An in-depth analysis of 10 epidemiological terminologies used in the context of COVID-19

Aim: In this paper, we explore the contextual use of 10 epidemiological terminologies, their significance, and interpretation/misinterpretation in explaining various aspects of the 2019 novel coronavirus disease (COVID-19) pandemic. Methods and Results: We first establish the different purposes of the terms ‘pandemic’ and ‘Public Health Emergency of International Concern.’ We then discuss the confusion caused by using the ‘case fatality rate’ as opposed to ‘infection fatality rate’ during the pandemic and the uncertainty surrounding the limited usefulness of identifying someone as ‘pre-symptomatic.’ We highlight the ambiguity in the ‘positivity rate’ and the need to be able to generate data on ‘excess mortality’ during public health emergencies. We discuss the relevance of ‘association and causation’ in the context of the facemask controversy that existed at the start of the pandemic. We point out how the accepted epidemiological practice of discussing ‘herd immunity’ in the context of vaccines has been twisted to suit the political motive of a public health approach. Given that a high proportion of COVID-19 cases are asymptomatic, we go on to show how COVID-19 has blurred the lines between ‘screening/diagnosis’ and ‘quarantine/isolation,’ while giving birth to the new terminology of ‘community quarantine.’ Conclusions: Applying the lessons learned from COVID-19 to better understand the above terminologies will help health professionals communicate effectively, strengthen the scientific agenda of epidemiology and public health, and support and manage future outbreaks efficiently.

Field Epidemiology and Public Health Research Priorities in the Eastern Mediterranean Region: Delphi Technique

Research is essential for evidence-based decision making. This study aimed to identify research priorities in the areas of field epidemiology and public health in the Eastern Mediterranean Region (EMR) from the perspectives of public health professionals. A Delphi technique, using online survey, was employed to reach 168 public health professionals who have experience in the EMR countries. The study took place between November 2019 and January 2020. Consensus on the research priorities was reached after two-round online questionnaires. A list of top 10 field epidemiology and public health research priorities in the EMR was developed. Of those priorities, four fell under health in emergency, war and armed conflict, two under communicable diseases, two under immunization, one under digital health, and one under sexual, reproductive, and adolescent health. Availability, adequacy, and quality of health services in crisis settings were scored as a top priority (mean = 4.4, rank 1), followed by use of technology to improve the collection, documentation, and analysis of health data (mean = 4.28, rank 2), and capacity of countries in the region to respond to emergencies (mean = 4.25, rank 3). This study was conducted prior to COVID-19 pandemic and, thus, it did not capture COVID-19 research as a priority area. Nevertheless, identified priorities under communicable diseases including outbreak investigation of infectious diseases, epidemics and challenges related to communicable diseases in the EMR were still notable. In conclusion, the field epidemiology and public health research priorities identified in this study through a systematic inclusive process could be useful to make informed decisions and gear the research efforts to improve the health of people in the EMR.

Cancer epidemiology and public health

Neoplasms continue to dominate globally as one of the major sources of human disease and death. There are multiple modifiable causes of cancer and understanding their attributable risk factors for each cancer is of importance. This chapter covers the role of cellular and molecular mechanisms as well as the experimental and epidemiological approaches as determinants of the main cancers. Even if major discoveries in the clinical management of cancer patients will be accomplished in the near future, the changes will mainly affect the affluent part of the world population. Promising approaches focused on prevention of the known causes, reducing its consequences, notably in resource-constrained settings are highlighted.

Natural and quasi-experiments

Natural experiments, defined as events or processes outwith the control of a researcher, which divide a population into exposed and unexposed groups, have long been used in epidemiology and public health. Evaluation methods that rely on observational rather than experimental data are classified as second best in conventional hierarchies of evidence. Natural experimental approaches have attracted renewed interest from public health researchers and decision-makers because they widen the range of interventions that can usefully be evaluated beyond those that are politically, ethically, or practically amenable to testing in randomized controlled trials. This chapter argues for seeing trials and natural experiments as part of a common toolkit for producers and users of evidence about the effectiveness of policies and programmes. It describes the most commonly used natural experimental approaches to evaluating population health interventions, and provides examples of their use in a wide range of countries and policy settings.

Response rate to an online questionnaire amidst the COVID-19 pandemic in undergraduate students and graduates from a Colombian university

In epidemiology and public health research, caution is necessary when addressing results reported by studies based on the administration of online questionnaires. The most critical limitation in such studies is their impossibility of guaranteeing the representativeness of the sample. However, when having a representative sample is secondary, online questionnaires are an excellent alternative for exploratory studies that seek to obtain information about emerging phenomena quickly and cost-effectively or address sensitive issues, for this approach allows reaching populations difficult to get in contact with using traditional strategies. Online research allows the complete anonymity of participants and ensures they provide a more honest response, regardless of their social desirability, any stigma, or discrimination.

Graphical Trajectory Comparison to Identify Errors in Data of COVID-19: A Cross-Country Analysis

Data from the early stage of a novel infectious disease outbreak provide vital information in risk assessment, prediction, and precise disease management. Since the first reported case of COVID-19, the pattern of the novel coronavirus transmission in Wuhan has become the interest of researchers in epidemiology and public health. To thoroughly map the mechanism of viral spreading, we used the patterns of data at the early onset of COVID-19 from seven countries to estimate the time lag between peak days of cases and deaths. This study compared these data with those of Wuhan and estimated the natural history of disease across the infected population and the time lag. The findings suggest that comparative analyses of data from different regions and countries reveal the differences between peaks of cases and deaths caused by COVID-19 and the incomplete and underestimated cases in Wuhan. Different countries may show different patterns of cases peak days, deaths peak days, and peak periods. Error in the early COVID-19 statistics in Brazil was identified. This study provides sound evidence for policymakers to understand the local circumstances in diagnosing the health of a population and propose precise and timely public health interventions to control and prevent infectious diseases.

Features of Laboratory Diagnostics CMVI by IFA Method (IgM, IgG) for the Period 2014-2020 in Kyrgyzstan

This article discusses the problem of informing students of medical universities in Kyrgyzstan about CMVI, as well as an analysis of the population survey by ELISA for the detection of specific immunoglobulins of class M and G for 7 years (2014–2020). The article provides an analysis of the surveyed by sex of all ages, which allows us to conclude that the bulk of the surveyed are women of childbearing age. Thus, cytomegalovirus infection poses a particular danger to the fetus, up to its intrauterine death. The work is interdisciplinary in nature, written at the intersection of medical microbiology, epidemiology and public health and health care. Considerable attention in the work is paid to the fact that those examined by the ELISA method for specific IgM are ten times less than for the detection of specific IgG. Although it is the detection of specific IgM that poses a particular danger to the fetus — it can lead to its especially life-threatening complications such as: heart disease, retinopathy, which can lead to blindness, deafness and even mental retardation, intrauterine hypotrophy, immaturity, prematurity, chronic intrauterine fetal hypoxia. The idea is substantiated how important it is for future and practicing doctors to inform the population about this infection, which will help in the future to timely detect IgM and possibly save the fetus from intrauterine death. Using the results of an ELISA test for the detection of specific IgM and IgG, which today is one of the most reliable and affordable ways to detect a disease, the author proves in his studies the huge problem of informing and examining the population. The topic under consideration will be of particular interest to specialists in the field of public health and health care, since this is a truly national problem. The presented work indicates that CMVI is currently a serious medical and social problem. This problem is extremely poorly understood and requires further study.

Deontological or Utilitarian? An Eternal Ethical Dilemma in Outbreak

Both deontological ethics and utilitarian ethics are important theories that affect decision making in medical and health care. However, it has been challenging to reach a balance between these two ethical theories. When there is a conflict between these two ethical principles in the medical context, the conflict must be addressed in order to reach an appropriate solution for patients and others involved. To demonstrate decisions made in terms of deontological ethics and utilitarian ethics, the study will use the film Outbreak as example to further understand these two ethics in relation to epidemiology and public health. The paper will also analyze film scenarios to examine how deontological ethics and utilitarian ethics are involved and strike a balance with different pearspectives to reach an appropriate public health solution. To reach more just solutions, it is essential to determine how to make wise decisions by balancing deontological ethics and utilitarian ethics. However, the decision-making process is complicated because any solution must consider not only medical ethics but also political, environmental, and military issues. In order to reach an appropriate public health decision, those involved should be inclined toward empathy and contemplate things from different ethical perspectives to deal with ethical/moral dilemmas and create greater beneficence and justice for patients and humanity at large.