Ecologic association between influenza and COVID-19 mortality rates in European countries

Ecologic studies investigating COVID-19 mortality determinants, used to make predictions and design public health control measures, generally focused on population-based variable counterparts of individual-based risk factors. Influenza is not causally associated with COVID-19, but shares population-based determinants, such as similar incidence/mortality trends, transmission patterns, efficacy of non-pharmaceutical interventions, comorbidities and underdiagnosis. We investigated the ecologic association between influenza mortality rates and COVID-19 mortality rates in the European context. We considered the 3-year average influenza (2014-2016) and COVID-19 (31 May 2020) crude mortality rates in 34 countries using EUROSTAT and ECDC databases and performed correlation and regression analyses. The two variables - log transformed, showed significant Spearman's correlation ρ = 0.439 (P = 0.01), and regression coefficients, b = 0.743 (95% confidence interval, 0.272-1.214; R2 = 0.244; P = 0.003), b = 0.472 (95% confidence interval, 0.067-0.878; R2 = 0.549; P = 0.02), unadjusted and adjusted for confounders (population size and cardiovascular disease mortality), respectively. Common significant determinants of both COVID-19 and influenza mortality rates were life expectancy, influenza vaccination in the elderly (direct associations), number of hospital beds per population unit and crude cardiovascular disease mortality rate (inverse associations). This analysis suggests that influenza mortality rates were independently associated with COVID-19 mortality rates in Europe, with implications for public health preparedness, and implies preliminary undetected SARS-CoV-2 spread in Europe

COVID‑19 vaccine distribution: exploring strategic alternatives for the greater good

The dire state of the COVID-19 pandemic crisis symbolized the urgency for efficient distribution and administration of vaccines to combat the virus as the most urgent public health service. This paper presents a prototype multi-criteria decision support model based on goal programming that can effectively support vaccination plans for the greater good of society. The optimization goals of the model include minimizing the number of fatalities and risk of spreading the disease, while complying with government health agency’s priority guidelines for vaccination. This study applied the model to a real-world dataset to demonstrate how it can be effectively applied as a decision support tool for vaccine distribution plans and manage future pandemics

Mortality impacts of the coronavirus disease (COVID-19) outbreak by sex and age: rapid mortality surveillance system, Italy, 1 February to 18 April 2020.

Data from the rapid mortality surveillance system in 19 major Italian cities were used to carry out a timely assessment of the health impact of the COVID-19 epidemic. By 18 April, a + 45% excess in mortality was observed, with a higher impact in the north of the country (+ 76%). The excess was greatest among men, with an increasing trend by age. Surveillance data can be used to evaluate the lockdown and re-opening phases

RISK-TAKING BEHAVIOR IN RECOVERED COVID-19 PATIENTS

Background: The aim of this study is to investigate risk-taking behavior and decision-making processes in recovered COVID- 19 patients. Subjects and methods: Twenty patients recovered from COVID-19 as confirmed by polymerase chain reaction (PCR) tests and twenty-one healthy individuals were recruited. A computerized version of the Iowa Gambling Test (IGT) for measuring risk taking behavior tendencies as a decision-making process and State-Trait Anxiety Inventory (STAI), Beck Depression Inventory (BDI), and WMS-R Digit Span Forward Test (DSFT) for clinical assessments included. The assessments of the recovered patients were applied on the initial phase that the tests of the patients were negative and on the 4-week follow up phase. Results: The results showed that the anxiety scores were significantly higher in the healthy control group than in the group of recovered patients. The IGT-Net 4 scores were significantly and IGT-Net total scores were marginally significantly lower in the group of recovered patients. In other words, recovered patients showed higher risk-taking behavior tendencies. This tendency difference is consistent with the anxiety levels of the groups. These IGT scores showed to be persistent in the 4-week follow up phase. Conclusions: Our findings indicate that recovered patients show higher risk-taking behavior tendencies than healthy controls and this may be the result of overcoming the COVID-19 threat

Inverse correlates of COVID-19 mortality across European countries during the first versus subsequent waves

The objectives of the study were to calculate the standardised mortality rates (SMRs) for COVID-19 in European Union/European Economic Area countries plus the UK and Switzerland and to evaluate the correlation between SMRs and selected indicators in the first versus the subsequent waves until 23 June 2021. We used indirect standardisation (using Italy as the reference) to compute SMRs and considered 16 indicators of health and social well-being, health system capacity and COVID-19 response. The highest SMRs were in Belgium, the UK and Spain in the first wave (1.20-1.84) and in Hungary, Czechia and Slovakia in the subsequent waves (2.50-2.69). Human Development Index (HDI), life expectancy, urbanisation and healthcare expenditure had positive correlations with SMR in the first wave (rho=0.30-0.46), but negative correlations (rho=-0.67 to -0.47) in the subsequent waves. Retail/recreation mobility and transit mobility were negatively correlated with SMR in the first wave, while transit mobility was inversely correlated with SMR in the subsequent waves. The first wave hit most hard countries with high HDI, high life expectancy, high urbanisation, high health expenditures and high tourism. This pattern may reflect higher early community seeding and circulation of the virus. Conversely, in the subsequent waves, this pattern was completely inversed: countries with more resources and better health status did better than eastern European countries. While major SMR differences existed across countries in the first wave, these differences largely dissipated by 23 June 2021, with few exceptions

A INFLUÊNCIA DA PANDEMIA COVID-19 NOS CUIDADOS À SAÚDE DE PARTICIPANTES EM UM PROGRAMA DE PREVENÇÃO E REABILITAÇÃO CARDIORRESPIRATÓRIA

The aim of the study was to evaluate by means of an online questionnaire the influence of the COVID-19 pandemic on exercise practice in the control of hypertension and type 2 diabetes. This is a cross-sectional study, which used a sample of patients with cardiovascular risk factors from a cardiorespiratory prevention and rehabilitation program. The questionnaire contains 29 questions about sociodemographic data and general health aspects. Regarding hypertension and diabetes, most participants reported the correct use of medications (76.0%). Regarding physical exercise, few remained active (56.0%). As for body mass, they reported an increase during the pandemic (52.0%). The COVID-19 pandemic negatively influenced the continuity of physical exercise, hypertension and diabetes control, and general health-related aspects of patients with cardiovascular risk factors in a cardiovascular prevention and rehabilitation program.El objetivo del estudio fue evaluar mediante un cuestionario online la influencia de la pandemia COVID-19 en la práctica de ejercicio físico en el control de la hipertensión y la diabetes tipo 2. Se trata de un estudio transversal, que utilizó una muestra de pacientes con factores de riesgo cardiovascular de un programa de prevención y rehabilitación cardiorrespiratoria. El cuestionario contiene 29 preguntas sobre datos sociodemográficos y aspectos generales de salud. En cuanto a la hipertensión y la diabetes, la mayoría de los participantes informaron del uso correcto de los medicamentos (76,0%). En cuanto a la práctica de ejercicio físico, pocos se mantuvieron activos (56,0%). En cuanto a la masa corporal, informaron de un aumento durante la pandemia (52,0%). La pandemia de COVID-19 influyó negativamente en la continuidad del ejercicio físico, el control de la hipertensión y la diabetes, y los aspectos generales relacionados con la salud de los pacientes con factores de riesgo cardiovascular en un programa de prevención y rehabilitación cardiovascular.O objetivo do estudo foi avaliar, por meio de um questionário online, a influência da pandemia de COVID-19 na prática de exercício físico no controle da hipertensão e do diabetes tipo 2. Este é um estudo transversal, conduzido com pacientes com fatores de risco cardiovascular, participantes de programa de prevenção e reabilitação cardiorrespiratória. O questionário continha 29 perguntas sobre dados sociodemográficos e aspectos gerais de saúde. Em relação à hipertensão e a diabetes, a maioria dos participantes relatou a utilização correta dos medicamentos (76.0%). Quanto à prática de exercício físico, poucos permaneceram ativos (56.0%) durante a pandemia. Quanto à massa corporal, relatou-se aumento durante a pandemia (52.0%). Conclui-se que a pandemia de COVID-19 influenciou negativamente a continuidade da prática de exercícios físicos, o controle da hipertensão e diabetes e os aspectos gerais relacionados à saúde dos participantes de um programa de prevenção e reabilitação cardiovascular

Addressing Food Insecurity During COVID-19: A Role for Rural Federally Qualified Health Centers

In rural communities, existing food insecurity, chronic diseases, and an aging population create a complex environment that has the potential to strain health systems despite lower overall COVID-19 case counts. Past pandemics have revealed that populations served by the primary care safety net require resources beyond federal and state aid programs. At our federally qualified health center (FQHC), we have adapted our food prescription program for patients with chronic diseases to a home delivery service, which leverages existing relationships between care coordinators and patients. Such efforts may fill underlying gaps in food supply and distribution through cross-sector collaboration with farms and non-governmental agencies. The current pandemic highlights an opportunity for FQHCs to proactively engage with communities and build upon existing outreach efforts to address issues of nutrition and food access. Prompt and targeted interventions can establish partnerships within community food systems and advance long-term program implementation.https://deepblue.lib.umich.edu/bitstream/2027.42/155450/1/Suresh_Barkatullah_Boardman_PrePrint_Final.pd

COVID-19 in people aged 18-64 in Sweden in the first year of the pandemic: Key factors for severe disease and death

Background: Studies on risk factors for severe COVID-19 in people of working age have generally not included non-working persons or established population attributable fractions (PAFs) for occupational and other factors. Objectives: We describe the effect of job-related, sociodemographic, and other exposures on the incidence, relative risks and PAFs of severe COVID-19 in individuals aged 18–64. Methods: We conducted a registry-based study in Swedish citizens aged 18–64 from 1 January 2020 to 1 February 2021 with respect to COVID-19-related hospitalizations and death. Results: Of 6,205,459 persons, 272,043 (7.5%) were registered as infected, 3399 (0.05%) needed intensive care, and 620 (0.01%) died, with an estimated case fatality rate of 0.06% over the last 4-month period when testing was adequate. Non-Nordic origin was associated with a RR for need of intensive care of 3·13, 95%CI 2·91–3·36, and a PAF of 32·2% after adjustment for age, sex, work, region and comorbidities. In a second model with occupation as main exposure, and adjusted for age, sex, region, comorbidities and origin, essential workers had an RR of 1·51, 95%CI, 1·35–1·6, blue-collar workers 1·18, 95%CI 1·06–1·31, school staff 1·21, 95%CI 1·01–1·46, and health and social care workers 1·89, 95%CI 1·67–2·135) compared with people able to work from home, with altogether about 13% of the PAF associated with these occupations. Essential workers and blue-collar workers, but no other job categories had higher risk of death, adjusted RRs of 1·79, 95%CI 1·34–2·38 and 1·37, 95%CI 1·04–1·81, with adjusted PAFs of altogether 9%. Conclusion: Among people of working age in Sweden, overall mortality and case fatality were low. Occupations that require physical presence at work were associated with elevated risk of needing intensive care for COVID-19, with 14% cases attributable to this factor, and 9% of deaths