An in-depth analysis of 10 epidemiological terminologies used in the context of COVID-19

2021 ◽  
pp. 140349482110577
Author(s):  
Sathyanarayanan Doraiswamy ◽  
Ravinder Mamtani ◽  
Sohaila Cheema
Keyword(s):  
Public Health ◽  
Herd Immunity ◽  
Case Fatality ◽  
Lessons Learned ◽  
Public Health Approach ◽  
Fatality Rate ◽  
Public Health Emergencies ◽  
Depth Analysis ◽  
Novel Coronavirus ◽  
Epidemiology And Public Health

Aim: In this paper, we explore the contextual use of 10 epidemiological terminologies, their significance, and interpretation/misinterpretation in explaining various aspects of the 2019 novel coronavirus disease (COVID-19) pandemic. Methods and Results: We first establish the different purposes of the terms ‘pandemic’ and ‘Public Health Emergency of International Concern.’ We then discuss the confusion caused by using the ‘case fatality rate’ as opposed to ‘infection fatality rate’ during the pandemic and the uncertainty surrounding the limited usefulness of identifying someone as ‘pre-symptomatic.’ We highlight the ambiguity in the ‘positivity rate’ and the need to be able to generate data on ‘excess mortality’ during public health emergencies. We discuss the relevance of ‘association and causation’ in the context of the facemask controversy that existed at the start of the pandemic. We point out how the accepted epidemiological practice of discussing ‘herd immunity’ in the context of vaccines has been twisted to suit the political motive of a public health approach. Given that a high proportion of COVID-19 cases are asymptomatic, we go on to show how COVID-19 has blurred the lines between ‘screening/diagnosis’ and ‘quarantine/isolation,’ while giving birth to the new terminology of ‘community quarantine.’ Conclusions: Applying the lessons learned from COVID-19 to better understand the above terminologies will help health professionals communicate effectively, strengthen the scientific agenda of epidemiology and public health, and support and manage future outbreaks efficiently.

scholarly journals Public Health Lessons Learned From Biases in Coronavirus Mortality Overestimation

2020 ◽  
Vol 14 (3) ◽  
pp. 364-371
Author(s):  
Ronald B. Brown
Keyword(s):  
Public Health ◽  
Influenza Infection ◽  
Case Fatality ◽  
Lessons Learned ◽  
World Health ◽  
Mitigation Measures ◽  
Fatality Rate ◽  
Health Campaigns ◽  
Mortality Estimation ◽  
Novel Coronavirus

ABSTRACTIn testimony before US Congress on March 11, 2020, members of the House Oversight and Reform Committee were informed that estimated mortality for the novel coronavirus was 10-times higher than for seasonal influenza. Additional evidence, however, suggests the validity of this estimation could benefit from vetting for biases and miscalculations. The main objective of this article is to critically appraise the coronavirus mortality estimation presented to Congress. Informational texts from the World Health Organization and the Centers for Disease Control and Prevention are compared with coronavirus mortality calculations in Congressional testimony. Results of this critical appraisal reveal information bias and selection bias in coronavirus mortality overestimation, most likely caused by misclassifying an influenza infection fatality rate as a case fatality rate. Public health lessons learned for future infectious disease pandemics include: safeguarding against research biases that may underestimate or overestimate an associated risk of disease and mortality; reassessing the ethics of fear-based public health campaigns; and providing full public disclosure of adverse effects from severe mitigation measures to contain viral transmission.

scholarly journals Excess Mortality from COVID-19: Lessons Learned from the Italian Experience

2020 ◽  
Author(s):  
Paolo Pasquariello ◽  
Saverio Stranges
Keyword(s):  
Public Health ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
Lessons Learned ◽  
Fatality Rate ◽  
Lombardy Region ◽  
Italian Experience ◽  
Health Authorities ◽  
Public Health Authorities

There is much discussion among clinicians, epidemiologists, and public health experts about why case fatality rate from COVID-19 in Italy (at 13.3% as of April 20, 2020, versus a global case fatality rate of 6.9%) is considerably higher than estimates from other countries (especially China, South Korea, and Germany). In this article, we propose several potential explanations for these differences. We suggest that Italy’s overall and relative case fatality rate, as reported by public health authorities, is likely to be inflated by such factors as heterogeneous reporting of coronavirus-related fatalities across countries and the iceberg effect of under-testing, yielding a distorted view of the global severity of the COVID-19 pandemic. We also acknowledge that deaths from COVID-19 in Italy are still likely to be higher than in other equally affected nations due to its unique demographic and socio-economic profile. Lastly, we discuss the important role of the stress imparted by the epidemic on the Italian healthcare system, which weakened its capacity to adequately respond to the sudden influx of COVID-19 patients in the most affected areas of the country, especially in the Lombardy region.

scholarly journals Scarce Health-care Resources and Higher Case-fatality Rates Early in an Epidemic: Analysis of Hospitalized Patients with COVID-19 in Tianmen.

2020 ◽  
Author(s):  
Jijia Hu ◽  
Zongwei Zhang ◽  
Wei Wang ◽  
Yingang Zhang ◽  
Juan Tian ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Case Fatality Rate ◽  
Early Stage ◽  
Case Fatality ◽  
Fatality Rate ◽  
Medical Resources ◽  
Health Care Resources ◽  
Public Health Emergencies ◽  
Per Capita

Abstract Background Tianmen had the highest case-fatality rate (CFR) among all the cities in China early in the transmission of SARS-CoV-2, but little is known about the details of the epidemic in Tianmen. Our study aims to reveal the causes of the high CFR from the aspects of clinical features, medical resources, and epidemic situation.Methods In this study, we report the admission and outcomes of 341 patients with confirmed COVID-19 who were admitted and hospitalized in the hospital (The First People's Hospital of Tianmen) from January 14 to February 25, 2020. Epidemic information and medical resources across different regions were collected and compared. Results All deaths from COVID-19 in Tianmen occurred in the hospital, and the proportion of patients with critical (8.5%) symptoms in the hospital is higher than the average in China. In addition, the number of affected patients in Tianmen is quite low, but the hospital and the whole city had the highest CFR in the early stage of the epidemic. Completely different from the stable CFR in Hubei Province, the CFR of COVID-19 in the hospital and city dropped dramatically, from the largest value in China to a more average level, within a few days. Analysis of government public documents showed that the per capita medical resources in Tianmen are worse than those of Wuhan and Hubei. Conclusions Our findings suggest that the inadequate capacity to respond to public health emergencies caused by relatively scarce health-care resources is a crucial factor contributing to the higher CFR of infectious diseases in regions with lower economic levels. Such countries and territories should implement strategies earlier to minimize the danger of COVID-19.

scholarly journals Excess Mortality from COVID-19: Lessons Learned from the Italian Experience

2020 ◽  
Author(s):  
Paolo Pasquariello ◽  
Saverio Stranges
Keyword(s):  
Public Health ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
Lessons Learned ◽  
Fatality Rate ◽  
Lombardy Region ◽  
Italian Experience ◽  
Health Authorities ◽  
Public Health Authorities

There is much discussion among clinicians, epidemiologists, and public health experts about why case fatality rate from COVID-19 in Italy (at 12.1% as of April 2, 2020, versus a global case fatality rate of 5.2%) is considerably higher than estimates from other countries (especially China, South Korea, and Germany). In this article, we propose several potential explanations for these differences. We suggest that Italy’s overall and relative case fatality rate, as reported by public health authorities, is likely to be inflated by such factors as heterogeneous reporting of coronavirus-related fatalities across countries and the iceberg effect of under-testing, yielding a distorted view of the global severity of the COVID-19 pandemic. We also acknowledge that deaths from COVID-19 in Italy are still likely to be higher than in other equally affected nations due to its unique demographic and socio-economic profile. Lastly, we discuss the important role of the stress imparted by the epidemic on the Italian healthcare system, which weakened its capacity to adequately respond to the sudden influx of COVID-19 patients in the most affected areas of the country, especially in the Lombardy region.

scholarly journals COVID-19: A Comprehensive Review of Epidemiology and Public Health System Response in Nordic Region

2021 ◽  
pp. 002073142199484
Author(s):  
Mehak Nanda ◽  
Rajesh Sharma ◽  
Keyword(s):  
Public Health ◽  
Case Fatality ◽  
System Response ◽  
Public Health Response ◽  
Mass Gatherings ◽  
Nordic Region ◽  
Health Response ◽  
Novel Coronavirus ◽  
And Control ◽  
Epidemiology And Public Health

This paper investigates the epidemiology and public health response of novel coronavirus infection (COVID-19) in the Nordic region. The data on cases and deaths due to COVID-19 were drawn from the European Centre for Disease Prevention and Control. The data on age- and sex-wise cases, deaths and intensive care unit (ICU) admissions, and public health interventions in the Nordic region through November 10, 2020, were obtained from respective countries’ health ministries. Sweden accounted for 60.59% of cases (162 240 of 267 768 cases) and 81% of deaths (6057 of 7477 cases) in the Nordic region. The incidence rate for the Nordic region was 989.59 per 100 000, varying from 327.30 per 100 000 in Finland to 1616.51 per 100 000 in Sweden, and the mortality rate for the region was 27.63 per 100 000, ranging from 5.3 per 100 000 in Norway to 60.35 per 100 000 in Sweden. The case–fatality ratio of the Nordic region was 2.79%. Females were more susceptible to COVID-19 infection than males (52.30% vs 47.66%), while males had a greater proportion of deaths (54.7%) and ICU need (71.99%) than females. It is imperative to continue with social distancing, mandatory masks, testing, prohibition of mass gatherings, isolation of confirmed cases, and preventing the importation of cases from other countries to avoid the further resurgence of cases.

scholarly journals JOINT REGIONAL MILITARY ACT TO CURB CORONA VIRUS PANDEMIC

2021 ◽  
Vol 7 (1) ◽  
pp. 158
Author(s):  
Thomas Atmaja Adi ◽  
Ganesha Wandawa ◽  
Wahyu Hidayat
Keyword(s):  
Public Health ◽  
Military Medicine ◽  
Case Fatality ◽  
Joint Research ◽  
Data Processing Tool ◽  
The Face ◽  
The Republic ◽  
Novel Coronavirus ◽  
And Control ◽  
The Military

<div><p class="Els-history-head">Threats to the security of the Republic of Indonesia are classified as military and non-military threats. One of the non-military threats is the danger of an epidemic, which includes a threat with a public safety dimension. The growth of novel coronavirus (2019-nCoV) cases has been very fast. As of August 4, 2020, globally 18.14 million cases were confirmed worldwide with 691,013 deaths or a Case Fatality Ratio (CFR) of 3.8%. The 2019-nCoV Outbreak became a COVID-19 pandemic which has an impact on public health and the world economy. ASEAN Plus member countries are deploying militaries to help contain the spread and control the effects of this pandemic. The military is deployed because it is considered a trained resource and is better prepared to deal with emergencies. The purpose of this study is to analyse the joint action of the regional military in the face of the COVID-19 pandemic. This study uses an explanative qualitative method using NVivo as a data processing tool and data analysis using Soft System Methodology (SSM). The results of this study found that the joint regional military actions that have been carried out to stem the spread of COVID-19 are dominated by activities carried out by the ASEAN Center of Military Medicine (ACMM) as the leading sector, activities that have been carried out are the exchange of information and sharing practical activities in managing COVID-19, holding a Tabletop Exercise (TTX) for public health emergency response, joint research and sharing health materials among ASEAN Plus member countries. Meanwhile, the ASEAN Plus network of biological and radiological defense experts has yet to show specific activities to curb the COVID-19 pandemic.</p></div>

scholarly journals Covid-19 Fatality Rate in Third World Countries: A Review of Environmental Challenges and Impacts on Public Health and Human Security

2021 ◽  
Vol 9 (1) ◽  
pp. 39-44
Author(s):  
Chukwuemeka E. Etodike ◽  
◽  
Elsie C. Ekeghalu ◽  
Kelechi Johnmary Ani ◽  
Emmanuel Mutambara
Keyword(s):  
Public Health ◽  
Case Fatality Rate ◽  
Third World ◽  
Case Fatality ◽  
Personal Hygiene ◽  
Fatality Rate ◽  
Environmental Challenges ◽  
The Third ◽  
The Third World ◽  
Sanitary Conditions

The novel coronavirus is far from being over; with the case-fatality rate (CFR) hitting more than 16,500 globally as of July, there is a worry that despite the fact that the global CFR curve is showing signs of flattening, the environmental peculiarities of the third world countries may be abetting global efforts towards containing the virus. Therefore, this review x-rayed these peculiarities in the light of their current concern in public health as per their contribution to the persistent surge in CFR in most developing nations. Given that the virus is transmitted via droplets, the review focused on how the state of public and environmental challenges such as air as well as water pollution and personal hygiene could be abetting the surge in coronavirus infections and morbidity. The review revealed, among other things, that challenges associated with poor sanitary conditions, lack of potable water, unventilated environments, air pollution, and poor inter-personal hygiene are devastating challenges in the fight against the pandemic. The implication is that since these conditions are systematic in nature, it may take more than average effort and public sacrifice to checkmate the case-fatality rate of the virus in the third world. Therefore, call for studies is necessary to establish empiricism for CFR patterns and ratio across areas in deplorable environmental and sanitary conditions.

scholarly journals 2019 Novel Coronavirus (COVID-19) pneumonia: an unusual lung ultrasound presentation.

2020 ◽  
Author(s):  
Letizia Consoli ◽  
Vittorio Bendotti ◽  
Sara Cicchinelli ◽  
Federico Gaioni ◽  
Paola Prandolini ◽  
...  
Keyword(s):  
Case Fatality Rate ◽  
Lung Ultrasound ◽  
Case Fatality ◽  
Ground Glass Opacity ◽  
Public Health Emergency ◽  
Fatality Rate ◽  
Chest Computed Tomography ◽  
Ultrasound Findings ◽  
The World ◽  
Novel Coronavirus

Abstract In December 2019, a novel coronavirus (SARS-Cov-2) was first reported in Wuhan, China, and rapidly spread around the world, leading to an international emerging public health emergency. As reported from Chinese experiences, approximately 20% of patients had a severe course, requiring intensive care, with an overall case fatality rate of 2.3%. In diagnosis, chest computed tomography most commonly showed ground-glass opacity with or without consolidative patterns.Herein we report a case of a patient affected by COVID-19 pneumonia referred in the emergency department of our institution on 4 April 2020 with peculiar lung ultrasound findings.

Subway-Related Trauma: An Urban Public Health Issue with a High Case-Fatality Rate

2018 ◽  
Vol 55 (2) ◽  
pp. 165-171.e1 ◽  
Author(s):  
Simon G. Rodier ◽  
Charles J. DiMaggio ◽  
Stephen Wall ◽  
Vasiliy Sim ◽  
Spiros G. Frangos ◽  
...  
Keyword(s):  
Public Health ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
Health Issue ◽  
Public Health Issue ◽  
Fatality Rate ◽  
High Case Fatality Rate

Biodefense and Emergency Use Authorization: Different Originations, Purposes, and Evolutionary Paths of Institutions in the United States and South Korea

2022 ◽  
Author(s):  
HyunJung Kim
Keyword(s):  
Public Health ◽  
United States ◽  
South Korea ◽  
Driving Forces ◽  
The United States ◽  
Lessons Learned ◽  
Post Exposure Prophylaxis ◽  
Meso Level ◽  
Public Health Emergencies ◽  
Level Analysis

Abstract Background: Historical institutionalism (HI) determines that institutions have been transformed by a pattern of punctuated evolution due to exogenous shocks. Although scholars frequently emphasize the role of agency - endogenous factors – when it comes to institutional changes, but the HI analytic narratives still remain in the meso-level analysis in the context of structure and agency. This article provides domestic and policy-level accounts of where biodefense institutions of the United States and South Korea come from, seeing through emergency-use-authorization (EUA) policy, and how the EUA policies have evolved by employing the policy-learning concepts through the Event-related Policy Change Model. Results: By employing the Birkland’s model, this article complements the limitation of the meso-level analysis in addressing that the 2001 Amerithrax and the 2015 Middle East Respiratory Syndrome (MERS) outbreak rooted originations and purposes of the biodefense respectively. Since the crisis, a new post-crisis agenda in society contributed to establishing new domestic coalition, which begin to act as endogenous driving forces that institutionalize new biodefense institutions and even reinforce them through path dependent way when the institutions evolved. Therefore, EUA policy cores (Post-Exposure Prophylaxis (PEP) in the United States and Non-Pharmaceutical Intervention (NPI) in South Korea keep strengthened during the policy revisions. Conclusions: The United States and South Korea have different originations and purposes of biodefense, which are institutions evolving through self-reinforce dependent way based on the lessons learned from past crises. In sum, under the homeland security biodefense institution, the US EUA focuses on the development of specialized, unlicensed PEP in response to public health emergencies; on the other hand, under the disease containment-centric biodefense institution, the Korean EUA is specialized to conduct NPI missions in response to public health emergencies.

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