The projected impact of mitigation and suppression strategies on the COVID-19 epidemic in Senegal: A modelling study

AbstractBackgroundPhysical distancing measures that reduce social contacts have formed a key part of national COVID-19 containment and mitigation strategies. Many Sub-Saharan African nations are now facing increasing numbers of cases of COVID-19 and there is a need to understand what levels of measures may be required to successfully reduce transmission.MethodsWe collated epidemiological data along with information on key COVID-19 specific response policies and health system capacity estimates for services needed to treat COVID-19 patients in Senegal. We calibrated an age-structured SEIR model to these data to capture transmission dynamics accounting for demography, contact patterns, hospital capacity and disease severity. We simulated the impact of mitigation and suppression strategies focussed on reducing social contact rates.ResultsSenegal acted promptly to contain the spread of SARS-CoV-2 and as a result has reduced the reproduction number from 1.9 (95% CI 1.7-2.2) to 1.3 (95% CI 1.2-1.5), which has slowed but not fully interrupted transmission. We estimate that continued spread is likely to peak in October, and to overwhelm the healthcare system with an estimated 77,400 deaths (95% CI 55,270-100,700). Further reductions in contact rates to suppress transmission (Rt<1) could significantly reduce this burden on healthcare services and improve overall health outcomes.ConclusionsOur results demonstrate that Senegal has already significantly reduced transmission. Enhanced physical distancing measures and rapid scale up of hospital capacity is likely to be needed to reduce mortality and protect healthcare infrastructure from high levels of demand.

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Years of life lost due to the psychosocial consequences of COVID-19 mitigation strategies based on Swiss data

European Psychiatry ◽

10.1192/j.eurpsy.2020.56 ◽

2020 ◽

Vol 63 (1) ◽

Cited By ~ 11

Author(s):

Dominik A. Moser ◽

Jennifer Glaus ◽

Sophia Frangou ◽

Daniel S. Schechter

Keyword(s):

Public Health ◽

Significant Risk ◽

Social Contact ◽

Mitigation Strategies ◽

Mitigation Measures ◽

Years Of Life Lost ◽

Psychosocial Consequence ◽

Psychosocial Consequences ◽

The Impact

Abstract Background. The pandemic caused by coronavirus disease 2019 (COVID-19) has forced governments to implement strict social mitigation strategies to reduce the morbidity and mortality from acute infections. These strategies, however, carry a significant risk for mental health, which can lead to increased short-term and long-term mortality and is currently not included in modeling the impact of the pandemic. Methods. We used years of life lost (YLL) as the main outcome measure, applied to Switzerland as an example. We focused on suicide, depression, alcohol use disorder, childhood trauma due to domestic violence, changes in marital status, and social isolation, as these are known to increase YLL in the context of imposed restriction in social contact and freedom of movement. We stipulated a minimum duration of mitigation of 3 months based on current public health plans. Results. The study projects that the average person would suffer 0.205 YLL due to psychosocial consequence of COVID-19 mitigation measures. However, this loss would be entirely borne by 2.1% of the population, who will suffer an average of 9.79 YLL. Conclusions. The results presented here are likely to underestimate the true impact of the mitigation strategies on YLL. However, they highlight the need for public health models to expand their scope in order to provide better estimates of the risks and benefits of mitigation.

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Perceived Consequences of Healthcare Service Decentralization on Access, Affordability and Quality of Care in Khartoum Locality, Sudan

10.21203/rs.3.rs-79989/v1 ◽

2020 ◽

Author(s):

Bandar Noory ◽

Sara Hassanein ◽

Jeffrey Edwards ◽

Benedikte Victoria Lindskog

Keyword(s):

Quality Of Care ◽

Healthcare Providers ◽

Quality Of Healthcare ◽

Healthcare Services ◽

System Capacity ◽

Cross Sectional ◽

Study Results ◽

Catchment Areas ◽

The Impact

Abstract Background: Decentralization of healthcare services have been widely utilized, especially in developing countries, to improve the performance of healthcare systems by increasing the access and efficiency of service delivery. Experiences have been variable secondary to disparities in financial and human resources, system capacity and community engagement. Sudan is no exception and understanding the perceived effect of decentralization on access, affordability, and quality of care among stakeholders is crucial.Methods: This was a mixed method, cross-sectional, explorative study that involved 418 household members among catchment areas and 40 healthcare providers of Ibrahim Malik Hospital (IBMH) and Khartoum Teaching Hospital (KTH). Data were collected through a structured survey and in-depth interviews from July-December 2015.Results: Access, affordability and quality of healthcare services were all perceived as worse, compared to before decentralization was implemented. Reported affordability was found to be 53% and 55% before decentralization compared to 24% to 16% after decentralization, within KTH and IBMH catchment areas respectively, (p= 0.01). The quality of healthcare services were reported to have declined from 47% and 38% before decentralization to 38% and 28% after, in KTH and IBMH respectively (p=0.02). Accessibility was found to be more limited, with services being accessible before decentralization approximately 59% and 52% of the time, compared to 41% and 30% after, in KTH and IBMH catchment areas respectively, (p=0.01).Accessibility to healthcare was reported to have decreased secondary to facility closures, reverse transference of services, and low capacity of devolved facilities. Lastly, privatized services were reported as strengthened in response to this decentralization of healthcare. Conclusions: The deterioration of access, affordability and quality of health services was experienced as the predominant perception among stakeholders after decentralization implementation. Our study results suggest there is an urgent need for a review of the current healthcare policies, structure and management within Sudan in order to provide evidence and insights regarding the impact of decentralization.

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A data-driven epidemiological model to explain the Covid-19 pandemic in multiple countries and help in choosing mitigation strategies

10.1101/2020.08.15.20175588 ◽

2020 ◽

Author(s):

Maria Jardim Beira ◽

Anant Kumar ◽

Lilia Perfeito ◽

Joana Goncalves-Sa ◽

Pedro Jose Sebastiao

Keyword(s):

Epidemiological Data ◽

Mitigation Strategies ◽

Mitigation Measures ◽

Policy Recommendations ◽

Protection Measures ◽

Collective Behaviors ◽

Self Protection ◽

The Impact ◽

Government Level

Accurate models are fundamental to understand the dynamics of the COVID-19 pandemic and to evaluate different mitigation strategies. Here, we present a multi-compartmental model that fits the epidemiological data for eleven countries, despite the reduced number of fitting parameters. This model consistently explains the data for the daily infected, recovered, and dead over the first six months of the pandemic. The good quality of the fits makes it possible to explore different scenarios and evaluate the impact of both individual and collective behaviors and government- level decisions to mitigate the epidemic. We identify robust alternatives to lockdown, such as self- protection measures, and massive testing. Furthermore, communication and risk perception are fundamental to modulate the success of different strategies. The fitting/simulation tool is publicly available for use and test of other models, allowing for comparisons between different underlying assumptions, mitigation measures, and policy recommendations.

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COVID-PCD – a participatory research study on the impact of COVID-19 in people with Primary Ciliary Dyskinesia

10.1101/2020.11.11.20229922 ◽

2020 ◽

Author(s):

Eva SL Pedersen ◽

Eugénie NR Collaud ◽

Rebeca Mozun ◽

Cristina Ardura-Garcia ◽

Yin Ting Lam ◽

...

Keyword(s):

Support Groups ◽

Social Contact ◽

Epidemiological Data ◽

Course Of Disease ◽

Baseline Questionnaire ◽

Study Results ◽

Contact Behaviour ◽

The Impact ◽

Ciliary Dyskinesia

AbstractIntroductionCOVID-PCD is a participatory study initiated by people with PCD who have an essential vote in all stages of the research from the design of the study to the recruitment of participants, and interpretation and communication of the study results. COVID-PCD aims to collect epidemiological data in real time from people with PCD throughout the pandemic to describe incidence of COVID-19, symptoms, and course of disease; identify risk factors for prognosis; and assess experiences, wishes, and needs.MethodsThe study is advertised through patient support groups and participants register online on the study website (www.covid19pcd.ispm.ch). The study invites persons of any age from anywhere in the world with a suspected or confirmed PCD. A baseline questionnaire assesses details on PCD diagnosis, habitual symptoms, and COVID-19 episodes that occurred before study entry. Afterwards, participants receive a weekly follow-up questionnaire with questions on incident SARS-CoV-2 infections, current symptoms, social contact behaviour, and physical activity. Occasional thematic questionnaires are sent out focusing on emerging questions of interest chosen by people with PCD. In case of hospitalisation, patients or family members are asked to obtain a hospital report. Results are continuously analysed and summaries put online.ConclusionThe study started recruitment on April 30, 2020, and 556 people with PCD completed the baseline questionnaire by November 2, 2020. The COVID-PCD study is a participatory study that follows people with PCD during the COVID-19 pandemic, helps to empower affected persons, and serves as a platform for communication between patients, physicians, and researchers.

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Close contact infection dynamics over time: insights from a second large-scale social contact survey in Flanders, Belgium, in 2010-2011

10.1101/2020.09.30.20204891 ◽

2020 ◽

Cited By ~ 2

Author(s):

Thang Van Hoang ◽

Pietro Coletti ◽

Yimer Wasihun Kiffe ◽

Kim Van Kerckhove ◽

Sarah Vercruysse ◽

...

Keyword(s):

Large Scale ◽

Close Contact ◽

Social Contact ◽

Contact Rates ◽

Contact Patterns ◽

Time Period ◽

Social Mixing ◽

Mixing Patterns ◽

Contact Survey ◽

The Impact

AbstractBackgroundIn 2010-2011, we conducted a social contact survey in Flanders, Belgium, aimed at improving and extending the design of the first social contact survey conducted in Belgium in 2006. This second social contact survey aimed to enable, for the first time, the estimation of social mixing patterns for an age range of 0 to 99 years and the investigation of whether contact rates remain stable over this 5-year time period.MethodsDifferent data mining techniques are used to explore the data, and the age-specific number of social contacts and the age-specific contact rates are modelled using a GAMLSS model. We compare different matrices using assortativeness measures. The relative change in the basic reproduction number (R0) and the ratio of relative incidences with 95% bootstrap confidence intervals (BCI) are employed to investigate and quantify the impact on epidemic spread due to differences in gender, day of the week, holiday vs. regular periods and changes in mixing patterns over the 5-year time gap between the 2006 and 2010-2011 surveys. Finally, we compare the fit of the contact matrices in 2006 and 2010-2011 to Varicella serological data.ResultsAll estimated contact patterns featured strong homophily in age and gender, especially for small children and adolescents. A 30% (95% BCI [17%; 37%] ) and 29% (95% BCI [14%; 40%] ) reduction in R0 was observed for weekend versus weekdays and for holiday versus regular periods, respectively. Significantly more interactions between people aged 60+ years and their grandchildren were observed on holiday and weekend days than on regular weekdays. Comparing contact patterns using different methods did not show any substantial differences over the 5-year time period under study.ConclusionsThe second social contact survey in Flanders, Belgium, endorses the findings of its 2006 predecessor and adds important information on the social mixing patterns of people older than 60 years of age. Based on this analysis, the mixing patterns of people older than 60 years exhibit considerable heterogeneity, and overall, the comparison of the two surveys shows that social contact rates can be assumed stable in Flanders over a time span of 5 years.

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Atopic Dermatitis and Infertility: A Nationwide Retrospective Cohort Study

Dermatology ◽

10.1159/000515600 ◽

2021 ◽

pp. 1-7

Author(s):

Amir Horev ◽

Guy Shalom ◽

Adi Y. Weintraub ◽

Tamar Freud ◽

Arnon D. Cohen

Keyword(s):

Atopic Dermatitis ◽

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Large Scale ◽

Epidemiological Data ◽

Healthcare Services ◽

Control Group ◽

Potential Association ◽

The Impact

Background: Given that common pathophysiological factors play a role in atopic dermatitis (AD) and infertility, we assumed that the 2 conditions might demonstrate an epidemiological association. Large-scale epidemiological data on this topic are lacking. Objectives: The aim of this work was to evaluate the potential association between AD and infertility in a broad community-based population. Methods: A nationwide retrospective cohort study was conducted, analyzing the association between AD and infertility. We compared AD patients diagnosed by a dermatologist between 2002 and 2018 and a matched control group. The study population was subdivided according to age into adults (age ≥18 years) and children (age <18 years), and was further subdivided according to AD severity, classified as either mild or moderate-to-severe according to AD-related drug use and healthcare services utilization. Results: The study included 127,150 patients with AD and 127,071 comparison enrollees. AD was associated with a higher prevalence of infertility than that of the control group (1.4 and 1.1%, respectively). The prevalence of infertility, per 1,000 patient-years, was increased in patients with AD compared to that of the control group (2.17 and 1.7, respectively). Multivariate analysis for infertility demonstrated that AD was a key risk factor for infertility in both males and females with mild AD and moderate-to-severe AD. Conclusion: A significant association between AD and infertility was observed. This association suggests that infertility may be an additional manifestation of AD. Further studies are warranted to evaluate the impact of AD management in the setting of infertility and vice versa.

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The impact of COVID-19 and strategies for mitigation and suppression in low- and middle-income countries

Science ◽

10.1126/science.abc0035 ◽

2020 ◽

pp. eabc0035 ◽

Cited By ~ 58

Author(s):

Patrick G. T. Walker ◽

Charles Whittaker ◽

Oliver J Watson ◽

Marc Baguelin ◽

Peter Winskill ◽

...

Keyword(s):

Health Care ◽

Well Being ◽

Mitigation Strategies ◽

System Capacity ◽

Lower Income ◽

Middle Income ◽

Contact Patterns ◽

Limited Health ◽

Lower Income Countries ◽

The Impact

The ongoing COVID-19 pandemic poses a severe threat to public health worldwide. We combine data on demography, contact patterns, disease severity, and health care capacity and quality to understand its impact and inform strategies for its control. Younger populations in lower income countries may reduce overall risk but limited health system capacity coupled with closer inter-generational contact largely negates this benefit. Mitigation strategies that slow but do not interrupt transmission will still lead to COVID-19 epidemics rapidly overwhelming health systems, with substantial excess deaths in lower income countries due to the poorer health care available. Of countries that have undertaken suppression to date, lower income countries have acted earlier. However, this will need to be maintained or triggered more frequently in these settings to keep below available health capacity, with associated detrimental consequences for the wider health, well-being and economies of these countries.

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COVID-PCD – a participatory research study on the impact of COVID-19 in people with Primary Ciliary Dyskinesia

ERJ Open Research ◽

10.1183/23120541.00843-2020 ◽

2020 ◽

pp. 00843-2020

Author(s):

Eva S. L. Pedersen ◽

Eugénie N. R. Collaud ◽

Rebeca Mozun ◽

Cristina Ardura-Garcia ◽

Yin Ting Lam ◽

...

Keyword(s):

Support Groups ◽

Social Contact ◽

Epidemiological Data ◽

Course Of Disease ◽

Baseline Questionnaire ◽

Study Results ◽

Contact Behaviour ◽

The Impact ◽

Ciliary Dyskinesia

IntroductionCOVID-PCD is a participatory study initiated by people with PCD who have an essential vote in all stages of the research from the design of the study to the recruitment of participants, and interpretation and communication of the study results. COVID-PCD aims to collect epidemiological data in real time from people with PCD throughout the pandemic to describe incidence of COVID-19, symptoms, and course of disease; identify risk factors for prognosis; and assess experiences, wishes, and needs.MethodsThe study is advertised through patient support groups and participants register online on the study website (www.covid19pcd.ispm.ch). The study invites persons of any age from anywhere in the world with a suspected or confirmed PCD. A baseline questionnaire assesses details on PCD diagnosis, habitual symptoms, and COVID-19 episodes that occurred before study entry. Afterwards, participants receive a weekly follow-up questionnaire with questions on incident SARS-CoV-2 infections, current symptoms, social contact behaviour, and physical activity. Occasional thematic questionnaires are sent out focusing on emerging questions of interest chosen by people with PCD. In case of hospitalisation, patients or family members are asked to obtain a hospital report. Results are continuously analysed and summaries put online.ConclusionThe study started recruitment on April 30, 2020, and 556 people with PCD completed the baseline questionnaire by November 2, 2020. The COVID-PCD study is a participatory study that follows people with PCD during the COVID-19 pandemic, helps to empower affected persons, and serves as a platform for communication between patients, physicians, and researchers.

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Years of life lost due to the psychosocial consequences of COVID19 mitigation strategies based on Swiss data

10.1101/2020.04.17.20069716 ◽

2020 ◽

Cited By ~ 4

Author(s):

Dominik A. Moser ◽

Jennifer Glaus ◽

Sophia Frangou ◽

Daniel S. Schechter

Keyword(s):

Public Health ◽

Significant Risk ◽

Social Contact ◽

Mitigation Strategies ◽

Mitigation Measures ◽

Years Of Life Lost ◽

Psychosocial Consequence ◽

Psychosocial Consequences ◽

The Impact

BackgroundThe pandemic caused by COVID-19 has forced governments to implement strict social mitigation strategies to reduce the morbidity and mortality from acute infections. These strategies however carry a significant risk for mental health which can lead to increased short-term and long-term mortality and is currently not included in modelling the impact of the pandemic.MethodsWe used years of life lost (YLL) as the main outcome measure as applied to Switzerland as an exemplar. We focused on suicide, depression, alcohol use disorder, childhood trauma due to domestic violence, changes in marital status and social isolation as these are known to increase YLL in the context of imposed restriction in social contact and freedom of movement. We stipulated a minimum duration of mitigation of 3 months based on current public health plans.ResultsThe study projects that the average person would suffer 0.205 YLL due to psychosocial consequence of COVID-19 mitigation measures. However, this loss would be entirely borne by 2.1% of the population, who will suffer an average 9.79 YLL.ConclusionsThe results presented here are likely to underestimate the true impact of the mitigation strategies on YLL. However, they highlight the need for public health models to expand their scope in order to provide better estimates of the risks and benefits of mitigation.

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Close contact infection dynamics over time: insights from a second large-scale social contact survey in Flanders, Belgium, in 2010-2011

BMC Infectious Diseases ◽

10.1186/s12879-021-05949-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Thang Van Hoang ◽

Pietro Coletti ◽

Yimer Wasihun Kifle ◽

Kim Van Kerckhove ◽

Sarah Vercruysse ◽

...

Keyword(s):

Close Contact ◽

Social Contact ◽

Additive Models ◽

Contact Rates ◽

Contact Patterns ◽

Time Period ◽

Social Mixing ◽

Mixing Patterns ◽

Contact Survey ◽

The Impact

Abstract Background In 2010-2011, we conducted a social contact survey in Flanders, Belgium, aimed at improving and extending the design of the first social contact survey conducted in Belgium in 2006. This second social contact survey aimed to enable, for the first time, the estimation of social mixing patterns for an age range of 0 to 99 years and the investigation of whether contact rates remain stable over this 5-year time period. Methods Different data mining techniques are used to explore the data, and the age-specific number of social contacts and the age-specific contact rates are modelled using a generalized additive models for location, scale and shape (GAMLSS) model. We compare different matrices using assortativeness measures. The relative change in the basic reproduction number (R0) and the ratio of relative incidences with 95% bootstrap confidence intervals (BCI) are employed to investigate and quantify the impact on epidemic spread due to differences in sex, day of the week, holiday vs. regular periods and changes in mixing patterns over the 5-year time gap between the 2006 and 2010-2011 surveys. Finally, we compare the fit of the contact matrices in 2006 and 2010-2011 to Varicella serological data. Results All estimated contact patterns featured strong homophily in age and sex, especially for small children and adolescents. A 30% (95% BCI [17%; 37%]) and 29% (95% BCI [14%; 40%]) reduction in R0 was observed for weekend versus weekdays and for holiday versus regular periods, respectively. Significantly more interactions between people aged 60+ years and their grandchildren were observed on holiday and weekend days than on regular weekdays. Comparing contact patterns using different methods did not show any substantial differences over the 5-year time period under study. Conclusions The second social contact survey in Flanders, Belgium, endorses the findings of its 2006 predecessor and adds important information on the social mixing patterns of people older than 60 years of age. Based on this analysis, the mixing patterns of people older than 60 years exhibit considerable heterogeneity, and overall, the comparison of the two surveys shows that social contact rates can be assumed stable in Flanders over a time span of 5 years.

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