scholarly journals Trends in reasons for emergency calls during the COVID-19 crisis in the department of Gironde, France using automatic classification.

Author(s):  
Cédric Gil-Jardiné ◽  
Gabrielle Chenais ◽  
Catherine Pradeau ◽  
Eric Tentillier ◽  
Philipe Revel ◽  
...  

Abstract Objectives During periods such as the COVID-19 crisis, there is a need for responsive public health surveillance indicators related to the epidemic and to preventative measures such as lockdown. The automatic classification of the content of calls to emergency medical communication centers could provide relevant and responsive indicators. Methods We retrieved all 796,209 free-text call reports from the emergency medical communication center of the Gironde department, France, between 2018 and 2020. We trained a natural language processing neural network model with a mixed unsupervised/supervised method to classify all reasons for calls in 2020. Validation and parameter adjustment were performed using a sample of 20,000 manually-coded free-text reports. Results The number of daily calls for flu-like symptoms began to increase from February 21, 2020 and reached an unprecedented level by February 28, 2020 and peaked on March 14, 2020, 3 days before lockdown. It was strongly correlated with daily emergency room admissions, with a delay of 14 days. Calls for chest pain, stress, but also those mentioning dyspnea, ageusia and anosmia peaked 12 days later. Calls for malaises with loss of consciousness, non-voluntary injuries and alcohol intoxications sharply decreased, starting one month before lockdown. Discussion This example of the COVID-19 crisis shows how the availability of reliable and unbiased surveillance platforms can be useful for a timely and relevant monitoring of all events with public health consequences. The use of an automatic classification system using artificial intelligence makes it possible to free itself from the context that could influence a human coder, especially in a crisis situation. Conclusion The content of calls to emergency medical communication centers is an efficient epidemiological surveillance data source that provides insights into the societal upheavals induced by a health crisis.

Author(s):  
Cédric Gil-Jardiné ◽  
Gabrielle Chenais ◽  
Catherine Pradeau ◽  
Eric Tentillier ◽  
Philippe Revel ◽  
...  

Abstract Objectives During periods such as the COVID-19 crisis, there is a need for responsive public health surveillance indicators in order to monitor both the epidemic growth and potential public health consequences of preventative measures such as lockdown. We assessed whether the automatic classification of the content of calls to emergency medical communication centers could provide relevant and responsive indicators. Methods We retrieved all 796,209 free-text call reports from the emergency medical communication center of the Gironde department, France, between 2018 and 2020. We trained a natural language processing neural network model with a mixed unsupervised/supervised method to classify all reasons for calls in 2020. Validation and parameter adjustment were performed using a sample of 39,907 manually-coded free-text reports. Results The number of daily calls for flu-like symptoms began to increase from February 21, 2020 and reached an unprecedented level by February 28, 2020 and peaked on March 14, 2020, 3 days before lockdown. It was strongly correlated with daily emergency room admissions, with a delay of 14 days. Calls for chest pain and stress and anxiety, peaked 12 days later. Calls for malaises with loss of consciousness, non-voluntary injuries and alcohol intoxications sharply decreased, starting one month before lockdown. No noticeable trends in relation to lockdown was found for other groups of reasons including gastroenteritis and abdominal pain, stroke, suicide and self-harm, pregnancy and delivery problems. Discussion The first wave of the COVID-19 crisis came along with increased levels of stress and anxiety but no increase in alcohol intoxication and violence. As expected, call related to road traffic crashes sharply decreased. The sharp decrease in the number of calls for malaise was more surprising. Conclusion The content of calls to emergency medical communication centers is an efficient epidemiological surveillance data source that provides insights into the societal upheavals induced by a health crisis. The use of an automatic classification system using artificial intelligence makes it possible to free itself from the context that could influence a human coder, especially in a crisis situation. The COVID-19 crisis and/or lockdown induced deep modifications in the population health profile.


Author(s):  
Mostafa Shokoohi ◽  
Mehdi Osooli ◽  
Saverio Stranges

Differences in public health approaches to control the coronavirus disease 2019 (COVID-19) pandemic could largely explain substantial variations in epidemiological indicators (such as incidence and mortality) between the West and the East. COVID-19 revealed vulnerabilities of most western countries’ healthcare systems in their response to the ongoing public health crisis. Hence, western countries can possibly learn from practices from several East Asian countries regarding infrastructures, epidemiological surveillance and control strategies to mitigate the public health impact of the pandemic. In this paper, we discuss that the lack of rapid and timely community-centered approaches, and most importantly weak public health infrastructures, might have resulted in a high number of infected cases and fatalities in many western countries.


2021 ◽  
Author(s):  
Patrik Bachtiger ◽  
Alexander Adamson ◽  
William A Maclean ◽  
Jennifer K Quint ◽  
Nicholas S Peters

ABSTRACTObjectivesTo inform critical public health messaging by determining how changes in Covid-19 vaccine hesitancy, attitudes to the priorities for administration, the emergence of new variants and availability of vaccines may affect the trajectory and achievement of herd immunity.Methods>9,000 respondents in an ongoing cross-sectional participatory longitudinal epidemiology study (LoC-19, n=18,581) completed a questionnaire within their personal electronic health record in the week reporting first effective Covid-19 vaccines, and then again after widespread publicity of the increased transmissibility of a new variant (November 13th and December 31st 2020 respectively). Questions covered willingness to receive Covid-19 vaccination and attitudes to prioritisation. Descriptive statistics, unadjusted and adjusted odds ratios (ORs) and natural language processing of free-text responses are reported, and how changes over the first 50 days of both vaccination roll-out and new-variant impact modelling of anticipated transmission rates and the likelihood and time to herd immunity.FindingsCompared with the week reporting the first efficacious vaccine there was a 15% increase in acceptance of Covid-19 vaccination, attributable in one third to the impact of the new variant, with 75% of respondents “shielding” – staying at home and not leaving unless essential – regardless of health status or tier rules. 12.5% of respondents plan to change their behaviour two weeks after completing vaccination compared with 45% intending to do so only when cases have reduced to a low level. Despite the increase from 71% to 86% over this critical 50-day period, modelling of planned uptake of vaccination remains below that required for rapid effective herd immunity – now estimated to be 90 percent in the presence of a new variant escalating R0 to levels requiring further lockdowns. To inform the public messaging essential therefore to improve uptake, age and female gender were, respectively, strongly positively and negatively associated with wanting a vaccine. 22.7% disagreed with the prioritisation list, though 70.3% were against being able to expedite vaccination through payment. Teachers (988, 12.6%) and Black, Asian and Minority Ethnic (BAME) (837, 10.7%) groups were most cited by respondents for prioritisation.InterpretationIn this sample, the growing impact of personal choice among the increasingly informed public highlights a decrease in Covid-19 vaccine hesitancy over time, with news of a new variant motivating increased willingness for vaccination but at levels below what may be required for effective herd immunity. We identify public preferences for next-in-line priorities, headed by teachers and BAME groups, consideration of which will help build trust and community engagement critical for maximising compliance with not only the vaccination programme but also all other public health measures.


Author(s):  
Ryan C. Moore ◽  
Angela Lee ◽  
Jeffrey T. Hancock ◽  
Meghan Halley ◽  
Eleni Linos

Our goal is to inform ongoing public health policy on the design and communication of COVID-19 social distancing measures to maximize compliance. We assessed the US public’s early experience with the COVID-19 crisis during the period when shelter-in-place orders were widely implemented to understand non-compliance with those orders, sentiment about the crisis, and to compare across age categories associated with different levels of risk. We posted our survey on Twitter, Facebook, and NextDoor on March 14th to March 23rd that included 21 questions including demographics, impact on daily life, actions taken, and difficulties faced.1 We analyzed the free-text responses to the impact question using LIWC, a computational natural language processing tool2, and performed a thematic content analysis of the reasons people gave for non-compliance with social distancing orders. Stanford University’s IRB approved the study.In 9 days, we collected a total of 20,734 responses. 6,573 individuals provided a response (≥30 words) to the question, “Tell us how the coronavirus crisis is impacting your life.” Our data (Figure 1) show that younger people (18-31) are more emotionally negative, self-centered, and less concerned with family, while middle-aged people are group-oriented (32-44) and focused on family (32-64) (all p values < .05 corrected for multiple comparisons). Unsurprisingly, the oldest and most at-risk group (65+) are more focused on biological terms (e.g., health-related topics), but were surprisingly low in anxiety and high in emotionally positive terms relative to those at lower risk.We also content-analyzed 7,355 responses (kappa’s > .75) to the question, “What are the reasons you are not self-isolating more?” Of these participants, 39.8% reported not being compliant, with the youngest group (18-31) having the lowest compliance rate (52.4%) compared to the other age groups (all > 60%; all p values < .01). Table 1 describes the seven primary themes for non-compliance. Non-essential work requirements, concerns about mental and physical health, and the belief that other precautions were sufficient were the most common reasons, although other rationales included wanting to continue everyday activities and beliefs that society is over-reacting. Childcare was an important concern for a subset of respondents.Overall, our findings suggest that public health messages should focus on young people and 1) address their negative affect, 2) refocus their self-orientation by emphasizing the importance of individual behavior to group-level health outcomes, and 3) target the specific rationales that different people have regarding the pandemic to maximize compliance with social distancing.


Author(s):  
Alyshia Gálvez

In the two decades since the North American Free Trade Agreement (NAFTA) went into effect, Mexico has seen an epidemic of diet-related illness. While globalization has been associated with an increase in chronic disease around the world, in Mexico, the speed and scope of the rise has been called a public health emergency. The shift in Mexican foodways is happening at a moment when the country’s ancestral cuisine is now more popular and appreciated around the world than ever. What does it mean for their health and well-being when many Mexicans eat fewer tortillas and more instant noodles, while global elites demand tacos made with handmade corn tortillas? This book examines the transformation of the Mexican food system since NAFTA and how it has made it harder for people to eat as they once did. The book contextualizes NAFTA within Mexico’s approach to economic development since the Revolution, noticing the role envisioned for rural and low-income people in the path to modernization. Examination of anti-poverty and public health policies in Mexico reveal how it has become easier for people to consume processed foods and beverages, even when to do so can be harmful to health. The book critiques Mexico’s strategy for addressing the public health crisis generated by rising rates of chronic disease for blaming the dietary habits of those whose lives have been upended by the economic and political shifts of NAFTA.


2020 ◽  
Vol 20 ◽  
Author(s):  
Miribane Dërmaku-Sopjani ◽  
Mentor Sopjani

Abstract:: The coronavirus disease 2019 (COVID-19) is currently a new public health crisis threatening the world. This pandemic disease is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The virus has been reported to be originated in bats and by yet unknown intermediary animals were transmitted to humans in China 2019. The SARSCoV- 2 spreads faster than its two ancestors the SARS-CoV and Middle East respiratory syndrome coronavirus (MERSCoV) but has reduced fatality. At present, the SARS-CoV-2 has caused about a 1.16 million of deaths with more than 43.4 million confirmed cases worldwide, resulting in a serious threat to public health globally with yet uncertain impact. The disease is transmitted by inhalation or direct contact with an infected person. The incubation period ranges from 1 to 14 days. COVID-19 is accompanied by various symptoms, including cough, fatigue. In most people the disease is mild, but in some other people, such as in elderly and people with chronic diseases, it may progress from pneumonia to a multi-organ dysfunction. Many people are reported asymptomatic. The virus genome is sequenced, but new variants are reported. Numerous biochemical aspects of its structure and function are revealed. To date, no clinically approved vaccines and/or specific therapeutic drugs are available to prevent or treat the COVID-19. However, there are reported intensive researches on the SARSCoV- 2 to potentially identify vaccines and/or drug targets, which may help to overcome the disease. In this review, we discuss recent advances in understanding the molecular structure of SARS-CoV-2 and its biochemical characteristics.


Coronaviruses ◽  
2020 ◽  
Vol 01 ◽  
Author(s):  
Saeed Khan ◽  
Tusha Sharma ◽  
Basu Dev Banerjee ◽  
Scotty Branch ◽  
Shea Harrelson

: Currently, Coronavirus disease 2019 (COVID-19) has transformed into a severe public health crisis and wreaking havoc worldwide. The ongoing pandemic has exposed the public healthcare system's weaknesses and highlighted the urgent need for investments in scientific programs and policies. A comprehensive program utilizing the science and technologydriven strategies combined with well-resourced healthcare organizations appears to be essential for current and future outbreak management.


Author(s):  
Joshua M. Sharfstein

An effective communications approach starts with a basic dictum set forth by the Centers for Disease Control and Prevention: “Be first, be right, be credible.” Agencies must establish themselves as vital sources of accurate information to maintain the public’s trust. At the same time, public health officials must recognize that communications play out in the context of ideological debates, electoral rivalries, and other political considerations. During a public health crisis, this means that health officials often need to constructively engage political leaders in communications and management. Navigating these waters in the middle of a crisis can be treacherous. Figuring out the best way to engage elected leaders is a core aspect of political judgment.


Author(s):  
Joshua M. Sharfstein

Firefighters fight fires. Police officers race to crime scenes, sirens blaring. And health officials? Health officials respond to crises. There are infectious disease crises, budget crises, environmental health crises, human resources crises—and many more. At such critical moments, what happens next really matters. A strong response can generate greater credibility and authority for a health agency and its leadership, while a bungled response can lead to humiliation and even resignation. Health officials must be able to manage and communicate effectively as emotions run high, communities become engaged, politicians lean in, and journalists circle. In popular imagination, leaders intuitively rise to the challenge of a crisis: Either they have what it takes or they do not. In fact, preparation is invaluable, and critical skills can be learned and practiced. Students and health officials alike can prepare not only to avoid catastrophe during crises, but to take advantage of new opportunities for health improvement. The Public Health Crisis Survival Guide provides historical perspective, managerial insight, and strategic guidance to help health officials at all levels not just survive but thrive in the most challenging of times.


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