Mandatory Public Health Measures for Coronavirus-19 Are Associated With Improved Mortality, Equity and Economic Outcomes

2021 ◽  
pp. 002073142110493
Author(s):  
Brita Lundberg ◽  
Kathryn McDonald
Keyword(s):  
Public Health ◽  
Negative Effects ◽  
Statistical Life ◽  
Health Measures ◽  
Cohort Study Design ◽  
Mortality Cost ◽  
Negative Impacts ◽  
Nonpharmaceutical Interventions ◽  
The Impact ◽  
The U.S

The impact of public health measures on the coronavirus-2019 pandemic was analyzed by comparing mandatory versus voluntary nonpharmaceutical interventions between 2 comparable European countries and among 3 U.S. states. Using an ecological retrospective cohort study design, we examine differences in mortality, economic impact, and equity. Compared to voluntary policies, mandatory shelter-in-place policies were associated with a 3- to 5-fold lower population-adjusted mortality in the U.S. model and between 11- to 12-fold lower in the European one. Voluntary shelter-in-place measures were associated with overall increased mortality cost, as measured by value of a statistical life; somewhat greater decreases in gross domestic product; and substantial negative impacts on minority communities, who experienced markedly increased mortality rates (the percentage of minority deaths was 2.3 and 4 times greater in the U.S. model and 14.5 times higher in the European one) and mortality cost (2.7- and 4.5-fold higher in the U.S. model and 11.1-fold higher in the European one). We conclude that voluntary policies are less effective than mandatory ones, based on historical precedent and the current analysis. Negative effects on health equity mirrored the increased mortality outcomes of voluntary policies, and there was no apparent economic benefit associated with voluntary measures.

scholarly journals Perceptions of Covid-19 lockdowns and related public health measures in Austria: a longitudinal online survey

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Agata Łaszewska ◽  
Timea Helter ◽  
Judit Simon
Keyword(s):  
Public Health ◽  
Online Survey ◽  
Leisure Activities ◽  
Well Being ◽  
Chi Square ◽  
Health Measures ◽  
Extended Duration ◽  
Negative Impacts ◽  
The Impact ◽  
Second Wave

Abstract Background Introducing national lockdown has been effective in containing Covid-19. However, several studies indicated negative impacts of lockdowns on the well-being and mental health of many people. In Austria, the first Covid-19-related lockdown was introduced on 16 March 2020 with most restrictions being lifted 1 month later. Seven months after that, in November 2020, the second full lockdown was implemented. The aim of this study was to compare the perceptions and experiences of the general population related to the first and second Covid-19 lockdowns in Austria. Methods Two waves of an online survey were conducted in May and December 2020 asking respondents about their concerns related to the Covid-19 illness, personal experiences of the lockdowns, perceptions of and compliance with imposed public health measures, and the impact of the Covid-19 pandemic on different aspects of life during the two lockdowns. Descriptive statistics including frequency analysis were used to compare respondents’ answers collected in the two waves of the survey. T-test and chi-square tests were used to test differences between the two lockdowns. Results Five hundred sixty participants were included in the first wave and a sub-sample of 134 participants in the second wave of data collection. During the second lockdown, study respondents were more concerned about their family members contracting Covid-19 when compared with the first lockdown. Compliance with public health measures was overall lower during the second lockdown, although it varied according to the type of the measure. Closure of schools was seen as the least essential restriction during the second lockdown, while wearing masks gained additional approval between the first and the second lockdown. Larger negative impacts of the Covid-19 pandemic on friendships, leisure activities, education and community were reported during the second lockdown. Conclusions The study found that the extended duration of the pandemic and recurring lockdowns restricting freedom of movement and social contacts appear to have caused significant disruptions to many areas of life. Furthermore, declining adherence to most public health measures over time raises a question about the effectiveness of future lockdown measures.

scholarly journals The effect of public health measures on the 1918 influenza pandemic in U.S. cities

2007 ◽  
Vol 104 (18) ◽  
pp. 7588-7593 ◽  
Author(s):  
Martin C. J. Bootsma ◽  
Neil M. Ferguson
Keyword(s):  
Public Health ◽  
Excess Mortality ◽  
Influenza Pandemic ◽  
Total Mortality ◽  
Health Measures ◽  
Per Capita ◽  
1918 Influenza ◽  
The Impact ◽  
The U.S ◽  
Overall Mortality

During the 1918 influenza pandemic, the U.S., unlike Europe, put considerable effort into public health interventions. There was also more geographic variation in the autumn wave of the pandemic in the U.S. compared with Europe, with some cities seeing only a single large peak in mortality and others seeing double-peaked epidemics. Here we examine whether differences in the public health measures adopted by different cities can explain the variation in epidemic patterns and overall mortality observed. We show that city-specific per-capita excess mortality in 1918 was significantly correlated with 1917 per-capita mortality, indicating some intrinsic variation in overall mortality, perhaps related to sociodemographic factors. In the subset of 23 cities for which we had partial data on the timing of interventions, an even stronger correlation was found between excess mortality and how early in the epidemic interventions were introduced. We then fitted an epidemic model to weekly mortality in 16 cities with nearly complete intervention-timing data and estimated the impact of interventions. The model reproduced the observed epidemic patterns well. In line with theoretical arguments, we found the time-limited interventions used reduced total mortality only moderately (perhaps 10–30%), and that the impact was often very limited because of interventions being introduced too late and lifted too early. San Francisco, St. Louis, Milwaukee, and Kansas City had the most effective interventions, reducing transmission rates by up to 30–50%. Our analysis also suggests that individuals reactively reduced their contact rates in response to high levels of mortality during the pandemic.

scholarly journals Emotional and Mental Wellbeing Following COVID-19 Public Health Measures on People Living With Dementia and Carers

2021 ◽  
pp. 089198872199681
Author(s):  
Kerry Hanna ◽  
Clarissa Giebel ◽  
Hilary Tetlow ◽  
Kym Ward ◽  
Justine Shenton ◽  
...  
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Social Support ◽  
Support Services ◽  
Mental Wellbeing ◽  
Daily Lives ◽  
Health Measures ◽  
Social Support Services ◽  
The Uk ◽  
The Impact

Background: To date, there appears to be no evidence on the longer-term impacts caused by COVID-19 and its related public health restrictions on some of the most vulnerable in our societies. The aim of this research was to explore the change in impact of COVID-19 public health measures on the mental wellbeing of people living with dementia (PLWD) and unpaid carers. Method: Semi-structured, follow-up telephone interviews were conducted with PLWD and unpaid carers between June and July 2020. Participants were asked about their experiences of accessing social support services during the pandemic, and the impact of restrictions on their daily lives. Results: 20 interviews were conducted and thematically analyzed, which produced 3 primary themes concerning emotional responses and impact to mental health and wellbeing during the course of the pandemic: 1) Impact on mental health during lockdown, 2) Changes to mental health following easing of public health, and 3) The long-term effect of public health measures. Conclusions: The findings from this research shed light on the longer-term psychological impacts of the UK Government’s public health measures on PLWD and their carers. The loss of social support services was key in impacting this cohort mentally and emotionally, displaying a need for better psychological support, for both carers and PLWD.

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 Harnessing testing strategies and public health measures to avert COVID-19 outbreaks during ocean cruises

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Gerardo Chowell ◽  
Sushma Dahal ◽  
Raquel Bono ◽  
Kenji Mizumoto
Keyword(s):  
Public Health ◽  
Cost Effective ◽  
Contact Network ◽  
Social Distancing ◽  
Individual Level ◽  
Health Measures ◽  
Testing Strategies ◽  
Novel Coronavirus ◽  
The Individual ◽  
The Impact

AbstractTo ensure the safe operation of schools, workplaces, nursing homes, and other businesses during COVID-19 pandemic there is an urgent need to develop cost-effective public health strategies. Here we focus on the cruise industry which was hit early by the COVID-19 pandemic, with more than 40 cruise ships reporting COVID-19 infections. We apply mathematical modeling to assess the impact of testing strategies together with social distancing protocols on the spread of the novel coronavirus during ocean cruises using an individual-level stochastic model of the transmission dynamics of COVID-19. We model the contact network, the potential importation of cases arising during shore excursions, the temporal course of infectivity at the individual level, the effects of social distancing strategies, different testing scenarios characterized by the test’s sensitivity profile, and testing frequency. Our findings indicate that PCR testing at embarkation and daily testing of all individuals aboard, together with increased social distancing and other public health measures, should allow for rapid detection and isolation of COVID-19 infections and dramatically reducing the probability of onboard COVID-19 community spread. In contrast, relying only on PCR testing at embarkation would not be sufficient to avert outbreaks, even when implementing substantial levels of social distancing measures.

A Control Approach to Guide Nonpharmaceutical Interventions in the Treatment of COVID-19 Disease Using a SEIHRD Dynamical Model

2021 ◽  
Vol 30 (3) ◽  
pp. 323-346
Author(s):  
Fernando Pazos ◽  
◽  
Flavia E. Felicioni ◽  
Keyword(s):  
Public Health ◽  
Ad Hoc ◽  
Early Stage ◽  
Control Law ◽  
Parametric Uncertainties ◽  
Social Unrest ◽  
Control Approach ◽  
Health Measures ◽  
Optimal Intensity ◽  
Nonpharmaceutical Interventions

The recent worldwide epidemic of COVID-19 disease, for which there are no medications to cure it and the vaccination is still at an early stage, led to the adoption of public health measures by governments and populations in most of the affected countries to avoid the contagion and its spread. These measures are known as nonpharmaceutical interventions (NPIs), and their implementation clearly produces social unrest as well as greatly affects the economy. Frequently, NPIs are implemented with an intensity quantified in an ad hoc manner. Control theory offers a worthwhile tool for determining the optimal intensity of the NPIs in order to avoid the collapse of the healthcare system while keeping them as low as possible, yielding concrete guidance to policymakers. A simple controller, which generates a control law that is easy to calculate and to implement is proposed. This controller is robust to large parametric uncertainties in the model used and to some level of noncompliance with the NPIs.

scholarly journals Rapid disappearance of influenza following the implementation of COVID-19 mitigation measures in Hamilton, Ontario

2021 ◽  
Vol 47 (04) ◽  
pp. 202-208
Author(s):  
Kevin Zhang ◽  
Avika Misra ◽  
Patrick J Kim ◽  
Seyed M Moghadas ◽  
Joanne M Langley ◽  
...  
Keyword(s):  
Public Health ◽  
Influenza A ◽  
Respiratory Virus ◽  
Respiratory Viruses ◽  
Mitigation Measures ◽  
Nasopharyngeal Swab ◽  
Health Measures ◽  
Bayesian Linear Regression ◽  
Syncytial Virus ◽  
The Impact

Background: Public health measures, such as physical distancing and closure of schools and non-essential services, were rapidly implemented in Canada to interrupt the spread of the coronavirus disease 2019 (COVID-19). We sought to investigate the impact of mitigation measures during the spring wave of COVID-19 on the incidence of other laboratory-confirmed respiratory viruses in Hamilton, Ontario. Methods: All nasopharyngeal swab specimens (n=57,503) submitted for routine respiratory virus testing at a regional laboratory serving all acute-care hospitals in Hamilton between January 2010 and June 2020 were reviewed. Testing for influenza A and B, respiratory syncytial virus, human metapneumovirus, parainfluenza I–III, adenovirus, and rhinovirus/enterovirus was done routinely using a laboratory-developed polymerase chain reaction multiplex respiratory viral panel. A Bayesian linear regression model was used to determine the trend of positivity rates of all influenza samples for the first 26 weeks of each year from 2010 to 2019. The mean positivity rate of Bayesian inference was compared with the weekly reported positivity rate of influenza samples in 2020. Results: The positivity rate of influenza in 2020 diminished sharply following the population-wide implementation of COVID-19 interventions. Weeks 12–26 reported 0% positivity for influenza, with the exception of 0.1% reported in week 13. Conclusion: Public health measures implemented during the COVID-19 pandemic were associated with a reduced incidence of other respiratory viruses and should be considered to mitigate severe seasonal influenza and other respiratory virus pandemics.

scholarly journals Quantifying contact patterns in response to COVID-19 public health measures in Canada

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Gabrielle Brankston ◽  
Eric Merkley ◽  
David N. Fisman ◽  
Ashleigh R. Tuite ◽  
Zvonimir Poljak ◽  
...  
Keyword(s):  
Public Health ◽  
Population Based ◽  
Skewed Distribution ◽  
Cross Sectional ◽  
Health Measures ◽  
Contact Patterns ◽  
Region Of Residence ◽  
Control Procedures ◽  
The Impact ◽  
Made In

Abstract Background A variety of public health measures have been implemented during the COVID-19 pandemic in Canada to reduce contact between individuals. The objective of this study was to provide empirical contact pattern data to evaluate the impact of public health measures, the degree to which social contacts rebounded to normal levels, as well as direct public health efforts toward age- and location-specific settings. Methods Four population-based cross-sectional surveys were administered to members of a paid panel representative of Canadian adults by age, gender, official language, and region of residence during May (Survey 1), July (Survey 2), September (Survey 3), and December (Survey 4) 2020. A total of 4981 (Survey 1), 2493 (Survey 2), 2495 (Survey 3), and 2491 (Survey 4) respondents provided information about the age and setting for each direct contact made in a 24-h period. Contact matrices were constructed and contacts for those under the age of 18 years imputed. The next generation matrix approach was used to estimate the reproduction number (Rt) for each survey. Respondents with children under 18 years estimated the number of contacts their children made in school and extracurricular settings. Results Estimated Rt values were 0.49 (95% CI: 0.29–0.69) for May, 0.48 (95% CI: 0.29–0.68) for July, 1.06 (95% CI: 0.63–1.52) for September, and 0.81 (0.47–1.17) for December. The highest proportion of reported contacts occurred within the home (51.3% in May), in ‘other’ locations (49.2% in July) and at work (66.3 and 65.4% in September and December). Respondents with children reported an average of 22.7 (95% CI: 21.1–24.3) (September) and 19.0 (95% CI 17.7–20.4) (December) contacts at school per day per child in attendance. Conclusion The skewed distribution of reported contacts toward workplace settings in September and December combined with the number of reported school-related contacts suggest that these settings represent important opportunities for transmission emphasizing the need to support and ensure infection control procedures in both workplaces and schools.

Estimating the Impact of Non-pharmaceutical Interventions Against COVID-19 on Mumps Incidence in Sichuan, China

2021 ◽  
Author(s):  
Wenqiang Zhang ◽  
Rongsheng Luan
Keyword(s):  
Public Health ◽  
Respiratory Virus ◽  
Moving Average ◽  
Sarima Model ◽  
Potential Reduction ◽  
Autoregressive Integrated Moving Average ◽  
Health Measures ◽  
Virus Incidence ◽  
The Impact ◽  
Pharmaceutical Interventions

Abstract Background: A series of social and public health measures have been implemented to contain coronavirus disease 2019 (COVID-19) in China. We examined the impact of non-pharmaceutical interventions against COVID-19 on mumps incidence as an agent to determine the potential reduction in other respiratory virus incidence.Methods: We modelled mumps incidence per month in Sichuan using a seasonal autoregressive integrated moving average (SARIMA) model, based on the reported number of mumps cases per month from 2017-2020. Results: The epidemic peak of mumps in 2020 is lower than in the preceding years. Whenever compared with the projected cases or the average from corresponding periods in the preceding years (2017-2019), the reported cases in 2020 markedly declined (P<0.001). From January to December, the number of mumps cases was estimated to decrease by 36.3% (33.9% - 38.8%), 34.3% (31.1% - 37.8%), 68.9% (66.1% - 71.6%), 76.0% (73.9% - 77.9%), 67.0% (65.0% - 69.0%), 59.6% (57.6% - 61.6%), 61.1% (58.8% - 63.3%), 49.2% (46.4% - 52.1%), 24.4% (22.1% - 26.8%), 30.0% (27.5% - 32.6%), 42.1% (39.6% - 44.7%), 63.5% (61.2% - 65.8%), respectively. The total number of mumps cases in 2020 was estimated to decrease by 53.6% (52.9% - 54.3%).Conclusion: Our study shows that non-pharmaceutical interventions against COVID-19 have had an effective impact on mumps incidence in Sichuan, China.

scholarly journals Quantifying the impact of nonpharmaceutical interventions during the COVID-19 outbreak: The case of Sweden

2020 ◽  
Vol 23 (3) ◽  
pp. 323-344 ◽  
Author(s):  
Sang-Wook (Stanley) Cho
Keyword(s):  
Public Health ◽  
Excess Mortality ◽  
Time Lag ◽  
Synthetic Control ◽  
Framework Analysis ◽  
Control Approach ◽  
Percentage Points ◽  
Elderly Cohort ◽  
Nonpharmaceutical Interventions ◽  
The Impact

Summary This paper estimates the effect of nonpharmaceutical intervention policies on public health during the COVID-19 outbreak by considering a counterfactual case for Sweden. Using a synthetic control approach, I find that strict initial lockdown measures play an important role in limiting the spread of the COVID-19 infection, as the infection cases in Sweden would have been reduced by almost 75 percent had its policymakers followed stricter containment policies. As people dynamically adjust their behaviour in response to information and policies, the impact of nonpharmaceutical interventions becomes visible, with a time lag of around 5 weeks. Supplementary robustness checks and an alternative difference-in-differences framework analysis do not fundamentally alter the main conclusions. Finally, extending the analysis to excess mortality, I find that the lockdown measures would have been associated with a lower excess mortality rate in Sweden by 25 percentage points, with a steep age gradient of 29 percentage points for the most vulnerable elderly cohort. The outcome of this study can assist policymakers in laying out future guidelines to further protect public health, as well as facilitate plans for economic recovery.

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