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COVID-19, a worldwide public health emergency? COVID-19, una emergencia de salud publica mundial

ABSTRACT: A new coronavirus outbreak emerged on the 31st of December 2019 in Wuhan, China, causing commotion among the medical community and the rest of the world. This new species of coronavirus has been termed 2019-nCoV and has caused a considerable number of cases of infection and deaths in China and, to a growing degree, beyond China, becoming a worldwide public health emergency. 2019-nCoV has high homology to other pathogenic coronaviruses, such as those originating from bat-related zoonosis (SARS-CoV), which caused approximately 646 deaths in China at the start of the decade. The mortality rate for 2019-nCoV is not as high (approximately 2–3%), but its rapid propagation has resulted in the activation of protocols to stop its spread. This pathogen has the potential to become a pandemic. It is therefore vital to follow the personal care recommendations issued by the World Health Organization.

SUBMITTER: Palacios Cruz M

PROVIDER: S-EPMC7173827 | biostudies-literature | 2020 Apr

REPOSITORIES: biostudies-literature

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Project description:Background: Contact tracing is a core element of the public health response to emerging infectious diseases including COVID-19. Better understanding the implementation context of contact tracing for pandemics, including individual- and systems-level predictors of success, is critical to preparing for future epidemics. Methods: We carried out a prospective implementation study of an emergency volunteer contact tracing program established in New Haven, Connecticut between April 4 and May 19, 2020. We assessed the yield and timeliness of case and contact outreach in reference to CDC benchmarks, and identified individual and programmatic predictors of successful implementation using multivariable regression models. We synthesized our findings using the RE-AIM implementation framework. Results: Case investigators interviewed only 826 (48%) of 1,705 cases and were unable to reach 545 (32%) because of incomplete information and 334 (20%) who missed or declined repeated outreach calls. Contact notifiers reached just 687 (28%) of 2,437 reported contacts, and were unable to reach 1,597 (66%) with incomplete information and 153 (6%) who missed or declined repeated outreach calls. The median time-to-case-interview was 5 days and time-to-contact-notification 8 days. However, among notified contacts with complete time data, 457 (71%) were reached within 6 days of exposure. The least likely groups to be interviewed were elderly (adjusted relative risk, aRR 0.74, 95% CI 0.61-0.89, p = 0.012, vs. young adult) and Black/African-American cases (aRR 0.88, 95% CI 0.80-0.97, pairwise p = 0.01, vs. Hispanic/Latinx). However, ties between cases and their contacts strongly influenced contact notification success (Intraclass Correlation Coefficient (ICC) 0.60). Surging caseloads and high volunteer turnover (case investigator n = 144, median time from sign-up to retirement from program was 4 weeks) required the program to supplement the volunteer workforce with paid public health nurses. Conclusions: An emergency volunteer-run contact tracing program fell short of CDC benchmarks for time and yield, largely due to difficulty collecting the information required for outreach to cases and contacts. To improve uptake, contact tracing programs must professionalize the workforce; better integrate testing and tracing services; capitalize on positive social influences between cases and contacts; and address racial and age-related disparities through enhanced community engagement.

Project description:ObjectiveCorrectly understanding and evaluating the level of public risk perception toward public health emergencies not only helps experts and decision-makers understand the public's preventative health behaviors to these emergencies but also enhances their risk information communication with the public. The aim of this study was to develop a risk perception scale for public health emergencies and test its validity and reliability during the coronavirus disease 2019 (COVID-19) pandemic.MethodsGuided by the theoretical model of risk perception, an initial scale was generated through literature review, group meetings, resident interviews, and expert consultation. A pretest and item screening were then conducted to develop a formal risk perception scale for public health emergencies. Finally, the reliability and validity of the scale were validated through a questionnaire survey of 504 Chinese adults.ResultsThe final scale had 9 items. The content validity index of the scale was 0.968, and the content validity index of individual items ranged from 0.83 to 1.00. Three common factors, dread risk perception, severe risk perception, and unknown risk perception, were extracted for exploratory factor analysis, and together they explained 66.26% of the variance in the score. Confirmatory factor analysis showed that the model had a satisfactory fit, where χ 2/df = 1.384, the goodness-of-fit index (GFI) = 0.989, root mean square error of approximation (RMSEA) = 0.028, root mean square residual (RMR) = 0.018, comparative fit index (CFI) = 0.995, normed fit index (NFI) = 0.982, and non-normed fit index (NNFI) = 0.990. The correlations between dimensions ranged from 0.306 to 0.483 (P < 0.01). Cronbach's α was 0.793 for the total scale and ranged between 0.687 and 0.801 for the individual dimensions. The split-half coefficient was 0.861 for the total scale and ranged from 0.727 to 0.856 for induvial dimensions. The test-retest coefficient was 0.846 for the total scale and ranged from 0.843 to 0.868 for induvial dimensions.ConclusionThe developed scale for the risk perception of public health emergencies showed acceptable levels of reliability and validity, suggesting that it is suitable for evaluating residents' risk perception of public health emergencies.

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COVID-19, a worldwide public health emergency? COVID-19, una emergencia de salud publica mundial

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