Epidemiological Reasons Research Articles

A Rat's Progress: Plague and the "Migratory Rat" in British India, 1896-1899.

Whether referring to oceanic travel on board of ships or to movement in terra firma, framings of the "migratory rat" formed a key epidemiological component of approaches to the Third Plague Pandemic (1894-1959) as the first pandemic to be understood as caused by a zoonotic disease. In this article, I examine the emergence and development of scientific framings of the migratory rat in the first, explosive years of the third plague pandemic in India (1896-1899). Examining publications and archival sources, I ask how this animal figure came to inform and transform epidemiological reasoning. Going beyond established approaches that have shown how the rat-plague relation was mobilised by colonial doctors to pathologise Indigenous lifeways, I argue that more complex and ambivalent processes were also set in motion by this figure. First, I show how the migratory rat became invested with attributes of invasiveness that assumed ontological qualities in colonial epidemiological reasoning. Second, comparing the migratory rat with the hitherto established "staggering rat," I argue that the former embodied new approaches to both space and time in epidemiology. Third, I show how Indigenous scientists came to mobilise this complex figure to contest colonial approaches to plague.

Prevalence of some metallo β-lactamase enzymes genes in P. aeruginosa isolated from different clinical sample in Baghdad, Iraq

The increasing challenge of carbapenem antibiotics resistance caused by Pseudomonas aeruginosa is one of the global healthcare problems. P. aeruginosa is a significant opportunistic infection. For epidemiological reasons, identifying resistance genes is essential, and it is also desirable to quickly identify the techniques for producing carbapenemase enzymes. So, the study aims to determine the prevalence of beta-lactamase encoding genes (blaIMP, blaVIM, bla GIM, and bla SPM) phenotypically and genotypically in P. aeruginosa isolates to address the epidemiological spread of these genes in Baghdad city. The study identified P. aeruginosa isolates from various clinical sources by chemical characterization and VITEK 2 system, the antibiogram test, phenotypic screening carbapenem resistance by Combined disk synergy test (CDST), and conventional PCR were used to detect presence of VIM, IMP, SPM, and GIM genes. Bacterial susceptibility testing revealed (40 %) of isolates were resistant to Imipenem and (85 %) of them positive to CDST. Genotypic screening on phenotypic Metallo-β-lactamase isolates showed that (100 %) isolates contained blaVIM genes, blaGIM genes (88 %), whereas (65 %) isolates carried blaSPM genes. In this investigation, there was no evidence of blaIMP among carbapenem-resistant isolates. The study appeared high prevalence of multi-drug resistance P. aeruginosa isolates that produce carbapenemase enzymes and having β-lactamase genes in local hospitalized patients compared to global ratio. Expanding the sample size and types of enzymes screening in MDR P. aeruginosa should be the main focus in the future research.

The meta-governance of quality registries for public health

Abstract Issue/problem Healthcare-related planning and policy requires evidence, which in turn requires data. Generating sensitive, high-quality data is expensive. Given the constraints of routine or study-related data for quality monitoring, quality registries are commonly used. But when is it adequate, from a public health meta-governance point of view, to establish dedicated quality registries? Description of the problem Many countries have established public patient registries over time. The lack of a meta-governance framework complicates decision-making for establishing and funding dedicated quality registries. Simultaneously, legal advancements like the European Health Data Space may enhance the use of routine data in healthcare policy, potentially transforming both registry and meta-governance practices. Results We identified key meta-governance challenges, such as setting criteria for the creation, modification, or closure of registries, deciding on public funding and choosing between routine and specially collected data. We argue against using absolute thresholds like disease prevalence, advocating for a scorecard approach that evaluates epidemiologic reasoning, policy relevance, healthcare impact and factors like data availability and registry synergies. Lessons The EHDS will enable enhanced secondary data use, necessitating decisions on when to use routine versus specifically collected data. Decision-makers must consider sustainability, ethics, practicability and data linkability, while recognizing risks such as data quality limitations and potential bias from original data collection purposes. Key messages • The necessity for quality registries varies by case, serving specific policy questions. Optimizing funds and avoiding arbitrary decisions require a strategy based on a meta-governance framework. • With the introduction of EHDS, the focus may shift more toward data curation and quality control, making it critical to align registry efforts with the broader health information system.

COVID-19 school closures in Latin America: untangling approaches impacting student health and wellbeing

PurposeThis study compared approaches to school closures in four Latin American countries (Bolivia, Colombia, Ecuador, Peru), describing the impact on the health and educational wellbeing of school-age children and youth, and evaluating their approaches in regard to continuing education through the pandemic.Design/methodology/approachWe collected 75 publicly available documents including scientific and gray literature (government documents and news releases), that referred to school closures and their impact on children’s health and wellbeing. We did thematic analyses using open, axial, and selective coding and applied the latest Health Promoting Schools standards and indicators to the findings.FindingsResults showed that countries followed epidemiological reasons for prioritizing school closures while adopting some policies that abide by Health Promoting School principles. While they emphasized the need to reopen schools so that instruction could continue, school closures were among the longest in the world. The most significant impacts on wellbeing identified in the four countries were related to food security and mental health.Research limitations/implicationsThis study focused on a particular set of documents, and it may not capture the full spectrum of relevant information in different contexts or regions.Practical implicationsBy comparing school closures approaches among four Latin American countries, this study highlights the importance of context-specific interventions. In a post-pandemic era, lessons learned from these experiences should help foster more resilient and inclusive educational systems and explore the paths forward for following the new Health Promoting Schools framework in the region.Originality/valueCross-country qualitative analyses on this topic are rare. This study adds to the knowledge base by eliciting lessons for future health education research and policy efforts.

Sentinel surveillance of COVID-19: the importance of epidemiologic concepts and reasoning.

Sentinel surveillance of COVID-19: the importance of epidemiologic concepts and reasoning.

Engaging the public in decisions about emergency vaccine deployment strategies: Lessons from scenario-based discussions in Sierra Leone

ABSTRACT The COVID-19 pandemic has amplified discussions on emergency vaccine deployment strategies, with current perspectives often neglecting extensive community involvement in ethical, logistical and political aspects. Existing social science literature predominantly delves into factors influencing trust, overlooking the untapped potential for community engagement. Our study examines community preparedness in Sierra Leone’s Kambia District, exploring diverse viewpoints on vaccine deployment strategies, emphasising Ebola and COVID-19 vaccinations. Utilising extensive ethnographic research from the Ebola vaccine trials (EBOVAC Salone) conducted in Kambia District from 2015 to 2021, including participant observation and tailored focus group discussions, we investigated various deployment scenarios with community leaders and citizens. Our findings underscore the multifaceted contributions of social science research with communities in shaping emergency vaccination strategies. These contributions span logistical insights, aligning campaigns with local livelihoods and social structures, and grounded ethical concerns assessing social justice outcomes across epidemic scenarios. This study emphasises the imperative of integrating discussions on vaccine confidence and deployment. It highlights communities’ proficiency in epidemiological reasoning and their ability to bring this in conversation with salient socio-cultural, economic and religious dimensions. We therefore promote the cultivation of public dialogue, collaborative creation of impactful vaccination initiatives alongside relevant communities in recognition of their invaluable perspectives .

Mpox across countries from Central and Eastern Europe - 2022 outbreak

BackgroundThe aim of the study was to assess socio-demographical characteristics, clinical presentation, and outcomes in patients diagnosed with mpox. MethodsA survey on patients diagnosed with mpox was performed in 14 countries from Central and Eastern Europe. Data was compared according to HIV status and country of origin (EU vs. non-EU). Mpox diagnosis was confirmed by RT-PCR from oropharyngeal swabs, skin lesions, and other body fluids. ResultsOut of 154 patients confirmed with mpox in 2022, 99.3% were males, with a median age (years) of 35 (IQR 30–39), 90.2% MSM and 48.7% PLWH. Compared to HIV-negative subjects, PLWH had more frequent high-risk behaviours:chemsex (p = 0.015), group sex (p = 0.027), and a history of sexually transmitted infections (STIs) (p = 0.004). Persons from EU were more often PLWH (p = 0.042), MSM (p < 0.0001), had multiple sexual partners (p = 0.025), practiced chemsex (p = 0.008) or group-sex (p = 0.005) and had more often history of STIs (p < 0.0001). The median CD4 cell count/mL at mpox diagnosis was 713 (IQR 486–996) and 73.5% had undetectable HIV VL. The commonest clinical features were fever (108 cases), lymphadenopathy (78), and vesiculo-pustular rash: penile (76), perianal (48), limbs (67). Fifty-one (31%) persons were hospitalized due to complications or epidemiological reasons. Three patients received tecovirimat or cidofovir. The outcome was favorable for all patients, including 4 with severe forms. ConclusionsMpox was diagnosed predominantly in young MSM, with high-risk behaviors and history of STIs. Effective contact tracing and vaccination are important strategic pillars to control mpox outbreaks.

An eco-epidemiological analysis of dengue outbreak in Port Blair, South Andaman Island, India.

In Port Blair, the capital of Andaman & Nicobar Islands, in the Bay of Bengal, India, there was a sudden increase in fever cases resembling the symptoms of dengue in the monsoon period of 2022. Hence, an investigation was carried out to find out epidemiological and entomological reasons behind the outbreak. An entomological survey was carried out in 24 wards of Port Blair Municipal Council (PBMC) area, epidemiological data of last six years (January-December 2017-2021 and January-October 2022) and patient details of the year 2022 were collected. Both the epidemiological and entomological data were analyzed concerning time and place. During this outbreak period tyres (22.4%) came out as a major breeding habitat followed by small discarded materials (17.5%), metal drums (15.3%), and plastic drums (11.7%). In rainy season, peri-domestic breeding (55%) was more than the domestic breeding (45%) habitat. Ae. aegypti had a high preference for indoor large containers (100-1000 L) like plastic tank, metal drum and cement tank whereasAe. albopictus prefers to breed in medium sized plastic container (20-100 L) and outdoor water receptacles like tyres, flower pots, and domestic discarded materials. By source reduction, indoor space spray and outdoor fogging, vector density was controlled which curtailed the transmission and within eight weeks a decreasing trend of dengue cases was noticed. A regular entomological survey is crucial to know the seasonality and key breeding habitats of the vector for proper planning of vector control.

Differences in oxazolidinone resistance mechanisms and small colony variants emergence of Staphylococcus aureus induced in an in vitro resistance development model

ABSTRACT Invasive Staphylococcus aureus infections are associated with a high burden of disease, case fatality rate and healthcare costs. Oxazolidinones such as linezolid and tedizolid are considered potential treatment choices for conditions involving methicillin resistance or penicillin allergies. Additionally, they are being investigated as potential inhibitors of toxins in toxin-mediated diseases. In this study, linezolid and tedizolid were evaluated in an in vitro resistance development model for induction of resistance in S. aureus. Whole genome sequencing was conducted to elucidate resistance mechanisms through the identification of causal mutations. After inducing resistance to both linezolid and tedizolid, several partially novel single nucleotide variants (SNVs) were detected in the rplC gene, which encodes the 50S ribosome protein L3 in S. aureus. These SNVs were found to decrease the binding affinity, potentially serving as the underlying cause for oxazolidinone resistance. Furthermore, in opposite to linezolid we were able to induce phenotypically small colony variants of S. aureus after induction of resistance with tedizolid for the first time in literature. In summary, even if different antibiotic concentrations were required and SNVs were detected, the principal capacity of S. aureus to develop resistance to oxazolidinones seems to differ between linezolid and tedizolid in-vivo but not in vitro. Stepwise induction of resistance seems to be a time and cost-effective tool for assessing resistance evolution. Inducted-resistant strains should be examined and documented for epidemiological reasons, if MICs start to rise or oxazolidinone-resistant S. aureus outbreaks become more frequent.

Integrating Hill’s classical considerations with modern causal inference methods in observational studies: a ‘How-Questions’ framework

Abstract Context Modern causal inference methods – although core to epidemiological reasoning – may be difficult to master and less intuitive than Hill’s classical considerations. We developed a ‘How-Questions’ (HQ) framework to integrate Hill's classical considerations with modern causal inference methods in observational studies. Methods First, we extracted the main causal considerations from contemporary philosophy of science: characteristics of empirical associations, universality, depth, and degree of corroboration of a theory. From these, we developed a HQ framework based on six domains formulated as questions: (1) how valid?, (2) how time-ordered?, (3) how big?, (4) how shaped?, (5) how replicable?, and (6) how explainable? Then, we qualitatively checked whether Hill's classical considerations and key selected modern causal inference methods were compatible with the HQ framework. Lastly, as a proof-of-concept, we applied the HQ framework to two observational studies of current topics in epidemiology. Findings Both Hill’s considerations and key selected modern causal inference methods were compatible with the six domains of the HQ framework. (1) The how-valid domain is addressed by considering the same internal validity issues in Hill’s and modern methods, namely confounding, selection and measurement biases; modern methods use more formalized techniques, including quantitative bias analyses/sensitivity analyses (QBA/SA). (2) The how-time-ordered domain is addressed by considering reverse causation in Hill’s; modern methods may use G methods within the context of longitudinal data analyses and time-varying exposures. (3) The how-big domain is addressed by strength of association in Hill’s; modern methods first consider estimands and may use QBA/SA to assess robustness of effect estimates. (4) The how-shaped domain is represented by biological gradient in Hill’s; modern methods may use generalized propensity scores to estimate dose-response functions. (5) The how-replicable domain is addressed in Hill’s by consistency of study findings with existing evidence; modern methods may use triangulation of different study designs and consider generalizability and transportability concepts. (6) The how-explainable domain is addressed by biological plausibility in Hill’s and by mediation/interaction analyses in modern methods. The application of the HQ framework to two observational studies provides a proof-of-concept and suggests its potential usefulness to integrate Hill’s considerations with modern causal inference methods. Perspective We found that the six dimensions of the HQ framework integrated Hill’s classical considerations with modern causal inference methods for observational studies. Apart from its potential pedagogical value, the HQ framework may provide a holistic view for the causal assessment of observational studies in epidemiology.

An eco-epidemiological analysis of Dengue outbreak in Port Blair, South Andaman Island, India, during 2022.

In Port Blair, the capital of Andaman & Nicobar Islands, in the Bay of Bengal, there was a sudden increase in fever cases resembling the symptoms of dengue in the monsoon period of 2022. Hence, an investigation was carried out to find out both epidemiological and entomological reasons behind the outbreak. An Entomological survey was carried out in 24 wards of Port Blair Municipal Council (PBMC) area, epidemiological data of last six years (January to December of 2017-2021 & January to October of 2022) and patient details of the year 2022 were collected. Both the epidemiological and entomological data were analyzed concerning time and place. During this outbreak period tyres (22.4%) came out as a major breeding habitat followed by small discarded materials (17.5%), metal drums (15.3%), and plastic drums (11.7%). In rainy season peri-domestic breeding (55%) was more than the domestic breeding (45%) habitat. Ae. aegypti had a high preference for indoor large containers (100-1000 L) like plastic tank, metal drum and cement tank whereas Ae. albopictus prefers to breed in medium sized plastic container (20-100 L) and outdoor water receptacles like tyres, flower pots, domestic discarded materials etc. By source reduction, indoor space spray and outdoor fogging vector density was controlled which curtailed the transmission and within 8 weeks decreasing trend of dengue cases were noticed. A regular entomological survey is very important to know the seasonality and key breeding habitats of the vector for proper planning of vector control.

Multicentric evaluation of sensitivity of eight commercial anti-SARS-CoV-2 antibody assays and their correlation to virus neutralization titers in seropositive subjects

Diagnosis of SARS-CoV-2 virus is mainly based on direct detection. Determination of specific antibodies has been used mostly for epidemiological reasons. However, select immunoassays showed good correlation to plaque reduction virus neutralization test (PRNT) in smaller patient cohorts, which suggests their potential as predictors of virus neutralization titer. A total of 3,699 samples from Covid-19 patients were included in the multicentric study performed in the Czech Republic. Anti-SARS-CoV-2 antibody levels were evaluated by 8 commercial antibody assays. Simultaneously, PRNT evaluations were performed with the SARS-CoV-2 B.1.258 variant. All immunoassays showed an overall high true positive diagnostic value ranging from 79.17 to 98.04%. Several commercial EIA methods showed highly positive correlation between the assay results and PRNT levels, e.g., Liaison CoV-2 TrimericS IgG DiaSorin (Spearman r = 0.8833; Architect SASRS-CoV-2 IgG Abbott (r = 0.7298); NovaLisa SARS-CoV-2 IgG NovaTec (r = 0.7103) and Anti-SARS-CoV-2 ELISA IgG Euroimmun (r = 0.7094). While this correlation was less positive for other assays, those, conversely, presented higher true positive values. For most immunoassays, the positive percent agreement of the results was ≥ 95% in sera exhibiting PRNT levels of 1:80 and higher. The assays tested have shown variable correlation to PRNT. Those possessing high positive predictive values serve well as qualitative tests, while others can be utilised as quantitative tests highly predictive of neutralization antibody levels.

Prevalence and mortality of ceftazidime/avibactam-resistant KPC-producing Klebsiella pneumoniae bloodstream infections (2018–2022)

IntroductionCeftazidime/avibactam-resistance in Klebsiella pneumoniae carbapenemase-producing Klebsiella pneumoniae (KPC-Kp) is a topic of great interest for epidemiological, diagnostic, and therapeutical reasons. However, data on its prevalence and burden on mortality in patients with bloodstream infection (BSI) are lacking. This study was aimed at identifying risk factors for mortality in patients suffering from ceftazidime/avibactam-resistant KPC-Kp BSI.MethodsAn observational retrospective study (January 2018–December 2022) was conducted at a tertiary hospital including all consecutive hospitalized adult patients with a ceftazidime/avibactam-resistant KPC-Kp BSI. Data on baseline clinical features, management, and admission outcomes were analyzed.ResultsOver the study period, among all the KPC-Kp BSI events recorded, 38 (10.5%) were caused by ceftazidime/avibactam-resistant KPC-Kp strains, 37 events being finally included. The ceftazidime/avibactam-resistant KPC-Kp strains revealed susceptibility restoration to at least one carbapenem in more than 60% of cases. In-hospital and 30-day all-cause mortality rates were 22% and 16.2%, respectively. Non-survivors suffered from more baseline comorbidities and experienced a more severe ceftazidime/avibactam-resistant KPC-Kp BSI presentation (i.e., both the Pitt Bacteremia and INCREMENT-CPE scores were significantly higher). Presenting with a higher Charlson Comorbidity Index, chronic kidney disease—KDIGO stage 3A or worse—having recently gone through renal replacement therapy, having suffered from an acute kidney injury following the ceftazidime/avibactam-resistant KPC-Kp BSI, and being admitted for cardiac surgery were the strongest predictors of mortality.ConclusionCeftazidime/avibactam resistance in KPC-Kp BSI easily emerged in our highly KPC-Kp endemic area with remarkable mortality rates. Our findings might provide physicians possibly actionable information when managing patients with a ceftazidime/avibactam-resistant KPC-Kp BSI.

Sufficient conditions for causal reasoning in mixtures epidemiology

Sufficient conditions for causal reasoning in mixtures epidemiology

When the Unknown Is Unknowable: Confronting Diagnostic Uncertainty.

The neonatology literature often refers to medical uncertainty and specifically the challenges of predicting morbidity for extremely premature infants, who can have widely varying outcomes. Less has been written about situations in which diagnoses are simply unknown or unattainable. This case highlights the importance of communication amidst uncertainty from a lack of knowledge about aspects of a patient's condition. Using epidemiologic and clinical reasoning, the authors challenge the assumption that diagnostic uncertainty must necessarily portend prognostic uncertainty. When physicians' quest for a diagnosis becomes burdensome and detrimental to the infant's quality of life, this should be abandoned and replaced by focusing on prognosis. The authors focus on the shift of the physician's role toward one of support, assisting the family in ascribing meaning to the dying experience. By focusing on prognosis and support, communication can proceed with more clarity, understanding, and empathy.

The Effect of Helicobacter pylori Density on Serum Vitamin B12 and Folate Levels in Patients With Non-atrophic Gastritis.

Introduction Chronic infection with Helicobacter pylori (Hp) is an essential cause of gastrointestinal pathologies in adults. Despite being a microorganism proven to play a role in vitamin B12 deficiency by causing gastric atrophy, Hp's role in patients with non-atrophic gastritis has not been fully explained. Our study investigated whether the presence and density of Hp is related to vitamin B12 and folate deficiencies in patients with non-atrophic gastritis. Methods This retrospective cohort study analyzed the following parameters, vitamin B12, folate, and mean red blood cell volume (MCV) in the hemogram; these were measured simultaneously in patients diagnosed with non-atrophic gastritiswho had undergone gastroscopy to investigate Hp levels. Patients with conditionsthat could have caused vitamin B12 and folate deficiencieswere excluded from the study. The study included 244 patientswho met the criteria. The Sydney classification was used for histopathologic grading and staging of gastric biopsies of patients with gastritis. Results There was no relationship between the presence and density of Hp with vitamin B12 levels. However, folate levels were significantly lower in Hp-positive patients than in Hp-negative patients (p = 0.017). Folate levels were substantially lower in patients with chronic pan-mucosal gastritis than in patients with chronic inactive gastritis (p = 0.034). Statistically, a significant difference was found between folate levels on the basis of neutrophil activity and inflammation score (p = 0.011 and p <0.001, respectively). Conclusions Although there was no statistically significant relationship between the presence and density of Hp and vitamin B12, our study found an association between folate levels and Hp density. This may be associated with the time for the depletion of vitamin B12 and folate stores and the relatively early stage of gastritis. In cases with vitamin B12 and folate deficiencies, appropriate studies should be performed for specific epidemiological reasons in respective fields.

Исследование современных экономических кризисов и их влияния на деятельность организаций

Economic crises affect modern organizations for different financial and epidemiological reasons. Sustainable development of the organization requires to a change the model of managerial decision-making. The purpose of the study is to identify the features of the crisis phenomena impact on the organization’s activities and to create a model of managerial decision-making that ensures adaptation to environmental challenges and sustainability of development. The authors use the analysis of open source content, systematization, tables; comparative, economic and morphological analysis. The authors analyze the impact of crises on the development of Russian organizations. The research shows that a crisis can have both negative and positive consequences for organizations. In order for an organization to benefit from the crisis, it is necessary to identify risks and weaknesses, assess emerging opportunities. A model of managerial decision-making in an organization under the conditions of the external uncertainty is proposed.

Mpox in pregnancy: Management, risks and challenges in Africa and lessons from the COVID-19 pandemic.

Data on mpox in pregnancy are currently limited. Historically, only 65 cases in pregnancy have been reported globally since mpox was discovered in 1958. This includes 59 cases in the current outbreak. Vertical transmission was confirmed in one patient. Pregnant women are at high risk of severe disease owing to immunological and hormonal changes that increase susceptibility to infections in pregnancy. African women appear to be at higher risk of mpox infection and adverse outcomes in pregnancy for epidemiological and immunologic reasons, in addition to the background high rates of adverse feto-maternal outcomes in the region. This risk is potentially heightened during the COVID-19 pandemic due to the possibility of mpox virus exportation/importation as a result of the lifting of movement restrictions and trans-border travels between countries affected by the current outbreak. Furthermore, coinfection with mpox and COVID-19 in pregnancy is possible, and the clinical features of both conditions may overlap. Challenges of diagnosis and management of mpox in pregnancy in Africa include patients concealing their travel history from healthcare providers and absconding from/evading isolation after diagnosis, shortage of personal protective equipment and polymerase chain reaction testing facilities for diagnosis, vaccine hesitancy/resistance, and poor disease notification systems. There is a need for local, regional and global support to strengthen the capacity of African countries to address these challenges and potentially reduce the disease burden among pregnant women in the continent.

Health care for school children. Part 2

The paper presents the Student Health Care Act of 2019. It shows in detail the scope of application of this legal act which children are covered by its protection and what types of benefits are provided to them. It also indicates the entities involved in the creation of the students' health care system and discusses their responsibilities. Particular emphasis is placed on the rules of giving consent to health care at school, depending on its types. The latest regulations regarding the duties and rights of the school headmaster in the event of a threat to children's health for epidemiological reasons were also discussed, in particular the possibility of suspending in-person learning and implementing remote learning.

Statistical Assessment of Biogenic Risk for the Human Population from New Viral Infections Based on COVID-19

Introduction. Understanding the epidemic curve and spatiotemporal dynamics of SARS-CoV-2 virus is of fundamental importance for the work of the health system during epidemic and pandemic periods. Firstly, the data obtained allow us to assess the epidemiological characteristics of the virus. Secondly, it becomes possible to develop and coordinate measures to counter the spread of COVID-19, to allocate resources reasonably. The work objective is to create and initialize a mathematical model of the epidemic process, which makes it possible to explain the observed dynamics, to predict its development and to assess the reliability of such forecasts. Materials and Methods. Scientific research was based on the statistical data analysis. A hierarchy of mathematical models describing the dynamics of the spread of a new coronavirus infection (COVID-19) and the mortality of COVID-positive patients from 12.02.2020 to 22.09.2021 has been constructed. The incidence submodel reflects regular (aperiodic and periodic), as well as random components. To study and predict the processes, the classical technique of time series research, correlation and Fourier analysis were used. This approach allowed using the method of moments to identify the statistical properties of the scientific research object, and then visualize the stages and algorithm of work. Results. An optimistic, pessimistic and intermediate scenario of infection spread has been mathematically investigated. Their strengths and weaknesses are noted. Numerical characteristics of the trend model and the model of fluctuations in the incidence of COVID-19 are systematized in the form of tables. Based on these data, a conclusion is formulated about the optimality of the pessimistic model: after the highest possible indicators, the infection curve reaches a plateau, and the virus remains in the population. It has been established that the spread of a new coronavirus infection has a pronounced seasonal character with a period of 1/3 of the year. Mathematical analysis and modeling of the mortality dynamics of COVID-positive patients revealed weekly fluctuations in the level of deaths. At the same time, it turned out that the maximum risk corresponds to the 15th and 22nd day of infection. According to the hypothesis proposed by the authors, this virus will be characteristic of the human population. The mortality rate is expected to be 1.75 %. The calculations have shown that the influence of random components of morbidity and mortality will correspond to seasonal fluctuations. Discussion and Conclusion. The probable frequency of the epidemic has been established — three times a year. The potential mortality rate is determined as constant. It is caused by epidemiological and organizational reasons, i. e. the work of medical institutions and authorities. Taking into account the features of the new coronavirus strain (omicron), it is possible to predict the further dynamics of the pandemic and make recommendations regarding its prevention. The authors believe that vaccination should be carried out three times a year. Optimal periods of vaccination campaigns:05. 02–15. 02, 17. 05–28. 05, 24. 09–5. 10.