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Assessing Mandatory Stay‐at‐Home and Business Closure Effects on the Spread of COVID‐19
Abstract
Background and Aims
The most restrictive non‐pharmaceutical interventions (NPIs) for controlling the spread of COVID‐19 are mandatory stay‐at‐home and business closures. Given the consequences of these policies, it is important to assess their effects. We evaluate the effects on epidemic case growth of more restrictive NPIs (mrNPIs), above and beyond those of less restrictive NPIs (lrNPIs).
Methods
We first estimate COVID‐19 case growth in relation to any NPI implementation in subnational regions of 10 countries: England, France, Germany, Iran, Italy, Netherlands, Spain, South Korea, Sweden, and the US. Using first‐difference models with fixed effects, we isolate the effects of mrNPIs by subtracting the combined effects of lrNPIs and epidemic dynamics from all NPIs. We use case growth in Sweden and South Korea, two countries that did not implement mandatory stay‐at‐home and business closures, as comparison countries for the other 8 countries (16 total comparisons).
Results
Implementing any NPIs was associated with significant reductions in case growth in 9 out of 10 study countries, including South Korea and Sweden that implemented only lrNPIs (Spain had a non‐significant effect). After subtracting the epidemic and lrNPI effects, we find no clear, significant beneficial effect of mrNPIs on case growth in any country. In France, e.g., the effect of mrNPIs was +7% (95CI ‐5%‐19%) when compared with Sweden, and +13% (‐12%‐38%) when compared with South Korea (positive means pro‐contagion). The 95% confidence intervals excluded 30% declines in all 16 comparisons and 15% declines in 11/16 comparisons.
Conclusions
While small benefits cannot be excluded, we do not find significant benefits on case growth of more restrictive NPIs. Similar reductions in case growth may be achievable with less restrictive interventions.
... Auf gesellschaftlicher Ebene ist es bedauerlich, zu beobachten, dass die gesamte Dynamik einen autonomen Verlauf genommen hat, der zur Aussetzung der visafreien Schengen-Zone führte und die Nationalitätenmentalität der Mitgliedsstaaten durch Grenzschließungen förderte, die in totalen Abriegelungen gipfelten. Dennoch waren diese extremen Maßnahmen nicht in der Lage, COVID-19-bedingte kritische Verläufe oder gar Todesfälle zu verhindern (Walach und Hockertz 2020;Chaudhry et al. 2020;Bendavid et al. 2021;Herby et al. 2022). Auf globaler Ebene lässt sich anhand der COVID-19-Krise ablesen, wie die Menschheit auf derlei Herausforderungen reagieren -ganz im Sinne der ursprünglichen Sorgen, die Garett Hardin in seinem Science-Artikel formulierte "the tragedy of the commons" (Hardin 1968). ...
Seit dem Ausbruch der Coronavirus-Krankheit 2019 (COVID-19), die mit dem neuartigen SARS- CoV-2 assoziiert ist, sind die Infektionszahlen regelrecht explodiert. Wir zeigen, dass die Spezifität der Geschwindigkeit des Anstiegs der COVID-19-Fälle über Norditalien, einer der am stärksten betroffenen Regionen, stark mit der vorherrschenden bodennahen Luftverschmutzung korreliert, insbesondere während der Jahreszeit. Auffällig sind Grenzwert-überschreitende Konzentrationen von PM10/PM2.5, und NO2. Defizite als auch ein auf Schadensbegrenzung und nicht auf Prävention ausgerichtetes Gesundheitssystem, eine überalternde Bevölkerung, sowie durch eine erhöhte virale Anfälligkeit die aufkeimende Gesundheitskrise verschärften. In weiterer Folge heben wir hervor, dass SARS-CoV-2 nur einen kleinen Beitrag in einem bereits überlasteten System leistete, welche speziell die Bewohner der Po-Ebene in einen völlig neuen, unvorbereiteten Gleichgewichtszustandes katapultierte. Die in der Not verordneten erratischen Gegenmassnahmen, als auch die übereilten Anstrengungen in der Entwicklung von COVID-Impfstoffen deuten eher auf eine «Krise der Wahrnehmung» hin als auf eine durchdachte Strategie, welche ein breites Spektrum möglicher Optionen hätte umfassen können. Dieser Beitrag befasst sich folglich kritisch mit der Problematik aus verschieden Blickwindeln: verabsäumte Implementierung der Luftreinhaltung; Ausbreitungsdynamik von Bioaerosolen einschliesslich der damit verbundenen atmosphärischen Faktoren sowie die langfristig induzierten Sekundär-Effekte als Folge des medial geschürten Alarmismus und der gesetzten Massnahmen seitens der Regierung.
... This is a reasonable assumption in this study's context, as there is no reason to believe that labor market variables would have behaved differently without COVID-19. Several papers have used this strategy to estimate the effect on case counts and mortality rates (Bendavid et al. 2021). Nevertheless, we discuss a number of potential threats to our design and measures adopted to mitigate those. ...
We provide new evidence on the economic and health impacts of government- mandated non-pharmaceutical interventions (NPIs) during the COVID-19 pandemic. Apart from labor force participation, unemployment, and hours worked, we provide novel results on work absence due to illness. We also examine the heterogeneity of these results by demographic and employment groups. We use recent innovations in the difference-in-differences methodology to capture the dynamic effects of these orders that were staggered in nature. Our findings show that states’ social distancing measures increased unemployment and lowered labor market participation and hours worked. The adverse labor market effects were more pronounced for single parents and those working non-teleworkable jobs. We find some evidence that workers’ health improved as absence from work due to illness significantly decreased, suggesting that NPIs protected many vulnerable workers.
... Orders for mandatory stay at home left many business without the needed staff members (Bendavid et al., 2021). The effect of this is that many businesses shut down their operations . ...
The emergence of the COVID-19 pandemic in late 2019 led to a global crisis of unprecedented scale and complexity that disrupted almost every aspect of human life. The pandemic has taken people, institutions and governments by surprise, so the impact of the virus has been profound and far-reaching. The rapid and relentless spread of the pandemic has challenged global health systems, strained economies, altered daily routines in educational settings and at work, and tested the resilience of communities worldwide. Different studies have identified vulnerabilities in the world’s ability to respond to health emergencies at the individual and societal levels. This study presents a systematic literature review and theoretical analysis of the disruptions caused by COVID-19 to help formulate strategies that encourage flexibility and resilience in the face of such complex and interconnected disruptions. The article analyzes the consequences of the COVID-19 pandemic through the prism of two main theories: the theory of situational crisis communications (type of crisis, its history, responsibility, perceived seriousness, predictable probability, crisis communications strategies, post-crisis reputation), as well as the theory of social learning (learning through observation, modeling and imitation, positive and negative reinforcement in the formation of behavior). In addition, the nature of society’s adaptation to the challenges of the COVID-19 pandemic is also considered through the prism of the theory of subversive innovations (progress in communication technologies, new methods of remote work and education, the entry of social networks into the business world, the introduction of asynchronous communication). The article summarizes the scientific progress on the following main consequences of the COVID-19 pandemic in the workplace, healthcare system, and education. The study provides recommendations on the steps that individuals, institutions and governments can take to increase readiness and ability to adapt to the next crisis (interdisciplinary cooperation, analysis of communication strategies, system analysis). The analysis conducted in the article also made it possible to outline the most promising directions for further qualitative intervention studies (in-depth case studies taking into account the specific context of regions, organizations or communities to identify effective and ineffective policies and practices; qualitative interviews with key stakeholders to understand the intricacies of decision-making in the context of the pandemic crisis); qualitative action studies (building community resilience, collaborative research efforts involving policymakers, health experts and community representatives to develop crisis response policies jointly) and quantitative studies (analysis of pandemic spread, impact of vaccination on disease control, analysis of the economic effects of the pandemic, etc.).
... Second, the reasonableness of behavior during the corona pandemic is far less clear-cut than is often assumed. For one thing, the effectiveness of measures such as mask-wearing, online purchases of food and dietary supplements, distancing and shut-downs, and even vaccination is less well established than, say, protective behavior in the face of the AIDS pandemic or lifestyle choices to avoid cardiovascular disease (e.g., Bendavid et al., 2021;Kosfeld et al., 2021;Li et al., 2022;Magli et al., 2022;Najib et al., 2022;Xiao et al., 2020). For another, all measures also have negative side effects. ...
The World Happiness Report (WHR) 2021 revealed that public trust in government institutions was helpful in reducing COVID-19 death rates. Societies with higher levels of institutional trust are more likely to follow official orders, leading to greater success of virus suppression strategies implemented by the government. This study adapted an original linear regression model from WHR 2021 to examine the relationship between cognitive ability (CA) and COVID-19 mortality at the crosscountry level. Regression analyses revealed that high-CA societies had significantly higher COVID-19 death rates (β = +.48 and +.64, r = +.43). Further regression analyses between CA and institutional variables demonstrated that CA is negatively associated with confidence in the national government (β =-.35 and-.56, r =-.10). CA also correlates negatively with institutional trust (β =-.20 and-.43, r = +.13), although its association with interpersonal trust is positive (r = +.68). To corroborate the negative patterns, correlations between CA and both public and expert perceptions of corruption were examined. Results showed that the negative correlation of CA with expert perception (r =-.70, more intelligent-less corrupt) was twice as strong as with public perception of corruption (r =-.35). Assuming that expert perception is a more reliable measure of corruption prevalence compared to public perception, the results imply that in societies with high CA, the public is under-convinced that their governments are not corrupt. Smarter societies appear to have missed opportunities to further reduce COVID-19 related deaths due to their relatively low level of trust in government and institutions.
This chapter lays out the foundations of modern science in Descartes, namely how the strive for objectivity requires disciplined scepticism as the method of science and at the same time implies that modern natural science can in principle not capture human thought and action. We explain how the success of modern science in improving human living conditions through technological engineering nevertheless leads to a hubris in the guise of scientism that takes science to be unlimited in its scope. In its political application, it conceives an art of social engineering that is supposed to morally improve human society. We show, however, how scientism destroys science. We retrace the history of science and scientism from Socrates and Plato to its current expression in the corona, the climate and the wokeness regimes, ushering in an epoch of actually existing postmodernism.
COVID-19 vaccines have been illustrated to lessen the growth of sickness caused by the virus effectively. In any case, inoculation has consistently been controversial, with differing opinions and viewpoints. This has compelled some individuals to decide against receiving the vaccine. These divergent viewpoints have had a trivial impact on the epidemic’s dynamics and the disease’s development. In response to vaccinated individuals still falling ill, many countries have implemented booster vaccines to protect further.
In this specific investigation, a mathematical model composed of seven compartments is employed to examine the effectiveness of a booster dose in preventing and treating the transmission of COVID-19. The principles of mathematics are employed to analyse and investigate the dynamics of the disease. Using a qualitative prototype analysis, we acquired valuable insights into its effectiveness. One essential aspect is the basic reproduction number, a critical determinant of the disease’s spread. This calculation is determined by studying the system’s equilibrium and evaluating its stability.
Furthermore, we examined the balance from a local and global viewpoint, considering the possibility of bifurcation and the model’s reproductive number sensitivity index. Through numerical simulations, we have visually illustrated the analytical findings outlined in this research paper and presented a thorough examination of the efficacy of booster shots as a preventive and therapeutic measure in the spread dynamics of COVID-19.
Purpose
This study aims to synthesize the existing literature with insights gained from interviews conducted with regulatory experts. The objective is to analyse the challenges associated with incorporating cryptocurrencies into regulatory frameworks and to explore constraints in the regulatory institutionalization of cryptocurrencies.
Design/methodology/approach
The study methodology consists of two steps. The first step is to identify regulatory constraints in the literature review and in the next step, interviews are conducted with officials of the State Bank of Pakistan (SBP). The study used a qualitative case study methodology, in which a single case (regulatory constraint) was selected as a unit of analysis.
Findings
The findings show that lack of traceability, legal status, lack of governmental control due to decentralization, difficulty enforcing laws, volatility, lack of skills with regulators and difficulty integrating cryptocurrencies into the current financial system are the main obstacles to the introduction of a regulatory framework. Thus, on a broader conceptual level, the findings can be grouped into opportunism, lack of strategic capability and fragmented global laws.
Research limitations/implications
This study could inform global cryptocurrency regulation discussions, sharing a developing country’s views on balancing the government, central banks, the financial sector and public interests. This could guide countries to consider cryptocurrency adoption in similar situations. This could affect the cryptocurrency market, impacting demand, supply and investor trust in Pakistan.
Practical implications
The study has implications for policy making officials. The research aims to offer valuable insights to the SBP and other regulatory authorities, helping them identify potential risks and create an effective regulatory framework for cryptocurrencies.
Social implications
The study has implications for society in knowing about the volatile nature of cryptos and anonymity of their issuers, which poses regulatory constraints. This then implies its harmfullness to its traders and the huge losses that may arise from their trading due to its volatile nature.
Originality/value
This study contributes to the literature on the constraints, responsibilities and consultation framework of cryptocurrency regulations.
Purpose
This paper examines the early pandemic experience in a large metropolitan area to differentiate the roles of the lifestyle and built environment factors associated with differing case rates across neighborhoods.
Design/methodology/approach
This paper develops a simple empirical methodology for sorting out the separate effects of lifestyle and the built environment factors along with their interactive effects when individuals’ behaviors not only reflect their observable characteristics but also are influenced by the physical environments in which they live and work, indirect connections implied by the early insights of Jacobs (1961) and more recently Hawley and Turnbull (2019).
Findings
The results demonstrate that lifestyle factors tied to employment show the strongest association with COVID-19 cases. Other lifestyle choices, built environment features, and demographic attributes such as household size, principal cities, highway connectivity, and population density also affect COVID-19 transmission at the onset of the disease outbreak. The analysis reveals a surprising spatial pattern; employment-related lifestyle factors on case rates in outlying neighborhoods are stronger than in neighborhoods within primary cities after accounting for various built environment factors.
Originality/value
This research addresses important questions and the perplexing outcomes related to lifestyle and the built environment’s multi-faceted role in spreading COVID-19. In addition, this study represents a pioneering effort in disentangling the pure lifestyle effect on virus transmission after eliminating potentially confounding impacts of built environment factors on household behavior that in turn influence virus transmission.
En France, une grave crise sanitaire s'est produite durant les années 2020-23. Pourtant, au cours du XXe siècle, une stratégie de veille et d'endiguement était parvenue à contrôler les principales infections, spécialement respiratoires. Mais au XXIe siècle, les autorités ont progressivement abandonné cette stratégie et se sont enfermées dans quelques dogmes qui ont conduit au désastre face au Covid. La médecine de ville a été désarmée, tout traitement a été interdit, hormis le paracétamol, la population a été soumise à des mesures brutales et contre-productives qui ont culminé avec l'administration massive de « vaccins » expérimentaux. Ces produits ont aggravé la maladie et leurs effets indésirables à moyen et long termes commencent à apparaître.
Article paru en mars 2024 dans l'ouvrage collectif Un autre regard sur le Covid-19 aux éditions Demi-Lune, p 53-87.
The ability to preferentially protect high-risk groups in COVID-19 is hotly debated. Here, the aim is to present simple metrics of such precision shielding of people at high risk of death after infection by SARS-CoV-2; demonstrate how they can estimated; and examine whether precision shielding was successfully achieved in the first COVID-19 wave. The shielding ratio, S, is defined as the ratio of prevalence of infection among people in a high-risk group versus among people in a low-risk group. The contrasted risk groups examined here are according to age (≥70 vs <70 years), and institutionalised (nursing home) setting. For age-related precision shielding, data were used from large seroprevalence studies with separate prevalence data for elderly versus non-elderly and with at least 1000 assessed people≥70 years old. For setting-related precision shielding, data were analysed from 10 countries where information was available on numbers of nursing home residents, proportion of nursing home residents among COVID-19 deaths and overall population infection fatality rate (IFR). Across 17 seroprevalence studies, the shielding ratio S for elderly versus non-elderly varied between 0.4 (substantial shielding) and 1.6 (substantial inverse protection, that is, low-risk people being protected more than high-risk people). Five studies in the USA all yielded S=0.4–0.8, consistent with some shielding being achieved, while two studies in China yielded S=1.5–1.6, consistent with inverse protection. Assuming 25% IFR among nursing home residents, S values for nursing home residents ranged from 0.07 to 3.1. The best shielding was seen in South Korea (S=0.07) and modest shielding was achieved in Israel, Slovenia, Germany and Denmark. No shielding was achieved in Hungary and Sweden. In Belgium (S=1.9), the UK (S=2.2) and Spain (S=3.1), nursing home residents were far more frequently infected than the rest of the population. In conclusion, the experience from the first wave of COVID-19 suggests that different locations and settings varied markedly in the extent to which they protected high-risk groups. Both effective precision shielding and detrimental inverse protection can happen in real-life circumstances. COVID-19 interventions should seek to achieve maximal precision shielding.
OBJECTIVE
To examine whether the age distribution of COVID-19 deaths and the share of deaths in nursing homes changed in the second versus the first pandemic wave.
ELIGIBLE DATA
We considered all countries that had at least 4000 COVID-19 deaths occurring as of November 25, 2020, at least 200 COVID-19 deaths occurring in the first wave period, and at least 200 COVID-19 deaths occurring in the second wave period; and which had sufficiently detailed information available on the age distribution of these deaths. We also considered countries with data available on COVID-19 deaths of nursing home residents for the two waves.
MAIN OUTCOME MEASURES
Change in the second wave versus the first wave in the proportion of COVID-19 deaths occurring in people <50 years old among all COVID-19 deaths and among COVID019 deaths in people <70 years old; and change in the proportion of COVID-19 deaths in nursing home residents among all COVID-19 deaths.
RESULTS
Data on age distribution in eligible locations were available for 11 countries. Individuals <50 years old tended to have a larger share in the total COVID-19 deaths in the second wave than in the first wave in western European countries and the USA, but the absolute difference did not exceed 0.5% in any country. The proportion of deaths in individuals <50 years old was higher in Turkey and Ukraine, but it decreased in the second wave. Separate data on nursing home COVID-19 deaths for first and second waves were available for 9 countries. With the exception of Australia, the share of COVID-19 deaths that were accounted by nursing home residents decreased in the second wave, and the decrease was significant and substantial (relative risk estimates: 0.28 to 0.78) in 7/9 countries.
CONCLUSIONS
In the examined countries, age distribution of COVID-19 deaths has been fairly similar in the second versus the first wave, but the contribution of COVID-19 deaths in nursing home residents to total fatalities has decreased in most countries in the second wave.
What is known on this topic
* COVID-19 risk of death has a very steep age gradient
* Many COVID-19 deaths occur in nursing home residents
* Many countries have seen a pattern of two separate waves of COVID-19, but it is unknown whether these two waves differ in the age distribution of COVID-19 deaths and in fatalities in nursing home residents
What this study adds
* Age distribution of COVID-19 deaths has been fairly similar in the second versus the first wave in most countries, with some exceptions.
* Deaths in people <50 years old remain a small minority of COVID-19 deaths.
* The contribution of deaths in nursing home residents to total fatalities remains high in absolute magnitude, but it has decreased in most countries in the second wave.
Time and intimacy drive transmission
A minority of people infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmit most infections. How does this happen? Sun et al. reconstructed transmission in Hunan, China, up to April 2020. Such detailed data can be used to separate out the relative contribution of transmission control measures aimed at isolating individuals relative to population-level distancing measures. The authors found that most of the secondary transmissions could be traced back to a minority of infected individuals, and well over half of transmission occurred in the presymptomatic phase. Furthermore, the duration of exposure to an infected person combined with closeness and number of household contacts constituted the greatest risks for transmission, particularly when lockdown conditions prevailed. These findings could help in the design of infection control policies that have the potential to minimize both virus transmission and economic strain.
Science , this issue p. eabe2424
Importance
United States primary school closures during the 2020 coronavirus disease 2019 (COVID-19) pandemic affected millions of children, with little understanding of the potential health outcomes associated with educational disruption.
Objective
To estimate the potential years of life lost (YLL) associated with the COVID-19 pandemic conditioned on primary schools being closed or remaining open.
Design, Setting, and Participants
This decision analytical model estimated the association between school closures and reduced educational attainment and the association between reduced educational attainment and life expectancy using publicly available data sources, including data for 2020 from the US Centers for Disease Control and Prevention, the US Social Security Administration, and the US Census Bureau. Direct COVID-19 mortality and potential increases in mortality that might have resulted if school opening led to increased transmission of COVID-19 were also estimated.
Main Outcomes and Measures
Years of life lost.
Results
A total of 24.2 million children aged 5 to 11 years attended public schools that were closed during the 2020 pandemic, losing a median of 54 (interquartile range, 48-62.5) days of instruction. Missed instruction was associated with a mean loss of 0.31 (95% credible interval [CI], 0.10-0.65) years of final educational attainment for boys and 0.21 (95% CI, 0.06-0.46) years for girls. Summed across the population, an estimated 5.53 million (95% CI, 1.88-10.80) YLL may be associated with school closures. The Centers for Disease Control and Prevention reported a total of 88 241 US deaths from COVID-19 through the end of May 2020, with an estimated 1.50 million (95% CI, 1.23-1.85 million) YLL as a result. Had schools remained open, 1.47 million (95% credible interval, 0.45-2.59) additional YLL could have been expected as a result, based on results of studies associating school closure with decreased pandemic spread. Comparing the full distributions of estimated YLL under both “schools open” and “schools closed” conditions, the analysis observed a 98.1% probability that school opening would have been associated with a lower total YLL than school closure.
Conclusions and Relevance
In this decision analytical model of years of life potentially lost under differing conditions of school closure, the analysis favored schools remaining open. Future decisions regarding school closures during the pandemic should consider the association between educational disruption and decreased expected lifespan and give greater weight to the potential outcomes of school closure on children’s health.
Background
The ability to preferentially protect high-groups in COVID-19 is hotly debated. Here, the aim is to present simple metrics of such precision shielding of people at high-risk of death after infection by SARS-CoV-2; demonstrate how they can estimated; and examine whether precision shielding was successfully achieved in the first COVID-19 wave.
Methods
The shielding ratio, S, is defined as the ratio of prevalence of infection among people at a high-risk group versus among people in a low-risk group. The contrasted risk groups examined here are according to age (>=70 versus <70 years), and institutionalized (nursing home) setting. For age-related precision shielding, data were used from large seroprevalence studies with separate prevalence data for elderly versus non-elderly and with at least 1000 assessed people >=70 years old. For setting-related precision shielding, data were analyzed from 10 countries where information was available on numbers of nursing home residents, proportion of nursing home residents among COVID-19 deaths, and overall population infection fatality rate.
Findings
Across 17 seroprevalence studies, the shielding ratio S for elderly versus non-elderly varied between 0.4 (substantial shielding) and 1.6 (substantial inverse protection, i.e. low-risk people being protected more than high-risk people). Five studies in USA all yielded S=0.4-0.8, consistent with some shielding being achieved, while two studies in China yielded S=1.5-1.6, consistent with inverse protection. Assuming 25% infection fatality rate among nursing home residents, S values for nursing home residents ranged from 0.07 to 3.1. The best shielding was seen in South Korea (S=0.07) and modest shielding was achieved in Israel, Slovenia, Germany, and Denmark. No shielding was achieved in Hungary and Sweden. In Belgium (S=1.9), UK (S=2.2) and Spain (S=3.1), nursing home residents were far more frequently infected that the rest of the population.
Interpretation
The experience from the first wave of COVID-19 suggests that different locations and settings varied markedly in the extent to which they protected high-risk groups. Both effective precision shielding and detrimental inverse protection can happen in real-life circumstances. COVID-19 interventions should seek to achieve maximal precision shielding.
Introduction
Since the emergence of SARS-CoV-2, governments have implemented a combination of public health responses based on non-pharmaceutical interventions (NPIs), with significant social and economic consequences. Quantifying the efficiency of different NPIs implemented by European countries to overcome the first epidemic wave could inform preparedness for forthcoming waves.
Methods
We used a dataset compiled by the European Centre for Disease Control (ECDC) on daily COVID-19 incidence, mortality and NPI implementation in 32 European countries. We adapted a capture-recapture method to limit non-reporting bias in incidence data, which we fitted to an age-structured mathematical model coupled with Monte Carlo Markov Chain to quantify the efficiency of 258 public health responses (PHR, a combination of several NPIs) in reducing SARS-Cov-2 transmission rates. From these PHR efficiencies, we used time series analyses to isolate the effect of 13 NPIs at different levels of implementation (fully implemented vs. partially relaxed).
Results
Public health responses implemented in Europe led to a median decrease in viral transmission of 71%, enough to suppress the epidemic. PHR efficiency was positively associated with the number of NPIs implemented simultaneously. The largest effect among NPIs was observed for stay at home orders targeted at risk groups (β=0.24, 95%CI 0.16-0.32) and teleworking (β=0.23, 95%CI 0.15-0.31), followed by enforced stay at home orders for the general population, closure of non-essential businesses and services, bans on gatherings of 50 individuals or more, and closure of universities. Partial relaxation of most NPIs resulted in lower than average or non-significant changes in response efficiency.
Conclusion
This large-scale estimation of NPI and PHR efficiency against SARS-COV-2 transmission in Europe suggests that a combination of NPIs targeting different population groups should be favored to control future epidemic waves.
OBJECTIVE
To examine whether the age distribution of COVID-19 deaths and the share of deaths in nursing homes changed in the second versus the first pandemic wave.
ELIGIBLE DATA
We considered all countries that had at least 4000 COVID-19 deaths occurring as of January 14, 2020, at least 200 COVID-19 deaths occurring in each of the two epidemic wave periods; and which had sufficiently detailed information available on the age distribution of these deaths. We also considered countries with data available on COVID-19 deaths of nursing home residents for the two waves.
MAIN OUTCOME MEASURES
Change in the second wave versus the first wave in the proportion of COVID-19 deaths occurring in people <50 years (“young deaths”) among all COVID-19 deaths and among COVID-19 deaths in people <70 years old; and change in the proportion of COVID-19 deaths in nursing home residents among all COVID-19 deaths.
RESULTS
Data on age distribution were available for 14 eligible countries. Individuals <50 years old had small absolute difference in their share of the total COVID-19 deaths in the two waves across 13 high-income countries (absolute differences 0.0-0.4%). Their proportion was higher in Ukraine, but it decreased markedly in the second wave. The odds of young deaths was lower in the second versus the first wave (summary prevalence ratio 0.81, 95% CI 0.71-0.92) with large between-country heterogeneity. The odds of young deaths among deaths <70 years did not differ significantly across the two waves (summary prevalence ratio 0.96, 95% CI 0.86-1.06). Eligible data on nursing home COVID-19 deaths were available for 11 countries. The share of COVID-19 deaths that were accounted by nursing home residents decreased in the second wave significantly and substantially in 8 countries (prevalence ratio estimates: 0.36 to 0.78), remained the same in Denmark and Norway and markedly increased in Australia.
CONCLUSIONS
In the examined countries, age distribution of COVID-19 deaths has been fairly similar in the second versus the first wave, but the contribution of COVID-19 deaths in nursing home residents to total fatalities has decreased in most countries in the second wave.
This study assesses the association of social distancing due to coronavirus disease 2019 (COVID-19) with immunizations administered by age category (0-2 years, 3-9 years, and 10-17 years) in Colorado.
Understanding the outbreak dynamics of the COVID-19 pandemic has important implications for successful containment and mitigation strategies. Recent studies suggest that the population prevalence of SARS-CoV-2 antibodies, a proxy for the number of asymptomatic cases, could be an order of magnitude larger than expected from the number of reported symptomatic cases. Knowing the precise prevalence and contagiousness of asymptomatic transmission is critical to estimate the overall dimension and pandemic potential of COVID-19. However, at this stage, the effect of the asymptomatic population, its size, and its outbreak dynamics remain largely unknown. Here we use reported symptomatic case data in conjunction with antibody seroprevalence studies, a mathematical epidemiology model, and a Bayesian framework to infer the epidemiological characteristics of COVID-19. Our model computes, in real time, the time-varying contact rate of the outbreak, and projects the temporal evolution and credible intervals of the effective reproduction number and the symptomatic, asymptomatic, and recovered populations. Our study quantifies the sensitivity of the outbreak dynamics of COVID-19 to three parameters: the effective reproduction number, the ratio between the symptomatic and asymptomatic populations, and the infectious periods of both groups. For nine distinct locations, our model estimates the fraction of the population that has been infected and recovered by Jun 15, 2020 to 24.15% (95% CI: 20.48%-28.14%) for Heinsberg (NRW, Germany), 2.40% (95% CI: 2.09%-2.76%) for Ada County (ID, USA), 46.19% (95% CI: 45.81%-46.60%) for New York City (NY, USA), 11.26% (95% CI: 7.21%-16.03%) for Santa Clara County (CA, USA), 3.09% (95% CI: 2.27%-4.03%) for Denmark, 12.35% (95% CI: 10.03%-15.18%) for Geneva Canton (Switzerland), 5.24% (95% CI: 4.84%-5.70%) for the Netherlands, 1.53% (95% CI: 0.76%-2.62%) for Rio Grande do Sul (Brazil), and 5.32% (95% CI: 4.77%-5.93%) for Belgium. Our method traces the initial outbreak date in Santa Clara County back to January 20, 2020 (95% CI: December 29, 2019–February 13, 2020). Our results could significantly change our understanding and management of the COVID-19 pandemic: A large asymptomatic population will make isolation, containment, and tracing of individual cases challenging. Instead, managing community transmission through increasing population awareness, promoting physical distancing, and encouraging behavioral changes could become more relevant.