scholarly journals The UK Covid-19 lockdown weakened in April and May 2020: implications for the size of the epidemic and for outcomes had lockdown been earlier

2020 ◽  
Author(s):  
Anthony D Lander
Keyword(s):  
Stochastic Model ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
Fatality Rate ◽  
Daily Mortality ◽  
Mortality Curve ◽  
Epidemic Curve ◽  
Mobility Data ◽  
The Uk ◽  
Low Prevalence

The number of active cases in the UK Covid-19 epidemic, the case fatality rate, the susceptible proportion of the population, and how well the lockdown was maintained during April-May 2020 are unknown. These four have a relationship with the shape of the daily mortality curve once one considers the intervals from infection to death or recovery. Without an understanding of this relationship we cannot say that an earlier lockdown would have saved lives. Using a small stochastic model, the lockdown had to be weakened, in April and May, for simulated deaths to match ongoing actual daily deaths. Google mobility data was found to be consistent with the weakening required in the model with similar changes from baseline in time and magnitude. If in an earlier lockdown, mobility and interactions would have followed a similar course, then with a large epidemic curve an earlier lockdown might be associated with many more deaths than some currently believe. This was confirmed in the stochastic model and in two modified SIR models of epidemics of various sizes. The first SIR model had a fixed period to recovery and the second used random periods, both models had random periods to death. Weakening of the mitigations was required to tune the output in large but not in small epidemics. This gives weight to the epidemic having affected many more individuals than some reports currently suggest. In both one and two-week earlier lockdowns, total deaths were found to depend on the size of the epidemic and to vary from 2,000-49,000 deaths. There was a linear relationship between the peak proportion of the population infected and the reciprocal of the case fatality rate. This work questions the low prevalence of < 0.1%, reported by the Office for National Statistics in May and June 2020, since to accommodate a weakening lockdown, the shape of the daily mortality curve, and an acceptable case fatality rate a much larger epidemic curve is required.

Road Traffic Collisions—Case Fatality Rate, Crash Injury Rate, and Number of Motor Vehicles: Time Trends between a Developed and Developing Country

2010 ◽  
Vol 76 (9) ◽  
pp. 977-981 ◽  
Author(s):  
Sanchia S. Goonewardene ◽  
Khalid Baloch ◽  
Keith Porter ◽  
Ian Sargeant ◽  
Gamini Punchihewa
Keyword(s):  
Visual Impairment ◽  
Case Fatality Rate ◽  
Road Traffic ◽  
Case Fatality ◽  
Injury Rate ◽  
Cross Sectional Study ◽  
Motor Vehicles ◽  
Fatality Rate ◽  
Cross Sectional ◽  
The Uk

Road traffic collisions (RTCs) are one of the most common preventable causes of death and disability worldwide. We investigated changes in numbers of motor vehicles, case fatality rate, and crash injury rate for the most present recorded year (2002) 5 and 10 years before that in the United Kingdom (UK) and Sri Lanka (SL). We also investigated environmental and individual factors impacting patients at South Birmingham Trauma Unit, UK and Colombo General Hospital, SL. We conducted a descriptive cross-sectional study (both quantitative and qualitative). Over the 10-year period, numbers of motor vehicles have risen in both countries; the crash injury remained stable in both countries. Case fatality rate (far higher) in SL has decreased, as in the UK. Three hundred and twenty-five patients took part in the survey in SL, with 83 in the UK. In the categories investigated, including patient demographics, RTC environment, visual impairment, pedestrian and driver factors, the majority of results were significantly different between the two countries. Target factors such as inadequate street lighting, visual impairment, speeding, and not wearing seatbelts at time of accident were identified, and recommendations developed as a result.

scholarly journals Egypt's COVID-19 Recent Happenings and Perspectives: A Mini-Review

2021 ◽  
Vol 9 ◽  
Author(s):  
AbdulRahman A. Saied ◽  
Asmaa A. Metwally ◽  
Norah Abdullah Bazekh Madkhali ◽  
Shafiul Haque ◽  
Kuldeep Dhama
Keyword(s):  
Case Fatality Rate ◽  
Case Fatality ◽  
Animal Origin ◽  
Fatality Rate ◽  
Health Concerns ◽  
The World ◽  
The Usa ◽  
Egyptian Government ◽  
Low Prevalence ◽  
And Control

The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has affected countries across the world. While the zoonotic aspects of SARS-CoV-2 are still under investigation, bats and pangolins are currently cited as the animal origin of the virus. Several types of vaccines against COVID-19 have been developed and are being used in vaccination drives across the world. A number of countries are experiencing second and third waves of the pandemic, which have claimed nearly four million lives out of the 180 million people infected globally as of June 2021. The emerging SARS-CoV-2 variants and mutants are posing high public health concerns owing to their rapid transmissibility, higher severity, and in some cases, ability to infect vaccinated people (vaccine breakthrough). Here in this mini-review, we specifically looked at the efforts and actions of the Egyptian government to slow down and control the spread of COVID-19. We also review the COVID-19 statistics in Egypt and the possible reasons behind the low prevalence and high case fatality rate (CFR%), comparing Egypt COVID-19 statistics with China (the epicenter of COVID-19 pandemic) and the USA, Brazil, India, Italy, and France (the first countries in which the numbers of patients infected with COVID-19). Additionally, we have summarized the SARS-CoV-2 variants, vaccines used in Egypt, and the use of medicinal plants as preventive and curative options.

scholarly journals The theoretical mortality risk of an asymptomatic patient with a negative SARS-CoV-2 test developing COVID-19 following elective orthopaedic surgery

2020 ◽  
Vol 102-B (9) ◽  
pp. 1256-1260 ◽  
Author(s):  
Nardeen Kader ◽  
Nick D. Clement ◽  
Vipul R. Patel ◽  
Nick Caplan ◽  
Paul Banaszkiewicz ◽  
...  
Keyword(s):  
Orthopaedic Surgery ◽  
Case Fatality Rate ◽  
False Negative ◽  
Case Fatality ◽  
Disease Prevalence ◽  
Fatality Rate ◽  
Rt Pcr ◽  
Worst Case ◽  
Risk Of Death ◽  
The Uk

Aims The risk to patients and healthcare workers of resuming elective orthopaedic surgery following the peak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has been difficult to quantify. This has prompted governing bodies to adopt a cautious approach that may be impractical and financially unsustainable. The lack of evidence has made it impossible for surgeons to give patients an informed perspective of the consequences of elective surgery in the presence of SARS-CoV-2. This study aims to determine, for the UK population, the probability of a patient being admitted with an undetected SARS-CoV-2 infection and their resulting risk of death; taking into consideration the current disease prevalence, reverse transcription-polymerase chain reaction (RT-PCR) testing, and preassessment pathway. Methods The probability of SARS-CoV-2 infection with a false negative test was calculated using a lower-end RT-PCR sensitivity of 71%, specificity of 95%, and the UK disease prevalence of 0.24% reported in May 2020. Subsequently, a case fatality rate of 20.5% was applied as a worst-case scenario. Results The probability of SARS-CoV-2 infection with a false negative preoperative test was 0.07% (around 1 in 1,400). The risk of a patient with an undetected infection being admitted for surgery and subsequently dying from the coronavirus disease 2019 (COVID-19) is estimated at approximately 1 in 7,000. However, if an estimate of the current global infection fatality rate (1.04%) is applied, the risk of death would be around 1 in 140,000, at most. This calculation does not take into account the risk of nosocomial infection. Conversely, it does not factor in that patients will also be clinically assessed and asked to self-isolate prior to surgery. Conclusion Our estimation suggests that the risk of patients being inadvertently admitted with an undetected SARS-CoV-2 infection for elective orthopaedic surgery is relatively low. Accordingly, the risk of death following elective orthopaedic surgery is low, even when applying the worst-case fatality rate. Cite this article: Bone Joint J 2020;102-B(9):1256–1260.

scholarly journals COVID-19 pandemic in India: A Comparison of pandemic pattern in Selected States

2020 ◽  
Vol 10 (2) ◽  
pp. 856-864
Author(s):  
Rama Shankar Rath ◽  
Anand Mohan Dixit ◽  
Anil Ramesh Koparkar ◽  
Pradip Kharya ◽  
Hari Shanker Joshi
Keyword(s):  
Case Fatality Rate ◽  
Descriptive Analysis ◽  
Case Fatality ◽  
Contact Tracing ◽  
Family Welfare ◽  
Fatality Rate ◽  
Strong Law ◽  
Preparedness Plan ◽  
Epidemic Curve ◽  
First Case

The COVID-19 pandemic currently expanded its roots to the 206 countries in the world. The morbidity and mortality are not only threat to humans but also its impact on economy is indirectly affecting us. The current review was done to find trend in various states of India. Data was collected from Ministry of Health and Family Welfare and descriptive analysis of the distribution of COVID-19 cases in different states of India. First case of COVID-19 was diagnosed in southern most state Kerala and after that it has spread to all other states but situations are more worsen in states with high international migration. Maharashtra is now the most affected state followed by Delhi. Among epidemic curve of all these states, Maharashtra has rapidly growing epidemic curve with highest slope, whereas Kerala has the lowest. When we compared the day wise cumulative case fatality rate, it was found that the case fatality rate of the states like Maharashtra, Madhya Pradesh & Rajasthan showed decrease in the case fatality rate over the period. Population density is also one of the key determinants of social interaction and thus the spread of disease specifically in communicable diseases. Government of India had taken many strong initiatives e.g. 40 days nation-wide lockdown, thermal screening at airport, announcement of relief packages for poor and quarantine of outsiders but still there are many missed opportunities like, early stoppage of international traffic, compulsory quarantine for all international travellers, better contact tracing, strong law and order and better preparedness plan.

scholarly journals A Short-Term Forecast Scenario for COVID-19 Epidemic and Allocated Hospital Readiness in Egypt

2020 ◽  
Author(s):  
Engy El-Ghitany
Keyword(s):  
Exponential Growth ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
Fatality Rate ◽  
Short Term ◽  
Epidemic Curve ◽  
Preparedness Planning ◽  
The Status ◽  
Hospital Preparedness ◽  
Hospital Readiness

BackgroundThe novel virus COVID-19, also known as SARS-CoV‑2, is currently rapidly spreading around the globe and pushing healthcare systems to the limits of their capacity. One of the functions of predictive models is to timely act for epidemic preparedness including hospital preparedness. In Egypt, like many other countries in the world, the epidemic situation and forecasting have not yet sufficiently studied. ObjectiveThe study was carried out to develop a short-term forecast scenario for the COVID-19 epidemic situation in Egypt and predict the hospital needs to accommodate the growing number of cases.MethodsSecondary data from the COVID-2019 daily reports and the report issued 8th of April by the Egyptian Ministry of Health and Population were used. Due to the daily changing level of knowledge and data, the article reflects the status up to 18 April 2020. The prediction was based on the exponential growth rate model. For the depiction of the situation, the full length of the epidemic timeline was analyzed (from February 14th till April 18th). The growth rates and their rates of decline during the period from the 22nd of March till the 18th of April were calculated and extrapolated in the coming 7 weeks. The predicted hospital needs were assessed against the announced allocated resources.ResultsThe epidemic curve in Egypt is on the ascending arm as of April, 18. The active cases showed exponential growth from the start of the epidemic till April, 18. At the end of this period time, the recovery rate was 23.12% and the case fatality rate (CFR) was7.39. The case fatality rate median level during the last four weeks was 6.64. The active cases are expected to reach more than 20,000 by late May then starts to decline. The allocated regular hospital beds are predicted to show shortage by the time of the release of the paper. The intensive care units (ICU) beds and ventilators are predicted to show insufficiency on May 6.Conclusions: The COVID-19 epidemic in Egypt is expected to continue on the rise for the next few weeks and expected to start to decline late in May, 2020. Our estimates should be useful in preparedness planning. Serious actions should be taken to provide ICU beds and ventilators enough for the predicted number of cases that would need them, not later than the end of April. Mitigation actions have to continue for the coming 6 weeks or until the epidemic situation is more clearly seen.

scholarly journals Oxygen and Mortality in COVID-19 Pneumonia: A Comparative Analysis of Supplemental Oxygen Policies and Health Outcomes Across 26 Countries

2021 ◽  
Vol 9 ◽  
Author(s):  
Fatma Mansab ◽  
Harry Donnelly ◽  
Albrecht Kussner ◽  
James Neil ◽  
Sohail Bhatti ◽  
...  
Keyword(s):  
Case Fatality Rate ◽  
Case Fatality ◽  
Mortality Rates ◽  
Supplemental Oxygen ◽  
Fatality Rate ◽  
National Mortality ◽  
Bivariate Association ◽  
The Uk ◽  
The Relationship ◽  
Mortality Estimates

Introduction: Hypoxia is the main cause of morbidity and mortality in COVID-19. During the COVID-19 pandemic, some countries have reduced access to supplemental oxygen, whereas other nations have maintained and even improved access to supplemental oxygen. We examined whether variation in the nationally determined oxygen guidelines had any association with national mortality rates in COVID-19.Methods: Three independent investigators searched for, identified, and extracted the nationally recommended target oxygen levels for the commencement of oxygen in COVID-19 pneumonia from the 29 worst affected countries. Mortality estimates were calculated from three independent sources. We then applied both parametric (Pearson's R) and non-parametric (Kendall's Tau B) tests of bivariate association to determine the relationship between case fatality rate (CFR) and target SpO2, and also between potential confounders and CFR.Results: Of the 26 nations included, 15 had employed conservative oxygen strategies to manage COVID-19 pneumonia. Of them, Belgium, France, USA, Canada, China, Germany, Mexico, Spain, Sweden, and the UK guidelines advised commencing oxygen when oxygen saturations (SpO2) fell to 91% or less. A statistically significant correlation was found between SpO2 and CFR both parametrically (R = −0.53, P &lt; 0.01) and non-parametrically (−0.474, P &lt; 0.01).Conclusion: Our study highlights the disparity in oxygen provision for COVID-19 patients between the nations analysed. In those nations that pursued a conservative oxygen strategy, there was an association with higher national mortality rates. We discuss the potential reasons for such an association.

scholarly journals Double COVID-19 Confirmed Case Fatality Rate in Countries with High Elderly Female Vitamin D Deficiency Prevalence

2020 ◽  
Author(s):  
Alex Bäcker ◽  
Myron Mageswaran
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Case Fatality Rate ◽  
Black People ◽  
Case Fatality ◽  
Growth Speed ◽  
Fatality Rate ◽  
Direct Demonstration ◽  
High Prevalence ◽  
Low Prevalence

AbstractA number of clues point to a possible role of vitamin D in fighting COVID-19: a reduction in case growth speed with solar zenith angle, higher fatality rate in black people, lower fatality rate in populations that spend more time outdoors. Yet a direct demonstration that vitamin D deficiency is associated with COVID-19 fatalities has remained elusive. We show here in a comparison of 32 countries that countries with high prevalence of vitamin D deficiency among elderly females show a confirmed case fatality rate twice as high as those with low prevalence. We then show that this effect cannot be explained by differences in life expectancy between countries. A mechanistic role for vitamin D in the severity of COVID-19 is proposed.One Sentence SummaryVitamin D deficiency among elderly females is associated with countrywide COVID-19 confirmed case fatality rates up to twice as high as those of countries with low vitamin D deficiency prevalence.

A Short-Term Forecast Scenario for COVID-19 Epidemic and Allocated Hospital Readiness in Egypt (Preprint)

2020 ◽  
Author(s):  
Engy ElGhitany
Keyword(s):  
Exponential Growth ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
Secondary Data ◽  
Fatality Rate ◽  
Short Term ◽  
Short Term Forecast ◽  
Epidemic Curve ◽  
Preparedness Planning ◽  
Term Forecast

BACKGROUND The novel virus COVID-19, also known as SARS-CoV 2, is currently rapidly spreading around the globe and pushing healthcare systems to the limits of their capacity. One of the functions of predictive models is to timely act for epidemic preparedness including hospital preparedness. In Egypt, like many other countries in the world, the epidemic situation and forecasting have not yet sufficiently studied. OBJECTIVE The study was carried out to develop a short-term forecast scenario for the COVID-19 epidemic situation in Egypt and predict the hospital needs to accommodate the growing number of cases. METHODS Secondary data from the COVID-2019 daily reports and the report issued 8th of April by the Egyptian Ministry of Health and Population were used. Due to the daily changing level of knowledge and data, the article reflects the status up to 18 April 2020. The prediction was based on the exponential growth rate model. For the depiction of the situation, the full length of the epidemic timeline was analyzed (from February 14th till April 18th). The growth rates and their rates of decline during the period from the 22nd of March till the 18th of April were calculated and extrapolated in the coming 7 weeks. The predicted hospital needs were assessed against the announced allocated resources. RESULTS The epidemic curve in Egypt is on the ascending arm as of April, 18. The active cases showed exponential growth from the start of the epidemic till April, 18. At the end of this period time, the recovery rate was 23.12% and the case fatality rate (CFR) was7.39. The case fatality rate median level during the last four weeks was 6.64. The active cases are expected to reach more than 20,000 by late May then starts to decline. The allocated regular hospital beds are predicted to show shortage by the time of the release of the paper. The intensive care units (ICU) beds and ventilators are predicted to show insufficiency on May 6. CONCLUSIONS The COVID-19 epidemic in Egypt is expected to continue on the rise for the next few weeks and expected to start to decline late in May, 2020. Our estimates should be useful in preparedness planning. Serious actions should be taken to provide ICU beds and ventilators enough for the predicted number of cases that would need them, not later than the end of April. Mitigation actions have to continue for the coming 6 weeks or until the epidemic situation is more clearly seen.

scholarly journals Sensitivity of UK Covid-19 deaths to the timing of suppression measures and their relaxation

2020 ◽  
Author(s):  
John S Dagpunar
Keyword(s):  
Case Fatality Rate ◽  
Hospital Admissions ◽  
Case Fatality ◽  
Infectious Period ◽  
Fatality Rate ◽  
Death Rates ◽  
Probability Of Death ◽  
Extreme Sensitivity ◽  
The Uk ◽  
Parameter Values

In this paper I examine the sensitivity of total UK Covid-19 deaths and the demand for intensive care and ward beds, to the timing and duration of suppression periods during a 500 day period. This is achieved via a SEIR model. Using an expected latent period of 4.5 days and infectious period of 3.8 days, R_0 was first estimated as 3.18 using observed death rates under unmitigated spread and then under the effects of the total lockdown (R_0=0.60) of 23 March. The case fatality rate given infection is taken as 1%. Parameter values for mean length of stay and conditional probability of death for ICU and non-ICU hospital admissions are guided by Ferguson et al.(2020). Under unmitigated spread the model predicts around 600,000 deaths in the UK. Starting with one exposed person at time zero and a suppression consistent with an R_0 of 0.60 on day 72, the model predicts around 39,000 deaths for a first wave, but this reduces to around 11,000 if the intervention takes place one week earlier. If the initial suppression were in place until day 200 and then relaxed to an R_0 of 1.5 between days 200 and 300, to be followed by a return to an R_0 of 0.60, the model predicts around 43,000 deaths. This would increase to around 64,000 if the release from the first suppression takes place 20 days earlier. The results indicate the extreme sensitivity to timing and the consequences of even small delays to suppression and premature relaxation of such measures.

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