scholarly journals Another vision of the situation of the COVID-19 pandemic in Mexico during 2020

Author(s):  
Sergio Isaac De La Cruz Hernández

Abstract The number of coronavirus disease 2019 (COVID-19) cases and deaths registered in Mexico during 2020 could be underestimated, due to the sentinel surveillance adopted in this country. Some consequences of following this type of epidemiological surveillance were the high case fatality rate and the high positivity rate for COVID-19 shown in Mexico in 2020. During this year, the Mexican Ministry of Health only considered cases from the public health system, which followed this sentinel surveillance, but did not consider those cases from the private health system. To better understand this pandemic, it is important to include all the results obtained by all the institutions capable of testing for COVID-19, thus the Mexican Government could make good decisions to protect the population from this disease.

2020 ◽  
Vol 19 (3) ◽  
pp. 2585 ◽  
Author(s):  
O. M. Drapkina ◽  
I. V. Samorodskaya ◽  
M. G. Sivtseva ◽  
E. P. Kakorina ◽  
N. I. Briko ◽  
...  

During epidemics, the usual statistical approaches will not allow determining the readiness of the public health system to take urgent measures to counteract the increase in morbidity, spread and mortality of the population. The quality of the medical, socio-economic and managerial decisions at all levels will depend on the accuracy of statistical data and the possibility of creating adequate prognostic models. However, there are still problems with the identification of COVID-19 cases and the diagnostic accuracy of the methods used. Complex analytical efforts require in order to determine the COVID-19 impact on the health status and case fatality rate/mortality rate.


2005 ◽  
Vol 134 (1) ◽  
pp. 103-110 ◽  
Author(s):  
I. SMITH ◽  
A. T. BJØRNEVIK ◽  
I. M. B. AUGLAND ◽  
A. BERSTAD ◽  
T. WENTZEL-LARSEN ◽  
...  

SUMMARYIn a retrospective epidemiological study, 293 meningococcal disease patients hospitalized during 1985–2002, were examined for fatality and risk factors related to death. The overall case fatality rate (CFR) was 8·2%, but increased from 4% during 1985–1993 to 17% during 1994–2002. The latter 9-year period was characterized by more serogroup C infections and more patients with thrombocytopenia on admission to hospital. All patients categorized as meningitis on admission survived. Of the 24 patients who died, 21 had meningococcal skin rash on admission, 23 had an onset to admission time of ⩽24 h, and 16 had severe septicaemia with hypotension and/or ecchymoses without meningitis on admission. By multivariate analyses, a short onset to admission time, >50 petechiae, thrombocytopenia and severe septicaemia on admission were associated with fatality. More lives could be saved through earlier admission to hospital. This can be achieved through more information to the public about the early signs of meningococcal septicaemia, with the recommendation to look for skin rash in patients with acute fever during the first day and night.


2021 ◽  
Vol 7 (2) ◽  
pp. 196-202
Author(s):  
Morgana Thaís Carollo Fernandes ◽  
Luciana Medeiros Paungartner ◽  
Roger Dos Santos Rosa

Resumo A bronquiolite aguda é uma doença caracterizada por inflamação aguda dos bronquíolos e aumento da produção e da secreção de muco que pode estar associada a broncoespasmo. Acomete principalmente os lactentes, sendo a causa mais comum de hospitalizações pediátricas no primeiro ano de vida. O objetivo deste trabalho foi descrever as características das hospitalizações e os gastos na rede pública por bronquiolite aguda de residentes de 0 a 2 anos da Região Metropolitana de Porto Alegre (RMPA), no sul do Brasil, no período 2012 a 2014. As hospitalizações com diagnóstico principal CID-10 J21.0 e J21.8 foram analisadas a partir de dados do Sistema de Informações Hospitalares, disponíveis publicamente. Foram calculados indicadores por sexo, faixas etárias, permanência, letalidade e gastos por internação. Ocorreram 7.091 internações (2.364/ano), na rede pública, por bronquiolite aguda de residentes da RMPA de 2012 a 2014 (153,6/10 mil habitantes/ano). O sexo masculino predominou (4.246 ou 59,9%) e as internações de pacientes de até um ano representaram 99,2%. Bronquiolite por vírus sincicial respiratório respondeu por 2.226 (31,4%) das internações, sendo que o tempo médio de permanência foi de 5,3 dias e a letalidade 0,2% tendo 12 pacientes falecidos. O gasto médio anual foi de R$ 946,2 mil e o valor médio por internação de R$ 400,29. Concluiu-se que as hospitalizações por bronquiolite aguda caracterizaram-se por elevada incidência, curta duração e baixa letalidade na rede pública da Região Metropolitana de Porto Alegre. Palavras-chave: Bronquiolite; hospitalização; Sistema Único de Saúde; criança; doenças respiratórias.     Abstract Hospitalizations for Acute Bronchiolitis in the public network of the Metropolitan Region of Porto Alegre– RS: a cross-sectional study from 2012 to 2014 The acute bronchiolitis is a disease characterized by acute inflammation of the bronchioles and increased mucus production and secretion that can be associated with bronchospasm. It mainly affects infants, being the most common cause of pediatric hospitalizations in the first year of life. The objective of this work was to describe the characteristics of hospitalizations and spent in the public network for acute bronchiolitis of residents aged 0 to 2 years in the Metropolitan Region of Porto Alegre (MRPA), in southern Brazil, from 2012 to 2014. Analysis of hospitalizations with the main diagnosis CID-10 J21.0 and J21.8was performed from the Hospital Information System, publicly available. Calculations of indicators by sex, age groups, length of stay, lethality and spent of hospitalization were also performed. A total of 7,091 hospitalizations occurred (2,364/year) in the public network for acute bronchiolitis of residents of the MRPA from 2012 to 2014 (153.6/10 thousand inhabitants/year). The male gender predominated (4,246 or 59.9%) and hospitalizations of patients up to one year accounted for 99.2%. Bronchiolitis due to respiratory syncytial virus accounted for 2,226 (31.4%) hospitalizations and the average length of stay was 5.3 days and the case fatality rate was 0.2% (12 patients deceased). The average annual expenditure was R $ 946.2 thousand and the average amount per hospitalization was R $ 400.29. It was concluded that hospitalizations for acute bronchiolitis were characterized by high incidence, short duration and low case fatality rate in the public network of the Metropolitan Region of Porto Alegre. Keywords: Bronchiolitis; hospitalization; Health Unic System; child; respiratory diseases.     Resumen Hospitalizaciones por Bronquiolitis Aguda em la Red Pública de la Región Metropolitana de Porto Alegre – RS: un estudio transversal de 2012 a 2014 La bronquiolitis aguda es una enfermedad caracterizada por la inflamación aguda de los bronquiolos y aumento de la producción y secreción de moco que puede asociarse a broncoespasmo. Afecta principalmente los lactantes, siendo la causa más común de hospitalizaciones pediátricas en el primer año de vida. El objetivo de este trabajo fue describir las características de las hospitalizaciones y costos en la red pública por bronquiolitis aguda de residentes de 0 a 2 años de edad de la Región Metropolitana de Porto Alegre, en el sur de Brasil, en el período 2012 a 2014. Las hospitalizaciones con diagnóstico principal CID-10 J21.0 y J21.8fueron analizadas a partir del Sistema de Información Hospitalaria, disponible publicamente. Fueron calculados indicadores por sexo, grupos de edad, permanencia, letalidad y costos por hospitalización. Hubo 7.091 hospitalizaciones (2.364/año) em la red pública por bronquiolitis aguda de residentes de la Región Metropolitana de Porto Alegre de 2012 a 2014 (153,6/10 mil habitantes/año). Predominó el género masculino (4.246 o 59,9%) y las hospitalizaciones de pacientes hasta un año representaron 99,2%. La bronquiolitis por virus respiratorio sincitial representó 2.226 (31,4%) de las hospitalizaciones y el promedio de permanencia fue de 5,3 días y la letalidad 0,2%, teniéndose 12 pacientes fallecidos. El costo pro medio anual fue de R$ 946,2 mil y el monto promedio por hospitalización fue de R$ 400,29. Se concluye que las hospitalizaciones por bronquiolitis aguda se caracterizaron por alta incidencia, corta duración y baja letalidad em la red pública de la Región Metropolitana de Porto Alegre. Palabras clave: Bronquiolitis; hospitalización; Sistema Único de Salud; niño; enfermidades respiratorias.


2020 ◽  
Vol 128 (S2) ◽  
pp. S242-S250
Author(s):  
Itzel Fuentes ◽  
Karla Henriquez ◽  
Fausto Muñoz ◽  
Elsa Palou ◽  
Tito Alvarado ◽  
...  

Introduction: Several emerging and re-emerging diseases in the last decade have shown the global weakness to detect and act in a timely manner in situations that threaten the health of the planet. Latin America has been vulnerable to outbreaks as a result of increased poverty, social inequity and the poor response capacity of the public health system. Objective: Describe the situation of COVID-19 in Honduras and the challenges it presents. Methodology: Analysis of the epidemiology and control strategies applied in the country to contain the spread of SARS-CoV-2, in the context of the social and economic reality until September 18, 2020. Results: Honduras ranks fifth in Central America in the number of tests performed; the cumulative incidence rate of cases is 7 105 per million inhabitants. The country has an accelerated growth in the percentage of positivity with intense community transmission. Some 63.4 % of cases are concentrated in the group 20-49 years old (43 624 cases); 15.2 % in adults 60+ (10 440 cases) and 7.5 % in children under 20 (5 133 cases). With a disjointed health system and a chronic and recurrent shortage of physical and human resources, the National Risk Management System (SINAGER), which includes the Ministry of Health (SESAL), implemented various strategies to reduce the spread of the virus. Some control measures were border closures, physical distancing and the use of masks were made mandatory by legislative decree. The serious impact on the weak national economy forced an intelligent opening coinciding with the rise of cases. Conclusions: Current data show that the age group most affected is adults between 20 and 49 years old. The country’s socioeconomic situation has been aggravated by the pandemic; the continuous rise in the number of cases, hospitalizations and deaths has collapsed the public health system leaving the majority of Hondurans in continuous vulnerability. Primary care clinics and mobile medical brigades have been implemented as a new way to contain the spread and impact of transmission. Several European countries and cities in the Americas have had to reverse the process of economic reopening when faced with successive waves of outbreaks. Honduras has demonstrated limited capacity to deal with catastrophic situations. The national epidemiological surveillance system and access to timely and quality diagnostic tests remain weak and fragmented. There is an urgent need to improve the health and surveillance system to guide strategic evidence-based decision making and to prevent future pandemics.


Author(s):  
A. H. Shulhai ◽  
H. S. Saturska ◽  
O. V. Saturskyi ◽  
N. O. Terenda ◽  
N. Ya. Panchyshyn ◽  
...  

Purpose: to highlight the concept of public health system and public health services in Ukraine. Materials and Methods. Scientific methods of analysis, synthesis and generalization were used in order to achieve this goal. Results. Considering in detail the functioning of public health institutions in Ukraine at the national and regional levels, we can note that to ensure the epidemiological surveillance and assessment of health and well-being of the population modern new tools were created. These tools have been used to monitor public health. The basic standards of activity and priorities are used. There are new structures, such as a clear reporting system, financing, monitoring of the quality of labor resources and rendering of services to consumers. The current state of social programs in public health research has shown the presence of a number of theoretical, methodological, economic, organizational, legal problems. Evidence suggests that investing in public health is generally cost-effective for the health care sector, other sectors, and the economy in a broad sense. A clear position of the state is important for the further development of social programs in public health. The state created the basic conditions for the development of such programs and these conditions were important for the initial stage of their formation. It is a need for creation a regulation system of such programs, which will reflect not only tax benefits, but also other preferences for developers of such programs. Particular attention should be paid to overcome the COVID-19 pandemic, which has made significant changes to the number of chronic and acute diseases and to the public health system. Conclusions. The adoption of the Concept for the Development of the Public Health System in Ukraine in 2016 was a driving stage in the modernization of public health in Ukraine and had a positive impact on its development. There are still problems with the need to improve the further development and modernization of the public health system in Ukraine, which ought to be addressed at the national and regional levels, taking into account the international experience of the highly efficient systems in Europe and the World.


2020 ◽  
Vol 8 (2) ◽  
pp. 97
Author(s):  
Connie CR Gan ◽  
Febi Dwirahmadi

INTRODUCTIONThe response to the COVID-19 pandemic is a tragic aberration gripping the world. As the disease evolves, uncertainty and fear of harm rise, which can significantly diminish community health and wellbeing. This article stresses the importance of public health preparedness in overcoming social and health risks associated with public panic.Since the COVID-19 outbreak began in late 2019, the numbers of people affected and fatalities continue to mount, causing panic and crippling vital economic and social activities. Authorities have failed to prevent inaccurate and misleading headlines that agitate the public and impinge on public communication. Fake news and rumors about magical products claiming to cure the virus abound. Additionally, people assumed emergency preparation meant stockpiling resources. Amid growing fears, consumers raided supermarkets and pharmacies for supplies, from masks to hygiene products, and people have fought over protective gear as tensions flared among anxious customers.When general panic starts driving political decision-making, public health professionals may be unable to implement strategies based on informed decisions. Researchers argue that government secrecy and non-transparency diminish people’s confidence and trust, creating panic (Wilson et al., 2007). Even naming the disease possibly triggered epidemic-related trauma and the ensuing public mistrust and disbelief of authorities; the panic has also sparked a wave of racial prejudice (Titanji, 2020). Although a series of emerging and re-emerging infectious diseases, from Avian flu to Zika virus, may have created more public awareness, whether leaders can translate this newfound awareness into meaningful policies and action is debatable.Globally, attention is growing on responses from state leaders, as some try to downplay the epidemic’s severity to maintain “business as usual”. In early March 2020, the Indonesian government was still in a state of denial and was attempting to convince the general public that the country was free from COVID-19 (Lindsey & Mann, 2020) Instead, currently confirmed cases are growing rapidly, suspected cases are far above the testing capacity, and case fatality is at an alarming rate.In contrast, several countries took drastic action by declaring travel restrictions and locking down cities. As an example, New Zealand decided to implement level-4 measures, with strict movement restrictions, not long after they confirmed their first case on 28 February 2020; they have recently begun a gradual exit from coronavirus lockdown (Knight, 2020).The public expects leaders to curb the spread of COVID-19 responsibly, appropriately, effectively, and proactively. Meanwhile, leaders are urging the public to stay calm and adopt new norms during this rapidly evolving situation. This crisis is not limited to any individual and requires cooperation rather than a unilateral response. DISCUSSIONHow to do this?A critical approach to pandemics is to ensure the preparedness of both healthcare capacity and public health systems (Jain, Duse, & Bausch, 2018). To respond to emergency needs—to have the capacity to treat rapidly increasing numbers of COVID-19 patients—it is important for each country to have existing policies and action plans for healthcare facilities to temporarily expand service capacity, cancel or postpone elective procedures, and engage in rapid intervention to conserve medical supplies, including personal protective equipment (Gan, Tseng, & Lee, 2020). Measures including recalling recently retired healthcare workers and providing drive-through services for chronic disease medications have been implemented to lessen pressures on hospitals (Wang, Ng, & Brook, 2020).While healthcare capacity is the ability to care for patients with COVID-19, the public health system aims to prevent people from being infected and mitigating the health risks associated with COVID-19. The public health system is important for strengthening community vigilance by promoting effective sanitation, a healthy lifestyle, and food safety, and preventing injuries, inequality, and violence. This involves not only healthcare professionals, but also well-planned strategies that consider various stakeholders’ perspectives and concerns (Glik, 2007). Despite the lockdown, we have seen healthcare workers and people in the community providing the basic essentials for those in need—from food, Personal Protective Equipment (PPE), mental health support, and evidence-based research communication, to virtual musical performances and concerts. Organizations in the virtual sphere, including WhatsApp (WhatsApp Inc, 2020) and TikTok, are partnering with health agencies to increase accessibility to health information.The best outbreak response is a collective response (Gille & Brall, 2020), which could effectively contain the disease and the panic caused by the disease. People naturally experience fear when dealing with a catastrophic event. This unprecedented threat triggered panic purchasing or falling for viral hoaxes, which reflects misconceptions about the problem, most likely because people lack trust in the measures taken (Heide, 2004), When designing and implementing public health measures, we must ensure we do not just acknowledge that, but actively engage relevant stakeholders. In an age of uncertainty, community solidarity and collective action are key to maintaining community vigilance against the crisis (Aldrich et al., 2015).


2020 ◽  
Author(s):  
Elham maraghi ◽  
Amal Saki Malehi ◽  
Fakher Rahim

AbstractBackgroundBecause infectious diseases, such as COVID-19, do not have specific boundaries, all countries must prioritize and use the necessary capabilities to prevent, detect, and respond quickly to public health emergencies. In this context, we aimed to review most recent GHS index annual report to observe the regional and global level of health security against COVID-19 outbreak, as well as their relationship with case fatality rate, among 210 countries and territories worldwide.MethodsWe reviewed and analyzed October 2019 GHS index co-leaders joint report, to review health security capacities on the basis of the GHS index in the context of six categories. we prioritized not only the capacities of 210 countries and territories around the world using the GHS Index, but also the existence of functional, tested, proven capabilities for stopping outbreaks at the source. Data were collected from global databases including Worldometer, WHO, and Disease Control and Prevention Center (CDC).FindingsThis study recruited data on 210 countries and territories, of which up to 14 April 2020, 72 countries (34.28%) with more than 1000 total COVID-19 cases were presents. In “most prepared group”, number of total COVID-19 diagnostic tests had a significant positive relation with GHS index (r=0.713; p=0.006). Case fatality rate was directly associated with the detection index (r=0.304; p=0.023) in “more prepared group”. In “Lower-middle-income economies” group, case fatality rate positively related to detection, response and risk environment indices.ImplementationWith the exception of a very small number, countries that were ranked as most prepared countries, they were more likely to be affected by the COVID-19 outbreak of the virus and its health consequences, and needed to seriously reconsider their capabilities and health security in the context of detection, prevention, rapid response, health system facilities, and risk environment against disease outbreakResearch in contextEvidence before this studyGiven the very rapid spread of the COVID-19 disease in a very short time, limited and few studies have shown weakness and strength in national and international capacity to deal with health emergencies. We systematically searched the Scopus, ISI web of science and PubMed from Jan 2019 to April 2020, using the search terms “health security” OR “emergency preparedness” AND “COVID-19” OR “SARS-CoV-2/nCoV-2019”. Our search returned only limited number of published evidences (n=37), of which only one was assessed the operational readiness among 182 countries based on the International Health Regulations (IHR) annual report 1.Added value of this studyGiven a very limited and insufficient on the regional, as well as global preparedness capacities to combat health emergencies, such as COVID-19 disease, we used most recent GHS index annual report (October 2019), to observe the regional and global level of health security in the context of detection, prevention, rapid response, health system facilities, and risk environment against COVID-19 outbreak among 210 countries and territories around the world. We found information about only 195 countries in the recent used report and imputed the data for the rest 15 countries and territories that facing COVID-19 outbreak.Implications of all the available evidenceOur results showed that, with the exception of a very small number of countries that were ranked as most prepared countries, they were more likely to be affected by the COVID-19 outbreak of the virus and its health consequences, and needed to seriously reconsider their capabilities and health security in the context of detection, prevention, rapid response, health system facilities, and risk environment against disease outbreak.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Stefan Walter ◽  
Ruth Gil-Prieto ◽  
Mario Gil-Conesa ◽  
Gil Rodriguez-Caravaca ◽  
Jesús San Román ◽  
...  

Abstract Background Baseline hospitalization, mortality, and in-hospital fatality rates for meningococcal infection are required to evaluate preventive interventions, such as the inclusion of the conjugated quadrivalent meningococcal vaccine and serogroup B based protein vaccines. Methods All meningococcal infection–related hospitalizations in any diagnostic position in Spain from 1st January 1997 through 31st December 2018 were analysed. The annual hospitalization rate, mortality rate and case-fatality rate were calculated. Results The average hospitalization rate for meningococcal infection was 1.64 (95% CI 1.61 to 1.66) hospitalizations per 100,000 inhabitants during the study period and significantly decreased from 1997 to 2018. Hospitalizations for meningococcal infection decreased significantly with age and were concentrated in children under 5 years of age (46%). The hospitalization rates reached 29 per 100,000 and 24 per 100,000 children under 1 and 2 years of age, respectively. The in-hospital case-fatality rate was 7.45% (95% CI 7.03 to 7.86). Thirty percent of the deaths occurred in children under 5 years of age, and more than half occurred in adults. The case fatality rate increased significantly with age (p < 0.001). Conclusion It is necessary to maintain epidemiological surveillance of meningococcal infection to determine the main circulating serogroups involved, track their evolution, and evaluate preventive measures whose effectiveness must be assessed in all age groups.


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