Face masks,public policies and slowing the spread of COVID-19: Evidence from Canada

We estimate the impact of indoor face mask mandates and other non-pharmaceutical interventions (NPI) on COVID-19 case growth in Canada. Mask mandate introduction was staggered from mid-June to mid-August 2020 in the 34 public health regions in Ontario, Canada’s largest province by population. Using this variation, we find that mask mandates are associated with a 22 percent weekly reduction in new COVID-19 cases, relative to the trend in absence of mandate. Province-level data provide corroborating evidence. We control for mobility behaviour using Google geo-location data and for lagged case totals and case growth as information variables. Our analysis of additional survey data shows that mask mandates led to an increase of about 27 percentage points in self-reported mask wearing in public. Counterfactual policy simulations suggest that adopting a nationwide mask mandate in June could have reduced the total number of diagnosed COVID-19 cases in Canada by over 50,000 over the period July–November 2020. Jointly, our results indicate that mandating mask wearing in indoor public places can be a powerful policy tool to slow the spread of COVID-19.     

Quantifying the Effect of Public Activity Intervention Policies on COVID-19 Pandemic Containment Using Epidemiologic Data From 145 Countries

ObjectivesMost countries have adopted public activity intervention policies to control the coronavirus disease 2019 (COVID-19) pandemic. Nevertheless, empirical evidence of the effectiveness of different interventions on the containment of the epidemic was inconsistent.MethodsWe retrieved time-series intervention policy data for 145 countries from the Oxford COVID-19 Government Response Tracker from December 31, 2019, to July 1, 2020, which included 8 containment and closure policies. We investigated the association of timeliness, stringency, and duration of intervention with cumulative infections per million population on July 1, 2020. We introduced a novel counterfactual estimator to estimate the effects of these interventions on COVID-19 time-varying reproduction number (R_t).ResultsThere is some evidence that earlier implementation, longer durations, and more strictness of intervention policies at the early but not middle stage were associated with reduced infections of COVID-19. The counterfactual model proved to have controlled for unobserved time-varying confounders and established a valid causal relationship between policy intervention and R_t reduction. The average intervention effect revealed that all interventions significantly decrease R_t after their implementation. R_t decreased by 30% (22%-41%) in 25 to 32 days after policy intervention. Among the 8 interventions, school closing, workplace closing, and public events cancellation demonstrated the strongest and most consistent evidence of associations.ConclusionsOur study provides more reliable evidence of the quantitative effects of policy interventions on the COVID-19 epidemic and suggested that stricter public activity interventions should be implemented at the early stage of the epidemic for improved containment.     

Public Discourse Against Masks in the COVID-19 Era: Infodemiology Study of Twitter Data

BackgroundDespite scientific evidence supporting the importance of wearing masks to curtail the spread of COVID-19, wearing masks has stirred up a significant debate particularly on social media.ObjectiveThis study aimed to investigate the topics associated with the public discourse against wearing masks in the United States. We also studied the relationship between the anti-mask discourse on social media and the number of new COVID-19 cases.MethodsWe collected a total of 51,170 English tweets between January 1, 2020, and October 27, 2020, by searching for hashtags against wearing masks. We used machine learning techniques to analyze the data collected. We investigated the relationship between the volume of tweets against mask-wearing and the daily volume of new COVID-19 cases using a Pearson correlation analysis between the two-time series.ResultsThe results and analysis showed that social media could help identify important insights related to wearing masks. The results of topic mining identified 10 categories or themes of user concerns dominated by (1) constitutional rights and freedom of choice; (2) conspiracy theory, population control, and big pharma; and (3) fake news, fake numbers, and fake pandemic. Altogether, these three categories represent almost 65% of the volume of tweets against wearing masks. The relationship between the volume of tweets against wearing masks and newly reported COVID-19 cases depicted a strong correlation wherein the rise in the volume of negative tweets led the rise in the number of new cases by 9 days.ConclusionsThese findings demonstrated the potential of mining social media for understanding the public discourse about public health issues such as wearing masks during the COVID-19 pandemic. The results emphasized the relationship between the discourse on social media and the potential impact on real events such as changing the course of the pandemic. Policy makers are advised to proactively address public perception and work on shaping this perception through raising awareness, debunking negative sentiments, and prioritizing early policy intervention toward the most prevalent topics.     

Transmission dynamics of COVID-19 in Algeria: The impact of physical distancing and face masks

We propose an SIR epidemic model taking into account prevention measures against coronavirus disease 2019 (COVID-19) such as wearing masks and respecting safety distances. We look for the conditions to avoid a second epidemic peak in the phase of release from confinement. We derive equations for the critical levels of mask efficiency, mask adoption (fraction of population wearing masks) and fraction of population engaging in physical distancing that lower the basic reproduction number ℜ₀ to unity. Conclusions: For ℜ₀ = 2.5, if at least 40% of people wear masks with efficiency 50%, and at least 20% of the population without masks (or anti-maskers) respect physical distancing measures, the effective reproduction number can be reduced to less than 1 and COVID-19 infections would plummet. The model predicts also that if at least half of the people respecting physical distancing, COVID-19 outbreaks with ℜ₀ of about 3, would be theoretically extinguished without wearing masks. The results of this study provide an alternative explanation for the spread of the disease, and suggest some valuable policy recommendations about the control strategies applied to mitigate disease transmission.     

COVID-19 vaccination attitudes,values and intentions among United States adults prior to emergency use authorization

IntroductionSafe and effective vaccines against Coronavirus Disease 2019 (COVID-19) provide the best opportunity to control the pandemic. Having safe and efficacious vaccines available is only half the equation; people must also take them. We describe a study to identify COVID-19 vaccine attitudes, values and intentions immediately preceding authorization of COVID-19 vaccines in the US.MethodsA national panel survey was conducted to measure intent to receive COVID-19 vaccines as well as disease and vaccine attitudes, values and trust in local, state and federal public health authorities.ResultsGreater than 80% of respondents reported confidence they could adhere to COVID recommendations such as mask wearing, social distancing and hand washing. The majority of respondents (70%) reported believing that current drugs were somewhat or very good at treating COVID-19 infection.Vaccine intent fell into three groups: Intenders (50%), Wait and Learn (40%), and Unlikelys (10%). Intent to get vaccinated was substantially lower among African American (32%), and higher among men (56%), those over 60 years of age (61%), those with a Bachelor’s degree or higher (63%), and Democrats (63%). The Wait and Learn group, compared to the Intenders, were less likely to report being diagnosed with a high risk condition for COVID-19, receiving an influenza vaccine in the past 12 months, discussing COVID-19 vaccine with their healthcare provider, perceiving COVID-19 as severe, considering a COVID-19 vaccine important to stop the spread of infection, and wering a mask usually or almost always.ConclusionOnly half of US adults intend to accept COVID-19 vaccines; most others (40%) are uncertain. Levels of immunity associated with community protection will not be achieved without reaching those who are currently uncertain. Characterizing COVID-19 vaccine attitudes and intentions and ascertaining values and trust in local, state, and federal public health authorities that impact vaccine decision-making are essential.     

The Impact of the COVID-19 Pandemic on the Uptake of Influenza Vaccine: UK-Wide Observational Study

BackgroundIn the face of the COVID-19 pandemic, the UK National Health Service (NHS) extended eligibility for influenza vaccination this season to approximately 32.4 million people (48.8% of the population). Knowing the intended uptake of the vaccine will inform supply and public health messaging to maximize vaccination.ObjectiveThe objective of this study was to measure the impact of the COVID-19 pandemic on the acceptance of influenza vaccination in the 2020-2021 season, specifically focusing on people who were previously eligible but routinely declined vaccination and newly eligible people.MethodsIntention to receive the influenza vaccine in 2020-2021 was asked of all registrants of the largest electronic personal health record in the NHS by a web-based questionnaire on July 31, 2020. Of those who were either newly or previously eligible but had not previously received an influenza vaccination, multivariable logistic regression and network diagrams were used to examine their reasons to undergo or decline vaccination.ResultsAmong 6641 respondents, 945 (14.2%) were previously eligible but were not vaccinated; of these, 536 (56.7%) intended to receive an influenza vaccination in 2020-2021, as did 466 (68.6%) of the newly eligible respondents. Intention to receive the influenza vaccine was associated with increased age, index of multiple deprivation quintile, and considering oneself to be at high risk from COVID-19. Among those who were eligible but not intending to be vaccinated in 2020-2021, 164/543 (30.2%) gave reasons based on misinformation. Of the previously unvaccinated health care workers, 47/96 (49%) stated they would decline vaccination in 2020-2021.ConclusionsIn this sample, COVID-19 has increased acceptance of influenza vaccination in previously eligible but unvaccinated people and has motivated substantial uptake in newly eligible people. This study is essential for informing resource planning and the need for effective messaging campaigns to address negative misconceptions, which is also necessary for COVID-19 vaccination programs.     

COVID-19 pandemic in China: Context,experience and lessons

The first cluster of COVID-19 cases was reported in Wuhan, China on December 29th, 2019. Since then, China has experienced a pandemic of COVID-19. Objective: This study aims to present the context in which the pandemic has evolved, the government's response and the pandemic's impact on public health and national economy. Methods: A review was conducted to collect relevant data from press releases and government reports. Results: COVID-19 poses a major public health threat on China with a cumulative number of cases over 89,000 (data cut-off date: August 9th, 2020). Between January and February 2020, China implemented a series of escalating policies (including a stringent nation-wide lockdown) to combat the pandemic. Therefore, it has been to a large extent limited to the Wuhan region. Social media such as WeChat and SinaWeibo played a crucial role in disseminating government information and public campaigns during the pandemic. Technologies were adopted to enable contact tracing and population travel patterns. The Chinese central government mobilized healthcare resources including healthcare personnel and medical materials to Wuhan in a highly effective way. Both central and regional governments launched financial policies to stimulate the economy, including special loans, tax extension, reduction or waiver. Nevertheless, the economy in China was significantly impacted especially during the lockdown period. Conclusions: China has responded to the COVID-19 epidemic in a highly centralized and effective way. Balancing the needs to prevent a future pandemic and to boost economic recovery remains a challenge.     

Geographic variations in opioid overdose patterns in Pennsylvania during the COVID-19 pandemic

The convergence of the opioid epidemic and the COVID-19 pandemic has created new health challenges throughout the United States. Since the onset of the pandemic, media attention and scholarly research have drawn attention to the intersections of addiction and COVID-19. However, there remain few empirical studies that examine the direct impacts of the COVID-19 pandemic for opioid overdose patterns. Even fewer have integrated quantitative and qualitative methods to detail the place-specific dynamics shaping opioid overdose and addiction treatment during the COVID-19 pandemic. This article measures and maps change in the age-adjusted rate of opioid-related overdose incidents at the county level from 2018 to 2020. These analyses are combined with interviews conducted since December 2020 with public health providers in the state of Pennsylvania to identify the key factors influencing opioid misuse and transformations in addiction treatment practices.     

The use of face masks during vaccine roll-out in New YorkCity and impact on epidemic control

Face masks were mandated in New York during the first wave in 2020, and in 2021 the first vaccine programs have commenced. We aimed to examine the impact of face mask and other NPIs use with a gradual roll out of vaccines in NYC on the epidemic trajectory.A SEIR mathematical model of SARS-CoV-2 transmission was developed for New York City (NYC), which accounted for decreased mobility for lockdown, testing and tracing. Varied mask’s usage and efficacy were tested, along with a gradual increase in vaccine uptake over five months. The model has been calibrated using notification data in NYC from March first to June 29.Masks and other NPIs result in immediate impact on the epidemic, while vaccination has a delayed impact, especially when implemented over a long period of time. A pre-emptive, early mandate for masks is more effective than late mask use, but even late mask mandates will reduce cases and deaths by over 20%. The epidemic curve is suppressed by at least 50% of people wearing a mask from the start of the outbreak but surges when mask wearing drops to 30% or less. With a slow roll out of vaccines over five months at uptake levels of 20–70%, NPIs use will still be needed and has a greater impact on epidemic control.When vaccine roll out is slow or partial in cities experiencing local transmission of COVID-19, masks and other NPIs will be necessary to mitigate transmission until vaccine coverage is high and complete. Vaccine alone cannot rapidly control an epidemic because of the time lag to two-dose immunity. Even after high coverage, the ongoing need for NPIs is unknown and will depend on long-term duration of vaccine efficacy, the use of boosters and optimized dosage scheduling and variants of concern.     

Mobility Change and COVID-19 in Japan: Mobile Data Analysis of Locations of Infection

BackgroundAs the COVID-19 pandemic spread, the Japanese government declared a state of emergency on April 7, 2020 for seven prefectures, and on April 16, 2020 for all prefectures. The Japanese Prime Minister and governors requested people to adopt self-restraint behaviors, including working from home and refraining from visiting nightlife spots. However, the effectiveness of the mobility change due to such requests in reducing the spread of COVID-19 has been little investigated. The present study examined the association of the mobility change in working, nightlife, and residential places and the COVID-19 outbreaks in Tokyo, Osaka, and Nagoya metropolitan areas in Japan.MethodsFirst, we calculated the daily mobility change in working, nightlife, and residential places compared to the mobility before the outbreak using mobile device data. Second, we estimated the sensitivity of mobility changes to the reproduction number by generalized least squares.ResultsMobility change had already started in March, 2020. However, mobility reduction in nightlife places was particularly significant due to the state of emergency declaration. Although the mobility in each place type was associated with the COVID-19 outbreak, the mobility changes in nightlife places were more significantly associated with the outbreak than those in the other place types. There were regional differences in intensity of sensitivity among each metropolitan area.ConclusionsOur findings indicated the effectiveness of the mobility changes, particularly in nightlife places, in reducing the outbreak of COVID-19.Key words: communicable diseases, COVID-19, big data, mobility, Japan     

Projected COVID-19 epidemic in the United States in the context of the effectiveness of a potential vaccine and implications for social distancing and face mask use

BackgroundMultiple candidates of COVID-19 vaccines have entered Phase III clinical trials in the United States (US). There is growing optimism that social distancing restrictions and face mask requirements could be eased with widespread vaccine adoption soon.MethodsWe developed a dynamic compartmental model of COVID-19 transmission for the four most severely affected states (New York, Texas, Florida, and California). We evaluated the vaccine effectiveness and coverage required to suppress the COVID-19 epidemic in scenarios when social contact was to return to pre-pandemic levels and face mask use was reduced. Daily and cumulative COVID-19 infection and death cases from 26th January to 15th September 2020 were obtained from the Johns Hopkins University Coronavirus resource center and used for model calibration.ResultsWithout a vaccine (scenario 1), the spread of COVID-19 could be suppressed in these states by maintaining strict social distancing measures and face mask use levels. But relaxing social distancing restrictions to the pre-pandemic level without changing the current face mask use would lead to a new COVID-19 outbreak, resulting in 0.8–4 million infections and 15,000–240,000 deaths across these four states over the next 12 months. Under this circumstance, introducing a vaccine (scenario 2) would partially offset this negative impact even if the vaccine effectiveness and coverage are relatively low. However, if face mask use is reduced by 50% (scenario 3), a vaccine that is only 50% effective (weak vaccine) would require coverage of 55–94% to suppress the epidemic in these states. A vaccine that is 80% effective (moderate vaccine) would only require 32–57% coverage to suppress the epidemic. In contrast, if face mask usage stops completely (scenario 4), a weak vaccine would not suppress the epidemic, and further major outbreaks would occur. A moderate vaccine with coverage of 48–78% or a strong vaccine (100% effective) with coverage of 33–58% would be required to suppress the epidemic. Delaying vaccination rollout for 1–2 months would not substantially alter the epidemic trend if the current non-pharmaceutical interventions are maintained.ConclusionsThe degree to which the US population can relax social distancing restrictions and face mask use will depend greatly on the effectiveness and coverage of a potential COVID-19 vaccine if future epidemics are to be prevented. Only a highly effective vaccine will enable the US population to return to life as it was before the pandemic.     

Community venue exposure risk estimator for the COVID-19 pandemic

Complexities of virus genotypes and the stochastic contacts in human society create a big challenge for estimating the potential risks of exposure to a widely spreading virus such as COVID-19. To increase public awareness of exposure risks in daily activities, we propose a birthday-paradox-based probability model to implement in a web-based system, named COSRE (community social risk estimator) and make in-time community exposure risk estimation during the ongoing COVID-19 pandemic. We define exposure risk to mean the probability of people meeting potential cases in public places such as grocery stores, gyms, libraries, restaurants, coffee shops, offices, etc. Our model has three inputs: the real-time number of active and asymptomatic cases, the population in local communities, and the customer counts in the room. With COSRE, possible impacts of the pandemic can be explored through spatiotemporal analysis, e.g., a variable number of people may be projected into public places through time to assess changes of risk as the pandemic unfolds. The system has potential to advance understanding of the true exposure risks in various communities. It introduces an objective element to plan, prepare and respond during a pandemic. Spatial analysis tools are used to draw county-level exposure risks of the United States from April 1 to July 15, 2020. The correlation experiment with the new cases in the next two weeks shows that the risk estimation model offers promise in assisting people to be more precise about their personal safety and control of daily routine and social interaction. It can inform business and municipal COVID-19 policy to accelerate recovery.     

新冠肺炎防控对疾病预防控制中心公共卫生人才队伍建设的启示

目的在新型冠状病毒肺炎（简称“新冠肺炎”）疫情防控背景下,梳理上海特大型城市区县级疾病预防控制（简称“疾控”）中心公共卫生人才队伍抗疫投入情况,分析总结区县级疾控中心公共卫生人才队伍现状和存在问题,提出加强和改进的建议措施。方法以服务人口数量568万的上海市浦东新区疾控中心（简称“浦东疾控”）为例,通过查阅资料、个别访谈、问卷调查、召开座谈会等方式,结合新冠肺炎疫情处置人员投入情况,描述浦东疾控人才队伍特征、人员招录与流失情况,调查影响人才队伍建设的因素。结果2014—2020年,浦东疾控计划招录人数175名,实际到岗人数115名,到岗率65.71%;离职共68名,平均每年离职近10名,流失率呈波动上升趋势（趋势χ2=0.158,P<0.05）。2020年新冠肺炎疫情防控常态化以来,按现场处置一起疫情的投入人时数和现有在岗人数估算,已超负荷工作。2017—2019年人员薪酬基本维持在2016年水平（年均增长约2.5%）,缺乏有针对性的人才引进和人才稳定政策,造成专业技术人才,特别是高学历、高职称人才的引进和培养困难。问卷结果显示,79.23%的被调查者认为需要完善人才激励机制,73.43%的被调查者认为需要营造良好的人才成长环境,50.24%的被调查者认为需要创新用人机制。目前普遍存在的问题有公共卫生人才数量难以满足新形势、新任务下的疫情防控需要,人员招录引进不足、流失相对严重,部分公共卫生人才的能力素质与新形势、新任务的需要存在一定差距等。结论上海特大型城市区县疾控公共卫生人才数量和质量难以满足新形势新任务下的疫情防控需要,公共卫生人才培训的针对性、系统性亟需加强,激励制度机制急待完善。     

COVID-19 pandemic in the United States

ObjectivesThe paper highlights US health policy and technology responses to the COVID-19 pandemic from January 1, 2020 – August 9, 2020.MethodsA review of primary data sources in the US was conducted. The data were summarized to describe national and state-level trends in the spread of COVID-19 and in policy and technology solutions.ResultsCOVID-19 cases and deaths initially peaked in late March and April, but after a brief reduction in June cases and deaths began rising again during July and continued to climb into early August. The US policy response is best characterized by its federalist, decentralized nature. The national government has led in terms of economic and fiscal response, increasing funding for scientific research into testing, treatment, and vaccines, and in creating more favorable regulations for the use of telemedicine. State governments have been responsible for many of the containment, testing, and treatment responses, often with little federal government support. Policies that favor economic re-opening are often followed by increases in state-level case numbers, which are then followed by stricter containment measures, such as mask wearing or pausing re-opening plans.ConclusionsWhile all US states have begun to “re-open” economic activities, this trend appears to be largely driven by social tensions and economic motivations rather than an ability to effectively test and surveil populations.     

An Environmental Dilemma for China During the COVID-19 Pandemic: The Explosion of Disposable Plastic Wastes

Plastic pollution control has been on top of the political agenda in China. In January 2020, China announced a phased ban on the production and usage of various types of single-use plastics as a solution to environmental pollution problems. However, the outbreak of COVID-19 seems to be a new obstacle to the ban on single-use plastic products. To basically satisfied the daily necessities and contain the spread of SARS-CoV-2 under the background of the regular epidemic prevention and control in China, online ordering, contactless delivery and wearing mask have become an important and feasible way of daily life. However, the unrestrained use of disposable plastic bags, lunch boxes and masks within the nationwide quarantine leads to hundreds of millions of plastics wastes every day. The potential environmental pollution caused by the use of disposable plastic products during the pandemic should arouse social concern. The Chinese government should manage environmental protection in parallel with anti-pandemic endeavors as the situation of the pandemic evolves.

     

全球卫生治理面临的困境、原因及应对：以新型冠状病毒肺炎疫苗实施计划为例

新型冠状病毒肺炎威胁着人民的生命健康和财产安全。新型冠状病毒肺炎疫苗是建立人群免疫屏障、实现疫情全球卫生治理的关键公共品,WHO、全球疫苗免疫联盟和流行病防范创新联盟于2020年创建新型冠状病毒肺炎疫苗实施计划（COVAX）,旨在让世界各国,尤其是中、低收入国家也能公平接种疫苗。尽管COVAX通过协调全球供应链加速了疫...     

新型冠状病毒肺炎疫情对中国成人慢性病治疗及健康状况的影响

  目的  探讨COVID-19疫情对中国成人慢性病治疗及健康状况的影响。  方法  通过随机数字拨号方法在全国所有地市级行政单位抽取≥18岁的人群样本,通过云端电话调查系统开展问卷访问,于2020年11―12月共收集具有全国代表性的问卷5 972份。  结果  高血压患者、血脂异常患者、糖尿病/血糖升高患者中分别有2.2%、4.6%和8.8%的患者其治疗受COVID-19疫情的影响比较大或非常大。与疫情前相比,有4.2%的人群报告健康状况明显变差或有所变差。高血压患者中,自报健康状况越差,其治疗受COVID-19疫情的影响越大;血脂异常患者中,年龄越大、家庭收入低、自报健康状况越差,其血脂异常的治疗受COVID-19疫情的影响越大;中老年人、居住在城市的人群健康变差的可能性大。  结论  目前,中国高血压、血脂异常、糖尿病/血糖升高患者的治疗以及人群健康状况受疫情的影响不大,对于受影响较大的高危人群需要特别给予关注。     

湖南省公众对新型冠状病毒肺炎疫情防控措施知识、态度、行为的网络调查情况分析

目的 调查湖南省新型冠状病毒肺炎(简称新冠肺炎,COVID-19)疫情期间公众关于疫情防控措施知识、态度、行为,防控措施效果评价、满意度的情况方面内容,为下阶段制定防控措施提供科学依据。方法 采用匿名网络调查方式,通过在线问卷平台发放自行设计的调查问卷,调查内容包括一般信息、公众对疫情防控措施态度与行为、对防控措施满意度、个人防护意识与行为以及对防控工作的问题与建议等。采用描述性方法分析问卷中数值变量以及等级变量数据,采用文本分析中的语句分词与词频分析、KMeans聚类分析方法来分析处理开放性主观题的文本数据。结果 本次调查共收集7 585份有效问卷,参与调查人群的职业主要有事业单位员工(27.20%)、自由职业者(18.89%)、企业员工(11.72%)、学生(10.34%)。99.88%的参与者认为外出需要佩戴口罩,最优先选择的防护口罩为医用外科口罩/一次性医用口罩(79.91%),其次为医用防护口罩(16.47%)。89.57%参与者认为含氯消毒剂可以用于家庭日常消毒,其次为医用酒精(86.32%)。94.23%的参与者满意疫情期间防控措施,88.27%认为防控措施落实到位。94%赞成当前延迟复工、复学政策,96.97%赞成限制外出的防控措施。超过99.30%的参与者配合健康监测及登记等防控工作。文本分析结果显示出现频率较高的词语主要有“防控”、“疫情”、“出门”、“口罩”等。提取了10类观点,有“鼓励”、“减少外出”、“继续加强防范,不能松懈”、“戴好口罩”、“疫情早日结束”、“加强防控宣传”、“积极配合防控”、“加大防控力度”、“买不到口罩”、“延迟复学”等。结论 湖南省公众对新冠肺炎疫情的防控措施知识了解与满意度较好,整体配合程度较高;对疫情形势看好的同时,湖南省公众对疫情防控仍保持警惕态度。