Health system, public health, and economic implications of managing COVID-19 from a cardiovascular perspective.
Ontology highlight
ABSTRACT:
SUBMITTER: Carter P
PROVIDER: S-EPMC7188109 | biostudies-literature | 2020 Jul
REPOSITORIES: biostudies-literature
Publications
Health system, public health, and economic implications of managing COVID-19 from a cardiovascular perspective.
Carter Paul P Anderson Michael M Mossialos Elias E
European heart journal 20200701 27
Similar Datasets
Project description:The coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), represents the pandemic of the century, with approximately 3.5 million cases and 250,000 deaths worldwide as of May 2020. Although respiratory symptoms usually dominate the clinical presentation, COVID-19 is now known to also have potentially serious cardiovascular consequences, including myocardial injury, myocarditis, acute coronary syndromes, pulmonary embolism, stroke, arrhythmias, heart failure, and cardiogenic shock. The cardiac manifestations of COVID-19 might be related to the adrenergic drive, systemic inflammatory milieu and cytokine-release syndrome caused by SARS-CoV-2, direct viral infection of myocardial and endothelial cells, hypoxia due to respiratory failure, electrolytic imbalances, fluid overload, and side effects of certain COVID-19 medications. COVID-19 has profoundly reshaped usual care of both ambulatory and acute cardiac patients, by leading to the cancellation of elective procedures and by reducing the efficiency of existing pathways of urgent care, respectively. Decreased use of health care services for acute conditions by non-COVID-19 patients has also been reported and attributed to concerns about acquiring in-hospital infection. Innovative approaches that leverage modern technologies to tackle the COVID-19 pandemic have been introduced, which include telemedicine, dissemination of educational material over social media, smartphone apps for case tracking, and artificial intelligence for pandemic modelling, among others. This article provides a comprehensive overview of the pathophysiology and cardiovascular implications of COVID-19, its impact on existing pathways of care, the role of modern technologies to tackle the pandemic, and a proposal of novel management algorithms for the most common acute cardiac conditions.
| S-EPMC7229739 | biostudies-literature
Project description:This paper presents an economic evaluation aimed at estimating malaria-related health care expenditures in Brazil from the perspective of the public health system. Comprehensive estimates of the costs of malaria remain scarce, in part because of limited data. Brazil has a universal health system (Sistema Único de Saúde-SUS) in which all cases of malaria are diagnosed and treated. In addition, antimalarial drugs are only available through the SUS. We compiled comprehensive data from multiple administrative sources. Expenditure indicators were calculated for municipalities and states in the Brazilian Amazon, a region where more than 99% of the country's malaria cases are concentrated. We also developed a digital platform that allows interactive visualization of the malaria cost indicators, disaggregated by cost type and geography. Our results show that control and prevention activities are the primary cost in all states, followed by human resources and disease treatment. Expenditures per malaria notification in the Amazon ranged from PPP (purchasing power parity)-US$59.00 (2017) to PPP-US$77.00 (2016), while per capita expenditures remained relatively stable at around PPP-US$3.50. The malaria cost estimates presented here contribute to a better negotiation of the financial resources needed by the NMCP and are one of the critical pieces of information for a strategic plan of activities needed to achieve the elimination goal.
| S-EPMC11488710 | biostudies-literature
Project description:BackgroundSince its appearance, COVID-19 has immensely impacted our society. Public health measures, from the initial lockdowns to vaccination campaigns, have mitigated the crisis. However, SARS-CoV-2's persistence and evolving variants continue to pose global threats, increasing the risk of reinfections. Despite vaccination progress, understanding reinfections remains crucial for informed public health responses.MethodsWe collected available data on clinical and genomic information for SARS-CoV-2 samples from patients treated in Mexico City from 2020 epidemiological week 10 to 2023 epidemiological week 06 encompassing the whole public health emergency's period. To identify clinical data we utilized the SISVER (Respiratory Disease Epidemiological Surveillance System) database for SARS-CoV-2 patients who received medical attention in Mexico City. For genomic surveillance we analyzed genomic data previously uploaded to GISAID generated by Mexican institutions. We used these data sources to generate descriptors of case number, hospitalization, death and reinfection rates, and viral variant prevalence throughout the pandemic period.FindingsThe fraction of reinfected individuals in the COVID-19 infected population steadily increased as the pandemic progressed in Mexico City. Most reinfections occurred during the fifth wave (40%). This wave was characterized by the coexistence of multiple variants exceeding 80% prevalence; whereas all other waves showed a unique characteristic dominant variant (prevalence >95%). Shifts in symptom patient care type and severity were observed, 2.53% transitioned from hospitalized to ambulatory care type during reinfection and 0.597% showed the opposite behavior; also 7.23% showed a reduction in severity of symptoms and 6.05% displayed an increase in severity. Unvaccinated individuals accounted for the highest percentage of reinfections (41.6%), followed by vaccinated individuals (31.9%). Most reinfections occurred after the fourth wave, dominated by the Omicron variant; and after the vaccination campaign was already underway.InterpretationOur analysis suggests reduced infection severity in reinfections, evident through shifts in symptom severity and care patterns. Unvaccinated individuals accounted for most reinfections. While our study centers on Mexico City, its findings may hold implications for broader regions, contributing insights into reinfection dynamics.
| S-EPMC10899476 | biostudies-literature
Project description:Current evidence suggests that severity and mortality of COVID-19 is higher in men than in women, whereas women might be at increased risk of COVID-19 reinfection and development of long COVID. Differences between sexes have been observed in other infectious diseases and in the response to vaccines. Sex-specific expression patterns of proteins mediating virus binding and entry, and divergent reactions of the immune and endocrine system, in particular the hypothalamic-pituitary-adrenal axis, in response to acute stress might explain the higher severity of COVID-19 in men. In this Personal View, we discuss how sex hormones, comorbidities, and the sex chromosome complement influence these mechanisms in the context of COVID-19. Due to its role in the severity and progression of SARS-CoV-2 infections, we argue that sexual dimorphism has potential implications for disease treatment, public health measures, and follow-up of patients predisposed to the development of long COVID. We suggest that sex differences could be considered in future pandemic surveillance and treatment of patients with COVID-19 to help to achieve better disease stratification and improved outcomes.
| S-EPMC8803381 | biostudies-literature
Project description:(1) Background: During the global spread of COVID-19, Japan has been among the top countries to maintain a relatively low number of infections, despite implementing limited institutional interventions and its high population density. This study investigated how limited intervention policies have affected public health and economic conditions in the COVID-19 context and aimed to gain insight into the effective and sustainable measures against new infectious diseases in densely inhabited areas. (2) Methods: A system dynamics approach was employed. Qualitative causal loop analysis and stock and quantitative flow model analysis were performed, using a Tokyo Metropolitan area dataset. (3) Results: A causal loop analysis suggested that there were risks in prematurely terminating such interventions. Based on this result and the subsequent quantitative modeling, we found that the short-term effectiveness of a short-term pre-emptive stay-at-home request caused a resurgence in the number of positive cases, whereas an additional request provided a limited negative add-on effect for economic measures (e.g., number of electronic word-of-mouth communications and restaurant visits). (4) Conclusions: These findings suggest the superiority of a mild and continuous intervention as a long-term countermeasure under epidemic pressures when compared with strong intermittent interventions.
| S-EPMC8398311 | biostudies-literature
Project description:This study examines the effects of local and nationwide COVID-19 disease control measures on the health and economy of China's rural population. We conducted phone surveys with 726 randomly selected village informants across seven rural Chinese provinces in February 2020. Four villages (0.55%) reported infections, and none reported deaths. Disease control measures had been universally implemented in all sample villages. About 74% of informants reported that villagers with wage-earning jobs outside the village had stopped working due to workplace closures. A higher percentage of rural individuals could not work due to transportation, housing, and other constraints. Local governments had taken measures to reduce the impact of COVID-19. Although schools in all surveyed villages were closed, 71% of village informants reported that students were attending classes online. Overall, measures to control COVID-19 appear to have been successful in limiting disease transmission in rural communities outside the main epidemic area. Rural Chinese citizens, however, have experienced significant economic consequences from the disease control measures.
| S-EPMC8207079 | biostudies-literature
Project description:IntroductionEvidence shows physical distancing of one metre or more is important to reduce person-to-person SARS-CoV-2 transmission. This puts the Malaysian public healthcare system to a test when overcrowding has always been an issue. A new clinical appointment structure was proposed in the Malaysian public healthcare system amidst the pandemic to reduce the transmission risk. We aim to explore the general public's view on the proposed clinic appointment structure.MethodsA cross-sectional anonymous web-based survey was conducted between 10th September 2020 and 30th November 2020. The survey was open to Malaysian aged 18 years and older via various social media platforms. The questionnaire consists of sociodemographic, experience of utilising healthcare facilities, and views on clinic appointment structure.ResultsA total of 1,144 complete responses were received. The mean age was 41.4 ± 12.4 years and more than half of the respondents had a preference for public healthcare. Among them, 77.1% reported to have a clinical appointment scheduled in the past. Less than a quarter experienced off-office hour appointments, mostly given by private healthcare. 70.2% answered they would arrive earlier if they were given a specific appointment slot at a public healthcare facility, as parking availability was the utmost concern. Majority hold positive views for after office hour clinical appointments, with 68.9% and 63.2% agreed for weekend and weekday evening appointment, respectively. The top reason of agreement was working commitment during office hours, while family commitment and personal resting time were the main reasons for disagreeing with off-office hour appointments.ConclusionWe found that majority of our respondents chose to come early instead of arriving on time which disrupts the staggered appointment system and causes over crowdedness. Our findings also show that the majority of our respondents accept off-office hour appointments. This positive response suggests that off-office hour appointments may have a high uptake amongst the public and thus be a possible solution to distribute the patient load. Therefore, this information may help policy makers to initiate future plans to resolve congestions within public health care facilities which in turn eases physical distancing during the pandemic.
| S-EPMC8811595 | biostudies-literature
Project description:Economic growth has a significant impact on health vulnerability primarily through the process of urbanization. This paper conducts a pioneer study by analyzing the impact of regional economic growth and urbanization on the public health vulnerability in the 51 states and territories of the USA from 2011 to 2018 with a fixed-effect panel data regression model. We construct an epidemiological vulnerability index (EVI) using regional smoking, diabetes, obesity, and hypertension, collect CDC social vulnerability index (SVI) as state-level public health vulnerability status, and use COVID-19 to test the actual effect of health vulnerability. The preliminary results show that higher regional economic growth is related to lower EVI and SVI, while urbanization is positively associated with regional health vulnerability and the severity of COVID-19 from case rate and death rate. Robustness check with unemployment shows the same result. We conclude that economic growth is related to lower public health vulnerability, and urbanization has negative public health benefits. Our finding indicates an urgent need to balance the externalities generated by economic development and urbanization trends on public health vulnerability by promoting reasonable medical resource distribution, health practices and safety, improving social and environmental justice, and other health management measures.Supplementary informationThe online version contains supplementary material available at 10.1007/s00168-021-01103-9.
| S-EPMC8782711 | biostudies-literature
Project description:Providing accurate and timely public health information is an ongoing challenge for public health officials. The COVID-19 pandemic has exacerbated such challenges and presented unique difficulties in providing public health information, through the parallel rise of an "infodemic" of mis/dis-information. Understanding why individuals select, use and change their public health information seeking behaviors around COVID-19, and the relationship of these decisions relative to participant characteristics, is therefore an important step in understanding and responding to infodemics. This study used a qualitative survey (n = 255) and free-text qualitative questions to ask (1) Why participants use an information source, (2) How participants used an information source, and (3) How information seeking behavior has changed since the COVID-19 pandemic. Participants were primarily women, born in Australia, with de-facto/married relationships, without children at home, with university/college qualifications, and employed full-time or unemployed/retired. Most participants identified "easiness" and "immediacy" as reasons why they chose and used information, with sources primarily used for planning, communication, and decision making. A minority of participants changed their information seeking behavior since the COVID-19 pandemic. Those who did change, desired more immediate and accurate information. Emergent themes of care and anxiety were also noted, raising questions around the impact of mental load and cognitive labor in some female populations. Women may be suffering from increased cognitive labor and a gendering of public health information seeking behavior in the context of COVID-19. The impact of these attributes on women requires greater empirical research and consideration amongst front line practitioners and public health professionals.
| S-EPMC9929454 | biostudies-literature
Project description:Despite loose restrictions and a low mortality rate due to COVID-19, Japan faced the challenge of stabilizing its economy during the pandemic. Here, we analyzed how the Japanese government attempted to maintain a balance between the health of the population and the health of the economy. We used a mix of quantitative data, information from policy documents, and news agency publications. Features of the Japanese government's handling of the pandemic include the lack of constitutional authority to enforce a lockdown, the laxer restrictions compared with other countries in which citizens were advised only to exercise self-restraint and avoid close social contact, and the existence of expert panels that had only an advisory role. Our findings address the slow initial response of the government, which feared that the 2020 Tokyo Olympics would be canceled, and the increased testing when the Olympics were postponed, as well as the expansion of vaccination efforts after the Olympics. In addition, there was a targeted campaign to promote national travel to increase economic revenue in the tourism sector, but this led to an increase in COVID-19 cases.
| S-EPMC9620936 | biostudies-literature