COVID-19 Incidence Rates Research Articles

Temporal Trends of Early COVID-19 Infections in New York City Transit Workers and Residents: March 01, 2020-May 02, 2020.

The continuity of public transportation was necessary during the COVID-19 pandemic so that essential workers could report for duty. Therefore, it is important to consider COVID-19's impact on transit workers themselves. We described COVID-19 incidence rates over time in New York City (NYC) transit workers and the NYC general population during March-May, 2020. NYC transit COVID-19 cases were abstracted from occupational injury and illness logs, and health department data was used to ascertain NYC resident cases. COVID-19 rates among transit workers peaked during the week of March 22-28 (429.8 cases/100,000 workers). The peak in transit workers occurred 1-2weeks before the general public's peak (March 29-April 4: 368.8 cases/100,000 people; April 5-11: 357.8 cases/100,000 people). These data suggest that NYC transit workers may have been impacted by COVID-19 earlier than the general public. Thus, improving early detection and response of respiratory disease outbreaks may be vital to protecting transit workers.

Exploring demographic, healthcare, and socio-economic factors as predictors of COVID-19 incidence rate: A spatial regression analysis.

This study investigated the relationship between demographic, healthcare, and socio-economic factors, and COVID-19 incidence rate per 100,000 population in Thailand at the province level between January 2020 and March 2022, using a five-phase approach by spatial analysis. OLS models were initially used with significant variables: household, hospital, and industry density, nighttime light index (NTLI). Spatial dependency led to spatial error (SEM) and spatial lag models (SLM), performing better with similar significant variables being applied. SEM explains 58, 65 and, 70 percent in Wave 1, 4 and 5 of COVID-19 variation. SLM explains 25 and 76 percent in Wave 2 and 3 of incidence rate. Positive associations were found between incidence and household density, hospital/medical establishments with beds, Nighttime Light Index (NTLI), and negative with population, hospital, and industry density. Wave 5 showed significant changes with negative for household, hospital, and industry density, urban population; positive for hospital/medical establishments with beds, internet access, NTLI. The study showed that significant predictors of COVID-19 incidence rate vary across waves. Population, household and hospital density, urbanization, access to medical facilities, industrialization, internet access, and NTLI all play a role. The study suggests SEM and SLM models are more appropriate, providing useful information for policymakers and health officials in managing pandemic in Thailand.

Influence of socioeconomic aspects on morbidity and mortality rates from COVID-19 in the state of Tocantins, Brazil

This study aimed to analyze the spatial correlation of COVID-19 with social vulnerability indices in the state of Tocantins. Methodology: An ecological and cross-sectional study was conducted, analyzing the temporal evolution of the pandemic using the local bivariate Moran's index and the Kernel intensity estimator for COVID-19 cases in Tocantins from 2020 to 2022. Results: The northern region of the state showed the highest concentration of cases and deaths, a concerning fact given the high social vulnerability of most municipalities in this region. Conclusion: The study identified a positive spatial correlation between the incidence and mortality rates of COVID-19 and the social vulnerability index of the municipalities. These findings highlight the need to strengthen preventive measures and expand the physical, technological, and human resources of the healthcare network, especially in areas serving populations with higher vulnerability and traditional communities. This is particularly relevant as the disease also affects more isolated areas, impacting indigenous, riverside, and quilombola populations.

Projections of anxiety disorder prevalence during and beyond the COVID-19 pandemic in Germany using the illness-death model.

Although there is now substantial evidence on the acute impacts of the COVID-19 pandemic on anxiety disorders, the long-term population impact of the pandemic remains largely unexplored. To quantify a possible longitudinal population-level impact of the pandemic by projecting the prevalence of anxiety disorders through 2030 among men and women aged up to 95 years in Germany under scenarios with varying impacts of the pandemic on the incidence of anxiety disorders. We used a three-state illness-death model and data from the Global Burden of Disease Study to model historical trends of the prevalence and incidence of anxiety disorders. The German population projections determined the initial values for projections. The COVID-19 incidence rate data informed an additional incidence model, which was parameterised with a wash-in period, delay, wash-out period, incidence increase level and decay constant. When no additional increase in the incidence during the pandemic waves during 2020-2022 was assumed, it was estimated that 3.86 million women (9.96%) and 2.13 million men (5.40%) would have anxiety disorders in 2030. When increases in incidence following pandemic waves were assumed, the most extreme scenario projected 5.67 million (14.02%) women and 3.30 million (8.14%) men with the mental disorder in 2030. Any increased incidence during the pandemic resulted in elevated prevalence over the projection period. Projection of anxiety disorder prevalence based on the illness-death model enables simulations with varying assumptions and provides insight for public health planning. These findings should be refined as trend data accumulate and become available.

Mental health disparities across sexual orientations during the COVID-19 pandemic: Longitudinal analysis of a UK nationally representative cohort

ObjectivesDuring COVID-19, sexual minority groups may have experienced heightened mental health challenges, amplified by unique stressors and the effects of pandemic-related restrictions. This study investigates the differential impact of the pandemic on mental health across sexual orientations, leveraging population-representative data to explore these disparities. Study designProspective cohort design. MethodsData from the United Kingdom Household Longitudinal Study (waves 8–12) was used. Monthly COVID-19 incidence rates at the regional level were used to indicate pandemic severity. Mental health outcomes were evaluated using the Mental Component Score of the Short Form-12 (MCS-12) survey. To examine whether COVID-19 led to differential impacts across sexual orientation, fixed-effect longitudinal models were employed, controlling for individual and time-variant covariates. ResultsLesbian women experienced a significant mental health decline during the COVID-19 pandemic, with a 3.10 MCS-12 score decrease (95 % confidence interval (CI): -5.77 to -0.43) and an 11.0 % higher likelihood of depression (95%CI: -0.3 % to 22.3 %, p = 0.057) compared to heterosexual women. Conversely, the impact on the mental health of heterosexual women was negative but not significant (-0.22; 95%CI: -0.47 to -0.04). Bisexual individuals and other women showed non-significant mental health declines. For men, COVID-19's effect on heterosexuals was similarly non-significant (-0.21; 95%CI: -0.48 to 0.1), with no significant differences observed in gay, bisexual, and other men. ConclusionsSexual minority individuals, especially lesbian women, faced heightened mental health challenges during COVID-19, emphasizing the urgency for targeted interventions.

A Longitudinal Investigation of the Prevalence and Incidence of Self-Reported COVID-19 Disease and the Pandemic's Impact Among Seventh-day Adventist and Non-Adventists Living in the UK.

This research investigated the prevalence and incidence of COVID-19 infection among Seventh-day Adventist Christians in the UK compared to non-Adventists and assessed the pandemic's impact on their health and dietary intake. Seventh-day Adventists and non-Adventists in the UK completed an online survey, including a Food Frequency Questionnaire, a 24-h dietary recall, and health and lifestyle questions. Participants were followed for 2years to determine COVID-19 incidence rates. The baseline survey was completed by 170 people, 86 of whom were Adventists. The follow-up at 2years showed a significantly lower self-reported COVID-19 incidence among Adventists (OR 0.45, 95% CI 0.2, 1.0, p = 0.05). The incidence rate among Adventists was 65.48 per 1000 person-years versus 121.79 per 1000 person-years among non-Adventists. Adventists were less likely to experience long COVID (OR 0.30, 95% CI 0.12, 0.78, p = 0.01). Despite being older, Adventists had a significantly lower COVID-19 incidence rate. The Adventist lifestyle, including healthy eating habits, fasting, a plant-based diet, and abstaining from alcohol and coffee, was prevalent in this sample. More research is needed to explore the association between the Adventist lifestyle and infectious disease.

Association of depressive symptoms with incidence and mortality rates of COVID-19 over 2 years among healthcare workers in 20 countries: multi-country serial cross-sectional study

BackgroundLong-term deterioration in the mental health of healthcare workers (HCWs) has been reported during and after the COVID-19 pandemic. Determining the impact of COVID-19 incidence and mortality rates on the mental health of HCWs is essential to prepare for potential new pandemics. This study aimed to investigate the association of COVID-19 incidence and mortality rates with depressive symptoms over 2 years among HCWs in 20 countries during and after the COVID-19 pandemic.MethodsThis was a multi-country serial cross-sectional study using data from the first and second survey waves of the COVID-19 HEalth caRe wOrkErS (HEROES) global study. The HEROES study prospectively collected data from HCWs at various health facilities. The target population included HCWs with both clinical and non-clinical roles. In most countries, healthcare centers were recruited based on convenience sampling.As an independent variable, daily COVID-19 incidence and mortality rates were calculated using confirmed cases and deaths reported by Johns Hopkins University. These rates represent the average for the 7 days preceding the participants’ response date. The primary outcome was depressive symptoms, assessed by the Patient Health Questionnaire-9. A multilevel linear mixed model (LMM) was conducted to investigate the association of depressive symptoms with the average incidence and mortality rates.ResultsA total of 32,223 responses from the participants who responded to all measures used in this study on either the first or second survey, and on both the first and second surveys in 20 countries were included in the analysis. The mean age was 40.1 (SD = 11.1), and 23,619 responses (73.3%) were from females. The 9323 responses (28.9%) were nurses and 9119 (28.3%) were physicians. LMM showed that the incidence rate was significantly and positively associated with depressive symptoms (coefficient = 0.008, standard error 0.003, p = 0.003). The mortality rate was significantly and positively associated with depressive symptoms (coefficient = 0.049, se = 0.020, p = 0.017).ConclusionsThis is the first study to show an association between COVID-19 incidence and mortality rates with depressive symptoms among HCWs during the first 2 years of the outbreak in multiple countries. This study’s findings indicate that additional mental health support for HCWs was needed when the COVID-19 incidence and mortality rates increase during and after the early phase of the pandemic, and these findings may apply to future pandemics.Trial registrationClinicaltrials.gov, NCT04352634.

Prevalence of COVID-19 Incidence Rates in Hypertension Patients at Ibnu Sina Hospital Makassar in 2020

The COVID-19 virus, which is caused by SARS-CoV-2, is a global health problem that affects many nations. Similar to the H7N9, SARS, and MERS viruses, COVID-19 can be more severe in hypertensive individuals. With a prevalence of 50.1% among COVID-19 patients, hypertension is a significant comorbidity that increases the risk of death by 1.37 times due to the increased number of ACE2 receptors that facilitate the virus's spread. This study uses a descriptive cross-sectional design with secondary data from medical records of COVID-19 patients with hypertension at Rumah Sakit Ibnu Sina Makassar. Data were collected through total sampling after obtaining permission from the hospital and then processed and analyzed descriptively. The study shows that the majority of COVID-19 patients with hypertension are aged 65 and over (33.4%). Male patients are slightly more prevalent (53%) compared to females (47%), possibly due to genetic factors affecting the immune system. Seventy-three percent of patients adhered to hypertension treatment, while 27% did not. The function of the ACE-2 enzyme, which is also affected by antihypertensive treatment, may have an impact on the relationship between COVID-19 and hypertension. These findings emphasize the significance of treating the elderly and remaining on treatment in order to reduce the likelihood of contracting COVID-19. The survey derives that the vast majority of Covid patients with hypertension are developed 65 and over (33.4%), with an insignificantly higher inescapability of folks (53.3%) diverged from females. Adherence to hypertension treatment is high, with 73.3% of patients following their prescribed regimen.

Interventions to Mitigate the Impact of COVID-19 Among People Experiencing Sheltered Homelessness: Chicago, Illinois, March 1, 2020-May 11, 2023.

Objectives. To compare the incidence, case-hospitalization rates, and vaccination rates of COVID-19 between people experiencing sheltered homelessness (PESH) and the broader community in Chicago, Illinois, and describe the impact of a whole community approach to disease mitigation during the public health emergency. Methods. Incidence of COVID-19 among PESH was compared with community-wide incidence using case-based surveillance data from March 1, 2020, to May 11, 2023. Seven-day rolling means of COVID-19 incidence were assessed for the overall study period and for each of 6 distinct waves of COVID-19 transmission. Results. A total of 774 009 cases of COVID-19 were detected: 2579 among PESH and 771 430 in the broader community. Incidence and hospitalization rates per 100 000 in PESH were more than 5 times higher (99.84 vs 13.94 and 16.88 vs 2.14) than the community at large in wave 1 (March 1, 2020-October 3, 2020). This difference decreased through wave 3 (March 7, 2021-June 26, 2021), with PESH having a lower incidence rate per 100 000 than the wider community (8.02 vs 13.03). Incidence and hospitalization of PESH rose again to rates higher than the broader community in waves 4 through 6 but never returned to wave 1 levels. Throughout the study period, COVID-19 incidence among PESH was 2.88 times higher than that of the community (70.90 vs 24.65), and hospitalization was 4.56 times higher among PESH (7.51 vs 1.65). Conclusions. Our findings suggest that whole-community approaches can minimize disparities in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission between vulnerable populations and the broader community, and reinforce the benefits of a shared approach that include multiple partners when addressing public health emergencies in special populations. (Am J Public Health. 2024;114(S7):S590-S598. https://doi.org/10.2105/AJPH.2024.307801).

The Role of Vaccination, Testing, and Public Restriction Policies in COVID-19 Mortality and Incidence: Insights from Global Burden of Disease Regions

IntroductionThis study aimed to examine the impacts of vaccination, testing, and government policies on COVID-19 mortality and incidence rates and compare these strategies' effectiveness by seven super regions of the Global Burden of Disease (GBD).Material and methodsThis study used data from January 3, 2020, to March 29, 2023. The incidence and mortality indices were calculated using “daily cases” and “daily deaths” and selected as dependent variables. Vaccination, COVID-19 tests, strictness of a government's policy were explored using corresponding metrics.ResultsDaily cases were four times higher in the high-income region (371.1) than those in the Latin America and the Caribbean region (98.3), but the mortality rate was similar (1.5). The number of vaccinated people did not consistently reduce the mortality across all GBD regions. However, full vaccination was associated with decreased mortality in all regions except Central, Eastern, and Southeastern Europe and Central Asia (CEEECA). Regarding daily testing, a favorable correlation was observed between daily deaths on a global scale, excluding Southeast Asia, East Asia, and Oceania. Overall, vaccination coverage and government policies were effective in reducing the COVID-19 mortality and incidence rates. However, only the high-income region showed a negative association between the stringency index to COVID-19 and incidence and mortality rates.ConclusionsFull vaccination significantly reduced COVID-19 mortality globally, except in the CEEECA region. HI regions showed lower incidence and mortality rates with stricter government measures. Effective vaccination programs and policies are crucial, emphasizing the need for strengthened international cooperation in future pandemics.

Incidence of Severe COVID-19 Outcomes and Immunization Rates in Apulian Individuals with Inflammatory Bowel Disease: A Retrospective Cohort Study.

The etiology of Inflammatory Bowel Disease (IBD) is not fully understood but is believed to involve a dysregulated immune response to intestinal microbiota in genetically susceptible individuals. Individuals with IBD are at increased risk of infections due to immunosuppressive treatments, comorbidities, and advanced age. Current evidence indicates that IBD patients are not at higher risk of SARS-CoV-2 infection compared to the general population, though the risk of severe outcomes remains debated. A retrospective observational study was conducted using Apulian regional health data from 2020 to 2022. This study included 1029 IBD patients and 3075 controls, matched by age and sex. COVID-19 incidence, hospitalization, and case fatality rates were analyzed alongside vaccination coverage. No significant differences in COVID-19 incidence (IRR = 0.97), hospitalization (p = 0.218), or lethality (p = 0.271) were evidenced between IBD patients and the general population. Vaccination rates were high in both groups, with slightly higher uptake in IBD patients. Multivariate analysis identified age and male sex as risk factors for severe COVID-19 outcomes, while vaccination significantly reduced hospitalization and lethality risks. IBD patients in Apulia do not have an increased risk of COVID-19 infection or severe outcomes compared to the general population. Vaccination is crucial in protecting IBD patients, and ongoing efforts to promote vaccination within this population are essential. Future research should focus on the impact of specific IBD treatments on COVID-19 outcomes and the long-term effectiveness of vaccines.

Breakthrough COVID-19 Infections after Booster SARS-CoV-2 Vaccination in a Greek Cohort of People Living with HIV during the Delta and Omicron Waves.

Currently approved SARS-CoV-2 vaccines have been proven effective in protecting against severe COVID-19; however, they show variable efficacy against symptomatic infection and disease transmission. We studied the breakthrough COVID-19 infection (BTI) after booster vaccination against SARS-CoV-2 in people living with HIV (PWH). This was a retrospective, single-center, descriptive cohort study involving PWH, who were followed in the HIV Clinic of "Attikon" University Hospital in Athens, Greece. A BTI was defined as a case of laboratory-confirmed COVID-19 occurring at least 14 days after the third (booster) vaccine dose. We studied 733 PWH [males: 89%, mean age: 45.2 ± 11.3 years, mean BMI: 26.1 ± 4.1, HIV stage at diagnosis (CDC classification): A/B/C = 80/9/11%, MSM: 72.6%] with well-controlled HIV infection. At least one comorbidity was recorded in 54% of cases. A history of ≥1 vaccination was reported by 90%, with 75% having been vaccinated with ≥3 vaccines. Four hundred and two (55%) PWH had a history of COVID-19 and 302 (41.2%) had a BTI, with only 15 (3.7%) needing hospitalization. Only one patient was admitted to the ICU, and no death was reported. Regarding BTI after booster dose, increased age (OR = 0.97, 95% CI: 0.96-0.99, per 1-year increase), and COVID-19 infection prior to booster dose (OR = 0.38, 95% CI: 0.21-0.68) were associated with a lower likelihood for BTI, whereas higher BMI (OR = 1.04, 95% CI: 1.01-1.08) and MSM as a mode of HIV transmission were associated with increased risk (OR = 2.59, 95% CI: 1.47-4.56). The incidence rate of total COVID-19 and BTI followed the epidemic curve of the general population, with the highest incidence recorded in June 2022. A significant proportion of PWH with well-controlled HIV infection experienced a BTI, with the majority of them having mild infection. These data, which include the period of Omicron variant predominance, confirm the importance of vaccination in the protection against severe COVID-19.

Tailored vs. General COVID-19 prevention for adults with mental disabilities residing in group homes: a randomized controlled effectiveness-implementation trial

BackgroundPeople with serious mental illness (SMI) and people with intellectual disabilities/developmental disabilities (ID/DD) are at higher risk for COVID-19 and more severe outcomes. We compare a tailored versus general best practice COVID-19 prevention program in group homes (GHs) for people with SMI or ID/DD in Massachusetts (MA).MethodsA hybrid effectiveness-implementation cluster randomized control trial compared a four-component implementation strategy (Tailored Best Practices: TBP) to dissemination of standard prevention guidelines (General Best-Practices: GBP) in GHs across six MA behavioral health agencies. GBP consisted of standard best practices for preventing COVID-19. TBP included GBP plus four components including: (1) trusted-messenger peer testimonials on benefits of vaccination; (2) motivational interviewing; (3) interactive education on preventive practices; and (4) fidelity feedback dashboards for GHs. Primary implementation outcomes were full COVID-19 vaccination rates (baseline: 1/1/2021–3/31/2021) and fidelity scores (baseline: 5/1/21–7/30/21), at 3-month intervals to 15-month follow-up until October 2022. The primary effectiveness outcome was COVID-19 infection (baseline: 1/1/2021–3/31/2021), measured every 3 months to 15-month follow-up. Cumulative incidence of vaccinations were estimated using Kaplan-Meier curves. Cox frailty models evaluate differences in vaccination uptake and secondary outcomes. Linear mixed models (LMMs) and Poisson generalized linear mixed models (GLMMs) were used to evaluate differences in fidelity scores and incidence of COVID-19 infections.ResultsGHs (n=415) were randomized to TBP (n=208) and GBP (n=207) including 3,836 residents (1,041 ID/DD; 2,795 SMI) and 5,538 staff. No differences were found in fidelity scores or COVID-19 incidence rates between TBP and GBP, however TBP had greater acceptability, appropriateness, and feasibility. No overall differences in vaccination rates were found between TBP and GBP. However, among unvaccinated group home residents with mental disabilities, non-White residents achieved full vaccination status at double the rate for TBP (28.6%) compared to GBP (14.4%) at 15 months. Additionally, the impact of TBP on vaccine uptake was over two-times greater for non-White residents compared to non-Hispanic White residents (ratio of HR for TBP between non-White and non-Hispanic White: 2.28, p = 0.03).ConclusionTailored COVID-19 prevention strategies are beneficial as a feasible and acceptable implementation strategy with the potential to reduce disparities in vaccine acceptance among the subgroup of non-White individuals with mental disabilities.Trial registrationClinicalTrials.gov, NCT04726371, 27/01/2021. https://clinicaltrials.gov/study/NCT04726371.

COVID-19 in correctional facilities in Ontario, Canada: a retrospective epidemiological analysis from 15 January 2020 to 31 December 2022.

The physical environment of correctional facilities promote infectious disease transmission and outbreaks. The purpose of this study is to compare the COVID-19 burden between the correctional facility (incarcerated individuals and staff members) and non-correctional facility population in Ontario during the COVID-19 pandemic. All individuals in Ontario with a laboratory confirmation of SARS-CoV-2 between 15 January 2020 and 31 December 2022 and entered into the provincial COVID-19 data were included. Cases were classified as a correctional facility case (living or working in a correctional facility) or a non-correctional facility case. COVID-19 vaccination status was obtained from the provincial COVID-19 vaccine registry. Statistics Canada census data were used to calculate COVID-19 incidence and hospitalization rates for incarcerated cases and the non-correctional facility population. Between 15 January 2020 and 31 December 2022, there were 1,550,045 COVID-19 cases in Ontario of which 8,292 (0.53%) cases were reported in correctional (63.8% amongst incarcerated individuals, 18.6% amongst staff and 17.7% amongst an unknown classification) and 1,541,753 (99.47%) were non-correctional facility cases. Most cases in correctional facilities were men (83.8%) and aged 20-59 years (93.1%). COVID-19 incidence and hospitalization rates were generally higher among incarcerated individuals compared to the non-correctional facility population throughout the study period. COVID-19 incidence peaked in January 2022 for both the correctional facility population (21,543.8 per 100,000 population) and the non-correctional facility population (1915.1 per 100,000 population). The rate of COVID-19 hospitalizations peaked for the correctional facility population aged 20-59 in March 2021 (70.7 per 100,000 population) and in April 2021 for the non-correctional facility population aged 20-59 (19.8 per 100,000 population). A greater percentage of incarcerated individuals (73.0%) were unvaccinated at time of their COVID-19 diagnosis compared to the non-correctional facility population (49.3%). Deaths amongst correctional facility cases were rare (0.1%, 6 / 8,292) compared to 1.0% of non-correctional facility cases (n = 15,787 / 1,541,753). During the COVID-19 pandemic, individuals incarcerated in correctional facilities in Ontario had higher COVID-19 incidence and hospitalization rates compared to the non-correctional facility population. These results support prioritizing incarcerated individuals for public health interventions to mitigate COVID-19 impacts in correctional facilities.

COVID-19 Vaccine Effectiveness and Digital Pandemic Surveillance in Germany (eCOV Study): Web Application-Based Prospective Observational Cohort Study.

The COVID-19 pandemic posed significant challenges to global health systems. Efficient public health responses required a rapid and secure collection of health data to improve the understanding of SARS-CoV-2 and examine the vaccine effectiveness (VE) and drug safety of the novel COVID-19 vaccines. This study (COVID-19 study on vaccinated and unvaccinated subjects over 16 years; eCOV study) aims to (1) evaluate the real-world effectiveness of COVID-19 vaccines through a digital participatory surveillance tool and (2) assess the potential of self-reported data for monitoring key parameters of the COVID-19 pandemic in Germany. Using a digital study web application, we collected self-reported data between May 1, 2021, and August 1, 2022, to assess VE, test positivity rates, COVID-19 incidence rates, and adverse events after COVID-19 vaccination. Our primary outcome measure was the VE of SARS-CoV-2 vaccines against laboratory-confirmed SARS-CoV-2 infection. The secondary outcome measures included VE against hospitalization and across different SARS-CoV-2 variants, adverse events after vaccination, and symptoms during infection. Logistic regression models adjusted for confounders were used to estimate VE 4 to 48 weeks after the primary vaccination series and after third-dose vaccination. Unvaccinated participants were compared with age- and gender-matched participants who had received 2 doses of BNT162b2 (Pfizer-BioNTech) and those who had received 3 doses of BNT162b2 and were not infected before the last vaccination. To assess the potential of self-reported digital data, the data were compared with official data from public health authorities. We enrolled 10,077 participants (aged ≥16 y) who contributed 44,786 tests and 5530 symptoms. In this young, primarily female, and digital-literate cohort, VE against infections of any severity waned from 91.2% (95% CI 70.4%-97.4%) at week 4 to 37.2% (95% CI 23.5%-48.5%) at week 48 after the second dose of BNT162b2. A third dose of BNT162b2 increased VE to 67.6% (95% CI 50.3%-78.8%) after 4 weeks. The low number of reported hospitalizations limited our ability to calculate VE against hospitalization. Adverse events after vaccination were consistent with previously published research. Seven-day incidences and test positivity rates reflected the course of the pandemic in Germany when compared with official numbers from the national infectious disease surveillance system. Our data indicate that COVID-19 vaccinations are safe and effective, and third-dose vaccinations partially restore protection against SARS-CoV-2 infection. The study showcased the successful use of a digital study web application for COVID-19 surveillance and continuous monitoring of VE in Germany, highlighting its potential to accelerate public health decision-making. Addressing biases in digital data collection is vital to ensure the accuracy and reliability of digital solutions as public health tools.

Air Pollution and Covid-19

Air quality stands out as an important determinant of health, as its degradation was associated with around 4.2 million premature deaths in 2019, primarily due to heart and respiratory problems. It is shown that the elderly, the children, and individuals with pre-existing health conditions are simultaneously more sensitive to the impacts of air pollution and Covid-19, due to their fragile immune systems. Scientific evidence has shown the consequences of exposure to air pollutants to respiratory system diseases, emphasizing that it could be an important factor in explaining the spatial pattern of Covid-19 incidence and mortality. The aim of this study is to analyze the spatial association between air pollutant PM₂.₅ and the incidence and mortality of Covid-19 during March and December of 2020 in mainland Portugal. Weighted geographical models (GWR), were applied to identify and understand patterns, as well as explanatory factors in this relationship. The results obtained through the GWR models reveal that the pollutant PM₂.₅ has an association that varies in space. The incidence rate is higher in the southern, central, and northern regions of the country. The results of this study contribute to the analysis and assessment of the impact of air pollutants on human health, specifically in relation to health outcomes associated with Covid-19. It became evident that the concentration of PM₂.₅ is an important factor in explaining Covid-19 incidence rate in Portugal.

Predicting air quality trends in Malaysia’s largest cities: the role of urban population dynamics and COVID-19 effects

This paper aims to explore the relationship between the Air Quality Index (AQI), COVID-19 incidence rates, and population density within Malaysia’s ten most populous cities from January 2018 to December 2021. Data were sourced from the Department of Statistics Malaysia, the World Air Quality Index Project, and Our World in Statistics. The methodology integrated population-based city classification and AQI assessment, cluster analysis through SPSS, and Generalized Additive Mixed Model (GAMM) analysis using R Studio despite encountering a data gap in AQI for five months in 2019. Cities were organized into three clusters based on their AQI: Cluster One included Ipoh, Penang, Kuala Lumpur, and Melaka, Cluster Two comprised Kuantan, Seremban, Johor Bahru, and Kota Bharu, Cluster Three featured Kota Kinabalu and Kuching. GAMM analysis revealed prediction accuracies for AQI variations of 58%, 60%, and 41% for the respective clusters, indicating a notable impact of population density on air quality. AQI variations remained unaffected by COVID-19, with a forecasted improvement in air quality across all clusters. The paper presents novel insights into the negligible impact of COVID-19 on AQI variations and underscores the predictive power of population dynamics on urban air quality, offering valuable perspectives for environmental and urban planning.

Coronavirus Infection Caused by the Omicron Variant and its Daughter Genovariants in Russia (2022–2023)

Relevance. Surveillance of new genetic variants and manifestations of the epidemic process in SARS-CoV-2 is relevant for predicting the epidemiological situation and timely introduction of anti-epidemic measures. Aim. To evaluate changes in the intensity of the epidemic process during the long circulation of the «omicron» variant and its daughter genovariants. Materials and methods. The analysis of the computer database of the WHO National Center for morbidity, hospitalization and deaths from COVID-19 of the population as a whole and by age groups of 54 cities of the Russian Federation was carried out. Results. Since the appearance of COVID-19 in Russia in 2020, the maximum intensity was the V (winter–spring) wave of 2022. The intensity of the VI (autumn) and VII (winter–spring) waves was lower. In the VI wave, the incidence and mortality from COVID-19 of the population of the RF as a whole decreased by 2.5 and 6.5 times, St. Petersburg – by 2.6 and 29.7 times, and Moscow by 1.6 and 26.6 times. In the VII wave, compared with the VI wave, the decrease in morbidity was less. By age groups, the incidence decreased more among children aged 7–14 years (4.3 times in the VI wave) and less among children 0 –2 and people over 65 years (2.0 times), there was a tendency to increase the proportion of people over 65 years from 18% to 27%. The incidence rates of COVID-19 in the population as a whole and in age groups were higher in 4 FD (North-West, Far East, Siberia and the Center). In 2022, an interepidemic period was revealed for the first time in Russia, the duration of which was in megacities for 9 and FD – from 11 to 13 weeks. In the interepidemic period, the incidence was less than in the minimum VII (winter-spring) wave in the RF as a whole – by 4.6 times, in St. Petersburg – by 7.1 times and in Moscow – by 15 times. There were no deaths among children in the observed cities, and an increase in the total coefficient of mortality rate is associated with mortality among people over 65 years of age. Conclusion. The decrease in the intensity of the epidemicprocess in the VI and VII waves is caused by the prolonged circulation of omicron and its daughter genovarians.

'Not finding causal effect' is not 'finding no causal effect' of school closure on COVID-19.

In a paper recently published in Nature Medicine, Fukumoto et al. tried to assess the government-led school closure policy during the early phase of the COVID-19 pandemic in Japan. They compared the reported incidence rates between municipalities that had and had not implemented school closure in selected periods from March-May 2020, where they matched for various potential confounders, and claimed that there was no causal effect on the incidence rates of COVID-19. However, the effective sample size (ESS) of their dataset had been substantially reduced in the process of matching due to imbalanced covariates between the treatment (i.e. with closure) and control (withoutclosure) municipalities, which led to the wide uncertainty in the estimates. Despite the study title starting with "No causal effect of school closures", their results are insufficient to exclude the possibility of a strong mitigating effect of school closure on incidence of COVID-19. In this replication/reanalysis study, we showed that the confidence intervals of the effect estimates from Fukumoto et al. included a 100% relative reduction in COVID-19 incidence. Simulations of a hypothetical 50% or 80% mitigating effect hardly yielded statistical significance with the same study design and sample size. We also showed that matching of variables that had large influence on propensity scores (e.g. prefecture dummy variables) may have been incomplete.

The Dynamics of COVID-19 in Hiroshima Prefecture Compared to Japan and Its Association With Meteorological Factors: A Comparative Analysis.

Introduction Despite the implementation of countermeasures and mass vaccination programs, the COVID-19 pandemic incidence was a vital public health concern. This study aimed to explore the dynamics of COVID-19 cases and assess the association of COVID-19 pandemic epidemiological data with meteorological factors in Hiroshima Prefecture compared to Japan. Methods We analyzed COVID-19 pandemic data in Japan's Hiroshima Prefecture from January 16, 2020, to May 9, 2023. Meteorological factors were examined at different time frames, and Spearman correlation coefficients were calculated for COVID-19 variables and variants based on GISAID whole genome analysis. Results Hiroshima Prefecture reported 816,788 COVID-19 cases and 1,371 fatalities, with a city-to-rural case ratio of 0.97:1. Infection rates were 17.42% for Japan and 15.83% for Hiroshima. Gender-wise, the ratio was 99:1, and the 30-39 age group in Hiroshima had the highest cases (15.5%). Among all meteorological factors, daily and 14-day average wind speed showed a weak correlation with incidence (-0.1954, P < 0.01; 0.3669 P < 0.01), fatalities (-0.1148, P < 0.01; -0.2232 P < 0.01), and incidence rate (-0.2042, P < 0.01; -0.3751, P < 0.01), respectively. Clade GRA was most frequent (39.7%), and among 61 variants, B.1.1.7, AY.29, and BA.1.1.2 were predominant. Precipitation was associated significantly with the Alpha variant (0.3373, P<0.01), while the Delta variant (0.2934, <0.05) weakly correlated with humidity. Conclusion COVID-19 pandemic trends in Hiroshima Prefecture paralleled Japan's, yet with lower incidence and fatalities compared to most prefectures. Significant associations were found between meteorological factors and COVID-19 metrics, including incidence, fatalities, incidence rate, and mutations in Hiroshima.