Inconsistent with the Intent of Public Health Strategies on Incidence Rates and Case-Fatality Ratio between States with Extra Stay-at-Home and Mandating Face Masks Orders and States Only Following CDC Recommendations During COVID-19 Pandemic in the US

2020 ◽  
Author(s):  
Samuel Xi Wu ◽  
Xin Wu
Keyword(s):  
Public Health ◽  
Case Fatality ◽  
Incidence Rates ◽  
Case Fatality Ratio ◽  
The Us ◽  
Public Health Strategies ◽  
At Home

scholarly journals Epidemiology of COVID-19 and effect of public health interventions, Chennai, India, March - October 2020

2021 ◽  
Author(s):  
M Jagadeesan ◽  
Parasuraman Ganeshkumar ◽  
Prabhdeep Kaur ◽  
Hemalatha Masanam Sriramulu ◽  
Manikandanesan Sakthivel ◽  
...  
Keyword(s):  
Public Health ◽  
Case Fatality ◽  
Contact Tracing ◽  
Severe Illness ◽  
List Type ◽  
Rt Pcr ◽  
Case Fatality Ratio ◽  
Metropolitan City ◽  
Lessons Learnt ◽  
Public Health Strategies

AbstractObjectivesTo describe the public health strategies and their effect in controlling the COVID-19 pandemic from March to October 2020 in Chennai, India.SettingChennai, a densely populated metropolitan city in Southern India, was one of the five cities which contributed to more than half of the COVID-19 cases in India.ParticipantsWe collected the de-identified line list of all the 192,450 COVID-19 case-patients reported from 17 March to 31 October 2020 in Chennai and their contacts for the analysis. We defined a COVID-19 case-patient based on the RT-PCR positive test in one of the Government approved labs.Outcome measuresThe primary outcomes of interest were incidence of COVID-19 per million population, case fatality ratio, deaths per million and the effective reproduction number (Rt). We also analysed the indicators for surveillance, testing, contact tracing and isolation.ResultsOf the 192,450 RT-PCR confirmed COVID-19 case-patients reported in Chennai from 17 March-31 October 2020, 114,889 (60%) were males. The highest incidence was 41,064 per million population among the 61-80 years. The incidence peaked during June 2020 at 5239 per million and declined to 3,627 per million in October 2020. The city reported 3,543 deaths, with a case fatality ratio (CFR) of 1.8% and the crude death rate was 431 per million. When lockdown began, Rt was high (4.2) in March and fluctuated from April to June 2020. The Rt dropped below one by the first week of July and remained so until October 2020, even with the relaxation of restrictionsConclusionThe combination of public health strategies controlled the COVID-19 epidemic in a large, densely populated city in India. We recommend continuing the interventions to prevent resurgence, even as vaccination is being rolled out.StrengthsWe did a comprehensive analysis of COVID-19 strategies and outcome in a large, densely populated metropolitan city in India.We documented that the community-centric public health strategies were feasible and effective in controlling the COVID-19 outbreak even in a large, thickly populated cityThe lessons learnt are relevant to similar settings in low-and middle-income countries. Given the ongoing multiple waves of COVID-19 and the difficulty in controlling the transmission, our experience and lessons learnt will be valuable for policymakers and scientific advisors globallyLimitationsWe analysed the data available from the GCC database and not from the hospitals where patients with moderate to severe illness were admitted. Hence, we could not report the severity of illness among admitted patients.Second, the COVID-19 incidence might have been underestimated while testing was low during the early phase of the epidemic

Cancer incidence and mortality in the USA Astronaut Corps, 1959–2017

2021 ◽  
pp. oemed-2020-107143
Author(s):  
Robert Reynolds ◽  
Mark P Little ◽  
Steven Day ◽  
Jacqueline Charvat ◽  
Steven Blattnig ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Colon Cancer ◽  
General Population ◽  
Cancer Incidence ◽  
Case Fatality ◽  
Incidence Rates ◽  
Cancer Case ◽  
Case Fatality Ratio ◽  
Incidence And Mortality ◽  
The Us

ObjectivesCancer incidence and mortality are important outcomes in the surveillance of long-term astronaut health. We compare cancer incidence rates, cancer-specific mortality rates, and cancer case-fatality ratios in US astronauts with those in the US general population.MethodsWe use standardised incidence ratios (SIRs) and standardised mortality ratios (SMRs) to index the incidence and mortality of various cancers against rates in the US general population, from the US astronaut cohort inception in April 1959 through 31 December 2017. We compare the lethality of these cancers using the relative case-fatality ratio.ResultsOverall cancer incidence and mortality were slightly lower than expected from national rates with SIR 82 (95% CI 63 to 104) and SMR 72 (95% CI 44 to 111) with a modest 14% reduction in case-fatality ratio. Prostate cancer and melanoma skin cancer had significant increases in incidence, with SIR of 162 (95% CI 109 to 232) and 252 (95% CI 126 to 452), respectively, though only melanoma had a significant increase in mortality, with SMR 508 (95% CI 105 to 1485). Lung cancer had a significant deficit of both cases and deaths, while colon cancer had sizeable (but not significant) reductions in incidence and mortality.ConclusionsThe increase in incidence of melanoma is consistent with that observed in aircraft pilots, suggesting this may be associated with ultraviolet radiation or lifestyle factors rather than any astronaut-specific exposure. Reductions in lung cancer incidence and mortality, and trends towards such reductions in colon cancer, may be explained in part by healthy lifestyle, as well as differential screening among astronauts.

scholarly journals Public health events in the maritime transport sector

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
C Varela Martinez ◽  
C Hadjichristodoulou ◽  
B Mouchtouri
Keyword(s):  
Public Health ◽  
Literature Review ◽  
Respiratory Diseases ◽  
Case Fatality ◽  
Transport Sector ◽  
Waterborne Diseases ◽  
Energy Agency ◽  
Case Fatality Ratio ◽  
Fishing Vessels ◽  
Chemical Events

Abstract Introduction A literature review to describe evidence on communicable diseases affecting people on ships or at ports, from 1990 to 2013 was carried out. Also, a literature review on radiological and chemical events of public health relevance associated with ships or at ports, from 1940 to 2013 was performed. Methodology Databases reviewed were: Medline, Scopus, Web of Science, Spanish Society of Maritime Medicine, and WebPages of WHO, The International Radio Medical Advice Centre, International Atomic Energy Agency, European Maritime Safety Agency, Marine Accident Investigation Branch, Spanish Nuclear Safety Council and the Major Accident Reporting System. Results From 1990 to 2013, 196 outbreaks relating to ships or ports with more than 24,000 cases and 19 deaths were published. 59% of outbreaks (n = 116) were food- and waterborne, causing 82% (n = 19741) of cases and 12 deaths (11 deaths due to Legionella, case fatality ratio of 7%); almost a third was caused by norovirus. Respiratory diseases, mainly Influenza, caused 18% of outbreaks and 2 deaths. Thirteen radiological events were published that affected 500 persons and caused 47 deaths, 24 due to exposure to elevated levels of radiation. During the study period 94 chemical events were published, of which 69 events affected people and in the remaining events only a public health risk was present. These 69 chemical events generated almost 12,000 cases and more than 2,000 deaths. Thirty countries, including all EU Member States, Norway and Iceland, were requested to complete the questionnaires regarding identification of authorities and practices for management of radiological and chemical events. Conclusions Food- and waterborne diseases are most reported; followed by respiratory diseases. Legionellosis accounted for the highest case fatality ratio. Tuberculosis was reported only on seafarers from cargo or fishing vessels and vaccine preventable diseases was mainly reported on crew members from cruise ships.

scholarly journals Stay-at-home and face mask policies intentions inconsistent with incidence and fatality during US COVID-19 pandemic

2020 ◽  
Author(s):  
Samuel X. Wu ◽  
Xin Wu
Keyword(s):  
Face Mask ◽  
The United States ◽  
Incidence Rates ◽  
Contact Tracing ◽  
Economic Damage ◽  
Close Monitoring ◽  
Effective Contact ◽  
Public Health Strategies ◽  
The Relationship ◽  
At Home

AbstractIn addition to the United States CDC recommendations, many states imposed stay-at-home (SAH) and mandatory face mask (MFM) orders during COVID-19 pandemic. The purpose of this study was to characterize the relationship between SAH and MFM approaches with the incidence and fatality during the pandemic period until the 2020-08-23 (about 171 days). States with SAH orders showed potential decreases of infection and fatality during SAH period (about 45 days). However, many results in this study were inconsistent with the intent of public health strategies of SAH and MFM. There were similar incidence rates among SAH + MFM, SAH + no-MFM and no-SAH + no-MFM states. After normalized to population density, there were no significant differences in total positive cases, average daily new cases and average daily fatality among the 3 groups during the pandemic period. This study suggested that SAH and MFM orders in the general public alone, probably have limited effects in lowering transmission and fatality. From the policy-making level, if we cannot strictly isolate contagious patients with effective contact tracing, we presume that following the CDC recommendations could be appropriate in helping mitigate the COVID-19 disaster and limiting collateral social-economic damage with close monitoring of healthcare capacity.

scholarly journals Notified cases of legionnaires’ disease in France in 2001

2002 ◽  
Vol 7 (9) ◽  
pp. 121-128 ◽  
Author(s):  
C Campese ◽  
B Decludt
Keyword(s):  
Public Health ◽  
Health Centre ◽  
Case Fatality ◽  
Contributing Factors ◽  
Public Health Centre ◽  
Case Fatality Ratio ◽  
Blood Disease ◽  
National Public Health ◽  
Legionnaires Disease ◽  
Immunosuppressant Treatment

In 2001, 807 cases of Legionnaires' disease were reported to the Institut de veille sanitaire (French national public health centre). The incidence of the disease was 1.35 cases per 100 000 inhabitants, compared to a mean European incidence of 0,6 per 100 000. The median age was 59 years [16-97], the group aged more than 80 being the most affected. The sex ratio M/W was 3.1. The outcome of the disease was known in 69% of all cases, the case fatality ratio rating 19.9%. Among the contributing factors found in 558 cases, 11% had a cancer or blood disease, 12% received an immunosuppressant treatment, 10% were diabetic and 40% were smokers. In 2001, 13% (105/807) cases stayed in a hospital or a clinic during the incubation period, compared to 20% in 2000, and 11% were travel-associated.

scholarly journals Cancer Incidence and Mortality in the U.S. Astronaut Corps, 1959-2017

2020 ◽  
Author(s):  
Robert Reynolds ◽  
Mark P Little ◽  
Steven M Day ◽  
Jacqueline Charvat ◽  
Steve Blattnig ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Colon Cancer ◽  
General Population ◽  
Cancer Incidence ◽  
Statistical Significance ◽  
Case Fatality ◽  
Detection Bias ◽  
Case Fatality Ratio ◽  
Incidence And Mortality ◽  
The Us

Abstract Background: Cancer incidence and mortality are important outcomes in the surveillance of long-term astronaut health. In this research, we compare cancer incidence rates, cancer-specific mortality rates, and cancer case fatality ratios in US astronauts with those in the US general population.Methods: We use standardized incidence ratios and standardized mortality ratios to index the incidence and mortality of various cancers against rates in the US general population, from the US astronaut cohort inception in April 1959 through 31 December 2017. We also compare the lethality of these cancers in astronauts and the general population using the relative case fatality ratio.Results: The astronaut cohort included 338 individuals and over 9600 person-years of follow-up time. The counts of most cancers were under 3, though there were 11 cases of melanoma and 30 cases of prostate cancer. Both prostate and melanoma had statistically significant increases in incidence, though only melanoma had a significant increase in mortality. Lung cancer had a statistically significant deficit of both cases and deaths, while colon cancer had sizable (but not statistically significant) reductions in incidence and mortality. Three cancers showed evidence of detection bias (colon, hematologic, prostate), possibly a result of astronaut health screening protocols. For all cancers combined, astronauts showed a non-significant reduction in incidence and mortality, and a significant reduction in case fatality ratio.Conclusions: Though there were observed increases in both incidence and mortality from melanoma among astronauts, these increases are consistent with those observed repeatedly among aircraft pilots, suggesting this may be associated with ultraviolet radiation or lifestyle factors rather than any astronaut-specific exposure. The increase in prostate cancer incidence is likely explained by detection bias, and the same may be true for hematologic cancers. The lack of statistical significance in the reduction of incidence and mortality for colon cancer may be attributable to relaxed screening practices for astronauts in recent years. As astronaut health surveillance continues and evolves, the growing database will lead to a clearer picture over time. The methods employed here provide a useful structure for ongoing analysis of this unique occupational cohort.

scholarly journals “There’s No Place Like Home for The Holidays:” Travel and SARS-CoV-2 Test Positivity Following Thanksgiving Weekend

2020 ◽  
Author(s):  
Shruti H. Mehta ◽  
Steven J. Clipman ◽  
Amy Wesolowski ◽  
Sunil S. Solomon
Keyword(s):  
Public Health ◽  
Self Report ◽  
Panel Survey ◽  
Health Authorities ◽  
The Us ◽  
Public Health Authorities ◽  
Public Health Officials ◽  
Household Members ◽  
Do So ◽  
At Home

AbstractIn the US, public health officials discouraged travel and social gatherings for Thanksgiving. Data suggests that many individuals did travel over the holidays, albeit in smaller numbers than previous years. Using an online panel survey of individuals across ten US states, we found that many individuals reported spending Thanksgiving outside of their home (25.9%) or at home with at least one non-household member (27.3%). Among those who were tested, those who had Thanksgiving outside their home were significantly more likely to self-report a positive PCR test for SARS-CoV-2 infection in the prior two weeks compared to those who had Thanksgiving at home with non-household members or with household members only (41.7% vs. 21.4% and 13.8%, respectively; p<0.001). Persons who had Thanksgiving outside their home and tested positive for SARS-CoV-2 participated in a median 35 (IQR: 21 - 53). non-essential activities compared to those who had Thanksgiving at home and tested positive (median 3 activities, IQR 0-13). Notably, planned travel over the December holidays was most common among those who tested positive for SARS-CoV-2 in the prior 2 weeks (66.5%) compared with 25.4% of those who tested negative in the prior 2 weeks and 11.0% among those who were not tested. While public health authorities should continue promoting messages to dissuade travel and social gatherings over the holidays, as supported by these data, it is equally important to promote messaging on how to get together in a “low-risk” manner for those who travel and plan gatherings. In particular, it is critical that those who do travel or visit with others outside their household do so cautiously and avoid or significantly minimize all other activities where they may potentially acquire and transmit infection in the weeks prior to and after their visit.

scholarly journals Delayed Interventions, Low Compliance, and Health Disparities Amplified the Early Spread of COVID-19

2020 ◽  
Author(s):  
Aliea M. Jalali ◽  
Sumaia G. Khoury ◽  
JongWon See ◽  
Alexis M. Gulsvig ◽  
Brent M. Peterson ◽  
...  
Keyword(s):  
Public Health ◽  
Health Disparities ◽  
State Level ◽  
The United States ◽  
Health Interventions ◽  
Systematic Evaluation ◽  
Public Health Interventions ◽  
Multivariate Statistical ◽  
The Us ◽  
At Home

AbstractThe United States (US) public health interventions were rigorous and rapid, yet failed to arrest the spread of the Coronavirus Disease 2019 (COVID-19) pandemic as infections spread throughout the US. Many factors have contributed to the spread of COVID-19, and the success of public health interventions depends on the level of community adherence to preventative measures. Public health professionals must also understand regional demographic variation in health disparities and determinants to target interventions more effectively. In this study, a systematic evaluation of three significant interventions employed in the US, and their effectiveness in slowing the early spread of COVID-19 was conducted. Next, community-level compliance with a state-level stay at home orders was assessed to determine COVID-19 spread behavior. Finally, health disparities that may have contributed to the disproportionate acceleration of early COVID-19 spread between certain counties were characterized. The contribution of these factors for the disproportionate spread of the disease was analyzed using both univariate and multivariate statistical analyses. Results of this investigation show that delayed implementation of public health interventions, a low level of compliance with the stay at home orders, in conjunction with health disparities, significantly contributed to the early spread of the COVID-19 pandemic.

scholarly journals Public health and economic costs of investigating a suspected outbreak of Legionnaires' disease

2007 ◽  
Vol 136 (10) ◽  
pp. 1306-1314 ◽  
Author(s):  
K. LOCK ◽  
C. MILLETT ◽  
R. HEATHCOCK ◽  
C. A. JOSEPH ◽  
T. G. HARRISON ◽  
...  
Keyword(s):  
Public Health ◽  
Case Fatality ◽  
Cost Effective ◽  
Incidence Rates ◽  
Hospital Treatment ◽  
Economic Costs ◽  
Public Health Services ◽  
Major Outbreak ◽  
Legionnaires Disease ◽  
The Cost

SUMMARYThis paper provides one of the first assessments of the burden of both the public health investigation and the economic costs associated with an apparent outbreak of Legionnaires' disease (LD) in South East London. In addition to epidemiological, microbiological and environmental investigations, we collected data on the staff time and resources committed by the 11 main organizations responsible for managing the outbreak. Of the overall estimated costs of £455 856, only 14% (£64 264) was spent on investigation and control of the outbreak compared with 86% (£391 592) spent on the hospital treatment of the patients. The time and money spent on public health services in this investigation appear to represent good value for money considering the potential costs of a major outbreak, including the high case-fatality rate in LD generally and the high health-care costs. Further research is needed to determine optimum strategies for the cost-effective use of health system resources in investigations of LD. Whether the threshold for investigation of cases should be based on observed incidence rates or the cost-effectiveness of investigations, or both, should be debated further.

scholarly journals Do racial and ethnic disparities in following stay-at-home orders influence COVID-19 health outcomes? A mediation analysis approach

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259803
Author(s):  
Songhua Hu ◽  
Weiyu Luo ◽  
Aref Darzi ◽  
Yixuan Pan ◽  
Guangchen Zhao ◽  
...  
Keyword(s):  
Health Outcomes ◽  
Infection Rate ◽  
Ethnic Differences ◽  
Human Mobility ◽  
Ethnic Disparities ◽  
Case Fatality ◽  
Equation Modeling ◽  
Case Fatality Ratio ◽  
Racial Ethnic ◽  
At Home

Racial/ethnic disparities are among the top-selective underlying determinants associated with the disproportional impact of the COVID-19 pandemic on human mobility and health outcomes. This study jointly examined county-level racial/ethnic differences in compliance with stay-at-home orders and COVID-19 health outcomes during 2020, leveraging two-year geo-tracking data of mobile devices across ~4.4 million point-of-interests (POIs) in the contiguous United States. Through a set of structural equation modeling, this study quantified how racial/ethnic differences in following stay-at-home orders could mediate COVID-19 health outcomes, controlling for state effects, socioeconomics, demographics, occupation, and partisanship. Results showed that counties with higher Asian populations decreased most in their travel, both in terms of reducing their overall POIs’ visiting and increasing their staying home percentage. Moreover, counties with higher White populations experienced the lowest infection rate, while counties with higher African American populations presented the highest case-fatality ratio. Additionally, control variables, particularly partisanship, median household income, percentage of elders, and urbanization, significantly accounted for the county differences in human mobility and COVID-19 health outcomes. Mediation analyses further revealed that human mobility only statistically influenced infection rate but not case-fatality ratio, and such mediation effects varied substantially among racial/ethnic compositions. Last, robustness check of racial gradient at census block group level documented consistent associations but greater magnitude. Taken together, these findings suggest that US residents’ responses to COVID-19 are subject to an entrenched and consequential racial/ethnic divide.

Sign in / Sign up

Export Citation Format

Share Document