scholarly journals Synergistic interventions to control COVID-19: Mass testing and isolation mitigates reliance on distancing

2021 ◽  
Vol 17 (10) ◽  
pp. e1009518
Author(s):  
Emily Howerton ◽  
Matthew J. Ferrari ◽  
Ottar N. Bjørnstad ◽  
Tiffany L. Bogich ◽  
Rebecca K. Borchering ◽  
...  
Keyword(s):  
Public Health ◽  
Health Outcomes ◽  
Management Strategies ◽  
Cost Benefit ◽  
Testing System ◽  
Test Administration ◽  
Rapid Diagnostics ◽  
Testing Strategies ◽  
Pharmaceutical Interventions ◽  
At Home

Stay-at-home orders and shutdowns of non-essential businesses are powerful, but socially costly, tools to control the pandemic spread of SARS-CoV-2. Mass testing strategies, which rely on widely administered frequent and rapid diagnostics to identify and isolate infected individuals, could be a potentially less disruptive management strategy, particularly where vaccine access is limited. In this paper, we assess the extent to which mass testing and isolation strategies can reduce reliance on socially costly non-pharmaceutical interventions, such as distancing and shutdowns. We develop a multi-compartmental model of SARS-CoV-2 transmission incorporating both preventative non-pharmaceutical interventions (NPIs) and testing and isolation to evaluate their combined effect on public health outcomes. Our model is designed to be a policy-guiding tool that captures important realities of the testing system, including constraints on test administration and non-random testing allocation. We show how strategic changes in the characteristics of the testing system, including test administration, test delays, and test sensitivity, can reduce reliance on preventative NPIs without compromising public health outcomes in the future. The lowest NPI levels are possible only when many tests are administered and test delays are short, given limited immunity in the population. Reducing reliance on NPIs is highly dependent on the ability of a testing program to identify and isolate unreported, asymptomatic infections. Changes in NPIs, including the intensity of lockdowns and stay at home orders, should be coordinated with increases in testing to ensure epidemic control; otherwise small additional lifting of these NPIs can lead to dramatic increases in infections, hospitalizations and deaths. Importantly, our results can be used to guide ramp-up of testing capacity in outbreak settings, allow for the flexible design of combined interventions based on social context, and inform future cost-benefit analyses to identify efficient pandemic management strategies.

scholarly journals Developing a risk management framework to improve public health outcomes by enumerating Salmonella in ground turkey

2018 ◽  
Vol 147 ◽  
Author(s):  
F. Sampedro ◽  
S. J. Wells ◽  
J. B. Bender ◽  
C. W. Hedberg
Keyword(s):  
Public Health ◽  
Risk Management ◽  
Health Outcomes ◽  
Management Strategies ◽  
Health Impact ◽  
Median Number ◽  
Assessment Model ◽  
Quantitative Risk Assessment ◽  
Contamination Levels ◽  
The Impact

AbstractSalmonella spp. continue to be a leading cause of foodborne morbidity worldwide. To assess the risk of foodborne disease, current national regulatory schemes focus on prevalence estimates of Salmonella and other pathogens. The role of pathogen quantification as a risk management measure and its impact on public health is not well understood. To address this information gap, a quantitative risk assessment model was developed to evaluate the impact of pathogen enumeration strategies on public health after consumption of contaminated ground turkey in the USA. Public health impact was evaluated by using several dose–response models for high- and low-virulent strains to account for potential under- or overestimation of human health impacts. The model predicted 2705–21 099 illnesses that would result in 93–727 reported cases of salmonellosis. Sensitivity analysis predicted cooking an unthawed product at home as the riskiest consumption scenario and microbial concentration the most influential input on the incidence of human illnesses. Model results indicated that removing ground turkey lots exceeding contamination levels of 1 MPN/g and 1 MPN in 25 g would decrease the median number of illnesses by 86–94% and 99%, respectively. For a single production lot, contamination levels higher than 1 MPN/g would be needed to result in a reported case to public health officials. At contamination levels of 10 MPN/g, there would be a 13% chance of detecting an outbreak, and at 100 MPN/g, the likelihood of detecting an outbreak increases to 41%. Based on these model prediction results, risk management strategies should incorporate pathogen enumeration. This would have a direct impact on illness incidence linking public health outcomes with measurable food safety objectives.

scholarly journals Integrated packages of non-pharmaceutical interventions increased public health response efficiency against COVID-19 during the first European wave: evidence from 32 European countries

2020 ◽  
Author(s):  
Andres Garchitorena ◽  
Hugo Gruson ◽  
Bernard Cazelles ◽  
Tommi Karki ◽  
Bertrand Sudre ◽  
...  
Keyword(s):  
Public Health ◽  
Large Scale ◽  
Risk Groups ◽  
Economic Consequences ◽  
European Countries ◽  
Public Health Response ◽  
Incidence Data ◽  
Age Structured ◽  
Pharmaceutical Interventions ◽  
At Home

AbstractIntroductionSince the emergence of SARS-CoV-2, governments have implemented a combination of public health responses based on non-pharmaceutical interventions (NPIs), with significant social and economic consequences. Quantifying the efficiency of different NPIs implemented by European countries to overcome the first epidemic wave could inform preparedness for forthcoming waves.MethodsWe used a dataset compiled by the European Centre for Disease Control (ECDC) on daily COVID-19 incidence, mortality and NPI implementation in 32 European countries. We adapted a capture-recapture method to limit non-reporting bias in incidence data, which we fitted to an age-structured mathematical model coupled with Monte Carlo Markov Chain to quantify the efficiency of 258 public health responses (PHR, a combination of several NPIs) in reducing SARS-Cov-2 transmission rates. From these PHR efficiencies, we used time series analyses to isolate the effect of 13 NPIs at different levels of implementation (fully implemented vs. partially relaxed).ResultsPublic health responses implemented in Europe led to a median decrease in viral transmission of 71%, enough to suppress the epidemic. PHR efficiency was positively associated with the number of NPIs implemented simultaneously. The largest effect among NPIs was observed for stay at home orders targeted at risk groups (β=0.24, 95%CI 0.16-0.32) and teleworking (β=0.23, 95%CI 0.15-0.31), followed by enforced stay at home orders for the general population, closure of non-essential businesses and services, bans on gatherings of 50 individuals or more, and closure of universities. Partial relaxation of most NPIs resulted in lower than average or non-significant changes in response efficiency.ConclusionThis large-scale estimation of NPI and PHR efficiency against SARS-COV-2 transmission in Europe suggests that a combination of NPIs targeting different population groups should be favored to control future epidemic waves.

Disposal Practices of Unused Medications Among Patients in Public Health Centers of Dessie Town, Northeast Ethiopia: A Cross-sectional Study

2020 ◽  
Vol 15 (2) ◽  
pp. 105-110
Author(s):  
Haile Kassahun ◽  
Dugessa Tesfaye
Keyword(s):  
Public Health ◽  
Health Care Professionals ◽  
Cross Sectional Study ◽  
Health Centers ◽  
Sectional Study ◽  
Cross Sectional ◽  
Global Challenge ◽  
Northeast Ethiopia ◽  
Unused Medications ◽  
At Home

Background: Disposal of pharmaceutical waste among patients is a global challenge especially in developing countries like Ethiopia. Improper medication disposal can lead to health problems and environmental contaminations. Therefore, the present study aimed to assess disposal practices of unused medications among patients in public health centers of Dessie town, Northeast Ethiopia. Methods: A descriptive cross-sectional study was conducted among 263 patients in four public health centers of Dessie town, Ethiopia from March to June, 2019. Face-to-face interviews using structured questionnaires were used to collect data from each study subject. Results: The majority of the respondents, 224 (85.17%) had unused medications at their home during the study period. The most commonly reported disposal method in the present study was flushing down into a toilet 66 (25.09%). None of the respondents practiced returning unused medications to Pharmacy. Moreover, 85 (32.31%) of the respondents reported never disposing their medications and believed that it is acceptable to store medications at home for future use. Conclusion: In the present study, there was a high practice of keeping medications at home and most of the disposal practices were not recommended methods. In addition, most of the respondents did not get advice from pharmacists and other health care professionals on how to dispose off unused medications. Hence, there is a need for proper education and guidance of patients regarding disposal practices of unused medications.

scholarly journals Working conditions and health status of 6,317 front line public health workers across five provinces in China during the COVID-19 epidemic: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jinghua Li ◽  
Jingdong Xu ◽  
Huan Zhou ◽  
Hua You ◽  
Xiaohui Wang ◽  
...  
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Health Status ◽  
Health Outcomes ◽  
Working Conditions ◽  
Health Workers ◽  
Front Line ◽  
Cross Sectional ◽  
Self Rated Health ◽  
Public Health Workers

ABSTRACT Background Public health workers at the Chinese Centre for Disease Control and Prevention (China CDC) and primary health care institutes (PHIs) were among the main workers who implemented prevention, control, and containment measures. However, their efforts and health status have not been well documented. We aimed to investigate the working conditions and health status of front line public health workers in China during the COVID-19 epidemic. Methods Between 18 February and 1 March 2020, we conducted an online cross-sectional survey of 2,313 CDC workers and 4,004 PHI workers in five provinces across China experiencing different scales of COVID-19 epidemic. We surveyed all participants about their work conditions, roles, burdens, perceptions, mental health, and self-rated health using a self-constructed questionnaire and standardised measurements (i.e., Patient Health Questionnaire and General Anxiety Disorder scale). To examine the independent associations between working conditions and health outcomes, we used multivariate regression models controlling for potential confounders. Results The prevalence of depression, anxiety, and poor self-rated health was 21.3, 19.0, and 9.8%, respectively, among public health workers (27.1, 20.6, and 15.0% among CDC workers and 17.5, 17.9, and 6.8% among PHI workers). The majority (71.6%) made immense efforts in both field and non-field work. Nearly 20.0% have worked all night for more than 3 days, and 45.3% had worked throughout the Chinese New Year holiday. Three risk factors and two protective factors were found to be independently associated with all three health outcomes in our final multivariate models: working all night for >3 days (multivariate odds ratio [ORm]=1.67~1.75, p<0.001), concerns about infection at work (ORm=1.46~1.89, p<0.001), perceived troubles at work (ORm=1.10~1.28, p<0.001), initiating COVID-19 prevention work after January 23 (ORm=0.78~0.82, p=0.002~0.008), and ability to persist for > 1 month at the current work intensity (ORm=0.44~0.55, p<0.001). Conclusions Chinese public health workers made immense efforts and personal sacrifices to control the COVID-19 epidemic and faced the risk of mental health problems. Efforts are needed to improve the working conditions and health status of public health workers and thus maintain their morale and effectiveness during the fight against COVID-19.

scholarly journals More Than Shelter: Housing for Urban Maternal and Infant Health

2021 ◽  
Vol 18 (7) ◽  
pp. 3331
Author(s):  
Jason Reece
Keyword(s):  
Public Health ◽  
Maternal Health ◽  
Health Outcomes ◽  
City Planning ◽  
Infant Health ◽  
The United States ◽  
Housing Quality ◽  
Housing Discrimination ◽  
Maternal Health Outcomes ◽  
The Impact

Housing quality, stability, and affordability have a direct relationship to socioemotional and physical health. Both city planning and public health have long recognized the role of housing in health, but the complexity of this relationship in regard to infant and maternal health is less understood. Focusing on literature specifically relevant to U.S. metropolitan areas, I conduct a multidisciplinary literature review to understand the influence of housing factors and interventions that impact infant and maternal health. The paper seeks to achieve three primary goals. First, to identify the primary “pathways” by which housing influences infant and maternal health. Second, the review focuses on the role and influence of historical housing discrimination on maternal health outcomes. Third, the review identifies emergent practice-based housing interventions in planning and public health practice to support infant and maternal health. The literature suggests that the impact of housing on infant health is complex, multifaceted, and intergenerational. Historical housing discrimination also directly impacts contemporary infant and maternal health outcomes. Policy interventions to support infant health through housing are just emerging but demonstrate promising outcomes. Structural barriers to housing affordability in the United States will require new resources to foster greater collaboration between the housing and the health sectors.

scholarly journals Epidemiological modelling of the health and economic effects of COVID-19 control in Australia’s second wave

2021 ◽  
Author(s):  
R. Quentin Grafton ◽  
John Parslow ◽  
Tom Kompas ◽  
Kathryn Glass ◽  
Emily Banks
Keyword(s):  
Public Health ◽  
Health Outcomes ◽  
Health Management ◽  
Economic Effects ◽  
Social Distancing ◽  
The Public ◽  
Long Duration ◽  
Community Transmission ◽  
Second Wave ◽  
Detection Strategies

Abstract Background We investigated the public health and economy outcomes of different levels of social distancing to control a ‘second wave’ outbreak in Australia and identify implications for public health management of COVID-19. Methods Individual-based and compartment models were used to simulate the effects of different social distancing and detection strategies on Australian COVID-19 infections and the economy from March to July 2020. These models were used to evaluate the effects of different social distancing levels and the early relaxation of suppression measures, in terms of public health and economy outcomes. Results The models, fitted to observations up to July 2020, yielded projections consistent with subsequent cases and showed that better public health outcomes and lower economy costs occur when social distancing measures are more stringent, implemented earlier and implemented for a sufficiently long duration. Early relaxation of suppression results in worse public health outcomes and higher economy costs. Conclusions Better public health outcomes (reduced COVID-19 fatalities) are positively associated with lower economy costs and higher levels of social distancing; achieving zero community transmission lowers both public health and economy costs compared to allowing community transmission to continue; and early relaxation of social distancing increases both public health and economy costs.

scholarly journals The Gender Pain Gap: gender inequalities in pain across 19 European countries

2021 ◽  
pp. 140349482098746
Author(s):  
Kweku Bimpong ◽  
Katie Thomson ◽  
Courtney L. Mcnamara ◽  
Mirza Balaj ◽  
Nasima Akhter ◽  
...  
Keyword(s):  
Public Health ◽  
Chronic Pain ◽  
Management Strategies ◽  
European Countries ◽  
Leg Pain ◽  
Health Concern ◽  
Public Health Issue ◽  
Gender Inequalities ◽  
Arm Pain ◽  
Adjusted Rate

Aims: Chronic pain is increasingly considered to be an international public health issue, yet gender differences in chronic pain in Europe are under-examined. This work aimed to examine gender inequalities in pain across Europe. Methods: Data for 27,552 men and women aged 25–74 years in 19 European countries were taken from the social determinants of health module of the European Social Survey (2014). Inequalities in reporting pain were measured by means of adjusted rate differences (ARD) and relative adjusted rate risks (ARR). Results: At the pooled pan-European level, a greater proportion of women (62.3%) reported pain than men (55.5%) (ARD 5.5% (95% confidence intervals (CI) 4.1, 6.9), ARR 1.10 (95% CI 1.08, 1.13)). These inequalities were greatest for back/neck pain (ARD 5.8% (95% CI 4.4, 7.1), ARR 1.15 (95% CI 1.12, 1.19)), but were also significant for hand/arm pain (ARD 4.6% (95% CI 3.5, 5.7), ARR 1.24 (95% CI 1.17, 1.30)) and foot/leg pain (ARD 2.6% (95% CI 1.5, 3.8), ARR 1.12 (95% CI 1.07, 1.18)). There was considerable cross-national variation in gender pain inequalities across European countries. Conclusions: Significant gender pain inequalities exist across Europe whereby women experience more pain than men. The extent of the gender pain gap varies by country. The gender pain gap is a public health concern and should be considered in future prevention and management strategies.

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