scholarly journals A prospect on the use of antiviral drugs to control local outbreaks of COVID-19

2020 ◽  
Author(s):  
Andrea Torneri ◽  
Pieter Libin ◽  
Joris Vanderlocht ◽  
Anne-Mieke Vandamme ◽  
Johan Neyts ◽  
...  
Keyword(s):  
Control Measure ◽  
Health Care Systems ◽  
Significant Proportion ◽  
Antiviral Drug ◽  
Control Measures ◽  
Contact Tracing ◽  
Final Size ◽  
Antiviral Compound ◽  
Intervention Measures ◽  
Care Systems

AbstractBackgroundCurrent outbreaks of COVID-19 are threatening the health care systems of several countries around the world. Control measures, based on isolation and quarantine, have been shown to decrease and delay the burden of the ongoing epidemic. With respect to the ongoing COVID-19 epidemic, recent modelling work shows that this intervention technique may be inadequate to control local outbreaks, even when perfect isolation is assumed. Furthermore, the effect of infectiousness prior to symptom onset combined with a significant proportion of asymptomatic infectees further complicates the use of contact tracing. Antivirals, which decrease the viral load and reduce the infectiousness, could be integrated in the control measures in order to augment the feasibility of controlling the epidemic.MethodsUsing a simulation-based model of viral transmission we tested the efficacy of different intervention measures for the control of COVID-19. For individuals that were identified through contact tracing, we evaluate two procedures: monitoring individuals for symptoms onset and testing of individuals. Moreover, we investigate the effect of a potent antiviral compound on the contact tracing process.FindingsThe use of an antiviral drug, in combination with contact tracing, quarantine and isolation, results in a significant decrease of the final size, the peak incidence, and increases the probability that the outbreak will fade out.InterpretationFor an infectious disease in which presymptomatic infections are plausible, an intervention measure based on contact tracing performs better when realized together with testing instead of monitoring, provided that the test is able to detect infections during the incubation period. In addition, in all tested scenarios, the model highlights the benefits of the administration of an antiviral drug in addition to quarantine, isolation and contact tracing. The resulting control measure, could be an effective strategy to control local and re-emerging out-breaks of COVID-19.

scholarly journals Potential impact of seasonal forcing on a SARS-CoV-2 pandemic

2020 ◽  
Author(s):  
Richard A. Neher ◽  
Robert Dyrdak ◽  
Valentin Druelle ◽  
Emma B. Hodcroft ◽  
Jan Albert
Keyword(s):  
Seasonal Variation ◽  
Infection Control ◽  
Transmission Rate ◽  
Health Care Systems ◽  
Control Measures ◽  
Rate Variation ◽  
Small Peak ◽  
Infection Control Measures ◽  
Care Systems ◽  
Novel Coronavirus

A novel coronavirus (SARS-CoV-2) first detected in Wuhan, China, has spread rapidly since December 2019, causing more than 80,000 confirmed infections and 2,700 fatalities (as of Feb 27, 2020). Imported cases and transmission clusters of various sizes have been reported globally suggesting a pandemic is likely.Here, we explore how seasonal variation in transmissibility could modulate a SARS-CoV-2 pandemic. Data from routine diagnostics show a strong and consistent seasonal variation of the four endemic coronaviruses (229E, HKU1, NL63, OC43) and we parameterize our model for SARS-CoV-2 using these data. The model allows for many subpopulations of different size with variable parameters. Simulations of different scenarios show that plausible parameters result in a small peak in early 2020 in temperate regions of the Northern Hemisphere and a larger peak in winter 2020/2021. Variation in transmission and migration rates can result in substantial variation in prevalence between regions.While the uncertainty in parameters is large, the scenarios we explore show that transient reductions in the incidence rate might be due to a combination of seasonal variation and infection control efforts but do not necessarily mean the epidemic is contained. Seasonal forcing on SARS-CoV-2 should thus be taken into account in the further monitoring of the global transmission. The likely aggregated effect of seasonal variation, infection control measures, and transmission rate variation is a prolonged pandemic wave with lower prevalence at any given time, thereby providing a window of opportunity for better preparation of health care systems.

scholarly journals UNDERSTANDING NON-MEDICAL COSTS FOR HEALTH CARE: EVIDENCE FROM INPATIENT CARE FOR OLDER PEOPLE IN CHINA

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S733-S733
Author(s):  
Wei Yang
Keyword(s):  
Health Care ◽  
Older People ◽  
Health Care Systems ◽  
Significant Proportion ◽  
Medical Costs ◽  
Urban China ◽  
Substantial Part ◽  
Rural And Urban ◽  
Care Systems ◽  
Health Payment

Abstract Non-medical costs can constitute a substantial part of total health care costs, especially for older people. Costs associated with carers, travel, food and accommodation for family members accompanying and caring for older people during their medical visits can be hefty. This study seeks to examine the effects of non-medical costs on catastrophic health payments and health payment-induced poverty among older people in rural and urban China. Using data from the China Health and Retirement Longitudinal Survey 2015, this study finds that inpatient costs account for a significant proportion of household expenditure, and non-medical costs can account for approximately 18% of total costs. That share is highest for those who belong to the lowest wealth groups. Non-medical costs increase the chances of older people incurring catastrophic health payments and suffering from health payment-induced poverty. Such effects are more concentrated among the poor than the rich. The results also show that the rural population are more likely to incur catastrophic health payments and suffer from health payment induced poverty compared to the urban population. This paper urges policy makers to consider reimbursing the non-medical costs of patient care, improving health care systems in general and for the rural populations specifically.

scholarly journals Οικονομική αξιολόγηση του ελληνικού συστήματος υγείας

2016 ◽  
Vol 3 (2) ◽  
Author(s):  
Νικόλαος Πολύζος ◽  
Στυλιανός Δρακόπουλος
Keyword(s):  
Health Care ◽  
Social Insurance ◽  
Health Care Systems ◽  
Control Measures ◽  
Main Element ◽  
International Context ◽  
Continuous Evaluation ◽  
Care Systems ◽  
And Control ◽  
Continuous Measures

<p>International analysis of macro-economic<br />indicators is the main element of economic<br />evaluation of health care systems. Health<br />expenditures have continuously increased<br />both in Greece and in the international context,<br />despite the continuous measures and the<br />reforms. Public fi nancing has remained<br />stable, while private fi nancing has gone<br />up. This situation is even worse in Greece,<br />where serious fi nancial inequalities, either<br />regionally, or among various social insurance<br />funds are predominant. Continuous evaluation<br />and control measures, along with a total<br />reconsideration and reform of fi nancing in<br />the health fi eld of our country will provide the<br />much needed solutions.</p>

scholarly journals Estimating transmission dynamics and serial interval of the first wave of COVID-19 infections under different control measures: A statistical analysis in Tunisia from February 29 to May 5, 2020

2020 ◽  
Author(s):  
Khouloud Talmoudi ◽  
Mouna Safer ◽  
Hejer Letaief ◽  
Aicha Hchaichi ◽  
Chahida Harizi ◽  
...  
Keyword(s):  
Emerging Diseases ◽  
Control Measures ◽  
Transmission Dynamics ◽  
Contact Tracing ◽  
Epidemic Threshold ◽  
Illness Onset ◽  
Intervention Measures ◽  
Temporal Reproduction ◽  
Prevention Measure ◽  
Serial Interval

Abstract Background Describing transmission dynamics of the outbreak and impact of intervention measures are critical to planning responses to future outbreaks and providing timely information to guide policy makers decision. We estimate serial interval (SI) and temporal reproduction number (Rt) of SARS-CoV-2 in Tunisia. Methods We collected data of investigations and contact tracing between March 1, 2020 and May 5, 2020 as well as illness onset data during the period February 29-May 5, 2020 from National Observatory of New and Emerging Diseases of Tunisia. Maximum likelihood (ML) approach is used to estimate dynamics of Rt. Results 491 of infector-infectee pairs were involved, with 14.46% reported pre-symptomatic transmission. SI follows Gamma distribution with mean 5.30 days [95% CI 4.66–5.95] and standard deviation 0.26 [95% CI 0.23–0.30]. Also, we estimated large changes in Rt in response to the combined lockdown interventions. The Rt moves from 3.18 [95% CI 2.73–3.69] to 1.77 [95% CI 1.49–2.08] with curfew prevention measure, and under the epidemic threshold (0.89 [95% CI 0.84–0.94]) by national lockdown measure. Conclusions Overall, our findings highlight contribution of interventions to interrupt transmission of SARS-CoV-2 in Tunisia.

scholarly journals Evaluation of the Design and Implementation of a Peer-To-Peer COVID-19 Contact Tracing Mobile App (COCOA) in Japan

10.2196/22098 ◽  
2020 ◽  
Vol 8 (12) ◽  
pp. e22098
Author(s):  
Ichiro Nakamoto ◽  
Ming Jiang ◽  
Jilin Zhang ◽  
Weiqing Zhuang ◽  
Yan Guo ◽  
...  
Keyword(s):  
Close Contact ◽  
Health Care Systems ◽  
Participation Rate ◽  
Peer To Peer ◽  
Mobile App ◽  
Contact Tracing ◽  
Population Mobility ◽  
Excessive Pressure ◽  
Public Authorities ◽  
Care Systems

We evaluate a Bluetooth-based mobile contact-confirming app, COVID-19 Contact-Confirming Application (COCOA), which is being used in Japan to contain the spread of COVID-19, the disease caused by the novel virus termed SARS-COV-2. The app prioritizes the protection of users’ privacy from a variety of parties (eg, other users, potential attackers, and public authorities), enhances the capacity to balance the current load of excessive pressure on health care systems (eg, local triage of exposure risk and reduction of in-person hospital visits), increases the speed of responses to the pandemic (eg, automated recording of close contact based on proximity), and reduces operation errors and population mobility. The peer-to-peer framework of COCOA is intended to provide the public with dynamic and credible updates on the COVID-19 pandemic without sacrificing the privacy of their information. However, cautions must be exercised to address critical concerns, such as the rate of participation and delays in data sharing. The results of a simulation imply that the participation rate in Japan needs to be close 90% to effectively control the spread of COVID-19.

scholarly journals THE IGNORED PANDEMIC OF PUBLIC HEALTH CORRUPTION: A CALL FOR ACTION AMID AND BEYOND SARS-COV-2/COVID-19

2021 ◽  
Vol 9 (2) ◽  
pp. 108-116
Author(s):  
Jorge A. Sánchez-Duque ◽  
◽  
Zhaohui Su ◽  
Diego Rosselli ◽  
Maria Camila Chica-Ocampo ◽  
...  
Keyword(s):  
Public Health ◽  
Global Health ◽  
Health Care Systems ◽  
Health Resources ◽  
Economic Consequences ◽  
Control Measures ◽  
Local Health ◽  
Middle Income ◽  
Health Initiatives ◽  
Care Systems

Corruption in healthcare is on the rise. When corruption infiltrates global health, causes embezzlement of public health funds, malfunctioning medical equipment, fraudulent or ineffective health services such as expired medicines and fake vaccines that could have life-or-death consequences. A corrupt healthcare system, amid global health crises like the COVID-19 pandemic, when resources are in constraint and trust is in high demand, can lead to devastating, though avoidable, health and economic consequences. It is imperative for policymakers, health experts, patients, caregivers, and global health funders to promptly acknowledge and address corruption in healthcare. The current pandemic generates an emergency and disorder state on health care systems across the globe, especially in low- and middle-income countries, where a weakening of control measures is evident, creating the perfect storm for corruption. This paper builds on existing research to examine processes that support essential stakeholder engagement in anti-corruption efforts. In this context, an extensive review of literature has been conducted by using various databases such as PubMed, Science direct, SCOPUS, Research Gate, and Google Scholar and a total of 45 articles and documents on corruption and COVID-19 were screened and selected by authors independently. To fill the knowledge gaps about the need for actions to be taken during a pandemic like COVID-19, we propose an anti-corruption grassroots movement that focuses on changing the social norms surrounding corruption in healthcare. By pushing forward a practice that normalizes conversations about corruption in everyday health practices and involving more stakeholders in the protection of public health resources, we argue that not only local health systems can become more resilient and resistant to corruption, but also global health initiatives can become more effective and efficient to improve individual and global health.

scholarly journals The COVID-19 pandemic in Norway and Sweden – threats, trust, and impact on daily life: A comparative survey

2020 ◽  
Author(s):  
Lise Helsingen ◽  
Erle Refsum ◽  
Dagrun Kyte Gjøstein ◽  
Magnus Løberg ◽  
Michael Bretthauer ◽  
...  
Keyword(s):  
Health Care ◽  
Infection Control ◽  
Preventive Measures ◽  
Daily Life ◽  
Health Care Systems ◽  
School Closure ◽  
Control Measures ◽  
Mitigation Measures ◽  
Infection Control Measures ◽  
Care Systems

Abstract Background: Norway and Sweden have similar populations and health care systems, but different reactions to the COVID-19 pandemic. Norway closed educational institutions, and banned sports and cultural activities; Sweden kept most institutions and training facilities open. We aimed to compare peoples’ attitudes towards authorities and control measures, and perceived impact of the pandemic and implemented control measures on life in Norway and Sweden.Methods: Anonymous web-based surveys for individuals age 15 or older distributed through Facebook using the snowball method, in Norway and Sweden from mid-March to mid-April, 2020. The survey contained questions about perceived threat of the pandemic, views on infection control measures, and impact on daily life. We performed descriptive analyses of the responses and compared the two countries.Results: 3,508 individuals participated in the survey (Norway 3000; Sweden 508). 79% were women, the majority were 30-49 years (Norway 60%; Sweden 47%), and about 45% of the participants in both countries had more than four years of higher education.Participants had high trust in the health services, but differed in the degree of trust in their government (High trust in Norway 17%; Sweden 37%). More Norwegians than Swedes agreed that school closure was a good measure (Norway 66%; Sweden 18%), that countries with open schools were irresponsible (Norway 65%; Sweden 23%), and that the threat from repercussions of the mitigation measures were large or very large (Norway 71%; Sweden 56%). Both countries had a high compliance with infection preventive measures (> 98%). Many lived a more sedentary life (Norway 69%; Sweden 50%) and ate more (Norway 44%; Sweden 33%) during the pandemic. Conclusion: Sweden had more trust in the authorities, while Norwegians reported a more negative lifestyle during the pandemic. The level of trust in the health care system and self-reported compliance with preventive measures was high in both countries despite the differences in infection control measures.

scholarly journals Estimating transmission dynamics and serial interval of the first wave of COVID-19 infections under different control measures: a statistical analysis in Tunisia from February 29 to May 5, 2020

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Khouloud Talmoudi ◽  
Mouna Safer ◽  
Hejer Letaief ◽  
Aicha Hchaichi ◽  
Chahida Harizi ◽  
...  
Keyword(s):  
Credible Interval ◽  
Emerging Diseases ◽  
Control Measures ◽  
Transmission Dynamics ◽  
Contact Tracing ◽  
Epidemic Threshold ◽  
Illness Onset ◽  
Intervention Measures ◽  
Temporal Reproduction ◽  
Serial Interval

Abstract Background Describing transmission dynamics of the outbreak and impact of intervention measures are critical to planning responses to future outbreaks and providing timely information to guide policy makers decision. We estimate serial interval (SI) and temporal reproduction number (Rt) of SARS-CoV-2 in Tunisia. Methods We collected data of investigations and contact tracing between March 1, 2020 and May 5, 2020 as well as illness onset data during the period February 29–May 5, 2020 from National Observatory of New and Emerging Diseases of Tunisia. Maximum likelihood (ML) approach is used to estimate dynamics of Rt. Results Four hundred ninety-one of infector-infectee pairs were involved, with 14.46% reported pre-symptomatic transmission. SI follows Gamma distribution with mean 5.30 days [95% Confidence Interval (CI) 4.66–5.95] and standard deviation 0.26 [95% CI 0.23–0.30]. Also, we estimated large changes in Rt in response to the combined lockdown interventions. The Rt moves from 3.18 [95% Credible Interval (CrI) 2.73–3.69] to 1.77 [95% CrI 1.49–2.08] with curfew prevention measure, and under the epidemic threshold (0.89 [95% CrI 0.84–0.94]) by national lockdown measure. Conclusions Overall, our findings highlight contribution of interventions to interrupt transmission of SARS-CoV-2 in Tunisia.

scholarly journals The COVID-19 pandemic in Norway and Sweden – threats, trust, and impact on daily life: a comparative survey

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Lise M. Helsingen ◽  
◽  
Erle Refsum ◽  
Dagrun Kyte Gjøstein ◽  
Magnus Løberg ◽  
...  
Keyword(s):  
Health Care ◽  
Infection Control ◽  
Preventive Measures ◽  
Daily Life ◽  
Health Care Systems ◽  
School Closure ◽  
Control Measures ◽  
Mitigation Measures ◽  
Infection Control Measures ◽  
Care Systems

Abstract Background Norway and Sweden have similar populations and health care systems, but different reactions to the COVID-19 pandemic. Norway closed educational institutions, and banned sports and cultural activities; Sweden kept most institutions and training facilities open. We aimed to compare peoples’ attitudes towards authorities and control measures, and perceived impact of the pandemic and implemented control measures on life in Norway and Sweden. Methods Anonymous web-based surveys for individuals age 15 or older distributed through Facebook using the snowball method, in Norway and Sweden from mid-March to mid-April, 2020. The survey contained questions about perceived threat of the pandemic, views on infection control measures, and impact on daily life. We performed descriptive analyses of the responses and compared the two countries. Results 3508 individuals participated in the survey (Norway 3000; Sweden 508). 79% were women, the majority were 30–49 years (Norway 60%; Sweden 47%), and about 45% of the participants in both countries had more than 4 years of higher education. Participants had high trust in the health services, but differed in the degree of trust in their government (High trust in Norway 17%; Sweden 37%). More Norwegians than Swedes agreed that school closure was a good measure (Norway 66%; Sweden 18%), that countries with open schools were irresponsible (Norway 65%; Sweden 23%), and that the threat from repercussions of the mitigation measures were large or very large (Norway 71%; Sweden 56%). Both countries had a high compliance with infection preventive measures (> 98%). Many lived a more sedentary life (Norway 69%; Sweden 50%) and ate more (Norway 44%; Sweden 33%) during the pandemic. Conclusion Sweden had more trust in the authorities, while Norwegians reported a more negative lifestyle during the pandemic. The level of trust in the health care system and self-reported compliance with preventive measures was high in both countries despite the differences in infection control measures.

scholarly journals Spatial and temporal dynamics of superspreading events in the 2014–2015 West Africa Ebola epidemic

2017 ◽  
Vol 114 (9) ◽  
pp. 2337-2342 ◽  
Author(s):  
Max S. Y. Lau ◽  
Benjamin Douglas Dalziel ◽  
Sebastian Funk ◽  
Amanda McClelland ◽  
Amanda Tiffany ◽  
...  
Keyword(s):  
Spatial Information ◽  
Temporal Dynamics ◽  
Clinical Care ◽  
Infected Individual ◽  
Significant Proportion ◽  
Control Measures ◽  
Community Based ◽  
Infectious Individual ◽  
Targeted Interventions ◽  
Care Systems

The unprecedented scale of the Ebola outbreak in Western Africa (2014–2015) has prompted an explosion of efforts to understand the transmission dynamics of the virus and to analyze the performance of possible containment strategies. Models have focused primarily on the reproductive numbers of the disease that represent the average number of secondary infections produced by a random infectious individual. However, these population-level estimates may conflate important systematic variation in the number of cases generated by infected individuals, particularly found in spatially localized transmission and superspreading events. Although superspreading features prominently in first-hand narratives of Ebola transmission, its dynamics have not been systematically characterized, hindering refinements of future epidemic predictions and explorations of targeted interventions. We used Bayesian model inference to integrate individual-level spatial information with other epidemiological data of community-based (undetected within clinical-care systems) cases and to explicitly infer distribution of the cases generated by each infected individual. Our results show that superspreaders play a key role in sustaining onward transmission of the epidemic, and they are responsible for a significant proportion (∼61%) of the infections. Our results also suggest age as a key demographic predictor for superspreading. We also show that community-based cases may have progressed more rapidly than those notified within clinical-care systems, and most transmission events occurred in a relatively short distance (with median value of 2.51 km). Our results stress the importance of characterizing superspreading of Ebola, enhance our current understanding of its spatiotemporal dynamics, and highlight the potential importance of targeted control measures.

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