Impact of COVID-19 outbreak by income: hitting hardest the most deprived

Abstract Background The impact of the 2019 coronavirus disease (COVID-19) has many facets. This ecological study analysed age-standardized incidence rates by economic level in Barcelona. Methods We evaluated confirmed cases of COVID-19 in Barcelona (Spain) between 26 February 2020 and 19 April 2020. Districts were classified according to most recent (2017) mean income data. The reference for estimating age-standardized cumulative incidence rates was the 2018 European population. The association between incidence rate and mean income by district was estimated with the Spearman rho. Results The lower the mean income, the higher the COVID-19 incidence (Spearman rho = 0.83; P value = 0.003). Districts with the lowest mean income had the highest incidence of COVID-19 per 10 000 inhabitants; in contrast, those with the highest income had the lowest incidence. Specifically, the district with the lowest income had 2.5 times greater incidence of the disease, compared with the highest-income district [70 (95% confidence interval 66–73) versus 28 (25–31), respectively]. Conclusions The incidence of COVID-19 showed an inverse socioeconomic gradient by mean income in the 10 districts of the city of Barcelona. Beyond healthcare for people with the disease, attention must focus on a health strategy for the whole population, particularly in the most deprived areas.

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COVID-19 among the inhabitants of the slums in the city of Buenos Aires: a population-based study

BMJ Open ◽

10.1136/bmjopen-2020-044592 ◽

2021 ◽

Vol 11 (1) ◽

pp. e044592

Author(s):

Alejandro Macchia ◽

Daniel Ferrante ◽

Gabriel Battistella ◽

Javier Mariani ◽

Fernán González Bernaldo de Quirós

Keyword(s):

Incidence Rate ◽

Buenos Aires ◽

Reporting System ◽

Incidence Rates ◽

Health Reporting ◽

Rt Pcr ◽

Slum Dwellers ◽

Integrated Health ◽

The Impact ◽

The City

ObjectiveTo summarise the unfolding of the COVID-19 epidemic among slum dwellers and different social strata in the city of Buenos Aires during the first 20 weeks after the first reported case.DesignObservational study using a time-series analysis. Natural experiment in a big city.SettingPopulation of the city of Buenos Aires and the integrated health reporting system records of positive RT-PCR for COVID-19 tests.ParticipantsRecords from the Argentine Integrated Health Reporting System for all persons with suspected and RT-PCR-confirmed diagnosis of COVID-19 between 31 January and 14 July 2020.OutcomesTo estimate the effects of living in a slum on the standardised incidence rate of COVID-19, corrected Poisson regression models were used. Additionally, the impact of socioeconomic status was performed using an ecological analysis at the community level.ResultsA total of 114 052 people were tested for symptoms related with COVID-19. Of these, 39 039 (34.2%) were RT-PCR positive. The incidence rates for COVID-19 towards the end of the 20th week were 160 (155 to 165) per 100 000 people among the inhabitants who did not reside in the slums (n=2 841 997) and 708 (674 to 642) among slums dwellers (n=233 749). Compared with the better-off socioeconomic quintile (1.00), there was a linear gradient on incidence rates: 1.36 (1.25 to 1.46), 1.61 (1.49 to 1.74), 1.86 (1.72 to 2.01), 2.94 (2.74 to 3.16) from Q2 to Q5, respectively. Slum dwellers were associated with an incidence rate of 14.3 (13.4 to 15.4).ConclusionsThe distribution of the epidemic is socially conditioned. Slum dwellers are at a much higher risk than the rest of the community. Slum dwellers should not be considered just another risk category but an entirely different reality that requires policies tailored to their needs.

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Comparing regional neonatal mortality rates: the influence of registration of births as live born for birth weight <500 g in Taiwan

BMJ Paediatrics Open ◽

10.1136/bmjpo-2019-000526 ◽

2019 ◽

Vol 3 (1) ◽

pp. e000526

Author(s):

Liang-Yi Wang ◽

Yu-Shan Chang ◽

Fu-Wen Liang ◽

Yung-Chieh Lin ◽

Yuh-Jyh Lin ◽

...

Keyword(s):

Birth Weight ◽

Neonatal Mortality ◽

Ecological Study ◽

Population Based ◽

Cross Sectional ◽

Neonatal Deaths ◽

Live Births ◽

Taipei City ◽

The Impact ◽

The City

ObjectiveTo investigate regional variation in the registration of births (still+live) as live born for birth weight <500 g and the impact on the city/county ranking of neonatal mortality rate (NMR) in Taiwan.DesignPopulation-based cross-sectional ecological study.Setting20 cities/counties in Taiwan.ParticipantsRegistered births for birth weight <500 g and neonatal deaths in 2015–2016.Main outcome measuresCity/county percentage of births <500 g registered as live born and ranking of city/county NMR (deaths per 1000 live births) including and excluding live births <500 g.ResultsThe percentage of births <500 g registered as live born ranged from 0% in Keelung City (0/26) and Penghu County (0/4) to 20% in Taipei City (112/558), 24% in Hsinchu County (5/21) and 28% in Hualien County (9/32). The change in city/county ranking of NMR from including to excluding live births <500 g was most prominent in Taipei City (from the 15th to the 1st) followed by Kaohsiung City (from the 18th to the 14th).ConclusionsThe city/county NMR in Taiwan is influenced by variation in the registration of live born for births with uncertain viability. We recommend presenting city/county NMR using both criteria (with or without minimum threshold of gestation period or birth weight) for better interpretation of the findings of comparisons of city/county NMR.

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The Impact of fodder on Bombyx Mori

10.1101/245654 ◽

2018 ◽

Author(s):

Victor Flores ◽

Katherine Medina

Keyword(s):

Bombyx Mori ◽

Production Performance ◽

P Value ◽

Demographic Profiles ◽

Silk Production ◽

Incubation Periods ◽

The Mean ◽

The Impact ◽

Cluster 2 ◽

Production Characteristics

AbstractSilk production by the Chilean silkworm, although an important source of revenue, has not been extensively studied. In the current study, we research 564 Mountain Silkworm (Bombyx mori), analyzing their silk harvests, silk production incubation periods and demographic profiles. The mountain silkworms were randomly divided into two clusters (cluster#1, cluster#2), each of which had 56 mountain silkworms. Crumpled maize were replaced by steam-flaked maize 30%, 50%, 100%, then researched the effects of nourishing steam-flaked maize on production performance of silk production by silkworm. The outcomes showed that the cluster#2 had better median silk harvest than cluster#1, the mean of these increment silk harvests was 3.48pounds (P-value <0.05); the protein proportion and the sugar in silk of cluster#2 went up than cluster#1; for the urine nitrogen and somatic cell count of cluster#2 were lower than cluster#1 by 0.9% (P-value >0.05), 30,800 cells/ml (P-value<0.05), respectively. The current research confirmed that utilizing the JHO nutrition heightened silk harvest, improved silk production characteristics, and enhanced the performance of mountain silkworms; furthermore, it heightened resistance to the sickness due to strengthened resistance.

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The Impact of the COVID-19 Pandemic on Medical Imaging Case Volumes in Aseer Region: A Retrospective Study

Medicines ◽

10.3390/medicines8110070 ◽

2021 ◽

Vol 8 (11) ◽

pp. 70

Author(s):

Magbool Alelyani ◽

Ali Alghamdi ◽

Nasser Shubayr ◽

Yazeed Alashban ◽

Hajar Almater ◽

...

Keyword(s):

Nuclear Medicine ◽

Emergency Departments ◽

Imaging Modality ◽

Significant Decline ◽

P Value ◽

Test Results ◽

Outpatient Departments ◽

The Mean ◽

Substantial Decline ◽

The Impact

COVID-19 has had a significant impact on global health systems. The aim of this study was to evaluate how imaging volumes and imaging types in radiology departments have been affected by the COVID-19 pandemic across different locations. Methods: Imaging volumes in the Aseer region (in the south of Saudi Arabia) across main hospitals were reviewed retrospectively including all cases referred from different locations (outpatient, inpatient and emergency departments). Data for years 2019 and 2020 were compared. The mean monthly cases were compared using a t-test. Results: The total imaging volumes in 2019 were 205,805 compared to 159,107 in 2020 with a 22.7% overall reduction. A substantial decline was observed in both the April to June and the July to September periods of approximately 42.9% and 44.4%, respectively. With respect to location, between April and June, the greatest decline was observed in outpatient departments (76% decline), followed by emergency departments (25% decline), and the least impact was observed in inpatient departments, with only 6.8% decline over the same period. According to modality type, the greatest decreases were reported in nuclear medicine, ultrasound, MRI, and mammography, by 100%, 76%, 74%, and 66%, respectively. Our results show a statistically significant (p-value ≤ 0.05) decrease of cases in 2020 compared to 2019, except for mammography procedures. Conclusion: There has been a significant decline in radiology volumes due to COVID-19. The overall reduction in radiology volumes was dependent on the stage/period of lockdown, location, and imaging modality.

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Role of training session in improving the knowledge of blood transfusion practices among undergraduates- a hospital based study.

Journal of Pathology of Nepal ◽

10.3126/jpn.v10i2.29827 ◽

2020 ◽

Vol 10 (2) ◽

pp. 1702-1705

Author(s):

Perada Vasavi ◽

Mahesh Kumar Usha ◽

Anurag Yadav

Keyword(s):

Blood Transfusion ◽

Training Program ◽

Training Session ◽

Limited Resource ◽

P Value ◽

Undergraduate Medical Students ◽

Post Test ◽

Minimum Score ◽

The Mean ◽

The Impact

Background: Blood is a vital and limited resource with a lifesaving therapeutic benefit. Knowledge of standard transfusion practices to be followed is important in delivering quality transfusion services. The present study aims at assessing the knowledge of transfusion practices among undergraduate medical students, train them, and to assess the impact of this type of training sessions in improving the outcome. Materials and methods: 82 undergraduate MBBS students participated in the study. The students were asked to attempt a pre-test and a post-test questionnaire before and after the training program. The training session comprised of audiovisual lecture and handout material given to the participants. The mean scores, percentage of both the tests, and percentage of improvement in scores from pre to post-test were analyzed. Results: The mean score in the pre-test was 8.3 with a minimum score of 3 and a maximum of 13 out of 15. The post-test mean score was 10.7 with a minimum score of 6 and a maximum score of 14 out of 15, which was significantly high. The training program helped in the overall improvement of the knowledge in various aspects of blood transfusion like indications, cross-matching, shelf life, transfusion practices, and management of adverse reactions. The p-value obtained was 0.003 (<0.05) which was significant. Conclusions: Knowledge of blood transfusion practices among the undergraduates was low. Training sessions helped improve the immediate knowledge and overall orientation toward the practices. Hence, blood transfusion syllabus should be included in the undergraduates' competency curriculum.

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Higher COVID-19 vaccination rates are linked to decreased county-level COVID-19 incidence across USA

10.1101/2021.03.05.21252946 ◽

2021 ◽

Author(s):

Arjun Puranik ◽

AJ Venkatakrishnan ◽

Colin Pawlowski ◽

Bharathwaj Raghunathan ◽

Eshwan Ramudu ◽

...

Keyword(s):

Incidence Rate ◽

Vaccine Efficacy ◽

Vaccine Dose ◽

The United States ◽

Vaccination Rate ◽

Incidence Rates ◽

P Value ◽

County Level ◽

Vaccination Rates ◽

The Impact

Real world evidence studies of mass vaccination across health systems have reaffirmed the safety1 and efficacy2,3 of the FDA-authorized mRNA vaccines for COVID-19. However, the impact of vaccination on community transmission remains to be characterized. Here, we compare the cumulative county-level vaccination rates with the corresponding COVID-19 incidence rates among 87 million individuals from 580 counties in the United States, including 12 million individuals who have received at least one vaccine dose. We find that cumulative county-level vaccination rate through March 1, 2021 is significantly associated with a concomitant decline in COVID-19 incidence (Spearman correlation ρ = −0.22, p-value = 8.3e-8), with stronger negative correlations in the Midwestern counties (ρ = −0.37, p-value = 1.3e-7) and Southern counties (ρ = −0.33, p-value = 4.5e-5) studied. Additionally, all examined US regions demonstrate significant negative correlations between cumulative COVID-19 incidence rate prior to the vaccine rollout and the decline in the COVID-19 incidence rate between December 1, 2020 and March 1, 2021, with the US western region being particularly striking (ρ = −0.66, p-value = 5.3e-37). However, the cumulative vaccination rate and cumulative incidence rate are noted to be statistically independent variables, emphasizing the need to continue the ongoing vaccination roll out at scale. Given confounders such as different coronavirus restrictions and mask mandates, varying population densities, and distinct levels of diagnostic testing and vaccine availabilities across US counties, we are advancing a public health resource to amplify transparency in vaccine efficacy monitoring (https://public.nferx.com/covid-monitor-lab/vaccinationcheck). Application of this resource highlights outliers like Dimmit county (Texas), where infection rates have increased significantly despite higher vaccination rates, ostensibly owing to amplified travel as a “vaccination hub”; as well as Henry county (Ohio) which encountered shipping delays leading to postponement of the vaccine clinics. This study underscores the importance of tying the ongoing vaccine rollout to a real-time monitor of spatio-temporal vaccine efficacy to help turn the tide of the COVID-19 pandemic.

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Awareness of Diagnosis and Decision-Making Preferences of Greek Cancer Patients

Pharmacovigilance and Pharmacoepidemiology ◽

10.33805/2638-8235.115 ◽

2020 ◽

pp. 5-12

Author(s):

Despoina G Alamanou ◽

Konstantinos Giakoumidakis ◽

Dimosthenis G Theodosiadis ◽

Nikolaos V Fotos ◽

Elissavet Patiraki ◽

...

Keyword(s):

Decision Making ◽

Cancer Patients ◽

Cancer Diagnosis ◽

Active Role ◽

Cross Sectional Study ◽

Cross Sectional ◽

Medical Encounter ◽

The Mean ◽

The Impact ◽

The City

Objective: In Greece, the old phenomenon of hiding cancer diagnosis and depriving cancer patients of their right to participate in decisionmaking remains a reality. The aim of this study was to assess the decision-making preferences of Greek cancer patients and their awareness of diagnosis. Methods: It was a cross-sectional study. The sample consisted of 229 adult Greek patients diagnosed with cancer, attending the oncology outpatient department (outpatients) or being hospitalized (inpatients), in one general hospital in Athens. Patients who were aware of cancer diagnosis (n=209) were administered at the Control Preference Scale (CPS), a tool, designed to elicit decision-making preferences. The IBM SPSS program, version 21.0 was used for statistical analysis. Results: One hundred and one patients (52.8%) were males. The mean [±standard deviation (SD)] age was 64.8 (±11.2) years. The vast majority of patients knew they suffered from cancer (n=209, 91.3%). Older patients (p=0.003), those who lived in suburbs of the city (p=0.01), those who had lower educational level (p=0.001), those with lower personal income (p=0.001) and shorter disease duration (p=0.001) stated that were unaware of cancer diagnosis. Seventy five (36.2%) patients chose the shared-decision role in decision-making procedures. Lower age (OR 1.04, 95%, CI: 1.00-1.08, p= 0.05) and higher education level (OR 2, 63, 95%, CI: 1.11-6.29, p=0.03) were significantly associated with the preference of patients to actively participate in decision-making regarding treatment. Conclusions: Although Greek cancer patients are aware of cancer diagnosis and treatment, nowadays, they still seem to hesitate in playing a more active role in the decision-making procedures, which portrays the impact of the dominating paternalistic model of doctor-patient relationship in the Greek medical encounter

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Counties with Lower Insurance Coverage and Housing Problems Are Associated with Both Slower Vaccine Rollout and Higher COVID-19 Incidence

Vaccines ◽

10.3390/vaccines9090973 ◽

2021 ◽

Vol 9 (9) ◽

pp. 973

Author(s):

Gregory Donadio ◽

Mayank Choudhary ◽

Emily Lindemer ◽

Colin Pawlowski ◽

Venky Soundararajan

Keyword(s):

Socioeconomic Factors ◽

Insurance Coverage ◽

Vaccination Rate ◽

Incidence Rates ◽

P Value ◽

Strongly Correlated ◽

Marginalized Communities ◽

Vaccination Rates ◽

Using Data ◽

The Impact

Equitable vaccination distribution is a priority for outcompeting the transmission of COVID-19. Here, the impact of demographic, socioeconomic, and environmental factors on county-level vaccination rates and COVID-19 incidence changes is assessed. In particular, using data from 3142 US counties with over 328 million individuals, correlations were computed between cumulative vaccination rate and change in COVID-19 incidence from 1 December 2020 to 6 June 2021, with 44 different demographic, environmental, and socioeconomic factors. This correlation analysis was also performed using multivariate linear regression to adjust for age as a potential confounding variable. These correlation analyses demonstrated that counties with high levels of uninsured individuals have significantly lower COVID-19 vaccination rates (Spearman correlation: −0.460, p-value: <0.001). In addition, severe housing problems and high housing costs were strongly correlated with increased COVID-19 incidence (Spearman correlations: 0.335, 0.314, p-values: <0.001, <0.001). This study shows that socioeconomic factors are strongly correlated to both COVID-19 vaccination rates and incidence rates, underscoring the need to improve COVID-19 vaccination campaigns in marginalized communities.

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The Impact of Healthcare Worker Influenza Vaccination on Nosocomial Influenza in a Tertiary Hospital: An Ecological Study

10.21203/rs.2.13528/v2 ◽

2020 ◽

Author(s):

Wycliffe Enli Wei ◽

Stephanie Fook-Chong ◽

Wen Kai Chen ◽

Maciej Piotr Chlebicki ◽

Wee Hoe Gan

Keyword(s):

Protective Effect ◽

Influenza Vaccination ◽

Healthcare Worker ◽

Healthcare Workers ◽

Ecological Study ◽

Tertiary Hospital ◽

Vaccination Rate ◽

Incidence Rates ◽

Vaccination Rates ◽

The Impact

Abstract Background: To protect hospitalized patients who are more susceptible to complications of influenza, seasonal influenza vaccination of healthcare workers (HCW) has been recommended internationally. However, its effectiveness is still being debated. To assess the effectiveness of HCW influenza vaccination, we performed an ecological study to evaluate the association between healthcare worker influenza vaccination and the incidence of nosocomial influenza in a tertiary hospital within Singapore between 2013-2018. Methods: Nosocomial influenza was defined by influenza among inpatients diagnosed 7 days or more post-admission by laboratory testing, while healthcare worker influenza vaccination rate was defined as the proportion of healthcare workers that was vaccinated at the end of each annual seasonal vaccination exercise. A modified Poisson regression was performed to assess the association between the HCW vaccination rates and monthly nosocomial influenza incidence rates. Results: Nosocomial influenza incidence rates followed the trend of non-nosocomial influenza, showing a predominant mid-year peak. Across 2,480,010 patient-days, there were 256 nosocomial influenza cases (1.03 per 10,000 patient-days). Controlling for background influenza activity and the number of influenza tests performed, no statistically significant association was observed between vaccination coverage and nosocomial influenza incidence rate although a protective effect was suggested (IRR 0.89, 95%CI:0.69-1.15, p =0.37). Conclusion: No significant association was observed between influenza vaccination rates and nosocomial influenza incidence rates, although a protective effect was suggested. Aligning local HCW vaccine timing and formulation to that of the Southern Hemisphere may improve effectiveness. HCW vaccination remains important but demonstrating its effectiveness in preventing nosocomial influenza is challenging.

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UNIDADES PARANÁ SEGURO E SEGURANÇA PÚBLICA NO MUNICÍPIO DE CURITIBA: uma avaliação quantitativa local da implementação das unidades

Revista Políticas Públicas ◽

10.18764/2178-2865.v18n2p497-510 ◽

2015 ◽

Vol 18 (2) ◽

pp. 497

Author(s):

Andréa Benetti Carvalho de Oliveira ◽

Thomaz Teodorovicz ◽

Luiz Alberto Esteves ◽

Marlon Alves Cardoso

Keyword(s):

State Government ◽

Impact Evaluation ◽

Study Groups ◽

Public Security ◽

Statistical Methodology ◽

Security Community ◽

The Mean ◽

Potential Impact ◽

The Impact ◽

The City

O governo estadual do Paraná começou, em 2012, a implantação de um novo modelo de policiamento, pautado no conceitode “policiamento comunitário”, voltado à redução de homicídios e combate a crimes relativos às drogas: as “Unidades Paraná Seguro”. O objetivo do trabalho é mensurar o impacto dessas unidades na criminalidade em Curitiba. A base de dados analisada continha informações trimestrais de ocorrências criminais para o período entre janeiro de 2011 e setembro de 2013. Essas informações foram agrupadas em três categorias: crimes contra pessoas; relativos a drogas; e contra o patrimônio. Para tanto, aplica a metodologia estatística de diferenças-em-diferenças em uma base de dados em painel para estimar o efeito tratamento médio, tanto nos bairros inseridos, como vizinhos às zonas de influência das unidades. Os resultados indicam que, embora o impacto sobre os crimes relativosàs drogas não tenha sido significativo, houve redução nos homicídios e significativo decréscimo dos crimes contra o patrimônio.Palavras-chave: Segurança pública, polícia comunitária, Unidades Paraná Seguro, avaliação de impacto, política pública.UNITS PARANÁ INSURANCE AND PUBLIC SAFETY IN THE CITY OF CURITIBA: a quantitative local evaluation of units’ implementationAbstract: In 2012 Paraná’s state government has begun the implementation of a new policing model: the “Unidade Paraná Seguro”(UPS). Based on the “community policy” concept, UPS’ main goal is to reduce both the rate of homicides and drug-related crimes.This paper aims to measure the results of such policy regarding its potential impact over Curitiba’s criminality rates. Quarterly crimerecords at a district-level from January/2011 until September/2013 were allocated in three different study-groups: crime againstindividuals; drug-related crimes; and property crimes. Differences-in-differences statistical methodology was applied to estimate the mean treatment effect on districts with an UPS and on its border districts. The results indicate that, although the impact over drug-related crimes was not statistically significant, there was reduction in homicides and significant reduction in property crimes.Key words: Public security, community police, Units Paraná Insurance, impact evaluation, public policy

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