scholarly journals Segmentation and shielding of the most vulnerable members of the population as elements of an exit strategy from COVID-19 lockdown

2021 ◽  
Vol 376 (1829) ◽  
pp. 20200275
Author(s):  
Bram A. D. van Bunnik ◽  
Alex L. K. Morgan ◽  
Paul R. Bessell ◽  
Giles Calder-Gerver ◽  
Feifei Zhang ◽  
...  
Keyword(s):  
General Population ◽  
Protective Measures ◽  
Transmission Rates ◽  
Population Immunity ◽  
Contact Matrix ◽  
Potential Applications ◽  
Pandemic Response ◽  
Future Policy ◽  
The Uk ◽  
Second Wave

This study demonstrates that an adoption of a segmenting and shielding strategy could increase the scope to partially exit COVID-19 lockdown while limiting the risk of an overwhelming second wave of infection. We illustrate this using a mathematical model that segments the vulnerable population and their closest contacts, the ‘shielders’. Effects of extending the duration of lockdown and faster or slower transition to post-lockdown conditions and, most importantly, the trade-off between increased protection of the vulnerable segment and fewer restrictions on the general population are explored. Our study shows that the most important determinants of outcome are: (i) post-lockdown transmission rates within the general and between the general and vulnerable segments; (ii) fractions of the population in the vulnerable and shielder segments; (iii) adherence to protective measures; and (iv) build-up of population immunity. Additionally, we found that effective measures in the shielder segment, e.g. intensive routine screening, allow further relaxations in the general population. We find that the outcome of any future policy is strongly influenced by the contact matrix between segments and the relationships between physical distancing measures and transmission rates. This strategy has potential applications for any infectious disease for which there are defined proportions of the population who cannot be treated or who are at risk of severe outcomes. This article is part of the theme issue ‘Modelling that shaped the early COVID-19 pandemic response in the UK’.

scholarly journals Segmentation and shielding of the most vulnerable members of the population as elements of an exit strategy from COVID-19 lockdown

2020 ◽  
Author(s):  
Bram A.D. van Bunnik ◽  
Alex L.K. Morgan ◽  
Paul R. Bessell ◽  
Giles Calder-Gerver ◽  
Feifei Zhang ◽  
...  
Keyword(s):  
General Population ◽  
Vulnerable Population ◽  
Infection Prevention And Control ◽  
Close Monitoring ◽  
Transmission Rates ◽  
Epidemic Curve ◽  
Population Immunity ◽  
Public Health Initiative ◽  
Potential Applications ◽  
Future Policy

AbstractIn this study we demonstrate that the adoption of a segmenting and shielding (S&S) strategy could increase scope to partially exit COVID-19 lockdown while limiting the risk of an overwhelming second wave of infection.The S&S strategy has an antecedent in the “cocooning” of infants by immunisation of close family members (Forsyth et al., 2015), and forms a pillar of infection, prevention and control (IPC) strategies (RCN, 2017). We are unaware of it being proposed as a major public health initiative previously.We illustrate the S&S strategy using a mathematical model that segments the vulnerable population and their closest contacts, the “shielders”. We explore the effects on the epidemic curve of a gradual ramping up of protection for the vulnerable population and a gradual ramping down of restrictions on the non-vulnerable population over a period of 12 weeks after lockdown.The most important determinants of outcome are: i) post-lockdown transmission rates within the general population segment and between the general and vulnerable segments; ii) the fraction of the population in the vulnerable and shielder segments; iii) adherence with need to be protected; and iv) the extent to which population immunity builds up in all segments.We explored the effects of extending the duration of lockdown and faster or slower transition to post-lockdown conditions and, most importantly, the trade-off between increased protection of the vulnerable segment and fewer restrictions on the general population.We illustrate how the potential for the relaxation of restrictions interacts with specific policy objectives. We show that the range of options for relaxation in the general population can be increased by maintaining restrictions on the shielder segment and by intensive routine screening of shielders.We find that the outcome of any future policy is strongly influenced by the contact matrix between segments and the relationships between physical distancing measures and transmission rates. These relationships are difficult to quantify so close monitoring of the epidemic would be essential during and after the exit from lockdown.More generally, S&S has potential applications for any infectious disease for which there are defined proportions of the population who cannot be treated or who are at risk of severe outcomes.

scholarly journals Real-time nowcasting and forecasting of COVID-19 dynamics in England: the first wave

2021 ◽  
Vol 376 (1829) ◽  
pp. 20200279
Author(s):  
Paul Birrell ◽  
Joshua Blake ◽  
Edwin van Leeuwen ◽  
Nick Gent ◽  
Daniela De Angelis
Keyword(s):  
Real Time ◽  
Credible Interval ◽  
Mitigation Measures ◽  
Contact Tracing ◽  
Effective Contact ◽  
Ongoing Work ◽  
Reproduction Numbers ◽  
Pandemic Response ◽  
The Uk ◽  
Second Wave

England has been heavily affected by the SARS-CoV-2 pandemic, with severe ‘lockdown’ mitigation measures now gradually being lifted. The real-time pandemic monitoring presented here has contributed to the evidence informing this pandemic management throughout the first wave. Estimates on the 10 May showed lockdown had reduced transmission by 75%, the reproduction number falling from 2.6 to 0.61. This regionally varying impact was largest in London with a reduction of 81% (95% credible interval: 77–84%). Reproduction numbers have since then slowly increased, and on 19 June the probability of the epidemic growing was greater than 5% in two regions, South West and London. By this date, an estimated 8% of the population had been infected, with a higher proportion in London (17%). The infection-to-fatality ratio is 1.1% (0.9–1.4%) overall but 17% (14–22%) among the over-75s. This ongoing work continues to be key to quantifying any widespread resurgence, should accrued immunity and effective contact tracing be insufficient to preclude a second wave. This article is part of the theme issue ‘Modelling that shaped the early COVID-19 pandemic response in the UK’.

An Expert Ranked List of Pro-nature Conservation Behaviours for Public Use

2019 ◽  
Author(s):  
Lea Barbett ◽  
Edward Stupple ◽  
Michael Sweet ◽  
Miles Richardson
Keyword(s):  
Nature Conservation ◽  
General Population ◽  
Mass Extinction ◽  
Negative Impact ◽  
Ecological Impact ◽  
Human Action ◽  
Short Paper ◽  
The Public ◽  
The Uk ◽  
Ranked List

The planet is facing an anthropogenic mass extinction of wildlife, which will have a grave impact on the environment and humans. Widespread human action is needed to minimize the negative impact of humans on biodiversity and support the restoration of wildlife. In order to find effective ways to promote pro-nature conservation behaviours to the general population, there is a need to provide a list of behaviours which will have worthwhile ecological impact and are worth encouraging. In a novel collaboration between psychologists and ecologists, 70 experts from practical and academic conservation backgrounds were asked to review and rate 48 conservation related behaviours. According to their judgement, this short paper presents a ranked list of pro-nature conservation behaviours for the public in the UK and similar landscapes. This includes behaviours people can engage in in their homes, their gardens, on their land, and in their roles as citizens.

scholarly journals SARS-CoV-2 Seroprevalence among Healthcare Workers in General Hospitals and Clinics in Japan

2021 ◽  
Vol 18 (7) ◽  
pp. 3786
Author(s):  
Tatsuya Yoshihara ◽  
Kazuya Ito ◽  
Masayoshi Zaitsu ◽  
Eunhee Chung ◽  
Izumi Aoyagi ◽  
...  
Keyword(s):  
Public Health ◽  
Social Support ◽  
General Population ◽  
Severe Acute Respiratory Syndrome ◽  
Immunoglobulin G ◽  
Health Problem ◽  
Healthcare Workers ◽  
Public Health Problem ◽  
General Hospitals ◽  
Second Wave

Coronavirus disease 2019 (COVID-19) has become a serious public health problem worldwide. In general, healthcare workers are considered to be at higher risk of COVID-19 infection. However, the prevalence of COVID-19 among healthcare workers in Japan is not well characterized. In this study, we aimed to examine the seroprevalence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) antibodies among 2160 healthcare workers in hospitals and clinics that are not designated to treat COVID-19 patients in Japan. The prevalence of SARS-CoV-2 immunoglobulin G was 1.2% in August and October 2020 (during and after the second wave of the pandemic in Japan), which is relatively higher than that in the general population in Japan (0.03–0.91%). Because of the higher risk of COVID-19 infection, healthcare workers should be the top priority for further social support and vaccination against SARS-CoV-2.

scholarly journals An Investigation of the General Population’s Self-Reported Hand Hygiene Behaviour and Compliance in a Cross-European Setting

2021 ◽  
Vol 18 (5) ◽  
pp. 2402
Author(s):  
Aaron Lawson ◽  
Marie Vaganay-Miller ◽  
Robert Cameron
Keyword(s):  
General Population ◽  
Hand Hygiene ◽  
Disease Transmission ◽  
Communicable Disease ◽  
Hygiene Practice ◽  
Hygiene Behaviour ◽  
Level Of Understanding ◽  
The Uk ◽  
Travel Abroad ◽  
And Control

Every year, thousands of people from the UK travel to other countries for work and leisure. Europe, and particularly Spain, is one of the most popular travel destinations for people from the UK. However, it is known that travel to other countries can enhance the risk of communicable disease transmission from person to person, especially when a new one emerges. Adequate hand hygiene behaviour and compliance is widely accepted as being a simple, effective method in preventing the spread of communicable diseases that may be contracted during travel abroad. There is a well-established body of work investigating hand hygiene practice and compliance in community settings, but no recent studies have examined the hand hygiene practice and compliance of the general population when travelling abroad or in a cross-European context. The findings of this study indicated that most UK members of the general population when travelling abroad have a good level of understanding of the importance of adequate hand hygiene practice and compliance and its role regarding communicable disease prevention and control. As such, self-reported levels of compliance were high. Similar findings were made for Spanish members of the general population. However, while self-reported perceptions of adequacy of hand hygiene performance were relatively high, particularly among UK respondents, this was not supported by responses specifically focused on hand hygiene behaviour. However, differences in self-reported adequacy regarding the importance of handwashing versus hand drying, the number of steps that should be followed and the length of time that should be spent washing and drying hands were found for each group. This suggests that self-reported compliance may reflect intention to practice hand hygiene rather than true compliance. It also suggests that there are gaps in knowledge regarding the adequate method of hand hygiene among the cohort as a whole, and indeed these differences may account be a factor in for the high transmission rates of communicable disease when travelling abroad.

scholarly journals The potential dangers of not understanding COVID-19 public health restrictions in dementia: “It’s a groundhog day – every single day she does not understand why she can’t go out for a walk”

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Clarissa Giebel ◽  
Kerry Hanna ◽  
Manoj Rajagopal ◽  
Aravind Komuravelli ◽  
Jacqueline Cannon ◽  
...  
Keyword(s):  
Public Health ◽  
Cognitive Deficits ◽  
Third Sector ◽  
Cognitive Capacity ◽  
The Public ◽  
Health Measures ◽  
Third Sector Organisations ◽  
The Uk ◽  
Second Wave

Abstract Background Sudden public health restrictions can be difficult to comprehend for people with cognitive deficits. However, these are even more important for them to adhere to due to their increased levels of vulnerability, particularly to COVID-19. With a lack of previous evidence, we explored the understanding and changes in adherence to COVID-19 public health restrictions over time in people living with dementia (PLWD). Methods Unpaid carers and PLWD were interviewed over the phone in April 2020, shortly after the nationwide UK lockdown, with a proportion followed up from 24th June to 10th July. Participants were recruited via social care and third sector organisations across the UK, and via social media. Findings A total of 70 interviews (50 baseline, 20 follow-up) were completed with unpaid carers and PLWD. Five themes emerged: Confusion and limited comprehension; Frustration and burden; Putting oneself in danger; Adherence to restrictions in wider society; (Un) changed perceptions. Most carers reported limited to no understanding of the public health measures in PLWD, causing distress and frustration for both the carer and the PLWD. Due to the lack of understanding, some PLWD put themselves in dangerous situations without adhering to the restrictions. PLWD with cognitive capacity who participated understood the measures and adhered to these. Discussion In light of the new second wave of the pandemic, public health measures need to be simpler for PLWD to avoid unwilful non-adherence. Society also needs to be more adaptive to the needs of people with cognitive disabilities more widely, as blanket rules cause distress to the lives of those affected by dementia.

scholarly journals The Brown Seaweeds of Scotland, Their Importance and Applications

Environments ◽  
2021 ◽  
Vol 8 (6) ◽  
pp. 59
Author(s):  
Omar Al-Dulaimi ◽  
Mostafa E. Rateb ◽  
Andrew S. Hursthouse ◽  
Gary Thomson ◽  
Mohammed Yaseen
Keyword(s):  
Waste Treatment ◽  
Biological Activities ◽  
Chemical Diversity ◽  
Great Opportunity ◽  
Brown Seaweeds ◽  
Extraction And Separation ◽  
The Status ◽  
Potential Applications ◽  
The Uk ◽  
Phytochemical Profiles

More than 50% of the UK coastline is situated in Scotland under legislative jurisdiction; therefore, there is a great opportunity for regionally focused economic development by the rational use of sustainable marine bio-sources. We review the importance of seaweeds in general, and more specifically, wrack brown seaweeds which are washed from the sea and accumulated in the wrack zone and their economic impact. Rules and regulations governing the harvesting of seaweed, potential sites for harvesting, along with the status of industrial application are discussed. We describe extraction and separation methods of natural products from these seaweeds along with their phytochemical profiles. Many potential applications for these derivatives exist in agriculture, energy, nutrition, biomaterials, waste treatment (composting), pharmaceuticals, cosmetics and other applications. The chemical diversity of the natural compounds present in these seaweeds is an opportunity to further investigate a range of chemical scaffolds, evaluate their biological activities, and develop them for better pharmaceutical or biotechnological applications. The key message is the significant opportunity for the development of high value products from a seaweed processing industry in Scotland, based on a sustainable resource, and locally regulated.

scholarly journals “At Least until the Second Wave Comes…”: A Twitter Analysis of the NHS and COVID-19 between March and June 2020

2021 ◽  
Vol 18 (8) ◽  
pp. 3943
Author(s):  
Kathy McKay ◽  
Sarah Wayland ◽  
David Ferguson ◽  
Jane Petty ◽  
Eilis Kennedy
Keyword(s):  
Health Care ◽  
Social Media ◽  
Content Analysis ◽  
Well Being ◽  
Profound Impact ◽  
Time Period ◽  
Twitter Analysis ◽  
The Uk ◽  
Media Narratives ◽  
Second Wave

In the UK, tweets around COVID-19 and health care have primarily focused on the NHS. Recent research has identified that the psychological well-being of NHS staff has been adversely impacted as a result of the COVID-19 pandemic. The aim of this study was to investigate narratives relating to the NHS and COVID-19 during the first lockdown (26 March–4 July 2020). A total of 123,880 tweets were collated and downloaded bound to the time period of the first lockdown in order to analyse the real-time discourse around COVID-19 and the NHS. Content analysis was undertaken and tweets were coded to positive and negative sentiments. Five main themes were identified: (1) the dichotomies of ‘clap for carers’; (2) problems with PPE and testing; (3) peaks of anger; (4) issues around hero worship; and (5) hints of a normality. Further research exploring and documenting social media narratives around COVID-19 and the NHS, in this and subsequent lockdowns, should help in tailoring suitable support for staff in the future and acknowledging the profound impact that the pandemic has had.

scholarly journals An OSCE as part of the first-year SpR assessmentinent in ENT

2006 ◽  
Vol 88 (9) ◽  
pp. 310-312 ◽  
Author(s):  
A Drake-Lee ◽  
D Skinner ◽  
A Reid
Keyword(s):  
First Year ◽  
European Law ◽  
Senior Registrar ◽  
The Uk ◽  
Second Wave

The structure of postgraduate hospital training in the UK has changed in the last 20 years: the Calman report brought training in line with European law and the SpR post was created out of the registrar and senior registrar posts. Implementation of the new training was staggered across specialties. ENT was included in the second wave of implementation in October 1995. At the same time, consultant expansion was envisaged.

The Regional Consequences of the Japanese Second Wave: A Case Study

1995 ◽  
Vol 10 (1) ◽  
pp. 4-20 ◽  
Author(s):  
Max Munday
Keyword(s):  
Local Economy ◽  
The Uk ◽  
Second Wave

Outline This paper examines the Japanese “second wave” sector in the local economy. Following an examination of the development of the second wave Japanese-owned supplier sector in the UK, the paper assesses the role of this sector in the local economy, and questions the policy rationale of attracting this particular type of inward investment.

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