scholarly journals Public Health Lessons Learned From Biases in Coronavirus Mortality Overestimation

2020 ◽  
Vol 14 (3) ◽  
pp. 364-371
Author(s):  
Ronald B. Brown
Keyword(s):  
Public Health ◽  
Influenza Infection ◽  
Case Fatality ◽  
Lessons Learned ◽  
World Health ◽  
Mitigation Measures ◽  
Fatality Rate ◽  
Health Campaigns ◽  
Mortality Estimation ◽  
Novel Coronavirus

ABSTRACTIn testimony before US Congress on March 11, 2020, members of the House Oversight and Reform Committee were informed that estimated mortality for the novel coronavirus was 10-times higher than for seasonal influenza. Additional evidence, however, suggests the validity of this estimation could benefit from vetting for biases and miscalculations. The main objective of this article is to critically appraise the coronavirus mortality estimation presented to Congress. Informational texts from the World Health Organization and the Centers for Disease Control and Prevention are compared with coronavirus mortality calculations in Congressional testimony. Results of this critical appraisal reveal information bias and selection bias in coronavirus mortality overestimation, most likely caused by misclassifying an influenza infection fatality rate as a case fatality rate. Public health lessons learned for future infectious disease pandemics include: safeguarding against research biases that may underestimate or overestimate an associated risk of disease and mortality; reassessing the ethics of fear-based public health campaigns; and providing full public disclosure of adverse effects from severe mitigation measures to contain viral transmission.

An in-depth analysis of 10 epidemiological terminologies used in the context of COVID-19

2021 ◽  
pp. 140349482110577
Author(s):  
Sathyanarayanan Doraiswamy ◽  
Ravinder Mamtani ◽  
Sohaila Cheema
Keyword(s):  
Public Health ◽  
Herd Immunity ◽  
Case Fatality ◽  
Lessons Learned ◽  
Public Health Approach ◽  
Fatality Rate ◽  
Public Health Emergencies ◽  
Depth Analysis ◽  
Novel Coronavirus ◽  
Epidemiology And Public Health

Aim: In this paper, we explore the contextual use of 10 epidemiological terminologies, their significance, and interpretation/misinterpretation in explaining various aspects of the 2019 novel coronavirus disease (COVID-19) pandemic. Methods and Results: We first establish the different purposes of the terms ‘pandemic’ and ‘Public Health Emergency of International Concern.’ We then discuss the confusion caused by using the ‘case fatality rate’ as opposed to ‘infection fatality rate’ during the pandemic and the uncertainty surrounding the limited usefulness of identifying someone as ‘pre-symptomatic.’ We highlight the ambiguity in the ‘positivity rate’ and the need to be able to generate data on ‘excess mortality’ during public health emergencies. We discuss the relevance of ‘association and causation’ in the context of the facemask controversy that existed at the start of the pandemic. We point out how the accepted epidemiological practice of discussing ‘herd immunity’ in the context of vaccines has been twisted to suit the political motive of a public health approach. Given that a high proportion of COVID-19 cases are asymptomatic, we go on to show how COVID-19 has blurred the lines between ‘screening/diagnosis’ and ‘quarantine/isolation,’ while giving birth to the new terminology of ‘community quarantine.’ Conclusions: Applying the lessons learned from COVID-19 to better understand the above terminologies will help health professionals communicate effectively, strengthen the scientific agenda of epidemiology and public health, and support and manage future outbreaks efficiently.

scholarly journals Lessons learned from China’s mitigation strategies in fighting COVID-19

2021 ◽  
Vol 292 ◽  
pp. 03088
Author(s):  
Sijiang Liu ◽  
Mingyuan Wan
Keyword(s):  
Public Health ◽  
Risk Mitigation ◽  
Arctic Region ◽  
Lessons Learned ◽  
Mitigation Strategies ◽  
World Health ◽  
Mitigation Measures ◽  
The Arctic ◽  
Health Complications ◽  
Health Organization

In late 2019, the first SARS-CoV-2 case was reported in Wuhan, China. It has been known as a deadly virus that could cause many severe health complications, particularly respiratory illnesses. With its extraordinary ability to transmit between humans, the coronavirus disease 2019 (COVID-19) has spread worldwide, including Antarctica and the Arctic region. On 11th March 2020, the World Health Organization (WHO) declared the COVID-19 as a public health emergency worldwide (global pandemic) to raise global awareness of the dangerous virus. With immediate and efficient public health interventions, progress has been seen in many countries such as China and New Zealand. Therefore, in this review, we summarized the important public health risk mitigation measures applied in China.

scholarly journals Excess Mortality from COVID-19: Lessons Learned from the Italian Experience

2020 ◽  
Author(s):  
Paolo Pasquariello ◽  
Saverio Stranges
Keyword(s):  
Public Health ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
Lessons Learned ◽  
Fatality Rate ◽  
Lombardy Region ◽  
Italian Experience ◽  
Health Authorities ◽  
Public Health Authorities

There is much discussion among clinicians, epidemiologists, and public health experts about why case fatality rate from COVID-19 in Italy (at 13.3% as of April 20, 2020, versus a global case fatality rate of 6.9%) is considerably higher than estimates from other countries (especially China, South Korea, and Germany). In this article, we propose several potential explanations for these differences. We suggest that Italy’s overall and relative case fatality rate, as reported by public health authorities, is likely to be inflated by such factors as heterogeneous reporting of coronavirus-related fatalities across countries and the iceberg effect of under-testing, yielding a distorted view of the global severity of the COVID-19 pandemic. We also acknowledge that deaths from COVID-19 in Italy are still likely to be higher than in other equally affected nations due to its unique demographic and socio-economic profile. Lastly, we discuss the important role of the stress imparted by the epidemic on the Italian healthcare system, which weakened its capacity to adequately respond to the sudden influx of COVID-19 patients in the most affected areas of the country, especially in the Lombardy region.

scholarly journals Analysis of Covid - 19 Situations in Davanagere District, Karnataka

2021 ◽  
Vol 2 (4) ◽  
pp. 01-08
Author(s):  
Gouri Sakre ◽  
Gulappa Devagappanavar
Keyword(s):  
Attack Rate ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
Secondary Data ◽  
World Health ◽  
Severe Illness ◽  
Fatality Rate ◽  
First Case ◽  
Increased Risk ◽  
Novel Coronavirus

Background: According to CDC, Coronavirus disease 2019 (COVID-19) is caused by a new coronavirus which was first identified in Wuhan, China, in December 2019. Although most people who have COVID-19 have mild symptoms, it can also cause severe illness and even death. Some groups, including older adults and people who have certain underlying medical conditions, are at increased risk of severe illness. On February 11, 2020, the World Health Organization announced an official name for the disease that is causing the 2019 novel coronavirus outbreak. The new name of this disease is coronavirus disease 2019, abbreviated as COVID-19. Objectives: Analysis of COVID 19 data in the Davanagere district from April 2020 to August 2020. Methods: In this current study the secondary data is obtained from the Official Website of Government of Karnataka, Covid-19 Informational Portal – Media Bulletin. By using different indicators Davanagere district covid data is further used to calculate Attack rate, Case fatality rate and complete case fatality rate. Results: In this study it is found that, in the month of April there were no covid positive cases reported till fourth week of month, by fourth week, total two positive cases were reported the first case being encountered on 28th April 2020, with discharge of those patient in the end of the month. The attack rate has steeped up from 8.018 to 355.74 per one lakh population i.e. about 44 times more than initial months of pandemic. The strict preventive measures were followed by public and government too. So the prevalence rate is less in May, June and went on increasing once the unlocking is done. In summer the total positive cases steeping up from 2 cases to 154 total positive cases for the month April to May, and there is steady in rise of total positive cases for the month June with total positive cases of 153. In the beginning of summer there were fewer cases as pandemic was just begun and chances of transmission were very less. As monsoon appeared in June last week there is surge in total positive cases. With added burden of Unlock 1.0 phase, as public started moving out from home without any freak of infection. Conclusion: In this study it is found that due to strict nationwide lockdown and social distancing, hygiene practices among the Davanagere people has made it possible to restrict the spread of covid among the people, although the international immigration of Davanagere residents lead to transmission of infection. Further removal of lockdown after three months has lead to three fold spread of disease. Also there is rise in death rate, attack rate and case fatality in Davanagere district.

scholarly journals Epidemia do novo coronavírus (COVID-19): análise dos indicadores nos três primeiros meses, Estado de São Paulo, Brasil

2020 ◽  
Vol 9 (4) ◽  
Author(s):  
Roudom Ferreira Moura ◽  
Ana Paula Miranda Mundim-Pombo ◽  
Rosângela Elaine Minéo Biagolini ◽  
Janessa de Fátima Morgado de Oliveira
Keyword(s):  
Public Health ◽  
Case Fatality ◽  
Sao Paulo ◽  
World Health ◽  
Health Concern ◽  
Current Status ◽  
São Paulo ◽  
America Latina ◽  
Novel Coronavirus ◽  
Health Organization

Introdução: O Estado de São Paulo foi a Unidade da Federação onde ocorreu a notificação do primeiro caso de COVID-19 no Brasil e América Latina,apresentando indicadores de saúde alarmantes e boa parte dos municípios afetados. Objetivo: Analisar os indicadores de saúde do Novo Coronavírus (COVID-19) no Estado de São Paulo (ESP) nos três primeiros meses da epidemia a partir da confirmação do primeiro caso. Material e método: Estudo ecológico, descritivo, considerando os casos confirmados de COVID-19 captados pelo Centro de Vigilância Epidemiológica do ESP para o período de 26 de fevereiro a 26 de maio de 2020. Resultados: Houve crescimento do número de municípios (35, 284 e 510), casos confirmados (1.015, 20.652 e 85.459), óbitos (57, 1.700 e 6.423), coeficientes de incidência (2,21; 44,97 e 186,11 para cada 100.000 habitantes) e mortalidade (0,12; 3,70 e 13,99 para cada 100.000 habitantes) - respectivamente, março, abril e maio. Observou-se declínio do coeficiente de letalidade no terceiro mês comparado ao segundo (respectivamente, 8,23 e 7,52 para cada 100 casos). Conclusão: A magnitude do COVID-19 extrapola os indicadores mundiais em algumas localidades do Estado de São Paulo.Descritores: Infecções por Coronavírus; Pandemias; Epidemiologia Descritiva; Estudos Ecológicos.ReferênciasTan W, Zhao X, Ma X, Wang W, Niu P, Xu W et al. A Novel Coronavirus Genome Identified in a Cluster of Pneumonia Cases — Wuhan, China 2019−2020. China CDC Weekly, 2020;2(4):61-2.Rafael RDMR, Neto M, Carvalho MMB de, David HMSL, Acioli S, Faria MG de A. Epidemiologia, políticas públicas e pandemia de Covid-19: o que esperar no Brasil? Rev enferm UERJ. 2020;28:e49570.Wang C, Horby PW, Hayden FG, Gao GF. A novel coronavirus outbreak of global health concern [published correction appears in Lancet. 2020. Lancet. 2020;395(10223):470-73.Di Gennaro F, Pizzol D, Marotta C, Antunes M, Racalbuto V, Veronese N et al.  Coronavirus Diseases (COVID-19) Current Status and Future Perspectives: A Narrative Review. Int J Environ Res Public Health. 2020;17(8):2690.World Health Organization. Coronavirus disease (COVID-19). Coronavirus disease (COVID-2019) Situation Report - 117. World Heal Organ [Internet]. 2020;8(1):3–8. Available at: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200516-covid-19-sitrep-117.pdf?sfvrsn=8f562cc_World Health Organization. Coronavirus disease (COVID-19). Coronavirus disease (COVID-19) Situation Report 138. 2020;(June). Available at: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200606-covid-19-sitrep-138.pdf?sfvrsn=c8abfb17_4BRASIL. Ministério da Saúde S de V em S. Boletim Epidemiológico Especial COE COVID-19. Bol Epidemiológico Espec COE-COVID19 [Internet]. 2020; Available at: https://www.saude.gov.br/images/pdf/2020/May/29/2020-05-25---BEE17---Boletim-do-COE.pdf.The Lancet. COVID-19 in Brazil: "So what?". Lancet. 2020;395(10235):1461.Rodriguez-Morales AJ, Gallego V, Escalera-Antezana JP, Mendez CA, Zambrano LI, Franco-Paredes  et. al.  COVID-19 in Latin America: The implications of the first confirmed case in Brazil. Travel Med Infect Dis. 2020;35:101613.Governo do Estado de São Paulo10 - Secretaria de Estado da Saúde - Coordenadoria de Controle de Doenças - Centro de Vigilância Epidemiológica “Prof. Alexandre Vranjac” – Novo Coronavírus (COVID-19) - Situação Epidemiológica 26 de fevereiro a 26 de maio de 2020, disponíveis em: http://www.saude.sp.gov.br/cve-centro-de-vigilancia-epidemiologica-prof.-alexandre-vranjac/areas-de-vigilancia/doencas-de-transmissao-respiratoria/coronavirus-covid-19/situacao-epidemiologicaIBGE. Instituto Brasileiro de Geografia e Estatística. Brasil. São Paulo. Arandu. Disponível em: https://cidades.ibge.gov.br/brasil/sp/arandu/pesquisa/37/30255Castro Delgado R, Arcos González P. Analyzing the health system's capacity to respond to epidemics: a key element in planning for emergencies. El análisis de la capacidad de respuesta sanitaria como elemento clave en la planificación ante emergencias epidémicas. Emergencias. 2020;32(3):157-59.World-o-Meter. Disponível em: https://www.worldometers.info/coronavirus/. Acesso em: 14 de maio de 2020.Ren H, Zhao L, Zhang A, Song L, Liao Y, Lu W et al. Early forecasting of the potential risk zones of COVID-19 in China's megacities. Sci Total Environ. 2020;729:138995.Morgenstern H. Ecologic studies in epidemiology: concepts, principles, and methods. Annu Rev Public Health. 1995;16:61-81. Organização Pan-americana de Saúde. REDE Interagencial de Informação para a Saúde – RIPSA. Indicadores Básicos para a Saúde no Brasil: conceitos e aplicações. 2. ed. – Brasília: Organização Pan-Americana da Saúde, 2008. p. 144. Disponível em: http://tabnet.datasus.gov.br/tabdata/livroidb/2ed/CapituloC.pdfMedeiros de Figueiredo A, Daponte A, Moreira Marculino de Figueiredo DC, Gil-García E, Kalache A. Letalidad del COVID-19: ausencia de patrón epidemiológico [Case fatality rate of COVID-19: absence of epidemiological pattern] Gac Sanit. 2020;S0213-9111(20)30084-4.SEADE – Fundação Sistema Estadual de Análise de Dados. Perfil dos Municípios Paulistas. Disponível em: https://perfil.seade.gov.br/. Acessado em: 10/06/2020.Governo de São Paulo. SP Contra o Novo Coronavírus. Adesão ao Isolamento Social em São Paulo. Disponível em: https://www.saopaulo.sp.gov.br/coronavirus/isolamento/. Acessado em 10/06/2020.

An App for Understanding the Case Fatality Rate of Novel Coronavirus (COVID -19): Observation Study (Preprint)

2020 ◽  
Author(s):  
Tsair-Wei Chien ◽  
Wei-Chih Kan ◽  
Yu-Tsen Yeh ◽  
Shu-Chun Kuo
Keyword(s):  
Death Rate ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
Daily Basis ◽  
World Health ◽  
Fatality Rate ◽  
Observation Study ◽  
The Mean ◽  
Novel Coronavirus ◽  
Health Organization

BACKGROUND When a new disease starts to spread, one of the commonly asked questions is (1) how deadly it is. World Health Organization (WHO) announced in a press conference on January 29th, 2020 and reported the death rate of COVID-19 was 2% on the case fatality rate(CFR). Whether the claim was underestimated is worthy of clarifications when considering the lag days from symptom onset to death. OBJECTIVE We developed an app for online displaying three types of computations of CFR and verifying the death rate of 2% substantially underestimated. METHODS We downloaded COVID-19 outbreak numbers from January 21 to February 25, 2020, in countries/regions on a daily basis from Github that contains daily information on confirmed cases, deaths, and the recovered in more than 30 Chinese locations and other worldwide countries/regions. Three CFRs on COVID-19 were compared, including (A) deaths/confirmed;(B) deaths/(deaths+recovered); and (C) deaths/(cases x days ago). The coefficients of variance (CV=the ratio of the standard deviation to the mean) were applied to measure the relative variability for each CFR. A dashboard was developed for daily display of the CFR on COVID-19 for each region. RESULTS We observed that the CVs were 0.07, 9.23, and 5.08 and the CFRs were 3.37%, 8.85%, and 3.58% for these three CFR computations, respectively, on Feb. 25, 2020. The death rate of COVID-19(=2%) announced by WHO using the formula of deaths/confirmed was substantially underestimated. A dashboard was created to present the provisional CFRs of COVID-19 on a daily basis. CONCLUSIONS We suggest examining these three CFRs as a reference to the final CFR. An app developed for displaying the provisional CFR with these three CFRs can modify the underestimated CFR reported by WHO and media. CLINICALTRIAL Not available

scholarly journals Excess Mortality from COVID-19: Lessons Learned from the Italian Experience

2020 ◽  
Author(s):  
Paolo Pasquariello ◽  
Saverio Stranges
Keyword(s):  
Public Health ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
Lessons Learned ◽  
Fatality Rate ◽  
Lombardy Region ◽  
Italian Experience ◽  
Health Authorities ◽  
Public Health Authorities

There is much discussion among clinicians, epidemiologists, and public health experts about why case fatality rate from COVID-19 in Italy (at 12.1% as of April 2, 2020, versus a global case fatality rate of 5.2%) is considerably higher than estimates from other countries (especially China, South Korea, and Germany). In this article, we propose several potential explanations for these differences. We suggest that Italy’s overall and relative case fatality rate, as reported by public health authorities, is likely to be inflated by such factors as heterogeneous reporting of coronavirus-related fatalities across countries and the iceberg effect of under-testing, yielding a distorted view of the global severity of the COVID-19 pandemic. We also acknowledge that deaths from COVID-19 in Italy are still likely to be higher than in other equally affected nations due to its unique demographic and socio-economic profile. Lastly, we discuss the important role of the stress imparted by the epidemic on the Italian healthcare system, which weakened its capacity to adequately respond to the sudden influx of COVID-19 patients in the most affected areas of the country, especially in the Lombardy region.

scholarly journals Effects of Air Temperature on COVID-19 Case Fatality Rate

2021 ◽  
Vol 15 (1) ◽  
pp. 53-63
Author(s):  
Anna Sączewska-Piotrowska ◽  
Damian Piotrowski
Keyword(s):  
Air Temperature ◽  
Case Fatality Rate ◽  
Proportional Hazards ◽  
Meta Analysis ◽  
Case Fatality ◽  
Cox Proportional Hazards ◽  
World Health ◽  
Fatality Rate ◽  
First Case ◽  
Novel Coronavirus

The aim of this study was to assess the case fatality rate (CFR) of COVID-19 by performing a meta-analysis according to the air temperature and to determine if the temperature modifies the pandemic duration to the peak day for CFR of the COVID-19. A novel coronavirus spread began in December 2019 in Wuhan, China, and half a year after, more than 9 million total cases were confirmed worldwide. Therefore, knowing the conditions favorable for the spread of the virus (including weather conditions) is crucial from the perspective of the entire population. Using information from the World Health Organization, subgroup meta-analysis by temperature was performed. Survival analysis using the Kaplan-Meier estimates and the Cox proportional hazards models was conducted. Based on the conducted analysis we can conclude that in countries with temperature equal or lower than 14.8°C the pooled CFR of COVID-19 is higher than in countries with tempera ture greater than 14.8°C. Besides, in countries with lower temperature the peak of the CFR appears after a longer time from the first case of the novel coronavirus than in countries with higher temperature.

A Serious Public Health Concern for India due to Newly Discovered Virus (COVID-19): Early Detection of all Possible Cases is the Only Way to Combat

2020 ◽  
Author(s):  
Vijay Kumar Mishra
Keyword(s):  
Public Health ◽  
Surveillance System ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
Public Health Problem ◽  
World Health ◽  
Health Concern ◽  
Family Welfare ◽  
Fatality Rate ◽  
Monitoring And Surveillance

Background: It is well known that India is having a massive population (around 130 crores) after China. So, it's more likely to be similar or more positive cases of corona among Indians. However, we are following the ways of social distancing and all possible ways to weaken the corona outbreak. But, India needs a good monitoring and surveillance system to tackle this problem otherwise it may become a serious public health problem. Objectives: This study has done to understand the severity of corona in India and its states and to device a tool based on symptoms suggested by the World Health Organization on the corona. Methods: We have utilized data extracted through the Ministry of Health & Family Welfare, GoI from 30th Jan to 26th March 2020. We have estimated the case fatality rate and cured rate to understand the severity of the newly discovered virus (COVID-19). Results: Out of 694 confirmed corona cases, 47 were foreigners and 647 Indians. Our study found that the case fatality rate due to COVID-19 was 23.1 per 1000 persons in India while the people who were still hospitalized under isolation wards were about 91 percent. The cure rate was estimated at around 64.8 per 1000 persons. Conclusions: Looking at the recovery rate, we may think about the severity of corona among Indians. We can reduce the chances of rapidly increasing corona cases through good monitoring and surveillance system. It is recommended that Government should not only focus on testing the passengers arriving at the airport but also test as much as possible cases based on the symptoms of corona in all the districts so that an actual number of cases can be estimated.

scholarly journals Characteristics of and Public Health Responses to the Coronavirus Disease 2019 Outbreak in China

2020 ◽  
Vol 9 (2) ◽  
pp. 575 ◽  
Author(s):  
Sheng-Qun Deng ◽  
Hong-Juan Peng
Keyword(s):  
Public Health ◽  
Case Fatality ◽  
World Health ◽  
Therapeutic Drug ◽  
Chinese Government ◽  
Public Health Response ◽  
Health Response ◽  
Lower Case ◽  
Novel Coronavirus ◽  
Health Organization

In December 2019, cases of unidentified pneumonia with a history of exposure in the Huanan Seafood Market were reported in Wuhan, Hubei Province. A novel coronavirus, SARS-CoV-2, was identified to be accountable for this disease. Human-to-human transmission is confirmed, and this disease (named COVID-19 by World Health Organization (WHO)) spread rapidly around the country and the world. As of 18 February 2020, the number of confirmed cases had reached 75,199 with 2009 fatalities. The COVID-19 resulted in a much lower case-fatality rate (about 2.67%) among the confirmed cases, compared with Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS). Among the symptom composition of the 45 fatality cases collected from the released official reports, the top four are fever, cough, short of breath, and chest tightness/pain. The major comorbidities of the fatality cases include hypertension, diabetes, coronary heart disease, cerebral infarction, and chronic bronchitis. The source of the virus and the pathogenesis of this disease are still unconfirmed. No specific therapeutic drug has been found. The Chinese Government has initiated a level-1 public health response to prevent the spread of the disease. Meanwhile, it is also crucial to speed up the development of vaccines and drugs for treatment, which will enable us to defeat COVID-19 as soon as possible.

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