scholarly journals Optimal Control Measures to Combat COVID 19 Spread in Sri Lanka: A Mathematical Model Considering the Heterogeneity of Cases

2020 ◽  
Author(s):  
Tharindu Wickramaarachchi ◽  
Sanjeewa Perera
Keyword(s):  
Public Health ◽  
Mathematical Model ◽  
Optimal Control ◽  
Sri Lanka ◽  
Health System ◽  
Economic Cost ◽  
Control Measures ◽  
Disease Spread ◽  
Local Case ◽  
The Government

The COVID 19 pandemic caused by the novel corona virus (SARS-CoV-2) has been one of the major public health concerns across the globe, currently more than 3.5 million individuals have been infected, and the number of deaths has passed 250,000. The world wide burden of the disease has been massive, and the governments are in dilemma to protect the health system of the country while safeguarding the economy. There is no vaccine or antivirus drug found against this virus while multiple research groups are actively working on a suitable candidate. The only available mode of minimizing the disease burden has been to control its transmission among the population. Since the occurrence of first COVID 19 local case on 11 March 2020, the government of Sri Lanka introduced serious social distancing and public health interventions in its fullest capacity as a developing nation to effectively combat with the disease spread. This study focuses to develop a mathematical model to investigate the dynamic of this novel disease using an extended version of an SEIR compartmental structure considering the heterogeneity of cases such as asymptomatic, symptomatic with mild indications and the cases required intensive care treatments. All the measures and interventions are in progress with a significantly large social and economic cost, thus, optimal control techniques are used to identify the most appropriate strategies to minimize this cost. The results of the simulations prove that optimal control measures can be worked out as the epidemic curves are flattened while delaying the outbreak so that the health system might not be under pressure to treat and care the patients.

scholarly journals Strengthening health system building blocks: configuring post-COVID-19 scenario in Pakistan

2021 ◽  
Vol 22 ◽  
Author(s):  
Babar Tasneem Shaikh
Keyword(s):  
Public Health ◽  
Developing Countries ◽  
Health System ◽  
Emergency Preparedness ◽  
Virus Disease ◽  
Building Blocks ◽  
Research Capacity ◽  
Control Measures ◽  
World Health ◽  
The Government

Abstract Aim: To gauge the level of preparedness of health system of Pakistan in the wake of Corona Virus Disease 2019 (COVID-19) pandemic. Background: The global COVID-19 outbreak and its subsequent repercussions and implications, after being declared as a pandemic by the World Health Organization (WHO), exposed all the inherent, lingering, and acute shortcomings of the health systems in many developing countries and Pakistan was no exception. Methods: A detailed literature review was done which included peer-reviewed articles on COVID-19 and health system, published in local and international journals, WHO and World Bank’s publications, and the documents and official reports of the government. Focus was to glean and cite strategies adopted by the developing countries in response to COVID-19 and to see the applicability of those which are feasible for Pakistan. Findings: Level of preparedness was minimal and the response to manage the outbreak was weak. Based on toll of the cases and number of deaths, this public health threat turned out to be a catastrophe beyond the controlling authority and capacity of the health system, and hence other sectors and agencies had to be engaged for devising a concerted and integrated response to deal with the emergency. Governance was disorderly, financing was inadequate, human resources were not trained, supplies and logistic were not stocked, information system was patchy, and research capacity was limited, and most of all the service delivery was in a biggest chaos of times. COVID-19 demanded to re-configure the health system of Pakistan. Conclusion: Improving the emergency preparedness of the hospitals is the foremost and an urgent need. A strong national public health system in Pakistan is needed to rapidly investigate and analyze the reports, assess the magnitude of the public health risk, share real-time information, and implement public health control measures in a concerted and systematic demeanor.

scholarly journals COVID-19 epidemic in Sri Lanka: A mathematical and computational modelling approach to control

2020 ◽  
Author(s):  
WPTM Wickramaarachchi ◽  
SSN Perera ◽  
S Jayasignhe
Keyword(s):  
Sri Lanka ◽  
Computational Modelling ◽  
Control Measures ◽  
Critical Parameters ◽  
World Population ◽  
Sri Lankan ◽  
Social Distancing ◽  
First Case ◽  
Local Case ◽  
The Government

AbstractThe ongoing COVID19 outbreak originated in the city of Wuhan, China has caused a significant damage to the world population and the global economy. It has claimed more than 50,000 lives worldwide and more than one million of people have been infected as of 04th April 2020.In Sri Lanka, the first case of COVI19 was reported late January 2020 was a Chinese national and the first local case was identified in the second week of March. Since then, the government of Sri Lanka introduced various sequential measures to improve social distancing such as closure of schools and education institutes, introducing work from home model to reduce the public gathering, introducing travel bans to international arrivals and more drastically, imposed island wide curfew expecting to minimize the burden of the disease to the Sri Lankan health system and the entire community. Currently, there are 159 cases with five fatalities and also reported that 24 patients are recovered and discharged from hospitals.In this study, we use the SEIR conceptual model and its modified version by decomposing infected patients into two classes; patients who show mild symptoms and patients who tend to face severe respiratory problems and are required to treat in intensive care units. We numerically simulate the models for about five months period considering three critical parameters of COVID transmission mainly in the Sri Lankan context; efficacy of control measures, rate of overseas imported cases and time to introduce social distancing measures by the respective authorities.

scholarly journals COVID-19 Crisis in Jordan: Response, Scenarios, Strategies, and Recommendations (Preprint)

2020 ◽  
Author(s):  
Raeda Alqutob ◽  
Mohannad Al Nsour ◽  
Mohammed Rasoul Tarawneh ◽  
Musa Ajlouni ◽  
Yousef Khader ◽  
...  
Keyword(s):  
Public Health ◽  
Health System ◽  
Prevention And Control ◽  
Civil Society Organizations ◽  
Control Measures ◽  
Disease Spread ◽  
Infection Prevention And Control ◽  
Health Staff ◽  
Prevention And Control Measures ◽  
And Control

UNSTRUCTURED As of April 12, 2020, a total of 389 cases of coronavirus disease were confirmed in Jordan. To control this imminent threat, Jordan has enforced public health infection prevention and control measures, called for social distancing, seized all forms of inbound and outbound movement and international travel, and enacted the Defence Law that transferred the authority to the Minister of Defence to work and formulate orders according to the situation. In an effort to support the government in anticipating the requirements of the health system in the upcoming period, an in-depth reflection and examination of different scenarios of the disease spread were developed. This viewpoint suggests different strategies and measures for case detection and contact tracing, clinical management of cases, public health system functioning, and civil society organizations’ contribution. It is necessary to accelerate containment of the disease to protect the economy and to maintain the continuity of some activities to mitigate the subsequent social, economic, and financial impacts. This requires finding a coping mechanism for a period that may be prolonged until laboratories develop a vaccine. Specifically, it is strongly recommended to promote community health awareness toward public health prevention and control measures, increase the efficiency and comprehensiveness of the epidemiological investigation and active and passive surveillance, and employ technology and digital health solutions to track cases and contacts. It is also recommended to increase and expand resources of intensive care units including respirators, increase the capacity and the number of trained health staff in the area of public health and epidemiology, ensure continued provision of essential public health programs, and mobilize the resources of nongovernmental sectors and donors to provide services for refugees and vulnerable populations.

scholarly journals COVID-19 Crisis in Jordan: Response, Scenarios, Strategies, and Recommendations

10.2196/19332 ◽  
2020 ◽  
Vol 6 (3) ◽  
pp. e19332 ◽  
Author(s):  
Raeda Alqutob ◽  
Mohannad Al Nsour ◽  
Mohammed Rasoul Tarawneh ◽  
Musa Ajlouni ◽  
Yousef Khader ◽  
...  
Keyword(s):  
Public Health ◽  
Health System ◽  
Prevention And Control ◽  
Civil Society Organizations ◽  
Control Measures ◽  
Disease Spread ◽  
Infection Prevention And Control ◽  
Health Staff ◽  
Prevention And Control Measures ◽  
And Control

As of April 12, 2020, a total of 389 cases of coronavirus disease were confirmed in Jordan. To control this imminent threat, Jordan has enforced public health infection prevention and control measures, called for social distancing, seized all forms of inbound and outbound movement and international travel, and enacted the Defence Law that transferred the authority to the Minister of Defence to work and formulate orders according to the situation. In an effort to support the government in anticipating the requirements of the health system in the upcoming period, an in-depth reflection and examination of different scenarios of the disease spread were developed. This viewpoint suggests different strategies and measures for case detection and contact tracing, clinical management of cases, public health system functioning, and civil society organizations’ contribution. It is necessary to accelerate containment of the disease to protect the economy and to maintain the continuity of some activities to mitigate the subsequent social, economic, and financial impacts. This requires finding a coping mechanism for a period that may be prolonged until laboratories develop a vaccine. Specifically, it is strongly recommended to promote community health awareness toward public health prevention and control measures, increase the efficiency and comprehensiveness of the epidemiological investigation and active and passive surveillance, and employ technology and digital health solutions to track cases and contacts. It is also recommended to increase and expand resources of intensive care units including respirators, increase the capacity and the number of trained health staff in the area of public health and epidemiology, ensure continued provision of essential public health programs, and mobilize the resources of nongovernmental sectors and donors to provide services for refugees and vulnerable populations.

scholarly journals AN EPIDEMIOLOGICAL MODEL TO AID DECISION-MAKING FOR COVID-19 CONTROL IN SRI LANKA

2020 ◽  
Author(s):  
Dileepa Senajith Ediriweera ◽  
Nilanthi Renuka de Silva ◽  
Neelika Gathsaurie Malavige ◽  
Hithanadura Janaka de Silva
Keyword(s):  
Sri Lanka ◽  
Health System ◽  
Web Application ◽  
Doubling Time ◽  
Moving Average ◽  
Health Resources ◽  
Infectious Period ◽  
Case Load ◽  
Local Case ◽  
The Government

AbstractBackgroundSri Lanka diagnosed its first local case of COVID-19 on 11 March 2020. The government acted swiftly to contain transmission, with extensive public health measures. At the end of 30 days, Sri Lanka had 197 cases, 54 recovered and 7 deaths; a staged relaxing of the lockdown is now underway. This paper proposes a theoretical basis for estimating the limits within which transmission should be constrained in order to ensure that the case load remains within the capacity of the health system.MethodsWe used Susceptible, Infected, Recovered model to estimate the ICU bed requirement at different levels of R0 values after lockout. We developed a web application that enables visualization of cases and ICU bed requirements with time, with adjustable parameters that include: population exposed; proportion asymptomatic; number of active and recovered cases; infectious period; R0 or doubling time; proportion critically ill; available ICU beds and duration of ICU stay.ResultsThe three-day moving average of the caseload suggested two waves of transmission from Day 0 to 17 (R0=3.32, 95% CI 1.85 - 5.41) and from Day 18 - 30 (R=1.25, 95%CI: 0.93 - 1.63). We estimate that if there are 156 active cases with 91 recovered at the time of lockout, and R increases to 1.5 (doubling time 19 days), under the standard parameters for Sri Lanka, the ICU bed capacity of 300 is likely to be saturated by about 100 days, signalled by 18 new infections (95% CI 15 - 22) on Day 14 after lockout.ConclusionOur model suggests that to ensure that the case load remains within the available capacity of the health system after lockout, transmission should not exceed R=1.5. This model and the web-based application may be useful in other low- and middle-income countries which have similar constraints on health resources.

scholarly journals Fractional-Order Modelling and Optimal Control of Cholera Transmission

2021 ◽  
Vol 5 (4) ◽  
pp. 261
Author(s):  
Silvério Rosa ◽  
Delfim F. M. Torres
Keyword(s):  
Mathematical Model ◽  
Optimal Control ◽  
Sensitivity Analysis ◽  
Fractional Order ◽  
Control Measures ◽  
Time Interval ◽  
Variable Order ◽  
Effectiveness Analysis ◽  
The Cost ◽  
Derivative Order

A Caputo-type fractional-order mathematical model for “metapopulation cholera transmission” was recently proposed in [Chaos Solitons Fractals 117 (2018), 37–49]. A sensitivity analysis of that model is done here to show the accuracy relevance of parameter estimation. Then, a fractional optimal control (FOC) problem is formulated and numerically solved. A cost-effectiveness analysis is performed to assess the relevance of studied control measures. Moreover, such analysis allows us to assess the cost and effectiveness of the control measures during intervention. We conclude that the FOC system is more effective only in part of the time interval. For this reason, we propose a system where the derivative order varies along the time interval, being fractional or classical when more advantageous. Such variable-order fractional model, that we call a FractInt system, shows to be the most effective in the control of the disease.

scholarly journals Effective COVID-19 Control: A Comparative Analysis of the Stringency and Timeliness of Government Responses in Asia

2021 ◽  
Vol 18 (16) ◽  
pp. 8686
Author(s):  
Shu Chen ◽  
Lei Guo ◽  
Taghred Alghaith ◽  
Di Dong ◽  
Mohammed Alluhidan ◽  
...  
Keyword(s):  
Public Health ◽  
Hong Kong ◽  
South Korea ◽  
Health System ◽  
Mainland China ◽  
Initial Response ◽  
Control Measures ◽  
System Control ◽  
East And Southeast Asia ◽  
Study Sites

Aim: Many governments in East and Southeast Asia responded promptly and effectively at the onset of the COVID-19 pandemic. Synthesizing and analyzing these responses is vital for disease control evidence-based policymaking. Methods: An extensive review of COVID-19 control measures was conducted in selected Asian countries and subregions, including Mainland China, Hong Kong, Taiwan, South Korea, Singapore, Japan, and Vietnam from 1 January to 30 May 2020. Control measures were categorized into administrative, public health, and health system measures. To evaluate the stringency and timeliness of responses, we developed two indices: the Initial Response Index (IRI) and the Modified Stringency Index (MSI), which builds on the Oxford COVID-19 Government Response Tracker (OxCGRT). Results: Comprehensive administrative, public health, and health system control measures were implemented at the onset of the outbreak. Despite variations in package components, the stringency of control measures across the study sites increased with the acceleration of the outbreak, with public health control measures implemented the most stringently. Variations in daily average MSI scores are observed, with Mainland China scoring the highest (74.2), followed by Singapore (67.4), Vietnam (66.8), Hong Kong (66.2), South Korea (62.3), Taiwan (52.1), and Japan (50.3). Variations in IRI scores depicting timeliness were higher: Hong Kong, Taiwan, Vietnam, and Singapore acted faster (IRI > 50.0), while Japan (42.4) and Mainland China (4.2) followed. Conclusions: Timely setting of stringency of the control measures, especially public health measures, at dynamically high levels is key to optimally controlling outbreaks.

COVID-19 in Ebola’s Wake

2021 ◽  
Vol 120 (826) ◽  
pp. 167-171
Author(s):  
Adia Benton
Keyword(s):  
Public Health ◽  
Health System ◽  
Sierra Leone ◽  
Media Coverage ◽  
International Travel ◽  
Previous Experience ◽  
Health Issues ◽  
Global Crisis ◽  
The Government ◽  
Western Media

Like other African nations, Sierra Leone seemed to avoid the worst pandemic scenarios. Its previous experience with Ebola may have led to improved preparedness in the health system. But the government has once again reverted to a militarized response, and elites returning from international travel may pose a risk of spreading the coronavirus. The author also reflects on the challenges of tracking the situation from afar, in the midst of a global crisis, and critically assesses Western media coverage of African public health issues.

scholarly journals Partnership for productive development of biosimilar products: perspectives of access to biological products in the Brazilian market

2018 ◽  
Vol 16 (3) ◽  
Author(s):  
Morton Aaron Scheinberg ◽  
Paulo Antonio Oldani Felix ◽  
Igor Age Kos ◽  
Maurício De Angelo Andrade ◽  
Valderilio Feijó Azevedo
Keyword(s):  
Public Health ◽  
Health System ◽  
Public Health System ◽  
Regulatory Agencies ◽  
Efficacy And Safety ◽  
Potential Cost ◽  
Biological Products ◽  
The Public ◽  
Technological Transfer ◽  
The Government

ABSTRACT The manufacturing process for biological products is complex, expensive and critical to the final product, with an impact on their efficacy and safety. They have been increasingly used to treat several diseases, and account for approximately 50% of the yearly budget for the Brazilian public health system. As the patents of biological products expire, several biosimilars are developed. However, there are concerns regarding their efficacy and safety; therefore, the regulatory agencies establish rules to approve and monitor these products. In Brazil, partnership programs between national government-owned companies and private technology holders have been implemented, aiming at knowledge sharing, capacity-building and technological transfer. Such partnerships locally promote manufacturing of these strategic drugs at reduced costs to the public health system. These agreements offer mutual advantages to both the government and patent holders: for the former, a biotechnological development flow is established and enables potential cost reduction and self-sufficient production; whereas for the latter, exclusive sales of the product are ensured during technological transfer, for a fixed period.

scholarly journals Breast Feeding in Pandemic Situation. How Does Sri Lanka Face the Challenge?

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 214-214
Author(s):  
Neerodha Dharmasoma
Keyword(s):  
Public Health ◽  
Sri Lanka ◽  
Health System ◽  
Breast Feeding ◽  
Public Health System ◽  
Feeding Practices ◽  
Health Staff ◽  
Emergency Situations ◽  
Public Health Staff ◽  
The Impact

Abstract Objectives Sri Lanka has been awarded the first-ever ‘Green’ breastfeeding (BF) nation status by the World Breastfeeding Trends Initiative (WBTi) in January 2020 (1) with the support of public health system. But, deviating attention of health services towards emergency pandemic situation has resulted in strained health systems and interruptions in humanitarian response leading to eroding access to essential and often life-saving nutrition services. Therefore, optimal breast feeding practices are at risk due to infected mothers’ isolation practices, exhausted public health system and misbeliefs among the community (2). This finds out how Sri Lanka plans to maintain high standards of breast feeding in pandemic situation. Methods We searched for the publications on breast feeding, Sri Lanka in pandemic situation from January 2020 to date. Results As a low and middle income country with an unbeatable public health system, Sri Lanka has already issued an interim guideline for public health staff in continuation maternal and child care services (3). It ensures domiciliary visits by public health midwives (PHMs), although the clinic based teaching sessions on breast feeding have been cancelled. Community awareness has been created that no evidence of transmission of SARS COV-2 via breast milk is available and how the benefits of breast feeding outweigh the risk of infection (4). It is recommended that breast feeding shouldn't be interrupted at all and hand hygienic practices before touching the baby are ideal. Infected mothers can wear a protective mask and rooming in, and kangaroo mother care should be practiced. Sri Lanka already had guidelines on ensuring adequate and appropriate infant feeding guidelines in emergency situations (5). Conclusions Despite the challenges faced by community and public health staff, Sri Lanka make efforts to maintain the achieved breast feeding standards. Further studies are needed to assess the impact of the pandemic on breast feeding practices in near future. Funding Sources None

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