Comparing containment measures among nations by epidemiological effects of COVID-19

Abstract Following exposure to a health care worker with an influenza-like illness, two preterm neonates and six staff members developed symptoms and tested positive for SARS-CoV-2. This neonatal unit COVID-19 outbreak occurred prior to implementation of universal masking and symptom screening policies. Both neonates and all staff recovered, with no further healthcare-associated SARS-CoV-2 transmission following implementation of effective outbreak containment measures.

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The effects of COVID ‐19 containment measures on the Asia‐Pacific region

Pacific Economic Review ◽

10.1111/1468-0106.12369 ◽

2021 ◽

Author(s):

Davide Furceri ◽

Siddharth Kothari ◽

Longmei Zhang

Keyword(s):

Asia Pacific ◽

Pacific Region ◽

Asia Pacific Region ◽

Containment Measures

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Behavior Patterns, Energy Consumption and Comfort during COVID-19 Lockdown Related to Home Features, Socioeconomic Factors and Energy Poverty in Madrid

Sustainability ◽

10.3390/su13115949 ◽

2021 ◽

Vol 13 (11) ◽

pp. 5949

Author(s):

Teresa Cuerdo-Vilches ◽

Miguel Ángel Navas-Martín ◽

Ignacio Oteiza

Keyword(s):

Energy Consumption ◽

Thermal Adaptation ◽

Vulnerability Index ◽

General Increase ◽

Energy Poverty ◽

Poor Households ◽

Global Spread ◽

Containment Measures ◽

The Face ◽

Future Harm

During spring 2020, the world was shocked at the imminent global spread of SARS-CoV-2, resorting to measures such as domestic confinement. This meant the reconfiguration of life in an unusual space; the home. However, not all households experienced it in the same way; many of them were vulnerable. A general increase in energy consumption and discomfort in many cases, led these families to suffer the ravages of confinement. This study analyzes the energy and comfort situation for the Madrid (Spain) population, according to the configuration of the homes, the characteristics of the dwellings, the vulnerability index by district, and energy poverty (measured with the 10% threshold of energy expenditure of home incomes). The results show a greater exposure, in confinement, of vulnerable and energy-poor households to scenarios of discomfort in the home, to which they could not respond, while energy consumption inevitably increased. Driven by need, energy-poor homes applied certain saving strategies, mainly resorting to thermal adaptation with clothing. This study shows the risk these households experienced in the face of an extreme situation, and invites reflection on preventive and containment measures that aim to avoid harming the disadvantaged in the future; harm that would also entail serious consequences on the health of their cohabitants.

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Tracing divergence in crisis governance: responses to the COVID-19 pandemic in France, Germany and Sweden compared

International Review of Administrative Sciences ◽

10.1177/0020852320979359 ◽

2021 ◽

pp. 002085232097935

Author(s):

Sabine Kuhlmann ◽

Mikael Hellström ◽

Ulf Ramberg ◽

Renate Reiter

Keyword(s):

Central Government ◽

Institutional Settings ◽

Containment Measures ◽

Local Discretion ◽

Institutional Contexts ◽

Administrative Procedures ◽

Decentralized Management ◽

Cross Country ◽

Legally Binding Regulations ◽

Governance Modes

This cross-country comparison of administrative responses to the COVID-19 pandemic in France, Germany and Sweden is aimed at exploring how institutional contexts and administrative cultures have shaped strategies of problem-solving and governance modes during the pandemic, and to what extent the crisis has been used for opportunity management. The article shows that in France, the central government reacted determinedly and hierarchically, with tough containment measures. By contrast, the response in Germany was characterized by an initial bottom-up approach that gave way to remarkable federal unity in the further course of the crisis, followed again by a return to regional variance and local discretion. In Sweden, there was a continuation of ‘normal governance’ and a strategy of relying on voluntary compliance largely based on recommendations and less – as in Germany and France – on a strategy of imposing legally binding regulations. The comparative analysis also reveals that relevant stakeholders in all three countries have used the crisis as an opportunity for changes in the institutional settings and administrative procedures. Points for practitioners COVID-19 has shown that national political and administrative standard operating procedures in preparation for crises are, at best, partially helpful. Notwithstanding the fact that dealing with the unpredictable is a necessary part of crisis management, a need to further improve the institutional preparedness for pandemic crises in all three countries examined here has also become clear. This should be done particularly by way of shifting resources to the health and care sectors, strengthening the decentralized management of health emergencies, stocking and/or self-producing protection material, assessing the effects of crisis measures, and opening the scientific discourse to broader arenas of experts.

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Exit strategies: optimising feasible surveillance for detection, elimination, and ongoing prevention of COVID-19 community transmission

BMC Medicine ◽

10.1186/s12916-021-01934-5 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

K. Lokuge ◽

E. Banks ◽

S. Davis ◽

L. Roberts ◽

T. Street ◽

...

Keyword(s):

Early Detection ◽

Respiratory Symptoms ◽

Respiratory Illness ◽

Reproductive Number ◽

Surveillance Strategy ◽

Transmission Chain ◽

Containment Measures ◽

Testing Uptake ◽

Community Transmission

Abstract Background Following implementation of strong containment measures, several countries and regions have low detectable community transmission of COVID-19. We developed an efficient, rapid, and scalable surveillance strategy to detect remaining COVID-19 community cases through exhaustive identification of every active transmission chain. We identified measures to enable early detection and effective management of any reintroduction of transmission once containment measures are lifted to ensure strong containment measures do not require reinstatement. Methods We compared efficiency and sensitivity to detect community transmission chains through testing of the following: hospital cases; fever, cough and/or ARI testing at community/primary care; and asymptomatic testing; using surveillance evaluation methods and mathematical modelling, varying testing capacities, reproductive number (R) and weekly cumulative incidence of COVID-19 and non-COVID-19 respiratory symptoms using data from Australia. We assessed system requirements to identify all transmission chains and follow up all cases and primary contacts within each chain, per million population. Results Assuming 20% of cases are asymptomatic and 30% of symptomatic COVID-19 cases present for testing, with R = 2.2, a median of 14 unrecognised community cases (8 infectious) occur when a transmission chain is identified through hospital surveillance versus 7 unrecognised cases (4 infectious) through community-based surveillance. The 7 unrecognised community upstream cases are estimated to generate a further 55–77 primary contacts requiring follow-up. The unrecognised community cases rise to 10 if 50% of cases are asymptomatic. Screening asymptomatic community members cannot exhaustively identify all cases under any of the scenarios assessed. The most important determinant of testing requirements for symptomatic screening is levels of non-COVID-19 respiratory illness. If 4% of the community have respiratory symptoms, and 1% of those with symptoms have COVID-19, exhaustive symptomatic screening requires approximately 11,600 tests/million population using 1/4 pooling, with 98% of cases detected (2% missed), given 99.9% sensitivity. Even with a drop in sensitivity to 70%, pooling was more effective at detecting cases than individual testing under all scenarios examined. Conclusions Screening all acute respiratory disease in the community, in combination with exhaustive and meticulous case and contact identification and management, enables appropriate early detection and elimination of COVID-19 community transmission. An important component is identification, testing, and management of all contacts, including upstream contacts (i.e. potential sources of infection for identified cases, and their related transmission chains). Pooling allows increased case detection when testing capacity is limited, even given reduced test sensitivity. Critical to the effectiveness of all aspects of surveillance is appropriate community engagement, messaging to optimise testing uptake and compliance with other measures.

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A Hybrid Modeling Technique of Epidemic Outbreaks with Application to COVID-19 Dynamics in West Africa

Biology ◽

10.3390/biology10050365 ◽

2021 ◽

Vol 10 (5) ◽

pp. 365

Author(s):

Chénangnon Frédéric Tovissodé ◽

Jonas Têlé Doumatè ◽

Romain Glèlè Kakaï

Keyword(s):

West Africa ◽

Growth Curve ◽

Exponential Growth ◽

Latency Period ◽

Growth Curves ◽

Exponential Growth Phase ◽

Model Framework ◽

Logistic Regression Models ◽

Containment Measures ◽

Reporting Data

The widely used logistic model for epidemic case reporting data may be either restrictive or unrealistic in presence of containment measures when implemented after an epidemic outbreak. For flexibility in epidemic case reporting data modeling, we combined an exponential growth curve for the early epidemic phase with a flexible growth curve to account for the potential change in growth pattern after implementation of containment measures. We also fitted logistic regression models to recoveries and deaths from the confirmed positive cases. In addition, the growth curves were integrated into a SIQR (Susceptible, Infective, Quarantined, Recovered) model framework to provide an overview on the modeled epidemic wave. We focused on the estimation of: (1) the delay between the appearance of the first infectious case in the population and the outbreak (“epidemic latency period”); (2) the duration of the exponential growth phase; (3) the basic and the time-varying reproduction numbers; and (4) the peaks (time and size) in confirmed positive cases, active cases and new infections. The application of this approach to COVID-19 data from West Africa allowed discussion on the effectiveness of some containment measures implemented across the region.

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Chasing the ghost of infection past: identifying thresholds of change during the COVID-19 infection in Spain

Epidemiology and Infection ◽

10.1017/s0950268820002782 ◽

2020 ◽

Vol 148 ◽

Cited By ~ 2

Author(s):

Luis Santamaría ◽

Joaquín Hortal

Keyword(s):

Public Health ◽

Growth Rate ◽

Health Communication ◽

Communication Strategies ◽

Growth Curves ◽

Personal Hygiene ◽

Exponential Growth Rate ◽

Public Health Communication ◽

Containment Measures ◽

Key Events

Abstract One of the largest nationwide bursts of the first COVID-19 outbreak occurred in Spain, where infection expanded in densely populated areas through March 2020. We analyse the cumulative growth curves of reported cases and deaths in all Spain and two highly populated regions, Madrid and Catalonia, identifying changes and sudden shifts in their exponential growth rate through segmented Poisson regressions. We associate these breakpoints with a timeline of key events and containment measures, and data on policy stringency and citizen mobility. Results were largely consistent for infections and deaths in all territories, showing four major shifts involving 19–71% reductions in growth rates originating from infections before 3 March and on 5–8, 10–12 and 14–18 March, but no identifiable effect of the strengthened lockdown of 29–30 March. Changes in stringency and mobility were only associated to the latter two shifts, evidencing an early deceleration in COVID-19 spread associated to personal hygiene and social distancing recommendations, followed by a stronger decrease when lockdown was enforced, leading to the contention of the outbreak by mid-April. This highlights the importance of combining public health communication strategies and hard confinement measures to contain epidemics.

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Depressive Symptoms in Swiss University Students during the COVID-19 Pandemic and Their Correlates

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18041458 ◽

2021 ◽

Vol 18 (4) ◽

pp. 1458 ◽

Cited By ~ 1

Author(s):

Thomas Volken ◽

Annina Zysset ◽

Simone Amendola ◽

Anthony Klein Swormink ◽

Marion Huber ◽

...

Keyword(s):

Mental Health ◽

Depressive Symptoms ◽

University Students ◽

Mental Health Problems ◽

Binary Logistic Regression ◽

Cross Sectional ◽

Logistic Regression Models ◽

National Population ◽

Student Cohorts ◽

Containment Measures

Background: COVID-19 containment measures and the uncertainties associated with the pandemic may have contributed to changes in mental health risks and mental health problems in university students. Due to the high burden of the disease, depression is of particular concern. However, knowledge about the prevalence of depressive symptoms in Swiss university students during the pandemic is limited. We therefore assessed the prevalence of depressive symptoms and their change during the COVID-19 pandemic in a large sample of Swiss university students. Methods: We assessed depressive symptoms in two cross-sectional cohorts of university students (n = 3571) in spring and autumn 2020 during the COVID-19 pandemic and compared them with a matched sample of the Swiss national population (n = 2328). Binary logistic regression models estimated prevalence with corresponding 95% confidence intervals (95% CI). Results: Adjusted prevalence of depressive symptoms in female (30.8% (95% CI: 28.6–33.0)) and male students (24.8% (95% CI: 21.7–28.1)) was substantially higher than in the matching female (10.9% (95% CI: 8.9–13.2)) and male (8.5% (6.6–11.0)) pre-pandemic national population. Depressive symptoms in the two consecutive student cohorts did not significantly differ. Conclusions: More than a quarter of Swiss university students reported depressive symptoms during the COVID-19 pandemic, which was substantially higher as compared to the matched general population. Universities should introduce measures to support students in such times of crisis and gain an understanding of the factors impacting mental health positively or negatively and related to university structures and procedures.

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Uncovering two phases of early intercontinental COVID-19 transmission dynamics

Journal of Travel Medicine ◽

10.1093/jtm/taaa200 ◽

2020 ◽

Vol 27 (8) ◽

Author(s):

Jing Yang ◽

Juan Li ◽

Shengjie Lai ◽

Corrine W Ruktanonchai ◽

Weijia Xing ◽

...

Keyword(s):

Phylogenetic Analyses ◽

International Travel ◽

Contact Tracing ◽

Genetic Sequencing ◽

Response Strategies ◽

The World ◽

Containment Measures ◽

The Usa ◽

Community Transmission ◽

Two Phases

Abstract Background The COVID-19 pandemic has posed an ongoing global crisis, but how the virus spread across the world remains poorly understood. This is of vital importance for informing current and future pandemic response strategies. Methods We performed two independent analyses, travel network-based epidemiological modelling and Bayesian phylogeographic inference, to investigate the intercontinental spread of COVID-19. Results Both approaches revealed two distinct phases of COVID-19 spread by the end of March 2020. In the first phase, COVID-19 largely circulated in China during mid-to-late January 2020 and was interrupted by containment measures in China. In the second and predominant phase extending from late February to mid-March, unrestricted movements between countries outside of China facilitated intercontinental spread, with Europe as a major source. Phylogenetic analyses also revealed that the dominant strains circulating in the USA were introduced from Europe. However, stringent restrictions on international travel across the world since late March have substantially reduced intercontinental transmission. Conclusions Our analyses highlight that heterogeneities in international travel have shaped the spatiotemporal characteristics of the pandemic. Unrestricted travel caused a large number of COVID-19 exportations from Europe to other continents between late February and mid-March, which facilitated the COVID-19 pandemic. Targeted restrictions on international travel from countries with widespread community transmission, together with improved capacity in testing, genetic sequencing and contact tracing, can inform timely strategies for mitigating and containing ongoing and future waves of COVID-19 pandemic.

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Modelling the COVID-19 pandemic in context: an international participatory approach

BMJ Global Health ◽

10.1136/bmjgh-2020-003126 ◽

2020 ◽

Vol 5 (12) ◽

pp. e003126

Author(s):

Ricardo Aguas ◽

Lisa White ◽

Nathaniel Hupert ◽

Rima Shretta ◽

Wirichada Pan-Ngum ◽

...

Keyword(s):

Mathematical Models ◽

Low Income ◽

Scientific Evidence ◽

Participatory Approach ◽

Middle Income ◽

Middle Income Countries ◽

Containment Measures ◽

History Of ◽

High Degree ◽

The Mathematical Model

The SARS-CoV-2 pandemic has had an unprecedented impact on multiple levels of society. Not only has the pandemic completely overwhelmed some health systems but it has also changed how scientific evidence is shared and increased the pace at which such evidence is published and consumed, by scientists, policymakers and the wider public. More significantly, the pandemic has created tremendous challenges for decision-makers, who have had to implement highly disruptive containment measures with very little empirical scientific evidence to support their decision-making process. Given this lack of data, predictive mathematical models have played an increasingly prominent role. In high-income countries, there is a long-standing history of established research groups advising policymakers, whereas a general lack of translational capacity has meant that mathematical models frequently remain inaccessible to policymakers in low-income and middle-income countries. Here, we describe a participatory approach to modelling that aims to circumvent this gap. Our approach involved the creation of an international group of infectious disease modellers and other public health experts, which culminated in the establishment of the COVID-19 Modelling (CoMo) Consortium. Here, we describe how the consortium was formed, the way it functions, the mathematical model used and, crucially, the high degree of engagement fostered between CoMo Consortium members and their respective local policymakers and ministries of health.

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