COVID-19 Pandemic Control Measures Research Articles

Effect of COVID-19 Pandemic Control Measures on Diagnoses of Hematologic Cancer Among CMS Population in 2020

IntroductionMeasures taken to mitigate infection spread during the 2020 COVID-19 pandemic are considered to have caused significant unintended consequences on other diseases. Large decreases in the numbers of symptomatic and asymptomatic people presenting for diagnosis of heart disease, diabetes and cancer have been observed. A recent analysis of solid tumors showed up to 70% reduction in the number of patients presenting for diagnosis. The potential exists for significantly increased morbidity and mortality for these missed or delayed presenting patients. Further, it is important to determine whether infection spread mitigation measures affected the diagnostic testing and treatment decisions for these patients. This study aimed to determine whether pandemic control measures affected presentation, testing and treatment of patients across eight different hematologic cancers.MethodsCMS claims data were analyzed for the presence of diagnostic (DX) ICD 10 codes indicative of hematologic cancer. Patients with a DX code first appearing in 2019 or in 2020 were selected to provide newly diagnosed pre-COVID-19 and during COVID-19 cohorts for comparison, with unique patient counts being calculated for each month. A “COVID-19 dip” i.e. a decrease in the number of patients was calculated as the change in number of patients diagnosed in a given month relative to the number for JAN2020. Dip duration was calculated only when the decrease was >10% of the JAN2020 figure. Patients who received treatment via a “J” code Healthcare Common Procedure Coding System (HCPCS) code were extracted from the cohorts and the time taken from initial diagnosis to first treatment calculated.ResultsEight hematologic cancers: AML, CLL, CML, HEME (a group of different hematologic cancers), Hodgkins (HOG), Myelodysplasia (MDS), Non-Follicular Lymphomas (NFL), and Non-Hodgkins Lymphoma (NHL) showed a decrease in the number of patients being diagnosed during the early part of 2020 (Fig.1)Fig.1. Change in new patient diagnoses for selected hematologic cancers as a proportion of their JAN2020 valueThere was some variation in the depth and duration of the COVID-19 dip (Table 1) with MDS having both the longest and deepest dip. Median depth and duration of the dip was 33% and 3.5 months, respectively, with all dips starting either in FEB or MAR2020.Table 1. Duration and depth of COVID-19 dips for selected hematological cancersThe proportions of patients receiving therapy via J HCPCS code (JRX) are shown in Table 2Table 2. Proportions of patients receiving J code therapyConclusionsThe decline in new patient diagnoses for heme cancers during the period when COVID-19 control measures were implemented is similar to that seen with solid tumors, although the depth of the COVID-19 dip was generally larger in the latter. There is no evidence of “catch up” diagnosis occurring i.e. patients missing from Q2 2020 are not reappearing en masse in subsequent quarters. The decline for MDS patients has, except for SEP to OCT2020, remained. Collectively, (depending on the calculation method), the COVID-19 dip for these eight heme cancers represents 16,584-33,671 patients who will likely have significantly increased rates of morbidity and mortality due to delayed diagnosis.Analysis of J code treatments show little difference between the proportions of patients receiving these treatments in 2020 compared to 2019 suggesting that at least some aspects of treatment e.g. infused chemotherapy, IO drugs for these patients was relatively unchanged by pandemic control measures. It also suggests that the main cause for decreased patient numbers treated is due to decreased testing for diagnosis, rather than not being treated once diagnosed. This aligns with findings from studies in the US and UK. The results of this study indicate that there may be a “backlog” of tens of thousands of people with cancer whose diagnosis has been significantly delayed and who urgently need to be identified in order to get on proper treatment to lessen the impact of that delay. [Display omitted] DisclosuresNo relevant conflicts of interest to declare.

Sexual activities during the COVID-19 pandemic in Indonesia

BackgroundCorona Virus Disease 2019 (COVID-19) has spread globally starting from late 2019. The WHO declared it a global pandemic in March 2020, causing nations around the world to introduce various control measures to halt the rapid spread of the disease, such as quarantines, lockdowns, and work from home (WFH) policies. These policies often force people to spend more time at home with their cohabitants, or possibly sexual partners. Various negative feelings experienced during those policies are considered to affect the general mood and sexual life of the population. This study aimed to investigate the difference in mood and sexual activity before and during the COVID-19 pandemic.MethodsThis research was a cross-sectional pilot study. Authors collected data from 131 randomly selected, sexually active volunteer subjects using a self-administered online questionnaire. Subjects’ mood status, behavior, and frequency of sexual intercourse before and during COVID-19 pandemic in Indonesia were analyzed.ResultsSubjects consisted of 67 (51.1%) men and 64 (48.9%) women. Our analysis shows that there was a decline in overall mood scale, and also sexual activity frequency, before and during the pandemic (4.63 vs. 4.03; 80.2% vs. 67.9%, respectively). The COVID-19 pandemic control measures may enable subjects to have more time with their sexual partners at home, but it does not increase the frequency of their sexual activities.ConclusionThere was a slight decrease in overall mood scale and sexual activity frequency during the COVID-19 pandemic recorded among subjects. The authors suspect that depression symptoms, fear, anxiety, irritability, boredom, confusion, and feeling of being isolated experienced during strict pandemic control measures, caused by stressors such as job loss, decreased monthly income, and the current state of the pandemic are influencing these phenomena.

Letter to the Editor: COVID-19 Pandemic Control Measures: Impact on Social Frailty and Health Outcomes in Non-Frail Community-Dwelling Older Adults.

Letter to the Editor: COVID-19 Pandemic Control Measures: Impact on Social Frailty and Health Outcomes in Non-Frail Community-Dwelling Older Adults.

COVID-19 Pandemic Effects on Breast Cancer Diagnosis in Croatia: A Population- and Registry-Based Study.

BackgroundOur objective was to assess the effects of COVID‐19 antiepidemic measures and subsequent changes in the function of the health care system on the number of newly diagnosed breast cancers in the Republic of Croatia.Subjects, Materials, and MethodsWe performed a retrospective, population‐ and registry‐based study during 2020. The comparator was the number of patients newly diagnosed with breast cancer during 2017, 2018, and 2019. The outcome was the change in number of newly diagnosed breast cancer cases.ResultsThe average monthly percent change after the initial lockdown measures were introduced was −11.0% (95% confidence interval − 22.0% to 1.5%), resulting in a 24% reduction of the newly diagnosed breast cancer cases in Croatia during April, May, and June compared with the same period of 2019. However, during 2020, only 1% fewer new cases were detected than in 2019, or 6% fewer than what would be expected based on the linear trend during 2017–2019.ConclusionIt seems that national health care system measures for controlling the spread of COVID‐19 had a detrimental effect on the number of newly diagnosed breast cancer cases in Croatia during the first lockdown. As it is not plausible to expect an epidemiological change to occur at the same time, this may result in later diagnosis, later initiation of treatment, and less favorable outcomes in the future. However, the effect weakened after the first lockdown and COVID‐19 control measures were relaxed, and it has not reoccurred during the second COVID‐19 wave. Although the COVID‐19 lockdown affected the number of newly diagnosed breast cancers, the oncology health care system has shown resilience and compensated for these effects by the end of 2020.Implications for PracticeIt is possible to compensate for the adverse effects of COVID‐19 pandemic control measures on breast cancer diagnosis relatively promptly, and it is of crucial importance to do it as soon as possible. Moreover, as shown by this study's results on the number of newly diagnosed breast cancer cases during the second wave of the pandemic, these adverse effects are preventable to a non‐negligible extent.

How Aotearoa New Zealand rapidly revised its Covid-19 response strategy: lessons for the next pandemic plan

ABSTRACT Public health lessons from one pandemic become the planning assumptions for the next one. Aotearoa New Zealand’s 2017 pandemic plan was derived from past experience of influenza. When Covid-19 emerged as a major global health threat, it took time for the realisation to crystallise that this infection was so different from influenza that it required a completely new pandemic response strategy. In this paper we describe how early evidence about SARS-CoV-2 transmission from China led to the adoption of an elimination strategy in Aotearoa New Zealand, making it the first country to choose elimination as a specific policy response. We discuss how further evidence has shaped the selection and design of Covid-19 pandemic control measures such as border restrictions, case and contact management, hygiene practices and use of face masks, physical distancing, and vaccines. This experience demonstrates the need for a different approach to the design of the next national pandemic plan. We identify key early evidence that will be required to develop a flexible and appropriate public health response to a new pandemic threat. We present a framework for a new pandemic plan that aims to learn from the Covid-19 experience by making as few limiting assumptions as possible.

Effects of COVID-19 pandemic control measures on air pollution in Lima metropolitan area, Peru in South America.

The sanitary measures implemented to control and prevent an increase in infections due to the COVID-19 pandemic have produced an improvement in the air quality of many urban areas around the world. We assessed air quality during the COVID-19 pandemic for particulate matter (PM2.5 and PM10), NO2 and O3 in in metropolitan area of Lima, Peru between pre-lockdown period (February 1 and March 15 of 2020), historical period (March 16 to April 30 2017–2019) and lockdown period (March 16 to April 30, 2020). The complete national lockdown that was implemented in Peru produced statistically significant reductions in the in-air pollutant (PM10 (-40% and -58%), PM2.5 (-31% and -43%) and NO2 (-46% and -48%)), as recorded by the by the ground-based air quality monitoring network throughout the metropolitan area, compared with the corresponding concentrations for the previous weeks and over the same period for 2017–2019. Analysis of the spatial Distribution of satellite data also show decreases in the concentrations of PM10, PM2.5 and NO2 as a result of the containment measures and suspension of activities implemented by the Peruvian government. The concentrations of O3 significantly increased (11% and 170%) as a result of the decrease in the concentration of NO2, confirming that the study area is a hydrocarbon-limited system, as previously reported. The results obtained contribute to the assessment by the regulatory agencies of the possible strategies of control and monitoring of air pollution in the study area.Graphical abstract Supplementary InformationThe online version contains supplementary material available at 10.1007/s11869-021-00990-3.

Modifiable Environmental Risk Factors Affecting Myopia

Purpose: The global rise in the prevalence of myopia calls for evidence-based strategies to be devised to reduce the incidence and delay the progression of Myopia. The aim of this study is to review the current literature on modifiable risk factors that control the development and progression of Myopia, specifically in paediatric population. Method: A comprehensive literature review was conducted using PubMed, ScienceDirect, Elsevier, and Google Scholar databases, including keywords such as environmental risk factors; myopia; “outdoor activity”; “near work”; “high body mass index”; “LED lamps usage”; “watching television”; “digital devices”; “sleep”; “melatonin”; “low vitamin D levels”; “sports”; “socioeconomic status”; “COVID-19 and online education”. English language full-text articles published between Jan 2010 and Oct 2020 were included in the study. Studies were critically reviewed for study methodology and robustness of data. Thirty six studies are included in this literature review. Conclusion: Prevention of onset of myopia and delay in progression of myopia can be altered by modifying the contributing risk factors. Increase in outdoor time with adequate sunlight exposure, rural environment, less duration of near work, use of incandescent lamp, normal circadian rhythms with adequate regular sleeping hours can prevent the onset and progression of myopia. Myopia association with high BMI, watching television, playing digital devices, serum vitamin D levels, participation in sports yet to be established. High socioeconomic status associated with more indoor activity, increased academic pressure, sedentary life style contributes to prevalence of myopia. COVID-19 pandemic control measures with consequent online education resulted in increased digital screen time, near work, and limited outdoor activities, causing rise of myopia pandemic.

COVID-19 pandemic and the widening gap to access cancer services in Uganda.

The COVID-19 pandemic and its public health control measures have led to worldwide interruptions in healthcare service delivery, and cancer services are no exception. These interruptions have exacerbated the effects of previously reported barriers to accessing cancer care which was reportedly low even before the pandemic. If these effects are not mitigated, the achievements in cancer control that had already been made could be watered down. Measuring the impact of COVID-19 pandemic control measures on delivery of and access to cancer services in Uganda as well as other countries worldwide can inform the design of current and future responses to epidemics while putting into context other diseases like cancer that have a high burden.

Stochastic and Deterministic Mathematical Modeling and Simulation to Evaluate the Novel COVID-19 Pandemic Control Measures

Background: In India, the novel Coronavirus Disease (COVID-19) epidemic has grown to 17,00000 cases and around 38,000 deaths up to 30th July, 2020. The impacts of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic in India were studied using modified age-structured stochastic and deterministic mathematical models. Methods: A compartmental susceptible (S)-infected (symptomatic) (IS) infected (asymptomatic) (IN) recovered (R) i.e., SISINR model is developed, in which the flow of individuals through compartments is modeled using a set of differential equations. The outbreak of the novel COVID-19 pandemic is critically evaluated from all major angles using base, education, vaccination and education and vaccination models based on the modified SISINR transmission network model for their simulations in MATLAB and peak of infected cases (both symptomatic and asymptomatic cases) as well as end of pandemic is predicted in each case. Result: The numerical investigations are done for both stochastic and deterministic studies using the modified SISINR transmission network model for effective prediction about the transmission of SARS-CoV-2 pandemic in India. The progress of the novel COVID-19 pandemic in India is estimated for various scenarios by varying the basic reproduction numbers from mean to extremes (general assumptions and strategies are inculcated through contact tracing based on the values of contact ratio operated for the basic reproduction numbers, 'R0'). The efficacy and potential of the education programs and vaccination programs were established with the published datasets through a validation studies. Furthermore, the outbreak of the novel COVID-19 pandemic is predicted for majorly affected cities in India on the basis of different reproduction numbers 'R0'. Conclusion: The report presented herewith could be referred to revise the government policies to (a) implement mitigatory measures such as the practice of social distancing, partial city lockdown across the nation, etc., (b) implement a 100% daily number of tests to the susceptible population of the nation, (c) improve hospital facilities and the novel COVID-19 wards, (d) improve the recovery rate with the effective implementation of base, education, vaccination and education and vaccination model to attain the equilibrium stage of pandemic at the earliest and (e) meet the objective of preventing the outbreak of the novel COVID-19 pandemic through the effective implementation of control and prevention strategies across the nation.