically had significant increases (March 16–March 23: 4%, April 1–April 8: 5%, April 9–April 16: 6%, and May 11–May 18: 5%). Of the 334 GSWs, there were significant increases in patients with mental illness (5% vs. 11%, p=0.03), alcohol use disorder (2% vs. 10%, p=0.003), substance use disorder (11% vs. 25%, p=0.001), and a significant decrease in mortality (14% vs. 7%, p=0.03) in 2020. No other significant differences between time periods were identified.ConclusionOur data suggest that trauma centers admitted significantly more patients with GSW following the national guidelines, including an increase in those with mental illness and substance use-related disorders. This could be attributable to the stay-at-home orders.Level of evidenceLevel III, retrospective study.

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Covid-19-induced fear in infoveillance studies: a meta-analysis (Preprint)

10.2196/preprints.21156 ◽

2020 ◽

Author(s):

Styliani Geronikolou ◽

George Chrousos

Keyword(s):

Social Media ◽

Meta Analysis ◽

World Health ◽

Forest Plot ◽

Health Authorities ◽

Prophylactic Measures ◽

The Social ◽

Public Health Authorities ◽

Health Organization ◽

The Impact

UNSTRUCTURED The World Health Organization named the phenomenon of misinformation spread through the social media “infodemics”, and recognized the need to curb it. Misinformation infodemics undermine not only population safety, but also compliance to the suggestions/prophylactic measures recommended in pandemics. The aim of this study was to review the impact of social media on general population fear in “infoveillance” studies during the COVID-19 pandemic. PRISMA protocol was followed and six out of twenty studies were retrieved, meta-analyzed, and had their findings presented in the form of a Forest plot. The summary random and significant event rate was 0.298, 95% CI respectively 0.213 and 0.400, suggesting that social media-circulated misinformation related to COVID-19 triggered public fear and other manifestations. These findings merit special attention by public health authorities. Thus, “infodemiology” and Infoveillance are valid tools in the hands of epidemiologists to help prevent dissemination of false information, with potentially damaging effects.

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