COVID-19 in the Caribbean small island developing states: lessons learnt from extreme weather events.
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ABSTRACT:
SUBMITTER: Hambleton IR
PROVIDER: S-EPMC7332258 | biostudies-literature | 2020 Sep
REPOSITORIES: biostudies-literature
Publications
COVID-19 in the Caribbean small island developing states: lessons learnt from extreme weather events.
Hambleton Ian R IR Jeyaseelan Selvi M SM Murphy Madhuvanti M MM
The Lancet. Global health 20200702 9
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Project description:Background Small island developing states (SIDS) have limited absolute resources for responding to national disasters, including health emergencies. Since the first confirmed case of COVID-19 in the Caribbean on 1st March 2020, non-pharmaceutical interventions (NPIs) have been widely used to control the resulting COVID-19 outbreak. We document the variety of government measures introduced across the Caribbean and explore their impact on aspects of outbreak control. Methods Drawing on publically available information, we present confirmed cases and confirmed deaths to describe the extent of the Caribbean outbreak. We document the range of outbreak containment measures implemented by national Governments, focussing on measures to control movement and gatherings. We explore the temporal association of containment measures with the start of the outbreak in each country, and with aggregated information on human movement, using smartphone positioning data. We include a set of comparator countries to provide an international context. Results As of 25th May, the Caribbean reported 18,755 confirmed cases and 631 deaths. There have been broad similarities but also variation in the number, the type, the intensity, and particularly the timing of the NPIs introduced across the Caribbean. On average, Caribbean governments began controlling movement into countries 27 days before their first confirmed case and 23 days before comparator countries. Controls on movement within country were introduced 9 days after the first case and 36 days before comparators. Controls on gatherings were implemented 1 day before the first confirmed case and 30 days before comparators. Confirmed case growth rates and numbers of deaths have remained low across much the Caribbean. Stringent Caribbean curfews and stay-at-home orders coincided with large reductions in community mobility, regularly above 60%, and higher than most international comparator countries. Conclusion Stringent controls to limit movement, and specifically the early timing of those controls has had an important impact on containing the spread of COVID-19 across much of the Caribbean. Very early controls to limit movement into countries may well be particularly effective for small island developing states. With much of the region economically reliant on international tourism, and with steps to open borders now being implemented, it is critical that the region draws on a solid evidence-base to balance the competing demands of economic wellbeing and public health.
| S-EPMC7402372 | biostudies-literature
Project description:BackgroundSmall island developing states (SIDS) have particular mental health system needs due to their remoteness and narrow resource base. We conducted situational analyses to support mental health system strengthening in six SIDS: Anguilla, Bermuda, British Virgin Islands, Cayman Islands, Montserrat and Turks and Caicos Islands.MethodsThe situational analyses covered five domains: 1. Socio-economic context and burden of mental disorders, 2. Leadership and governance for mental health 3. Mental health and social care services 4. Strategies for promotion and prevention in mental health and 5. Information systems, evidence and research for mental health. First, a desk-based exercise was conducted, in which data was drawn from the public domain. Second, a field visit was conducted at each site, comprising visits to facilities and consultation meetings with key stakeholders.ResultsOur key findings were 1. Despite most of these SIDS being high-income economies, social inequalities within states exist. There was no population-level data on mental health burden. 2. All SIDS have a mental health policy or plan, but implementation is typically limited due to lack of funds or staff shortages. There was minimal evidence of service user involvement in policy or service development. 3. All SIDS have a specialist, multi-disciplinary mental health workforce, however Montserrat and Anguilla rely on visiting psychiatrists. Child and adolescent and dedicated crisis intervention services were found in only two and one SIDS respectively. A recovery-oriented ethos was not identified in any SIDS. 4. Mental illness stigma was prevalent in all SIDS. Promotion and prevention were objectives of mental health strategies for all SIDS, however activities tended to be sporadic. No mental health non-Governmental organisations were identified in three SIDS. 5. Health information systems are generally underdeveloped, with paper-based systems in three SIDS. There has been no rigorous local mental health research.ConclusionCross-cutting recommendations include: to develop mental health action plans that include clear implementation indicators; to facilitate community surveys to ascertain the prevalence of mental disorders; to explore task-sharing approaches to increase access to primary mental health care; and to develop programmes of mental health promotion and prevention.
| S-EPMC9372926 | biostudies-literature
Project description:BackgroundCOVID-19 became a global pandemic within weeks, as every country including small states and islands experienced a surge in cases. Small islands are known to face several challenges in the quest to curb the viral spread, but with the absence of land boarders and small population size, these factors should have played to their advantage to minimize the spread. The aim of this article was to compare and contrast the COVID-19 situation, restrictions, preparedness, management and the healthcare systems between the small population island states of Cyprus, Iceland and Malta.MethodsData were obtained from Ministry of Health websites and COVID dashboards of the three respective Island states in Europe. Comparisons were made between the reported cases, deaths, excess deaths, years of life lost, swabbing rates, restrictive measures, vaccination roll-out and healthcare system structures.ResultsCyprus and Malta contained the COVID-19 spread better than Iceland during the first wave. However, a significantly higher viral spread and mortality rates were observed in Malta during the second waves. Similar healthcare preparedness and services, restrictions and relaxation measures were implemented across the three islands with some exceptions. Covid-19 vaccination has initiated across all Islands with Malta leading the vaccination roll-out.ConclusionThe small population size and island status proved to be an asset during the first wave of COVID-19, but different governance approaches led to a different COVID-19 outcomes, including high mortality rates during the transition phases and the subsequent waves.
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Project description:Extreme weather and climate-related events occur in a particular place, by definition, infrequently. It is therefore challenging to detect systematic changes in their occurrence given the relative shortness of observational records. However, there is a clear interest from outside the climate science community in the extent to which recent damaging extreme events can be linked to human-induced climate change or natural climate variability. Event attribution studies seek to determine to what extent anthropogenic climate change has altered the probability or magnitude of particular events. They have shown clear evidence for human influence having increased the probability of many extremely warm seasonal temperatures and reduced the probability of extremely cold seasonal temperatures in many parts of the world. The evidence for human influence on the probability of extreme precipitation events, droughts, and storms is more mixed. Although the science of event attribution has developed rapidly in recent years, geographical coverage of events remains patchy and based on the interests and capabilities of individual research groups. The development of operational event attribution would allow a more timely and methodical production of attribution assessments than currently obtained on an ad hoc basis. For event attribution assessments to be most useful, remaining scientific uncertainties need to be robustly assessed and the results clearly communicated. This requires the continuing development of methodologies to assess the reliability of event attribution results and further work to understand the potential utility of event attribution for stakeholder groups and decision makers. WIREs Clim Change 2016, 7:23-41. doi: 10.1002/wcc.380 For further resources related to this article, please visit the WIREs website.
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Project description:Flood, drought, and frost may be disruptive events for agriculture. The subsidised crop insurance schemes are coping strategies that increase farms resilience to weather shocks and in fact the occurrence of extreme weather events and the level of subsidised crop insurance are correlated. Stronger evidence is found in Southern geographical areas, where drought (a major risking risk) is more frequent, and for spring-summer crops, that are less resilient to weather shocks. The article points at the need to reform extant policies to move toward a holistic approach for risk management.
| S-EPMC10979153 | biostudies-literature
Project description:Ensuring healthy and sustainable food systems in increasing social, economic, and ecological change is a key global priority to protect human and environmental health. Seafood is an essential component of these food systems and a critical source of nutrients, especially in coastal communities. However, despite rapid transformations in aquatic food systems, and our urgent need to understand them, there is a dearth of data connecting harvested food production to actualized food consumption. Many analyses suggest institutional, legal, or technological innovations to improve food systems, but few have analyzed the pathways through which people already gain access to nutritious food. Here, using a random forest model and cluster analysis of a nationally representative data set from Kiribati, we operationalize access theory to trace the flows of consumptive benefit in a fisheries-based food system. We demonstrate that the market access mechanism is the key mechanism mediating seafood access in Kiribati, but importantly, the highest seafood consumption households showed lower market access, pointing to the importance of non-market acquisition (e.g., home production and gifting). We reveal six distinct household strategies that employ different sets of access mechanisms to ensure high levels of local seafood consumption in different contexts. We demonstrate the impacts of these strategies on the composition of household seafoods consumed, stressing the need to support these existing successful strategies. Finally, we point to key policy and management insights (e.g., improved infrastructure, shifts in species management) that may be more effective in reinforcing these existing pathways than commonly proposed food system interventions.
| S-EPMC10873629 | biostudies-literature
Project description:At a global level, climate change is expected to result in more frequent and higher-intensity weather events, with impacts ranging from inconvenient to catastrophic. The potential for disasters to act as "focusing events" for policy change, including adaptation to climate change risk, is well known. Moreover, local action is an important element of climate change adaptation and related risk management efforts. As such, there is a good reason to expect local communities to mobilize in response to disaster events, both with immediate response and recovery-focused activities, as well as longer-term preparedness and adaptation-focused public policy changes. However, scholars also note that the experience of disaster does not always yield policy change; indeed, disasters can also result in policy inertia and failure, perhaps as often or more often than major policy change. This study poses two key research questions. First, we ask to what degree policy change occurs in communities impacted by an extreme weather event. Second, we seek to understand the conditions that lead to adaptation-oriented policy adoption in response to an extreme weather event. Our results suggest two main recipes for future-oriented policy adoption in the wake of an extreme weather event. For both recipes, a high-impact event is a necessary condition for future-oriented policy adoption. In the first recipe for change, policy adoption occurs in Democratic communities with highly focused media attention. The second, less expected recipe for change involves Republican communities that have experienced other uncommon weather events in the recent past. We use a comparative case approach with 15 cases and fuzzy set qualitative comparative analysis methods. Our approach adds to the existing literature on policy change and local adaptation by selecting a mid-N range of cases where extreme weather events have the potential to act as focusing events, thereby sidestepping selection on the dependent variable. Our approach also takes advantage of a novel method for measuring attention, the latent Dirichlet allocation approach.
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Project description:Global climate change is expected to affect the frequency, intensity and duration of extreme water-related weather events such as excessive precipitation, floods, and drought. We conducted a systematic review to examine waterborne outbreaks following such events and explored their distribution between the different types of extreme water-related weather events. Four medical and meteorological databases (Medline, Embase, GeoRef, PubMed) and a global electronic reporting system (ProMED) were searched, from 1910 to 2010. Eighty-seven waterborne outbreaks involving extreme water-related weather events were identified and included, alongside 235 ProMED reports. Heavy rainfall and flooding were the most common events preceding outbreaks associated with extreme weather and were reported in 55·2% and 52·9% of accounts, respectively. The most common pathogens reported in these outbreaks were Vibrio spp. (21·6%) and Leptospira spp. (12·7%). Outbreaks following extreme water-related weather events were often the result of contamination of the drinking-water supply (53·7%). Differences in reporting of outbreaks were seen between the scientific literature and ProMED. Extreme water-related weather events represent a risk to public health in both developed and developing countries, but impact will be disproportionate and likely to compound existing health disparities.
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Project description:An increase in the intensity and frequency of extreme events is predicted to occur as a result of climate change. In coastal ecosystems, hurricanes and flooding can cause dramatic changes in water quality resulting in large mortality events in estuarine fauna. Facultative migration behaviors represent a key adaptation by which animals can evacuate ecological catastrophes, but remain poorly studied in marine systems. Here we identify coastal evacuations by otherwise resident riverine striped bass in the Hudson River Estuary, New York, USA, caused by an intense period of tropical storms in autumn 2011. These storms produced record rainfall and high water discharges into the Hudson River Estuary that increased the water level and reduced the water temperature, salinity and dissolved oxygen levels. Striped bass moved out of the estuary, exhibiting novel migration behaviours, that may have been in response to the strong flow and unsuitable conditions. In the months following the storms, some fish demonstrated exploratory trips back to the estuary, which may have been to assess the conditions before returning for the remainder of the winter. Behavioural adaptions to weather events by striped bass and other coastal fishes will depend on maintenance of key population segments and unimpeded evacuation routes.
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Project description:Since 1975, northern fur seal (Callorhinus ursinus) numbers at the Pribilof Islands (PI) in the Bering Sea have declined rapidly for unknown reasons. Migratory dispersal and habitat choice may affect first-year survivorship, thereby contributing to this decline. We compared migratory behaviour of 166 naive pups during 2 years from islands with disparate population trends (increasing: Bogoslof and San Miguel Islands; declining: PI), hypothesizing that climatic conditions at weaning may differentially affect dispersal and survival. Atmospheric conditions (Bering Sea) in autumn 2005-2006 were anomalously cold, while 2006-2007 was considerably warmer and less stormy. In 2005, pups departed earlier at all sites, and the majority of PI pups (68-85%) departed within 1 day of Arctic storms and dispersed quickly, travelling southwards through the Aleutian Islands. Tailwinds enabled faster rates of travel than headwinds, a trend not previously shown for marine mammals. Weather effects were less pronounced at Bogoslof Island (approx. 400 km further south), and, at San Miguel Island, (California) departures were more gradual, and only influenced by wind and air pressure in 2005. We suggest that increasingly variable climatic conditions at weaning, particularly timing, frequency and intensity of autumnal storms in the Bering Sea, may alter timing, direction of dispersal and potentially survival of pups.
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