scholarly journals Initial Assessment of the Impact of the Emergency State Lockdown Measures on the 1st Wave of the COVID-19 Epidemic in Portugal

2020 ◽  
Vol 33 (11) ◽  
pp. 733
Author(s):  
Vasco Ricoca Peixoto ◽  
André Vieira ◽  
Pedro Aguiar ◽  
Carlos Carvalho ◽  
Daniel Rhys Thomas ◽  
...  
Keyword(s):  
Intensive Care ◽  
Arima Model ◽  
Control Measures ◽  
Contact Tracing ◽  
Initial Assessment ◽  
Early Action ◽  
Containment Measures ◽  
Prevention And Control Measures ◽  
Care Capacity ◽  
The Impact

Introduction: Portugal took early action to control the COVID-19 epidemic, initiating lockdown measures on March 16th when it recorded only 62 cases of COVID-19 per million inhabitants and reported no deaths. The Portuguese public complied quickly, reducing their overall mobility by 80%. The aim of this study was to estimate the initial impact of the lockdown in Portugal in terms of the reduction of the burden on the healthcare system.Material and Methods: We forecasted epidemic curves for: Cases, hospital inpatients (overall and in intensive care), and deaths without lockdown, assuming that the impact of containment measures would start 14 days after initial lockdown was implemented. We used exponential smoothing models for deaths, intensive care and hospitalizations and an ARIMA model for number of cases. Models were selected considering fitness to the observed data up to the 31st March 2020. We then compared observed (with intervention) and forecasted curves (without intervention).Results: Between April 1st and April 15th, there were 146 fewer deaths (-25%), 5568 fewer cases (-23%) and, as of April 15th, there were 519 fewer intensive care inpatients (-69%) than forecasted without the lockdown. On April 15th, the number of intensive care inpatients could have reached 748, three times higher than the observed value (229) if the intervention had been delayed.Discussion: If the lockdown had not been implemented in mid-March, Portugal intensive care capacity (528 beds) would have likely been breached during the first half of April. The lockdown seems to have been effective in reducing transmission of SARS-CoV-2, serious COVID-19 disease, and associated mortality, thus decreasing demand on health services.Conclusion: An early lockdown allowed time for the National Health Service to mobilize resources and acquire personal protective equipment, increase testing, contact tracing and hospital and intensive care capacity and to promote broad prevention and control measures. When lifting more stringent measures, strong surveillance and communication strategies that mobilize individual prevention efforts are necessary.

scholarly journals Rapid assessment of the impact of lockdown on the COVID-19 epidemic in Portugal

2020 ◽  
Author(s):  
Vasco Ricoca Peixoto ◽  
Andre Vieira ◽  
Pedro Aguiar ◽  
Carlos Carvalho ◽  
Daniel Thomas ◽  
...  
Keyword(s):  
Health Service ◽  
Arima Model ◽  
Rapid Assessment ◽  
Protective Equipment ◽  
Early Action ◽  
Directorate General ◽  
Containment Measures ◽  
The Impact ◽  
Hospital Inpatients ◽  
Official Data

Background: Portugal took early action to control the COVID19 epidemic, imposing a lockdown on March 16 when it recorded only 62 cases of COVID-19 per million inhabitants and no reported deaths. The Portuguese people complied quickly, reducing their overall mobility by 80% . We estimate the impact of the lockdown in Portugal in terms of reducing burden on the health service. Methods: Using publicly available official data from the Portuguese Directorate-General of Health we forecasted epidemic curves for: Cases, hospital inpatients (overall and in ICU), and deaths without lockdown, assuming that the impact of containment measures would start 14 days after lockdown was implemented. We used exponential smoothing models for deaths, intensive care (ICU) and hospitalizations and an ARIMA model for number of cases. Models were selected considering fitness to the observed data to the 31st of March 2020. We then compared observed(with intervention) and forecasted curves( without intervention). Results: Between April 1 and April 15, there were 146 fewer deaths(-25%), 5568 fewer cases (-23%) and, as of April 15, there were 519 fewer ICU inpatients(-69%) and 508 fewer overall hospital inpatients(-28%) than forecasted without lockdown. On April 15 the number of ICU inpatients could have reached 748, three times higher than the observed value (229) if the intervention had been delayed. Conclusion: If the lockdown had not been implemented in mid-March, Portugal ICU capacity (528 ICU beds) would likely have been breached in the first half of April. The lockdown seems to have been effective in reducing transmission of SARS-Cov-2, serious Covid-19 illness and associated mortality, thereby decreasing demand on health services. Early action allowed time for the National Health Service to acquire protective equipment, to increase capacity to test and cope with the surge in hospital and ICU demand caused by the pandemic.

scholarly journals Investigating the effectiveness of re-opening policies before vaccination during a pandemic: SD modelling research based on COVID-19 in Wuhan

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ying Qian ◽  
Wei Xie ◽  
Jidi Zhao ◽  
Ming Xue ◽  
Shiyong Liu ◽  
...  
Keyword(s):  
Model Simulation ◽  
Control Measures ◽  
World Health ◽  
Contact Tracing ◽  
Infection Prevention And Control ◽  
Real World Data ◽  
Medical Resources ◽  
Health Organization ◽  
The Impact ◽  
Different Levels

Abstract Background Lockdown policies were widely adopted during the coronavirus disease 2019 (COVID-19) pandemic to control the spread of the virus before vaccines became available. These policies had significant economic impacts and caused social disruptions. Early re-opening is preferable, but it introduces the risk of a resurgence of the epidemic. Although the World Health Organization has outlined criteria for re-opening, decisions on re-opening are mainly based on epidemiologic criteria. To date, the effectiveness of re-opening policies remains unclear. Methods A system dynamics COVID-19 model, SEIHR(Q), was constructed by integrating infection prevention and control measures implemented in Wuhan into the classic SEIR epidemiological model and was validated with real-world data. The input data were obtained from official websites and the published literature. Results The simulation results showed that track-and-trace measures had significant effects on the level of risk associated with re-opening. In the case of Wuhan, where comprehensive contact tracing was implemented, there would have been almost no risk associated with re-opening. With partial contact tracing, re-opening would have led to a minor second wave of the epidemic. However, if only limited contact tracing had been implemented, a more severe second outbreak of the epidemic would have occurred, overwhelming the available medical resources. If the ability to implement a track-trace-quarantine policy is fixed, the epidemiological criteria need to be further taken into account. The model simulation revealed different levels of risk associated with re-opening under different levels of track-and-trace ability and various epidemiological criteria. A matrix was developed to evaluate the effectiveness of the re-opening policies. Conclusions The SEIHR(Q) model designed in this study can quantify the impact of various re-opening policies on the spread of COVID-19. Integrating epidemiologic criteria, the contact tracing policy, and medical resources, the model simulation predicts whether the re-opening policy is likely to lead to a further outbreak of the epidemic and provides evidence-based support for decisions regarding safe re-opening during an ongoing epidemic. Keyords COVID-19; Risk of re-opening; Effectiveness of re-opening policies; IPC measures; SD modelling.

scholarly journals Estimating the burden of SARS-CoV-2 in France

Science ◽  
2020 ◽  
Vol 369 (6500) ◽  
pp. 208-211 ◽  
Author(s):  
Henrik Salje ◽  
Cécile Tran Kiem ◽  
Noémie Lefrancq ◽  
Noémie Courtejoie ◽  
Paolo Bosetti ◽  
...  
Keyword(s):  
Intensive Care ◽  
Severe Acute Respiratory Syndrome ◽  
Credible Interval ◽  
Control Measures ◽  
Reproductive Number ◽  
Infected Population ◽  
Population Immunity ◽  
The Impact ◽  
Second Wave ◽  
Death Data

France has been heavily affected by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic and went into lockdown on 17 March 2020. Using models applied to hospital and death data, we estimate the impact of the lockdown and current population immunity. We find that 2.9% of infected individuals are hospitalized and 0.5% of those infected die (95% credible interval: 0.3 to 0.9%), ranging from 0.001% in those under 20 years of age to 8.3% in those 80 years of age or older. Across all ages, men are more likely to be hospitalized, enter intensive care, and die than women. The lockdown reduced the reproductive number from 2.90 to 0.67 (77% reduction). By 11 May 2020, when interventions are scheduled to be eased, we project that 3.5 million people (range: 2.1 million to 6.0 million), or 5.3% of the population (range: 3.3 to 9.3%), will have been infected. Population immunity appears to be insufficient to avoid a second wave if all control measures are released at the end of the lockdown.

scholarly journals Impact of the Inflow Population From Outbreak Areas on the COVID-19 Epidemic in Yunnan Province and the Recommended Control Measures: A Preliminary Study

2020 ◽  
Vol 8 ◽  
Author(s):  
Zhong Sun ◽  
Guozhong He ◽  
Ninghao Huang ◽  
Hongyu Chen ◽  
Shuwei Zhang ◽  
...  
Keyword(s):  
Prevention And Control ◽  
Yunnan Province ◽  
Clinical Manifestations ◽  
Control Measures ◽  
Proper Management ◽  
Outbreak Areas ◽  
Prevention And Control Measures ◽  
And Gender ◽  
And Control ◽  
The Impact

Background: COVID-19 developed into a global pandemic in 2020 and poses challenges regarding the prevention and control capabilities of countries. A large number of inbound travelers from other regions could lead to a renewed outbreak of COVID-19 in the local regions. Globally, as a result of the imbalance in the control of the epidemic, all countries are facing the risk of a renewed COVID-19 outbreak brought about by travelers from epidemic areas. Therefore, studies on a proper management of the inbound travelers are urgent.Methods: We collected a total of 4,733,414 inbound travelers and 174 COVID-19 diagnosed patients in Yunnan province from 21 January 2020 to 20 February 2020. Data on place of origin, travel history, age, and gender, as well as whether they had suspected clinical manifestations for inbound travelers in Yunnan were collected. The impact of inbound travelers on the local epidemic was analyzed with a collinear statistical analysis and the effect of the control measures on the epidemic was evaluated with a sophisticated modeling approach.Results: Of the 174 COVID-19 patients, 60.9% were not from Yunnan, and 76.4% had a history of travel in Hubei. The amount of new daily cases in Yunnan was significant correlated with the number of inbound travelers from Hubei and suspected cases among them. Using Susceptible–Exposed–Infectious–Recovered (SEIR) model analysis, we found that the prevention and control measures dropped the local R0 down to 1.07 in Yunnan province.Conclusions: Our preliminary analysis showed that the proper management of inbound travelers from outbreak areas has a significantly positive effect on the prevention and control of the virus. In the process of resettlement, some effective measures taken by Yunnan province may provide an important reference for preventing the renewed COVID-19 outbreak in other regions.

scholarly journals Changes in Prevalence of Nosocomial Infection Pre- and Post-COVID-19 pandemic from a Tertiary Hospital in China

2021 ◽  
Author(s):  
Chunmei Su ◽  
Zhiqin Zhang ◽  
Xu Zhao ◽  
Hanlin Peng ◽  
Yi Hong ◽  
...  
Keyword(s):  
Nosocomial Infection ◽  
Nosocomial Infections ◽  
Prevention And Control ◽  
Control Measures ◽  
Gastrointestinal Infections ◽  
Effective Prevention ◽  
Oral Infections ◽  
Prevention And Control Measures ◽  
And Control ◽  
The Impact

Abstract Background: Nosocomial infections (NIs) are an important cause of mortality, and increasing evidence reveals that the prevalence of NIs can be reduced through effective prevention and control measures. The aim of this study was to investigate the impact of the prevention and control measures for the COVID-19 pandemic on NIs.Methods: A retrospective study was conducted to analyze the prevalence of NIs before and after COVID-19 pandemic for six months in the Children’s Hospital of Soochow University.Results: A total of 39,914 patients in 2019 and 34,645 patients in 2020 were admitted to the hospital during the study. There were 1.39% (481/34645) of patients with NIs in 2020, which was significantly lower than the 2.56% (1021/39914) of patients in 2019. The rate of critical and fatal cases was also decreased. Except for the ICU, the prevalence of nosocomial infection in most departments decreased from 2019 to 2020. Regarding the source of infections, a significant reduction was mainly observed in respiratory (0.99% vs 0.42%, p=0.000) and digestive tract (0.63% vs 0.14%, p=0.000). The microorganism analysis of respiratory infections indicated an obvious decline in acinetobacters and fungi. The most significant decline of pathogens in gastrointestinal infections was observed for rotavirus. The comparison of catheter-related nosocomial infections between 2019 and 2020 did not show significant differences. Conclusions: The prevention and control measures for the COVID-19 pandemic have reduced the nosocomial infection in almost all departments, except the ICU, mainly regarding respiratory, gastrointestinal, and oral infections, while catheter-related infections did not show any differences.

scholarly journals The impact of management practices to prevent and control mycotoxins in the European food supply chain: MyToolBox project results

2021 ◽  
Vol 14 (2) ◽  
pp. 139-154
Author(s):  
M. Focker ◽  
H.J. van der Fels-Klerx ◽  
N. Magan ◽  
S.G. Edwards ◽  
M. Grahovac ◽  
...  
Keyword(s):  
Supply Chain ◽  
Impact Assessment ◽  
Prevention And Control ◽  
Control Measures ◽  
Economic Losses ◽  
Crop Losses ◽  
Mycotoxin Contamination ◽  
Prevention And Control Measures ◽  
And Control ◽  
The Impact

The presence of mycotoxins in cereals has led to large economic losses in Europe. In the course of the European project MyToolBox, prevention and control measures to reduce mycotoxin contamination in cereals were developed. This study aimed to estimate the impact of these prevention and control measures on both the reduction in crop losses and the increased volume of crops suitable for food and/or feed. It focused on the following measures: the use of fungicides during wheat cultivation, the use of resistant maize cultivars and/or biocontrol during maize cultivation, the use of real time sensors in storage silos, the use of innovative milling strategies during the pasta making process, and the employment of degrading enzymes during the process of bioethanol and Dried Distillers Grains with Solubles (DDGS) production. The impact assessment was based on the annual volume of cereals produced, the annual levels of mycotoxin contamination, and experimental data on the prevention and control measures collected in the course of the MyToolBox project. Results are expressed in terms of reduced volumes of cereals lost, or as additional volumes of cereals available for food meeting the current European legal limits. Results showed that a reduction in crop losses as well as an increase in the volume of crops suitable as food and/or feed is feasible with each proposed prevention or control measure along the supply chain. The impact was the largest in areas and in years with the highest mycotoxin contamination levels but would have less impact in years with low mycotoxin levels. In further research, the impact assessment may be validated using future data from more years and European sites. Decision makers in the food and feed supply chain can use this impact assessment to decide on the relevant prevention and control strategies to apply.

scholarly journals The Use of Digital Tools to Mitigate the COVID-19 Pandemic: Comparative Retrospective Study of Six Countries

10.2196/24598 ◽  
2020 ◽  
Vol 6 (4) ◽  
pp. e24598
Author(s):  
Kylie Zeng ◽  
Stephanie N Bernardo ◽  
Weldon E Havins
Keyword(s):  
United States ◽  
South Korea ◽  
Transmission Rate ◽  
The United States ◽  
Control Measures ◽  
Digital Tools ◽  
Contact Tracing ◽  
Border Control ◽  
Significant Difference ◽  
Containment Measures

Background Since the COVID-19 outbreak began in Wuhan, China, countries worldwide have been forced to take unprecedented measures to combat it. While some countries are still grappling with the COVID-19 pandemic, others have fared better and have re-established relative normalcy quickly. The rapid transmission rate of the virus has shown a greater need for efficient and technologically modern containment measures. The use of digital tools to facilitate strict containment measures in countries that have fared well against the COVID-19 pandemic has sparked both interest and controversy. Objective In this study, we compare the precautions taken against the spread of COVID-19 in the United States, Spain, and Italy, with Taiwan, South Korea, and Singapore, particularly related to the use of digital tools for contact tracing, and propose policies that could be used in the United States for future COVID-19 waves or pandemics. Methods COVID-19 death rate data were obtained from the European Center for Disease Prevention and Control (ECDC), accessed through the Our World in Data database, and were evaluated based on population size per 100,000 people from December 31, 2019, to September 6, 2020. All policies and measures enacted were obtained from their respective governmental websites. Results We found a strong association between lower death rates per capita and countries that implemented early mask use and strict border control measures that included mandatory quarantine using digital tools. There is a significant difference in the number of deaths per 100,000 when comparing Taiwan, South Korea, and Singapore with the United States, Spain, and Italy. Conclusions Based on our research, it is evident that early intervention with the use of digital tools had a strong correlation with the successful containment of COVID-19. Infection rates and subsequent deaths in Italy, Spain, and the United States could have been much lower with early mask use and, more importantly, timely border control measures using modern digital tools. Thus, we propose that the United States execute the following national policies should a public health emergency be declared: (1) immediately establish a National Command responsible for enacting strict mandatory guidelines enforced by federal and state governments, including national mask use; (2) mandate civilian cooperation with health officials in contact tracing and quarantine orders; and (3) require incoming travelers to the United States and those quarantined to download a contact tracing app. We acknowledge the countries we studied differ in their cultures, political systems, and reporting criteria for COVID-19 deaths. Further research may need to be conducted to address these limitations; however, we believe that the proposed policies could protect the American public.

scholarly journals Estimating the Impact of Control Measures to Prevent Outbreaks of COVID-19 Associated with Air Travel into a COVID-19-free country: A Simulation Modelling Study

2020 ◽  
Author(s):  
Nick Wilson ◽  
Michael G Baker ◽  
Martin Eichner
Keyword(s):  
Simulation Modelling ◽  
Air Travel ◽  
Control Measures ◽  
Contact Tracing ◽  
Uncertainty Interval ◽  
Policy Makers ◽  
Stochastic Version ◽  
Low Prevalence ◽  
And Control ◽  
The Impact

AbstractAimsWe aimed to estimate the risk of COVID-19 outbreaks associated with air travel from a country with a very low prevalence of COVID-19 infection (Australia) to a COVID-19-free country (New Zealand; [NZ]), along with the likely impact of various control measures for passengers and cabin crew.MethodsA stochastic version of the SEIR model CovidSIM v1.1, designed specifically for COVID-19 was utilized. It was populated with data for both countries and parameters for SARS-CoV-2 transmission and control measures. We assumed one Australia to NZ flight per day.ResultsWhen no interventions were in place, an outbreak of COVID-19 in NZ was estimated to occur after an average time of 1.7 years (95% uncertainty interval [UI]: 0.04-6.09). However, the combined use of exit and entry screening (symptom questionnaire and thermal camera), masks on aircraft and two PCR tests (on days 3 and 12 in NZ), combined with self-reporting of symptoms and contact tracing and mask use until the second PCR test, reduced this risk to one outbreak every 29.8 years (0.8 to 110). If no PCR testing was performed, but mask use was used by passengers up to day 15 in NZ, the risk was one outbreak every 14.1 years. However, 14 days quarantine (NZ practice in May 2020), was the most effective strategy at one outbreak every 34.1 years (0.06 to 125); albeit combined with exit screening and mask use on flights.ConclusionsPolicy-makers can require multi-layered interventions to markedly reduce the risk of importing the pandemic virus into a COVID-19-free nation via air travel. There is potential to replace 14-day quarantine with PCR testing or interventions involving mask use by passengers in NZ. However, all approaches require continuous careful management and evaluation.

scholarly journals Using simulation Technology to Analyze the COVID-19 Epidemic in Changsha, Hunan Province, China

2020 ◽  
Author(s):  
Nan Zhou ◽  
Guoqun LI ◽  
Tong LI ◽  
Weitong LI ◽  
Mengxiang CHEN ◽  
...  
Keyword(s):  
Virus Transmission ◽  
Control Measures ◽  
Hunan Province ◽  
Contact Rate ◽  
Simulation Technology ◽  
Simulation Results ◽  
Prevention And Control Measures ◽  
And Control ◽  
The Impact ◽  
Infectious Disease Dynamics

Abstract This study mainly uses simulation technology to simulate the COVID-19 epidemic in Changsha, Hunan Province, China, and analyze the impact of different prevention and control measures on the epidemic. we Collect the information of all COVID-19 patients in Changsha from January 21, 2020 to March 14, 2020 and relevant policies during the COVID-19 epidemic in Changsha. Established the SEIAR infectious disease dynamics model under natural conditions, and added isolation measures on this basis. Using Anylogic8.5, the COVID-19 epidemic in Changsha City was simulated under various conditions based on the established model.In this study we find that There were 242 COVID-19 patients in Changsha. including 121 males (50%) and 121 females (50%).Most cases occurred between February 6 and February 16. Through the calculation of the Rt during the epidemic in Changsha, it is found that it is reasonable to resume work on February 8, because the Rt value of Changsha dropped below 1 at this time.The simulation results show that reducing the contact rate of residents and reducing the success rate of virus transmission (wearing masks, disinfection, etc.) can effectively prevent the spread of COVID-19 and significantly reduce the number of peak patients.We believe that the disease is mainly spread by the respiratory tract. Therefore, the simulation results show that whether in the early or mid-stage of the epidemic, quarantining the names of residents or reducing the contact rate of residents is very effective in controlling the COVID-19 epidemic.

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