We conducted a comparative historical study to interrogate Professor Peter Doherty's warning to Australians in April 2020 that 'COVID-19 is just as lethal as the Spanish flu'. We identified the ...epicentres of both pandemics, namely, metropolitan Sydney in 1919 and metropolitan Melbourne in 2020 and compared the lethality of the Spanish Flu and COVID-19 in these two cities. Lethality was measured by the number and rate of hospital admissions, death rates, age-specific death rates and age-standardised mortality rates (ASMRs). Using these measures, we demonstrated the strikingly different waves of infection, their severity at various points in time and the cumulative impact of the viruses by the end of our study period, i.e., 30 September in 1919 and 2020. Hospital admissions and deaths from the Spanish Flu in 1919 were more than 30 times higher than those for COVID-19 in 2020. The ASMR per 100,000 population for the Spanish Flu was 383 compared to 7 for COVID-19: The former was about 55 times higher than the latter. These results suggest that the Spanish Flu was more lethal than COVID-19. Professor Doherty's warning was perhaps taken seriously and that partly explains the findings of this study. Containing infection in 1919 and 2020 threw the burden on nonpharmaceutical interventions (NPIs) such as 'protective sequestration' (quarantine), contact tracing, lockdowns and masks. It is likely that the persistent and detailed contact tracing scheme provides the best possible explanation for why NPIs in 2020 were more effective than in 1919 and therefore contributed to the lower lethality of the COVID-19 pandemic in its first year.
In the early stages of the pandemic, Saudi Arabia and other countries in the Arab Gulf region relied on non-pharmaceutical therapies to limit the effect of the pandemic, much like other nations ...across the world. In comparison to other nations in the area or globally, these interventions were successful at lowering the healthcare burden. This was accomplished via the deterioration of the economy, education, and a variety of other societal activities. By the end of 2020, the promise of effective vaccinations against SARS-CoV-2 have been realized, and vaccination programs have begun in developed countries, followed by the rest of the world. Despite this, there is still a long way to go in the fight against the disease. In order to explore disease transmission, vaccine rollout and prioritisation, as well as behavioural dynamics, we expand the classic SEIR model and build an age-structured compartmental model. We examine how individual and social behaviour changes in response to the initiation of vaccination campaigns and the relaxation of non-pharmacological treatments. Overall, vaccination remains the most effective method of containing the disease and resuming normal life. Additionally, we evaluate several vaccination prioritisation schemes based on age group, behavioural responses, vaccine effectiveness, and vaccination rollout speed. We applied our model to four Arab Gulf nations (Saudi Arabia, Bahrain, the United Arab Emirates, and Oman), which were chosen for their low mortality rate compared to other countries in the region or worldwide, as well as their demographic and economic settings. We fitted the model using actual pandemic data in these countries. Our results suggest that vaccinations focused on the elderly and rapid vaccine distribution are critical for reducing disease resurgence. Our result also reinforce the cautious note that early relaxation of safety measures may compromise the vaccine's short-term advantages.
The declaration of a nationwide lockdown in India led to millions of migrant workers, particularly from Uttar Pradesh (UP) and Bihar, returning to their home states without proper transportation and ...social distancing from cities such as Delhi, Mumbai, and Hyderabad. This unforeseen migration and social mixing accelerated the transmission of diseases across the country. To analyze the impact of reverse migration on disease progression, we have developed a disease transmission model for the neighboring Indian states of Delhi and UP. The model’s essential mathematical properties, including positivity, boundedness, equilibrium points (EPs), and their linear stability, as well as computation of the basic reproduction number
, are studied. The mathematical analysis reveals that the model with active reverse migration cannot reach a disease-free equilibrium, indicating that the failure of restrictive mobility intervention caused by reverse migration kept the disease propagation alive. Further, PRCC analysis highlights the need for effective home isolation, better disease detection techniques, and medical interventions to curb the spread. The study estimates a significantly shorter doubling time for exponential growth of the disease in both regions. In addition, the occurrence of synchronous patterns between epidemic trajectories of the Delhi and UP regions accentuates the severe implications of migrant plight on UP’s already fragile rural health infrastructure. By using COVID-19 incidence data, we quantify key epidemiological parameters, and our scenario analyses demonstrate how different lockdown plans might have impacted disease prevalence. Based on our observations, the transmission rate has the most significant impact on COVID-19 cases. This case study exemplifies the importance of carefully considering these issues before implementing lockdowns and social isolation throughout the country to combat future outbreaks.
L’article explicite la définition des interventions non médicamenteuses (INM) proposée depuis 2023 par la société savante internationale Non-Pharmacological Intervention Society (NPIS). Ce travail ...résulte de l’incitation en 2011 de la Haute Autorité de Santé de qualifier d’INM les protocoles physiques, psychosociaux et nutritionnels de prévention et de soin fondés sur des données probantes. L’article précise le périmètre de ces pratiques de santé, nommées en anglais Normalized Person-centered Intervention, à partir d’un cadre éthique et scientifique d’évaluation co-construit sous la coordination de la NPIS. Ce paradigme standardisé permet d’identifier un patrimoine universel de protocoles immatériels de prévention et de soin, complémentaires d’autres pratiques conventionnelles de santé. La recherche permettra d’élargir le nombre de protocoles labellisés et traçables dans un référentiel à la disposition des kinésithérapeutes.
This article presents the definition of non-pharmacological interventions (NPIs) proposed in 2023 by an international scientific society, the Non-Pharmacological Intervention Society (NPIS). The article specifies the scope of these prevention and care practices, based on a standardized ethical and scientific evaluation framework established in 2023 under the coordination of the NPIS. This framework makes it possible to establish a universal heritage of intangible, evidence-based prevention and care protocols, complementary to other conventional healthcare practices. A register of accredited protocols entitled normalized person-centered intervention will gradually be made available to physiotherapists.
France implemented a combination of non-pharmaceutical interventions (NPIs) to manage the COVID-19 pandemic between September 2020 and June 2021. These included a lockdown in the fall 2020 - the ...second since the start of the pandemic - to counteract the second wave, followed by a long period of nighttime curfew, and by a third lockdown in the spring 2021 against the Alpha wave. Interventions have so far been evaluated in isolation, neglecting the spatial connectivity between regions through mobility that may impact NPI effectiveness.
Focusing on September 2020-June 2021, we developed a regionally-based epidemic metapopulation model informed by observed mobility fluxes from daily mobile phone data and fitted the model to regional hospital admissions. The model integrated data on vaccination and variants spread. Scenarios were designed to assess the impact of the Alpha variant, characterized by increased transmissibility and risk of hospitalization, of the vaccination campaign and alternative policy decisions.
The spatial model better captured the heterogeneity observed in the regional dynamics, compared to models neglecting inter-regional mobility. The third lockdown was similarly effective to the second lockdown after discounting for immunity, Alpha, and seasonality (51% vs 52% median regional reduction in the reproductive number R
, respectively). The 6pm nighttime curfew with bars and restaurants closed, implemented in January 2021, substantially reduced COVID-19 transmission. It initially led to 49% median regional reduction of R
, decreasing to 43% reduction by March 2021. In absence of vaccination, implemented interventions would have been insufficient against the Alpha wave. Counterfactual scenarios proposing a sequence of lockdowns in a stop-and-go fashion would have reduced hospitalizations and restriction days for low enough thresholds triggering and lifting restrictions.
Spatial connectivity induced by mobility impacted the effectiveness of interventions especially in regions with higher mobility rates. Early evening curfew with gastronomy sector closed allowed authorities to delay the third wave. Stop-and-go lockdowns could have substantially lowered both healthcare and societal burdens if implemented early enough, compared to the observed application of lockdown-curfew-lockdown, but likely at the expense of several labor sectors. These findings contribute to characterize the effectiveness of implemented strategies and improve pandemic preparedness.
COVID-19 has affected the various aspects of social service delivery worldwide. Explicitly, pediatric service was affected mainly due to the travel restrictions, and children were at heightened risk ...due to these circumstances. Therefore, this study aims to analyze the Pediatric Clinical Practice in a Chinese children's hospital to describe and acknowledge the impact of COVID-19 on the pediatric healthcare system. For this purpose, the hospital's outpatient registration database was the primary information source, which comprises demographic data, including age, gender, city of residence, and hospital departments visited. Data on patients admitted from January 25, 2019, to April 16, 2019, were collected and used as a baseline. The results revealed that the number of pediatric visits to the case study hospital decreased during the COVID-19 pandemic, accounting for 40% of that in 2019, especially during the early stage of the pandemic. The proportion of pediatric patients from outside Chongqing decreased by approximately 14% in the early stages and increased by 24% in the second and third stages, corresponding to an overall decrease of 8.5%. Accordingly, the hospital responds to COVID-19 by providing valuable information and a guiding framework to the rest of the world on how to respond to a crisis.
We quantified the effects of adherence to various non-pharmaceutical interventions (NPIs) on the seasonal influenza epidemic dynamics in Japan during 2020. The total monthly number of seasonal ...influenza cases per sentinel site (seasonal influenza activity) reported to the National Epidemiological Surveillance of Infectious Diseases and alternative NPI indicators (retail sales of hand hygiene products and number of airline passenger arrivals) from 2014−2020 were collected. The average number of monthly seasonal influenza cases in 2020 had decreased by approximately 66.0% (p < 0.001) compared to those in the preceding six years. An increase in retail sales of hand hygiene products of ¥1 billion over a 3-month period led to a 15.5% (95% confidence interval CI: 10.9−20.0%; p < 0.001) reduction in seasonal influenza activity. An increase in the average of one million domestic and international airline passenger arrivals had a significant association with seasonal influenza activity by 11.6% at lag 0−2 months (95% CI: 6.70−16.5%; p < 0.001) and 30.9% at lag 0−2 months (95% CI: 20.9−40.9%; p < 0.001). NPI adherence was associated with decreased seasonal influenza activity during the COVID-19 pandemic in Japan, which has crucial implications for planning public health interventions to minimize the health consequences of adverse seasonal influenza epidemics.
Background
During the initial phases of the vaccination campaign worldwide, nonpharmaceutical interventions (NPIs) remained pivotal in the fight against the COVID-19 pandemic. In this context, it is ...important to understand how the arrival of vaccines affected the adoption of NPIs. Indeed, some individuals might have seen the start of mass vaccination campaigns as the end of the emergency and, as a result, relaxed their COVID-safe behaviors, facilitating the spread of the virus in a delicate epidemic phase such as the initial rollout.
Objective
The aim of this study was to collect information about the possible relaxation of protective behaviors following key events of the vaccination campaign in four countries and to analyze possible associations of these behavioral tendencies with the sociodemographic characteristics of participants.
Methods
We developed an online survey named “COVID-19 Prevention and Behavior Survey” that was conducted between November 26 and December 22, 2021. Participants were recruited using targeted ads on Facebook in four different countries: Brazil, Italy, South Africa, and the United Kingdom. We measured the onset of relaxation of protective measures in response to key events of the vaccination campaign, namely personal vaccination and vaccination of the most vulnerable population. Through calculation of odds ratios (ORs) and regression analysis, we assessed the strength of association between compliance with NPIs and sociodemographic characteristics of participants.
Results
We received 2263 questionnaires from the four countries. Participants reported the most significant changes in social activities such as going to a restaurant or the cinema and visiting relatives and friends. This is in good agreement with validated psychological models of health-related behavioral change such as the Health Belief Model, according to which activities with higher costs and perceived barriers (eg, social activities) are more prone to early relaxation. Multivariate analysis using a generalized linear model showed that the two main determinants of the drop of social NPIs were (1) having previously tested positive for COVID-19 (after the second vaccine dose: OR 2.46, 95% CI 1.73-3.49) and (2) living with people at risk (after the second vaccine dose: OR 1.57, 95% CI 1.22-2.03).
Conclusions
This work shows that particular caution has to be taken during vaccination campaigns. Indeed, people might relax their safe behaviors regardless of the dynamics of the epidemic. For this reason, it is crucial to maintain high compliance with NPIs to avoid hindering the beneficial effects of the vaccine.
In response to the COVID-19 pandemic, many governments swiftly decided to order nationwide lockdowns based on limited evidence that such extreme measures were effective in containing the epidemic. A ...growing concern is that governments were given little time to adopt effective and proportional interventions protecting citizens' lives while observing their freedom and rights. This paper examines the effectiveness of non-pharmaceutical interventions (NPIs) in containing COVID-19, by conducting a linear regression over 108 countries, and the implication for human rights. The regression results are supported by evidence that shows the change in 10 selected countries' responding strategies and their effects as the confirmed cases increase. We found that school closures are effective in containing COVID-19 only when they are implemented along with complete contact tracing. Our findings imply that to contain COVID-19 effectively and minimize the risk of human rights abuses, governments should consider implementing prudently designed full contact tracing and school closure policies, among others. Minimizing the risk of human rights abuses should be a principle even when full contact tracing is implemented.
This study aims to evaluate the impact of non-pharmaceutical interventions (NPIs) on the prevalence of respiratory pathogens among hospitalised children with acute respiratory infections (ARIs) in ...Suzhou. Children with ARIs admitted to the Children’s Hospital of Soochow University between 1 September 2021 and 31 December 2022 and subjected to 13 respiratory pathogen multiplex PCR assays were included in the study. We retrospectively collected demographic details, results of respiratory pathogen panel tests, and discharge diagnostic information of the participants, and described the age and seasonal distribution of respiratory pathogens and risk factors for developing pneumonia. A total of 10,396 children <16 years of age, including 5,905 males and 4,491 females, were part of the study. The positive rates of the 11 respiratory pathogen assays were 23.3% (human rhinovirus (HRV)), 15.9% (human respiratory syncytial virus (HRSV)), 10.5% (human metapneumovirus (HMPV)), 10.3% (human parainfluenza virus (HPIV)), 8.6% (mycoplasma pneumoniae (MP)), 5.8% (Boca), 3.5% (influenza A (InfA)), 2.9% (influenza B (InfB)), 2.7% (human coronavirus (HCOV)), 2.0% (adenovirus (ADV)), and 0.5% (Ch), respectively. Bocavirus and HPIV detection peaked during the period from September to November (autumn), and MP and HMPV peaked in the months of November and December. The peak of InfA detection was found to be in summer (July and August), whereas the InfB peak was observed to be in winter (December, January, and February). HRSV and HRV predominated in the <3 years age group. HRV and HMPV were common in the 3–6 years group, whereas MP was predominant in the ≥6 years group. MP (odds ratio (OR): 70.068, 95%CI: 32.665–150.298, P < 0.01), HMPV (OR: 6.493, 95%CI: 4.802–8.780, P < 0.01), Boca (OR: 3.300, 95%CI: 2.186–4.980, P < 0.01), and HRSV (OR: 2.649, 95%CI: 2.089–3.358, P < 0.01) infections were more likely to develop into pneumonia than the other pathogens. With the use of NPIs, HRV was the most common pathogen in children with ARIs, and MP was more likely to progress to pneumonia than other pathogens.
PDF
