The COVID-19 pandemic in Africa’s Island Nations: A descriptive study of the course of the COVID-19 outbreaks and the national response plans

Introduction: The main objective is to present an overview of the evolution of the COVID-19pandemic in the six African island nations: Cabo Verde, Comoros, Madagascar, Mauritius, SãoTomé e Príncipe and Seychelles, up until 29 November 2020. The relevance of studying theoutbreak in these countries is their distinct geography, which may facilitate rapid closure andcontrol of their international borders. Here, we investigate whether this geography may haveled to an effective response and management of their respective COVID-19 epidemics.Methods: A literature review and analysis of national public health reports, officialcoronavirus websites and previously published research in each of the studied countries fromthe start of the pandemic through 29 November 2020 was performed. Data on metrics on thecountry-specific progression of COVID-19, the level of strictness of the governmental policies,the testing practices, as well the national healthcare systems, the description and the state ofhealth of the populations in the African island nations were reported.Results: Five out of six countries controlled their respective COVID-19 epidemics at an earlystage in the context of the total number of confirmed cases and deaths. In Cabo Verde, therewas an increasing number of cases as of 29 November 2020, when 10,526 total cases and 104total deaths were reported nationally. All six nations maintained a case fatality rate (CFR)lower than the global average, estimated between 2 - 3% in previously published research.Among the island nations, Mauritius had the highest CFR of 2%.Discussion: African island nations have different demographic, socioeconomic, and healthcareprofiles. However, their shared geographic characteristics likely played a role in limiting thespread of the infection. Furthermore, data from these nations support the idea that theimplementation of strict restrictions at an early stage, such as border closure and lockdowns,was crucial for the epidemic response.

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Genetic risk for coronary heart disease alters the influence of Alzheimer’s genetic risk on mild cognitive impairment

10.1101/432443 ◽

2018 ◽

Author(s):

Jeremy A. Elman ◽

Matthew S. Panizzon ◽

Mark W. Logue ◽

Nathan A. Gillespie ◽

Michael C. Neale ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Genetic Risk ◽

Early Stage ◽

Case Fatality ◽

Polygenic Risk Score ◽

Protective Effects ◽

Increased Risk ◽

Incident Cases ◽

The Impact

ABSTRACTBACKGROUNDAlzheimer’s disease (AD) is under considerable genetic influence. However, known susceptibility loci only explain a modest proportion of variance in disease outcomes. This small proportion could occur if the etiology of AD is heterogeneous. We previously found that an AD polygenic risk score (PRS) was significantly associated with mild cognitive impairment (MCI), an early stage of AD. Poor cardiovascular health is also associated with increased risk for AD and has been found to interact with AD pathology. Conditions such as coronary artery disease (CAD) are also heritable, and may contribute to heterogeneity if there are interactions of genetic risk for these conditions as there is phenotypically. However, case-control designs based on prevalent cases of a disease with relatively high case-fatality rate such as CAD may be biased toward individuals who have long post-event survival times and may therefore also identify loci with protective effects.METHODSWe compared interactions between an AD-PRS and two CAD-PRSs, one based on a GWAS of incident cases and one on prevalent cases, on MCI status in 1,209 individuals.RESULTSAs expected, the incidence-based CAD-PRS interacts with the AD-PRS to further increase MCI risk. Conversely, higher prevalence-based CAD-PRSs reduced the effect of AD genetic risk on MCI status.CONCLUSIONSThese results demonstrate: i) the utility of including multiple PRSs and their interaction effects; ii) how genetic risk for one disease may modify the impact of genetic risk for another; and iii) the importance of considering ascertainment procedures of GWAS being used for genetic risk prediction.

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402. COVID-19 Infection in Nepal: Epidemiological Analysis from April 2020 to March 2021

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab466.603 ◽

2021 ◽

Vol 8 (Supplement_1) ◽

pp. S302-S303

Author(s):

Hai V Le

Keyword(s):

Case Fatality ◽

Epidemiological Data ◽

Epidemiological Analysis ◽

International Borders ◽

Global Pandemic ◽

Early Implementation ◽

Recent Outbreak ◽

One Year ◽

The One ◽

Second Wave

Abstract Background In December 2019, SARS-CoV-2 or coronavirus disease 2019 (COVID-19) emerged from Wuhan, China. A global pandemic quickly unfolded, infecting >137 million people and causing >2.9 million deaths globally as of April 13, 2021. Before April 1, 2020, there were only five confirmed COVID-19 cases in Nepal. Like many countries around the world, the COVID-19 situation quickly escalated in Nepal. The purpose of this study was to determine the trends in COVID-19 cases and deaths in Nepal from April 2020 to March 2021. Methods We utilized epidemiological data from daily Situation Reports published by the Ministry of Health and Population (MOHP) of Nepal. Data were extracted or calculated from April 1, 2020 to March 31, 2021. Primary variables of interest were national and provincial daily cases, total cases, daily deaths, and total deaths. Results Between April 1, 2020 to March 31, 2021, there were 277,304 cases. October 2020 had the highest monthly cases with 92,926 cases. During the one-year study period, the infection rate was 915 cases per 100,000 people. The largest single-day new cases was October 21, 2020 with 5,743 cases, which is calculated to 19 cases per 100,000 people. There were a total of 3,030 deaths. The largest daily new deaths was November 4, 2020 with 43 cases. June 10, 2020 had the highest number of people in quarantine with 172,266 people. October 23, 2020 had the highest number of active cases with 46,329 cases. By March 31, 2021, the percent of mortality was 1.1%, active infection was 0.5%, and recovery was 98.4%. Conclusion Nepal had lower COVID-19 infection and case-fatality rates compared to other countries most affected by the pandemic. This was due to several factors, most notably early implementation of strict lockdown measures and closing of international borders on March 24, 2020 after the second confirmed COVID-19 case. As lockdown restrictions were lifted on July 7, 2020, COVID-19 cases and deaths in Nepal rose rapidly. As vaccination begun on January 27, 2021, cases started to slow down until the most recent outbreak coinciding with the second wave in its neighboring country, India. Now, infection and case-fatality rates in Nepal are at an all-time high, prompting further lockdowns on April 29, 2021. Disclosures All Authors: No reported disclosures

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A Reachable Governance to Fight COVID-19: Democracy and the Legacy of Embedded Autonomy in Taiwan

Asian Journal of Social Science Studies ◽

10.20849/ajsss.v5i3.777 ◽

2020 ◽

Vol 5 (3) ◽

pp. 18

Author(s):

Peters Li-ying Chen

Keyword(s):

Political Theory ◽

Political System ◽

Early Stage ◽

Developmental State ◽

Effective Response ◽

Democratic State ◽

Long Term Effect ◽

Embedded Autonomy ◽

Democratic Country

Different country showed different governing capacity to the COVID-19 pandemic in 2020. With reference to the classical concept of embedded autonomy, as used in developmental state of political theory, this paper aims to study the capacity and progression of democratic country, Taiwan, in its fight with the emergence of the COVID-19 pandemic and how democratic state, civil society and bureaucrats have affected the response and measures. Taiwan’s case provides a valuable empirical contribution to the understanding of the long term effect of embedded autonomy in a democratic country. This study argues that democracy does matter to fight Covid-19 pandemic, moreover, the legacy of embedded autonomy can be expanded beyond economic development, and successfully used to explain Taiwan’s capacity to fight the COVID-19 pandemic in its early stage. Key observations and discussion addressed in this study includes, first, the extent to which the concept of embedded autonomy is applicable in evaluating and in shaping Taiwan’s efforts to manage the pandemic; second, the extent to which the political system is better at managing COVID-19 crisis by comparing democratic Taiwan and authoritarian China. A central finding of this paper is that, democracy has proven it has the edge in coping with COVID-19 pandemic practically. Theoretically, Taiwan’s case demonstrates a valuable and supplementary example to Evans and Heller (2018) on their broadening view of embedded autonomy. The legacy of the developmental state is applicable to explain Taiwan’s immediate and effective response to the COVID-19 outbreak. A reachable governance to fight COVID-19 lies in ‘the nature of democracy’ and ‘the legacy of embedded autonomy’.

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Estimating the real-time case fatality rate of COVID-19 using Poisson mixtures model

10.1101/2020.04.11.20062190 ◽

2020 ◽

Cited By ~ 1

Author(s):

Paul H. Lee

Keyword(s):

Real Time ◽

Case Fatality Rate ◽

Early Stage ◽

Case Fatality ◽

Hubei Province ◽

Fatality Rate ◽

The Real ◽

Poisson Mixtures

ABSTRACTWe proposed using Poisson mixtures model that utilized data of deaths, recoveries, and total confirmed cases in each day since the outbreak. We demonstrated that our CFR estimates for Hubei Province and other parts of China were superior to the simple CFR estimators in the early stage of COVID-19 outbreak.

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Analytical Review of COVID-19 Outbreak in India During the Global Pandemic

Journal of Pure and Applied Microbiology ◽

10.22207/jpam.14.spl1.27 ◽

2020 ◽

Vol 14 (suppl 1) ◽

pp. 903-910

Author(s):

Parth Goel ◽

Dweepna Garg ◽

Amit Ganatra

Keyword(s):

Early Stage ◽

Case Fatality ◽

Epidemiological Data ◽

Vital Role ◽

Data Repository ◽

Contagious Diseases ◽

First Case ◽

The World ◽

Analytical Review ◽

And Gender

COVID-19 is one of the very contagious diseases from the family Coronaviridae and spreading at a faster rate in the community. In December 2019, the first case of COVID-19 was reported in Wuhan, China. An epidemic outbreak of COVID-19 was seen in India from March 2020. Epidemiological data of COVID-19 cases of the world and India have been analyzed in our study. We have utilized publicly available two databases from data repository by Johns Hopkins CSSE and covid19india.org. COVID-19 cases and case fatality rate (CFR) of the world have been summarized and compared with India from January 22, 2020 to April 15, 2020. Indian cases were analyzed among states of India and also compared with age and gender by performing statistical approaches such as central tendency, standard deviation and interquartile range. By April 15, 2020, Indian has reported 12,322 confirmed cases, 1,498 recovered cases and 405 death cases of COVID-19. In spite of India being a diverse country with the second-highest population, the deadly side of COVID-19 was comparatively far less as compared to the other countries. India has taken preemptive measures at an early stage to prevent transmission of COVID-19 outbreak and it is reviewed from our study by comparing India with other countries. Our study also summarizes that age also plays a vital role in the intervention of COVID-19 cases.

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Cost-effectiveness of primary prophylaxis with pegfilgrastim in early-stage breast cancer patients receiving chemotherapy in China.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.e18349 ◽

2019 ◽

Vol 37 (15_suppl) ◽

pp. e18349-e18349

Author(s):

Wen Xia ◽

Shusen Wang ◽

Hao Hu ◽

Fei Xu ◽

Kuikui Jiang ◽

...

Keyword(s):

Breast Cancer ◽

Cost Effectiveness ◽

Early Stage ◽

Case Fatality ◽

Primary Prophylaxis ◽

Early Stage Breast Cancer ◽

Base Case ◽

Second Phase ◽

Term Survival ◽

The Cost

e18349 Background: Guidelines recommend primary prophylaxis(PP) use for patients receiving chemotherapy regimens with a high risk of febrile neutropenia (FN), which is 20% or higher. This study aim to evaluate the cost effectiveness of PP with pegfilgrastim (Brand name:Jinyouli), PP with filgrastim or no prophylaxis in women with early-stage breast cancer(BC) in China. Methods: A two-phase Markov model was developed for a hypothetical cohort of patients age 45 with stage II BC. First phase modeled costs/outcomes of 4 cycles docetaxel combined cyclophosphamide(TC×4) chemotherapy, with assumptions based on literature reviews including FN rates(Base-case (DSA range),0.29(0.24–0.35)) and related events (FN case-fatality, 3.4 (2.7–4.1)). Second phase models the long term survival which was suggested to link with the relative dose intensity (RDI)( Mortality HR for RDI < 85% vs. ≥85%,1.45 (1.00–2.32)). Clinical effectiveness, costs, and utilities were estimated from peer-reviewed publications and expert opinions in case of unavailability of published evidences. Results: Compared to PP filgrastim and no prophylaxis, PP pegfilgrastim was associated with higher costs 5208.19RMB and 5222.73RMB respectively, and increased quality-adjusted life-year (QALY) gained 0.066 and 0.297 respectively. Accordingly, the incremental cost effectiveness ratios (ICERs) are 79146.3RMB and 17558.77 RMB per QALY, which are both below the three times GDP per capita as the willingness to pay (WTP) threshold suggested by the WHO. Conclusions: Although the cost of PP pegfilgrastim is higher, considering the additional benefits, the administrating of PP pegfilgrastim is likely to be a cost-effective alternative to PP filgrastim and no prophylaxis in patients with early stage breast cancer in China.

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Transmission dynamics and control measures of COVID-19 outbreak in China: a modelling study

Scientific Reports ◽

10.1038/s41598-021-81985-z ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Xu-Sheng Zhang ◽

Emilia Vynnycky ◽

Andre Charlett ◽

Daniela De Angelis ◽

Zhengji Chen ◽

...

Keyword(s):

Reproduction Number ◽

Early Stage ◽

Case Fatality ◽

Control Measures ◽

Infected People ◽

Contact Rates ◽

Multiple Datasets ◽

Dynamics And Control ◽

Successful Control ◽

And Control

AbstractCOVID-19 is reported to have been brought under control in China. To understand the COVID-19 outbreak in China and provide potential lessons for other parts of the world, in this study we apply a mathematical model with multiple datasets to estimate the transmissibility of the SARS-CoV-2 virus and the severity of the illness associated with the infection, and how both were affected by unprecedented control measures. Our analyses show that before 19th January 2020, 3.5% (95% CI 1.7–8.3%) of infected people were detected; this percentage increased to 36.6% (95% CI 26.1–55.4%) thereafter. The basic reproduction number (R0) was 2.33 (95% CI 1.96–3.69) before 8th February 2020; then the effective reproduction number dropped to 0.04(95% CI 0.01–0.10). This estimation also indicates that control measures taken since 23rd January 2020 affected the transmissibility about 2 weeks after they were introduced. The confirmed case fatality rate is estimated at 9.6% (95% CI 8.1–11.4%) before 15 February 2020, and then it reduced to 0.7% (95% CI 0.4–1.0%). This shows that SARS-CoV-2 virus is highly transmissible but may be less severe than SARS-CoV-1 and MERS-CoV. We found that at the early stage, the majority of R0 comes from undetected infectious people. This implies that successful control in China was achieved through reducing the contact rates among people in the general population and increasing the rate of detection and quarantine of the infectious cases.

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U.S. APPROACH TO IMPLEMENTING IMO GUIDELINES ON PLACES OF REFUGE1

International Oil Spill Conference Proceedings ◽

10.7901/2169-3358-2005-1-305 ◽

2005 ◽

Vol 2005 (1) ◽

pp. 305-309 ◽

Cited By ~ 1

Author(s):

Paul Albertson

Keyword(s):

Coast Guard ◽

Maritime History ◽

Real Thing ◽

Effective Response ◽

Response System ◽

National Response ◽

Safety Committees ◽

Oil Tanker ◽

The U.S

ABSTRACT When the oil tanker Prestige broke apart and sank off the coast of Spain in November 2002, it joined an infamous line of environmental catastrophes in maritime history. The way in which the Prestige incident unfolded and, in particular, the denial of a place of refuge for the tanker intensified existing pressures on the IMO to finalize and adopt guidelines intended to assist all concerned parties in dealing with similar circumstances. At the 23rd Assembly, the IMO answered by adopting two resolutions on the issue. These resolutions offer excellent planning, preparedness, and response guidelines and a framework for effectively dealing with the next Prestige. The IMO guidelines are compatible with the U.S. National Response System and existing laws designed to protect the environment, public health, and welfare. As such, their implementation requires neither regulation nor significant adjustments to U.S. policy. With few exceptions, the National Response System should assimilate the IMO guidelines. Specifically, Area Committees and Harbor Safety Committees should plow the IMO guidelines into current planning, preparedness, and response activities in order to ensure effective response to places of refuge scenarios. The most critical and urgent issue is to ensure the decisionmaking criteria and process for both allowing and taking a ship in need of assistance to a place of refuge is well developed, agreed upon, and exercised beforehand, so that when the real thing occurs those who need to make the decision know exactly what to do and who to contact. This paper discusses relevant aspects of the National Response System and authorities as they pertain to the IMO guidelines and the role of the U.S. Coast Guard as the federal agency charged with their implementation.

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Quantitative SARS-CoV-2 Antibody Screening of Healthcare Workers in the Southern Part of Kyoto City During the COVID-19 Pre-pandemic Period

Frontiers in Public Health ◽

10.3389/fpubh.2020.595348 ◽

2020 ◽

Vol 8 ◽

Cited By ~ 1

Author(s):

Kohei Fujita ◽

Shinpei Kada ◽

Osamu Kanai ◽

Hiroaki Hata ◽

Takao Odagaki ◽

...

Keyword(s):

Healthcare Workers ◽

Early Stage ◽

Case Fatality ◽

Serum Samples ◽

Igg Antibody ◽

Kyoto City ◽

History Of ◽

Heavy Burden ◽

Antibody Levels ◽

Mental And Physical Health

Background: The coronavirus disease-2019 (COVID-19) pandemic is associated with a heavy burden on the mental and physical health of patients, regional healthcare resources, and global economic activity. While understanding of the incidence and case-fatality rates has increased, there are limited data concerning seroprevalence of antibodies against the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) in healthcare workers during the pre-pandemic period. This study aimed to quantitatively evaluate seroprevalence of SARS-CoV-2 antibodies in healthcare workers in the southern part of Kyoto city, Japan.Methods: We prospectively recruited healthcare workers from a single hospital between April 10 and April 20, 2020. We collected serum samples from these participants and quantitatively evaluated SARS-CoV-2 IgG antibody levels using enzyme-linked immunosorbent assays.Results: Five (5.4%), 15 (16.3%), and 72 (78.3%) participants showed positive, borderline, and negative serum SARS-CoV-2 IgG antibody status, respectively. We found the mean titer associated with each antibody status (overall, positive, borderline, and negative) was clearly differentiated. Participants working at the otolaryngology department and/or with a history of seasonal common cold symptoms had a significantly higher SARS-CoV-2 IgG antibody titer (p = 0.046, p = 0.046, respectively).Conclusions: Five (5.4%) and 15 (16.3%) participants tested positive and borderline, respectively, for SARS-CoV-2 IgG antibody during the COVID-19 pre-pandemic period. These rates were higher than expected, based on government situation reports. These findings suggest that COVID-19 had already spread within the southern part of Kyoto city at the early stage of the pandemic.

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Asymptomatic carriage rates and case fatality of SARS-CoV-2 infection in residents and staff in Irish nursing homes

Age and Ageing ◽

10.1093/ageing/afaa220 ◽

2020 ◽

Author(s):

Sean P Kennelly ◽

Adam H Dyer ◽

Claire Noonan ◽

Ruth Martin ◽

Siobhan M Kennelly ◽

...

Keyword(s):

Nursing Homes ◽

Early Stage ◽

Case Fatality ◽

Point Prevalence ◽

Infection Rates ◽

Symptom Profile ◽

Asymptomatic Carriage ◽

First Case ◽

Reduce Risk ◽

Systematic Point

Abstract Background SARS-CoV-2 has disproportionately affected nursing homes (NH). In Ireland, the first NH case COVID-19 occurred on 16 March 2020. A national point-prevalence testing programme of all NH residents and staff took place (18 April 2020 to 5 May 2020). Aims to examine characteristics of NHs across three Irish Community Health Organisations, proportions with COVID-19 outbreaks, staff and resident infection rates symptom profile and resident case fatality. Methods in total, 45 NHs surveyed, requesting details on occupancy, size, COVID-19 outbreak, outbreak timing, total symptomatic/asymptomatic cases and outcomes for residents from 29 February 2020 to 22 May 2020. Results surveys were returned from 62.2% (28/45) of NHs (2,043 residents, 2,303 beds). Three-quarters (21/28) had COVID-19 outbreaks (1,741 residents, 1,972 beds). Median time from first COVID-19 case in Ireland to first case in these NHs was 27.0 days. Resident incidence was 43.9% (764/1,741)—40.8% (710/1,741) laboratory confirmed, with 27.2% (193/710) asymptomatic and 3.1% (54/1,741) clinically suspected. Resident case fatality was 27.6% (211/764) for combined laboratory-confirmed/clinically suspected COVID-19. Similar proportions of residents in NHs with ‘early-stage’ (<28 days) versus ‘later-stage’ outbreaks developed COVID-19. Lower proportions of residents in ‘early’ outbreak NHs had recovered compared with those with ‘late’ outbreaks (37.4 versus 61.7%; χ2 = 56.9, P < 0.001). Of 395 NH staff across 12 sites with confirmed COVID-19, 24.7% (99/398) were asymptomatic. There was a significant correlation between the proportion of staff with symptomatic COVID-19 and resident numbers with confirmed/suspected COVID-19 (Spearman’s rho = 0.81, P < 0.001). Conclusion this study demonstrates the significant impact of COVID-19 on the NH sector. Systematic point-prevalence testing is necessary to reduce risk of transmission from asymptomatic carriers and manage outbreaks in this setting.

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