COVID-19 Infection Rates Research Articles

The effect of COVID-19 infection on patients with rheumatic diseases in China.

At the end of 2022, the COVID-19 outbreak erupted in China, and BA.5.2 or BF.7 subtypes of Omicron novel variations were implicated in more than 90% of the cases. We created a real-world questionnaire survey to better understand how this new variant pandemic was affecting rheumatic patients in China. During the COVID-19 outbreak in China, the subjects of this study were rheumatic patients and non-rheumatic individuals (control group), who were matched for sex and age. Professional physicians carefully questioned the participants before administering a questionnaire as part of the study. This study focused on the general baseline characteristics, clinical symptoms and treatment after COVID-19 infection, and the target populations' awareness of COVID-19. The study included 1130 participants, of whom 572 were assigned to the rheumatic group and 558 to the control group. The percentage of vaccinated controls was significantly higher than that of rheumatic patients (90.1% vs. 62.8%, p < 0.001), while the rate of COVID-19 infection was not significantly different between the two groups (82.3% vs. 86.6%, p = 0.051). Patients with rheumatic disease experienced substantially more days of fever following infection (2.87 ± 3.42 vs. 2.18 ± 1.65, p = 0.002) compared to individuals in the control group. The rheumatic patients had a greater prevalence of cough (67.1% vs. 54.0%, p < 0.001), somnipathy (13.8% vs. 6.0%, p < 0.001), and conjunctivitis/ophthalmodynia (5.3% vs. 2.1%, p = 0.008), while dry throat/throat pain/weakness (49.9% vs. 59.4%, p = 0.003), myalgia/osteodynia (33.3% vs. 41.8%, p = 0.003), and dyspnea (14.0% vs. 25.3%, p < 0.001) were more likely to occur in non-rheumatic group after infection. Human immunoglobulin (2.1% vs. 0.2%, p = 0.006), glucocorticoids (19.5% vs. 1.6%, p < 0.001), oxygen support (6.8% vs. 2.1%, p < 0.001), and traditional Chinese medicine (21.9% vs. 16.6%, p = 0.037) were all more frequently used by rheumatic patients with COVID-19 infection. People in the control group were more confused about whether to use masks in following social activities after contracting COVID-19 (14.7% vs. 7.6%, p = 0.001). In the control group, more individuals than patients with rheumatic disease (25.1% vs. 13.4%, p < 0.001) expressed an interest to receive the vaccine again. After being exposed to COVID-19, the majority of rheumatic patients (66.9%) reported no discernible change, only 29.1% reported a worsening of their symptoms, and the remaining 4% indicated an improvement. After the COVID-19 outbreak in China, the proportion of patients with rheumatic diseases infected with the virus was similar to that of normal individuals. But the clinical symptoms, follow-up treatment requirements, and awareness of the COVID-19 among rheumatic patients were distinct from those among non-rheumatic patients, necessitating the use of individualized diagnosis and treatment plans as well as health advice by medical professionals in clinical work. Key Points • Despite there were different comorbidities and vaccination rates, the rate of COVID-19 infection in patients with rheumatic disease was similar to that of normal individuals. • After COVID-19 infection, rheumatic patients and normal controls had different clinical symptoms and drug usage. • After being exposed to COVID-19, the majority of rheumatic patients felt no significant change in the primary disease, while the normal controls was more likely to accept a new vaccine injection and confused about whether to use masks in following social activities.

Is a municipal socio-economic ranking more influential than vaccination on daily growth in COVID-19 infection rate?

Is a municipal socio-economic ranking more influential than vaccination on daily growth in COVID-19 infection rate?

Living with facioscapulohumeral muscular dystrophy during the first two COVID-19 outbreaks: a repeated patient survey in the Netherlands.

Patients with facioscapulohumeral dystrophy (FSHD) suffer from slowly progressive muscle weakness. Approximately 20% of FSHD patients end up wheelchair-dependent. FSHD patients benefit from physical activity to maintain their muscle strength as much as possible. The impact of the COVID-19 pandemic on the health of FSHD patients was unknown. This study assessed changes in daily care received, perceived psychosocial stress, and worsening of FSHD complaints in 2020. Furthermore, we compared COVID-19 infection incidence and severity of symptoms between FSHD patients and non-FSHD housemates. Three online survey rounds were sent out to all adult participants of the Dutch FSHD registry regarding daily care received, perceived psychosocial stress, COVID-19 infection rate, and COVID-19 symptoms severity. They also included COVID-19-related questions regarding the participants' housemates, which served as control group. Participation rate was 210 (61%), 186 (54%), and 205 (59%) for survey 1, 2, and 3, respectively. Care reduction was reported by 42.7%, 40%, and 28.8% of the participants in the respective surveys. Perceived psychosocial stress increased in 44%, 30%, and 40% of the participants. Compared to the 197 non-FSHD housemates, the 213 FSHD patients reported more possibly COVID-19-related symptoms (27% vs. 39%, p = 0.017) of mostly minimal severity (63%). No difference in (possible) COVID-19 infection incidence rates was found (2.0% vs. 2.8%, p = 0.527). The COVID-19 pandemic negatively impacted care received and increased perceived psychosocial stress in FSHD patients. However, COVID-19 infection incidence in FSHD patients was similar to their non-FSHD housemates.

Relationship between urban form and COVID-19 severity: impact of compactness during the lockdown and post-lockdown periods

ABSTRACT This research paper examines the relationships between urban form and COVID-19 outcomes in U.S. metropolitan counties. Using multivariate regression analysis, the study investigates the impact of demographic characteristics, social distancing measures, healthcare capacity, and urban form indicators (density, land use mix, street accessibility, street centering), on COVID-19 infection and death rates. The analysis has been implemented during the lockdown (March 1 to June 30) and post-lockdown (Sept 1 to Dec 31) in 2020. The results reveal significant associations between several variables and COVID-19 rates. The compactness index showed mixed results, with a positive relationship observed during the lockdown phase and a negative relationship during the post-lockdown period. Demographic factors including a higher percentage of the black population, older age, and lower educational attainment are positively correlated with case and death rates. These findings suggest that the influence of urban form on COVID-19 outcomes varies across different stages of the pandemic. The research highlights the importance of considering both demographic and urban form factors when analyzing the impact of COVID-19, contributing to the growing body of literature on the complex interplay between urban environment and public health.

Two versus three doses of COVID-19 vaccine and post-vaccination COVID-19 infection in hemodialysis patients

Background and aimPatients with chronic kidney disease including those undergoing hemodialysis (HD) constitute a particularly challenging group regarding COVID-19 vaccination. The present study aimed to compare the rate of reinfection after two and three doses of Sinopharm COVID-19 vaccine in HD patients. Patients and methodsThe study included 80 HD patients who received three doses of Sinopharm COVID-19 vaccine. In addition, there were another 80 patients who received only two doses of the vaccine. Patients in the latter group were selected based on propensity matching score with 1:1 ratio. Patients were monitored for post-vaccination COVID-19 infection using PCR examination of nasopharyngeal swabs. Patients were also monitored for post-vaccination complications including general complaints (headache, fever, fatigue), injection site complaints (arm pain, swelling, itching, rash), musculoskeletal complaints (muscle spasm or pain, joint pain) and others. All patients were followed for six months. ResultsThe present study included 80 patients submitted to COVID-19 vaccination with two doses of Sinopharm vaccine (GI) and other 80 patients who received three doses of the same vaccine (GII). At the end of follow up, 11 patients (13.8 %) in GI caught COVID-19 infection. In contrast, no patient in GII had infection (p<0.001). Comparison between patients who had COVID-19 infection and those without infection revealed that the former subgroup had significantly lower BMI (23.3 ± 2.3 versus 27.5 ± 8.1 Kg/m2), higher frequency of associated Hepatitis C (HCV) infection (54.6 % versus 2.9 %, p<0.001) and higher serum ferritin levels [median (IQR): 1101.0 (836.0-1564.0) versus 675.0 (467.0-767.7) ng/mL, p=0.01]. Binary logistic regression analysis identified high serum ferritin levels [OR (95% CI): 0.014 (0.001-0.15), p<0.001] and associated HCV infection [OR (95% CI): 0.99 (0.98-1.01), p=0.02] as significant predictors of post-vaccination COVID-19 infection in multivariate analysis. ConclusionsA three dose regime of Sinopharm COVID-19 vaccine associated with significantly lower rate of reinfection COVID-19 infection in HD patients. Infected patients had significantly lower BMI, higher frequency of HCV and higher ferritin levels.

Impact of COVID-19 on migrant remittances in South Asia

ABSTRACT This paper investigates the impact of COVID-19 on remittance flows to South Asia. Using a monthly panel data set of five South Asian countries (namely Bangladesh, India, Nepal, Pakistan, and Sri Lanka) for the period January 2020 to August 2021. This study, applying the pooled ordinary least square estimation method, generally, finds a positive impact of COVID-19 on remittance flows to South Asia. Further investigation reveals the existence of a non-linear (inverted U-shaped) relationship between COVID-19 cases and remittances. This means that with the initial covid spread leading to temporary restrictions affecting economic activity in home countries, remittances start increasing to support families’ income and consumption affected by the regulations. However, the very high levels of infection rates leading to continued lockdowns in home countries decrease the incentives for investment with substantially reduced economic activities, thus decreasing aggregate remittances. We found similar results when replacing infection rates with deaths from COVID-19. However, increasing COVID-19 infection rates and deaths in migrants’ host countries reduce remittances to migrants’ home countries.

Global trends in COVID-19 incidence and case fatality rates (2019-2023): a retrospective analysis.

Analyzing and comparing COVID-19 infection and case-fatality rates across different regions can help improve our response to future pandemics. We used public data from the WHO to calculate and compare the COVID-19 infection and case-fatality rates in different continents and income levels from 2019 to 2023. The Global prevalence of COVID-19 increased from 0.011 to 0.098, while case fatality rates declined from 0.024 to 0.009. Europe reported the highest cumulative infection rate (0.326), with Africa showing the lowest (0.011). Conversely, Africa experienced the highest cumulative case fatality rates (0.020), with Oceania the lowest (0.002). Infection rates in Asia showed a steady increase in contrast to other continents which observed initial rises followed by decreases. A correlation between economic status and infection rates was identified; high-income countries had the highest cumulative infection rate (0.353) and lowest case fatality rate (0.006). Low-income countries showed low cumulative infection rates (0.006) but the highest case fatality rate (0.016). Initially, high and upper-middle-income countries experienced elevated initial infection and case fatality rates, which subsequently underwent significant reductions. COVID-19 rates varied significantly by continent and income level. Europe and the Americas faced surges in infections and low case fatality rates. In contrast, Africa experienced low infection rates and higher case fatality rates, with lower- and middle-income nations exceeding case fatality rates in high-income countries over time.

Social determinants of health disparities in Staten Island compared with Manhattan, Queens, Brooklyn, and the Bronx: Contribution to COVID-19 outcomes.

Social determinants of health (SDH) negatively affectedCoronavirus disease-2019 (COVID-19) outcomes within the five boroughs of New York City. The goal of this study was to determine whether differences in social demographics within the borough of Staten Island, compared with the other four boroughs, may have contributed to poor COVID-19 outcomes in Staten Island. Data were obtained from public data sources. Social demographics obtained included age, household income, poverty status, and education level. COVID-19 infection, hospitalization, and death rates reported from Staten Island were compared with rates from Manhattan, Queens, Brooklyn, and the Bronx (February 29, 2020-October 31, 2022). Mean differences in case rates of COVID-19 were higher in Staten Island compared to all four boroughs. Mean differences in hospitalization and death rates were higher than Manhattan but similar to the other four boroughs. Within Staten Island, case rates were highest in zip codes 10306 and 10309. Hospitalization and death rates were highest in Staten Island zip code 10304. We found that the zip codes of Staten Island with poorer COVID-19 outcomes had more individuals with less than a high school degree, lower mean household income, higher proportion of households earning less than $25,000 a year, and a greater proportion of individuals using public transportation. Differences in COVID-19 infection, hospitalization, and death rates exist between the five boroughs and between the 12 zip codes within Staten Island. These differences in COVID-19 outcomes can be attributed to different SDH.

Epidemiological Analysis of Vaccination Strategies and Demographic Patterns In COVID-19 Cases in The Midwest Region of The United States

Introduction: The study discusses the uneven impact of the COVID-19 pandemic across various demographic groups in the US, focusing on Boone County, Missouri. The aim is to identify any correlation between factors such as gender, age, ethnicity, and religious beliefs with COVID-19 infection rates over a span of 22 months (from March 15, 2020, to December 2, 2021). Methods: The research methodology involves time trend analysis graphs for each demographic group, benchmarked against significant events like vaccine launches, the introduction of the delta variant, vaccine boosters, and the arrival of the omicron variant. Results: Preliminary findings suggest that males and certain racial groups, including Black or African Americans and the “All-Other” category, exhibit higher COVID-19 positivity rates throughout these defined periods. The study also delves into unique patterns among demographic groups during various phases of the pandemic. Conclusion: Our results supported the hypothesis that males and minority races such as Black or African Americans and All-Other are more likely to have a higher COVID-19 positivity rate across our defined epochs.

The impact of the 2022 spring COVID-19 booster vaccination programme on hospital occupancy in England: An interrupted time series analysis.

Regular booster vaccination programmes help protect the most vulnerable from COVID-19 and limit pressure on health systems. Existing studies find booster doses to be effective in preventing hospital admissions and deaths but focus on individual effects, failing to consider the population impact of incomplete vaccination coverage and seasonal patterns in disease transmission. We estimated the effectiveness of the 2022 spring booster vaccination programme, available for those aged 75 years and older, residents in care homes, and adults with weakened immune systems, on COVID-19 hospital bed occupancy in England. Booster vaccine coverage in the eligible population increased rapidly in the months after rollout (from 21st March 2022), flattening out just below 80% by July 2022. We used interrupted time series analysis to estimate a 23.7% overall reduction in the rate of hospital occupancy for COVID-19 following the programme, with a statistically significant benefit in the 6-12 weeks following rollout. In the absence of the programme, we calculate that a total of 380,104 additional hospital bed-days would have been occupied by patients with COVID-19 from 4th April to 31st August 2022 (95% CI: -122,842 to 1,034,590). The programme delayed and shortened the duration of the peak while not reducing its magnitude. In sensitivity analyses adjusting the start of the post-intervention period or removing the rate of COVID-19 infection in the over 60s from the model, the effect of the spring booster programme on hospital bed occupancy remained similar. Our findings suggest that timing is a critical consideration in the implementation of COVID-19 booster programmes and that policymakers cannot rely on intermittent booster vaccination of high-risk groups alone to mitigate anticipated peaks in hospital pressure due to COVID-19 epidemics.

Managed Care After Discharge of COVID-19 Patients in North Iran

Background and Purpose: After-discharge follow-up is one of the branches of managed care used for information exchange, health education, early diagnosis of symptoms, symptom management, and high-quality aftercare services. The present study aims to elucidate the managed care of COVID-19 patients after discharge from hospitals affiliated with Mazandaran University of Medical Sciences, Mazandaran Province, Iran. Materials and Methods: The present cross-sectional study was conducted in 2019. The study sample included all COVID-19 patients discharged from public, private, and social security hospitals affiliated with Mazandaran University of Medical Sciences. The census method was used to recruit 14625 discharged patients. The data collection tool was based on the information registration form “Follow-up of the treatment process of discharged COVID-19 patients,” which was prepared in three sections (demographic, clinical characteristics, and follow-up of the treatment process) based on the opinions of 15 experts. Data analysis was carried out via the chi-square test in SPSS software, version 21. Results: The findings of the demographic section showed that 35.8% of COVID-19-related admissions were over 65 years old. Intensive care unit (ICU) admissions were necessary for 13% of cases, with the highest ICU admission rates among those aged 65 and above. Based on the findings of the clinical characteristics section, the most common underlying disease (46.7%) was diabetes, and the most common symptom upon admission was fever (higher than 38°C) (44.8%). Also, according to the findings of the “treatment follow-up” section, 7.04% of the discharged patients were readmitted, and 14.5% of patients infected their family members with COVID-19. Also, 57.82% adhered to the health and safety protocols and self-quarantine at home, which varied in different months. Conclusion: Follow-up after the discharge of COVID-19 patients as one of the branches of managed care increased the compliance with health principles and decreased the rate of COVID-19 infection of the patient’s family members and the readmission of patients. Therefore, appropriate follow-up after discharge is suggested as a low-cost method to shorten the recovery period of patients, prevent other family members from contracting this disease, and detect the worsening of disease symptoms among discharged patients.

Diagnosis of COVID-19 obtained by rapid antigen test and reverse transcription–polymerase chain reaction in a medical college in Eastern India-a record-based observational descriptive study

Background: In December 2019 in Wuhan, China, a new coronavirus known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) appeared. Gradually, the virus started spreading around the world, which was life-threatening. Aims and Objectives: The study’s objective was to find out the positivity rate of infection, the category of patients included in the study, the percentage of positive and negative cases, comparison of rapid antigen detection in relation to real-time reverse transcription–polymerase chain reaction (RT-PCR) test, and rapid antigen detection test’s sensitivity and specificity. Materials and Methods: Eight hundred sixty-five patients’ samples and nasopharyngeal swabs were collected within 3 months as routine samples. Two hundred thirty-two samples were compared by both rapid antigen test (RAT) and RT-PCR. To rule out false negatives, those who tested negative for COVID-19 using a RAT underwent testing by RT-PCR. To rule out false positives, a small number of patients who tested positive for COVID-19 by RAT also underwent validation by RT-PCR test. Results: Two hundred thirty-two samples were obtained for rapid antigen detection, then RT-PCR testing. Both the results were compared. According to the findings, the positivity rate of COVID-19 infection was 0.86%. Two patients (0.86%) tested positive (either by one or both methods) and the number of patients who tested negative was 230 (99.14%). RAT sensitivity and specificity were 50% and 100%, respectively, compared to gold standard RT-PCR. The positive predictive value was 100% and the negative predictive value was 99%. Conclusion: We conclude that antigen detection methods are less sensitive than real-time RT-PCR but they can be used for COVID-19 mass screening and can be used as a quick diagnostic tool in remote locations without molecular testing facilities.

Curb the spread: Leveraging intensive longitudinal data to unravel within- and between-person processes in adherence to nonpharmaceutical interventions during COVID-19.

Adhering to behavioral recommendations and nonpharmaceutical interventions (NPIs) is a key to control COVID-19 infection rates. However, rates have decreased globally, and potentially modifiable determinants of ongoing adherence and their interaction with social and physical momentary environments are still poorly understood. Here, we comprehensively examine within-person variations and between-person differences in known behavioral determinants (capability and motivation), as well as the moderating role of situational variable environmental factors (opportunity) in predicting adherence to hygiene and social distancing behaviors. Ecological momentary assessment study over 6 months with monthly assessment bouts (4 days each and five daily assessments) in 623 German adults. Repeated daily assessments of capability, opportunity, motivation, and behavior (COM-B) model factors. Bayesian multilevel logistic regression models were estimated to examine main effects of COM-B factors and moderating effects of momentary environmental factors. Momentary adherence to NPIs was predicted by within-person changes in COM-B factors (motivation: intentions, goal conflict, and control beliefs; opportunities: regulations and norms). Between-person differences in capabilities (habit strength) and motivation (intentions and control beliefs) predicted adherence across situations. Situation-specific environmental factors moderated the motivation-behavior association (regulation measures increased; goal conflict and nonadherent others decreased the association). Individual momentary (within-person) and stable (between-person) motivation indicators predicted adherence. However, situational environmental factors such as regulations or norms have strong main effects and moderate the motivation-behavior translation. These findings have policy implications, supporting recent claims to not rely on the narrative of "personal responsibility," but instead combine health education measures to increase individual motivation with consistent regulation. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

HOUSEHOLDS’ FOOD CONSUMPTION BEHAVIOUR DURING COVID-19 PANDEMIC: EVIDENCE FROM RURAL HOUSEHOLDS IN SOUTH AFRICA

The food consumption behaviour of households has been affected by the lockdown restrictions that were implemented to reduce the COVID-19 infection rate. This study was aimed at analysing the food consumption behaviour of rural households during the COVID-19 pandemic in South Africa. To achieve this, a simple random technique was used to collect data from 120 in Merry Pebble (MP) Stream Village. Thereafter, an Ordered Probit Model was used to examine the extent to which households have increased, decreased or maintained the same quantity of food consumed during COVID-19. The results indicated that 46.7% of the rural households had consumed less food during COVID-19 pandemic, 32.5% consumed about the same amount of food, and 20.8% consumed more food. The variables that contributed towards a decrease in food consumption are employment status, household size, loss of income, and social relief grants. On the contrary, bulk buying and food parcels had stabilised food consumption, while the number of employed people in a household and food bought from restaurants contributed towards an increase in food consumption during COVID-19 pandemic. With regard to consumption behaviour per food item, fresh produce, meat, snacks and fast food were consumed less during COVID-19, while there was a constant consumption in dairy products, and an increase in consumption of canned food, frozen food, prepared food, grains and water. The study recommends that the government should continue with the economic and social relief programmes that were created during COVID-19, as they play an important role in increasing and stabilising food consumption by rural households.

Results of a Study on the Impact of Surface Ozone Concentration on the Spread of COVID-19 in Tbilisi

The results of a study of the influence of diurnal values of surface ozone concentration (SOC) on the infection positivity rate with coronavirus COVID-19 (IR) of the population of Tbilisi from October 8, 2020 to May 31, 2021 are presented. It was found that IR values are inversely correlated with SOC. For example, at ozone concentrations from 0 to 20 mcg/m3 values of COVID-19 Infection Rate on average was 18.5 %, whereas with SOC values from 80 to 100 mcg/m3 – only 2.3%. Connection daily values of IR with SOC has an inverse linear form. IR = -0.2307·SOC + 20.543 for individual cases; IR = -0.2113·SOC + 19.756 for averaged values of IR in different ranges of SOC values.

COVID-19 in a Dutch Nursing Home: A Longitudinal Retrospective Care-Home-Level Case Study on Infection Rate, Survival Rate, and Daily Functioning.

During the pandemic, nursing homes in the Netherlands were heavily affected by COVID-19. This study assesses the impact of COVID-19 on infection rate, survival rate, and daily functioning over the course of two years among residents of a nursing home in the Netherlands that was amongst the first nursing homes to be affected by the pandemic. This retrospective study followed 70 residents during a two-year period, starting in March 2020. Data were collected on baseline characteristics of participants and the onset, duration, and sequelae of COVID-19 infections. Primary outcomes were mortality and infection rate. The secondary outcome was daily functioning using the Barthel Index at intervals of six months. Within two years, 44 (62.9%) residents were diagnosed with COVID-19. During this study, 72.7% (n = 32) of the COVID-positive residents died, of which 22 deaths were related to the COVID-19 infection. Overall mortality was 60% (n = 42), while COVID-related mortality was 31.4% (n = 22). COVID-19 and multimorbidity (>3 morbidities) were independent risk factors for mortality. Barthel Index scores showed no significant difference in daily functioning. Overall, a high COVID-19 infection rate was seen and was the most common cause of death. COVID-19 did not affect functional status over time.

Effectiveness of Covid-19 Vaccine in Pregnant Women: A Systematic Review

The newly developed COVID-19 vaccine faces public's concerns in terms of its effectiveness and safety as an approach in combating COVID-19 pandemic. It is well-established that COVID-19 vaccine is effective alongside being the most promising approach against COVID-19 infection in both general and vulnerable populations. This study aims to evaluate the effectiveness of COVID-19 vaccine in pregnant women as a subgroup of vulnerable population by analysing several important immunological parameters in pregnant women. Specifically, it investigates how effective the COVID-19 vaccine will reduce the infection rate and how it will affect the mothers' antibody levels against SARS-CoV-2. In this study, the immunological parameters investigated are maternal antibody response against SARS-CoV-2 and the transplacental transfer of the antibody. To test the hypothesis that COVID-19 vaccine is effective in pregnant women, a systematic review was conducted on previous studies regarding COVID-19 vaccine and its outcomes in pregnancy. Results were narratively analysed. The results showed reduced COVID-19 infection rate, elevated maternal antibody titre against SARS-CoV-2 and positive transplacental anti-SARS-CoV-2 IgG antibody transfer in vaccinated pregnant women in comparison to unvaccinated pregnant women. These results suggest that COVID-19 vaccine is highly effective against COVID-19 infection in pregnant women. Furthermore, COVID-19 vaccine not only elicits sufficient maternal antibody response as an immunity for mothers against COVID-19 infection but also provides similar protection for infants via passive immunity by means of transplacental antibody transfer. In conclusion, the uptake of COVID-19 vaccine and future booster dose by pregnant women should be strongly encouraged due to its favourable outcomes and protection against COVID-19 disease.

Application of a composite, multi-scale COVID-19 mitigation framework: US border use-case

ABSTRACT Airborne pathogen transmission within crowded facilities can be modelled by combining several interrelated mechanisms of spread: movement of people, airflow dynamics, and aerosol dispersion. This paper describes a composite model framework combining analytical models to demonstrate the spread of an airborne pathogen in a crowded, confined space at an immigrant processing centre on the southern US border during the border crisis of March 2021. Recommendations that could reduce current COVID-19 infection rate from 11% to 6.16% at relatively low additional cost to the government are given. These recommendations could also lower the infection rate by approximately five times from 31.14% worst case from long indoor exposures down to 6.35% when immigrant processing times surge to 10 days. This work highlights the challenges of managing COVID-19 in crowded facilities, and provides quantitative decision options with potential both to slow and prevent disease spread, while lessening the economic burden on communities.

Neighborhood-level vaccine impact on COVID-19 infection and hospital admission in Quebec, Canada, during the Delta and early Omicron periods

ObjectiveTo assess the impact of COVID-19 vaccination on COVID-19 infection and hospitalisation at the population-level, and to assess the indirect effects of vaccination in the province of Quebec, Canada. MethodsWe performed a time-stratified, neighborhood-level ecologic study. The exposure was neighborhood-level vaccination (primary series) coverage; outcomes were COVID-19 infection and hospitalisation rates. We used robust Poisson regression to estimate weekly relative rates of infection and hospitalisation versus vaccination. ResultsHigher vaccination coverage was associated with lower COVID-19 infection rates from July 18-December 4 for the year 2021 (Delta period) (RR≈0.46 [0.39; 0.54] – 0.94 [0.83; 1.05], 85–100% vs. 60–74% coverage). From December 5-December 25, this association reversed (RR≈1.28 [1.16; 1.41] – 1.41 [1.31; 1.52]), possibly due to the Omicron variant, social behaviors and accumulation of susceptibles in more vaccinated neighborhoods. Vaccine impact against hospitalisation was maintained throughout (RR≈0.43 [0.29; 0.65] – 0.88 [0.64; 1.22]). Vaccination provided substantial indirect protection (RR≈0.43 [0.34; 0.54] – 0.81 [0.65; 1.03]). ConclusionsThis study confirmed the protective impact of vaccination against severe disease regardless of variant, at the population level. Ecological analyses are a valuable strategy to evaluate vaccination programs. Population-level effects can have substantial effects and should be accounted for in public health and vaccination program planning.

Primary healthcare workers' COVID-19 infection status following implementation of adjusted epidemic prevention and control strategies: a cross-sectional study in Jiangsu, China.

In times of epidemic outbreaks, healthcare workers (HCWs) emerge as a particularly vulnerable group. This cross-sectional study endeavors to assess the COVID-19 infection rate among the primary HCWs in Jiangsu Province subsequent to the implementation of adjusted epidemic prevention and control strategies. From January 17 to February 2, 2023, an extensive survey was conducted among primary HCWs in Jiangsu Province, employing a self-designed questionnaire. Logistic regression analysis was utilized to identify the factors associated with COVID-19 infection. The overall infection rate among primary HCWs stood at 81.05%, with a 95% confidence interval (CI) of 80.61-81.48%. Among those afflicted, cough, fatigue, and fever emerged as the three most prevalent symptoms, each with an incidence rate exceeding 80%. In the context of multivariate logistic regression, an elevated risk of COVID-19 infection was observed in correlation with female gender (adjusted odds ratio [aOR] = 1.12, 95% CI: 1.04-1.21), possessing a bachelor's degree or higher (aOR = 1.32, 95% CI: 1.23-1.41), accumulating over 10 years of work experience (aOR = 1.28, 95% CI: 1.11-1.47), holding a middle-level cadre position (aOR = 1.22, 95% CI: 1.11-1.35), assuming the role of a unit leader (aOR = 1.30, 95% CI: 1.11-1.54), and working in a fever clinic for 1 to 10 days per month (aOR = 1.42, 95% CI: 1.29-1.57). Conversely, advanced age (aOR = 0.76, 95% CI: 0.70-0.82), being underweight (aOR = 0.78, 95% CI: 0.69-0.90), current smoking (aOR = 0.64, 95% CI: 0.57-0.71), receiving 4 doses of COVID-19 vaccine (aOR = 0.49, 95% CI: 0.37-0.66), and pregnancy or perinatal status (aOR = 0.85, 95% CI: 0.72-0.99) were associated with a diminished risk of infection. Following the implementation of adjusted policies, a substantial proportion of primary HCWs in Jiangsu province contracted COVID-19. Female gender and younger age emerged as risk factors for COVID-19 infection, while no discernible link was established between professions and COVID-19 susceptibility. The receipt of COVID-19 vaccines demonstrated efficacy in curtailing the infection rate, underscoring the significance of bolstering prevention knowledge and heightening self-protective awareness among primary HCWs.