Frontiers in public health
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Front Public Health · Jan 2020
Transitioning Out of the Coronavirus Lockdown: A Framework for Evaluating Zone-Based Social Distancing.
In the face of elevated pandemic risk, canonical epidemiological models imply the need for extreme social distancing over a prolonged period. Alternatively, people could be organized into zones, with more interactions inside their zone than across zones. Zones can deliver significantly lower infection rates, with less social distancing, particularly if combined with simple quarantine rules and contact tracing. This paper provides a framework for understanding and evaluating the implications of zones, quarantines, and other complementary policies.
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Front Public Health · Jan 2020
A Comprehensive Evaluation of China's TCM Medical Service System: An Empirical Research by Integrated Factor Analysis and TOPSIS.
Objectives: This paper constructs a comprehensive evaluation index of the traditional Chinese medicine (TCM) medical service system and summarizes the development of TCM medical services in China. Methods: We chose 31 provinces' TCM hospitals as research objects. The data were obtained from the Health Statistics Yearbook from 2013 to 2018 and from the National Statistics of Chinese Medicine from 2012 to 2017. ⋯ The per capita of medical resources in the Southwest and Northwest are stronger than those in Central and South China, but overall medical resources are weaker than those in East China and North China. TCM medical service institutions in East China, South China and Central China have achieved better service results and higher economic benefits with less resource input, which further indicates the efficient allocation of resources and the balanced operation of TCM medical service institutions. Conclusion: The development of China's TCM medical service system shows the imbalance and inadequacy of "East is strong, West is weak" and "South is superior, North is inferior."
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Front Public Health · Jan 2020
Underreporting of Death by COVID-19 in Brazil's Second Most Populous State.
The COVID-19 pandemic brings to light the reality of the Brazilian health system. The underreporting of COVID-19 deaths in the state of Minas Gerais (MG), where the second largest population of the country is concentrated, reveals government unpreparedness, as there is a low capacity of testing in the population, which prevents the real understanding of the general panorama of SARS-CoV-2 dissemination. The goals of this research are to analyze the causes of deaths in different Brazilian government databases (Civil Registry Transparency Portal and InfoGripe) and to assess whether there are sub-records showing an unexpected increase in the frequency of deaths from causes clinically similar to COVID-19. ⋯ There was also a 758.57% increase in SARI deaths in 2020, when compared to the average of previous years. Finally, it was shown that there was an increase in the rate of pneumonia and respiratory insufficiency (RI) by 6.34 and 6.25%, respectively. In conclusion, there is an underreporting of COVID-19 deaths in MG due to the unexplained excess of deaths caused by SARI, respiratory insufficiency, and pneumonia compared to previous years.
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Front Public Health · Jan 2020
ReviewSevere COVID-19: A Review of Recent Progress With a Look Toward the Future.
The novel coronavirus disease 2019 (COVID-19) is an acute infectious disease caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Currently, the World Health Organization has confirmed that COVID-19 is a global infectious disease pandemic. This is the third acute infectious disease caused by coronavirus infection in this century, after sudden acute respirator syndrome and Middle East respiratory syndrome. ⋯ Currently, there are no specific antiviral drugs for the treatment of COVID-19. Most patients need to be admitted to the intensive care unit for intensive monitoring and supportive organ function treatments. This article reviews the epidemiology, pathogenesis, clinical manifestations, diagnosis, and treatment methods of severe COVID-19 and puts forward some tentative ideas, aiming to provide some guidance for the diagnosis and treatment of severe COVID-19.
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Front Public Health · Jan 2020
Multicenter Study Observational StudySensitivity of SARS-CoV-2 Detection With Nasopharyngeal Swabs.
Background: SARS-CoV-2-infected subjects have been proven contagious in the symptomatic, pre-symptomatic and asymptomatic phase. The identification of these patients is crucial in order to prevent virus circulation. No reliable data on the sensitivity of nasopharyngeal swabs (NPS) are available because of the lack of a shared reference standard to identify SARS-CoV-2 infected patients. ⋯ Sensitivity of the first follow-up NPS (n = 233) was 79% (95% CI, 73 to 84%) with no significant variations over time. We found no statistically significant differences in the sensitivity of the first follow-up NPS according to time since symptom onset, age, sex, number of comorbidities, and onset symptoms. Conclusions: NPS utility in the diagnostic algorithm of COVID-19 should be reconsidered.