scholarly journals Does the data tell the true story? A modelling assessment of early COVID-19 pandemic suppression and mitigation strategies in Ghana

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0258164
Author(s):  
Nana Kena Frempong ◽  
Theophilus Acheampong ◽  
Ofosuhene O. Apenteng ◽  
Emmanuel Nakua ◽  
John H. Amuasi
Keyword(s):  
Public Health ◽  
Reproduction Number ◽  
Severe Disease ◽  
Mitigation Strategies ◽  
Health Interventions ◽  
New Wave ◽  
Systematic Testing ◽  
True Incidence ◽  
True Story ◽  
Health Measures

This paper uses publicly available data and various statistical models to estimate the basic reproduction number (R0) and other disease parameters for Ghana’s early COVID-19 pandemic outbreak. We also test the effectiveness of government imposition of public health measures to reduce the risk of transmission and impact of the pandemic, especially in the early phase. R0 is estimated from the statistical model as 3.21 using a 0.147 estimated growth rate [95% C.I.: 0.137–0.157] and a 15-day time to recovery after COVID-19 infection. This estimate of the initial R0 is consistent with others reported in the literature from other parts of Africa, China and Europe. Our results also indicate that COVID-19 transmission reduced consistently in Ghana after the imposition of public health interventions—such as border restrictions, intra-city movement, quarantine and isolation—during the first phase of the pandemic from March to May 2020. However, the time-dependent reproduction number (Rt) beyond mid-May 2020 does not represent the true situation, given that there was not a consistent testing regime in place. This is also confirmed by our Jack-knife bootstrap estimates which show that the positivity rate over-estimates the true incidence rate from mid-May 2020. Given concerns about virus mutations, delays in vaccination and a possible new wave of the pandemic, there is a need for systematic testing of a representative sample of the population to monitor the reproduction number. There is also an urgent need to increase the availability of testing for the general population to enable early detection, isolation and treatment of infected individuals to reduce progression to severe disease and mortality.

scholarly journals A window of opportunity for intensifying testing and tracing efforts to prevent new COVID-19 outbreaks due to more transmissible variants

2021 ◽  
Vol 47 (7/8) ◽  
pp. 329-338
Author(s):  
Jianhong Wu ◽  
Francesca Scarabel ◽  
Zachary McCarthy ◽  
Yanyu Xiao ◽  
Nicholas H Ogden
Keyword(s):  
Public Health ◽  
Reproduction Number ◽  
Health Interventions ◽  
Contact Tracing ◽  
Window Of Opportunity ◽  
New Wave ◽  
Public Health Interventions ◽  
Contact Rates ◽  
Large Outbreak ◽  
Restrictive Measures

Background: When public health interventions are being loosened after several days of decline in the number of coronavirus disease 2019 (COVID-19) cases, it is of critical importance to identify potential strategies to ease restrictions while mitigating a new wave of more transmissible variants of concern (VOCs). We estimated the necessary enhancements to public health interventions for a partial reopening of the economy while avoiding the worst consequences of a new outbreak, associated with more transmissible VOCs. Methods: We used a transmission dynamics model to quantify conditions that combined public health interventions must meet to reopen the economy without a large outbreak. These conditions are those that maintain the control reproduction number below unity, while accounting for an increase in transmissibility due to VOC. Results: We identified combinations of the proportion of individuals exposed to the virus who are traced and quarantined before becoming infectious, the proportion of symptomatic individuals confirmed and isolated, and individual daily contact rates needed to ensure the control reproduction number remains below unity. Conclusion: Our analysis indicates that the success of restrictive measures including lockdown and stay-at-home orders, as reflected by a reduction in number of cases, provides a narrow window of opportunity to intensify case detection and contact tracing efforts to prevent a new wave associated with circulation of more transmissible VOCs.

scholarly journals Spatiotemporal patterns and progression of the Delta variant of COVID-19 and their health intervention linkages in Southeast Asia

2021 ◽  
Author(s):  
Wei Luo ◽  
Zhaoyin Liu ◽  
Yuxuan Zhou ◽  
Yumin Zhao ◽  
Yunyue Elita Li ◽  
...  
Keyword(s):  
Public Health ◽  
Southeast Asia ◽  
Spatiotemporal Analysis ◽  
Health Interventions ◽  
Disease Spread ◽  
Epidemic Dynamics ◽  
Health Measures ◽  
Global Pandemic ◽  
Public Health Strategies ◽  
Time Scan

The global pandemic of COVID-19 presented an unprecedented challenge to all countries in the world, among which Southeast Asia (SEA) countries managed to maintain and mitigate the first wave of COVID-19 in 2020. However, these countries were caught in the crisis after the Delta variant was introduced to SEA, though many countries had immediately implemented non-pharmaceutical intervention (NPI) measures along with vaccination in order to contain the disease spread. To investigate the potential linkages between epidemic dynamics and public health interventions, we adopted a prospective space-time scan method to conduct spatiotemporal analysis at the district level in the seven selected countries in SEA from June 2021 to October 2021. Results reveal the spatial and temporal propagation and progression of COVID-19 risks relative to public health measures implemented by different countries. Our research benefits continuous improvements of public health strategies in preventing and containing this pandemic.

scholarly journals Time Course of COVID-19 Cases in Austria

2020 ◽  
Vol 17 (9) ◽  
pp. 3270 ◽  
Author(s):  
Hanns Moshammer ◽  
Michael Poteser ◽  
Kathrin Lemmerer ◽  
Peter Wallner ◽  
Hans-Peter Hutter
Keyword(s):  
Public Health ◽  
Infectious Disease ◽  
Time Course ◽  
Reproduction Number ◽  
Average Duration ◽  
Northern Italy ◽  
Reproduction Rate ◽  
Health Measures ◽  
Major Outbreak ◽  
Novel Coronavirus

COVID-19 is an infectious disease caused by a novel coronavirus, which first appeared in China in late 2019, and reached pandemic distribution in early 2020. The first major outbreak in Europe occurred in Northern Italy where it spread to neighboring countries, notably to Austria, where skiing resorts served as a main transmission hub. Soon, the Austrian government introduced strict measures to curb the spread of the virus. Using publicly available data, we assessed the efficiency of the governmental measures. We assumed an average incubation period of one week and an average duration of infectivity of 10 days. One week after the introduction of strict measures, the increase in daily new cases was reversed, and the reproduction number dropped. The crude estimates tended to overestimate the reproduction rate in the early phase. Publicly available data provide a first estimate about the effectiveness of public health measures. However, more data are needed for an unbiased assessment.

Public Health or Clinical Ethics: Thinking beyond Borders

2002 ◽  
Vol 16 (2) ◽  
pp. 35-45 ◽  
Author(s):  
Onora O'Neill
Keyword(s):  
Public Health ◽  
Medical Ethics ◽  
Clinical Medicine ◽  
Clinical Care ◽  
Effective Means ◽  
Cost Effective ◽  
Health Interventions ◽  
Individual Autonomy ◽  
Public Health Interventions ◽  
Health Measures

Most work in medical ethics across the last twenty-five years has centered on the ethics of clinical medicine. Even work on health and justice has, in the main, been concerned with the just distribution of (access to) clinical care for individual patients. By contrast, the ethics of public health has been widely neglected. This neglect is surprising, given that public health interventions are often the most effective (and most cost-effective) means of improving health in rich and poor societies alike.In this essay I explore two sources of contemporary neglect of public health ethics. One source of neglect is that contemporary medical ethics has been preoccupied—in my view damagingly preoccupied—with the autonomy of individual patients. Yet individual autonomy can hardly be a guiding ethical principle for public health measures, since many of them must be uniform and compulsory if they are to be effective. A second source of neglect is that contemporary political philosophy has been preoccupied—in my view damagingly preoccupied—with the requirements for justice within states or societies, and (until very recently) has hardly discussed justice across borders. Yet public health problems often cross borders, and public health interventions have to measure up to the problems they address.

scholarly journals Evolution of disease transmission rate during the course of SARS-COV-2: Patterns and determinants

2020 ◽  
Author(s):  
Jie Zhu ◽  
Blanca Gallego
Keyword(s):  
Public Health ◽  
Disease Transmission ◽  
Reproduction Number ◽  
Transmission Rate ◽  
Region Of Interest ◽  
Health Interventions ◽  
Transmission Model ◽  
Public Health Interventions ◽  
Containment Measures ◽  
The Impact

Abstract To date, many studies have argued the potential impact of public health interventions on flattening the epidemic curve of SARS-CoV-2. Most of them have focused on simulating the impact of interventions in a region of interest by manipulating contact patterns and key transmission parameters to reflect different scenarios. Our study looks into the evolution of the daily effective reproduction number during the epidemic via a stochastic transmission model. We found this measure (although model-dependent) provides an early signal of the efficacy of containment measures. This epidemiological parameter when updated in real-time can also provide better predictions of future outbreaks. Our results found a substantial variation in the effect of public health interventions on the dynamic of SARS-CoV-2 transmission over time and across countries, that could not be explained solely by the timing and number of the adopted interventions. This suggests that further knowledge about the idiosyncrasy of their implementation and effectiveness is required. Although sustained containment measures have successfully lowered growth in disease transmission, more than half of the 101 studied countries failed to maintain the effective reproduction number close to or below 1. This resulted in continued growth in reported cases. Finally, we were able to predict with reasonable accuracy which countries would experience outbreaks in the next 30 days.

scholarly journals Adaptive Time-Dependent Priors and Bayesian Inference to Evaluate SARS-CoV-2 Public Health Measures Validated on 31 Countries

2021 ◽  
Vol 8 ◽  
Author(s):  
Hugues Turbé ◽  
Mina Bjelogrlic ◽  
Arnaud Robert ◽  
Christophe Gaudet-Blavignac ◽  
Jean-Philippe Goldman ◽  
...  
Keyword(s):  
Public Health ◽  
Bayesian Inference ◽  
Reproduction Number ◽  
Fast Response ◽  
Time Dependent ◽  
Health Measures ◽  
Time Required ◽  
State Interventions ◽  
Restrictive Measures ◽  
And Control

With the rapid spread of the SARS-CoV-2 virus since the end of 2019, public health confinement measures to contain the propagation of the pandemic have been implemented. Our method to estimate the reproduction number using Bayesian inference with time-dependent priors enhances previous approaches by considering a dynamic prior continuously updated as restrictive measures and comportments within the society evolve. In addition, to allow direct comparison between reproduction number and introduction of public health measures in a specific country, the infection dates are inferred from daily confirmed cases and confirmed death. The evolution of this reproduction number in combination with the stringency index is analyzed on 31 European countries. We show that most countries required tough state interventions with a stringency index equal to 79.6 out of 100 to reduce their reproduction number below one and control the progression of the pandemic. In addition, we show a direct correlation between the time taken to introduce restrictive measures and the time required to contain the spread of the pandemic with a median time of 8 days. This analysis is validated by comparing the excess deaths and the time taken to implement restrictive measures. Our analysis reinforces the importance of having a fast response with a coherent and comprehensive set of confinement measures to control the pandemic. Only restrictions or combinations of those have shown to effectively control the pandemic.

scholarly journals The Effect of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Mitigation Strategies on Seasonal Respiratory Viruses: A Tale of 2 Large Metropolitan Centers in the United States

2020 ◽  
Author(s):  
Amy C Sherman ◽  
Ahmed Babiker ◽  
Andrew J Sieben ◽  
Alexander Pyden ◽  
James Steinberg ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Severe Acute Respiratory Syndrome ◽  
The United States ◽  
Respiratory Viruses ◽  
Mitigation Strategies ◽  
The Public ◽  
Health Measures ◽  
Reproductive Rates ◽  
The Impact

Abstract To assess the impact of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic on seasonal respiratory viruses, absolute case counts and viral reproductive rates from 2019–2020 were compared against previous seasons. Our findings suggest that the public health measures implemented to reduce SARS-CoV-2 transmission significantly reduced the transmission of other respiratory viruses.

scholarly journals Public Health Policies and Global COVID-19 Outbreak

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Komaroff ◽  
A A Belhouchet
Keyword(s):  
Public Health ◽  
South Korea ◽  
Health Interventions ◽  
Health Policies ◽  
P Value ◽  
Public Health Interventions ◽  
Public Health Policies ◽  
The Public ◽  
Health Measures ◽  
The Usa

Abstract Background Was the world prepared to face the pandemic with a standard strategy? Objectives To evaluate the association between public health interventions against the COVID-19 outbreak and the outcome. Methods The observational study included data on incidence of confirmed COVID-19 cases (outcome) and public health non-pharmaceutical interventions (exposure) from five countries: France, Italy, Japan, South Korea, and the USA, December 31, 2019 through April 12, 2020. The public health measures were grouped into five categories: lockdown, movement restrictions, public health measures, social (including social distancing) and economic measures, and use of facial mask. The multiple linear regressions were utilized to test the hypothesis that implementation of some public health measures was associated with the change in the incident number of COVID-19 cases, 2-sided, α = 0.05. Results The incidence of COVID-19 would be significantly greater without lockdown (1.89 times, p-value <.0001), public health and economic measures (25.17, p-value <.0001), and using masks (11.93, p-value=0.002), assuming that all other public health policies are the same. The effectiveness increases with earlier time of implementation. Among considered countries, South Korea was the most efficacious, where all measures were statistically significantly efficacious (p-value <0.05). Conclusions The findings demonstrate an association between public health measures and the outcome. The experience from South Korea should be studied further as the most effective non-pharmacological approach to fight the disease. This paper is the first step to develop the standardized approach utilizing the public health interventions to be applied effectively to the globe population. Key messages the most effective measures to control the COVID-19, and future outbreaks. The effect of particular measure varied by country and time of implementation.

scholarly journals Mathematical Parameters of the COVID-19 Epidemic in Brazil and Evaluation of the Impact of Different Public Health Measures

Biology ◽  
2020 ◽  
Vol 9 (8) ◽  
pp. 220 ◽  
Author(s):  
Renato M. Cotta ◽  
Carolina P. Naveira-Cotta ◽  
Pierre Magal
Keyword(s):  
Public Health ◽  
Initial Conditions ◽  
Transmission Rate ◽  
Time Variable ◽  
Health Interventions ◽  
Public Health Interventions ◽  
Problem Model ◽  
Social Distancing ◽  
Health Measures ◽  
The Impact

A SIRU-type epidemic model is employed for the prediction of the COVID-19 epidemy evolution in Brazil, and analyze the influence of public health measures on simulating the control of this infectious disease. The proposed model allows for a time variable functional form of both the transmission rate and the fraction of asymptomatic infectious individuals that become reported symptomatic individuals, to reflect public health interventions, towards the epidemy control. An exponential analytical behavior for the accumulated reported cases evolution is assumed at the onset of the epidemy, for explicitly estimating initial conditions, while a Bayesian inference approach is adopted for the estimation of parameters by employing the direct problem model with the data from the first phase of the epidemy evolution, represented by the time series for the reported cases of infected individuals. The evolution of the COVID-19 epidemy in China is considered for validation purposes, by taking the first part of the dataset of accumulated reported infectious individuals to estimate the related parameters, and retaining the rest of the evolution data for direct comparison with the predicted results. Then, the available data on reported cases in Brazil from 15 February until 29 March, is used for estimating parameters and then predicting the first phase of the epidemy evolution from these initial conditions. The data for the reported cases in Brazil from 30 March until 23 April are reserved for validation of the model. Then, public health interventions are simulated, aimed at evaluating the effects on the disease spreading, by acting on both the transmission rate and the fraction of the total number of the symptomatic infectious individuals, considering time variable exponential behaviors for these two parameters. This first constructed model provides fairly accurate predictions up to day 65 below 5% relative deviation, when the data starts detaching from the theoretical curve. From the simulated public health intervention measures through five different scenarios, it was observed that a combination of careful control of the social distancing relaxation and improved sanitary habits, together with more intensive testing for isolation of symptomatic cases, is essential to achieve the overall control of the disease and avoid a second more strict social distancing intervention. Finally, the full dataset available by the completion of the present work is employed in redefining the model to yield updated epidemy evolution estimates.

Sign in / Sign up

Export Citation Format

Share Document