RESUMO
In a severe epidemic such as the COVID-19 pandemic, social distancing can be a vital tool to stop the spread of the disease and save lives. However, social distancing may induce profound negative social or economic impacts as well. How to optimize social distancing is a serious social, political, as well as public health issue yet to be resolved. This work investigates social distancing with a focus on how every individual reacts to an epidemic, what role he/she plays in social distancing, and how every individual's decision contributes to the action of the population and vice versa. Social distancing is thus modeled as a population game, where every individual makes decision on how to participate in a set of social activities, some with higher frequencies while others lower or completely avoided, to minimize his/her social contacts with least possible social or economic costs. An optimal distancing strategy is then obtained when the game reaches an equilibrium. The game is simulated with various realistic restraints including (i) when the population is distributed over a social network, and the decision of each individual is made through the interactions with his/her social neighbors; (ii) when the individuals in different social groups such as children vs. adults or the vaccinated vs. unprotected have different distancing preferences; (iii) when leadership plays a role in decision making, with a certain number of leaders making decisions while the rest of the population just follow. The simulation results show how the distancing game is played out in each of these scenarios, reveal the conflicting yet cooperative nature of social distancing, and shed lights on a self-organizing, bottom-up perspective of distancing practices.
Assuntos
COVID-19 , Distanciamento Físico , Humanos , COVID-19/prevenção & controle , COVID-19/epidemiologia , COVID-19/psicologia , SARS-CoV-2 , Pandemias/prevenção & controle , Comportamento SocialRESUMO
OBJECTIVE: The aim of this study was to investigate the contextual factors associated with the quality of life (QOL) of Brazilian children aged 0-12 years during the strict period of social isolation. METHODS: This observational cross-sectional study was conducted between July and September 2020 using an online questionnaire on QOL-related family factors and the Pediatric Quality of Life Inventory (PedsQL™). Results were analyzed by multinomial logistic regression analysis. RESULTS: The sample had 849 children, mostly from the South Region of Brazil (75%), white (83%), with typical development (79%), sedentary (68%), using screen (85%) for >3 h/day (44%). Their mothers were their main caregivers (90%). The following variables were significantly associated with high scores of QOL: typical health status (OR 2.38; 95%CI 1.60-3.55; screen time ≤2 h/day (OR 1.62; 95%CI 1.17-2.24); social distancing considered as "easy" (OR 1.67; 95%CI 1.20-2.32), and stimulation of the child by the family (OR 1.93; 95%CI 1.08-3.45). CONCLUSIONS: This study indicates that the family context can influence children's QOL, especially during the COVID-19 pandemic and home environment reorganization.
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COVID-19 , Qualidade de Vida , Humanos , COVID-19/epidemiologia , COVID-19/psicologia , Brasil/epidemiologia , Estudos Transversais , Feminino , Masculino , Pré-Escolar , Lactente , Criança , Isolamento Social/psicologia , Inquéritos e Questionários , Recém-Nascido , Pandemias , Tempo de Tela , Distanciamento Físico , Nível de SaúdeRESUMO
INTRODUCTION: We aimed to explore the impact of social distancing on the incidence, severity and microbiology of patients with acute tonsillitis (AT). METHODS: In this single-centre study, we retrospectively included all patients with AT referred to the Ear-Nose-Throat Department, Aarhus University Hospital, Denmark, in the two years preceding versus the two years after the COVID-19 lockdown in Denmark (11 March 2020). RESULTS: In total, 425 patients were included. The incidence of AT was significantly lower in the post-lockdown period (n = 128) than in the pre-lockdown period (n = 297) (p less-than 0.001). Reduced incidence was observed across all age groups. No significant differences were found in patient characteristics between periods. The proportion of hospitalised patients was significantly lower in the post- than in the pre-lockdown period (36% versus 25%, p = 0.032). Prevalent culture findings were Streptococcus pyogenes (15%), S. anginosus group (11%) and Fusobacterium necrophorum (5%). No statistically significant differences in the relative prevalence of individual bacteria were found between periods. CONCLUSIONS: The incidence of patients with AT referred to hospital decreased by 57% in the two-year period after the COVID-19 lockdown compared with the period leading up to the lockdown. Our findings suggest that this decrease mirrored a general decline in AT incidence rather than altered referral patterns. FUNDING: None. TRIAL REGISTRATION: The study was approved by the Danish Data Protection Agency (#1-16-02-134-23) and the Danish Patient Safety Authority (#1-45-70-41-23).
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COVID-19 , Tonsilite , Humanos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Tonsilite/epidemiologia , Tonsilite/microbiologia , Incidência , Dinamarca/epidemiologia , Feminino , Masculino , Estudos Retrospectivos , Adulto , Adolescente , SARS-CoV-2 , Adulto Jovem , Criança , Pessoa de Meia-Idade , Doença Aguda , Streptococcus pyogenes , Pré-Escolar , Fusobacterium necrophorum/isolamento & purificação , Distanciamento Físico , Infecções Estreptocócicas/epidemiologia , Infecções Estreptocócicas/prevenção & controleRESUMO
The Corona Virus Disease (COVID-19) has a huge impact on all of humanity, and people's disregard for COVID-19 regulations has sped up the disease's spread. Our study uses a state-of-the-art object detection model like YOLOv4 (You Only Look Once, version 4), a very effective tool, on real-time 25fps, 1920 X 1080 video data streamed live by a camera-mounted Unmanned Aerial Vehicle (UAV) quad-copter to observe proper maintenance of social distance in an area of 35m range in this study. The model has demonstrated remarkable efficacy in identifying and quantifying instances of social distancing, with an accuracy of 82% and little latency. It has been able to work efficiently with real-time streaming at 25-30 ms. Our model is based on CSPDarkNet-53, which was trained on the MS COCO dataset for image classification. It includes additional layers to capture feature maps from different phases. Additionally, the model's neck is made up of PANet, which is used to aggregate the parameters from various CSPDarkNet-53 layers. The CSPDarkNet-53's 53 convolutional layers are followed by 53 more layers in the model head, for a total of 106 completely convolutional layers in the design. This architecture is further integrated with YOLOv3, resulting in the YOLOv4 model, which will be used by our detection model. Furthermore, to differentiate humans The aforementioned method was used to evaluate drone footage and count social distance violations in real time. Our findings show that our model was reliable and successful at detecting social distance violations in real-time with an average accuracy of 82%.
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COVID-19 , Aprendizado Profundo , Pandemias , Distanciamento Físico , COVID-19/epidemiologia , COVID-19/prevenção & controle , Humanos , Pandemias/prevenção & controle , Vigilância em Saúde Pública/métodos , SARS-CoV-2/isolamento & purificação , Dispositivos Aéreos não TripuladosRESUMO
Background: The COVID-19 social distancing guidelines resulted in a dramatic transition to telephone and video technologies to deliver substance use disorder (SUD) treatment. Before COVID-19, the question was "Will telehealth ever take hold for SUD services?" Now that social distancing guidelines have been lifted, the question is "Will telehealth remain a commonly used care modality?" Objective: The principal purpose of this investigation was to examine the extent to which telehealth use in SUD service settings persisted following the lifting of COVID-19 safety distancing recommendations. Additionally, the study aimed to explore practitioners' perceptions of telehealth convenience and value after its regular implementation during the pandemic. Specifically, the goal of this study was to compare telehealth activity between time intervals: May-August 2020 (during peak COVID-19 safety distancing recommendations) and October-December 2022 (following discontinuation of distancing recommendations). Specifically, we compared (1) telehealth technologies and services, (2) perceived usefulness of telehealth, (3) ease of use of telephone- and video-based telehealth services, and (4) organizational readiness to use telehealth. Methods: An online cross-sectional survey consisting of 108 items was conducted to measure the use of telehealth technologies for delivering a specific set of SUD services in the United States and to explore the perceived readiness for use and satisfaction with telephonic and video services. The survey took approximately 25-35 minutes to complete and used the same 3 sets of questions and 2 theory-driven scales as in a previous cross-sectional survey conducted in 2020. Six of 10 Regional Addiction Technology Transfer Centers funded by the Substance Abuse and Mental Health Services Administration distributed the survey in their respective regions, collectively spanning 37 states. Responses of administrators and clinicians (hereafter referred to as staff) from this 2022 survey were compared to those obtained in the 2020 survey. Responses in 2020 and 2022 were anonymous and comprised two separate samples; therefore, an accurate longitudinal model could not be analyzed. Results: A total of 375 staff responded to the 2022 survey (vs 457 in 2020). Baseline organizational characteristics of the 2022 sample were similar to those of the 2020 sample. Phone and video telehealth utilization rates remained greater than 50% in 2022 for screening and assessment, case management, peer recovery support services, and regular outpatient services. The perceived usefulness of phone-based telehealth was higher in 2022 than in 2020 (mean difference [MD] -0.23; P=.002), but not for video-based telehealth (MD -0.12; P=.13). Ease of use of video-based telehealth was perceived as higher in 2022 than in 2020 (MD-0.35; P<.001), but no difference was found for phone-based telehealth (MD -0.12; P=.11). From the staff's perspective, patients had greater readiness for using telehealth via phone than video, but the staff perceived their personal and organizational readiness for using telehealth as greater for video-based than for phone-based telehealth. Conclusions: Despite lower telephone and video use in 2022 for telehealth services than in 2020, both modalities continue to be perceived positively. Future research may further determine the relative cost and clinical effectiveness of video-based services and thereby help to address some sources of the noted challenges to implementation by SUD organizations.
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COVID-19 , Transtornos Relacionados ao Uso de Substâncias , Telemedicina , Humanos , COVID-19/prevenção & controle , COVID-19/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Estudos Transversais , Distanciamento Físico , Inquéritos e Questionários , Masculino , Adulto , FemininoRESUMO
BACKGROUND: Immunocompromised individuals are known to respond inadequately to SARS-CoV-2 vaccines, placing them at high risk of severe or fatal COVID-19. Thus, immunocompromised individuals and their caregivers may still practice varying degrees of social or physical distancing to avoid COVID-19. However, the association between physical distancing to avoid COVID-19 and quality of life has not been comprehensively evaluated in any study. OBJECTIVE: We aim to measure physical distancing behaviors among immunocompromised individuals and the association between those behaviors and person-centric outcomes, including health-related quality of life (HRQoL) measures, health state utilities, anxiety and depression, and work and school productivity impairment. METHODS: A patient-informed protocol was developed to conduct the EAGLE Study, a large cross-sectional, observational study, and this paper describes that protocol. EAGLE is designed to measure distancing behaviors and outcomes in immunocompromised individuals, including children (aged ≥6 mo) and their caregivers, and nonimmunocompromised adults in the United States and United Kingdom who report no receipt of passive immunization against COVID-19. We previously developed a novel self- and observer-reported instrument, the Physical Distancing Scale for COVID-19 Avoidance (PDS-C19), to measure physical distancing behavior levels cross-sectionally and retrospectively. Using an interim or a randomly selected subset of the study population, the PDS-C19 psychometric properties will be assessed, including structural validity, internal consistency, known-group validity, and convergent validity. Associations (correlations) will be assessed between the PDS-C19 and validated HRQoL-related measures and utilities. Structural equation modeling and regression will be used to assess these associations, adjusting for potential confounders. Participant recruitment and data collection took place from December 2022 to June 2023 using direct-to-patient channels, including panels, clinician referral, patient advocacy groups, and social media, with immunocompromising diagnosis confirmation collected and assessed for a randomly selected 25% of immunocompromised participants. The planned total sample size is 3718 participants and participant-caregiver pairs. Results will be reported by immunocompromised status, immunocompromising condition category, country, age group, and other subgroups. RESULTS: All data analyses and reporting were planned to be completed by December 2023. Results are planned to be submitted for publication in peer-reviewed journals in 2024-2025. CONCLUSIONS: This study will quantify immunocompromised individuals' physical distancing behaviors to avoid COVID-19 and their association with HRQoL as well as health state utilities. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR1-10.2196/52643.
Assuntos
COVID-19 , Hospedeiro Imunocomprometido , Distanciamento Físico , Qualidade de Vida , Humanos , COVID-19/prevenção & controle , COVID-19/epidemiologia , Estudos Transversais , Hospedeiro Imunocomprometido/imunologia , Adulto , Masculino , Feminino , Estados Unidos/epidemiologia , Reino Unido/epidemiologia , CriançaRESUMO
OBJECTIVES: This multicountry analysis aimed to assess the prevalence of key hygiene prevention behaviours and their determinants, associated with international non-governmental organisation (WaterAid) hygiene behaviour change programmes for COVID-19 prevention. The goal of this analysis is to inform future outbreak preparedness and pandemic response in low and middle-income countries. DESIGN: Cross-sectional study. SETTING: Households in seven countries where WaterAid implemented a first-phase COVID-19 response programme in 2020 (Ethiopia, Ghana, Nepal, Nigeria, Rwanda, Tanzania and Zambia). PARTICIPANTS: 3033 adults (1469 men and 1564 women, alternately sampled from one household to the next to maintain gender balance) in specific programme areas (211 villages) surveyed between October and November 2020. PRIMARY OUTCOME MEASURES: Self-reported primary outcomes were: a composite measure of HWWS for prevention of respiratory infection/COVID-19 (total of 5 key moments); respondent increased HWWS behaviour after the COVID-19 pandemic; respondent always wears a mask in public spaces; respondent always practices physical distancing in public spaces. RESULTS: Most respondents (80%) reported increasing their handwashing behaviour after the pandemic, but practice of HWWS at COVID-19-specific prevention moments was low. Mask wearing (58%) and physical distancing (29%) varied substantially between countries. Determinants of key behaviours were identified, including age and socioeconomic status, perceived norms, self-regulation and the motive of protecting others. Incidence rate ratios or odds ratios and 95% CIs for a range of psychosocial determinants for each of the four primary outcomes are reported. CONCLUSIONS: These findings highlight that leveraging behaviour-specific emotional drivers and norms, reducing common barriers and promoting targeted messages about specific behaviours and actions individuals can take to reduce risk are necessary to support large-scale behaviour change. Learning from the COVID-19 response to more effectively integrate novel behaviours into existing health promotion will be vital for disease prevention and outbreak resilience.
Assuntos
COVID-19 , Desinfecção das Mãos , Comportamentos Relacionados com a Saúde , SARS-CoV-2 , Humanos , COVID-19/prevenção & controle , COVID-19/epidemiologia , Estudos Transversais , Masculino , Feminino , Adulto , Distanciamento Físico , Pessoa de Meia-Idade , Máscaras/estatística & dados numéricos , Adulto Jovem , Higiene , Pandemias/prevenção & controle , África/epidemiologiaRESUMO
PURPOSE: Non-pharmaceutical interventions (NPIs) have been the cornerstone of COVID-19 pandemic control, but evidence on their effectiveness varies according to the methods and approaches taken to empirical analysis. We analysed the impact of NPIs on incident SARS-CoV-2 across 32 European countries (March-December 2020) using two NPI trackers: the Corona Virus Pandemic Policy Monitor - COV-PPM, and the Oxford Covid-19 Government Response Tracker - OxCGRT. METHODS: NPIs were summarized through principal component analysis into three sets, stratified by two waves (C1-C3, weeks 5-25, and C4-C6, weeks 35-52). Longitudinal, multi-level mixed-effects negative binomial regression models were fitted to estimate incidence rate ratios for cases and deaths considering different time-lags and reverse causation (i.e. changing incidence causing NPIs), stratified by waves and geographical regions (Western, Eastern, Northern, Southern, Others). RESULTS: During the first wave, restrictions on movement/mobility, public transport, public events, and public spaces (C1) and healthcare system improvements, border closures and restrictions to public institutions (C2) were associated with a reduction in SARS-CoV-2 incidence after 28 and 35-days. Mask policies (C3) were associated with a reduction in SARS-CoV-2 incidence (except after 35-days). During wave 1, C1 and C2 were associated with a decrease in deaths after 49-days and C3 after 21, 28 and 35-days. During wave 2, restrictions on movement/mobility, public transport and healthcare system improvements (C5) were also associated with a decrease in SARS-CoV-2 cases and deaths across all countries. CONCLUSION: In the absence of pre-existing immunity, vaccines or treatment options, our results suggest that the observed implementation of different categories of NPIs, showed varied associations with SARS-CoV-2 incidence and deaths across regions, and varied associations across waves. These relationships were consistent across components of NPIs derived from two policy trackers (CoV-PPM and OxCGRT).
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COVID-19 , Humanos , COVID-19/prevenção & controle , COVID-19/epidemiologia , COVID-19/mortalidade , Europa (Continente)/epidemiologia , Incidência , SARS-CoV-2 , Pandemias/prevenção & controle , Controle de Doenças Transmissíveis/métodos , Distanciamento FísicoRESUMO
After the many failures in the control of the COVID-19 pandemic, identifying robust principles of epidemic control will be key in future preparedness. In this work, we propose an optimal control model of an age-of-infection transmission model under a two-phase control regime where social distancing is the only available control tool in the first phase, while the second phase also benefits from the arrival of vaccines. We analyzed the problem by an ad-hoc numerical algorithm under a strong hypothesis implying a high degree of prioritization to the protection of health from the epidemic attack, which we termed the "low attack rate" hypothesis. The outputs of the model were also compared with the data from the Italian COVID-19 experience to provide a crude assessment of the goodness of the enacted interventions prior to the onset of the Omicron variant.
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Algoritmos , COVID-19 , Pandemias , Distanciamento Físico , SARS-CoV-2 , Vacinação , COVID-19/prevenção & controle , COVID-19/epidemiologia , COVID-19/transmissão , Humanos , Itália/epidemiologia , SARS-CoV-2/imunologia , Pandemias/prevenção & controle , Vacinas contra COVID-19/administração & dosagem , Simulação por Computador , Controle de Doenças Transmissíveis/métodos , Política de Saúde , QuarentenaRESUMO
Strict social isolation and physical distancing measures implemented during the COVID-19 pandemic had significant implications for the psychological well-being of middle-aged and older adults. This study aimed to investigate factors associated with depressive symptoms during the pandemic period among individuals who reported no significant depressive symptoms before the pandemic. Individuals from the Korean Longitudinal Study of Aging without a previous report of significant depressive symptoms across Waves 6 (2016) and 7 (2018) were investigated for the development of depressive symptoms in Wave 8 (2020). The multivariable logistic regression results revealed that both men and women who participated in social gatherings and physical exercise less than once a week were associated with an increase in the likelihood of depressive symptoms (odds ratio [OR] 2.88; 95% confidence interval [CI] 1.80-4.61 and OR 2.61; 95% CI 1.64-4.15, respectively for men and OR 2.58; 95% CI 1.80-3.70 and OR 1.51; 95% CI 1.02-2.23, respectively for women). In addition, unmarried men (OR 2.38; 95% CI 1.37-4.14) and women with one chronic disease (OR 1.98; 95% CI 1.14-3.43) or two or more chronic diseases (OR 2.28; 95% CI 1.31-3.99) reported a significant increase in the likelihood of depressive symptoms. Regular social gatherings and physical exercise were identified as key factors in mitigating depressive symptoms among middle-aged and older adults. The findings can inform the development of public health strategies that promote regular social interactions and physical activity to enhance the psychological resilience and overall well-being of middle-aged and older adults in the endemic era.
Assuntos
COVID-19 , Depressão , Exercício Físico , Isolamento Social , Humanos , COVID-19/prevenção & controle , COVID-19/epidemiologia , Masculino , Feminino , Pessoa de Meia-Idade , Depressão/epidemiologia , Idoso , Estudos Longitudinais , Isolamento Social/psicologia , República da Coreia/epidemiologia , Distanciamento Físico , SARS-CoV-2 , Idoso de 80 Anos ou maisRESUMO
In response to COVID-19 social distancing restrictions, digitally delivered health interventions present as a potential solution for maintaining or improving individuals' physical activity. This study explored the feasibility of a web-based intervention, informed by the multi-process action control (M-PAC) framework to promote PA among individuals affected by social distancing. Fifty adults self-reporting as insufficiently active were randomized to a 6-week web-intervention (n = 27) or wait-list control (n = 23). Primary feasibility outcomes included recruitment and retention rates and usability and satisfaction scores; secondary outcomes of MVPA and M-PAC constructs and tertiary outcomes of mental health and wellbeing were also assessed. Overall, feasibility of the intervention was high, with a 96% recruitment rate, 84% retention rate, high satisfaction and usability scores, and comparable website usage to similar eHealth interventions. Intervention participants trended towards improved MVPA and M-PAC constructs and outcomes of mental health and wellbeing. Findings suggest study extension to a full-scale RCT.
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COVID-19 , Exercício Físico , Estudos de Viabilidade , Intervenção Baseada em Internet , Distanciamento Físico , Humanos , COVID-19/prevenção & controle , COVID-19/psicologia , Masculino , Feminino , Exercício Físico/psicologia , Adulto , Pessoa de Meia-Idade , Saúde Mental , Promoção da Saúde/métodosRESUMO
The COVID-19 pandemic exacerbated various determinants of mental disorders. Several behavioral changes were observed given this increase, including harmful health consequences, such as excessive consumption of ultra-processed foods (UPFs). To assess this relationship, we investigated the meditational role of symptoms of mental disorders (anxiety and depression) in the association between stress resulting from social distancing during the COVID-19 pandemic and the consumption of UPFs in 3884 Brazilian public employees in a supplementary study of the ELSA-Brasil study. Structural equation models (SEMs) were estimated to assess the direct and indirect effects mediated by symptoms of mental disorders. The results suggested a significant and positive mediational effect of the symptoms of mental disorders on the association between the stress resulting from social distancing and the consumption of UPFs. These findings contribute to informing the need for policies and early interventions in potentially stressful situations, with a focus on the promotion of mental health, and may thus help prevent or reduce the consumption of unhealthy foods.
Assuntos
COVID-19 , Fast Foods , Distanciamento Físico , SARS-CoV-2 , Estresse Psicológico , Humanos , COVID-19/psicologia , COVID-19/epidemiologia , COVID-19/prevenção & controle , Brasil/epidemiologia , Feminino , Masculino , Pessoa de Meia-Idade , Adulto , Depressão/epidemiologia , Ansiedade , Transtornos Mentais/epidemiologia , Transtornos Mentais/etiologia , Saúde Mental/estatística & dados numéricos , Pandemias , Alimento ProcessadoRESUMO
BACKGROUND: The sudden introduction of social distancing measures in response to the COVID-19 pandemic resulted in significant lifestyle changes for the UK population. People living with physical disabilities were deemed to be at greater risk of complications following COVID-19 infection and were subjected to stricter social distancing guidelines. But gaps remain in our understanding of how the COVID-19 pandemic and associated restrictions affected the ability to access support, health and wellbeing of people with physical disabilities. Such understanding is vital to ensure equitable future pandemic preparedness for people living with physical disabilities. METHODS: We conducted qualitative semi-structured interviews with 31 people living in the UK between May 2020 and January 2022. All participants self-identified as having a physical disability that affected their mobility, sight, or hearing. We analysed the data using reflexive thematic analysis. RESULTS: Six themes were identified that described the impact of the pandemic on ability to access support, health and wellbeing: (i) adaptations to healthcare provision led to difficulties in managing health and wellbeing; (ii) exacerbations of inequalities in access to public space due to social distancing guidelines; (iii) experiences of hostility from able-bodied people; (iv) loss of social lives and encounters; (v) difficulties maintaining distance from others and subsequent fear of infection and (vi) strategies to support wellbeing and coping when confined to the home. CONCLUSION: The COVID-19 pandemic exacerbated existing health and social inequalities experienced by disabled people. The disproportionate impact of the pandemic on service provision and social connections resulted in challenging circumstances for disabled people who faced unmet medical needs, deteriorating health, and at times, hostile public spaces. Disabled people's experiences need to be incorporated into future pandemic or health-related emergency planning to ensure equality of access to services and public spaces to ensure their health and wellbeing is supported and maintained.
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COVID-19 , Pessoas com Deficiência , Distanciamento Físico , Pesquisa Qualitativa , Humanos , COVID-19/prevenção & controle , COVID-19/epidemiologia , COVID-19/psicologia , Pessoas com Deficiência/psicologia , Reino Unido , Feminino , Masculino , Adulto , Pessoa de Meia-Idade , Idoso , Acessibilidade aos Serviços de Saúde , Pandemias , Adulto Jovem , Entrevistas como AssuntoRESUMO
OBJECTIVE: We aimed to analyze the frequency of adherence to social distancing and individual protection measures of adult and older populations in two cities in southern Brazil and to characterize the sociodemographic aspects of these individuals. METHODS: This cross-sectional, population-based study was conducted in the cities of Rio Grande, RS, and Criciúma, SC, Brazil. The outcome measure was the frequency of adherence to social distancing measures. Fisher's exact test (5% significance) was used to calculate the differences in prevalence according to exposure variables. RESULTS: Among the 2,170 participants over the age of 18, the prevalence of adherence to social distancing was 18.5%. Adherence was significantly higher among women; older adults; single, divorced, or widowed people with a low educational level; people of lower socioeconomic status; and people affected by multiple chronic diseases. CONCLUSION: Approximately one in five respondents adhered to measures of social distancing, and adherence was more prevalent among the risk groups.
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COVID-19 , Distanciamento Físico , Humanos , Brasil , Estudos Transversais , Feminino , Masculino , Pessoa de Meia-Idade , COVID-19/prevenção & controle , COVID-19/epidemiologia , Adulto , Idoso , Adulto Jovem , Fatores Socioeconômicos , Adolescente , Fatores Sociodemográficos , SARS-CoV-2RESUMO
Non-pharmaceutical interventions (NPI) have been proven successful in a population-based approach to protect from SARS-CoV-2 transmission during the COVID-19 pandemic. As a consequential-effect, a reduction in the spread of all respiratory viruses has been observed, but the primary factors behind this phenomenon have yet to be identified. We conducted a subgroup analysis of participants from the ELISA study, a prospective longitudinal cohort study on SARS-CoV-2 transmission, at four timepoints from November 2020 - September 2022. The aim was to provide a detailed overview of the circulation of respiratory viruses over 2 years and to identify potential personal risk factors of virus distribution. All participants were screened using qPCR for respiratory viral infections from nasopharyngeal swabs and answered a questionnaire regarding behavioral factors. Several categories of risk factors for the transmission of respiratory viruses were evaluated using a scoring system. In total, 1,124 participants were included in the study, showing high adherence to governmental-introduced NPI. The overall number of respiratory virus infections was low (0-4.9% of participants), with adenovirus (1.7%), rhino-/enterovirus (3.2%) and SARS-CoV-2 (1.2%) being the most abundant. We detected an inverse correlation between the number and intensity of NPI and the number of detected respiratory viruses. More precisely, the attendance of social events and household size was associated with rhino-/enterovirus infection while social contacts were associated with being positive for any virus. NPI introduced during the COVID-19 pandemic reduced the occurrence of seasonal respiratory viruses in our study, showing different risk-factors for enhanced transmission between viruses. Trial registration: DRKS.de, German Clinical Trials Register (DRKS), Identifier: DRKS00023418, Registered on 28 October 2020.
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COVID-19 , Infecções Respiratórias , SARS-CoV-2 , Humanos , COVID-19/epidemiologia , COVID-19/prevenção & controle , COVID-19/transmissão , Estudos Prospectivos , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/prevenção & controle , Infecções Respiratórias/virologia , Masculino , Feminino , Pessoa de Meia-Idade , Adulto , Estudos Longitudinais , Fatores de Risco , Idoso , Distanciamento Físico , Adolescente , Adulto Jovem , Alemanha/epidemiologiaRESUMO
OBJECTIVE: To analyze adherence to standard precautions by healthcare professionals and associated factors during the COVID-19 pandemic in Brazilian university hospitals. METHOD: Multicenter study, with a mixed approach, with a concomitant incorporated strategy and a sample of 559 health professionals and 53 managers from five university hospitals in Southern Brazil. Data collected online from September 2020 to October 2021 with the Instrument of Variables Related to Standard Precautions and sociodemographic and pandemic-related variables. Descriptive and inferential statistical analysis (Mann-Whitney and Kruskal-Wallis test) and content analysis were performed. RESULTS: High level of adherence to standard precautions, with a significant association with having children (p = 0.014); COVID area (p < 0.001), biosafety training (p = 0.018), and social distancing (p < 0.001). The testimonies demonstrated a high risk perception and search for the use of protective equipment and biosafety knowledge. CONCLUSION: High adherence to standard precautions, associated with having children, working in COVID-19 care units, receiving biosafety guidance/training at the institution and practicing social distancing.
Assuntos
COVID-19 , Fidelidade a Diretrizes , Pessoal de Saúde , Hospitais Universitários , Humanos , COVID-19/prevenção & controle , Brasil , Fidelidade a Diretrizes/estatística & dados numéricos , Feminino , Masculino , Adulto , Pessoa de Meia-Idade , Equipamento de Proteção Individual , Controle de Infecções/métodos , Controle de Infecções/normas , Conhecimentos, Atitudes e Prática em Saúde , Distanciamento FísicoRESUMO
OBJECTIVE: To assess the level of compliance with COVID-19 preventive measures and compliance-associated factors in the Rwanda community. DESIGN: Cross-sectional study. SETTINGS: Country-wide community survey in Rwanda. PARTICIPANTS: 4763 participants were randomly sampled following the sampling frame used for the recent Rwanda Demographic Health Survey. Participants were aged between 22 years and 94 years. OUTCOMES: The participants' compliance with three preventive measures (wearing a face mask, washing hands and social distancing) was the main outcome. METHODS: From 14 February 2022 to 27 February 2022, a cross-sectional survey using telephone calls was conducted. Study questionnaires included different questions such as participants' demographics and compliance with COVID-19 preventives measures. Verbal consent was obtained from each participant. The compliance on three main preventive measures (wearing a mask, washing hands and social distancing) were the main outcomes. Univariate and multivariable logistic regression analyses were performed to evaluate factors associated with compliance (age, gender, level of education, socioeconomic status). RESULTS: Compliance with the three primary preventive measures (washing hands 98%, wearing a mask 97% and observing social distance 98%) was at a rate of 95%. The respondents' mean age was 46±11 SD (range 22-98) years. In addition, 69% were female and 86% had attended primary education. Bivariate and regression analyses indicated a significant association among the three primary preventive measures (p<0.05). The results showed factors associated significantly between the different models (p<0.05): proper mask use and social distancing in the hand washing model; hand washing, social distancing, avoiding handshakes and not attending gatherings in the proper mask use model; hand washing and avoiding handshakes in the social distancing model. CONCLUSION: Compliance with the three key preventive measures against COVID-19 was high in the Rwandan community and these measures were interdependent. Therefore, the importance of all three measures should be emphasised for effective disease control.
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COVID-19 , Desinfecção das Mãos , Máscaras , Distanciamento Físico , SARS-CoV-2 , Humanos , COVID-19/prevenção & controle , COVID-19/epidemiologia , Ruanda/epidemiologia , Feminino , Adulto , Masculino , Estudos Transversais , Pessoa de Meia-Idade , Máscaras/estatística & dados numéricos , Idoso , Adulto Jovem , Idoso de 80 Anos ou mais , Inquéritos e Questionários , Cooperação do Paciente/estatística & dados numéricosRESUMO
Importance: Neonatal mortality is a major public health concern that was potentially impacted by the COVID-19 pandemic. To prepare for future health crises, it is important to investigate whether COVID-19 pandemic-related interventions were associated with changes in neonatal mortality. Objective: To investigate whether social distancing during the pandemic was associated with a higher neonatal mortality rate. Design, Setting, and Participants: This cohort study examined maternal-linked birth and infant death records from the National Center for Health Statistics, a population-level US database, from 2016 through 2020. The mortality rates were correlated using machine learning-based autoregressive integrated moving average (ARIMA) models with the social distancing index (SDI). The reference period was January 2016 through February 2020, and the pandemic period was March through December 2020. Statistical analysis was performed from March 2023 to May 2024. Exposures: SDI, computed from 6 mobility metrics. Main Outcomes and Measures: The primary outcome was neonatal mortality rate, defined as death at age less than 28 days. Results: The study included 18â¯011â¯173 births, of which 15â¯136â¯596 were from the reference period (7â¯753â¯555 [51.22%] male; 11â¯643â¯094 [76.92%] with maternal age of 20 to 34 years) and 2â¯874â¯577 were from the pandemic period (1â¯472â¯539 [51.23%] male; 2â¯190â¯158 [76.19%] with maternal age of 20 to 34 years). Through ARIMA-adjusted analyses, accounting for the declining mortality trend in the reference period, the mortality rates during the pandemic period did not significantly differ from the expected rates. SDI did not exhibit significant correlations with neonatal mortality (unadjusted: correlation coefficient [CC], 0.14 [95% CI, -0.53 to 0.70]; ARIMA adjusted: CC, 0.29 [95% CI, -0.41 to 0.77]), early neonatal mortality (unadjusted: CC, 0.33 [95% CI, -0.37 to 0.79]; ARIMA adjusted: CC, 0.45 [95% CI, -0.24 to 0.84]), and infant mortality (unadjusted: CC, -0.09 [95% CI, -0.68 to 0.57]; ARIMA adjusted: CC, 0.35 [95% CI, -0.35 to 0.80]). However, lag analyses found that SDI was associated with higher neonatal and early neonatal mortality rates with a 2-month lag period, but not with infant mortality rate. SDI was also associated with increases in 22-to-27 weeks' and 28-to-32 weeks' preterm delivery with a 1-month lag period. Conclusions and Relevance: In this population-level study of National Center for Health Statistics databases, neonatal, early neonatal, and infant mortality rates did not increase during the initial COVID-19 pandemic period. However, associations were observed between the pandemic period social distancing measures and higher rates of neonatal and early neonatal mortality, as well as preterm birth rate with a lag period, suggesting the importance of monitoring infant health outcomes following pandemic-related population behavior changes.
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COVID-19 , Mortalidade Infantil , Distanciamento Físico , SARS-CoV-2 , Humanos , COVID-19/mortalidade , COVID-19/epidemiologia , Mortalidade Infantil/tendências , Recém-Nascido , Estados Unidos/epidemiologia , Feminino , Lactente , Pandemias , Adulto , Masculino , Estudos de Coortes , GravidezRESUMO
BACKGROUND: During the COVID-19 pandemic, social distancing and reduced social contact may have affected older adults' health. OBJECTIVES: To evaluate the perceived impact of social distancing on older adults' health and explore the association between social contact and health outcomes. DESIGN: Cross-sectional and longitudinal analyses of the OPAL cohort study. SUBJECTS: Community dwelling older adults. METHODS: We sent questionnaires to participants of an existing cohort study (n = 4328). Questions included the amount and type of social contact, and how often they went outside. Participants rated the impact of social distancing on their health. Sociodemographic factors and quality of life were available from previous questionnaires. We examined quality of life prior to and during the pandemic and explored the cross-sectional relationship between social contact and health using logistic regression. RESULTS: There were 3856/4328 (89%) questionnaires returned. EQ-5D scores changed little compared to pre-pandemic scores but 25% of participants reported their overall health had worsened. The telephone was the most used method of contact (78%). Video calls were used least with 35% of participants not using them or having no access to them. 13% of respondents never went outside. Lower levels of contact were associated with increased risk of reporting worse health (Odds ratio (OR) 1.04 (95% CI 1.01-1.08)). Those experiencing financial strain and who spent less time outside experienced the largest increase in risk of reporting perceived worsened overall health. Those reporting a strain to get by financially were 4 times more likely to report worsened health than those who described themselves as quite comfortably off (OR 4.00 (95% CI 1.86-8.16)). Participants who reported never going outside were twice as likely to report worsened health compared to those who went outside daily (OR 2.00 (95% CI 1.57-2.54)). CONCLUSIONS: Less contact with other people was associated with perceived worsening in overall health. Although many older people reported using online technology, such as video calls, a substantial proportion were not using them. Older people facing financial strain were more likely to report worsened health, highlighting the impact of social inequalities during the pandemic. Going outside less was also associated with perceived worsened health.
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COVID-19 , Vida Independente , Distanciamento Físico , Qualidade de Vida , Humanos , COVID-19/prevenção & controle , COVID-19/epidemiologia , Feminino , Masculino , Idoso , Estudos Transversais , Inquéritos e Questionários , Idoso de 80 Anos ou mais , Estudos Longitudinais , Estudos de Coortes , Pandemias , Nível de SaúdeRESUMO
Research suggests that discounting of delayed rewards (i.e., tendency to choose smaller immediate rewards over large later rewards) is a promising target of intervention to encourage compliance with public health measures (PHM), such as vaccination compliance. The effects of delay discounting, however, may differ across the types of PHMs, given that the benefits of vaccination, unlike other PHMs (physical distancing, handwashing, and mask-wearing), are more temporally delayed. Here, we examined whether delay discounting predicts engaging in COVID-19 PHMs in approximately 7,000 participants recruited from 13 countries in June-August 2021. After controlling for demographic and distress variables, delay discounting was a negative predictor of vaccination, but a positive predictor of physical distancing (when restrictions are in place) and handwashing. There was no significant association between delay discounting and frequency of mask-wearing. It is possible that increasing vaccination compliance may require greater emphasis on future benefits of vaccination, whereas promotion of physical distancing and hand hygiene may require greater focus on the present moment. Further research is needed to investigate the nature of this relationship and its implications for public health messaging.