Optimal SARS-CoV-2 vaccine allocation using real-time attack-rate estimates in Rhode Island and Massachusetts

Abstract Background When three SARS-CoV-2 vaccines came to market in Europe and North America in the winter of 2020–2021, distribution networks were in a race against a major epidemiological wave of SARS-CoV-2 that began in autumn 2020. Rapid and optimized vaccine allocation was critical during this time. With 95% efficacy reported for two of the vaccines, near-term public health needs likely require that distribution is prioritized to the elderly, health care workers, teachers, essential workers, and individuals with comorbidities putting them at risk of severe clinical progression. Methods We evaluate various age-based vaccine distributions using a validated mathematical model based on current epidemic trends in Rhode Island and Massachusetts. We allow for varying waning efficacy of vaccine-induced immunity, as this has not yet been measured. We account for the fact that known COVID-positive cases may not have been included in the first round of vaccination. And, we account for age-specific immune patterns in both states at the time of the start of the vaccination program. Our analysis assumes that health systems during winter 2020–2021 had equal staffing and capacity to previous phases of the SARS-CoV-2 epidemic; we do not consider the effects of understaffed hospitals or unvaccinated medical staff. Results We find that allocating a substantial proportion (>75%) of vaccine supply to individuals over the age of 70 is optimal in terms of reducing total cumulative deaths through mid-2021. This result is robust to different profiles of waning vaccine efficacy and several different assumptions on age mixing during and after lockdown periods. As we do not explicitly model other high-mortality groups, our results on vaccine allocation apply to all groups at high risk of mortality if infected. A median of 327 to 340 deaths can be avoided in Rhode Island (3444 to 3647 in Massachusetts) by optimizing vaccine allocation and vaccinating the elderly first. The vaccination campaigns are expected to save a median of 639 to 664 lives in Rhode Island and 6278 to 6618 lives in Massachusetts in the first half of 2021 when compared to a scenario with no vaccine. A policy of vaccinating only seronegative individuals avoids redundancy in vaccine use on individuals that may already be immune, and would result in 0.5% to 1% reductions in cumulative hospitalizations and deaths by mid-2021. Conclusions Assuming high vaccination coverage (>28%) and no major changes in distancing, masking, gathering size, hygiene guidelines, and virus transmissibility between 1 January 2021 and 1 July 2021 a combination of vaccination and population immunity may lead to low or near-zero transmission levels by the second quarter of 2021.

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Optimal SARS-CoV-2 vaccine allocation using real-time seroprevalence estimates in Rhode Island and Massachusetts

10.1101/2021.01.12.21249694 ◽

2021 ◽

Author(s):

Thu Nguyen-Anh Tran ◽

Nathan Wikle ◽

Joseph Albert ◽

Haider Inam ◽

Emily Strong ◽

...

Keyword(s):

Rhode Island ◽

The Elderly ◽

Distribution Networks ◽

Clinical Progression ◽

Population Immunity ◽

Risk Of Mortality ◽

Care Workers ◽

Elderly Health ◽

Near Term ◽

Induced Immunity

AbstractAs three SARS-CoV-2 vaccines come to market in Europe and North America in the winter of 2020-2021, distribution networks will be in a race against a major epidemiological wave of SARS-CoV-2 that began in autumn 2020. Rapid and optimized vaccine allocation is critical during this time. With 95% efficacy reported for two of the vaccines, near-term public health needs require that distribution is prioritized to the elderly, health-care workers, teachers, essential workers, and individuals with co-morbidities putting them at risk of severe clinical progression. Here, we evaluate various age-based vaccine distributions using a validated mathematical model based on current epidemic trends in Rhode Island and Massachusetts. We allow for varying waning efficacy of vaccine-induced immunity, as this has not yet been measured. We account for the fact that known COVID-positive cases may not be included in the first round of vaccination. And, we account for current age-specific immune patterns in both states. We find that allocating a substantial proportion (> 75%) of vaccine supply to individuals over the age of 70 is optimal in terms of reducing total cumulative deaths through mid-2021. As we do not explicitly model other high mortality groups, this result on vaccine allocation applies to all groups at high risk of mortality if infected. Our analysis confirms that for an easily transmissible respiratory virus, allocating a large majority of vaccinations to groups with the highest mortality risk is optimal. Our analysis assumes that health systems during winter 2020-2021 have equal staffing and capacity to previous phases of the SARS-CoV-2 epidemic; we do not consider the effects of understaffed hospitals or unvaccinated medical staff. Vaccinating only seronegative individuals avoids redundancy in vaccine use on individuals that may already be immune, and will result in 1% to 2% reductions in cumulative hospitalizations and deaths by mid-2021. Assuming high vaccination coverage (> 28%) and no major relaxations in distancing, masking, gathering size, or hygiene guidelines between now and spring 2021, our model predicts that a combination of vaccination and population immunity will lead to low or near-zero transmission levels by the second quarter of 2021.

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Cultural attitudes to the aged: An Indian perspective

South African Journal of Physiotherapy ◽

10.4102/sajp.v55i3.565 ◽

1999 ◽

Vol 55 (3) ◽

pp. 3-5

Author(s):

P. Gounden ◽

T. Puckree

Keyword(s):

Time Perspective ◽

Extended Family ◽

The Elderly ◽

Cultural Practice ◽

Cultural Attitudes ◽

Indian Thought ◽

Care Workers ◽

Elderly Health ◽

Indian Perspective

Institutionalization of elderly Indians seems to have been increasing with the aging of the twentieth century. This paper looks at Indian thought and cultural practice with regard to the elderly in time perspective. Historically, although the main prescription to cultural practice and respect for the elderly came from the various Indian Scriptures, this was coloured by the specific needs of each society which changed when these societies were nomadic, settled farmers or were actively engaged in war. Later other factors like industrialization resulted in a breakdown of the extended family in which the father no matter how old or productive was the authority figure who demanded respect. This trend was also seen in published literature about the attitude of other nationalities towards their elderly. Health professionals have been grappling with the role of health care workers in achieving successful patients outcomes based on attitudes towards the elderly. More work needs to be done on this subject in this country.

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A Social Marketing Approach to Increasing Rates of Influenza Vaccinations Among Health Care Workers in Rhode Island

PsycEXTRA Dataset ◽

10.1037/e521582014-108 ◽

2009 ◽

Author(s):

Linda M. TetuMouradjian ◽

Robert Marshall ◽

John Fulton ◽

Stacie Hogan

Keyword(s):

Health Care ◽

Rhode Island ◽

Social Marketing ◽

Health Care Workers ◽

Care Workers ◽

Influenza Vaccinations ◽

Marketing Approach

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The Development of Intelligence Walking Stick for Elderly Health Care using IoT

International Journal of Innovative Technology and Exploring Engineering - Special Issue ◽

10.35940/ijitee.e3208.039520 ◽

2020 ◽

Vol 9 (5) ◽

pp. 1334-1338

Keyword(s):

Health Care ◽

Daily Living ◽

The Elderly ◽

Mean Value ◽

Real Time System ◽

Pressure Oxygen ◽

Elderly Health ◽

The Mean ◽

Iot Devices ◽

Walking Stick

Nowadays, Thailand is stepping into an aging society. This research purposes developing the intelligence walking stick for the elderly in terms of the health care system by applied the IoT devices and biometric sensors in a real-time system. The heart rate, blood pressure, oxygen saturation, and temperature were measured at the finger of the elderly that holding the intelligence walking stick. All data can monitor and display on mobile devices. The intelligence walking stick system was evaluated by twenty users who are five experts and fifteen elderly in Ratchaburi province. As a result of the mean value at 4.88 and 4.85 by experts and elderly, respectively. It could be said that the development of intelligence walking stick by using IoT can help and improve the daily living of the elderly at the highest level.

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Meta-analysis of Predictive Variables of Exhaustion of the Care Workers for the Elderly

The Journal of Humanities and Social sciences 21 ◽

10.22143/hss21.10.4.3 ◽

2019 ◽

Vol 10 (4) ◽

pp. 27-42

Author(s):

Dongjoo Kim ◽

Nahyun Kim ◽

Kwangjo Do

Keyword(s):

Meta Analysis ◽

The Elderly ◽

Predictive Variables ◽

Care Workers

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Age is just a number: Is frailty being ignored in vascular access planning for dialysis?

The Journal of Vascular Access ◽

10.1177/1129729821989902 ◽

2021 ◽

pp. 112972982198990

Author(s):

Kulli Kuningas ◽

Nicholas Inston

Keyword(s):

Decision Making ◽

Kidney Disease ◽

Vascular Access ◽

Clinical Condition ◽

The Elderly ◽

Dialysis Access ◽

Adverse Health Outcomes ◽

Risk Of Mortality ◽

Increased Risk ◽

First Choice

Current international guidelines advocate fistula creation as first choice for vascular access in haemodialysis patients, however, there have been suggestions that in certain groups of patients, in particular the elderly, a more tailored approach is needed. The prevalence of more senior individuals receiving renal replacement therapy has increased in recent years and therefore including patient age in decision making regarding choice of vascular access for dialysis has gained more relevance. However, it seems that age is being used as a surrogate for overall clinical condition and it can be proposed that frailty may be a better basis to considering when advising and counselling patients with regard to vascular access for dialysis. Frailty is a clinical condition in which the person is in a vulnerable state with reduced functional capacity and has a higher risk of adverse health outcomes when exposed to stress inducing events. Prevalence of frailty increases with age and has been associated with an increased risk of mortality, hospitalisation, disability and falls. Chronic kidney disease is associated with premature ageing and therefore patients with kidney disease are prone to be frailer irrespective of age and the risk increases further with declining kidney function. Limited data exists on the relationship between frailty and vascular access, but it appears that frailty may have an association with poorer outcomes from vascular access. However, further research is warranted. Due to complexity in decision making in dialysis access, frailty assessment could be a key element in providing patient-centred approach in planning and maintaining vascular access for dialysis.

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Are We Ready for the Arrival of the New COVID-19 Vaccinations? Great Promises and Unknown Challenges Still to Come

Vaccines ◽

10.3390/vaccines9020173 ◽

2021 ◽

Vol 9 (2) ◽

pp. 173

Author(s):

Davide Gori ◽

Chiara Reno ◽

Daniel Remondini ◽

Francesco Durazzi ◽

Maria Pia Fantini

Keyword(s):

Herd Immunity ◽

The Elderly ◽

Vaccine Hesitancy ◽

Current Crisis ◽

Complex Issue ◽

The Public ◽

The Social ◽

To Come ◽

Vaccination Campaigns ◽

The Eu

While the SARS-CoV-2 pandemic continues to strike and collect its death toll throughout the globe, as of 31 January 2021, the vaccine candidates worldwide were 292, of which 70 were in clinical testing. Several vaccines have been approved worldwide, and in particular, three have been so far authorized for use in the EU. Vaccination can be, in fact, an efficient way to mitigate the devastating effect of the pandemic and offer protection to some vulnerable strata of the population (i.e., the elderly) and reduce the social and economic burden of the current crisis. Regardless, a question is still open: after vaccination availability for the public, will vaccination campaigns be effective in reaching all the strata and a sufficient number of people in order to guarantee herd immunity? In other words: after we have it, will we be able to use it? Following the trends in vaccine hesitancy in recent years, there is a growing distrust of COVID-19 vaccinations. In addition, the online context and competition between pro- and anti-vaxxers show a trend in which anti-vaccination movements tend to capture the attention of those who are hesitant. Describing this context and analyzing its possible causes, what interventions or strategies could be effective to reduce COVID-19 vaccine hesitancy? Will social media trend analysis be helpful in trying to solve this complex issue? Are there perspectives for an efficient implementation of COVID-19 vaccination coverage as well as for all the other vaccinations?

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Mortality Risk from Respiratory Diseases due to Non-Optimal Temperature among Brazilian Elderlies

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18115550 ◽

2021 ◽

Vol 18 (11) ◽

pp. 5550

Author(s):

Ludmilla da Silva Viana Jacobson ◽

Beatriz Fátima Alves de Oliveira ◽

Rochelle Schneider ◽

Antonio Gasparrini ◽

Sandra de Souza Hacon

Keyword(s):

Time Series ◽

Respiratory Diseases ◽

Respiratory Health ◽

The Elderly ◽

Optimal Temperature ◽

Average Temperature ◽

Exposure Response ◽

Mean Temperature ◽

Risk Of Mortality ◽

Exposure Variable

Over the past decade, Brazil has experienced and continues to be impacted by extreme climate events. This study aims to evaluate the association between daily average temperature and mortality from respiratory disease among Brazilian elderlies. A daily time-series study between 2000 and 2017 in 27 Brazilian cities was conducted. Data outcomes were daily counts of deaths due to respiratory diseases in the elderly aged 60 or more. The exposure variable was the daily mean temperature from Copernicus ERA5-Land reanalysis. The association was estimated from a two-stage time series analysis method. We also calculated deaths attributable to heat and cold. The pooled exposure–response curve presented a J-shaped format. The exposure to extreme heat increased the risk of mortality by 27% (95% CI: 15–39%), while the exposure to extreme cold increased the risk of mortality by 16% (95% CI: 8–24%). The heterogeneity between cities was explained by city-specific mean temperature and temperature range. The fractions of deaths attributable to cold and heat were 4.7% (95% CI: 2.94–6.17%) and 2.8% (95% CI: 1.45–3.95%), respectively. Our results show a significant impact of non-optimal temperature on the respiratory health of elderlies living in Brazil. It may support proactive action implementation in cities that have critical temperature variations.

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