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1.
BMC Health Serv Res ; 24(1): 1171, 2024 Oct 03.
Artículo en Inglés | MEDLINE | ID: mdl-39363165

RESUMEN

BACKGROUND: After the establishment of the public health emergency of international concern in 2020, health systems worldwide and in Brazil observed the need to apply more extraordinary logistical efforts and possibly resources to combat the imminent pandemic. METHODS: Using the historical series of public expenditures of the National Health Fund (FNS), 2015 to 2021, the number of confirmed cases of COVID-19, and a seasonal ARIMAX model, we sought to assess how the increase in the new virus infections affected the systematic financing of the SUS in Brazil. RESULTS: There were signs of seasonality and an increasing trend in the expenditure variable, which in practical terms, only indicated that the resource contributions followed an increasing trajectory already underway before the advent of the pandemic. The 1% increase in COVID-19 cases, with a one-month lag, contributes to the 0.062% increase in the variation in FNS expenditures but a decrease of 0.058% with a two-month lag. CONCLUSION: The tests showed no evidence to confirm a positive shift on FNS spending growth trajectory due to the increase of COVID-19 cases, only observing a significant increase one month after the occurrence of COVID cases, probably due to their worsening after this period, which was followed by a similar and comparable decrease in percentage of growth in the following month.


Asunto(s)
COVID-19 , Gastos en Salud , COVID-19/epidemiología , COVID-19/economía , Humanos , Brasil/epidemiología , Gastos en Salud/estadística & datos numéricos , Pandemias/economía , SARS-CoV-2 , Programas Nacionales de Salud/economía , Financiación de la Atención de la Salud , Financiación Gubernamental
2.
Rev Bras Enferm ; 77Suppl 1(Suppl 1): e20240078, 2024.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-39230125

RESUMEN

OBJECTIVES: to identify the repercussions of financial toxicity on the lives of adult cancer patients during the COVID-19 pandemic. METHODS: an integrative review was conducted using the PubMed, Web of Science, Scopus, and Embase databases, as well as the Virtual Health Library portal, in March 2023. RESULTS: out of 62 studies found, 13 were included for analysis. The primary repercussions of financial toxicity included difficulties in covering basic expenses such as food, housing, medication, transportation, and internet access; increased anxiety and concerns related to health and financial situations; reduction or absence of income; challenges in obtaining treatment or accessing healthcare services; rising expenses; and telemedicine as a less burdensome alternative. CONCLUSIONS: the pandemic has exacerbated financial toxicity; therefore, healthcare teams must recognize it as an adverse event of oncological treatment and understand its potential to affect various aspects of patients' lives.


Asunto(s)
COVID-19 , Neoplasias , Pandemias , Adulto , Humanos , Costo de Enfermedad , COVID-19/economía , COVID-19/epidemiología , COVID-19/prevención & control , Neoplasias/complicaciones , Neoplasias/economía , Neoplasias/psicología , Pandemias/economía , Pandemias/prevención & control , SARS-CoV-2 , Telemedicina/economía
3.
Value Health Reg Issues ; 44: 101032, 2024 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-39191116

RESUMEN

OBJECTIVE: This study aimed to analyze the changes in the health expenditure of households in Mexico during the COVID-19 pandemic to approximate changes in healthcare that can lead to difficulties in detecting noncommunicable diseases, among others. METHODS: We compare health spending before and after the pandemic through various estimators using multivariate linear regression models at the household level. We also explore heterogeneous effects by zone, sex, and household composition by age. We explore potential mechanisms of change estimating probit models of healthcare. We use microdata from the National Health and Nutrition Survey 2018 and COVID-19. RESULTS: The results suggest a significant reduction in health spending, mainly referring to oral health, clinical analysis, and medical studies. Moreover, differences arise by type of area and household age profile. Changes are more significant among families with children younger than 12 years and households situated in urban areas. Regarding the mechanisms, the results suggest that the lower spending is not due to fewer health needs but rather due to less healthcare attention. CONCLUSION: The COVID-19 pandemic had a significant and heterogeneous impact on household health spending. This lower spending could lead to less detection of noncommunicable diseases, translating into more pressure on the health system in the medium and long term.


Asunto(s)
COVID-19 , Composición Familiar , Gastos en Salud , Humanos , COVID-19/epidemiología , COVID-19/economía , México/epidemiología , Gastos en Salud/estadística & datos numéricos , Masculino , Femenino , SARS-CoV-2 , Adulto , Pandemias/economía , Persona de Mediana Edad , Niño
4.
PLoS One ; 19(8): e0309531, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39190748

RESUMEN

Peru has a fragmented health insurance system in which most insureds can only access the providers in their insurer's network. The two largest sub-systems covered about 53% and 30% of the population at the start of the pandemic; however, some individuals have dual insurance and can thereby access both sets of providers. We use data on 24.7 million individuals who belonged to one or both sub-systems to investigate the effect of dual insurance on COVID-19 mortality. We estimate recursive bivariate probit models using the difference in the distance to the nearest hospital in the two insurance sub-systems as Instrumental Variable. The effect of dual insurance was to reduce COVID-19 mortality risk by 0.23% compared with the sample mean risk of 0.54%. This implies that the 133,128 COVID-19 deaths in the sample would have been reduced by 56,418 (95%CI: 34,894, 78,069) if all individuals in the sample had dual insurance.


Asunto(s)
COVID-19 , Seguro de Salud , Humanos , COVID-19/mortalidad , COVID-19/epidemiología , COVID-19/economía , Perú/epidemiología , Seguro de Salud/estadística & datos numéricos , Femenino , Masculino , Persona de Mediana Edad , Adulto , SARS-CoV-2/aislamiento & purificación , Pandemias/economía , Anciano , Adulto Joven
5.
J Occup Environ Med ; 66(10): e506-e512, 2024 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-39043668

RESUMEN

OBJECTIVES: To assess the impact of the COVID-19 pandemic on disability insurance grants and related costs for workers with cancer. METHODS: This ecological time series study uses the inflection point regression model and the federal government's open-access dataset. We analyze the annual grant and cost rates of cancer-related disability insurance in Brazil (2010-2021). RESULTS: In 2020, the number of disability insurance grants due to malignant neoplasms decreased by 62.26%, and the total annual cost decreased by 62.94% compared to those in 2019. All illnesses and injuries were reduced by 2.56% and 20.02%, respectively. Between 2010 and 2021, the COVID-19 pandemic has reversed the increasing trend in annual disability insurance granted due to cancer and its associated expenses to a stable trend. CONCLUSION: The COVID-19 pandemic has harmed the provision of disability insurance for workers with cancer.


Asunto(s)
COVID-19 , Seguro por Discapacidad , Neoplasias , SARS-CoV-2 , Humanos , COVID-19/economía , COVID-19/epidemiología , Brasil/epidemiología , Neoplasias/economía , Neoplasias/epidemiología , Seguro por Discapacidad/estadística & datos numéricos , Seguro por Discapacidad/economía , Pandemias/economía , Personas con Discapacidad/estadística & datos numéricos
6.
PLoS One ; 19(7): e0305955, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39046943

RESUMEN

This study delves into the global evolution of 43 Sustainable Development Goals (SDG) indicators, spanning 7 major health themes across 185 countries to evaluate the potential progress loss due to the COVID-19 pandemic. Both the cross-country and temporal variability of the dataset are employed to estimate an empirical model based on an extended version of the Preston curve, which links well-being to income levels and other key socioeconomic health determinants. The approach reveals significant global evolution trends operating in each SDG indicator assessed. We extrapolate the model yearly between 2020 and 2030 using the IMF's pre-COVID-19 economic growth projections to show how each country in the dataset are expected to evolve in these health topics throughout the decade, assuming no other external shocks. The results of this baseline scenario are contrasted with a post-COVID-19 scenario, where most of the pandemic costs were already known. The study reveals that economic growth losses are, on average, estimated as 42% and 28% for low- and lower middle-income countries, and of 15% and 7% in high- and upper middle-income countries, respectively, according to the IMF's projections. These disproportional figures are shown to exacerbate global health inequalities revealed by the curves. The expected progress loss in infectious diseases in low-income countries, for instance, is an average of 34%, against a mean of 6% in high-income countries. The theme of Infectious diseases is followed by injuries and violence; maternal and reproductive health; health systems coverage; and neonatal and infant health as those with worse performance. Low-income countries can expect an average progress loss of 16% across all health indicators assessed, whereas in high-income countries the estimated loss is as low as 3%. The disparity across countries is even more pronounced, with cases where the estimated progress loss is as high as nine times worse than the average loss of 8%. Conversely, countries with greater fiscal capacity are likely to fare much better under the circumstances, despite their worse death count, in many cases. Overall, these findings support the critical importance of integrating the fight against inequalities into the global development agendas.


Asunto(s)
COVID-19 , Salud Global , Desarrollo Sostenible , Humanos , COVID-19/epidemiología , COVID-19/economía , Desarrollo Sostenible/tendencias , SARS-CoV-2/aislamiento & purificación , Pandemias/economía , Factores Socioeconómicos , Disparidades en el Estado de Salud
7.
PLoS One ; 19(5): e0303777, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38781260

RESUMEN

The present study aims to analyze the trends in food price in Brazil with emphasis on the period of the Covid-19 pandemic (from March 2020 to March 2022). Data from the Brazilian Household Budget Survey and the National System of Consumer Price Indexes were used as input to create a novel data set containing monthly prices (R$/Kg) for the foods and beverages most consumed in the country between January 2018 and March 2022. All food items were divided according to the Nova food classification system. We estimated the mean price of each food group for each year of study and the entire period. The monthly price of each group was plotted to analyze changes from January 2018 to March 2022. Fractional polynomial models were used to synthesize price changes up to 2025. Results of the present study showed that in Brazil unprocessed or minimally processed foods and processed culinary ingredients were more affordable than processed and ultra-processed foods. However, trend analyses suggested the reversal of the pricing pattern. The anticipated changes in the prices of minimally processed food relative to ultra-processed food, initially forecasted for Brazil, seem to reflect the impact of the Covid-19 pandemic on the global economy. These results are concerning as the increase in the price of healthy foods aggravates food and nutrition insecurity in Brazil. Additionally, this trend encourages the replacement of traditional meals for the consumption of unhealthy foods, increasing a health risk to the population.


Asunto(s)
COVID-19 , Comercio , Alimentos , Pandemias , Brasil/epidemiología , COVID-19/epidemiología , COVID-19/economía , Humanos , Pandemias/economía , Comercio/economía , Comercio/tendencias , Alimentos/economía , SARS-CoV-2/aislamiento & purificación , Abastecimiento de Alimentos/economía
8.
Value Health Reg Issues ; 42: 100984, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38663059

RESUMEN

OBJECTIVES: To calculate the direct cost of personal protective equipment (PPE) used during the COVID-19 pandemic from the perspective of a Brazilian tertiary public hospital. METHODS: We evaluated the cost of PPE during the pandemic to the cost before (2021 vs 2019, respectively) using the microcosting method. Cost estimates were converted into US dollars in 2023, taking inflation into account and using purchasing power parity conversion rates. Our expenses included gloves, disposable gowns, head coverings, masks, N95 respirators, and eye protection. The number of PPE used was determined by the hospital's usual protocol, the total number of hospitalized patients, and the number of days of hospitalization. We used the following variables for uncertainty analysis: PPE adherence, an interquartile range of median length of hospitalization, and variance in the cost of each PPE. RESULTS: In 2021, 26 618 individuals were hospitalized compared with 31 948 in 2019. The median length of stay was 6 and 4 days, respectively. The total and per-patient direct cost of PPE were projected to be 2 939 935.47 US dollar (USD) and 110.45 USD, respectively, during the pandemic, and 1 570 124.08 USD and 49.15 USD, respectively, before the pandemic. The individual cost of PPE was the most influential cost variable. CONCLUSIONS: According to the hospital's perspective, the total estimated direct cost of PPE during the COVID-19 pandemic was nearly twice as high as the previous year. This difference might be explained by the 3-fold increase in PPE in the treatment of patients with COVID-19 compared with patients without isolation precautions.


Asunto(s)
COVID-19 , Equipo de Protección Personal , Humanos , COVID-19/epidemiología , COVID-19/prevención & control , COVID-19/economía , Equipo de Protección Personal/economía , Equipo de Protección Personal/estadística & datos numéricos , Brasil/epidemiología , SARS-CoV-2 , Pandemias/economía , Pandemias/prevención & control , Centros de Atención Terciaria/economía , Centros de Atención Terciaria/estadística & datos numéricos , Hospitalización/economía , Hospitalización/estadística & datos numéricos
9.
Can Rev Sociol ; 61(4): 339-355, 2024 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-38520133

RESUMEN

This study sought to explore the uses meanings and negotiation that female heads of household from low-income areas gave to the transferred money in the COVID health emergency period. Our specific interest is in the withdrawal of 10% of pension funds and the Emergency Family Income (IFE) due to the monetary relevance of both programs. Based on a 10th-month follow-up of 14 female heads of household from low-income areas of Santiago, Chile, this qualitative study examines how the participating women "mark," in Zelizer's sense, the money they received. Thus, we seek to account for how, based on the source of money, its forms of access and the amounts received, women determine how to use it and assign meaning to its value.


Cette étude a cherché à explorer les usages, les significations et les négociations que les femmes chefs de famille des zones à faibles revenus ont donné à l'argent transféré pendant la période d'urgence sanitaire COVID. Nous intéressons plus particulièrement au retrait de 10% des fonds de pension et au revenu familial d'urgence (IFE) en raison de l'importance monétaire de ces deux programmes. Basée sur un suivi de dix mois de 14 femmes chefs de famille issues de quartiers défavorisés de Santiago du Chili, cette étude qualitative examine la manière dont les femmes participantes "marquent", au sens de Zelizer, l'argent qu'elles ont reçu. Ainsi, nous cherchons à expliquer comment, en fonction de la source de l'argent, de ses formes d'accès et des montants reçus, les femmes déterminent comment l'utiliser et attribuent une signification à sa valeur.


Asunto(s)
COVID-19 , Pobreza , Humanos , COVID-19/psicología , COVID-19/economía , Femenino , Incertidumbre , Pobreza/estadística & datos numéricos , Pobreza/psicología , Chile , SARS-CoV-2 , Pandemias/economía , Adulto , Renta/estadística & datos numéricos , Negociación/psicología , Persona de Mediana Edad , Investigación Cualitativa
10.
PLoS One ; 17(2): e0264137, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35192660

RESUMEN

BACKGROUND: The World Health Organization stated a pandemic by severe acute respiratory syndrome coronavirus SARS-Cov2 (COVID-19) on March, 2020 with devastating implications for populations, healthcare systems, and economies globally. OBJECTIVE: The present study explores the association between patients living in municipalities with crowding conditions and poverty and mortality from COVID-19 in Mexico; specifically evaluating the socioeconomic characteristics of the municipality in which the patients reside and some individual characteristics. METHODS: In the present study, we examined public information collected from the National Epidemiological Surveillance System informing all persons tested for SARS-CoV-2 and published by the Ministry of Health. The present analysis was restricted to those with the date of registration to October 12, 2021. The association between the main exposures (overcrowded conditions and poverty) and the outcomes of interest (death by COVID-19) was explored using Cox proportional hazard regression models, including frailty penalties to accommodate multilevel data and random effects for the municipality of case occurrence. RESULTS: A total of 9619917 subjects were included in the Epidemiological Surveillance System for viral respiratory disease platform. Of those for which results were available, 6141403 were negative for COVID-19 and 3478514 were positive for COVID-19; with a total of 273216 deaths in those who tested positive. Among those positive to COVID-19 mean age was 46.9. Patients living in municipalities with high rates of crowding conditions increased the risk of dying from COVID-19 by 8% (95% CI: 1.03, 1.14). Individuals living in municipalities with indigenous background was associated with an increased risk of dying from COVID-19 (HR = 1.10; 95% CI: 1.04, 1.17). Individuals living in municipalities with illiteracy (HR = 1.09; 95% CI: 1.03, 1.11), poverty (HR = 1.17; 95% CI: 1.14, 1.19), food insecurity (HR = 1.094; 95% CI 1.02, 1.06), limited access to social security (HR = 1.10; 95% CI: 1.08, 1.13) and health services (HR = 1.06; 95% CI: 1.04, 1.08) had a higher risk of mortality from COVID-19. CONCLUSION: Our data suggest that patients living in municipalities with higher rates of crowding conditions and higher rates of poverty had elevated risk of mortality from COVID-19. In Mexico, the COVID-19 pandemic is a systemic crisis linked to human development since we have seen that it affects less developed and more vulnerable municipalities. Policies to reduce vulnerabilities and develop strategies to deal with health crises like the current one needs to be considered.


Asunto(s)
COVID-19/economía , COVID-19/mortalidad , Pandemias/economía , Pobreza , SARS-CoV-2 , Adulto , Ciudades/epidemiología , Femenino , Humanos , Masculino , México/epidemiología , Persona de Mediana Edad , Pandemias/prevención & control
11.
Nutrients ; 13(10)2021 Oct 09.
Artículo en Inglés | MEDLINE | ID: mdl-34684547

RESUMEN

Peruvian households have experienced one of the most prevalent economic shocks due to COVID-19, significantly increasing their vulnerability to food insecurity (FI). To understand the vulnerability characteristics of these households among the Peruvian young population, including the role of the government's response through emergency cash transfer, we analysed longitudinal data from the Young Lives study (n = 2026), a study that follows the livelihoods of two birth cohorts currently aged 18 to 27 years old. FI was assessed using the Food Insecurity Experience Scale. Household characteristics were collected before and during the COVID-19 outbreak in Peru to characterise participants' vulnerability to FI. Multivariate logistic regression was used to evaluate the association between government support and participants' vulnerability characteristics to FI. During the period under study (March to December 2020), 24% (95% CI: 22.1-25.9%) of the participants experienced FI. Families in the top wealth tercile were 49% less likely to experience FI. Larger families (>5 members) and those with increased household expenses and decreased income due to COVID-19 were more likely to experience FI (by 35%, 39% and 42%, respectively). There was no significant association between government support and FI (p = 0.768). We conclude that pre-pandemic socioeconomic status, family size, and the economic disruption during COVID-19 contribute to the risk of FI among the Peruvian young population, while government support insufficiently curtailed the risk to these households.


Asunto(s)
COVID-19/economía , Apoyo Financiero , Inseguridad Alimentaria/economía , Abastecimiento de Alimentos/economía , Gobierno , Pandemias/economía , Adolescente , Adulto , Estudios de Cohortes , Femenino , Abastecimiento de Alimentos/métodos , Humanos , Renta , Estudios Longitudinales , Masculino , Perú , SARS-CoV-2 , Factores Socioeconómicos , Adulto Joven
15.
Sci Adv ; 7(6)2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33547077

RESUMEN

Despite numerous journalistic accounts, systematic quantitative evidence on economic conditions during the ongoing COVID-19 pandemic remains scarce for most low- and middle-income countries, partly due to limitations of official economic statistics in environments with large informal sectors and subsistence agriculture. We assemble evidence from over 30,000 respondents in 16 original household surveys from nine countries in Africa (Burkina Faso, Ghana, Kenya, Rwanda, Sierra Leone), Asia (Bangladesh, Nepal, Philippines), and Latin America (Colombia). We document declines in employment and income in all settings beginning March 2020. The share of households experiencing an income drop ranges from 8 to 87% (median, 68%). Household coping strategies and government assistance were insufficient to sustain precrisis living standards, resulting in widespread food insecurity and dire economic conditions even 3 months into the crisis. We discuss promising policy responses and speculate about the risk of persistent adverse effects, especially among children and other vulnerable groups.


Asunto(s)
COVID-19/economía , COVID-19/epidemiología , Países en Desarrollo/economía , Empleo/tendencias , Renta/tendencias , Pandemias/economía , SARS-CoV-2 , Adulto , África/epidemiología , Agricultura/economía , Asia/epidemiología , COVID-19/virología , Niño , Colombia/epidemiología , Violencia Doméstica , Recesión Económica , Composición Familiar , Femenino , Inseguridad Alimentaria/economía , Programas de Gobierno/economía , Humanos , Masculino , Estaciones del Año , Encuestas y Cuestionarios
16.
PLoS One ; 16(2): e0245011, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33596219

RESUMEN

We analyze the trade-offs between health and the economy during the period of social distancing in São Paulo, the state hardest hit by the COVID-19 pandemic in Brazil. We use longitudinal data with municipal-level information and check the robustness of our estimates to several sources of bias, including spatial dependence, reverse causality, and time-variant omitted variables. We use exogenous climate shocks as instruments for social distancing since people are more likely to stay home in wetter and colder periods. Our findings suggest that the health benefits of social distancing differ by levels of municipal development and may have vanished if the COVID-19 spread was not controlled in neighboring municipalities. In turn, we did not find evidence that municipalities with tougher social distancing performed worse economically. Our results also highlight that estimates that do not account for endogeneity may largely underestimate the benefits of social distancing on reducing the spread of COVID-19.


Asunto(s)
COVID-19/economía , COVID-19/psicología , Cuarentena/economía , Brasil/epidemiología , COVID-19/epidemiología , COVID-19/prevención & control , Ciudades/economía , Ciudades/epidemiología , Humanos , Pandemias/economía , Pandemias/prevención & control , Distanciamiento Físico , Cuarentena/psicología , SARS-CoV-2/aislamiento & purificación
17.
Rev Bras Epidemiol ; 23: e200105, 2021.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-33439938

RESUMEN

OBJECTIVE: To describe changes in socioeconomic and health conditions of Brazilians during the COVID-19 pandemic. METHODOLOGY: Cross-sectional study with data from a web-based behavioral survey carried out from April 24 to May 24, 2020, with 45,161 participants recruited by the chain sampling method. A descriptive analysis of the survey topics was performed: adherence to social restriction measures, diagnosis of the new coronavirus, work situation and income, difficulties in routine activities, presence of comorbidities, psychological issues, and access to health services. Prevalence and respective 95% confidence intervals were estimated. RESULTS: Approximately 74% of Brazilians adhered to social restrictions. As for flu symptoms, 28.1% reported having at least one flu symptom, but only 5.9% underwent testing for COVID-19. Regarding the socioeconomic impact, 55.1% reported a decrease in family income, and 7.0% were left without any income; 25.8% of the people lost their jobs, with the group of informal workers being the most affected (50.6%). As for health conditions, 29.4% reported worsening of health status; 45%, having sleep problems; 40% frequently presented feelings of sadness, and 52.5%, of anxiety; 21.7% sought health care, and, among them, 13.9% did not get care. CONCLUSION: The findings show the importance of controlling the COVID-19 pandemic in Brazil, to mitigate the adverse effects on the socioeconomic and health conditions related to social restriction measures.


OBJETIVO: Descrever as mudanças nas condições socioeconômicas e de saúde dos brasileiros durante a pandemia de COVID-19. MÉTODOS: Estudo transversal com dados de pesquisa de comportamentos realizada pela internet de 24 de abril a 24 de maio de 2020 com 45.161 participantes recrutados por amostragem em cadeia. Foi feita uma análise descritiva de temas abordados na pesquisa: adesão às medidas de restrição social, diagnóstico do novo coronavírus, situação de trabalho e rendimentos, dificuldades nas atividades de rotina, presença de comorbidades, estado de ânimo e acesso aos serviços de saúde. Foram estimados as prevalências e os intervalos de 95% de confiança. RESULTADOS: Aproximadamente 75% dos brasileiros aderiram à restrição social. Quanto aos sintomas de gripe, 28,1% relatou ter apresentado algum sintoma, mas apenas 5,9% realizou teste para COVID-19. Em relação à situação socioeconômica, 55,1% relatou diminuição do rendimento familiar, e 7% ficou sem rendimento; 25,8% dos indivíduos ficaram sem trabalhar, sendo o grupo de trabalhadores informais o mais afetado (50,6%). Quanto às condições de saúde, 29,4% avaliou que a sua saúde piorou; 45% teve problemas no sono, 40% apresentou, frequentemente, sentimento de tristeza e 52,5% de ansiedade/nervosismo; 21,7% procurou serviço de saúde e, entre estes, 13,9% não conseguiu atendimento. CONCLUSÃO: Os achados mostram a importância do controle da pandemia de COVID-19 no Brasil, para mitigar os efeitos adversos na situação socioeconômica e nas condições de saúde relacionados às medidas de restrição social.


Asunto(s)
COVID-19/economía , COVID-19/epidemiología , Pandemias/economía , Factores Socioeconómicos , Brasil/epidemiología , Prueba de COVID-19/estadística & datos numéricos , Estudios Transversales , Humanos , Renta , Estrés Psicológico/epidemiología
18.
Vaccine ; 38(51): 8090-8098, 2020 12 03.
Artículo en Inglés | MEDLINE | ID: mdl-33187765

RESUMEN

In Latin America, the country of Ecuador was one of the first and most severely affected by the COVID-19 pandemic. This study aimed to evaluate the demand for a COVID-19 vaccine in Ecuador by estimating individuals' willingness to pay (WTP) for the vaccine, and by assessing the effect of vaccine attributes (duration of protection and efficacy) and individuals' characteristics on this valuation. The sample used (N = 1,050) was obtained through an online survey conducted from April 2 to April 7, 2020. Two levels of vaccine efficacy (70% and 98%) and two levels of vaccine duration of protection (1 and 20 years) were considered. The willingness to pay estimates were obtained using a double-bounded dichotomous-choice contingent valuation format. Survey results show that a very large proportion of individuals (at least 97%) were willing to accept a COVID-19 vaccine, and at least 85% of individuals were willing to pay a positive amount for that vaccine. Conservative estimates of the average WTP values ranged from USD 147.61 to 196.65 and the median WTP from USD 76.9 to 102.5. Only the duration of protection was found to influence individuals' WTP for the vaccine (p < 0.01). On average, respondents were willing to pay 30% more for a COVID-19 vaccine with 20 years of protection relative to the vaccine with 1 year of protection. Regression results show that WTP for the vaccine was associated with income, employment status, the perceived probability of needing hospitalization if contracting the virus causing COVID-19, and region of residence.


Asunto(s)
Vacunas contra la COVID-19/economía , Vacunas contra la COVID-19/inmunología , COVID-19/inmunología , Adulto , Ecuador , Femenino , Humanos , Masculino , Pandemias/economía , Pandemias/prevención & control , SARS-CoV-2/inmunología , Encuestas y Cuestionarios , Vacunación/economía
19.
Salud Colect ; 16: e2995, 2020 10 29.
Artículo en Español | MEDLINE | ID: mdl-33147394

RESUMEN

This essay intends to carry out an ethical and philosophical reflection on the effects of the emergency contingencies of the COVID-19 pandemic. With a focus on Brazil, it seeks to understand, critique, and attribute meaning to references to the pandemic, in particularly dramatic moments brought about by the synergy produced between the serious disease affecting the country and the world and a government that stands out for its remarkable unwillingness and inability to deal with this calamity. This text was written during the Brazilian "quarantine," which lasted from mid-March to late April, 2020. During this period, we were bombarded by facts that never ceased to haunt us, and lived each day under the terrible dominion of the pandemic. Therefore, this text was written in the midst of a social context marked by control efforts, with great attention directed at the health of those affected, despite the complex political framework and serious economic difficulties facing the country.


Este ensayo crítico acerca de las declaraciones sobre la técnica y la vida en el planeta COVID-19 propone una reflexión ético-filosófica de los efectos de la pandemia. Trata de entender, atribuir significados y criticar las referencias a la pandemia, especialmente en Brasil, en momentos especialmente dramáticos, debido a la sinergia entre la grave enfermedad que afecta al país y al planeta, y un gobierno que se destaca por su gigantesca incapacidad para hacer frente a la calamidad. Este texto fue escrito en el periodo de "cuarentena" brasileña, desde mediados de marzo hasta fines de abril de 2020. Es un momento en el que los hechos nos golpean y no dejan de atormentarnos, y se vive a diario bajo el terrible dominio de esta pandemia. Así, este texto se caracteriza por estar elaborado en medio de un contexto social marcado por los esfuerzos de control y atención de la salud de los afectados, a pesar del complejo marco político actual y de las profundas dificultades económicas del país.


Asunto(s)
Infecciones por Coronavirus , Política de Salud , Pandemias , Neumonía Viral , Cuarentena , Actitud Frente a la Salud , Brasil/epidemiología , COVID-19 , Infecciones por Coronavirus/economía , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/psicología , Gobierno Federal , Humanos , Pandemias/economía , Pandemias/prevención & control , Neumonía Viral/economía , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Neumonía Viral/psicología , Cuarentena/economía , Cuarentena/métodos , Cuarentena/psicología , Riesgo
20.
J Acquir Immune Defic Syndr ; 85(4): 475-482, 2020 12 01.
Artículo en Inglés | MEDLINE | ID: mdl-33136748

RESUMEN

BACKGROUND: The spread of severe acute respiratory syndrome coronavirus 2, causative agent of the coronavirus disease 2019 (COVID-19), has necessitated widespread lockdown to mitigate the pandemic. This study examines the influence of resilience on the impact of COVID-related stress and enforced lockdown on mental health, drug use, and treatment adherence among people living with HIV (PLWH) in Argentina. SETTING: PLWH residing predominantly in Buenos Aires Metropolitan Area and urban regions of Argentina were identified from a private clinic electronic database. METHODS: Participants completed an anonymous online survey to evaluate the impact of COVID-19 on economic disruption, resilience, mental health outcomes (depression, anxiety, stress, and loneliness), adherence to HIV treatment, and substance use. We performed ordinary least squares and logistic regressions to test whether resilient coping buffered the impact of economic disruption on mental health and drug use during quarantine. RESULTS: A total of 1336 PLWH aged 18-82 were enrolled. The impact of economic disruption on mental health ΔF(1,1321) = 8.86, P = 0.003 and loneliness ΔF(1,1326) = 5.77, P = 0.016 was buffered by resilience. A 3-way interaction between resilient buffering, stress, and sex was significant ΔF(1,1325) = 4.76, P = 0.029. Participants reported less than excellent adherence to medication (33%), disruption to mental health services (11%), and disruption to substance abuse treatment (1.3%) during lockdown. DISCUSSION: The impact of COVID-stress and lockdown on emotional distress seemed mitigated by resilience coping strategies, and the buffering impact of resilience on perceived stress was greater among women. Results highlight PLWH's capacity to adhere to treatment in challenging circumstances and the importance of developing resilience skills for better coping with stress and adversity.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/psicología , Infecciones por VIH/psicología , Salud Mental/tendencias , Neumonía Viral/psicología , Trastornos de Estrés Traumático Agudo/psicología , Adaptación Psicológica , Adulto , Anciano , Anciano de 80 o más Años , Argentina , COVID-19 , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/economía , Infecciones por Coronavirus/prevención & control , Femenino , Infecciones por VIH/complicaciones , Humanos , Violencia de Pareja/tendencias , Análisis de los Mínimos Cuadrados , Modelos Logísticos , Soledad , Masculino , Servicios de Salud Mental/normas , Persona de Mediana Edad , Pandemias/economía , Pandemias/prevención & control , Neumonía Viral/complicaciones , Neumonía Viral/economía , Neumonía Viral/prevención & control , Resiliencia Psicológica , SARS-CoV-2 , Factores Sexuales , Aislamiento Social/psicología , Apoyo Social , Trastornos de Estrés Traumático Agudo/etiología , Trastornos Relacionados con Sustancias/etiología , Trastornos Relacionados con Sustancias/terapia , Encuestas y Cuestionarios , Cumplimiento y Adherencia al Tratamiento , Adulto Joven
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