scholarly journals How many lives can be saved? A global view on the impact of testing, herd immunity and demographics on COVID-19 fatality rates

2020 ◽  
Author(s):  
Miguel Sanchez-Romero ◽  
Vanessa di Lego ◽  
Alexia Prskawetz ◽  
Bernardo L Queiroz
Keyword(s):  
Herd Immunity ◽  
Age Distribution ◽  
Case Fatality ◽  
Population Characteristics ◽  
Seir Model ◽  
Testing Strategies ◽  
The Impact ◽  
Testing Policies ◽  
Different Levels

In this work, we assess the global impact of COVID-19 showing how demographic factors, testing policies and herd immunity are key for saving lives. We extend a standard epidemiological SEIR model in order to: (a) identify the role of demographics (population size and population age distribution) on COVID-19 fatality rates; (b) quantify the maximum number of lives that can be saved according to different testing strategies, different levels of herd immunity, and specific population characteristics; and (d) infer from the observed case fatality rates (CFR) what the true fatality rate might be. Different from previous SEIR model extensions, we implement a Bayesian Melding method in our calibration strategy which enables us to account for data limitation on the total number of deaths. We derive a distribution of the set of parameters that best replicate the observed evolution of deaths by using information from both the model and the data.

scholarly journals The role of age distribution, time lag between reporting and death and healthcare system capacity on case fatality estimates of COVID-19

2020 ◽  
Author(s):  
Patrizio Vanella ◽  
Christian Wiessner ◽  
Anja Holz ◽  
Gerard Krause ◽  
Annika Moehl ◽  
...  
Keyword(s):  
Time Lag ◽  
Age Distribution ◽  
Case Fatality ◽  
System Capacity ◽  
Time Lags ◽  
Cross Country ◽  
The Difference ◽  
Case Fatality Risk ◽  
The Impact

European countries report large differences in coronavirus disease (COVID-19) case fatality risk (CFR). CFR estimates depend on demographic characteristics of the cases, time lags between reporting of infections and deaths and infrastructural characteristics, such as healthcare and surveillance capacities. We discuss the impact of these factors on the CFR estimates for Germany, Italy, France, and Spain for the COVID-19 pandemic from early March to mid-April, 2020. We found that, first, a large proportion of the difference in CFRs can be attributed to different age structures of the cases. Second, lags of 5-10 days between day of case report and death should be used, since these provide the most constant estimates. Third, for France, Italy, and Spain, intensive care beds occupied by COVID-19 patients were positively associated with fatality risks of hospitalized cases. Our results highlight that cross-country comparisons of crude CFR estimates can be misleading and should be avoided.

scholarly journals Estimating the impact of virus testing strategies on the COVID-19 case fatality rate using fixed-effects models

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Anthony Terriau ◽  
Julien Albertini ◽  
Emmanuel Montassier ◽  
Arthur Poirier ◽  
Quentin Le Bastard
Keyword(s):  
Fixed Effects ◽  
Case Fatality Rate ◽  
Large Scale ◽  
Case Fatality ◽  
Fatality Rate ◽  
Testing Strategies ◽  
Fixed Effects Models ◽  
Screening Strategies ◽  
The Impact ◽  
Testing Policies

AbstractThe SARS-CoV2 has now spread worldwide causing over four million deaths. Testing strategies are highly variable between countries and their impact on mortality is a major issue. Retrospective multicenter study with a prospective database on all inpatients throughout mainland France. Using fixed effects models, we exploit policy discontinuities at region borders in France to estimate the effect of testing on the case fatality rate. In France, testing policies are determined at a regional level, generating exogenous variation in testing rates between departments on each side of a region border. We compared all contiguous department pairs located on the opposite sides of a region border. The increase of one percentage point in the test rate is associated with a decrease of 0.0015 percentage point in the death rate, that is, for each additional 2000 tests, we could observe three fewer deaths. Our study suggests that COVID-19 population testing could have a significant impact on the mortality rate which should be considered in decision-making. As concern grows over the current second wave of COVID-19, our findings support the implementation of large-scale screening strategies in such epidemic contexts.

scholarly journals Exploring the effectiveness of a COVID-19 contact tracing app using an agent-based model

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Jonatan Almagor ◽  
Stefano Picascia
Keyword(s):  
High Rate ◽  
Contact Tracing ◽  
Agent Based Model ◽  
Agent Based ◽  
The Social ◽  
Behavioural Factors ◽  
The Impact ◽  
Different Levels ◽  
User Rate

AbstractA contact-tracing strategy has been deemed necessary to contain the spread of COVID-19 following the relaxation of lockdown measures. Using an agent-based model, we explore one of the technology-based strategies proposed, a contact-tracing smartphone app. The model simulates the spread of COVID-19 in a population of agents on an urban scale. Agents are heterogeneous in their characteristics and are linked in a multi-layered network representing the social structure—including households, friendships, employment and schools. We explore the interplay of various adoption rates of the contact-tracing app, different levels of testing capacity, and behavioural factors to assess the impact on the epidemic. Results suggest that a contact tracing app can contribute substantially to reducing infection rates in the population when accompanied by a sufficient testing capacity or when the testing policy prioritises symptomatic cases. As user rate increases, prevalence of infection decreases. With that, when symptomatic cases are not prioritised for testing, a high rate of app users can generate an extensive increase in the demand for testing, which, if not met with adequate supply, may render the app counterproductive. This points to the crucial role of an efficient testing policy and the necessity to upscale testing capacity.

scholarly journals Religiosity as a factor protecting against problem behaviour in adolescence

2015 ◽  
Vol 21 (1-2) ◽  
pp. 63-89
Author(s):  
Iwona Niewiadomska ◽  
Rafał P. Bartczuk ◽  
Joanna Chwaszcz ◽  
Stanisław Fel ◽  
Weronika Augustynowicz ◽  
...  
Keyword(s):  
Problem Behaviour ◽  
Problem Behaviours ◽  
Upper Secondary ◽  
The Impact ◽  
The Relationship ◽  
Moderating Role ◽  
Upper Secondary Schools ◽  
Conceptual Work ◽  
Different Levels

Abstract This article explores the question, to what degree religiosity contributes, as a protecting factor against a broad category of socially deviant adolescent and youth behaviours. It also tests the hypothesis that gender plays a moderating role in the relationship between religiosity and problem behaviour. It employs a modified version of the Problem Behaviour Syndrome Measure (PBSM), in concert with Jessor and Jessor’s conceptual work. It also makes use of the Duke Religion Index (DUREL) to assess religiosity. The empirical study deals with a representative group of 960 students of upper-secondary schools in the Lubelskie province, Poland. The results were analyzed using canonical analysis and ANOVA. The achievements of the article are twofold. First, it identifies significant correlations between the different levels of religiosity among youth, and the occurrence and intensification of problem behaviours, particularly in regard to organized activity. Organized and intrinsic religiosity play principal protective roles, while the impact of personal religious practices is less significant. Secondly, while analyzing the moderating role of gender in the relationship between religiosity and the intensity of problem behaviour, it was found that gender does not have a significant interactive impact. An affirmative conclusion was confirmed in only two instances.

scholarly journals Servitization strategies from customers’ perspective: the moderating role of co-creation

2019 ◽  
Vol 34 (3) ◽  
pp. 628-642 ◽  
Author(s):  
José L. Ruiz-Alba ◽  
Anabela Soares ◽  
Miguel A. Rodríguez-Molina ◽  
Dolores M. Frías-Jamilena
Keyword(s):  
Structural Equation ◽  
Business Models ◽  
Service Providers ◽  
Moderating Effect ◽  
Mediating Effect ◽  
Content Type ◽  
The Impact ◽  
Moderating Role ◽  
Different Levels

Purpose This paper aims to investigate the moderating role of co-creation in the implementation of servitization strategies in the pharmaceutical industry in a business-to-business (B-to-B) context. More specifically, this investigation explores the impact of different levels of services (base, intermediate and advanced) on servitization and on performance by using co-creation as a moderating factor. Design/methodology/approach A research framework was developed and empirically tested in the pharmaceutical sector. Data collection was conducted through the online distribution of questionnaires. The final sample included 219 pharmacy stores, and the data were analysed using structural equation modelling. Findings Main findings suggest that when the level of co-creation of the design of services is high, there are significant effects of servitization on firm performance. The moderating effect of co-creation is illustrated in regard to intermediate and advanced services, but results referring to the impact of intermediate services on servitization appear non-significant with a low degree of co-creation. No significant effects could be found for the impact of base services on performance and servitization for both high and low degrees of co-creation. Findings show an impact of advanced services on performance through the mediating effect of servitization when the degree of co-creation is high. Originality/value Most research concerning servitization has been done from the perspective of manufacturers and service providers. This study adds value to the literature because it was designed from a customer’s perspective. Moreover, it contributes towards the conceptualization of the servitization research strategy and business models in a B2B context. This is accomplished through the investigation of the moderating effect of co-creation on the impact of the different levels of services on servitization and on performance.

scholarly journals COVID-19 Healthcare Planning: Predicting Mortality and the Role of the Herd Immunity Barrier in the General Population

2020 ◽  
Vol 12 (13) ◽  
pp. 5228
Author(s):  
Julio Emilio Marco-Franco ◽  
Natividad Guadalajara-Olmeda ◽  
Silvia González-de Julián ◽  
David Vivas-Consuelo
Keyword(s):  
General Population ◽  
Case Fatality Rate ◽  
Meta Analysis ◽  
Herd Immunity ◽  
Case Fatality ◽  
Fatality Rate ◽  
Daily Monitoring ◽  
Age Related ◽  
The Impact ◽  
Carlos Iii

Using a mathematical model for COVID-19 incorporating data on excess of mortality compared to the corresponding period of the previous year obtained from the daily monitoring of mortality in Spain (MoMo), the prediction of total number of casualties in Spain for the first outbreak has been computed. From this figure, and following a stepwise meta-analysis of available reports, the case fatality rate (CFR) and the infectious case fatality rate (IFR) for the outbreak have been estimated. As the impact of age on these rates is notable, it is proposed to include an age-related adjusted fatality ratio in future comparative analyses between studies, calculated by adjusting the results by risk ratio to a reference age band (e.g., 60–69). From the casualty figures, and the corresponding CFR and IFR ratios, the forecast of serologically positive cases in the general Spanish population has been estimated at approximately 1% (0.87–1.3%) of the samples. If the data are confirmed by the ongoing study of the Carlos III Institute, until a vaccine is found, the immunity acquired in the general population after the infectious outbreak is far from the 65–70% herd immunity required as a barrier for COVID-19.

scholarly journals Corruption and satisfaction with democracy: the conditional role of electoral disproportionality and ballot control

2018 ◽  
Vol 10 (3) ◽  
pp. 393-416 ◽  
Author(s):  
Alessandro Pellegata ◽  
Vincenzo Memoli
Keyword(s):  
Electoral Systems ◽  
Aggregate Level ◽  
Negative Effects ◽  
Empirical Results ◽  
Satisfaction With Democracy ◽  
Level Data ◽  
The Impact ◽  
The Relationship ◽  
Different Levels

Existing literature has analysed the relationship between electoral systems and either corruption or satisfaction with democracy (SWD) focussing on the traditional distinction between majoritarian and proportional systems. This paper, instead, investigates if and how specific aspects of electoral systems moderate the negative effects of corruption perceptions on SWD. We argue that two mechanisms act simultaneously but at different levels. The first mechanism is the relationship between voters and the national government, while the second links single representatives to their constituents. We advance conditional hypotheses that postulate an attenuating effect of disproportionality and a reinforcing impact of personal vote. Empirical results from 35 elections in 33 democracies, using both individual and aggregate-level data, confirm the research hypotheses. More disproportional electoral systems weaken the impact of citizens’ perceived corruption on their democratic satisfaction, while this is strengthened by systems in which the ballot control is mostly in the hand of the voters.

The Public Debate on Life and Death Choices: A Response from a Jewish Hospital Chaplain

2000 ◽  
Vol 54 (1) ◽  
pp. 23-32 ◽  
Author(s):  
Phyllis Brooks Toback
Keyword(s):  
Meaning In Life ◽  
Oral Tradition ◽  
Hospital Chaplain ◽  
Life And Death ◽  
The Public ◽  
Modern Times ◽  
Jewish Hospital ◽  
The Impact ◽  
Different Levels

Addresses the issue of life and death choices from the perspective of a Jewish chaplain. Explores the tension between the law ( Halachah) and experience or story ( Aggadah) and the impact of that tension on lives and decisions. Cites persons and situations from biblical material, oral tradition, and modern times which illustrate the human struggle with these disputed issues. Explores different levels of pain and our understanding of and response to suffering. Invites reflection on the range of responses to pain that are humanly possible. Illustrates how meaning in life nurtures the desire to live. Claims this meaning aspect is not adequately addressed in the current dialogue. Focusses on the role of chaplains in listening and responding to persons and in helping to activate the impulse of hope. Suggests ways in which chaplains can be advocates for patients, prophetic voices within communities and institutions, and empowering of the gifts of others.

scholarly journals Estimating the impact of interventions against COVID-19: from lockdown to vaccination

2021 ◽  
Author(s):  
James Thompson ◽  
Stephen Wattam
Keyword(s):  
Spatial Clustering ◽  
Herd Immunity ◽  
Contact Tracing ◽  
Agent Based Model ◽  
Seir Model ◽  
Agent Based ◽  
Resident Population ◽  
First Case ◽  
Equivalent Equation ◽  
The Impact

AbstractCoronavirus disease 2019 (COVID-19) is an infectious disease of humans caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Since the first case was identified in China in December 2019 the disease has spread worldwide, leading to an ongoing pandemic. In this article, we present a detailed agent-based model of COVID-19 in Luxembourg, and use it to estimate the impact, on cases and deaths, of interventions including testing, contact tracing, lockdown, curfew and vaccination.Our model is based on collation, with agents performing activities and moving between locations accordingly. The model is highly heterogeneous, featuring spatial clustering, over 2000 behavioural types and a 10 minute time resolution. The model is validated against COVID-19 clinical monitoring data collected in Luxembourg in 2020.Our model predicts far fewer cases and deaths than the equivalent equation-based SEIR model. In particular, with R0 = 2.45, the SEIR model infects 87% of the resident population while our agent-based model results, on average, in only around 23% of the resident population infected. Our simulations suggest that testing and contract tracing reduce cases substantially, but are much less effective at reducing deaths. Lockdowns appear very effective although costly, while the impact of an 11pm-6am curfew is relatively small. When vaccinating against a future outbreak, our results suggest that herd immunity can be achieved at relatively low levels, with substantial levels of protection achieved with only 30% of the population immune. When vaccinating in midst of an outbreak, the challenge is more difficult. In this context, we investigate the impact of vaccine efficacy, capacity, hesitancy and strategy.We conclude that, short of a permanent lockdown, vaccination is by far the most effective way to suppress and ultimately control the spread of COVID-19.

scholarly journals Enhanced comparisons of COVID-19 mortality across populations

2020 ◽  
Author(s):  
Chalapati Rao ◽  
Suhail A. Doi ◽  
Gail Williams
Keyword(s):  
Health System ◽  
Age Distribution ◽  
Case Fatality ◽  
The South ◽  
South Korean ◽  
Age Variations ◽  
Incidence And Mortality ◽  
System Factors ◽  
The Impact ◽  
Age Structures

AbstractBackgroundThe reported crude case fatality rate (CFR) for COVID-19 varies considerably across countries. Crude CFRs could by biased by larger proportions of older COVID-19 cases in population data, who are also at increased mortality risk. Such distorted age case structures are a common feature of selective COVID 19 testing strategies in many countries, and they potentially mask underlying differences arising from other important factors such as health system burden.MethodsWe used the method of direct case-age standardisation to evaluate the effects of age variations on CFRs. Data on cases and death by age from Italy, Spain, China, Australia and South Korea were analysed to derive standardised CFRs. Findings were compared across different case age distribution references as standards.ResultsUsing the South Korean case age distribution as a standard, the fivefold higher crude CFR for Italy is reduced to less than two-fold after adjustment, while the crude CFR difference for Spain is virtually eliminated. The adjusted CFR for Australia is the lowest among all countries.DiscussionMortality differences based on crude CFRs are exaggerated by age structures, which are effectively controlled by case age standardization. Residual CFR differences could be attributed to health and health system factors. The South Korean case age distribution is an appropriate reference standard, given its robust case detection and contact tracing program. Till reliable population level indicators of incidence and mortality are available, the age-standardized CFR could be a viable option for international comparison of the impact of the COVID 19 epidemic.SummaryThe knownThere are intense debates around the magnitude of and reasons for wide variations in observed case fatality rates (CFRs) from COVID 19 across countries. Age is commonly speculated as a reason, but this has not been technically quantified or explained.The newThe technique of direct standardization using reference distributions of case age structures eliminates the effects of age on CFR, thus enhancing the comparability as well as understanding of differentialsThe implicationsResidual differences between adjusted CFRs can be used to infer health and health system factors that influence mortality in COVID 19 cases in different populations

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