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Disaster Medicine and Public Health Preparedness [website]
"'Disaster Medicine and Public Health Preparedness' is the first comprehensive and authoritative journal emphasizing public health preparedness and disaster response for all health care and public health professionals globally. The journal seeks to translate science into practice and integrate medical and public health perspectives. With the events of September 11, the subsequent anthrax attacks, the tsunami in Indonesia, hurricane Katrina, SARS [severe acute respiratory syndrome] and the H1N1 Influenza Pandemic, all health care and public health professionals must be prepared to respond to emergency situations. In support of these pressing public health needs, 'Disaster Medicine and Public Health Preparedness' is committed to the medical and public health communities who are the stewards of the health and security of citizens worldwide."
Cambridge University Press
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Feedback to Prepare EMS Teams to Manage Infected Patients with COVID-19: A Case Series
From the Abstract: "Coronavirus Disease 2019 (COVID-19), a new respiratory disease, is spreading globally. In France, Emergency Medical Service (EMS) teams are mobile medicalized resuscitation teams composed of emergency physician, nurse or anesthesiologist nurse, ambulance driver, and resident. Four types of clinical cases are presented here because they have led these EMS teams to change practices in their management of patients suspected of COVID-19 infection: cardiac arrest, hypoxia on an acute pneumonia, acute chronic obstructive pulmonary disease (COPD) exacerbation with respiratory and hemodynamic disorders, and upper function disorders in a patient in a long-term care facility. The last case raised the question of COVID-19 cases with atypical forms in elderly subjects. Providers were contaminated during the management of these patients. These cases highlighted the need to review the way these EMS teams are responding to the COVID-19 pandemic, in view of heightening potential for early identification of suspicious cases, and of reinforcing the application of staff protection equipment to limit risk of contamination."
Cambridge University Press
Ghazali, Daniel Aiham; Ouersighni, Amina; Gay, Matthieu . . .
2020-08
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Insight into the Sex Differences in COVID-19 Patients: What Are the Possible Causes?
From the Abstract: "Studies have reported a sex bias in case fatalities of COVID-19 [coronavirus disease 2019] patients.Moreover, it is observed that men have a higher risk of developing a severe form of the disease compared to women, highlighting the importance of disaggregated data of male and female COVID-19 patients. On the other hand, other factors (eg, hormonal levels and immune functions) also need to be addressed due to the effects of sex differences on the outcomes of COVID-19 patients. An insight into the underlying causes of sex differences in COVID-19 patients may provide an opportunity for better care of the patients or prevention of the disease."
Cambridge University Press
Dana, Parisa Maleki; Sadoughi, Fatemeh; Hallajzadeh, Jamal . . .
2020-06-10
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Treatment and Preliminary Outcomes of 150 Acute Care Patients with COVID-19 in a Rural Health System in the Dakotas
From the Abstract: "The majority of available US-published reports present populations with community spread in urban areas. The objective of this report is to describe a rural healthcare system's utilisation of therapeutic options available to treat Coronavirus Disease 2019 (COVID-19) and subsequent patient outcomes. A total of 150 patients were treated for COVID-19 at three hospitals in the Dakotas from 21 March 2020 to 30 April 2020. The most common pharmacological treatment regimens administered were zinc, hydroxychloroquine plus azithromycin and convalescent plasma. Adjunctive treatments included therapeutic anticoagulation, tocilizumab and corticosteroids. As of 1 June 2020, 127 patients have survived to hospital discharge, 12 patients remain hospitalised and 11 patients have expired. The efficacy of hydroxychloroquine and azithromycin use has yet to be determined but was not without risks of corrected QT interval prolongation and arrhythmias in our cohort. We did not appreciate any adverse effects that appeared related to tocilizumab or convalescent plasma administration in those patient subsets. These findings may provide insight into disease severity and treatment options in the rural setting with limited resources to participate in clinical trials and encourage larger comparative studies evaluating treatment efficacy."
Cambridge University Press
Enzmann, Maxx; Erickson, M. P.; Grindeland, Carlina J. . . .
2020-06-16
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Mortality and Survival of COVID-19
From the Abstract: "This study aims to identify the risk factors associated with mortality and survival of COVID-19 [coronavirus disease 2019] cases in a state of the Brazilian Northeast. It is a historical cohort with a secondary database of 2070 people that presented flu-like symptoms, sought health assistance in the state and tested positive to COVID-19 until 14 April 2020, only moderate and severe cases were hospitalised. The main outcome was death as a binary variable (yes/no). It also investigated the main factors related to mortality and survival of the disease. Time since the beginning of symptoms until death/end of the survey (14 April 2020) was the time variable of this study. Mortality was analysed by robust Poisson regression, and survival by Kaplan-Meier and Cox regression."
Cambridge University Press
Sousa, G. J. B.; Garces, T. S.; Cestari, V. R. F. . . .
2020-06-22
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COVID-19, Fiscal Federalism and Provincial Debt: Have We Reached a Critical Juncture?
From the Introduction: "In 2019, Canada's gross subnational debt to GDP [gross domestic product] was well over 40 per cent, easily the highest in the world[.] This level will only grow as the provinces grapple with the pandemic and its fiscal effects. Some believe surging provincial debts have brought Canadian federalism to a critical juncture: they have greatly increased the odds of federal measures to stabilize provincial finances. This article assesses this claim. The cleanest and most balanced path to fiscal sustainability is a combination of enhanced federal transfers, which would bolster provincial fiscal capacity, and national fiscal rules, which would constrain provincial borrowing. But the former is unlikely to restore sustainability on its own, and the latter would require a severe provincial debt crisis, which Canada's existing fiscal federal structures can avoid. COVID-19 [coronavirus disease 2019] has increased the odds of certain reforms, and it is difficult to predict their long-run effects. But any obvious paths to fiscal sustainability remain hidden."
Cambridge University Press
Hanniman, Kyle
2020
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COVID-19: Asymptomatic Carrier Transmission is an Underestimated Problem
From the Abstract: "At the present time, COVID-19 [coronavirus disease 2019] is spreading rapidly. The global prevention and control of COVID-19 is focused on the estimation of the relevant incubation period, basic reproduction number (R0), effective reproduction number (Rt) and death risk. Although the prevention and control of COVID-19 requires a reliable estimation of the relevant incubation period, R0, Rt and death risk. Another key epidemiological parameter-asymptomatic ratio that provides strength and range for social alienation strategies of COVID-19, which is widely defined as the proportion of asymptomatic infections among all disease infections. In fact, the ratio of asymptomatic infection is a useful indicator of the burden of disease and a better measurement of the transmissibility of the virus. So far, people have not paid enough attention to asymptomatic carriers. The asymptomatic carriers discussed in this study are recessive infections, that is, those who have never shown symptoms after onset of infection. We will discuss three aspects: detection, infectivity and proportion of healthy carriers."
Cambridge University Press
Zhao, Hongjun; Lu, Xiaoxiao; Deng, Yibin . . .
2020-06-04
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Emotional Distress in Young Adults During the COVID-19 Pandemic: Evidence of Risk and Resilience from a Longitudinal Cohort Study
From the Abstract: "The coronavirus disease 2019 (COVID-19) pandemic and associated lockdown could be considered a 'perfect storm' for increases in emotional distress. Such increases can only be identified by studies that use data collected 'before' and 'during' the pandemic. Longitudinal data are also needed to examine (1) the roles of previous distress and stressors in emotional distress during the pandemic and (2) how COVID-19-related stressors and coping strategies are associated with emotional distress when pre-pandemic distress is accounted for. [...] In our community sample, pre-pandemic distress, secondary consequences of the pandemic (e.g. lifestyle and economic disruptions), and pre-pandemic social stressors were more consistently associated with young adults' emotional distress than COVID-19- related health risk exposures."
Cambridge University Press
Nivette, Amy; Shanahan, Lilly; Steinhoff, Annekatrin . . .
2020-06-19
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Two Complementary Model-Based Methods for Calculating the Risk of International Spreading of a Novel Virus from the Outbreak Epicentre. The Case of COVID-19
From the Abstract: "We present two complementary model-based methods for calculating the risk of international spread of the novel coronavirus SARS-CoV-2 [severe acute respiratory syndrome coronavirus 2] from the outbreak epicentre. One model aims to calculate the number of cases that would be exported from an endemic country to disease-free regions by travellers. The second model calculates the probability that an infected traveller will generate at least one secondary autochthonous case in the visited country. Although this paper focuses on the data from China, our methods can be adapted to calculate the risk of importation and subsequent outbreaks. We found an average R0 = 5.31 (ranging from 4.08 to 7.91) and a risk of spreading of 0.75 latent individuals per 1000 travellers. In addition, one infective traveller would be able to generate at least one secondary autochthonous case in the visited country with a probability of 23%."
Cambridge University Press
Massad, Eduardo; Amaku, Marcos; Wilder-Smith, Annelies . . .
2020-06-04
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To Follow or Not to Follow: Social Norms and Civic Duty During a Pandemic
From the Document: "The outbreak of COVID-19 [coronavirus disease 2019] has put substantial pressure on individuals to adapt and change their behaviours. As the hope of a vaccine remains at least a year away, everyone is urged to take action to slow the spread of the virus. Thus, 'flattening the curve' has become vital in preventing medical systems from being overrun, and it relies on massive collective action by citizens to follow specific public health measures such as physical distancing, hand washing, and physical isolation for vulnerable individuals. Despite the recommendations, the public has often been confronted with the reality that some individuals are not respecting them, including elected officials. [...] In this article, we explore the effects of civic duty and social norms on adherence to public health recommendations. We find that civic duty promotes following health recommendations and that norms become important in the absence of duty."
Cambridge University Press
Bourgeois, Laura French; Stephenson, Laura Beth, 1976-; Harell, Allison
2020
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Health-Protective Behaviour, Social Media Usage and Conspiracy Belief During the COVID-19 Public Health Emergency
From the Abstract: "Social media platforms have long been recognised as major disseminators of health misinformation. Many previous studies have found a negative association between health-protective behaviours and belief in the specific form of misinformation popularly known as 'conspiracy theory'. Concerns have arisen regarding the spread of COVID-19 [coronavirus disease 2019] conspiracy theories on social media. [...] Three questionnaire surveys of social media use, conspiracy beliefs and health-protective behaviours with regard to COVID-19 among UK residents were carried out online, one using a self-selecting sample (N = 949) and two using stratified random samples from a recruited panel (N = 2250, N = 2254). [...] All three studies found a negative relationship between COVID-19 conspiracy beliefs and COVID-19 health-protective behaviours, and a positive relationship between COVID-19 conspiracy beliefs and use of social media as a source of information about COVID-19. Studies 2 and 3 also found a negative relationship between COVID-19 health-protective behaviours and use of social media as a source of information, and Study 3 found a positive relationship between health-protective behaviours and use of broadcast media as a source of information."
Cambridge University Press
Allington, Daniel; Wessely, Simon; Duffy, Bobby . . .
2020-06-05
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Basic Reproduction Number and Prediction of the Epidemic Size of the Novel Coronavirus (COVID-19) in Shahroud, Iran
From the Abstract: "The aim of this study was to estimate the basic reproduction number (R0) of COVID-19 [coronavirus disease 2019] in the early stage of the epidemic and predict the expected number of new cases in Shahroud in Northeastern Iran. The R0 of COVID-19 was estimated using the serial interval distribution and the number of incidence cases. The 30-day probable incidence and cumulative incidence were predicted using the assumption that daily incidence follows a Poisson distribution determined by daily infectiousness. Data analysis was done using 'earlyR' and 'projections' packages in R software. The maximum-likelihood value of R0 was 2.7 (95% confidence interval (CI): 2.1-3.4) for the COVID-19 epidemic in the early 14 days and decreased to 1.13 (95% CI 1.03-1.25) by the end of day 42. The expected average number of new cases in Shahroud was 9.0 ± 3.8 cases/day, which means an estimated total of 271 (95% CI: 178-383) new cases for the period between 02 April to 03 May 2020. By day 67 (27 April), the effective reproduction number (Rt), which had a descending trend and was around 1, reduced to 0.70. Based on the Rt for the last 21 days (days 46-67 of the epidemic), the prediction for 27 April to 26 May is a mean daily cases of 2.9 ± 2.0 with 87 (48-136) new cases. In order to maintain R below 1, we strongly recommend enforcing and continuing the current preventive measures, restricting travel and providing screening tests for a larger proportion of the population."
Cambridge University Press
Khosravi, Ahamd; Chaman, Reza; Rohani-Rasaf, Marzieh . . .
2020-06-04
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Psychogeriatric Research During COVID-19 Pandemic: Qualitative Analysis of Participant Views
From the Document: "Conducting clinical research during pandemics is critical not only for the management of the ongoing pandemic but also for future pandemic preparedness. The Department of Veterans Affairs (VA), a large integrated health organization and a major sponsor of patient-centered research, is a key player in shaping the conduct of psychogeriatric research in the USA. Sponsored by the VA Office of Research and Development (ORD), VA investigators are involved in over 7,000 funded research projects and often focus on psychogeriatric patient-centered research due to the demographics of Veterans and their family caregivers (ORD, 2020). Hence, it is important to understand how the ORD is handling clinical research during the current pandemic."
Cambridge University Press
Lum, Hillary D.; Padala, Kalpana P.; Dean, Kim T. . . .
2020
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Epidemiological Characteristics of COVID-19: A Systematic Review and Meta-Analysis
From the Abstract: "Our understanding of the Coronavirus disease 2019 (COVID-19) continues to evolve and there are many unknowns about its epidemiology. This study aims to synthesise case fatality rate (CFR) among confirmed COVID-19 patients, incubation period and time from onset of COVID-19 symptoms to first medical visit, intensive care unit (ICU) admission, recovery, and death. We searched MEDLINE, Embase, Google Scholar, and bibliographies of relevant articles from 01 December 2019 to 11 March 2020 without any language restrictions. Quantitative studies that recruited people with confirmed COVID-19 diagnosis were included. Two independent reviewers extracted the data. Out of 1675 non-duplicate studies, 43 were included in the meta-analysis."
Cambridge University Press
Khalili, Malahat; Karamouzian, Mohammad; Nasiri, Naser . . .
2020-06-10
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COVID-19 Pandemic: A New Challenge for Syndromic Surveillance
From the Abstract: "Surveillance is the core function of any public health system, and a multi-component surveillance system for COVID-19 [coronavirus disease 2019] is essential to understand the burden across the different strata of any health system and the population. Many countries and public health bodies utilise 'syndromic surveillance' (using real-time, often non-specific symptom/preliminary diagnosis information collected during routine healthcare provision) to supplement public health surveillance programmes. The current COVID-19 pandemic has revealed a series of unprecedented challenges to syndromic surveillance including: the impact of media reporting during early stages of the pandemic; changes in healthcare-seeking behaviour resulting from government guidance on social distancing and accessing healthcare services; and changes in clinical coding and patient management systems. These have impacted on the presentation of syndromic outputs, with changes in denominators creating challenges for the interpretation of surveillance data. Monitoring changes in healthcare utilisation is key to interpreting COVID-19 surveillance data, which can then be used to better understand the impact of the pandemic on the population."
Cambridge University Press
Elliot, Alex J.; Harcourt, Sally E.; Hughes, Helen E. . . .
2020-06-16
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Factors Associated with the Duration of Hospitalisation Among COVID-19 Patients in Vietnam: A Survival Analysis
From the Abstract Background: "The median duration of hospital stays due to COVID-19 [coronavirus disease 2019] has been reported in several studies on China as 10-13 days. Global studies have indicated that the length of hospitalisation depends on different factors, such as the time elapsed from exposure to symptom onset, and from symptom onset to hospital admission, as well as specificities of the country under study. The goal of this paper is to identify factors associated with the median duration of hospital stays of COVID-19 patients during the second COVID-19 wave that hit Vietnam from 5 March to 8 April 2020."
Cambridge University Press
Thai, Pham Quang
2020
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Estimation of Incubation Period and Serial Interval of COVID-19: Analysis of 178 Cases and 131 Transmission Chains in Hubei Province, China
From the Abstract: "A novel coronavirus disease, designated as COVID-19 [coronavirus disease 2019], has become a pandemic worldwide. This study aims to estimate the incubation period and serial interval of COVID-19. We collected contact tracing data in a municipality in Hubei province during a full outbreak period. The date of infection and infector-infectee pairs were inferred from the history of travel in Wuhan or exposed to confirmed cases. The incubation periods and serial intervals were estimated using parametric accelerated failure time models, accounting for interval censoring of the exposures. Our estimated median incubation period of COVID-19 is 5.4 days (bootstrapped 95% confidence interval (CI) 4.8-6.0), and the 2.5th and 97.5th percentiles are 1 and 15 days, respectively; while the estimated serial interval of COVID-19 falls within the range of -4 to 13 days with 95% confidence and has a median of 4.6 days (95% CI 3.7- 5.5). Ninety-five per cent of symptomatic cases showed symptoms by 13.7 days (95% CI 12.5-14.9). The incubation periods and serial intervals were not significantly different between male and female, and among age groups. Our results suggest a considerable proportion of secondary transmission occurred prior to symptom onset. And the current practice of 14-day quarantine period in many regions is reasonable."
Cambridge University Press
Yang, Lin; Dai, Jingyi; Zhao, Jun . . .
2020-06-16
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Taking the Inner Route: Spatial and Demographic Factors Affecting Vulnerability to COVID-19 Among 604 Cities from Inner São Paulo State, Brazil
From the Abstract: "Even though the impact of COVID-19 [coronavirus disease 2019] in metropolitan areas has been extensively studied, the geographic spread to smaller cities is also of great concern. We conducted an ecological study aimed at identifying predictors of early introduction, incidence rates of COVID-19 and mortality (up to 8 May 2020) among 604 municipalities in inner São Paulo State, Brazil. Socio-demographic indexes, road distance to the state capital and a classification of regional relevance were included in predictive models for time to COVID-19 introduction (Cox regression), incidence and mortality rates (zero-inflated binomial negative regression). In multivariable analyses, greater demographic density and higher classification of regional relevance were associated with both early introduction and increased rates of COVID-19 incidence and mortality. Other predictive factors varied, but distance from the State Capital (São Paulo City) was negatively associated with time-to-introduction and with incidence rates of COVID-19. Our results reinforce the hypothesis of two patterns of geographical spread of SARS-Cov-2 [severe acute respiratory syndrome coronavirus 2] infection: one that is spatial (from the metropolitan area into the inner state) and another which is hierarchical (from urban centres of regional relevance to smaller and less connected municipalities). Those findings may apply to other settings, especially in developing and highly heterogeneous countries, and point to a potential benefit from strengthening non-pharmaceutical control strategies in areas of greater risk."
Cambridge University Press
Fortaleza, C. M. C. B.; Guimarães, R. B.; de Almeida, G. B. . . .
2020-06-16
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Can COVID-Era Export Restrictions Be Deterred?
From the Document: "The COVID-19 [coronavirus disease 2019] pandemic has led some 75 countries to restrict their exports of hundreds of essential products, ranging from antibiotics and face masks to medical ventilators. Since banning exports decreases global supply and leads to price surges on world markets, the cost of these measures may ultimately be counted in human lives. To make matters worse, the international trade regime is ill-designed to deal with export restrictions. Since the beginning of the pandemic, trade experts have called for greater global cooperation (Beattie, 2020), yet such level-headed appeals ignore the long and unsuccessful history of attempts to discipline export restraints. Export restraints currently fall into something of a legal grey zone: they are nominally considered violations, but there are sufficient exceptions written into multilateral rules to render them permissible in any circumstances under which they may be needed, including the current pandemic. This is not happenstance. For the past 70 years of multilateral trade negotiations, there has been a widespread recognition that governments are unlikely to commit to meaningful discipline on export restraints, given the necessity to secure domestic supplies by any means necessary in times of crisis."
Cambridge University Press
Pelc, Krzysztof J.
2020
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COVID-19 in Adult Patients with CHD: A Matter of Anatomy or Comorbidities?
From the Abstract: "Little is know about COVID-19 [coronavirus disease 2019] outcome in specific populations such as Adult congenital heart disease (ACHD) patients. We report three cases of adult patients with similar underlying disease with completely different clinical severity at the time of COVID-19 infection. The patient with the most severe clinical course was obese and diabetic, suggesting that COVID-19 mortality and morbidity in Adult congenital heart disease patients might be independent of anatomic complexity."
Cambridge University Press
Ferrero, Paolo; Piazza, Isabelle; Ciuffreda, Matteo
2020-05-28
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Nationally Representative Sample Shows an Increase in Domestic Conflict Early in the COVID-19 Pandemic
From the Introduction: "The coronavirus disease (COVID-19) pandemic and subsequent social and physical restrictions put in place to address this crisis have caused personal and economic stressors and uncertainty about the future on a national level. One of the main concerns during disaster conditions is that pressures put on households may increase domestic conflict, including verbal and physical fights between partners. To understand the impact of COVID-19 on domestic conflict, we assessed reports of increased verbal and physical fights in a nationally representative sample of the U.S. adult population. In the wake of disaster, rates of domestic conflict often increase in the weeks/months following the event. Economic disasters, such as periods of recession, are also related to increases in domestic violence (e.g., 2007-2009) and have been linked to underlying conditions, like prevalence of economic uncertainty. Evidence suggests that risk for domestic conflict is not evenly distributed. Socially vulnerable populations (e.g., women, low socioeconomic status, people of color, low education level) experience disproportionate losses and high levels of stress following natural and economic disasters, and increases in domestic violence. Such findings suggest that economically vulnerable groups may be at increased risk for domestic conflict in the early days of the COVID-19 pandemic. Additionally, a longer duration of disaster condition exposure is positively associated with the number of domestic assaults. The effect of duration of disaster on domestic violence outcomes would also suggest that certain groups need continued assistance during prolonged disaster conditions and in the months that follow."
Cambridge University Press; Society for Disaster Medicine and Public Health, Inc.
Locker, Alicia R.; Finucane, Melissa L.; Roth, Elizabeth . . .
2022-02-23
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