scholarly journals Global disparities in SARS-CoV-2 genomic surveillance

2021 ◽  
Author(s):  
Anderson F. Brito ◽  
Elizaveta Semenova ◽  
Gytis Dudas ◽  
Gabriel W. Hassler ◽  
Chaney C. Kalinich ◽  
...  
Keyword(s):  
Public Health ◽  
Genome Sequencing ◽  
Virus Transmission ◽  
Virus Genome ◽  
Middle Income ◽  
Middle Income Countries ◽  
Spatial And Temporal Heterogeneity ◽  
Control Virus ◽  
The Impact ◽  
Lineage Diversity

The COVID-19 pandemic has revealed the importance of virus genome sequencing to guide public health interventions to control virus transmission and understand SARS-CoV-2 evolution. As of July 20th, 2021, >2 million SARS-CoV-2 genomes have been submitted to GISAID, 94% from high income and 6% from low and middle income countries. Here, we analyse the spatial and temporal heterogeneity in SARS-CoV-2 global genomic surveillance efforts. We report a comprehensive analysis of virus lineage diversity and genomic surveillance strategies adopted globally, and investigate their impact on the detection of known SARS-CoV-2 virus lineages and variants of concern. Our study provides a perspective on the global disparities surrounding SARS-CoV-2 genomic surveillance, their causes and consequences, and possible solutions to maximize the impact of pathogen genome sequencing for efforts on public health.

scholarly journals The impact of COVID-19 on the care of people living with noncommunicable diseases in low- and middle-income countries: an online survey of physicians and pharmacists in nine countries

2021 ◽  
Vol 22 ◽  
Author(s):  
Chris Bullen ◽  
Jessica McCormack ◽  
Amanda Calder ◽  
Varsha Parag ◽  
Kannan Subramaniam ◽  
...  
Keyword(s):  
Public Health ◽  
Healthcare Workers ◽  
Online Survey ◽  
World Health ◽  
Noncommunicable Diseases ◽  
Middle Income ◽  
Middle Income Countries ◽  
Health Measures ◽  
The Impact ◽  
Low And Middle Income

Abstract Background: The global COVID-19 pandemic has disrupted healthcare worldwide. In low- and middle-income countries (LMICs), where people may have limited access to affordable quality care, the COVID-19 pandemic has the potential to have a particularly adverse impact on the health and healthcare of individuals with noncommunicable diseases (NCDs). A World Health Organization survey found that disruption of delivery of healthcare for NCDs was more significant in LMICs than in high-income countries. However, the study did not elicit insights into the day-to-day impacts of COVID-19 on healthcare by front-line healthcare workers (FLHCWs). Aim: To gain insights directly from FLHCWs working in countries with a high NCD burden, and thereby identify opportunities to improve the provision of healthcare during the current pandemic and in future healthcare emergencies. Methods: We recruited selected frontline healthcare workers (general practitioners, pharmacists, and other medical specialists) from nine countries to complete an online survey (n = 1347). Survey questions focused on the impact of COVID-19 pandemic on clinical practice and NCDs; barriers to clinical care during the pandemic; and innovative responses to the many challenges presented by the pandemic. Findings: The majority of FLHCWs responding to our survey reported that their care of patients had been impacted both adversely and positively by the public health measures imposed. Most FLHCs (95%) reported a deterioration in the mental health of their patients. Conclusions: Continuity of care for NCDs as part of pandemic preparedness is needed so that chronic conditions are not exacerbated by public health measures and the direct impacts of the pandemic.

scholarly journals COVID-19, Governance, and Conflict: Emerging Impacts and Future Evidence Needs

2021 ◽  
Author(s):  
Siân Herbert ◽  
Heather Marquette
Keyword(s):  
Social Sciences ◽  
Public Health ◽  
High Income ◽  
Middle Income ◽  
Middle Income Countries ◽  
The Social ◽  
Global Nature ◽  
Bodies Of Evidence ◽  
The Impact ◽  
Low And Middle Income

This paper reviews emerging evidence of the impact of COVID-19 on governance and conflict, using a “governance and conflict first” approach in contrast to other research and synthesis on COVID-19 in the social sciences that tends to be structured through a public health lens. It largely focuses on evidence on low- and middle-income countries but also includes a number of examples from high-income countries, reflecting the global nature of the crisis. It is organised around four cross-cutting themes that have enabled the identification of emerging bodies of evidence and/or analysis: Power and legitimacy; Effectiveness, capacity, and corruption; Violence, unrest, and conflict; and Resilience, vulnerability, and risk. The paper concludes with three over-arching insights that have emerged from the research: (1) the importance of leadership; (2) resilience and what “fixing the cracks” really means; and (3) why better ways are needed to add up all the “noise” when it comes to COVID-19 and evidence.

Evaluation of a massive open online course for just-in-time training in resource-limited settings: evidence from a COVID-19 course for healthcare workers (Preprint)

2020 ◽  
Author(s):  
Matthew Charles Strehlow ◽  
Kelly Zhang Aluri ◽  
Jamie Sewan Johnston ◽  
Charles G Prober ◽  
Peter Corrigan Acker ◽  
...  
Keyword(s):  
Public Health ◽  
Online Courses ◽  
Course Completion ◽  
Online Course ◽  
Massive Open Online ◽  
Final Exam ◽  
Middle Income ◽  
Middle Income Countries ◽  
Massive Open Online Course ◽  
The Impact

BACKGROUND The COVID-19 pandemic created an urgent global need for healthcare worker (HCW) training. Initial COVID-19-related online courses focused primarily on training public health workers and physicians caring for patients in intensive care units (ICUs). However, in resource-constrained settings, nurses and general practitioners are responsible for providing most COVID-19 patient medical care, typically lacking the training and equipment necessary to manage complex, critically ill patients. In these environments, early recognition and interventions to prevent patient deterioration are essential to optimizing outcomes. We developed a massive open online course (MOOC) for HCWs in resource-constrained settings aimed at training bedside providers caring for patients with COVID-19. OBJECTIVE This study evaluates the impact of this MOOC by assessing HCW course engagement, knowledge, confidence in caring for COVID-19 patients, and user experience. METHODS From May thru June of 2020, the course was rapidly developed by a team of physicians, educators, medical illustrators, and education technology staff, and was subsequently launched on two online platforms in July 2020. The approximately 4-hour course comprises 6 video-based modules with accompanying handouts. Student knowledge was assessed using pre- and post-module quizzes and a final exam, while demographics and user experience were evaluated by pre- and post-course surveys and data collected through the platforms. RESULTS From July 17th to September 24th, 30,859 students enrolled, 18,818 started, and 7,101 completed the course. Most participants worked in healthcare (86%) and resided in lower middle- (36%) or upper middle- (21%) income countries. Higher course completion rates were observed among learners who were from upper middle-income (aOR 1.152 [95% CI 1.019-1.303]) and lower middle-income countries (aOR 1.229 [95% CI 1.104-1.368]). Significant knowledge gains were observed from pre-module (mean 56% [SD 17%]) to post-module quizzes (80% [SD 15%], P<.001), and from pre-module quizzes to the final exam (78% [SD 17%], P<.001). After course completion, participants reported increased self-efficacy regarding the course objectives, with a 0.63 mean increase on a 4-point scale (95% CI [0.60,0.66]). Overall, there was high satisfaction with the course experience, with 93% of participants reporting they would recommend the course to others. CONCLUSIONS This study demonstrates the potential of MOOCs to rapidly provide access to emerging medical knowledge during a public health crisis, particularly for HCWs in high- and middle-income countries. Further research is required to understand the impact of such online courses on patient care and how to better reach learners in low-income countries.

Economic Evaluation of Interventions to Reduce Road Traffic injuries - A Review of the Literature with Applications to Low and Middie-income Countries

2004 ◽  
Vol 16 (1) ◽  
pp. 23-31 ◽  
Author(s):  
H.R. Waters ◽  
A.A. Hyder ◽  
T.L. Phillips
Keyword(s):  
Public Health ◽  
Road Traffic ◽  
The United States ◽  
Economic Evaluations ◽  
Review Of The Literature ◽  
Middle Income ◽  
Road Traffic Injuries ◽  
Middle Income Countries ◽  
The Impact ◽  
Low And Middle Income

Road Traffic Injuries (RTIs) kill over one million people worldwide annually. This article takes the perspective of economic costs and benefits to review the impact of available road safety interventions in industrialized countries - and the potential effect of these interventions in low and middle-income countries, where RTIs pose an increasingly large public health problem. A comprehensive review of the literature on cost-benefits and cost-effectiveness studies related to road traffic injuries internationally, with comparisons of costs adjusted for inflation and exchange differentials was conducted. In the United States (US), motor vehicle inspection laws resulted in annual savings of US $1.7 to $2.3 billion. The installation of seatbelts results in net savings of $162 per vehicle; with benefits outweighing costs by a factor ranging from 240 to 1,727. Other cost effective interventions include mandatory seatbelt use, lowering speed limits, motorcycle helmet laws, and traffic calming devices such as speed bumps and road deviations. The dearth of similar economic evaluations of interventions for road traffic injuries in low and middle-income countries represents a serious research gap and hinders the implementation of effective strategies in those countries. Asia Pac J Public Health 2004; 16(1): 23-31.

scholarly journals A Model Based Analysis for COVID-19 Pandemic in India: Implications for Health Systems and Policy for Low- and Middle-Income Countries

2020 ◽  
Author(s):  
Shankar Prinja ◽  
Pankaj Bahuguna ◽  
Yashika Chugh ◽  
Anna Vassall ◽  
Arvind Pandey ◽  
...  
Keyword(s):  
Public Health ◽  
Health System ◽  
Air Travel ◽  
Contact Tracing ◽  
System Response ◽  
Middle Income ◽  
Middle Income Countries ◽  
Health Measures ◽  
Travel Restrictions ◽  
The Impact

AbstractBackgroundOur analysis aims to model COVID-19 pandemic in India, potential impact of various measures, along with assessment of health system preparedness and cost to manage the epidemic.MethodsWe developed a susceptible-exposed-infectious-recovered (SEIR) mathematical model to predict the health outcomes under an unmitigated scenario which comprises of air travel restrictions alone, and the current scenario consisting of air travel restrictions along with 8-week lockdown. In addition, we also evaluate the effectiveness of 8-week lockdown along with intensified public health measures at varying level of effectiveness. We assessed the impact of these interventions on COVID-19 related health outcomes in comparison to the unmitigated scenario. Next, we ascertain the need for augmenting infrastructure and the costs of COVID-19 management in India.FindingsIn the event of a lockdown for 8 weeks, the peak of the epidemic shifts by 34-76 days, and the number of cases at the end of 8-week lockdown reduces by 69% to 97% with varying effectiveness of lockdown. However, the cumulative long-term cases remain the same. Intensification of public health surveillance measures with 60% effectiveness is estimated to reduce the cases at peak and cumulative number of infections by 70% and 26.6% respectively. The requirement of ICU beds and ventilators would reduce by 83% with intensified public health measures. The cost of managing COVID-19 in India is nearly 4.5% of the gross domestic product (GDP) in the absence of any intervention which increases to 6.2% with intensified public health measures for COVID-19 response.ConclusionLockdown measures delay the onset of peak, and give much needed time to health system to prepare. Strengthening the public health system response in terms of testing, isolation treatment of cases, and contact tracing needs would lead to significant gains in terms of case load, and meeting health system needs.SummaryWhat is already known?A few studies have been carried out in Indian context to model the epidemic. These models explored the impact of lockdowns and social distancing measures focusing more on the course of the epidemic but none of these evaluated the impact on health system’s response needed as well as the economic impact of COVID-19 management in India. The findings from these studies are limited in a sense that either these studies evaluated the hypothetical scenarios of strategies implemented or focusing to smaller geographical regions in India.What are the new findings?Evidence pertaining to health economic impact of COVID-19 management, in context to Low- and Middle-Income countries, is very limited. To address this, we used the susceptible-exposed-infectious-recovered (SEIR) model to assess:the health system preparedness challenge in terms of hospital beds for isolation, intensive care and ventilators which would be required to manage the epidemic and the economic implications of managing the COVID-19 pandemic in India.the incremental cost of intensified public health measures per infection and per death averted.What do the new finding imply?In India, measures such as lockdowns would certainly delays the onset of peak of COVID-19 epidemic. This would help delay the surge of cases, which would buy time for the health system to prepare. Strengthening the health system response in terms of enhanced testing, isolation of cases, treatment and contact tracing, as is being done currently, would have to be the mainstay to reduce the impact of the pandemic in terms of reduction in infected population and COID-19 deaths in India until vaccine becomes available.

The Impact of Covid 19 on Pregnant Women and Child Health

2020 ◽  
Vol 11 (SPL1) ◽  
pp. 1367-1373
Author(s):  
Nikhil Sanjay Mujbaile ◽  
Smita Damke
Keyword(s):  
Social Issues ◽  
Middle Income ◽  
Web Based ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
The Social ◽  
Social Separation ◽  
The Impact ◽  
And Child Health ◽  
General Wellbeing

The Covid illness (COVID-19) pandemic has spread rapidly all through the world and has had a drawn-out impact. The Pandemic has done incredible damage to society and made genuine mental injury to numerous individuals. Mental emergencies frequently cause youngsters to deliver sentiments of relinquishment, despondency, insufficiency, and fatigue and even raise the danger of self-destruction. Youngsters with psychological instabilities are particularly powerless during the isolate and colonial removing period. Convenient and proper assurances are expected to forestall the event of mental and social issues. The rising advanced applications and wellbeing administrations, for example, telehealth, web-based media, versatile wellbeing, and far off intuitive online instruction can connect the social separation and backing mental and conduct wellbeing for youngsters. Because of the mental advancement qualities of youngsters, this investigation additionally outlines intercessions on the mental effect of the COVID-19 Pandemic. Further difficulties in Low Middle-Income Countries incorporate the failure to actualize successful general wellbeing estimates, for example, social separating, hand cleanliness, definitive distinguishing proof of contaminated individuals with self-disconnection and widespread utilization of covers The aberrant impacts of the Pandemic on youngster wellbeing are of extensive concern, including expanding neediness levels, upset tutoring, absence of admittance to the class taking care of plans, decreased admittance to wellbeing offices and breaks in inoculation and other kid wellbeing programs. Kept tutoring is critical for kids in Low Middle-Income Countries. Arrangement of safe situations is mainly testing in packed asset obliged schools. 

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