scholarly journals Precautionary breaks: planned, limited duration circuit breaks to control the prevalence of COVID-19

2020 ◽  
Author(s):  
Matt J. Keeling ◽  
Glen Guyver-Fletcher ◽  
Alex Holmes ◽  
Louise Dyson ◽  
Michael J. Tildesley ◽  
...  
Keyword(s):  
Growth Rate ◽  
Exponential Growth ◽  
Negative Impact ◽  
Control Measures ◽  
Contact Tracing ◽  
Societal Costs ◽  
Alternative Approach ◽  
Age Structured ◽  
The Uk ◽  
Limited Duration

AbstractThe COVID-19 pandemic in the UK has been characterised by periods of exponential growth and decline, as different non-pharmaceutical interventions (NPIs) are brought into play. During the early uncontrolled phase of the outbreak (early March 2020) there was a period of prolonged exponential growth with epidemiological observations such as hospitalisation doubling every 3-4 days (growth rate r ≈ 0.2). The enforcement of strict lockdown measures led to a noticeable decline in all epidemic quantities (r ≈ −0.06) that slowed during the summer as control measures were relaxed (r ≈ −0.02). Since August, infections, hospitalisations and deaths have been rising (precise estimation of the current growth rate is difficult due to extreme regional heterogeneity and temporal lags between the different epidemiological observations) and various NPIs have been applied locally throughout the UK in response.Controlling any rise in infection is a compromise between public health and societal costs, with more stringent NPIs reducing cases but damaging the economy and restricting freedoms. Currently, NPI imposition is made in response to the epidemiological state, are of indefinite length and are often imposed at short notice, greatly increasing the negative impact. An alternative approach is to consider planned, limited duration periods of strict NPIs aiming to purposefully reduce prevalence before such emergency NPIs are required. These “precautionary breaks” may offer a means of keeping control of the epidemic, while their fixed duration and the forewarning may limit their society impact. Here, using simple analysis and age-structured models matched to the unfolding UK epidemic, we investigate the action of precautionary breaks. In particular we consider their impact on the prevalence of infection, as well as the total number of predicted hospitalisations and deaths. We find that precautionary breaks provide the biggest gains when the growth rate is low, but offer a much needed brake on increasing infection when the growth rate is higher, potentially allowing other measures (such as contact tracing) to regain control.

scholarly journals Growth, reproduction numbers and factors affecting the spread of SARS-CoV-2 novel variants of concern in the UK from October 2020 to July 2021: a modelling analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e056636
Author(s):  
Thomas Ward ◽  
Alex Glaser ◽  
Alexander Johnsen ◽  
Feng Xu ◽  
Ian Hall ◽  
...  
Keyword(s):  
Growth Rate ◽  
Exponential Growth ◽  
Doubling Time ◽  
Reproduction Number ◽  
Age Groups ◽  
Instantaneous Growth Rate ◽  
Rt Pcr ◽  
Gene Target ◽  
Novel Variants ◽  
The Uk

ObjectivesImportations of novel variants of concern (VOC), particularly B.1.617.2, have become the impetus behind recent outbreaks of SARS-CoV-2. Concerns around the impact on vaccine effectiveness, transmissibility and severity are now driving the public health response to these variants. This paper analyses the patterns of growth in hospitalisations and confirmed cases for novel VOCs by age groups, geography and ethnicity in the context of changing behaviour, non-pharmaceutical interventions (NPIs) and the UK vaccination programme. We seek to highlight where strategies have been effective and periods that have facilitated the establishment of new variants.DesignWe have algorithmically linked the most complete testing and hospitalisation data in England to create a data set of confirmed infections and hospitalisations by SARS-CoV-2 genomic variant. We have used these linked data sets to analyse temporal, geographic and demographic distinctions.Setting and participantsThe setting is England from October 2020 to July 2021. Participants included all COVID-19 tests that included RT-PCR CT gene target data or underwent sequencing and hospitalisations that could be linked to these tests.MethodsTo calculate the instantaneous growth rate for VOCs we have developed a generalised additive model fit to multiple splines and varying day of the week effects. We have further modelled the instantaneous reproduction number Rt for the B.1.1.7 and B.1.617.2 variants and included a doubly interval censored model to temporally adjust the confirmed variant cases.ResultsWe observed a clear replacement of the predominant B.1.1.7 by the B.1.617.2 variant without observing sustained exponential growth in other novel variants. Modelled exponential growth of RT PCR gene target triple-positive cases was initially detected in the youngest age groups, although we now observe across all ages a very small doubling time of 10.7 (95% CI 9.1 to 13.2) days and 8 (95% CI 6.9 to 9.1) days for cases and hospitalisations, respectively. We observe that growth in RT PCR gene target triple-positive cases was first detected in the Indian ethnicity group in late February, with a peak of 0.06 (95% CI 0.07 to 0.05) in the instantaneous growth rate, but is now maintained by the white ethnicity groups, observing a doubling time of 6.8 (95% CI 4.9 to 11) days. Rt analysis indicates a reproduction number advantage of 0.45 for B.1.617.2 relative to B.1.1.7, with the Rt value peaking at 1.85 for B.1.617.2.ConclusionsOur results illustrate a clear transmission advantage for the B.1.617.2 variant and the growth in hospitalisations illustrates that this variant is able to maintain exponential growth within age groups that are largely doubly vaccinated. There are concerning signs of intermittent growth in the B.1.351 variant, reaching a 28-day doubling time peak in March 2021, although this variant is presently not showing any evidence of a transmission advantage over B.1.617.2. Step 1b of the UK national lockdown easing was sufficient to precipitate exponential growth in B.1.617.2 cases for most regions and younger adult age groups. The final stages of NPI easing appeared to have a negligible impact on the growth of B.1.617.2 with every region experiencing sustained exponential growth from step 2. Nonetheless, early targeted local NPIs appeared to markedly reduced growth of B.1.617.2. Later localised interventions, at a time of higher prevalence and greater geographic dispersion of this variant, appeared to have a negligible impact on growth.

scholarly journals 13.A. Workshop: Responding to COVID19 in Europe: a tale of five countries

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
Keyword(s):  
Public Health ◽  
Control Measures ◽  
World Health ◽  
Contact Tracing ◽  
Outbreak Management ◽  
Eu Countries ◽  
Incidence And Mortality ◽  
The World ◽  
The Uk ◽  
Population Attitudes

Abstract Since emerging from a market in Wuhan China in December 2019, SARS-CoV-2, the pathogen causing COVID-19, has spread worldwide. On January 30th 2020 the World Health Organization declared the COVID19 outbreak a Public Health Emergency of International Concern, and declared it a pandemic on March 11th 2020. With over 2.4 million cases and 180,000 deaths reported by mid-June, Europe has been the second most affected region in the world. Individual countries such as Italy and the UK have been amongst the hardest hit in the world. However, the COVID19 situation in Europe is marked by wide variations both in terms of how countries have been affected, and in terms of how they have responded. The proposed workshop will provide compare and contrast the situation and response in five countries in the European region: The UK, Italy, Poland, Portugal and Sweden, moderated by a firm and charismatic chair. This interactive workshop will enable better understanding of the disease's spread and trajectory in different EU countries. International comparisons will help to describe the growth and scale of the pandemic in the selected EU countries. The choice of countries reflects those that have reported high and low incidence and mortality, as well as represent a range in the strictness of the control measures implemented, from full lockdown to the most permissive. The session will go beyond describing those and will be an opportunity to discuss the pros and cons of these different approaches and lessons learnt around the different components of the response such as case identification, contact tracing, testing, social distancing, mask use, health communication and inequalities. We plan to have short and effective 5 min presentations followed by a longer and constructively provocative moderated discussion. Importantly, the five European case studies will offer ground to discuss the public health principles behind outbreak management preparedness and balancing public health with other imperatives such as economic ones, but also social frustration. The audience will be engaged through a Q&A session. Key messages The approach to managing the COVID19 outbreak has varied among European countries, and the optimal approach is likely to be context specific. The effect of the pandemic will be long term and public health imperatives must take population attitudes and behavior as well as economic and indirect health effects into account.

scholarly journals The Impact of Universal Mask Use on SARS-COV-2 in Victoria, Australia on the Epidemic Trajectory of COVID-19

2021 ◽  
Vol 9 ◽  
Author(s):  
Valentina Costantino ◽  
Chandini Raina MacIntyre
Keyword(s):  
Mathematical Modeling ◽  
Deterministic Model ◽  
Face Mask ◽  
Control Measures ◽  
Contact Tracing ◽  
Epidemic Size ◽  
Community Transmission ◽  
Age Structured ◽  
The Impact ◽  
Mask Effectiveness

Objective(s): To estimate the impact of universal community face mask use in Victoria, Australia along with other routine disease control measures in place.Methods: A mathematical modeling study using an age structured deterministic model for Victoria, was simulated for 123 days between 1 June 2020 and 1 October 2020, incorporating lockdown, contact tracing, and case findings with and without mask use in varied scenarios. The model tested the impact of differing scenarios of the universal use of face masks in Victoria, by timing, varying mask effectiveness, and uptake.Results: A six-week lockdown with standard control measures, but no masks, would have resulted in a large resurgence by September, following the lifting of restrictions. Mask use can substantially reduce the epidemic size, with a greater impact if at least 50% of people wear a mask which has an effectiveness of at least 40%. Early mask use averts more cases than mask usage that is only implemented closer to the peak. No mask use, with a 6-week lockdown, results in 67,636 cases and 120 deaths by 1 October 2020 if no further lockdowns are used. If mask use at 70% uptake commences on 23 July 2020, this is reduced to 7,961 cases and 42 deaths. We estimated community mask effectiveness to be 11%.Conclusion(s): Lockdown and standard control measures may not have controlled the epidemic in Victoria. Mask use can substantially improve epidemic control if its uptake is higher than 50% and if moderately effective masks are used. Early mask use should be considered in other states if community transmission is present, as this has a greater effect than later mask wearing mandates.

scholarly journals The effect of non-pharmaceutical interventions on COVID-19 cases, deaths and demand for hospital services in the UK: a modelling study

2020 ◽  
Author(s):  
Nicholas G. Davies ◽  
Adam J. Kucharski ◽  
Rosalind M. Eggo ◽  
Amy Gimma ◽  
W. John Edmunds ◽  
...  
Keyword(s):  
Intensive Care ◽  
Healthcare System ◽  
Control Measures ◽  
Transmission Model ◽  
School Closures ◽  
Social Distancing ◽  
Age Structured ◽  
The Uk ◽  
The Impact ◽  
Pharmaceutical Interventions

AbstractBackgroundNon-pharmaceutical interventions have been implemented to reduce transmission of SARS-CoV-2 in the UK. Projecting the size of an unmitigated epidemic and the potential effect of different control measures has been critical to support evidence-based policymaking during the early stages of the epidemic.MethodsWe used a stochastic age-structured transmission model to explore a range of intervention scenarios, including the introduction of school closures, social distancing, shielding of elderly groups, self-isolation of symptomatic cases, and extreme “lockdown”-type restrictions. We simulated different durations of interventions and triggers for introduction, as well as combinations of interventions. For each scenario, we projected estimated new cases over time, patients requiring inpatient and critical care (intensive care unit, ICU) treatment, and deaths.FindingsWe found that mitigation measures aimed at reducing transmission would likely have decreased the reproduction number, but not sufficiently to prevent ICU demand from exceeding NHS availability. To keep ICU bed demand below capacity in the model, more extreme restrictions were necessary. In a scenario where “lockdown”-type interventions were put in place to reduce transmission, these interventions would need to be in place for a large proportion of the coming year in order to prevent healthcare demand exceeding availability.InterpretationThe characteristics of SARS-CoV-2 mean that extreme measures are likely required to bring the epidemic under control and to prevent very large numbers of deaths and an excess of demand on hospital beds, especially those in ICUs.Research in ContextEvidence before this studyAs countries have moved from early containment efforts to planning for the introduction of large-scale non-pharmaceutical interventions to control COVID-19 outbreaks, epidemic modelling studies have explored the potential for extensive social distancing measures to curb transmission. However, it remains unclear how different combinations of interventions, timings, and triggers for the introduction and lifting of control measures may affect the impact of the epidemic on health services, and what the range of uncertainty associated with these estimates would be.Added value of this studyUsing a stochastic, age-structured epidemic model, we explored how eight different intervention scenarios could influence the number of new cases and deaths, as well as intensive care beds required over the projected course of the epidemic. We also assessed the potential impact of local versus national targeting of interventions, reduction in leisure events, impact of increased childcare by grandparents, and timing of triggers for different control measures. We simulated multiple realisations for each scenario to reflect uncertainty in possible epidemic trajectories.Implications of all the available evidenceOur results support early modelling findings, and subsequent empirical observations, that in the absence of control measures, a COVID-19 epidemic could quickly overwhelm a healthcare system. We found that even a combination of moderate interventions – such as school closures, shielding of older groups and self-isolation – would be unlikely to prevent an epidemic that would far exceed available ICU capacity in the UK. Intermittent periods of more intensive lockdown-type measures are predicted to be effective for preventing the healthcare system from being overwhelmed.

Implications for Growth

2019 ◽  
pp. 88-89
Author(s):  
Andrew Smithers
Keyword(s):  
Growth Rate ◽  
Capital Stock ◽  
Negative Impact ◽  
The Us ◽  
Working Age ◽  
Policy Measures ◽  
Hurdle Rate ◽  
Working Age Population ◽  
The Uk ◽  
Trend Growth

Without policy measures to offset the negative impact of the bonus culture, investment, productivity, and growth are likely to remain depressed. Given the slow growth of the working age population, the UK’s trend growth rate will thus be 1 per cent and that of the US 0.87 per cent, unless productivity improves. An alternative method of estimating US trend growth from the value data for tangible capital stock provides a slightly better rate of 1.1 per cent per annum. The prospects for the UK and US are so poor that policy measures to stimulate growth are vital. All growth is the result of changes in either TFP or NTV, so one or other must improve to avoid stagnation. There is no way to improve the former, but changes in NTV can be brought about through a lower hurdle rate, which requires the damage from the bonus culture to end.

scholarly journals Interim estimates of increased transmissibility, growth rate, and reproduction number of the Covid-19 B.1.617.2 variant of concern in the United Kingdom

2021 ◽  
Author(s):  
John S Dagpunar
Keyword(s):  
Growth Rate ◽  
Simple Model ◽  
Exponential Growth ◽  
Reproduction Number ◽  
Actual Distribution ◽  
Sanger Institute ◽  
The United Kingdom ◽  
Point Estimates ◽  
Reproduction Numbers ◽  
The Uk

This paper relates to data from the Wellcome Sanger Institute, UK, regarding Covid-19 genomic surveillance. We use a simple model to give point estimates of the effective reproduction numbers of the B.1.617.2 and B.1.1.7 lineages in England, from sequenced data as at 15 May 2021. Comparison with the estimated reproduction number of B.1.1.7 enables an estimate of the increased transmissibility of B.1.617.2. We conclude that it is almost certain that there is increased transmissibility that will rapidly lead to B.1.617.2 becoming the prevailing variant in the UK. The derived estimates of increased transmissibility have uncertainty relating to the actual distribution of the generation interval, but they do point, under present conditions of vaccination coverage and NPIs, to exponential growth of positive cases.

An Expert Ranked List of Pro-nature Conservation Behaviours for Public Use

2019 ◽  
Author(s):  
Lea Barbett ◽  
Edward Stupple ◽  
Michael Sweet ◽  
Miles Richardson
Keyword(s):  
Nature Conservation ◽  
General Population ◽  
Mass Extinction ◽  
Negative Impact ◽  
Ecological Impact ◽  
Human Action ◽  
Short Paper ◽  
The Public ◽  
The Uk ◽  
Ranked List

The planet is facing an anthropogenic mass extinction of wildlife, which will have a grave impact on the environment and humans. Widespread human action is needed to minimize the negative impact of humans on biodiversity and support the restoration of wildlife. In order to find effective ways to promote pro-nature conservation behaviours to the general population, there is a need to provide a list of behaviours which will have worthwhile ecological impact and are worth encouraging. In a novel collaboration between psychologists and ecologists, 70 experts from practical and academic conservation backgrounds were asked to review and rate 48 conservation related behaviours. According to their judgement, this short paper presents a ranked list of pro-nature conservation behaviours for the public in the UK and similar landscapes. This includes behaviours people can engage in in their homes, their gardens, on their land, and in their roles as citizens.

An Epidemiological Analysis of COVID-19 Confirmed Cases, Reported at National Institute of Health, Pakistan (Preprint)

2020 ◽  
Author(s):  
Ambreen Chaudhry
Keyword(s):  
Age Groups ◽  
Target Population ◽  
Control Measures ◽  
Contact Tracing ◽  
Bivariate Analysis ◽  
Travel History ◽  
Disease Epidemiology ◽  
Hygiene Practices ◽  
Multi Center Study ◽  
Epidemiological Characteristics

BACKGROUND Coronavirus disease (Covid-19) is a zoonotic disease of novel origin that posed a continuous threat to health worldwide after taking the shape of the pandemic. An understanding of disease epidemiology is supportive in timely preventive and control measures as well as contact tracing and curbing surveillance activities. OBJECTIVE The objective of our study was to determine the epidemiological characteristics of COVID-19 confirmed cases reported at the National Institute of Health Pakistan and elements of its spread in Pakistan. METHODS A retrospective record review was conducted at the National Institute of Health (NIH) Islamabad, Pakistan from January 25 to April 4, 2020. Univariate and bivariate analysis was done with 95% CI and p<0.05. RESULTS A total of 14,422 samples of suspected COVID-19 cases were received with a positivity rate of 9% (n=1348). Among all 70% (n=939) were male. The median age was 41years of age (range: 01-99Years). Among all, 19% were from 30-39 years old followed by 50-59 years old (17%). Children remained the least affected by 3% (n=35). Of the total reported cases, 55% (n=735) have reported the travel history within the last 14 days. Among these travelers’ international travelers were 23% (n=166) and domestic travelers were 77% (n=569). Travel history including both international and domestic remained significantly associated with the different age groups and Young adults remained more vulnerable to COVID-19 (P=0.03). Fever, SOB, and Cough remained the most significantly associated (P<0.05) in all age groups. CONCLUSIONS A higher incidence of COVID-19 among elderly men suggests robust quarantine measures for this target population. An escalating incidence of local transmission needs strict social distancing and hygiene practices to help flatten the curve. An extensive multi-center study is also recommended for a full understanding of disease dynamics.

scholarly journals Mental Health, Information and Being Connected: Qualitative Experiences of Social Media Use during the COVID-19 Pandemic from a Trans-National Sample

Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 735
Author(s):  
Schoultz Mariyana ◽  
Leung Janni ◽  
Bonsaksen Tore ◽  
Ruffolo Mary ◽  
Thygesen Hilde ◽  
...  
Keyword(s):  
Mental Health ◽  
Social Media ◽  
Health Information ◽  
Online Survey ◽  
Negative Impact ◽  
National Study ◽  
Free Text ◽  
Cross Sectional ◽  
Mental Health Information ◽  
The Uk

Background: Due to the COVID-19 pandemic and the strict national policies regarding social distancing behavior in Europe, America and Australia, people became reliant on social media as a means for gathering information and as a tool for staying connected to family, friends and work. This is the first trans-national study exploring the qualitative experiences and challenges of using social media while in lockdown or shelter-in-place during the current pandemic. Methods: This study was part of a wider cross-sectional online survey conducted in Norway, the UK, USA and Australia during April/May 2020. The manuscript reports on the qualitative free-text component of the study asking about the challenges of social media users during the COVID-19 pandemic in the UK, USA and Australia. A total of 1991 responses were included in the analysis. Thematic analysis was conducted independently by two researchers. Results: Three overarching themes identified were: Emotional/Mental Health, Information and Being Connected. Participants experienced that using social media during the pandemic amplified anxiety, depression, fear, panic, anger, frustration and loneliness. They felt that there was information overload and social media was full of misleading or polarized opinions which were difficult to switch off. Nonetheless, participants also thought that there was an urge for connection and learning, which was positive and stressful at the same time. Conclusion: Using social media while in a shelter-in-place or lockdown could have a negative impact on the emotional and mental health of some of the population. To support policy and practice in strengthening mental health care in the community, social media could be used to deliver practical advice on coping and stress management. Communication with the public should be strengthened by unambiguous and clear messages and clear communication pathways. We should be looking at alternative ways of staying connected.

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