International Journal of Environmental Research and Public Health

Research

8 pages, 1767 KiB

Open AccessArticle

Real-Time CDC Consultation during the COVID-19 Pandemic—United States, March–July, 2020

by Daniel Wozniczka, Hanna B. Demeke, Angela M. Thompson-Paul, Ugonna Ijeoma, Tonya R. Williams, Allan W. Taylor, Kathrine R. Tan, Michelle S. Chevalier, Elfriede Agyemang, Deborah Dowell, Titilope Oduyebo, Miriam Shiferaw, Sallyann M. Coleman King, Anna A. Minta, Katherine Shealy, Sara E. Oliver, Catherine McLean, Maleeka Glover and John Iskander

Int. J. Environ. Res. Public Health 2021, 18(14), 7251; https://doi.org/10.3390/ijerph18147251 - 6 Jul 2021

Cited by 5 | Viewed by 2979

Abstract

Context: In response to the COVID-19 pandemic, the Centers for Disease Prevention and Control (CDC) clinicians provided real-time telephone consultation to healthcare providers, public health practitioners, and health department personnel. Objective: To describe the demographic and public health characteristics of inquiries, trends, and [...] Read more.

Context: In response to the COVID-19 pandemic, the Centers for Disease Prevention and Control (CDC) clinicians provided real-time telephone consultation to healthcare providers, public health practitioners, and health department personnel. Objective: To describe the demographic and public health characteristics of inquiries, trends, and correlation of inquiries with national COVID-19 case reports. We summarize the results of real-time CDC clinician consultation service provided during 11 March to 31 July 2020 to understand the impact and utility of this service by CDC for the COVID-19 pandemic emergency response and for future outbreak responses. Design: Clinicians documented inquiries received including information about the call source, population for which guidance was sought, and a detailed description of the inquiry and resolution. Descriptive analyses were conducted, with a focus on characteristics of callers as well as public health and clinical content of inquiries. Setting: Real-time telephone consultations with CDC Clinicians in Atlanta, GA. Participants: Health care providers and public health professionals who called CDC with COVID-19 related inquiries from throughout the United States. Main Outcome Measures: Characteristics of inquiries including topic of inquiry, inquiry population, resolution, and demographic information. Results: A total of 3154 COVID-19 related telephone inquiries were answered in real-time. More than half (62.0%) of inquiries came from frontline healthcare providers and clinical sites, followed by 14.1% from state and local health departments. The majority of inquiries focused on issues involving healthcare workers (27.7%) and interpretation or application of CDC’s COVID-19 guidance (44%). Conclusion: The COVID-19 pandemic resulted in a substantial number of inquiries to CDC, with the large majority originating from the frontline clinical and public health workforce. Analysis of inquiries suggests that the ongoing focus on refining COVID-19 guidance documents is warranted, which facilitates bidirectional feedback between the public, medical professionals, and public health authorities. Full article

(This article belongs to the Special Issue COVID-19 Public Policies Around the World: Lessons Learnt from a Series of Case Studies of the First Pandemic Wave)

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21 pages, 4161 KiB

Open AccessArticle

Changes in Domestic Energy and Water Usage during the UK COVID-19 Lockdown Using High-Resolution Temporal Data

by Tamaryn Menneer, Zening Qi, Timothy Taylor, Cheryl Paterson, Gengyang Tu, Lewis R. Elliott, Karyn Morrissey and Markus Mueller

Int. J. Environ. Res. Public Health 2021, 18(13), 6818; https://doi.org/10.3390/ijerph18136818 - 25 Jun 2021

Cited by 28 | Viewed by 4995

Abstract

In response to the COVID-19 outbreak, the UK Government provided public health advice to stay at home from 16 March 2020, followed by instruction to stay at home (full lockdown) from 24 March 2020. We use data with high temporal resolution from utility [...] Read more.

In response to the COVID-19 outbreak, the UK Government provided public health advice to stay at home from 16 March 2020, followed by instruction to stay at home (full lockdown) from 24 March 2020. We use data with high temporal resolution from utility sensors installed in 280 homes across social housing in Cornwall, UK, to test for changes in domestic electricity, gas and water usage in response to government guidance. Gas usage increased by 20% following advice to stay at home, the week before full lockdown, although no difference was seen during full lockdown itself. During full lockdown, morning electricity usage shifted to later in the day, decreasing at 6 a.m. and increasing at midday. These changes in energy were echoed in water usage, with a 17% increase and a one-hour delay in peak morning usage. Changes were consistent with people getting up later, spending more time at home and washing more during full lockdown. Evidence for these changes was also observed in later lockdowns, but not between lockdowns. Our findings suggest more compliance with an enforced stay-at-home message than with advice. We discuss implications for socioeconomically disadvantaged households given the indication of inability to achieve increased energy needs during the pandemic. Full article

(This article belongs to the Special Issue COVID-19 Public Policies Around the World: Lessons Learnt from a Series of Case Studies of the First Pandemic Wave)

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13 pages, 323 KiB

Open AccessArticle

How Did Italian Adolescents with Disability and Parents Deal with the COVID-19 Emergency?

by Silvia Faccioli, Francesco Lombardi, Pierantonio Bellini, Stefania Costi, Silvia Sassi and Maria Cristina Pesci

Int. J. Environ. Res. Public Health 2021, 18(4), 1687; https://doi.org/10.3390/ijerph18041687 - 10 Feb 2021

Cited by 30 | Viewed by 3851

Abstract

The COVID-19 emergency has imposed distanced education and has interrupted most rehabilitation services. Adolescents with disabilities have been isolated, and the burden on their families has been exacerbated. A cross-sectional survey was administered to adolescents with disability and to parents of disabled children [...] Read more.

The COVID-19 emergency has imposed distanced education and has interrupted most rehabilitation services. Adolescents with disabilities have been isolated, and the burden on their families has been exacerbated. A cross-sectional survey was administered to adolescents with disability and to parents of disabled children to describe their experience during lockdown and their concerns or expectations about rehabilitation. A sample of 53 adolescents and 239 parents completed the survey. Adolescents were ages 13–18 years old (45.3% female). Most parents were between 35 and 55 years old (84.9% female). While 53.6% of the parents reported no positive effects of the lockdown, 92.5% of the adolescents expressed favorable consequences. The increased time spent with family members was judged positively by 27.2% of parents and by 64.2% of adolescents. Concern for their child’s disability was expressed by 47.3% of parents, while 73.6% of adolescents expressed concerns regarding the ban on meeting friends. In both groups, anxiety symptoms were correlated with the fear of contracting COVID-19 and with financial problems. Parents would have liked even more remote support from school and healthcare professionals, which was available for most participants. Thus, socioeconomic support, assistive technology and telerehabilitation strategies might help families with disabilities during a lockdown. Full article

(This article belongs to the Special Issue COVID-19 Public Policies Around the World: Lessons Learnt from a Series of Case Studies of the First Pandemic Wave)

16 pages, 411 KiB

Open AccessArticle

Refugees in Canada during the First Wave of the COVID-19 Pandemic

by Jennifer Edmonds and Antoine Flahault

Int. J. Environ. Res. Public Health 2021, 18(3), 947; https://doi.org/10.3390/ijerph18030947 - 22 Jan 2021

Cited by 38 | Viewed by 8911

Abstract

It is crucial to understand how the most vulnerable populations have been impacted by the ongoing COVID-19 pandemic. This paper intends to contextualize the experience of resettled refugees in Canada during the COVID-19 pandemic, framing the issue for further study as the situation [...] Read more.

It is crucial to understand how the most vulnerable populations have been impacted by the ongoing COVID-19 pandemic. This paper intends to contextualize the experience of resettled refugees in Canada during the COVID-19 pandemic, framing the issue for further study as the situation evolves. Based on the experience drawn from the first wave of the pandemic, the findings of this paper suggest that refugees in Canada encounter barriers to healthcare, economic support, education, social support, and border crossing impediments, all of which can have a compounding effect. These findings provide needed information to inform the development of effective policies and strategies to support refugees during health security emergencies in Canada. Full article

(This article belongs to the Special Issue COVID-19 Public Policies Around the World: Lessons Learnt from a Series of Case Studies of the First Pandemic Wave)

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15 pages, 1551 KiB

Open AccessArticle

Analysis of the Different Approaches Adopted in the Italian Regions to Care for Patients Affected by COVID-19

by Fabrizio Pecoraro, Daniela Luzi and Fabrizio Clemente

Int. J. Environ. Res. Public Health 2021, 18(3), 848; https://doi.org/10.3390/ijerph18030848 - 20 Jan 2021

Cited by 17 | Viewed by 2731

Abstract

As the Italian health system is regionally based, COVID-19 emergency actions are based on a general lockdown imposed by national authority and then management at local level by 21 regional authorities. Therefore, the pandemic response plan developed by each region led to different [...] Read more.

As the Italian health system is regionally based, COVID-19 emergency actions are based on a general lockdown imposed by national authority and then management at local level by 21 regional authorities. Therefore, the pandemic response plan developed by each region led to different approaches. The aim of this paper is to analyze whether differences in patient management may have influenced the local course of the epidemic. The analysis on the 21 Italian regions considers the strategies adopted in terms of hospitalization, treatment in the ICU and at home. Moreover, an in-depth analysis was carried out on: Lombardia, which adopted a hospitalization approach; Veneto, which tended to confine patients at home; and Emilia Romagna, which adopted a mixed hospitalization-home based approach. The majority of regions implemented a home-based approach, while the hospital approach was followed in three regions (Lombardia, Piemonte, and Lazio), mainly limited to the first period of the outbreak. All regions in the later phases tended to reduce hospitalization, preferring to confine patients at home. This comparison, highlighting the different phases of the pandemic, outlined that the adoption of home-based practices contributed to limiting infection rates among patients and health professionals as well as decreasing the number of deaths. Full article

(This article belongs to the Special Issue COVID-19 Public Policies Around the World: Lessons Learnt from a Series of Case Studies of the First Pandemic Wave)

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17 pages, 1328 KiB

Open AccessArticle

Comparing the Scope and Efficacy of COVID-19 Response Strategies in 16 Countries: An Overview

by Liudmila Rozanova, Alexander Temerev and Antoine Flahault

Int. J. Environ. Res. Public Health 2020, 17(24), 9421; https://doi.org/10.3390/ijerph17249421 - 16 Dec 2020

Cited by 23 | Viewed by 4220

Abstract

This article synthesizes the results of case studies on the development of the coronavirus disease 2019 (COVID-19) pandemic and control measures by governments in 16 countries. When this work was conducted, only 6 months had passed since the pandemic began, and only 4 [...] Read more.

This article synthesizes the results of case studies on the development of the coronavirus disease 2019 (COVID-19) pandemic and control measures by governments in 16 countries. When this work was conducted, only 6 months had passed since the pandemic began, and only 4 months since the first events were recognized outside of China. It was too early to draw firm conclusions about the effectiveness of measures in each of the selected countries; however, the authors present some efforts to identify and classify response and containment measures, country-by-country, for future comparison and analysis. There is a significant variety of policy tools and response measures employed in different countries, and while it is still hard to directly compare the different approaches based on their efficacy, it will definitely provide many inputs for the future data analysis efforts. Full article

(This article belongs to the Special Issue COVID-19 Public Policies Around the World: Lessons Learnt from a Series of Case Studies of the First Pandemic Wave)

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Review

Jump to: Research, Other

27 pages, 2159 KiB

Open AccessReview

Factors Influencing Asia-Pacific Countries’ Success Level in Curbing COVID-19: A Review Using a Social–Ecological System (SES) Framework

by Gabriel Hoh Teck Ling, Nur Amiera binti Md Suhud, Pau Chung Leng, Lee Bak Yeo, Chin Tiong Cheng, Mohd Hamdan Haji Ahmad and Ak Mohd Rafiq Ak Matusin

Int. J. Environ. Res. Public Health 2021, 18(4), 1704; https://doi.org/10.3390/ijerph18041704 - 10 Feb 2021

Cited by 28 | Viewed by 8233

Abstract

Little attention has been paid to the impacts of institutional–human–environment dimensions on the outcome of Coronavirus disease 2019 (COVID-19) abatement. Through the diagnostic social–ecological system (SES) framework, this review paper aimed to investigate what and how the multifaceted social, physical, and governance factors [...] Read more.

Little attention has been paid to the impacts of institutional–human–environment dimensions on the outcome of Coronavirus disease 2019 (COVID-19) abatement. Through the diagnostic social–ecological system (SES) framework, this review paper aimed to investigate what and how the multifaceted social, physical, and governance factors affected the success level of seven selected Asia-Pacific countries (namely, South Korea, Japan, Malaysia, Singapore, Vietnam, Indonesia, and New Zealand) in combatting COVID-19. Drawing on statistical data from the Our World In Data website, we measured the COVID-19 severity or abatement success level of the countries on the basis of cumulative positive cases, average daily cases, and mortality rates for the period of 1 February 2020 to 30 June 2020. A qualitative content analysis using three codes, i.e., present (P), partially present (PP), and absent (A) for each SES attribute, as well as score calculation and rank ordering for government response effectiveness and the abatement success level across the countries, was undertaken. Not only did the standard coding process ensure data comparability but the data were deemed substantially reliable with Cohen’s kappa of 0.76. Among 13 attributes of the SES factors, high facility adequacy, comprehensive COVID-19 testing policies, strict lockdown measures, imposition of penalty, and the high trust level towards the government seemed to be significant in determining the COVID-19 severity in a country. The results show that Vietnam (ranked first) and New Zealand (ranked second), with a high presence of attributes/design principles contributing to high-level government stringency and health and containment indices, successfully controlled the virus, while Indonesia (ranked seventh) and Japan (ranked sixth), associated with the low presence of design principles, were deemed least successful. Two lessons can be drawn: (i) having high number of P for SES attributes does not always mean a panacea for the pandemic; however, it would be detrimental to a country if it lacked them severely, and (ii) some attributes (mostly from the governance factor) may carry higher weightage towards explaining the success level. This comparative study providing an overview of critical SES attributes in relation to COVID-19 offers novel policy insights, thus helping policymakers devise more strategic, coordinated measures, particularly for effective country preparedness and response in addressing the current and the future health crisis. Full article

(This article belongs to the Special Issue COVID-19 Public Policies Around the World: Lessons Learnt from a Series of Case Studies of the First Pandemic Wave)

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17 pages, 3455 KiB

Open AccessReview

The Early Stage of COVID-19 Outbreak in Greece: A Review of the National Response and the Socioeconomic Impact

by Timokleia Kousi, Lefkothea-Christina Mitsi and Jean Simos

Int. J. Environ. Res. Public Health 2021, 18(1), 322; https://doi.org/10.3390/ijerph18010322 - 4 Jan 2021

Cited by 41 | Viewed by 9630

Abstract

Greece is a European-Union country, of around 10 million people, located in the southeast part of Europe. The economy is recovering from a long period of deep recession, due to the economic crisis that started in 2008. The economic problems greatly influenced the [...] Read more.

Greece is a European-Union country, of around 10 million people, located in the southeast part of Europe. The economy is recovering from a long period of deep recession, due to the economic crisis that started in 2008. The economic problems greatly influenced the structure and resources of the healthcare system of the country. In addition to the economic challenges, the country has been facing a refugee crisis, characterized by many overcrowded hotspots and tensions with neighboring Turkey. The COVID-19 outbreak arrived in Greece on 26 February 2020, at the time that Athens had declared a state of emergency at the Greek/Turkish border. From this point in time the government enforced a series of measurements, aiming to contain the epidemic and avoid the collapse of the healthcare system. The vast majority of the general population complied to the measures and consequently Greece’s death toll was low. The impacts of the outbreak are expected to be, as everywhere worldwide, multifaceted and to affect many parts of the economic, social and political life of the country. Full article

(This article belongs to the Special Issue COVID-19 Public Policies Around the World: Lessons Learnt from a Series of Case Studies of the First Pandemic Wave)

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13 pages, 3342 KiB

Open AccessReview

Initial COVID-19 Outbreak: An Epidemiological and Socioeconomic Case Review of Iran

by Elise Blandenier, Zahra Habibi, Timokleia Kousi, Paolo Sestito, Antoine Flahault and Liudmila Rozanova

Int. J. Environ. Res. Public Health 2020, 17(24), 9593; https://doi.org/10.3390/ijerph17249593 - 21 Dec 2020

Cited by 29 | Viewed by 5412

Abstract

The coronavirus disease 2019 (COVID-19) pandemic has affected millions of people worldwide. It brought about the implementation of various measures and restrictions at a global level. Iran has been one of the countries with the highest rates of COVID-19 cases. This study reviews [...] Read more.

The coronavirus disease 2019 (COVID-19) pandemic has affected millions of people worldwide. It brought about the implementation of various measures and restrictions at a global level. Iran has been one of the countries with the highest rates of COVID-19 cases. This study reviews the initial outbreak of COVID-19 in Iran and examines the mitigation strategies adopted by the country. Moreover, it reports the socioeconomic challenges faced by the authorities during the efforts to contain the virus. A transdisciplinary literature review was carried out and a political measures timeline was constructed. A broad overview of the initial phase of the COVID-19 outbreak in Iran is presented, starting from the first confirmed case on 19 February 2020 until April 2020. The results of this epidemiological and socioeconomic case review of Iran suggests that the political measures undertaken by the Republic of Iran contributed to the decrease of the prevalence of COVID-19. However, due to the existing financial bottleneck, Iran has faced limited health system resources. Therefore, the response was not sufficient to restrict the spread and the efficient handling of the virus in the long-term. Full article

(This article belongs to the Special Issue COVID-19 Public Policies Around the World: Lessons Learnt from a Series of Case Studies of the First Pandemic Wave)

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Other

Jump to: Research, Review

15 pages, 2281 KiB

Open AccessCase Report

Overview of Canada’s Answer to the COVID-19 Pandemic’s First Wave (January–April 2020)

by Deborah Urrutia, Elisa Manetti, Megan Williamson and Emeline Lequy

Int. J. Environ. Res. Public Health 2021, 18(13), 7131; https://doi.org/10.3390/ijerph18137131 - 3 Jul 2021

Cited by 27 | Viewed by 7037

Abstract

Canada is a federal state of almost 38 million inhabitants distributed over ten provinces and three territories, each with their own power regarding health. This case study describes the health infrastructures’ situation before the COVID-19 outbreak and their adaptations to face the expected [...] Read more.

Canada is a federal state of almost 38 million inhabitants distributed over ten provinces and three territories, each with their own power regarding health. This case study describes the health infrastructures’ situation before the COVID-19 outbreak and their adaptations to face the expected cases, the available epidemiologic data for the beginning of the first wave (January–April 2020), and the public health and economic measures taken to control the pandemic both at the federal level and breaking down by province and territory. Canadian health infrastructures offered on average 12.9 intensive care units beds per 100,000 (occupancy rate ~90% before the outbreak), unevenly distributed across provinces and territories. Canada implemented public health measures, such as social distancing, when hospitalization and death rates due to the pandemic were still lower than in other countries; each province and territory adapted and implemented specific measures. Cumulated cases and deaths substantially increased from mid-March 2020, reaching 65 cases and 2 deaths per 100,000 on April 12, with strong differences across provinces and territories. Canada has been affected by the COVID-19 pandemic’s first wave with a generally slower dynamic than in the USA or in the European Union at the same period. This suggests that implementation of public health measures when health indicators were still low may have been efficient in Canada; yet the long-term care sector faced many challenges in some provinces, which drove a large part of the pandemic indicators. Full article

(This article belongs to the Special Issue COVID-19 Public Policies Around the World: Lessons Learnt from a Series of Case Studies of the First Pandemic Wave)

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21 pages, 926 KiB

Open AccessCase Report

The COVID-19 Pandemic Situation in Malaysia: Lessons Learned from the Perspective of Population Density

by Siew Bee Aw, Bor Tsong Teh, Gabriel Hoh Teck Ling, Pau Chung Leng, Weng Howe Chan and Mohd Hamdan Ahmad

Int. J. Environ. Res. Public Health 2021, 18(12), 6566; https://doi.org/10.3390/ijerph18126566 - 18 Jun 2021

Cited by 33 | Viewed by 8475

Abstract

This paper attempts to ascertain the impacts of population density on the spread and severity of COVID-19 in Malaysia. Besides describing the spatio-temporal contagion risk of the virus, ultimately, it seeks to test the hypothesis that higher population density results in exacerbated COVID-19 [...] Read more.

This paper attempts to ascertain the impacts of population density on the spread and severity of COVID-19 in Malaysia. Besides describing the spatio-temporal contagion risk of the virus, ultimately, it seeks to test the hypothesis that higher population density results in exacerbated COVID-19 virulence in the community. The population density of 143 districts in Malaysia, as per data from Malaysia’s 2010 population census, was plotted against cumulative COVID-19 cases and infection rates of COVID-19 cases, which were obtained from Malaysia’s Ministry of Health official website. The data of these three variables were collected between 19 January 2020 and 31 December 2020. Based on the observations, districts that have high population densities and are highly inter-connected with neighbouring districts, whether geographically, socio-economically, or infrastructurally, tend to experience spikes in COVID-19 cases within weeks of each other. Using a parametric approach of the Pearson correlation, population density was found to have a moderately strong relationship to cumulative COVID-19 cases (p-value of 0.000 and R² of 0.415) and a weak relationship to COVID-19 infection rates (p-value of 0.005 and R² of 0.047). Consequently, we provide several non-pharmaceutical lessons, including urban planning strategies, as passive containment measures that may better support disease interventions against future contagious diseases. Full article

(This article belongs to the Special Issue COVID-19 Public Policies Around the World: Lessons Learnt from a Series of Case Studies of the First Pandemic Wave)

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9 pages, 3236 KiB

Open AccessBrief Report

Alcohol and Tobacco Use in a Tuberculosis Treatment Cohort during South Africa’s COVID-19 Sales Bans: A Case Series

by Bronwyn Myers, Tara Carney, Jennifer Rooney, Samantha Malatesta, Laura F. White, Charles D. H. Parry, Tara C. Bouton, Elizabeth J. Ragan, Charles Robert Horsburgh, Jr., Robin M. Warren and Karen R. Jacobson

Int. J. Environ. Res. Public Health 2021, 18(10), 5449; https://doi.org/10.3390/ijerph18105449 - 19 May 2021

Cited by 11 | Viewed by 4298

Abstract

Background: South Africa temporarily banned alcohol and tobacco sales for about 20 weeks during the COVID-19 lockdown. We described changes in alcohol and tobacco consumption after implementation of these restrictions among a small number of participants in a tuberculosis treatment cohort. Method: The [...] Read more.

Background: South Africa temporarily banned alcohol and tobacco sales for about 20 weeks during the COVID-19 lockdown. We described changes in alcohol and tobacco consumption after implementation of these restrictions among a small number of participants in a tuberculosis treatment cohort. Method: The timeline follow-back procedure and Fägerstrom test for nicotine dependence was used to collect monthly alcohol and tobacco use information. We report changes in heavy drinking days (HDD), average amount of absolute alcohol (AA) consumed per drinking day, and cigarettes smoked daily during the alcohol and tobacco ban compared to use prior to the ban. Results: Of the 61 participants for whom we have pre-ban and within-ban alcohol use information, 17 (27.9%) reported within-ban alcohol use. On average, participants reported one less HDD per fortnight (interquartile range (IQR): −4, 1), but their amount of AA consumed increased by 37.4 g per drinking occasion (IQR: −65.9 g, 71.0 g). Of 53 participants who reported pre-ban tobacco use, 17 (32.1%) stopped smoking during the ban. The number of participants smoking >10 cigarettes per day decreased from 8 to 1. Conclusions: From these observations, we hypothesize that policies restricting alcohol and tobacco availability seem to enable some individuals to reduce their consumption. However, these appear to have little effect on the volume of AA consumed among individuals with more harmful patterns of drinking in the absence of additional behavior change interventions. Full article

(This article belongs to the Special Issue COVID-19 Public Policies Around the World: Lessons Learnt from a Series of Case Studies of the First Pandemic Wave)

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15 pages, 1626 KiB

Open AccessCase Report

Early Interventions and Impact of COVID-19 in Spain

by Uxue Alfonso Viguria and Núria Casamitjana

Int. J. Environ. Res. Public Health 2021, 18(8), 4026; https://doi.org/10.3390/ijerph18084026 - 12 Apr 2021

Cited by 26 | Viewed by 3774

Abstract

The health crisis emerging from China in January 2020 has spread around the world resulting in a disruption of daily life activity in many countries. In response to this health threat, different measures have been implemented by national governments to minimize the possible [...] Read more.

The health crisis emerging from China in January 2020 has spread around the world resulting in a disruption of daily life activity in many countries. In response to this health threat, different measures have been implemented by national governments to minimize the possible health consequences. This article explores the initial impact of the COVID-19 pandemic in Spain, providing an epidemiological overview and reviewing the early measures developed to control its spread. On 1 April, Spain was the country with the second highest incidence in the world; with 104,118 positive cases detected and 9387 deaths recorded. Among these, 20.2% of positive cases were among healthcare professionals. In addition to the unprecedented health crisis, the lockdown interventions employed were considered to be among the strictest measures implemented through European countries. These measures were initially successful in controlling local transmission, but resulted in severe economic and social impacts. A critical review of the actions taken and their impact on the Spanish population could contribute to guide and inform decision-making in future pandemic situations. Full article

(This article belongs to the Special Issue COVID-19 Public Policies Around the World: Lessons Learnt from a Series of Case Studies of the First Pandemic Wave)

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15 pages, 2013 KiB

Open AccessCase Report

The Progression of COVID-19 and the Government Response in China

by Xinyi Hu, Antoine Flahault, Alexander Temerev and Liudmila Rozanova

Int. J. Environ. Res. Public Health 2021, 18(6), 3002; https://doi.org/10.3390/ijerph18063002 - 15 Mar 2021

Cited by 8 | Viewed by 3403

Abstract

The ongoing pandemic of COVID-19 (Coronavirus Infectious Disease-2019) was first reported at the end of 2019 in Wuhan, China. On 30 January 2020, the WHO declared a Public Health Emergency for the novel coronavirus. On 11 March 2020, the WHO officially declared the [...] Read more.

The ongoing pandemic of COVID-19 (Coronavirus Infectious Disease-2019) was first reported at the end of 2019 in Wuhan, China. On 30 January 2020, the WHO declared a Public Health Emergency for the novel coronavirus. On 11 March 2020, the WHO officially declared the COVID-19 outbreak as a pandemic. Due to the differences in population distribution, economic structure, degree of damage and other factors, the affected countries have introduced policies tailored to local conditions as a response to the pandemic, leading to different economic and social impacts. Considering the highly heterogeneous spreading of COVID-19 across regions, this paper takes a specific country (China) as a case study of the spread of the disease and national intervention models for the COVID-19 pandemic. The research period of this article is from 17 December to 26 April 2020, because this time period basically covered the important time nodes of the epidemic in China from animal-to-human transmission, limited human-to-human transmission, epidemic to gradual control. This study is useful for comparing the effectiveness of different interventions at various stages of epidemic development within the same country and can also promote the comparison of the epidemic response interventions of different countries. Based on the conclusions of the model simulation, this article evaluates the dual impact of the epidemic on people’s wellbeing and the economy. Full article

(This article belongs to the Special Issue COVID-19 Public Policies Around the World: Lessons Learnt from a Series of Case Studies of the First Pandemic Wave)

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10 pages, 1472 KiB

Open AccessCase Report

COVID-19 on the Nile: Review on the Management and Outcomes of the COVID-19 Pandemic in the Arab Republic of Egypt from February to August 2020

by Yai-Ellen Gaye, Christopher Agbajogu and Reida El Oakley

Int. J. Environ. Res. Public Health 2021, 18(4), 1588; https://doi.org/10.3390/ijerph18041588 - 8 Feb 2021

Cited by 8 | Viewed by 5095

Abstract

As the world fights the coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the World Health Organization (WHO) reports that over 17 million people globally were infected with SARS-CoV-2 as of 1 August 2020. Although infections are [...] Read more.

As the world fights the coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the World Health Organization (WHO) reports that over 17 million people globally were infected with SARS-CoV-2 as of 1 August 2020. Although infections are asymptomatic in 80% of cases, severe respiratory illness occurs in 20% of cases, requiring hospitalization and highly specialized intensive care. The WHO, under the International Health Regulations, declared this pandemic a public health emergency of international concern; it has affected nearly all health systems worldwide. The health system in Egypt, similar to many others, was severely challenged when confronted with the need for urgent and major expansion required to manage such a significant pandemic. This review uses publicly available data to provide an epidemiological summary of the COVID-19 pandemic behavior during the first wave of the outbreak in Egypt. The article covers mathematical modeling predictions, Egypt’s healthcare system, economic and social impacts of COVID-19, as well as national responses that were crucial to the initial containment of the pandemic. We observed how the government managed the outbreak by enhancing testing capacity, contact tracing, announcing public health and social measures (PHSMs), as well as allocating extra funds and human resources to contain SARS-COV-2. Prospectively, economic losses from major sources of revenues—tourism, travel, and trade—may be reflected in future timelines, as Egypt continues to control cases and loss of life from COVID-19. Overall, trends indicate that the spread of COVID-19 in Egypt was initially contained. Revalidation of prediction models and follow-up studies may reveal the aftermath of the pandemic and how well it was managed in Egypt. Full article

(This article belongs to the Special Issue COVID-19 Public Policies Around the World: Lessons Learnt from a Series of Case Studies of the First Pandemic Wave)

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17 pages, 1486 KiB

Open AccessCase Report

Brazil’s Actions and Reactions in the Fight against COVID-19 from January to March 2020

by Ana Szylovec, Isis Umbelino-Walker, Brittany Nicole Cain, Hoi Tung Ng, Antoine Flahault and Liudmila Rozanova

Int. J. Environ. Res. Public Health 2021, 18(2), 555; https://doi.org/10.3390/ijerph18020555 - 11 Jan 2021

Cited by 20 | Viewed by 6251

Abstract

The outbreak of the novel coronavirus SARS-CoV-2 and the disease it causes, COVID-19, which emerged in 2019, was identified by the World Health Organization as a public health emergency of international concern. Brazil actively responded to contain the virus. This case study aims [...] Read more.

The outbreak of the novel coronavirus SARS-CoV-2 and the disease it causes, COVID-19, which emerged in 2019, was identified by the World Health Organization as a public health emergency of international concern. Brazil actively responded to contain the virus. This case study aims to examine Brazil’s response to COVID-19 by investigating the country’s actions and reflecting upon the outcomes throughout January and March 2020. The data collection strategy included gathering data from the country’s intergovernmental organization’s official website, epidemiological bulletins, and news reports, guided by intersectoral and interdisciplinary themes. Although the highest incidence rates were in the most rich and populated region in Brazil, it was the poorest region that had the highest case fatality rate. Nevertheless, Brazil took several non-pharmaceutical measures to control and mitigate the spread of the virus. However, the strategy seems to have failed to consider regional and social inequalities. The actions of the health minister were undermined by a conflicting discourse between the minister and the president. The outbreak of COVID-19 added an extra burden on the country’s healthcare system and the existing economic crises; exacerbated the inherent social, political, and economic challenges; and exposed the country’s contradictions. Full article

(This article belongs to the Special Issue COVID-19 Public Policies Around the World: Lessons Learnt from a Series of Case Studies of the First Pandemic Wave)

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21 pages, 2971 KiB

Open AccessCase Report

Singapore’s Pandemic Preparedness: An Overview of the First Wave of COVID-19

by Jia Bin Tan, Matthew James Cook, Prishanee Logan, Liudmila Rozanova and Annelies Wilder-Smith

Int. J. Environ. Res. Public Health 2021, 18(1), 252; https://doi.org/10.3390/ijerph18010252 - 31 Dec 2020

Cited by 40 | Viewed by 15239

Abstract

A global response to the rapid spread of the 2019 novel coronavirus disease (COVID-19) is imperative in order to reduce mortality and morbidity as well as preventing a country’s health system from collapse. Singapore showed exceptional leadership in the containment of the spread [...] Read more.

A global response to the rapid spread of the 2019 novel coronavirus disease (COVID-19) is imperative in order to reduce mortality and morbidity as well as preventing a country’s health system from collapse. Singapore showed exceptional leadership in the containment of the spread of the virus, however through April 2020 the country experienced exponential growth in the number of infections, particularly migrant workers living in dormitories. The following historical case study provides an overview of Singapore’s country profile, their healthcare system and the country’s non pharmaceutical measures taken to mitigate and contain the spread of COVID-19 in the first few months of the pandemic. We explore the impact COVID-19 had on Singapore’s economy at that time and the implications of the resultant social and political disruptions. We conclude our study by using mathematical modelling to explore confirmed COVID-19 cases in Singapore’s local community and those living in dormitories and use this data to forecast the progression of the epidemic in Singapore given the non-pharmaceutical interventions in place at that time. Our results indicate the COVID-19 outbreak in Singapore increased 3-fold the initial doubling rate of 22.5 days in the first 2 months of the outbreak to 6.7 days in the 5th month; We note a faster doubling rate of 4.9 days for those living in dormitories compared to a doubling rate of 13.5 days for the rest of the community. Full article

(This article belongs to the Special Issue COVID-19 Public Policies Around the World: Lessons Learnt from a Series of Case Studies of the First Pandemic Wave)

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18 pages, 4412 KiB

Open AccessCase Report

It Takes More than Two to Tango with COVID-19: Analyzing Argentina’s Early Pandemic Response (Jan 2020–April 2020)

by Analya Romo and Citlaly Ojeda-Galaviz

Int. J. Environ. Res. Public Health 2021, 18(1), 73; https://doi.org/10.3390/ijerph18010073 - 24 Dec 2020

Cited by 4 | Viewed by 3911

Abstract

In November 2019, the world was introduced to a new coronavirus that has since ravaged it. Argentina began to see an increase of COVID-19 quickly in the new year and as of April 2020 the country was still being burdened by the transmission [...] Read more.

In November 2019, the world was introduced to a new coronavirus that has since ravaged it. Argentina began to see an increase of COVID-19 quickly in the new year and as of April 2020 the country was still being burdened by the transmission of the virus. With the progression of the epidemic turning into a pandemic, health authorities constantly updated health prevention strategies and responses to the novel coronavirus in its first wave. The Center for Disease Control and Prevention (CDC) issued a level three warning for international travel to/from Argentina because of COVID-19′s rapid transmission. With Argentina’s already fragile economy, health systems had to meet the challenge of being able to treat the infected. This case presentation aims to provide an overview of Argentina’s earliest epidemiological situation of the COVID-19 pandemic. The data provided in this study concern Argentina’s COVID-19 situation during the period of January 2020–April 2020. Mathematical modeling was used to forecast COVID-19 transmission after the first wave, specifically focusing on Buenos Aires. The country’s demographics and an impression of its health systems will be analyzed in this case presentation for preparedness. The case study concludes in depicting Argentina’s current and anticipated economic, social, and political disruptions because of the first wave of the pandemic. Full article

(This article belongs to the Special Issue COVID-19 Public Policies Around the World: Lessons Learnt from a Series of Case Studies of the First Pandemic Wave)

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18 pages, 4155 KiB

Open AccessCase Report

Understanding South Korea’s Response to the COVID-19 Outbreak: A Real-Time Analysis

by Eunsun Jeong, Munire Hagose, Hyungul Jung, Moran Ki and Antoine Flahault

Int. J. Environ. Res. Public Health 2020, 17(24), 9571; https://doi.org/10.3390/ijerph17249571 - 21 Dec 2020

Cited by 30 | Viewed by 6935

Abstract

This case study focuses on the epidemiological situation of the COVID-19 outbreak, its impacts and the measures South Korea undertook during the first wave of the COVID-19 pandemic. Since the first case was confirmed on 20 January 2020, South Korea has been actively [...] Read more.

This case study focuses on the epidemiological situation of the COVID-19 outbreak, its impacts and the measures South Korea undertook during the first wave of the COVID-19 pandemic. Since the first case was confirmed on 20 January 2020, South Korea has been actively experiencing the COVID-19 outbreak. In the early stage of the pandemic, South Korea was one of the most-affected countries because of a large outbreak related to meetings of a religious movement, namely the Shincheonji Church of Jesus, in a city called Daegu and North Gyeongsang province. However, South Korea was held as a model for many other countries as it appeared to slow the spread of the outbreak with distinctive approaches and interventions. First of all, with drastic and early intervention strategies it conducted massive tracing and testing in a combination of case isolation. These measures were underpinned by transparent risk communication, civil society mobilization, improvement of accessibility and affordability of the treatment and test, the consistent public message on the potential benefit of wearing a mask, and innovation. Innovative measures include the mobile case-tracing application, mobile self-quarantine safety protection application, mobile self-diagnosis application, and drive-thru screening centres. Meanwhile, the epidemic has brought enormous impacts on society economically and socially. Given its relationship with China, where the outbreak originated, the economic impact in South Korea was predicted to be intense and it was already observed since February due to a decline in exports. The pandemic and measures undertaken by the government also have resulted in social conflicts and debates, human-right concerns, and political tension. Moreover, it was believed that the outbreak of COVID-19 and the governmental responses towards it has brought a huge impact on the general election in April. Despite of the large outbreak in late February, the Korean government has flattened the COVID-19 curve successfully and the downward trend in the number of new cases remained continuously as of 30 April. The most distinctive feature of South Korea’s responses is that South Korea conducted proactive case finding, contacts tracing, and isolations of cases instead of taking traditional measures of the containment of the epidemic such as boarder closures and lockdowns. Full article

(This article belongs to the Special Issue COVID-19 Public Policies Around the World: Lessons Learnt from a Series of Case Studies of the First Pandemic Wave)

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12 pages, 824 KiB

Open AccessCase Report

A Transdisciplinary Analysis of COVID-19 in Italy: The Most Affected Country in Europe

by Flaminia Ortenzi, Emiliano Albanese and Marta Fadda

Int. J. Environ. Res. Public Health 2020, 17(24), 9488; https://doi.org/10.3390/ijerph17249488 - 18 Dec 2020

Cited by 29 | Viewed by 4762

Abstract

As of 27 March 2020, 199 countries and territories and one international conveyance are affected by the COVID-19 pandemic. As of the same date, Italy represents the third country worldwide in total number of cases and the first one in total number of [...] Read more.

As of 27 March 2020, 199 countries and territories and one international conveyance are affected by the COVID-19 pandemic. As of the same date, Italy represents the third country worldwide in total number of cases and the first one in total number of deaths. The purpose of this study is to analyse the Italian case and identify key problem questions and lessons learned from the Italian experience. The study initially provides a general overview of the country’s characteristics and health care system, followed by a detailed description of the Italian epidemiological picture regarding COVID-19. Afterwards, all non-pharmaceutical measures adopted by the Government against COVID-19 are presented in chronological order. The study explores some estimations of the economic impact of the epidemic, as well as its implications for society, lifestyle, and social media reactions. Finally, the study refers to two types of mathematical models to predict the evolution of the spread of COVID-19 disease. Having considered all of the above-mentioned aspects, some significant issues can be raised, including the following: (1) the available epidemiological data presents some gaps and potential biases; (2) mathematical models always come with high levels of uncertainty; (3) the high number of deaths should be interpreted in light of the national demographic context; and (4) the long-term management of the epidemic remains an open question. In conclusion, the Italian experience definitely highlights the importance of preparedness and early action, effective interventions and risk communication. Full article

(This article belongs to the Special Issue COVID-19 Public Policies Around the World: Lessons Learnt from a Series of Case Studies of the First Pandemic Wave)

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18 pages, 8025 KiB

Open AccessCase Report

Situation of India in the COVID-19 Pandemic: India’s Initial Pandemic Experience

by Azizah F. Siddiqui, Manuel Wiederkehr, Liudmila Rozanova and Antoine Flahault

Int. J. Environ. Res. Public Health 2020, 17(23), 8994; https://doi.org/10.3390/ijerph17238994 - 2 Dec 2020

Cited by 47 | Viewed by 9663

Abstract

In this article, we investigate the impact of COVID-19 through screening and surveillance methods adopted in India, as well as the potential health system, social, political, and economic consequences. The research was done in a chronological manner, and data was collected between 30 [...] Read more.

In this article, we investigate the impact of COVID-19 through screening and surveillance methods adopted in India, as well as the potential health system, social, political, and economic consequences. The research was done in a chronological manner, and data was collected between 30 January 2020 till 12 June 2020. Initial containment measures, including point of entry screenings and testing protocols, appeared insufficient. However, testing capacity was gradually expanded after the commencement of a nation-wide lockdown. Modeling predictions have shown varying results on the emergence of cases depending on the infectiousness of asymptomatic individuals, with a peak predicted in mid-July having over two million cases. The country also faces risks of the economic plunge by losing approximately 4% of its gross domestic product, due to containment measures and reduction in goods importation. The low public health expenditure combined with a lack of infrastructure and low fiscal response implies several challenges to scale up the COVID-19 response and management. Therefore, an emergency preparedness and response plan is essential to integrate into the health system of India. Full article

(This article belongs to the Special Issue COVID-19 Public Policies Around the World: Lessons Learnt from a Series of Case Studies of the First Pandemic Wave)

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19 pages, 2734 KiB

Open AccessCase Report

COVID-19 Down Under: Australia’s Initial Pandemic Experience

by Matthew James Cook, Gabriela Guizzo Dri, Prishanee Logan, Jia Bin Tan and Antoine Flahault

Int. J. Environ. Res. Public Health 2020, 17(23), 8939; https://doi.org/10.3390/ijerph17238939 - 1 Dec 2020

Cited by 16 | Viewed by 6046

Abstract

The following case study aims to provide a broad overview of the initial Australian epidemiological situation of the novel coronavirus disease (COVID-19) pandemic. We provide a case presentation of Australia’s current demographic characteristics and an overview of their health care system. The data [...] Read more.

The following case study aims to provide a broad overview of the initial Australian epidemiological situation of the novel coronavirus disease (COVID-19) pandemic. We provide a case presentation of Australia’s current demographic characteristics and an overview of their health care system. The data we present on Australia’s COVID-19 situation pertain to the initial wave of the pandemic from January through to 20 April 2020. The results of our study indicate the number of reported COVID-19 cases in Australia reduced, and Australia initially managed to successfully flatten the curve—from an initial doubling time of 3.4 days at the end of March 2020 to a doubling time of 112 days as of 20 April 2020. Using SEIR mathematical modelling, we investigate a scenario assuming infections increase once mitigation measures are lifted. In this case, Australia could experience over 15,000 confirmed cases by the end of April 2020. How Australia’s government, health authorities and citizens adjust to preventative measures to reduce the risk of transmission as well as the risk of overburdening Australia’s health care system is crucial. Our study presents the initial non-pharmaceutical intervention measures undertaken by the Australian health authorities in efforts to mitigate the rate of infection, and their observed and predicted outcomes. Finally, we conclude our study by presenting the observed and expected economic, social, and political disruptions Australians may endure as a result of the initial phase of the pandemic. Full article

(This article belongs to the Special Issue COVID-19 Public Policies Around the World: Lessons Learnt from a Series of Case Studies of the First Pandemic Wave)

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17 pages, 2703 KiB

Open AccessCase Report

Understanding the Dynamics of the COVID-19 Pandemic: A Real-Time Analysis of Switzerland’s First Wave

by Marina Giachino, Camille Beatrice G. Valera, Sabina Rodriguez Velásquez, Muriel Anna Dohrendorf-Wyss, Liudmila Rozanova and Antoine Flahault

Int. J. Environ. Res. Public Health 2020, 17(23), 8825; https://doi.org/10.3390/ijerph17238825 - 27 Nov 2020

Cited by 15 | Viewed by 4353

Abstract

Since the novel coronavirus outbreak of SARS-CoV-2 from the first cases whereof were reported in Wuhan, China, in December 2019, our globalized world has changed enormously. On the 11th of March 2020, the World Health Organization (WHO) declared COVID-19 a pandemic, and nations [...] Read more.

Since the novel coronavirus outbreak of SARS-CoV-2 from the first cases whereof were reported in Wuhan, China, in December 2019, our globalized world has changed enormously. On the 11th of March 2020, the World Health Organization (WHO) declared COVID-19 a pandemic, and nations around the world have taken drastic measures to reduce transmission of the disease. The situation is similar in Switzerland, a small high-income country in Central Europe, where the first COVID-19 case was registered on the 25th of February 2020. Through literature review as well as correspondence with public health professionals and experts in mathematical modeling, this case study focuses on the outbreak’s impact on Switzerland and on the measures this country has implemented thus far. Along with the rapid spread of the virus, the political organization, economy, healthcare system, and characteristics of the country greatly influence the approach taken in facing the crisis. Switzerland appears to be structurally well-prepared, but, according to mathematical modeling predictions, in order to avoid total collapse of healthcare facilities, the measures taken by the Swiss Government need to reduce the virus transmission chain by at least 70%. Fortunately, updated models on April 22nd show evidence that the non-pharmaceutical measures invoked have decreased transmission by an estimated 89%, proving effective management by the federal government and allowing for progressive deconfinement measures. Full article

(This article belongs to the Special Issue COVID-19 Public Policies Around the World: Lessons Learnt from a Series of Case Studies of the First Pandemic Wave)

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