An update on travel and COVID-19: what the practice nurse needs to know

2021 ◽  
Vol 32 (Sup6) ◽  
pp. S7-S12
Author(s):  
Mary Gawthrop

Lockdown and international travel restrictions are once again being eased in many countries, including the UK. However, travellers need to be aware that COVID-19 remains a worldwide risk. Practice nurses have a role to play in supporting UK travellers to make an informed choice about travelling abroad during this ongoing pandemic.

2020 ◽  
Vol 31 (9) ◽  
pp. 369-373
Author(s):  
Mary Gawthrop

As individuals start planning travel abroad again, Mary Gawthrop explains the key considerations for travel health consultations during the COVID-19 pandemic While COVID-19 continues to be a risk worldwide, lockdown and international travel restrictions are being eased in many countries, including the UK. General practice nurses have a role to play in assisting UK residents to make an informed choice about travelling abroad during this pandemic.


2021 ◽  
Vol 32 (12) ◽  
pp. 468-472
Author(s):  
Peter Ellis

Chronic kidney disease is highly prevalent in the community. Peter Ellis looks at the role of the practice nurse in diagnosing and managing chronic kidney disease in general practice Chronic kidney disease (CKD) is defined as a reduction in kidney function, or damage to kidney structure, which has persisted for greater than 3 months and which is associated with other health-related issues. While there are many causes of CKD, the most prevalent in western societies, including the UK, are diabetes and hypertension. This article identifies the role of the practice nurse in applying the National Institute for Health and Care Excellence (NICE) guidelines for CKD.


BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Gwithyen Silk ◽  
Niraj Vetherajan ◽  
Alice Blohm ◽  
Katie Keen ◽  
Fiona Teeling ◽  
...  

Abstract Introduction Bristol is the vegan capital of the UK. The UK vegan index reveals that Bristol has 360,000 Google searches each month for Vegan content. However, do we think about the possible animal source of the medications we prescribe. Although all medications in the UK need to be tested on animals prior to being licensed and therefore cannot be truly “vegan”, there are alternatives available for some commonly used medications that do not contain animal products. Several world religions prohibit their followers from consuming certain foods, ranging from those not prepared in a specific manner to those derived from certain animals. Kosher and halal diet adherents share concerns with those on vegan diets. Vegan options are a solution when only non-conforming or uncertain products are available. Methods We conducted a review of commonly used medications in Orthopaedics and reviewed their source. The BNF, local pharmacy and online Summary of Product Characteristics (SPCs) for the medications were reviewed. Results Where possible we have compiled a list of those that contain animal derived components and suggest alternatives. Sometimes, pharmaceutical companies cannot guarantee or differentiate the specific sources of animal-derived ingredients, as various suppliers are used in the manufacturing process and the sources can change. All unfractionated or standard heparin is porcine in origin; Rivaroxaban and Fondaparinux are simple alternatives for example. Cholecalciferol (vitamin D3) – Manufacture also involves the use of lanolin from sheep’s wool. Vitamin D2 (ergocalciferol) is vegan. Conclusion Disclosure of animal content and excipients would help patients make an informed choice. With an increasingly informed population and ethnic diversity, we should all be aware of the drugs that may contain animal products so that we can offer alternatives. Patients are more likely to adhere to prescribed medicines if they have been actively involved in prescribing decisions.


2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Steve J. Bickley ◽  
Ho Fai Chan ◽  
Ahmed Skali ◽  
David Stadelmann ◽  
Benno Torgler

Abstract Background The ongoing COVID-19 pandemic has highlighted the vast differences in approaches to the control and containment of coronavirus across the world and has demonstrated the varied success of such approaches in minimizing the transmission of coronavirus. While previous studies have demonstrated high predictive power of incorporating air travel data and governmental policy responses in global disease transmission modelling, factors influencing the decision to implement travel and border restriction policies have attracted relatively less attention. This paper examines the role of globalization on the pace of adoption of international travel-related non-pharmaceutical interventions (NPIs) during the coronavirus pandemic. This study aims to offer advice on how to improve the global planning, preparation, and coordination of actions and policy responses during future infectious disease outbreaks with empirical evidence. Methods and data We analyzed data on international travel restrictions in response to COVID-19 of 185 countries from January to October 2020. We applied time-to-event analysis to examine the relationship between globalization and the timing of travel restrictions implementation. Results The results of our survival analysis suggest that, in general, more globalized countries, accounting for the country-specific timing of the virus outbreak and other factors, are more likely to adopt international travel restrictions policies. However, countries with high government effectiveness and globalization were more cautious in implementing travel restrictions, particularly if through formal political and trade policy integration. This finding is supported by a placebo analysis of domestic NPIs, where such a relationship is absent. Additionally, we find that globalized countries with high state capacity are more likely to have higher numbers of confirmed cases by the time a first restriction policy measure was taken. Conclusions The findings highlight the dynamic relationship between globalization and protectionism when governments respond to significant global events such as a public health crisis. We suggest that the observed caution of policy implementation by countries with high government efficiency and globalization is a by-product of commitment to existing trade agreements, a greater desire to ‘learn from others’ and also perhaps of ‘confidence’ in a government’s ability to deal with a pandemic through its health system and state capacity. Our results suggest further research is warranted to explore whether global infectious disease forecasting could be improved by including the globalization index and in particular, the de jure economic and political, and de facto social dimensions of globalization, while accounting for the mediating role of government effectiveness. By acting as proxies for a countries’ likelihood and speed of implementation for international travel restriction policies, such measures may predict the likely time delays in disease emergence and transmission across national borders.


International tourism shows slight recovery in June and July 2021 driven by vaccinations and border reopening International tourist arrivals (overnight visitors) in the first seven months of 2021 were 40% below the levels of 2020, and still 80% down when compared to the same period of pre-pandemic year 2019. After a weak start of the year, international tourism saw a modest improvement during the months of June and July 2021. The small improvement in June and July was underpinned by the reopening of many destinations to international travel, mostly in Europe and the Americas. The relaxation of travel restrictions to vaccinated travellers, coupled with progress made in the roll-out of COVID-19 vaccines, contributed to ease travel restrictions, lift consumer confidence and gradually restore safe mobility in Europe and other parts of the world. Small islands in the Caribbean, Africa, and Asia and the Pacific, together with a few small European destinations recorded the best performance in June and July, with arrivals coming close to, or sometimes exceeding pre-pandemic levels. July (-67%) saw comparatively better performance than June (-77%), making it the best month so far since April 2020. Asia and the Pacific continued to suffer the weakest results in January-July 2021, with a 95% drop in international arrivals compared to the same period in 2019. The Middle East (-82%) recorded the second largest decline, followed by Europe and Africa (both -77%). The Americas (-68%) saw a comparatively smaller decrease. Although destinations continued to report very weak international tourism revenues in the first seven months of 2021, several countries recorded a modest improvement in the months of June and July, and some even surpassed the earnings of 2019. The same is true for outbound travel. Among the larger source markets, France (-35% over 2019) and the United States (-49%) saw a small rebound in expenditure in July. Despite the relative improvement over the low levels of 2020, international tourism remained well below 2019 levels. This is also reflected in the evaluation made by the UNWTO Panel of Experts in the September survey, showing mixed results for the period May-August 2021. Looking ahead, most experts continue to expect a rebound in 2022, driven by unleashed pent-up demand, mostly during the second and third quarter of that year. Nearly one-third of respondents expect a potential rebound in 2023. Almost half of all experts continue to see a return of international arrivals to 2019 levels in 2024 or later.


2021 ◽  
Vol 29 (10) ◽  
pp. 579-588
Author(s):  
Clementine Djatmika ◽  
Joanne Lusher ◽  
Jane Meyrick ◽  
James Byron-Daniel

Background Despite the steady increase in the number of women giving birth via caesarean section in the UK, little is understood about how shared decision making is implemented in obstetrics or what this means for women that have given birth via caesarean. The aim of this review is to assess narratives of women's experiences of caesarean birth as an informed choice and their involvement in this process. Methods A number of databases were searched, including MEDLINE via EBSCO, EMBASE via OVID, MIDIRS via OVID, Scopus, Wiley Online Library, Google Scholar and Ethos, as well as the reference sections of the included studies. Primary studies published between 1990–2020 were included and quality was assessed using the critical appraisal skills programme tool. Findings were analysed using a thematic synthesis framework to elicit higher order interpretations. Results A total of 11 studies were included in the final review. Quality assessment indicated the studies were generally of good quality, with the main limitations being in methodology quality indicators. Thematic synthesis identified eight subthemes within three main themes: ‘patient-doctor relationships’, ‘decision making as an emotional journey’ and ‘caesarean not really an informed “choice”’. The role of healthcare providers in promoting women's agency via patient-centred care was a prominent theme in women's narratives. Conclusions Women's decision making in consent to undergo caesarean births is a complex, emotionally driven process that can have a significant long-term psychological impact.


2020 ◽  
Vol 18 (6) ◽  
pp. 1-36 ◽  

International travel plunges 70% in the first eight months of 2020 International tourist arrivals (overnight visitors) declined 70% in the first eight months of 2020 over the same period of last year, amid global travel restrictions including many borders fully closed, to contain the ongoing COVID-19 pandemic. International arrivals plunged 81% in July and 79% in August, traditionally the two busiest months of the year and the peak of the Northern Hemisphere summer season. Despite such large declines, this represents a relative improvement over the 90% or greater decreases of the previous months, as some destinations started to reopen to international tourism, mostly in the European Union. The decline in January-August 2020 represents 700 million fewer international tourist arrivals compared to the same period in 2019, and translates into a loss of US$ 730 billion in export revenues from international tourism, more than 8 times the loss in 2009 under the impact of the global economic crisis. Asia and the Pacific, the first region to suffer the impact of the pandemic, saw a 79% decrease in arrivals in January-August 2020. Africa and the Middle East both recorded a 69% drop this eight-month period, while Europe saw a 68% decline and the Americas 65%. Data on international tourism expenditure continues to reflect very weak demand for outbound travel, though in several large markets such as the United States, Germany and Italy there is a small uptick in spending in the months of July and August. Based on latest trends, a 75% decrease in international arrivals is estimated for the month of September and a drop of close to 70% for the whole of 2020. While demand for international travel remains subdued, domestic tourism is strengthening recovery in several large markets such as China and Russia. The UNWTO Confidence Index continues at record lows. Most UNWTO Panel Experts expect a rebound in international tourism by the third quarter of 2021 and a return to pre-pandemic 2019 levels not before 2023. Experts consider travel restrictions as the main barrier weighing on the recovery of international tourism, along with slow virus containment and low consumer confidence.


2021 ◽  
Author(s):  
Tara Alpert ◽  
Erica Lasek-Nesselquist ◽  
Anderson F. Brito ◽  
Andrew L. Valesano ◽  
Jessica Rothman ◽  
...  

SummaryThe emergence and spread of SARS-CoV-2 lineage B.1.1.7, first detected in the United Kingdom, has become a national public health concern in the United States because of its increased transmissibility. Over 500 COVID-19 cases associated with this variant have been detected since December 2020, but its local establishment and pathways of spread are relatively unknown. Using travel, genomic, and diagnostic testing data, we highlight the primary ports of entry for B.1.1.7 in the US and locations of possible underreporting of B.1.1.7 cases. New York, which receives the most international travel from the UK, is likely one of the key hubs for introductions and domestic spread. Finally, we provide evidence for increased community transmission in several states. Thus, genomic surveillance for B.1.1.7 and other variants urgently needs to be enhanced to better inform the public health response.


Author(s):  
Thai Quang Pham ◽  
Maia Rabaa ◽  
Luong Huy Duong ◽  
Tan Quang Dang ◽  
Quang Dai Tran ◽  
...  

Background: One hundred days after SARS-CoV-2 was first reported in Vietnam on January 23rd, 270 cases have been confirmed, with no deaths. We describe the control measures used and their relationship with imported and domestically-acquired case numbers. Methods: Data on the first 270 SARS-CoV-2 infected cases and the timing and nature of control measures were captured by Vietnam's National Steering Committee for COVID-19 response. Apple and Google mobility data provided population movement proxies. Serial intervals were calculated from 33 infector-infectee pairs and used to estimate the proportion of pre-symptomatic transmission events and time-varying reproduction numbers. Results: After the first confirmed case on January 23rd, the Vietnamese Government initiated mass communications measures, contact tracing, mandatory 14-day quarantine, school and university closures, and progressive flight restrictions. A national lockdown was implemented between April 1st and 22nd. Around 200,000 people were quarantined and 266,122 RT-PCR tests conducted. Population mobility decreased progressively before lockdown. 60% (163/270) of cases were imported; 43% (89/208) of resolved infections were asymptomatic. 21 developed severe disease, with no deaths. The serial interval was 3.24 days, and 27.5% (95% confidence interval, 15.7%-40.0%) of transmissions occurred pre-symptomatically. Limited transmission amounted to a maximum reproduction number of 1.15 (95% confidence interval, 0.37-2.36). No community transmission has been detected since April 15th. Conclusions: Vietnam has controlled SARS-CoV-2 spread through the early introduction of communication, contact-tracing, quarantine, and international travel restrictions. The value of these interventions is supported by the high proportion of asymptomatic cases and imported cases, and evidence for substantial pre-symptomatic transmission.


2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Harry E. R. Shepherd ◽  
Florence S. Atherden ◽  
Ho Man Theophilus Chan ◽  
Alexandra Loveridge ◽  
Andrew J. Tatem

Abstract Background Since early March 2020, the COVID-19 epidemic across the United Kingdom has led to a range of social distancing policies, which resulted in changes to mobility across different regions. An understanding of how these policies impacted travel patterns over time and at different spatial scales is important for designing effective strategies, future pandemic planning and in providing broader insights on the population geography of the country. Crowd level data on mobile phone usage can be used as a proxy for population mobility patterns and provide a way of quantifying in near-real time the impact of social distancing measures on changes in mobility. Methods Here we explore patterns of change in densities, domestic and international flows and co-location of Facebook users in the UK from March 2020 to March 2021. Results We find substantial heterogeneities across time and region, with large changes observed compared to pre-pademic patterns. The impacts of periods of lockdown on distances travelled and flow volumes are evident, with each showing variations, but some significant reductions in co-location rates. Clear differences in multiple metrics of mobility are seen in central London compared to the rest of the UK, with each of Scotland, Wales and Northern Ireland showing significant deviations from England at times. Moreover, the impacts of rapid changes in rules on international travel to and from the UK are seen in substantial fluctuations in traveller volumes by destination. Conclusions While questions remain about the representativeness of the Facebook data, previous studies have shown strong correspondence with census-based data and alternative mobility measures, suggesting that findings here are valuable for guiding strategies.


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