Early Stages Of Pandemic Research Articles

Coping with Unknown Health Crisis via Social Media: A Content Analysis of Online Mutual Aid Group in the Beginning of the COVID-19 Pandemic.

The initial emergence of SARS-CoV-2 created uncertainty for humanity, driving people to seek assistance on social media. This study aims to understand the role of social media in coping with crises and to offer guidance for future uncertainties by examining the experiences of Wuhan during the early stages of the pandemic. Using quantitative content analysis, this study investigated 2207 Weibo posts tagged with "COVID-19 Mutual Aid" from individuals located in Wuhan during the early lockdown period from January 23, 2020, to March 23, 2020. At the start of pandemic, messages seeking tangible support were most common. A hurdle regression model showed that deeper self-disclosure led to more retransmission of help-seeking messages. The Chi-Square and Mann-Whitney U tests revealed that health professionals and laypeople had different self-disclosure strategies. This study provides insight into the online social support exchange during the early stages of the COVID-19 pandemic in Wuhan, highlighting the importance of self-disclosure on message retransmission, and the differences in self-disclosure strategies between health professionals and laypeople in online help-seeking.

Reactions Among Mental Health Professionals During Early Stages of the COVID-19 Pandemic

The COVID-19 pandemic has challenged mental health professionals in many unexpected ways. Research completed in the years following the pandemic suggests that individuals around the globe have experienced significant mental health difficulties since the start of the pandemic, including posttraumatic stress disorder (PTSD) and complicated grief. Much of this research has examined the general population or medical personnel specifically and has neglected to turn attention to mental health professionals who have been on the frontlines of treating these mental health difficulties. This study fills this gap in the literature by examining mental health professionals’ reactions during the early stages of the pandemic. Sixty-nine mental health professionals completed questionnaires examining trauma, grief, and resilience during the COVID-19 pandemic. Results indicated that 48% of participants met criteria for a provisional diagnosis of posttraumatic stress disorder (PTSD) and 7% were experiencing severe grief. Those who first began using virtual platforms during the pandemic reported less grief and fewer PTSD symptoms. Those with children reported more resilience. Further, resilience mediated the relationship between having children and grief. Resilience and PTSD symptoms independently predicted grief responses. The results suggest the COVID-19 pandemic had profound effects on mental healthcare providers during the early stages of the pandemic.

Who has dominated information spreading on social media during the early stage of COVID-19 pandemic in China? A temporal network analysis

In times of crisis, social media emerges as a pivotal channel for government-public communication. This study delves into the dynamics of a temporal weighted network on Weibo, analyzing 39,567,227 reposted data points related to the COVID-19 pandemic, specifically during its critical early stage. We examine the information dissemination roles of eight distinct user types: state-run news media, non-state-run news media, influential we media, normal we media, celebrities, organizations, governmental departments, and normal users. This is achieved through the application of three centrality metrics: temporal weighted degree centrality (TWDC), temporal weighted closeness centrality (TWCC), and temporal weighted betweenness centrality (TWBC), focusing on three cases (Top 10, Top 20, and Top 50) based on ranking results. Our findings reveal that while state-run news media were prolific in information publishing, their roles as central and mediator agents in information spreading were comparatively weaker than those of non-state-run news media and we media, especially influential we media. This pattern underscores potential risks in false information propagation and highlights gaps in the government's information dissemination strategy during the early stages of the pandemic. The study offers targeted theoretical and practical implications, suggesting how governments might more effectively leverage social media for crisis communication, thereby enhancing their role in combating misinformation and guiding public perception. These insights are crucial for framing more responsive and adaptive communication strategies in the initial phases of a crisis, providing a global blueprint for effective information management in public health emergencies.

Telerehabilitation use and experiences in occupational and physical therapy through the early stages of the COVID-19 pandemic.

Telehealth has helped to increase access to rehabilitative services such as occupational and physical therapy. The early COVID-19 pandemic amplified the need for remote access to care, and the rapid implementation of telehealth systems provided a unique opportunity to learn from clinicians' experiences adopting telehealth for telerehabilitation applications. To understand these experiences, a self-administered online survey was conducted to capture perspectives on ease of telerehabilitation use and adoption from occupational and physical therapists. The survey captured retrospective views on telerehabilitation use pre-pandemic as well as real-time perspectives on telerehabilitation during the early stages of the pandemic (July to August 2020). The survey gathered information on clinician demographics (N = 109), clinicians' experiences with adopting or utilizing telerehabilitation systems, and their perceptions on remotely performing cognitive, emotional, and physical assessments via video-conferencing (a common mode of telehealth). Responses demonstrated a modest increase in telerehabilitation as a care setting (rate increase from 3.4% to 19.3%), and telerehabilitation was more generally tried during the early stages of the pandemic (41 clinicians explicitly reported telerehabilitation use). However, technology access and acceptance remained low, with 38 clinicians (35%) expressing concerns that technology was ineffective or impractical, unavailable, not covered by insurance, or not desired by their patients. Video-conferencing technology was perceived as generally ill-equipped to support clinicians in performing remote assessment tasks. Physical assessment tasks were considered particularly difficult, with 55% of clinicians rating their ability to perform these tasks in the range of moderately difficult to unable to perform. To address these difficulties and better augment clinical care, clinicians require more robust assessment methods that may combine video, mobile, and wearable technologies that would be accessible to a patient at home. When designing future telerehabilitation tools, information captured through these modes must be task-relevant, standardized, and understandable to a remote clinician.

Impact of COVID-19 and restricted self-help group attendance on drinking behavior among people with alcohol use disorder: Results of a nationwide cross-sectional survey.

Concerns regarding symptom severity and the risk of relapse among people seeking recovery from alcohol use disorder (AUD) have been raised since the onset of the COVID-19 pandemic. Owing to preventive measures implemented during the pandemic (social distancing or lockdown), self-help group (SHG) meetings were restricted. However, the impact of deprivation of onsite recovery meetings on drinking behavior and risk among SHG members with AUD remains unclear. We examined the proportion of SHG members who reported drinking and their reasons for drinking during the early stages of the pandemic and the effect of nonattendance at onsite recovery meetings on drinking behavior during the early pandemic period, stratified by gender. A national cross-sectional survey of Japanese SHG members was conducted to measure self-reported alcohol consumption, sociodemographic characteristics, AUD diagnosis, treatment status, SHG meeting attendance, membership duration, psychological distress, and health-related variables. Of 6478 SHG members, 2955 (male: n = 2678; female: n = 277; response rate: 46.7%) responded, and the responses were analyzed using a gender-stratified multivariate logistic regression model. Most participants reported having abstained from alcohol use, while 6% of the respondents reported having consumed alcohol during the early stages of the pandemic. The proportion of "drinkers" among women (10.5%) was significantly higher than that among men (5.9%; p = 0.012). Through multivariate model analysis, the factors associated with drinking during the pandemic were identified as psychological distress (among men and women) and not attending onsite recovery meetings (among men). Conversely, a longer duration of SHG membership was associated with less drinking during the pandemic for both genders. Most SHG members appear to have remained abstinent during the early stages of the COVID-19 pandemic. However, psychological distress in both genders and the inability to attend recovery meetings among men may have influenced drinking behavior.

An exploration of mental health, stress and well-being concerns among health students undertaking rural placements in Australia during the early stages of the COVID-19 pandemic.

The emergence of COVID-19 in 2020 led to an increase in stressors for students on rural placements, but little is known about how this impacted their mental health and well-being. To explore self-reported mental health, stress and well-being concerns among allied health, nursing and medical students who completed a scheduled University Department of Rural Health (UDRH)-faciliated rural placement in Australia between February and October 2020 (n = 1066). Cross-sectional design involving an online survey measuring mental health, stress and well-being concerns. The survey was distributed via email by the 16 UDRHs across Australia. A total of 42.9%, 63.8% and 41.1% of survey respondents reported concerns about their mental health, levels of stress and well-being, respectively, during the early stages of the pandemic. Multiple logistic regression models found clinical training, course progression and financial concerns were predictive of negative mental health, increased stress and reduced well-being, while feeling connected was predictive of positive mental health, reduced stress and increased well-being. Universities, UDRHs and health placement sites all have a responsibility to support the mental health and well-being of students undertaking rural placements. This support needs to encompass strategies to reduce financial stress, protect learning opportunities and increase connectedness. Ensuring adequate resourcing and support for those providing rural placement opportunities will safeguard quality rural placements during times of pandemic disruption.

Informational Justice, Organizational Communication, and Job Insecurity in the Early Stages of the COVID-19 Pandemic

Abstract: The early stages of the COVID-19 pandemic were a time of great job insecurity. Knowledge of how such feelings of insecurity were mitigated during a time of crisis has important implications for the development of future interventions. Drawing from uncertainty management theory (UMT), we explored the impact of informational justice perceptions on the effects of job insecurity in a sample collected during the early stages of the pandemic (March–May 2020). The findings indicated that informational justice buffered the impacts of job insecurity on employee life satisfaction and perceived ability to perform. Furthermore, the source of information regarding COVID-19-related job changes mattered for predicting informational justice perceptions. Our findings bolster UMT and have important practical implications for future times of crisis.

Partisanship, Religion, and Social Class: Attitudes and Behaviors in the Early Stages of the Covid-19 Pandemic

This article investigates differences in health precautions taken during the pandemic and the degree to which individuals had faith in the government’s response to Covid-19 in the early stages of the pandemic. Using a sample designed to be nationally representative as well as representative of three lockdown zones, we find that local social-distancing policies, social class, religion, and political partisanship all influenced how Indonesians experienced the pandemic and their perceptions of the government’s response. We found that fear levels and pandemic behavior are associated with religion as well as economic status. Fear levels are much higher among lowest-paid Indonesians and among Muslims outside of the capital city Jakarta, while non-Muslims reported greater levels of precaution-taking measures. Though among Islamic parties’ voters, the difference is less pronounced, there are notable partisan differences as stronger predictors of attitude and behavior during the pandemic where there have been conflicts between local and national health authorities.

Evaluating the Impact of Executive Orders Lifting Restrictions on Advanced Practice Registered Nurses During the COVID-19 Pandemic

In the early stages of the COVID-19 pandemic, strains on the healthcare system forced many U.S. states to revisit long-standing statutory limitations on the care coordinated by advanced practice registered nurses (APRNs). This was done by issuing waivers via executive, legislative, or board of nursing orders. To identify the impact of temporary practice waivers on APRNs' direct patient care during the COVID-19 pandemic. This cross-sectional study utilized a two-phased approach. First, a confidential online survey was conducted of APRNs practicing across 27 U.S. states. Second, comprehensive APRN discipline data from 2019 to 2021 were retrieved from the National Council of State Boards of Nursing's Nursys database and reviewed. Univariable and multivariable binary logistic regression models were used to determine the significance of observed trends. A total of 16,699 APRNs responded to the survey for a response rate of 14.2%. APRNs practicing in private outpatient clinics, in rural areas, and in health provider shortage areas were more likely to report a positive effect of the practice waiver (all p < .05). Providers noted that the waivers allowed them more time with their current patients and expanded the geographic boundaries of their direct patient care to take on new patients. Furthermore, despite the changing profile of APRN care during the early stages of the pandemic, including a pronounced increase in telehealth usage, the current review found no evidence of an uptick in discipline cases brought against APRNs in 2021. Full practice authority for APRNs benefits patients by promoting expanded access to care and increasing the resiliency of our healthcare system without compromising patient safety. It is time for states and organizations that employ APRNs to recognize that permanently removing barriers to APRN practice is essential to the health of our nation.

How Hospitals Overcame Disruptions in the Early Stages of the COVID-19 Pandemic: A Case Study from Tokyo, Japan

ABSTRACT The COVID-19 pandemic has caused serious disruptions to health systems across the world. While the pandemic has not ended, it is important to better understand the resilience of health systems by looking at the response to COVID-19 by hospitals and hospital staff. Part of a multi-country study, this study looks at the first and second waves of the pandemic in Japan and examines disruptions experienced by hospitals because of COVID-19 and the processes through which they overcame those disruptions. A holistic multiple case study design was employed, and two public hospitals were selected for the study. A total of 57 interviews were undertaken with purposively selected participants. A thematic approach was used in the analysis. The study found that in the early stages of the pandemic, faced with a previously unknown infectious disease, to facilitate the delivery of care to COVID-19 patients while also providing limited non-COVID-19 health care services, the case study hospitals undertook absorptive, adaptive, and transformative actions in the areas of hospital governance, human resources, nosocomial infection control, space and infrastructure management, and management of supplies. The process of overcoming the disruptions caused by the pandemic was complex, and the solution to one issue often caused other problems. To inform preparations for future health shocks and promote resilience, it is imperative to further investigate both organizational and broader health system factors that build absorptive, adaptive, and transformative capacity in hospitals.

Disparities in Physical Activity and Depressive Symptoms among Young Adults in the Early Stage of the COVID-19 Pandemic

Background of the study: The COVID-19 pandemic has deeply impacted people’s daily lives, while the influence on behaviors and mental health among college students at the early stage of this pandemic is rarely studied. Objective: This study examined the impact of the COVID-19 pandemic in the early stage on college students’ physical activity (PA), sedentary behavior, and depressive symptoms and its impact on sex and ethnic disparities in these outcomes. Methods: Using a cross-sectional design, 111 college students were recruited, and the data were collected before COVID-19 (n = 64) and in the early stage of the COVID-19 pandemic (n = 47), respectively. All participants completed a survey measuring depressive symptoms and wore an accelerometer to monitor PA behavior (light PA [LPA], moderate-to-vigorous PA [MVPA]), and sedentary behavior. Results: More MVPA engagement and lower levels of depressive symptoms were observed in the early-stage COVID-19 group compared to the before-COVID-19 group. The magnitude of the sex and ethnicity disparities in PA and depressive symptoms were reduced in the early-stage of the COVID-19 pandemic. Conclusion: Understanding college students’ behaviors and mental health in the midst of a global crisis can be useful to determine appropriate strategies to address health and wellness in the chance of the lockdown returning and to further promote this vulnerable population’s physical and mental wellness.

Impact of policy response on health protection and economic recovery in OECD and BRIICS countries during the early stages of the COVID-19 pandemic

ObjectivesDuring the early stages of the COVID-19 pandemic, the full reopening of the economy typically accelerated viral transmission. This study aims to determine whether policy response could contribute to the dual objective of both reducing the spread of the epidemic and revitalising economic activities. Study designThis is a longitudinal study of Organization for Economic Cooperation and Development (OECD) and Brazil, Russia, India, Indonesia, China, and South Africa (BRIICS) from the first quarter (Q1) of 2020 to the same period of 2021. MethodsFrom a health-economic perspective, this study established a framework to illustrate the following outcomes: suppression-prosperity, outbreak-stagnancy, outbreak-prosperity and suppression-stagnancy scenarios. Multinomial logistic models were used to analyse the associations between policy response with both the pandemic and the economy. The study further examined two subtypes of policy response, stringency/health measures and economic support measures, separately. The probabilities of the different scenarios were estimated. ResultsEconomic prosperity and epidemic suppression were significantly associated with policy response. The effects of policy response on health-economic scenarios took the form of inverse U-shapes with the increase in intensity. ‘Leptokurtic’, ‘bimodal’ and ‘long-tailed’ curves demonstrated the estimated possibilities of suppression-prosperity, outbreak-prosperity and suppression-stagnancy scenarios, respectively. In addition, stringency/health policies followed the inverted U-shaped pattern, whereas economic support policies showed a linear pattern. ConclusionsIt was possible to achieve the dual objective of economic growth and epidemic control simultaneously, and the effects of policy response were shaped like an inverse U. These findings provide a new perspective for balancing the economy with public health during the early stages of the pandemic.

The roles and challenges of the primary health care systems in epidemic management: a scoping review.

During the early stage of pandemics, primary health care (PHC) is the first point of contact with the health system for people. This study aimed to find the leading roles and challenges of the PHC system in dealing with the outbreak of infectious diseases. The current scoping review was conducted in 2022 using the Arkesy and O'Malley framework. A bibliographic search was conducted in PubMed, Web of Science, and Scopus databases. Following a Google Scholar search, a manual search in some journals, reference checks for articles, and a review of organizational reports, websites, and other sources of information were also conducted. Data were analyzed using the content-analysis method. Finally, 65 documents (42 articles and 23 reports, books, and news) were included in the study. Initially, 626 codes were extracted, and 132 final codes were categorized into eight main themes and 44 sub-themes. The main themes for the roles of PHC included: service provision, education and knowledge, surveillance, access, coordination and communication, management and leadership, infrastructure change and rapid preparation, and patient and community management. Regarding the challenges faced by PHC in the epidemic of infectious diseases, 24 key challenges were identified and categorized into four major areas. Based on the results of the present study, there is a need for further studies to formulate and theorize the specific roles of PHC in managing infectious disease epidemics. The results of this study can be utilized by researchers and officials to inform their efforts in addressing this purpose.

Detection of Respiratory Viruses during the Early Phase of the Coronavirus Disease 2019 Pandemic in Ibaraki and Gunma Prefectures, Japan.

Respiratory infections are common, and the most common causative agent is a virus. Therefore, routine surveillance of respiratory viruses is useful in the case of novel viral diseases such as coronavirus disease 2019 (COVID-19). In this study, to clarify the kind of virus involved in suspected cases of COVID-19 in the early stages of the pandemic, we attempted to detect various respiratory viruses in 613 specimens that tested negative for severe acute respiratory syndrome coronavirus 2 using reverse transcription polymerase chain reaction. As a result, viruses were detected in 59 (9.6%) patients. In addition, human rhinovirus (HRV), human metapneumovirus (HMPV), human respiratory syncytial virus, and human parechovirus were detected in 29, 25, 3, and 2 patients, respectively. Although this study was conducted over a short period of time and not all specimens were tested, these results indicate that various respiratory viruses, especially HRV and HMPV, can be detected even during the early stages of the COVID-19 pandemic. Because various respiratory viruses maintain a constant effect during the outbreak of the newly emerged pandemic, systematic surveillance of respiratory viruses is needed during the normal period to make good use for clinical and public health.

The UK Coronavirus Job Retention Scheme and smoking, alcohol consumption and vaping during the COVID-19 pandemic: evidence from eight longitudinal population surveys

BackgroundEmployment disruptions can impact smoking and alcohol consumption. During the COVID-19 pandemic, many countries implemented furlough schemes to prevent job loss. We examine how furlough was associated with smoking, vaping and alcohol consumption in the UK.MethodsData from 27,841 participants in eight UK adult longitudinal surveys were analysed. Participants self-reported employment status and current smoking, current vaping and alcohol consumption (>4 days/week or 5+ drinks per typical occasion) both before and during the early stages of the pandemic (April–July 2020). Risk ratios were estimated within each study using modified Poisson regression, adjusting for a range of potential confounders, including pre-pandemic behaviour. Findings were synthesised using random effects meta-analysis.ResultsCompared to stable employment and after adjustment for pre-pandemic characteristics, furlough was not associated with smoking (ARR = 1.05; 95% CI: 0.95–1.16; I2: 10%), vaping (ARR = 0.89; 95% CI: 0.74–1.08; I2: 0%) or drinking (ARR = 1.03; 95% CI: 0.94–1.13; I2: 48%). There were similar findings for no longer being employed, and stable unemployment, though this varied by sex: stable unemployment was associated with smoking for women (ARR = 1.35; 95% CI: 1.00–1.82; I2: 47%) but not men (0.84; 95% CI: 0.67–1.05; I2: 0%). No longer being employed was associated with vaping among women (ARR = 2.74; 95% CI: 1.59–4.72; I2: 0%) but not men (ARR = 1.25; 95% CI: 0.83–1.87; I2: 0%).ConclusionsWe found no clear evidence of furlough or unemployment having adverse impacts on smoking, vaping or drinking behaviours during the early stages of the COVID-19 pandemic in the UK. Differences in risk compared to those who remained employed were largely explained by pre-pandemic characteristics.

Consumer Behavior and Business Strategy During the Early Stages of the COVID-19 Pandemic

Consumer behavior is dynamic and contextual. An individual’s consumption habit is formed over time and is influenced by many internal and external factors. The consumption habit itself reflects what, where, when, why, and how to choose, purchase, consume, and dispose goods and services. When the COVID-19 pandemic hit, all consumers around the globe were forced to adapt into the never-happened-before realities, such as regional and national lockdowns, stay-at-home campaign, social/physical distancing policy, mandatory quarantine, and self-isolation. Utilizing available and accessible published materials, this paper aims to examine the significant impacts of the outbreak on consumer behavior in Indonesia and identify how the businesses respond to the changes in consumer behavior caused by the coronavirus. The timeframe of the analysis focuses on the early stages of the pandemic. Using the framework developed by Sheth (2020), the present study found supporting evidence of the eight impacts of COVID-19 on consumer behavior (e.g., hoarding behavior, improvisation, and the adoption of digital technology) in Indonesia. Furthermore, companies were found to respond to the pandemic and changes in consumer behavior by employing a combination of four business strategies: survival strategy, synchronizing strategy, stretching strategy, and shifting strategy.

Antimicrobial use and aetiology of bloodstream infections in critically ill patients during early stages of SARS-CoV-2 pandemic

BackgroundDuring early stages of COVID-19 pandemic, antimicrobials were commonly prescribed.AimTo describe clinical, microbiological and antimicrobial use changes in bloodstream infections (BSI) of ICU patients during the first wave of COVID-19 pandemic compared to pre-COVID-19 era.MethodsObservational cohort study of patients admitted to ICU of Bellvitge University Hospital was conducted during the COVID-19 pandemic (March-June 2020) and before COVID-19 pandemic (March-June 2019). Differences in clinical characteristics, antimicrobial consumption and incidence and aetiology of BSI were measured.FindingsCOVID-19 patients had significantly less comorbidities with obesity the only risk factor that increased in frequency. COVID-19 patients more frequently required invasive supportive care measures, had longer median ICU stay and higher mortality rates. The incidence of BSIs was higher in COVID-19 period (RR 3.2 [95%CI 2.2–4.7]), occurred in patients who showed prolonged median ICU stay (21days) and was associated with high mortality rate (47%). The highest increases in the aetiological agents were observed for AmpC-producing bacteria (RR 11.1 [95%CI 2.6–47.9]) and non-fermenting rods (RR 7.0 [95%CI 1.5–31.4]). The emergence of bacteraemia caused by Gram-negative rods resistant to amoxicillin-clavulanate, which was used as empirical therapy during early stages of the pandemic, led to an escalation towards broader-spectrum antimicrobials such as meropenem and colistin which was also associated with the emergence of resistant isolates.ConclusionsThe epidemiological shift towards resistant phenotypes in critically ill COVID-19 patients was associated with the selective use of antimicrobials. Our study provides evidence of the impact of empirical therapy on the selection of bacteria and their consequences on BSI over the subsequent months.

Impact of lockdown and government subsidies on rural households at early COVID-19 pandemic in China

PurposeGiven the scarcity of data during the early stages of the COVID-19 pandemic in China, the decision-making for non-pharmaceutical policies was mostly based on insufficient evidence. The purpose of this study is to assess the effectiveness of these policies, such as lockdown and government subsidies, on rural households and identify policy implications for China and other countries in dealing with pandemics.Design/methodology/approachThe authors survey 2,408 rural households by telephone from 101 counties across 17 provinces in China during the first stage of the pandemic (March 2020). The authors use the ordered probit model and linear regression model to study the overall impact of policies and then use the quantile regression model and sub-sample regression method to study the heterogeneity of the effects of government policies.FindingsThe authors find that logistics disruption due to lockdown negatively affected rural households. Obstructed logistics is associated with a more significant loss for high-income households, while its impact on the loss expectation of low-income households is more severe. Breeding and other industries such as transport and sales suffer more from logistics than cultivation. The impact of logistics on intensive agricultural entities is more serious than that on professional farms. The government subsidy is more effective at reducing loss for low-income households. Lockdown and government subsidies have shown heterogeneous impacts on rural households.Practical implicationsThe overall economic losses experienced by rural households in the early stages of the pandemic are controllable. The government policies of logistics and subsidies should target specific groups.Originality/valueThe authors evaluate the economic impacts of lockdown and government subsidies on rural households and show their heterogeneity among different groups. The authors further demonstrate the policy effectiveness in supporting rural households during the early stages of the pandemic and provide future policy guidance on major public health event.

Hospitalizations for Cardiovascular Diseases During the Early Stage of the COVID-19 Pandemic in Japan.

Background: Although reductions in hospitalizations for myocardial infarction and heart failure have been reported during the period of COVID-19 pandemic restrictions, it is unclear how the overall number of hospitalizations for cardiovascular disease (CVD) treatment changed in the early stages of the pandemic.Methods and Results: We analyzed the records of 574 certified hospitals affiliated with the Japanese Circulation Society and retrieved data from April 2015 to March 2020. Records were obtained from the nationwide Japanese Registry of All Cardiac and Vascular Diseases–Diagnosis Procedure Combination database. A quasi-Poisson regression model was used to estimate the number of hospitalizations for CVD treatment. Between January and March 2020, when the number of COVID-19 cases was relatively low in Japan, the actual/estimated number of hospitalizations for acute CVD was 18,233/21,634 (84.3%), whereas the actual/estimated number of scheduled hospitalizations was 16,921/19,066 (88.7%). The number of hospitalizations for acute heart failure and scheduled hospitalizations for valvular disease and aortic aneurysm were 81.1%, 84.6%, and 83.8% of the estimated values, respectively. A subanalysis that considered only facilities without hospitalization restrictions did not alter the results for these diseases.Conclusions: The spread of COVID-19 was associated with a decreased number of hospitalizations for CVD in Japan, even in the early stages of the pandemic.

Cost-effectiveness of Public Health Strategies on COVID-19 Control: A Systematic Review

The COVID-19 pandemic has been one of the greatest public health challenges imposing significant economic and societal costs. A wide range of public health interventions (PHIs) have been implemented to control the virus, with many aggressive measures that led to economic downturn and social calamity. However, evidence concerning their impacts in terms of costs and benefits of the best buy strategy is limited. This systematic review aimed to provide a critical summary of full economic evaluations (EEs) to inform decisions concerning their adoptions. A systemic search in 7 relevant databases and other sources were conducted. Out of 11,584 and 11 records identified from databases and other sources, a total 31 full EEs focusing on PHIs were included. Majority of studies included were in good quality and from the US and upper-middle, and high-income countries whereas only 6 studies were from low and middle-income countries. Suppression/containment was the most deployed strategy (n = 19), followed by screening/detection (n = 8), and protection (n = 4). Aggressive elimination strategy usually results in more lives or QALYs saved compared to mitigation strategies but at a very high cost. The trade-off between aggressive and loose suppressions depends on several factors including timing of implementation, duration, epidemiological characteristics of the virus, and the healthcare capacity. Tight and timely adoption of effective intervention at the early stage of pandemic is key in shrinking the number of cases. Using a combination approach is generally more cost-effective compared to a single intervention. Personal protective measure is highly cost-effective in protecting healthcare workers in a high prevalence scenario and when it is adopted together with social distancing strategy. Future studies to address the flaws of current evidence are warranted. This review provides important insights regarding adoption of PHIs and their cost-effectiveness which would be useful to inform policy decisions in response to COVID-19 and future pandemics.