scholarly journals Estimating the Proportion of Asymptomatic COVID-19 Cases in an Italian Region with Intermediate Incidence during the First Pandemic Wave: An Observational Retrospective Study

2022 ◽  
Vol 2022 ◽  
pp. 1-6
Author(s):  
Domenico Martinelli ◽  
Francesca Fortunato ◽  
Sara Mazzilli ◽  
Lucia Bisceglia ◽  
Pier Luigi Lopalco ◽  
...  
Keyword(s):  
Public Health ◽  
Clinical Signs ◽  
Virus Transmission ◽  
Contact Tracing ◽  
The Public ◽  
Health Community ◽  
Important Challenge ◽  
Asymptomatic Infections ◽  
Public Health Strategies

Early in the COVID-19 pandemic, asymptomatic transmission represented an important challenge for controlling the spread of SARS-CoV-2 through the traditional public health strategies. Further understanding of the contribution of asymptomatic infections to SARS-CoV-2 transmission has been of crucial importance for pandemic control. We conducted a retrospective epidemiological study to characterize asymptomatic COVID-19 cases occurred in the Apulia region, Italy, during the first epidemic wave of COVID-19 outbreak (February 29-July 7, 2020). We analyzed data collected in a regional platform developed to manage surveillance activities, namely, investigation and follow-up of cases and contacts, contact tracing, and laboratory and clinical data collection. We included all asymptomatic cases that were laboratory-confirmed during the appropriate follow-up, defined as persons infected with SARS-CoV-2 who did not develop symptoms/clinical signs of the disease. Between February 29 and July 7, 2020, a total of 4,536 cases were diagnosed with COVID-19 among 193,757 tests performed. The group of persons with asymptomatic SARS-CoV-2 infection consisted of 903 cases; the asymptomatic proportion was 19.9% (95% CI: 18.8-21.1%); this decreased with increasing age (OR: 0.89, 95% CI: 0.83-0.96; p = 0.001 ), in individuals with underlying comorbidities (OR: 0.55, 95% CI: 0.41-0.73; p < 0.001 ), and in males (OR: 0.69, 95% CI: 0.54-0.87; p = 0.002 ). The median asymptomatic SARS-CoV-2 RNA positive period was 19 days (IQR: 14-31) and the cumulative proportion of persons with resolution of infection 14 days after the first positive PCR test was 74%. As the public health community is debating the question of whether asymptomatic and late spreaders could sustain virus transmission in the communities, such cases present unique opportunities to gain insight into SARS-CoV-2 adaptation to human host. This has important implications for future COVID-19 surveillance and prevention.

scholarly journals Estimating the proportion of asymptomatic COVID-19 cases in an Italian region with intermediate incidence during the first pandemic wave: an observational retrospective study

2021 ◽  
Author(s):  
Domenico Martinelli ◽  
Francesca Fortunato ◽  
Sara Mazzilli ◽  
Lucia Bisceglia ◽  
Pier Luigi Lopalco ◽  
...  
Keyword(s):  
Public Health ◽  
Clinical Signs ◽  
Virus Transmission ◽  
Contact Tracing ◽  
The Public ◽  
Health Community ◽  
Important Challenge ◽  
Asymptomatic Infections ◽  
Public Health Strategies

Abstract Early in the COVID-19 pandemic, asymptomatic transmission represented an important challenge for controlling the spread of SARS-CoV-2 through the traditional public health strategies. Further understanding of the contribution of asymptomatic infections to SARS-CoV-2 transmission has been of crucial importance for pandemic control. We conducted a retrospective epidemiological study to characterize asymptomatic COVID-19 cases occurred in the Apulia region, Italy, during the first epidemic wave of COVID-19 outbreak (February 29 - July 7, 2020). We analyzed data collected in a regional platform developed to manage surveillance activities, namely investigation and follow-up of cases and contacts, contact tracing, laboratory and clinical data collection. We included all asymptomatic cases that were laboratory-confirmed during the appropriate follow-up, defined as persons infected with SARS-CoV-2 who did not develop symptoms/clinical signs of the disease. Between February 29 and July 7, 2020, a total of 4,536 cases were diagnosed with COVID-19 among 193,757 tests performed. The group of persons with asymptomatic SARS-CoV-2 infection consisted of 903 cases; the asymptomatic proportion was 19.9% (95%CI: 18.8-21.1%); this decreased with increasing age (OR: 0.89, 95%CI: 0.83-0.96; p=0.001), in individuals with underlying comorbidities (OR: 0.55, 95%CI: 0.41-0.73; p<0.001), and in males (OR: 0.69, 95%CI: 0.54-0.87; p=0.002). The median asymptomatic SARS-CoV-2 RNA positive period was 19 days (IQR: 14-31) and the cumulative proportion of persons with resolution of infection 14 days after the first positive PCR test was 74%. As the public health community is debating the question of whether asymptomatic and late spreaders could sustain virus transmission in the communities, such cases present unique opportunities to gain insight into SARS-CoV-2 adaptation to human host. This has important implications for future COVID-19 surveillance and prevention.

scholarly journals Estimating the proportion of asymptomatic COVID-19 cases during the first pandemic wave in Apulia region, Italy

2020 ◽  
Author(s):  
Domenico Martinelli ◽  
Francesca Fortunato ◽  
Sara Mazzilli ◽  
Lucia Bisceglia ◽  
Pier Luigi Lopalco ◽  
...  
Keyword(s):  
Clinical Signs ◽  
Virus Transmission ◽  
Contact Tracing ◽  
Infectious Period ◽  
The Public ◽  
Apulia Region ◽  
Health Community ◽  
Asymptomatic Infections ◽  
Regional Surveillance

Abstract In the current epidemiological situation of COVID-19 in countries such as Italy, quantifying the contribution of asymptomatic infections to SARS-CoV-2 transmission is of crucial importance for pandemic control. We conducted a retrospective epidemiological study to characterize asymptomatic COVID-19 cases occurred in the Apulia region, Italy, during the first epidemic wave of COVID-19 outbreak.We analyzed data collected in a regional surveillance platform developed to manage the emergency through investigation and follow-up of cases and contacts, contact tracing, laboratory and clinical data collection. We included asymptomatic laboratory-confirmed cases defined as persons infected with SARS-CoV-2 who did not develop symptoms/clinical signs of the disease.Between February 29 and July 7, 2020, a total of 4,536 cases were diagnosed with COVID-19 among 193.757 tests performed. The group of persons with asymptomatic SARS-CoV-2 infection consisted of 903 cases; the asymptomatic proportion was 19.9% (95%CI: 18.8-21.1%); this decreased with increasing age (OR: 0.89, 95%CI: 0.83-0.96; p=0.001), in individuals with underlying comorbidities (OR: 0.55, 95%CI: 0.41-0.73; p<0.001), and males (OR: 0.69, 95%CI: 0.54-0.87; p=0.002). The median asymptomatic infectious period was 19 days (IQR: 14-31) and the cumulative proportion of persons with resolution of infection 14 days after the first positive PCR test was 74%.In Europe and globally, there is again an increase in the number of new cases, mainly asymptomatic. As the public health community debates the question of whether asymptomatic and late spreaders could sustain virus transmission in the communities, such cases present unique opportunities to gain insight into SARS-CoV-2 adaptation to human host.

scholarly journals Public Health, Ministry of Health and Economic Actors: the case of food and information of public

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
P Lombrail
Keyword(s):  
Public Health ◽  
Western Europe ◽  
Nutritional Composition ◽  
The Public ◽  
Health Community ◽  
Food And Beverage ◽  
Key Policy ◽  
Public Health Strategies ◽  
The Impact

Abstract The experience of France in the implementation of a frontof- pack label, the Nutri-Score, clearly illustrates the constant tug-ofwar between public health experts and the industry and provides a framework for an efficient strategy that could be replicated at the EU level. Dietary risk factors is in the top three leading causes of morbidity and mortality in Western Europe. Such high burden of diseases urges the implementation of strong and efficient public health strategies in order to curb the impact of poor diets. The public health community has long promoted strategies impacting both individual dietary behavior and the food environment, in a consistent global framework. However, the latter strategies imply to act upon the food and beverage manufacturers, to provide consumers with better information on the nutritional quality of the foods they produce and to ensure a shift in the nutritional composition of the food offer towards healthier foods. Among the various public health nutrition strategies that are considered efficient in both modifying consumer behavior and enticing reformulations by the food industry, front-of-pack food labeling has been identified as a key policy component in a global program.

scholarly journals Public health response to two incidents of confirmed MERS-CoV cases travelling on flights through London Heathrow Airport in 2014 – lessons learnt

2015 ◽  
Vol 20 (18) ◽  
Author(s):  
F Parry-Ford ◽  
N Boddington ◽  
R Pebody ◽  
N Phin ◽  
Collective on behalf of the Incident Management Team
Keyword(s):  
Public Health ◽  
International Health ◽  
The United States ◽  
World Health ◽  
Contact Tracing ◽  
Public Health Response ◽  
The Public ◽  
Health Response ◽  
Health Organization

In May 2014, Public Health England was alerted to two separate laboratory-confirmed cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection who transited through London Heathrow Airport while symptomatic on flights from Saudi Arabia to the United States of America. We present the rationale for the public health response to both incidents, and report results of contact tracing. Following a risk assessment, passengers seated two seats around the cases were prioritised for contact tracing and a proactive media approach was used to alert all passengers on the planes of their possible exposure in both incidents. In total, 64 United Kingdom (UK) residents were successfully contacted, 14 of whom were sat in the priority area two seats all around the case(s). Five passengers reported respiratory symptoms within 14 days of the flight, but all tested were negative for MERS-CoV. Details of non-UK residents were passed on to relevant World Health Organization International Health Regulation focal points for follow-up, and no further cases were reported back. Different approaches were used to manage contact tracing for each flight due to variations in the quality and timeliness of the passenger contact information provided by the airlines involved. No evidence of symptomatic onward transmission was found.

Navigating the Ethics of Big Data in Public Health

2019 ◽  
pp. 353-367
Author(s):  
Effy Vayena ◽  
Lawrence Madoff
Keyword(s):  
Public Health ◽  
Big Data ◽  
Credit Card ◽  
Health Sector ◽  
Public Health Research ◽  
Ethical Challenges ◽  
The Public ◽  
Health Community ◽  
Digital Disease Detection ◽  
The Public Sphere

“Big data,” which encompasses massive amounts of information from both within the health sector (such as electronic health records) and outside the health sector (social media, search queries, cell phone metadata, credit card expenditures), is increasingly envisioned as a rich source to inform public health research and practice. This chapter examines the enormous range of sources, the highly varied nature of these data, and the differing motivations for their collection, which together challenge the public health community in ethically mining and exploiting big data. Ethical challenges revolve around the blurring of three previously clearer boundaries: between personal health data and nonhealth data; between the private and the public sphere in the online world; and, finally, between the powers and responsibilities of state and nonstate actors in relation to big data. Considerations include the implications for privacy, control and sharing of data, fair distribution of benefits and burdens, civic empowerment, accountability, and digital disease detection.

scholarly journals The potential dangers of not understanding COVID-19 public health restrictions in dementia: “It’s a groundhog day – every single day she does not understand why she can’t go out for a walk”

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Clarissa Giebel ◽  
Kerry Hanna ◽  
Manoj Rajagopal ◽  
Aravind Komuravelli ◽  
Jacqueline Cannon ◽  
...  
Keyword(s):  
Public Health ◽  
Cognitive Deficits ◽  
Third Sector ◽  
Cognitive Capacity ◽  
The Public ◽  
Health Measures ◽  
Third Sector Organisations ◽  
The Uk ◽  
Second Wave

Abstract Background Sudden public health restrictions can be difficult to comprehend for people with cognitive deficits. However, these are even more important for them to adhere to due to their increased levels of vulnerability, particularly to COVID-19. With a lack of previous evidence, we explored the understanding and changes in adherence to COVID-19 public health restrictions over time in people living with dementia (PLWD). Methods Unpaid carers and PLWD were interviewed over the phone in April 2020, shortly after the nationwide UK lockdown, with a proportion followed up from 24th June to 10th July. Participants were recruited via social care and third sector organisations across the UK, and via social media. Findings A total of 70 interviews (50 baseline, 20 follow-up) were completed with unpaid carers and PLWD. Five themes emerged: Confusion and limited comprehension; Frustration and burden; Putting oneself in danger; Adherence to restrictions in wider society; (Un) changed perceptions. Most carers reported limited to no understanding of the public health measures in PLWD, causing distress and frustration for both the carer and the PLWD. Due to the lack of understanding, some PLWD put themselves in dangerous situations without adhering to the restrictions. PLWD with cognitive capacity who participated understood the measures and adhered to these. Discussion In light of the new second wave of the pandemic, public health measures need to be simpler for PLWD to avoid unwilful non-adherence. Society also needs to be more adaptive to the needs of people with cognitive disabilities more widely, as blanket rules cause distress to the lives of those affected by dementia.

Zoom; or, Obsolescence

2021 ◽  
Vol 65 (3) ◽  
pp. 181-200
Author(s):  
W.B. Worthen
Keyword(s):  
Public Health ◽  
New Technologies ◽  
Virus Transmission ◽  
Electronic Media ◽  
Theatrical Production ◽  
Health Concerns ◽  
The Public

The signal modality of theatrical production during the pandemic crisis of 2020–21 has been Zoom theatre. While Zoom theatre responds to public health concerns regarding virus transmission, it also articulates a vision of performance at the intersection of the public and the private, at the juncture between theatre and electronic media, and as a representation of theatre as a humanizing technology. Theatre has suggestively foregrounded new technologies under the sign of obsolescence, and in the affective register of nostalgia.

scholarly journals Challenges in Contact Tracing by Mining Mobile Phone Location Data for COVID-19: Implications for Public Governance in South Africa

10.28945/4736 ◽  
2021 ◽  
Vol 16 ◽  
pp. 101-124
Author(s):  
Paul Kariuki ◽  
Lizzy O Ofusori ◽  
Prabhakar Rontala Subramanniam ◽  
Moses Okpeku ◽  
Maria L Goyayi
Keyword(s):  
Public Health ◽  
South Africa ◽  
Mobile Phone ◽  
Contact Tracing ◽  
Future Research ◽  
Public Governance ◽  
The Public ◽  
Location Data ◽  
Pertinent Data ◽  
Privacy And Confidentiality

Aim/Purpose: The paper’s objective is to examine the challenges of using the mobile phone to mine location data for effective contact tracing of symptomatic, pre-symptomatic, and asymptomatic individuals and the implications of this technology for public health governance. Background: The COVID-19 crisis has created an unprecedented need for contact tracing across South Africa, requiring thousands of people to be traced and their details captured in government health databases as part of public health efforts aimed at breaking the chains of transmission. Contact tracing for COVID-19 requires the identification of persons who may have been exposed to the virus and following them up daily for 14 days from the last point of exposure. Mining mobile phone location data can play a critical role in locating people from the time they were identified as contacts to the time they access medical assistance. In this case, it aids data flow to various databases designated for COVID-19 work. Methodology: The researchers conducted a review of the available literature on this subject drawing from academic articles published in peer-reviewed journals, research reports, and other relevant national and international government documents reporting on public health and COVID-19. Document analysis was used as the primary research method, drawing on the case studies. Contribution: Contact tracing remains a critical strategy in curbing the deadly COVID-19 pandemic in South Africa and elsewhere in the world. However, given increasing concern regarding its invasive nature and possible infringement of individual liberties, it is imperative to interrogate the challenges related to its implementation to ensure a balance with public governance. The research findings can thus be used to inform policies and practices associated with contact tracing in South Africa. Findings: The study found that contact tracing using mobile phone location data mining can be used to enforce quarantine measures such as lockdowns aimed at mitigating a public health emergency such as COVID-19. However, the use of technology can expose the public to criminal activities by exposing their locations. From a public governance point of view, any exposure of the public to social ills is highly undesirable. Recommendations for Practitioners: In using contact tracing apps to provide pertinent data location caution needs to be exercised to ensure that sensitive private information is not made public to the extent that it compromises citizens’ safety and security. The study recommends the development and implementation of data use protocols to support the use of this technology, in order to mitigate against infringement of individual privacy and other civil liberties. Recommendation for Researchers: Researchers should explore ways of improving digital applications in order to improve the acceptability of the use of contact tracing technology to manage pandemics such as COVID-19, paying attention to ethical considerations. Impact on Society: Since contact tracing has implications for privacy and confidentiality it must be conducted with caution. This research highlights the challenges that the authorities must address to ensure that the right to privacy and confidentiality is upheld. Future Research: Future research could focus on collecting primary data to provide insight on contact tracing through mining mobile phone location data. Research could also be conducted on how app-based technology can enhance the effectiveness of contact tracing in order to optimize testing and tracing coverage. This has the potential to minimize transmission whilst also minimizing tracing delays. Moreover, it is important to develop contact tracing apps that are universally inter-operable and privacy-preserving.

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