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Epidemic trends, public health response and health system capacity: the Chilean experience in four months of the COVID-19 pandemic.

ABSTRACT: Objectives:To report the surveillance of COVID-19 pandemic in Chile and analyse the response to public health interventions implemented from 3 March to 30 June 2020 and to assess the risks of collapse of the health care system. Methods:We analysed the effective reproductive number, underreporting of cases, burden of critical beds, case fatality ratio and number of diagnostic RT-PCR for SARS-CoV-2. Results:After an accelerated onset, the COVID-19 pandemic seemed to be relatively controlled in Chile (late April 2020), with reproductive numbers close to 1.00. However, at this time, the load of infected patients was high, with an important number of underreported cases; the diagnostic effort was still limited and heterogeneous across regions. After 1 May up to 30 June a marked exponential increase in the number of cases was observed with a peak on June 14. In this last period the occupation of intensive care unit beds increased to saturation level (89% nationally; 95% in the Metropolitan Region). Conclusions:Our findings suggest that the implemented public health interventions have been initially effective in decreasing the spread of the pandemic. Premature decisions to relax these interventions may have resulted in a rebound in cases with a rapid saturation of the health care system.

SUBMITTER: Canals M

PROVIDER: S-EPMC7429930 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Epidemic trends, public health response and health system capacity: the Chilean experience in four months of the COVID-19 pandemic.

Canals Mauricio M Cuadrado Cristóbal C Canals Andrea A Yohannessen Karla K Lefio Luis A LA Bertoglia Maria P MP Eguiguren Pamela P Siches Izkia I Iglesias Verónica V Arteaga Oscar O

Revista panamericana de salud publica = Pan American journal of public health 20200817

<h4>Objectives</h4>To report the surveillance of COVID-19 pandemic in Chile and analyse the response to public health interventions implemented from 3 March to 30 June 2020 and to assess the risks of collapse of the health care system.<h4>Methods</h4>We analysed the effective reproductive number, underreporting of cases, burden of critical beds, case fatality ratio and number of diagnostic RT-PCR for SARS-CoV-2.<h4>Results</h4>After an accelerated onset, the COVID-19 pandemic seemed to be relati ...[more]

PMID: 32821259

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Project description:Prior experience and the persisting threat of influenza pandemic indicate the need for global and local preparedness and public health response capacity. The pandemic of 2009 highlighted the importance of such planning and the value of prior efforts at all levels. Our review of the public health response to this pandemic in Pune, India, considers the challenges of integrating global and national strategies in local programmes and lessons learned for influenza pandemic preparedness.Global, national and local pandemic preparedness and response plans have been reviewed. In-depth interviews were undertaken with district health policy-makers and administrators who coordinated the pandemic response in Pune.In the absence of a comprehensive district-level pandemic preparedness plan, the response had to be improvised. Media reporting of the influenza pandemic and inaccurate information that was reported at times contributed to anxiety in the general public and to widespread fear and panic. Additional challenges included inadequate public health services and reluctance of private healthcare providers to treat people with flu-like symptoms. Policy-makers developed a response strategy that they referred to as the Pune plan, which relied on powers sanctioned by the Epidemic Act of 1897 and resources made available by the union health ministry, state health department and a government diagnostic laboratory in Pune.The World Health Organization's (WHO's) global strategy for pandemic control focuses on national planning, but state-level and local experience in a large nation like India shows how national planning may be adapted and implemented. The priority of local experience and requirements does not negate the need for higher level planning. It does, however, indicate the importance of local adaptability as an essential feature of the planning process. Experience and the implicit Pune plan that emerged are relevant for pandemic preparedness and other public health emergencies.

Project description:BACKGROUND:Although long-term alcohol and tobacco use have widely been recognised as important risk factors for cancer, the impacts of alcohol and tobacco health policies on cancer mortality have not been examined in previous studies. This study aims to estimate the association of key alcohol and tobacco policy or events in Australia with changes in overall and five specific types of cancer mortality between the 1950s and 2013. METHODS:Annual population-based time-series data between 1911 and 2013 on per capita alcohol and tobacco consumption and head and neck (lip, oral cavity, pharynx, larynx and oesophagus), lung, breast, colorectum and anus, liver and total cancer mortality data from the 1950s to 2013 were collected from the Australian Bureau of Statistics and Cancer Council Victoria, the WHO Cancer Mortality Database and the Australian Institute of Health and Welfare. The policies with significant relations to changes in alcohol and tobacco consumption were identified in an initial model. Intervention dummies with estimated lags were then developed based on these key alcohol and tobacco policies and events and inserted into time-series models to estimate the relation of the particular policy changes with cancer mortality. RESULTS:Liquor licence liberalisation in the 1960s was significantly associated with increases in the level of population drinking and thereafter of male cancer mortality. The introduction of random breath testing programs in Australia after 1976 was associated with a reduction in population drinking and thereafter in cancer mortality for both men and women. Meanwhile, the release of UK and US public health reports on tobacco in 1962 and 1964 and the ban on cigarette ads on TV and radio in 1976 were found to have been associated with a reduction in Australian tobacco consumption and thereafter a reduction in mortality from all cancer types except liver cancer. Policy changes on alcohol and tobacco during the 1960s-1980s were associated with greater changes for men than for women, particularly for head and neck, lung and colorectum cancer sites. CONCLUSION:This study provides evidence that some changes to public health policies in Australia in the twentieth century were related to the changes in the population consumption of alcohol and tobacco, and in subsequent mortality from various cancers over the following 20?years.

Project description:BackgroundThe COVID-19 pandemic and its associated national lockdowns have been linked to deteriorations in mental health worldwide. A number of studies analysed changes in mental health indicators during the pandemic; however, these studies generally had a small number of timepoints, and focused on the initial months of the pandemic. Furthermore, most studies followed-up the same individuals, resulting in significant loss to follow-up and biased estimates of mental health and its change. Here we report on time trends in key mental health indicators amongst Danish adults over the course of the pandemic (March 2020 - July 2021) focusing on subgroups defined by gender, age, and self-reported previously diagnosed chronic and/or mental illness.MethodsWe used time-series data collected by Epinion (N=8,261) with 43 timepoints between 20 March 2020 and 22 July 2021. Using a repeated cross-sectional study design, independent sets of individuals were asked to respond to the Copenhagen Corona-Related Mental Health questionnaire at each timepoint, and data was weighted to population proportions. The six mental health indicators examined were loneliness, anxiety, social isolation, quality of life, COVID-19-related worries, and the mental health scale. Gender, age, and the presence of previously diagnosed mental and/or chronic illness were used to stratify the population into subgroups for comparisons.ResultsPoorer mental health were observed during the strictest phases of the lockdowns, whereas better outcomes occurred during reopening phases. Women, young individuals (<34 yrs), and those with a mental- and/or chronic illness demonstrated poorer mean time-series than others. Those with a pre-existing mental illness further had a less reactive mental health time-series. The greatest differences between women/men and younger/older age groups were observed during the second lockdown.ConclusionsPeople with mental illness have reported disadvantageous but stable levels of mental health indicators during the pandemic thus far, and they seem to be less affected by the factors that result in fluctuating time-series in other subgroups.

Dataset Information

Epidemic trends, public health response and health system capacity: the Chilean experience in four months of the COVID-19 pandemic.

Publications

Epidemic trends, public health response and health system capacity: the Chilean experience in four months of the COVID-19 pandemic.

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