scholarly journals Model-based evaluation of school- and non-school-related measures to control the COVID-19 pandemic

2020 ◽  
Author(s):  
Ganna Rozhnova ◽  
Christiaan H van Dorp ◽  
Patricia Bruijning-Verhagen ◽  
Martin C J Bootsma ◽  
Janneke H H M van de Wijgert ◽  
...  
Keyword(s):  
The Netherlands ◽  
School Closure ◽  
Transmission Model ◽  
Time Points ◽  
School Based ◽  
Age Structured ◽  
The Right ◽  
Age Structured Model ◽  
The Impact ◽  
Second Wave

Background: In autumn 2020, many countries, including the Netherlands, are experiencing a second wave of the COVID-19 pandemic. Health policymakers are struggling with choosing the right mix of measures to keep the COVID-19 case numbers under control, but still allow a minimum of social and economic activity. The priority to keep schools open is high, but the role of school-based contacts in the epidemiology of SARS-CoV-2 is incompletely understood. We used a transmission model to estimate the impact of school contacts on the transmission of SARS-CoV-2 and to assess the effects of school-based measures, including school closure, on controlling the pandemic at different time points during the pandemic. Methods and Findings: The age-structured model was fitted to age-specific seroprevalence and hospital admission data from the Netherlands during spring 2020. Compared to adults older than 60 years, the estimated susceptibility was 23% (95%CrI 20-28%) for children aged 0 to 20 years and 61% (95%CrI 50%-72%) for the age group of 20 to 60 years. The time points considered in the analyses were (i) August 2020 when the effective reproduction number (R_e) was estimated to be 1.31 (95%CrI 1.15-2.07), schools just opened after the summer holidays and measures were reinforced with the aim to reduce R_e to a value below 1, and (ii) November 2020 when measures had reduced R_e to 1.00 (95%CrI 0.94-1.33). In this period schools remained open. Our model predicts that keeping schools closed after the summer holidays, in the absence of other measures, would have reduced R_e by 10% (from 1.31 to 1.18 (95%CrI 1.04-1.83)) and thus would not have prevented the second wave in autumn 2020. Reducing non-school-based contacts in August 2020 to the level observed during the first wave of the pandemic would have reduced R_e to 0.83 (95%CrI 0.75-1.10). Yet, this reduction was not achieved and the observed R_e in November was 1.00. Our model predicts that closing schools in November 2020 could reduce R_e from the observed value of 1.00 to 0.84 (95%CrI 0.81-0.90), with unchanged non-school based contacts. Reductions in R_e due to closing schools in November 2020 were 8% for 10 to 20 years old children, 5% for 5 to 10 years old children and negligible for 0 to 5 years old children. Conclusions: The impact of measures reducing school-based contacts, including school closure, depends on the remaining opportunities to reduce non-school-based contacts. If opportunities to reduce R_e with non-school-based measures are exhausted or undesired and R_e is still close to 1, the additional benefit of school-based measures may be considerable, particularly among the older school children.

scholarly journals Model-based evaluation of school- and non-school-related measures to control the COVID-19 pandemic

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Ganna Rozhnova ◽  
Christiaan H. van Dorp ◽  
Patricia Bruijning-Verhagen ◽  
Martin C. J. Bootsma ◽  
Janneke H. H. M. van de Wijgert ◽  
...  
Keyword(s):  
Reproduction Number ◽  
Additional Benefit ◽  
Transmission Model ◽  
Time Points ◽  
School Based ◽  
Admission Data ◽  
Age Structured ◽  
The Impact ◽  
Pandemic Wave

AbstractThe role of school-based contacts in the epidemiology of SARS-CoV-2 is incompletely understood. We use an age-structured transmission model fitted to age-specific seroprevalence and hospital admission data to assess the effects of school-based measures at different time points during the COVID-19 pandemic in the Netherlands. Our analyses suggest that the impact of measures reducing school-based contacts depends on the remaining opportunities to reduce non-school-based contacts. If opportunities to reduce the effective reproduction number (Re) with non-school-based measures are exhausted or undesired and Re is still close to 1, the additional benefit of school-based measures may be considerable, particularly among older school children. As two examples, we demonstrate that keeping schools closed after the summer holidays in 2020, in the absence of other measures, would not have prevented the second pandemic wave in autumn 2020 but closing schools in November 2020 could have reduced Re below 1, with unchanged non-school-based contacts.

scholarly journals Model-based evaluation of school- and non-school-related measures to control the COVID-19 pandemic

2021 ◽  
Author(s):  
Ganna Rozhnova ◽  
Christiaan van Dorp ◽  
Patricia Bruijning-Verhagen ◽  
Martin Bootsma ◽  
Janneke van de Wijgert ◽  
...  
Keyword(s):  
Reproduction Number ◽  
Additional Benefit ◽  
Transmission Model ◽  
Time Points ◽  
School Based ◽  
Admission Data ◽  
Age Structured ◽  
The Impact ◽  
Pandemic Wave

Abstract The role of school-based contacts in the epidemiology of SARS-CoV-2 is incompletely understood. We used an age-structured transmission model fitted to age-specific seroprevalence and hospital admission data to assess the effects of school-based measures at different time points during the COVID-19 pandemic in the Netherlands. Our analyses suggest that the impact of measures reducing school-based contacts depends on the remaining opportunities to reduce non-school-based contacts. If opportunities to reduce the effective reproduction number (Re) with non-school-based measures are exhausted or undesired and Re is still close to 1, the additional benefit of school-based measures may be considerable, particularly among older school children. As two examples, we demonstrate that keeping schools closed after the summer holidays in 2020, in the absence of other measures, would not have prevented the second pandemic wave in autumn 2020 but closing schools in November 2020 could have reduced Re below 1, with unchanged non-school-based contacts.

scholarly journals The impact of regionalized trauma care on the distribution of severely injured patients in the Netherlands

2021 ◽  
Author(s):  
Suzan Dijkink ◽  
Erik W. van Zwet ◽  
Pieta Krijnen ◽  
Luke P. H. Leenen ◽  
Frank W. Bloemers ◽  
...  
Keyword(s):  
The Netherlands ◽  
Trauma Care ◽  
Trauma System ◽  
Future Research ◽  
Severely Injured ◽  
Trauma Centers ◽  
Severely Injured Patients ◽  
The Right ◽  
Injured Patients ◽  
The Impact

Abstract Background Twenty years ago, an inclusive trauma system was implemented in the Netherlands. The goal of this study was to evaluate the impact of structured trauma care on the concentration of severely injured patients over time. Methods All severely injured patients (Injury Severity Score [ISS] ≥ 16) documented in the Dutch Trauma Registry (DTR) in the calendar period 2008–2018 were included for analysis. We compared severely injured patients, with and without severe neurotrauma, directly brought to trauma centers (TC) and non-trauma centers (NTC). The proportion of patients being directly transported to a trauma center was determined, as was the total Abbreviated Injury Score (AIS), and ISS. Results The documented number of severely injured patients increased from 2350 in 2008 to 4694 in 2018. During this period, on average, 70% of these patients were directly admitted to a TC (range 63–74%). Patients without severe neurotrauma had a lower chance of being brought to a TC compared to those with severe neurotrauma. Patients directly presented to a TC were more severely injured, reflected by a higher total AIS and ISS, than those directly transported to a NTC. Conclusion Since the introduction of a well-organized trauma system in the Netherlands, trauma care has become progressively centralized, with more severely injured patients being directly presented to a TC. However, still 30% of these patients is initially brought to a NTC. Future research should focus on improving pre-hospital triage to facilitate swift transfer of the right patient to the right hospital.

scholarly journals Changes in contact patterns shape the dynamics of the COVID-19 outbreak in China

Science ◽  
2020 ◽  
Vol 368 (6498) ◽  
pp. 1481-1486 ◽  
Author(s):  
Juanjuan Zhang ◽  
Maria Litvinova ◽  
Yuxia Liang ◽  
Yan Wang ◽  
Wei Wang ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Odds Ratio ◽  
School Closure ◽  
Hunan Province ◽  
Contact Tracing ◽  
Transmission Model ◽  
Social Distancing ◽  
Susceptibility To Infection ◽  
Contact Patterns ◽  
The Impact

Intense nonpharmaceutical interventions were put in place in China to stop transmission of the novel coronavirus disease 2019 (COVID-19). As transmission intensifies in other countries, the interplay between age, contact patterns, social distancing, susceptibility to infection, and COVID-19 dynamics remains unclear. To answer these questions, we analyze contact survey data for Wuhan and Shanghai before and during the outbreak and contact-tracing information from Hunan province. Daily contacts were reduced seven- to eightfold during the COVID-19 social distancing period, with most interactions restricted to the household. We find that children 0 to 14 years of age are less susceptible to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection than adults 15 to 64 years of age (odds ratio 0.34, 95% confidence interval 0.24 to 0.49), whereas individuals more than 65 years of age are more susceptible to infection (odds ratio 1.47, 95% confidence interval 1.12 to 1.92). Based on these data, we built a transmission model to study the impact of social distancing and school closure on transmission. We find that social distancing alone, as implemented in China during the outbreak, is sufficient to control COVID-19. Although proactive school closures cannot interrupt transmission on their own, they can reduce peak incidence by 40 to 60% and delay the epidemic.

scholarly journals Reactive school closure weakens the network of social interactions and reduces the spread of influenza

2019 ◽  
Vol 116 (27) ◽  
pp. 13174-13181 ◽  
Author(s):  
Maria Litvinova ◽  
Quan-Hui Liu ◽  
Evgeny S. Kulikov ◽  
Marco Ajelli
Keyword(s):  
Social Interactions ◽  
Influenza Season ◽  
School Closure ◽  
Transmission Model ◽  
Modeling Framework ◽  
School Closures ◽  
Student Absenteeism ◽  
Contact Survey ◽  
Closure Policy ◽  
The Impact

School-closure policies are considered one of the most promising nonpharmaceutical interventions for mitigating seasonal and pandemic influenza. However, their effectiveness is still debated, primarily due to the lack of empirical evidence about the behavior of the population during the implementation of the policy. Over the course of the 2015 to 2016 influenza season in Russia, we performed a diary-based contact survey to estimate the patterns of social interactions before and during the implementation of reactive school-closure strategies. We develop an innovative hybrid survey-modeling framework to estimate the time-varying network of human social interactions. By integrating this network with an infection transmission model, we reduce the uncertainty surrounding the impact of school-closure policies in mitigating the spread of influenza. When the school-closure policy is in place, we measure a significant reduction in the number of contacts made by students (14.2 vs. 6.5 contacts per day) and workers (11.2 vs. 8.7 contacts per day). This reduction is not offset by the measured increase in the number of contacts between students and nonhousehold relatives. Model simulations suggest that gradual reactive school-closure policies based on monitoring student absenteeism rates are capable of mitigating influenza spread. We estimate that without the implemented reactive strategies the attack rate of the 2015 to 2016 influenza season would have been 33% larger. Our study sheds light on the social mixing patterns of the population during the implementation of reactive school closures and provides key instruments for future cost-effectiveness analyses of school-closure policies.

scholarly journals The Right to Education and ICT during COVID-19: An International Perspective

2020 ◽  
Vol 12 (21) ◽  
pp. 9091
Author(s):  
Luis Miguel Lázaro Lorente ◽  
Ana Ancheta Arrabal ◽  
Cristina Pulido-Montes
Keyword(s):  
Low Income ◽  
International Perspective ◽  
School Closure ◽  
Global Perspective ◽  
Low Income Countries ◽  
Right To Education ◽  
The World ◽  
The Government ◽  
The Right ◽  
The Impact

There is a lack of concluding evidence among epidemiologists and public health specialists about how school closures reduce the spread of COVID-19. Herein, we attend to the generalization of this action throughout the world, specifically in its quest to reduce mortality and avoid infections. Considering the impact on the right to education from a global perspective, this article discusses how COVID-19 has exacerbated inequalities and pre-existing problems in education systems around the world. Therefore, the institutional responses to guaranteeing remote continuity of the teaching–learning process during this educational crisis was compared regionally through international databases. Three categories of analysis were established: infrastructure and equipment, both basic and computer-based, as well as internet access of schools; preparation and means of teachers to develop distance learning; and implemented measures and resources to continue educational processes. The results showed an uneven capacity in terms of response and preparation to face the learning losses derived from school closure, both in low-income regions and within middle- and high-income countries. We concluded that it is essential to articulate inclusive educational policies that support strengthening the government response capacity, especially in low-income countries, to address the sustainability of education.

scholarly journals Optimal intervention strategies of staged progression HIV infections through an age-structured model with probabilities of ART drop out

2021 ◽  
Author(s):  
Ramsès Djidjou-Demasse
Keyword(s):  
Global Analysis ◽  
Hiv Infections ◽  
Host Population ◽  
Drop Out ◽  
Globally Asymptotically Stable ◽  
Optimal Intervention ◽  
Age Structured ◽  
Age Structured Model ◽  
The Impact ◽  
Disease Free

In this paper, we construct a model to describe the transmission of HIV in a homogeneous host population. By considering the specific mechanism of HIV, we derive a model structured in three successive stages: (i) primary infection, (ii) long phase of latency without symptoms and (iii) AIDS. Each HIV stage is stratified by the duration for which individuals have been in the stage, leading to a continuous age-structure model. In the first part of the paper, we provide a global analysis of the model depending upon the basic reproduction number R0. When R0<=1, then the disease-free equilibrium is globally asymptotically stable and the infection is cleared in the host population. On the contrary, if R0>1, we prove the epidemic's persistence with the asymptotic stability of the endemic equilibrium. By performing the sensitivity analysis, we then determine the impact of control-related parameters of the outbreak severity. For the second part, the initial model is extended with intervention methods. By taking into account ART interventions and the probability of treatment drop out, we discuss optimal interventions methods which minimize the number of AIDS cases.

scholarly journals Human Mobility and Epidemic Evolution

2021 ◽  
Author(s):  
Fabio Vanni ◽  
David Lambert ◽  
Luigi Palatella ◽  
Paolo Grigolini
Keyword(s):  
Reproduction Number ◽  
Human Mobility ◽  
Theoretical Framework ◽  
Infection Age ◽  
Mobility Data ◽  
Risk Of Disease ◽  
Age Structured ◽  
Using Data ◽  
Age Structured Model ◽  
The Impact

Abstract The CoViD-19 pandemic ceased to be describable by a susceptible-infected-recovered (SIR) model when lockdowns were enforced. We introduce a theoretical framework to explain and predict changes in the reproduction number of SARS-CoV-2 (Sudden Acute Respiratory Syndrome Coronavirus 2) in terms of individual mobility and interpersonal proximity (alongside other epidemiological and environmental variables) during and after the lockdown period. We use an infection-age structured model described by a renewal equation. The model predicts the evolution of the reproduction number up to a week ahead of well-established estimates used in the literature. We show how lockdown policies, via reduction of proximity and mobility, reduce the impact of CoViD-19 and mitigate the risk of disease resurgence. We validate our theoretical framework using data from Google, Voxel51, Unacast, The CoViD-19 Mobility Data Network, and Analisi Distribuzione Aiuti.

scholarly journals On the use of aggregated human mobility data to estimate the reproduction number

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Fabio Vanni ◽  
David Lambert ◽  
Luigi Palatella ◽  
Paolo Grigolini
Keyword(s):  
Reproduction Number ◽  
Human Mobility ◽  
Theoretical Framework ◽  
Infection Age ◽  
Mobility Data ◽  
Risk Of Disease ◽  
Age Structured ◽  
Using Data ◽  
Age Structured Model ◽  
The Impact

AbstractThe reproduction number of an infectious disease, such as CoViD-19, can be described through a modified version of the susceptible-infected-recovered (SIR) model with time-dependent contact rate, where mobility data are used as proxy of average movement trends and interpersonal distances. We introduce a theoretical framework to explain and predict changes in the reproduction number of SARS-CoV-2 in terms of aggregated individual mobility and interpersonal proximity (alongside other epidemiological and environmental variables) during and after the lockdown period. We use an infection-age structured model described by a renewal equation. The model predicts the evolution of the reproduction number up to a week ahead of well-established estimates used in the literature. We show how lockdown policies, via reduction of proximity and mobility, reduce the impact of CoViD-19 and mitigate the risk of disease resurgence. We validate our theoretical framework using data from Google, Voxel51, Unacast, The CoViD-19 Mobility Data Network, and Analisi Distribuzione Aiuti.

The Link between Estradiol and Neuroplasticity in Transgender Women after Gender-Affirming Surgery: A Bimodal Hypothesis

2019 ◽  
Vol 110 (6) ◽  
pp. 489-500 ◽  
Author(s):  
Maiko A. Schneider ◽  
Poli M. Spritzer ◽  
Jee Su Suh ◽  
Luciano Minuzzi ◽  
Benicio N. Frey ◽  
...  
Keyword(s):  
Verbal Memory ◽  
Longitudinal Design ◽  
Scientific Evidence ◽  
Occipital Cortex ◽  
Transgender Women ◽  
Middle Temporal Gyrus ◽  
Precentral Gyrus ◽  
Time Points ◽  
The Right ◽  
The Impact

For transgender individuals, gender-affirming surgery (GAS) and cross-sex hormone therapy (CSHT) are part of the gender transition process. Scientific evidence supporting the maintenance of CSHT after GAS-related gonadectomy is accumulating. However, few data are available on the impact of CSHT on the brain structure following hypogonadism. Thus, we aimed to investigate links between estradiol and brain cortical thickness (CTh) and cognition in 18 post-gonadectomy transgender women using a longitudinal design. For this purpose, the participants underwent a voluntary period of CSHT washout of at least 30 days, followed by estradiol re-institution for 60 days. High-resolution T1-weighted brain images, hormonal measures, working and verbal memory were collected at 2 time points: on the last day of the washout (t1) and on the last day of the 2-month CSHT period (t2). Between these 2 time points, CTh increased within the left precentral gyrus and right precuneus but decreased within the right lateral occipital cortex. However, these findings did not survive corrections of multiple comparisons. Nevertheless, there was a significant negative correlation between changes in estradiol levels and changes in CTh. This effect was evident in the left superior frontal gyrus, the left middle temporal gyrus, the right precuneus, the right superior temporal gyrus, and the right pars opercularis. Although there was an improvement in verbal memory following hypogonadism correction, we did not observe a significant relationship between changes in memory scores and CTh. Altogether, these findings suggest that there is a link between estradiol and CTh.

Sign in / Sign up

Export Citation Format

Share Document