Field epidemiology training programs contribute to COVID-19 preparedness and response globally

Background Field epidemiology training programs (FETPs) have trained field epidemiologists who strengthen global capacities for surveillance and response to public health threats. We describe how FETP residents and graduates have contributed to COVID-19 preparedness and response globally. Methods We conducted a cross-sectional survey of FETPs between March 13 and April 15, 2020 to understand how FETP residents or graduates were contributing to COVID-19 response activities. The survey tool was structured around the eight Pillars of the World Health Organization’s (WHO) Strategic Preparedness and Response Plan for COVID-19. We used descriptive statistics to summarize quantitative results and content analysis for qualitative data. Results Among 88 invited programs, 65 (74%) responded and indicated that FETP residents and graduates have engaged in the COVID-19 response across all six WHO regions. Response efforts focused on country-level coordination (98%), surveillance, rapid response teams, case investigations (97%), activities at points of entry (92%), and risk communication and community engagement (82%). Descriptions of FETP contributions to COVID-19 preparedness and response are categorized into seven main themes: conducting epidemiological activities, managing logistics and coordination, leading risk communication efforts, providing guidance, supporting surveillance activities, training and developing the workforce, and holding leadership positions. Conclusions Our findings demonstrate the value of FETPs in responding to public health threats like COVID-19. This program provides critical assistance to countries' COVID-19 response efforts but also enhances epidemiologic workforce capacity, public health emergency infrastructure and helps ensure global health security as prescribed in the WHO’s International Health Regulations.

Internal Border Control in the Schengen Area and Health Threats: Any Lessons from the COVID-19 Pandemic?

The COVID-19 pandemic has exacerbated the Member States’ overreliance on the rules of the Schengen Borders Code allowing for temporary reintroduction of border control and has questioned the institutional narrative of an EU-wide borderless area as a key achievement of the integration process. This article focuses on the legal implications of the border measures enacted by the Member States following the COVID-19 outbreak and discusses their compatibility with relevant EU law, also in the light of available epidemiological studies on the link between border controls and spread of the virus. The analysis contends that the pandemic has offered an unprecedented opportunity to pave the way to shared solutions to the enduring crisis of the internal dimension of the Schengen area, such as a detailed reform of the Schengen Borders Code and a reconsideration of the current governance of the Schengen area itself.

Smoke and COVID-19 case fatality ratios during California wildfires

Background: Recent evidence has shown an association between wildfire smoke and COVID-19 cases and deaths. The San Francisco Bay Area, in California (USA), experienced two major concurrent public health threats in 2020: the COVID-19 pandemic and dense smoke emitted by wildfires. This provides a unprecedented context to unravel the role of acute air pollution exposure on COVID-19 severity. Methods: A smoke product provided by the National Oceanic and Atmospheric Association Hazard Mapping System was used to identify counties exposed to heavy smoke in summer and fall of 2020. Daily COVID-19 cases and deaths for the United States were downloaded at the county-level from the CDC COVID Data Tracker. Synthetic control methods were used to estimate the causal effect of the wildfire smoke on daily COVID-19 case fatality ratios, adjusting for population mobility. Results: Evidence of an impact of wildfire smoke on COVID-19 case fatality ratios was observed, with precise estimates in Alameda and San Francisco. Up to 58 (95% CI: 29, 87) additional deaths for every 1,000 COVID-19 incident daily cases attributable to wildfire smoke was estimated in Alameda in early September. Conclusions: Findings indicated that extreme weather events such as wildfires smoke can drive increased vulnerability to infectious diseases, highlighting the need to further study these colliding crises. Understanding the environmental drivers of COVID-19 mortality can be used to protect vulnerable populations from these potentially concomitant public health threats.

Similar Trajectories in Current Alcohol Consumption and Tick-Borne Diseases: Only Parallel Changes in Time or Links Between?

In a modern world, both tick-borne diseases and alcohol consumption are among major public health threats. In the present opinion article, we pose the question, whether these two health problems: alcohol consumption and tick-borne diseases prevalence can be related. We hypothesize that it is possible due to at least three factors: outdoor places chosen for alcohol consumption, behavioral changes induced by alcohol, and possible stronger attraction of human hosts after alcohol consumption to ticks. Many important clues are coming from social studies about people’s preference of places to consume alcohol and from studies regarding the attraction of people consuming alcohol to mosquitos. These data, however, cannot be directly transferred to the case of alcohol consumption and ticks. Therefore, we suggest that more detailed studies are needed to better understand the possible individual attractiveness of people to ticks and ways alcohol may influence it.

An Assessment of Air and Water Pollution Accrued from Stone Quarrying in Mukono District, Central Uganda

The unquenchable demand for rock materials has attracted many companies within the building and construction sector to invest in stone quarrying. However, this has brought about the environmental impacts with health threats to people. There is a paucity of information about the magnitude of pollution on air and water and how it varies with quarry sites. This study therefore investigated the physical impacts of quarrying on air and water and explored the in-situ mitigations to undesirable effects due to stone quarrying. Four active quarry sites were identified. Field measurements of dust (particulate matter) was conducted within the four quarry sites and in the nearby community. Water samples were collected from quarry pits and nearby shallow wells for laboratory analysis of water quality. Statistical Analysis of Variance (ANOVA) was used to test for differences in pollution across the four studied sites. Results revealed that, amidst use of wet crushing and water sprinkling on bare surfaces, dust emission was higher than the recommended permissible standards levels with a significant variation across the quarry sites with ANOVA (P-value=0.003) for PM2.5 and (P-value=0.04366) for PM10. Water pollution was mainly contributed by the non-permissive levels of nitrates, chromium, and pH. Polluted air and water are associated with sparking off health threats to the users in the community. In conclusion, quarry companies should strengthen the already existing mitigation of dust suppression. The study recommends additional measures such as treating quarry pit water before discharging to the open environment

Older Black Americans and Depressive Symptoms During the COVID-19 Pandemic

Black Americans have experienced multiple health threats during the COVID-19 pandemic, including greater risk of infection compared to Whites. In addition, older adults are more susceptible to worse disease consequences including hospitalization and mortality compared to those who are younger. Racism and economic costs are additional public health crises during this time that have disproportionately impacted Black Americans. Using data from the Uncovering COVID-19 Experiences and Realities (UnCOVER) Study, we examined depressive symptoms in relation to: (1) worry/fear of COVID-19; (2) work loss among household members (being laid off, reduced work hours); and (3) vicarious racism, a particularly salient source of psychosocial stress during the COVID-19 pandemic, including hearing about or seeing acts of racism committed against other race group members. Participants were Black Americans aged 50 years or older (n=300) from five cities (Atlanta, Chicago, Los Angeles, New Orleans, and New York) from May-July 2020. Depression was assessed using the Patient-Reported Outcomes Measurement Information System Short Form. In multivariable linear regression models, all three public health threats were significantly associated with depressive symptoms. When in the model simultaneously, worry/fear of COVID-19 (b=0.30, SE=0.12, p<0.01) and vicarious racism (b=0.62, SE=0.15, p<0.001) showed positive associations; work loss was no longer statistically significant (b=0.62, SE=0.43, p=0.15). When added, the corresponding three-way interaction term was significant (b=0.12, SE=0.04, p<0.01). Synergistic epidemics (“syndemics”) among older Black Americans amplify mental health tolls. Multi-pronged public health strategies are required to address depression in this population.