Project description:Whether lockdown related to the COVID-19 pandemic influences alcohol consumption is not well known. This study assesses alcohol consumption and hazardous drinking behavior during the initial phase of pandemic measures in Norway and identifies potential risk factors. A cross-sectional study (N = 25,708) was conducted in Bergen, Norway, following the first six weeks of strict infection control measures. In a model of self-assessed increased alcohol consumption, logistic regression analysis was conducted with independent variables for COVID-19-related worries, joblessness, quarantine, self-reported drinking behavior, age, gender, and occupational situation. These are reported with odds ratios (ORs) with 95% confidence intervals. Fifty-one percent of respondents reported economic or health-related worries due to COVID-19, 16% had been in quarantine, 49% worked/studied from home, 54% reported hazardous drinking behavior, and 13% reported increased alcohol consumption. People aged 30-39 years had elevated odds of increased alcohol consumption during lockdown (OR 3.1, 2.4-3.8) compared to the oldest adults. Increased drinking was more frequent among people reporting economic worries (OR 1.6, 1.4-1.8), those quarantined (OR 1.2, 1.1-1.4), and those studying or working at home (OR 1.4, 1.3-1.6). More than half of respondents reported hazardous drinking behavior. Increased alcohol consumption during lockdown was common among people with economic worries, people in quarantine, and people studying or working at home. These data could be important when adjusting pandemic measures.
Project description:ObjectivesTo assess the risks associated with relaxing coronavirus disease 2019 (COVID-19)-related physical distancing restrictions and lockdown policies during a period of low viral transmission.DesignNetwork-based viral transmission risks in households, schools, workplaces, and a variety of community spaces and activities were simulated in an agent-based model, Covasim.SettingThe model was calibrated for a baseline scenario reflecting the epidemiological and policy environment in Victoria during March-May 2020, a period of low community viral transmission.InterventionPolicy changes for easing COVID-19-related restrictions from May 2020 were simulated in the context of interventions that included testing, contact tracing (including with a smartphone app), and quarantine.Main outcome measureIncrease in detected COVID-19 cases following relaxation of restrictions.ResultsPolicy changes that facilitate contact of individuals with large numbers of unknown people (eg, opening bars, increased public transport use) were associated with the greatest risk of COVID-19 case numbers increasing; changes leading to smaller, structured gatherings with known contacts (eg, small social gatherings, opening schools) were associated with lower risks. In our model, the rise in case numbers following some policy changes was notable only two months after their implementation.ConclusionsRemoving several COVID-19-related restrictions within a short period of time should be undertaken with care, as the consequences may not be apparent for more than two months. Our findings support continuation of work from home policies (to reduce public transport use) and strategies that mitigate the risk associated with re-opening of social venues.
Project description:AimsTo review the consequences of the changes in Finnish alcohol policy in 2004, when quotas for travellers' tax-free imports of alcoholic beverages from other European Union (EU) countries were abolished, Estonia joined the EU and excise duties on alcoholic beverages were reduced in Finland by one-third, on average.DesignA review of published research and routinely available data.SettingFinland.MeasurementsPrices of alcoholic beverages, recorded and unrecorded alcohol consumption, data on criminality and other police statistics, alcohol-related deaths and hospitalizations, service use.FindingsAlcohol consumption increased 10% in 2004, clearly more than in the early 2000s. With few exceptions, alcohol-related harms increased. Alcohol-induced liver disease deaths increased the most, by 46% in 2004-06 compared to 2001-03, which indicates a strong effect on pre-2004 heavy drinkers. Consumption and harms increased most among middle-aged and older segments of the population, and harms in the worst-off parts of the population in particular.ConclusionsAlcohol taxation and alcohol prices affect consumption and related harms, and heavy drinkers are responsive to price. In Finland in 2004, the worst-off parts of the population paid the highest price in terms of health for cuts in alcohol prices. The removal of travellers' import quotas, which was an inherent part of creating the single European market, had serious public health consequences in Finland.
Project description:Background: This study aimed to assess the impacts of achieving a 10% alcohol reduction target and different alcohol policy interventions on NCD premature deaths during 2010-2025 in Thailand. Methods: The researchers estimated the impacts on three main NCDs: cancers, cardiovascular diseases, and diabetes. These represent two ideal scenarios, which are the target reduction and five intervention scenarios. These intervention scenarios comprise taxation with 50% price increases, a total ban on advertisements, availability restriction by shortening sales times, early psychological intervention, and combined interventions. Consumption data and mortality trends were obtained from available national data. Relative risks and intervention effects were derived from the literature. Results: Achieving a 10% reduction target would lead to 3903-7997 avoidable NCD deaths. Taxation was the most effective intervention, with the highest number of avoidable NCD deaths, followed by early psychological intervention, availability restriction, and an advertisement ban. A combination of these four interventions would reduce 13,286 NCD deaths among men and 4994 NCD deaths among women, accounting for 46.8% of the NCD mortality target. Conclusion: This study suggests using Thailand as an example for low- and middle-income countries to enhance implementation and enforcement of the recommended effective alcohol policies for achieving the global targets.
Project description:ImportanceAlcohol consumption rates have been increasing among women in the US, which may affect mortality rates and sex gaps. Therefore, conducting a comprehensive assessment of sex differences in alcohol-related deaths is essential to inform targeted interventions and policies aimed at reducing the burden of alcohol-related harm among the population.ObjectiveTo examine sex differences in the burden and trends of alcohol-related mortality in the US from 1999 to 2020.Design, setting, and participantsThis cross-sectional time series study used Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research data on alcohol-related deaths from 1999 to 2020. Alcohol-related deaths were identified from the underlying cause of death files using International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, codes, including alcohol-related poisoning, liver disease, gastritis, cardiomyopathy, myopathy, polyneuropathy, and pseudo-Cushing syndrome, among others.Main outcomes and measuresAge-adjusted mortality rates (AAMRs) were analyzed by sex and substratified by race and ethnicity, age, and census region. Rate ratios and 95% CIs calculated by Taylor series were used to assess sex differences in mortality burden. Joinpoint regression was used to assess temporal trends.ResultsA total of 605 948 alcohol-attributed deaths were identified in the US from 1999 through 2020 (AAMR, 8.3 per 100 000 persons; 95% CI, 8.3-8.3 per 100 000 persons). The mortality burden was higher among male individuals than female individuals, with male individuals being 2.88 (95% CI, 2.86-2.89) times more likely to die compared with female individuals. However, temporal trends showed an increase in alcohol-related deaths for both male and female individuals in recent years, with higher rates of increase among female individuals relative to male individuals. The AAMR increased by 12.5% (95% CI, 6.4%-19.1%) per year among male individuals from 2018 to 2020 but increased by 14.7% (95% CI, 9.1%-20.5%) per year among female individuals during the same period. Trend differences were observed across subtypes of age, race and ethnicity, cause, and region.Conclusions and relevanceThis study of alcohol-related mortality in the US suggests there has been a significantly higher rate of increase in deaths among female individuals in recent years. These findings underscore the need for further research to understand the specific factors associated with this trend. The development of targeted interventions and evidence-based treatments for alcohol use among female individuals becomes imperative in effectively addressing the increasing rates of alcohol-related deaths.
Project description:ObjectivesThis study aims to evaluate the public acceptance of coronavirus disease 2019 (COVID-19) control measures during the Omicron-dominant period and its associated factors.MethodsA cross-sectional design was conducted and 1391 study participants were openly recruited to participate in the questionnaire survey. Logistic regression model was performed to assess the association between the public acceptance and potential factors more specifically.ResultsBy August 26, 2022, 58.9% of the study participants were less acceptive of the control measures while 41.1% expressed higher acceptance. Factors associated with lower acceptance included young age, such as < 18 (OR = 8.251, 95% CI: 2.009 to 33.889) and 18-29 (OR = 2.349, 95% CI: 1.564 to 3.529), and household per capita monthly income lower than 5000 yuan (OR = 1.512, 95% CI: 1.085 to 2.105). Furthermore, individuals who perceived that the case fatality rate (CFR) of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) was very low (OR = 6.010, 95% CI: 2.475 to 14.595) and that the restrictions could be eased once the CFR dropped to 2-3 times of the influenza (OR = 2.792, 95% CI: 1.939 to 4.023) showed greater oppositional attitudes. Likewise, respondents who were dissatisfied with control measures (OR = 9.639, 95% CI: 4.425 to 20.998) or preferred fully relaxation as soon as possible (OR = 13.571, 95% CI: 7.751 to 23.758) had even lower acceptability. By contrast, rural residents (OR = 0.683, 95% CI: 0.473 to 0.987), students (OR = 0.510, 95% CI: 0.276 to 0.941), public (OR = 0.417, 95% CI: 0.240 to 0.727) and private (OR = 0.562, 95% CI: 0.320 to 0.986) employees, and vaccinated participants (OR = 0.393, 95% CI: 0.204 to 0.756) were more compliant with control measures.ConclusionMore than half of the Chinese public were less supportive of COVID-19 control measures during Omicron-dominant period, which varied based on their different demographic characteristics, cognition and overall attitude towards SARS-CoV-2 infection. Control measures that struck a balance between public safety and individual freedom would be more acceptable during the pandemic.
Project description:BackgroundGiven the nature of the spread of SARS-CoV-2, strong regional patterns in the fatal consequences of the COVID-19 pandemic related to local characteristics such as population and health care infrastructures were to be expected. In this paper we conduct a detailed examination of the spatial correlation of deaths in the first year of the pandemic in two neighbouring countries - Germany and Poland, which, among high income countries, seem particularly different in terms of the death toll associated with the COVID-19 pandemic. The analysis aims to yield evidence that spatial patterns of mortality can provide important clues as to the reasons behind significant differences in the consequences of the COVID-19 pandemic in these two countries.MethodsBased on official health and population statistics on the level of counties, we explore the spatial nature of mortality in 2020 in the two countries - which, as we show, reflects important contextual differences. We investigate three different measures of deaths: the officially recorded COVID-19 deaths, the total values of excessive deaths and the difference between the two. We link them to important pre-pandemic regional characteristics such as population, health care and economic conditions in multivariate spatial autoregressive models. From the point of view of pandemic related fatalities we stress the distinction between direct and indirect consequences of COVID-19, separating the latter further into two types, the spatial nature of which is likely to differ.ResultsThe COVID-19 pandemic led to much more excess deaths in Poland than in Germany. Detailed spatial analysis of deaths at the regional level shows a consistent pattern of deaths officially registered as related to COVID-19. For excess deaths, however, we find strong spatial correlation in Germany but little such evidence in Poland.ConclusionsIn contrast to Germany, for Poland we do not observe the expected spatial pattern of total excess deaths and the excess deaths over and above the official COVID-19 deaths. This difference cannot be explained by pre-pandemic regional factors such as economic and population structures or by healthcare infrastructure. The findings point to the need for alternative explanations related to the Polish policy reaction to the pandemic and failures in the areas of healthcare and public health, which resulted in a massive loss of life.
Project description:The ongoing COVID-19 pandemic has significantly limited social contacts, thus contributing to deepening isolation. Therefore, SARS-CoV-2 exerted on humanity not only a physical impact but also a psychological one, often increasing the feeling of stress. The long-term effects of such a state could include the management of depression, so our study aimed to analyze groups of medical students in different periods of the pandemic (at the beginning of the pandemic, after half a year of the pandemic, after one year of the pandemic) in order to assess the impact of this situation on coping with stress. The impact of the pandemic on the development of stress factors such as alcohol consumption and smoking was also studied. The level of physical activity in the context of coping with an uncertain situation was also assessed. The impact of the above-mentioned factors on the behavior of students, including the Mini-COPE questionnaire, AUDIT test, the Fagerström test and the IPAQ questionnaire was analyzed. It has been shown that as the pandemic and the lockdown progressed, patients consumed more often or larger amounts of alcohol, smoked more cigarettes, and levels of physical activity decreased. All these factors may have had some impact on the deterioration of coping with stress among the respondents, which would indicate that the COVID-19 pandemic significantly contributed to an increase in the sense of stress among the students.
Project description:We reviewed historical data from 2 smallpox outbreaks in Liverpool and Edinburgh during the early and middle years of the 20th century to assess their contribution to developing modern strategies for response to a deliberate release of smallpox virus. Reports contemporaneous to these outbreaks provide detail on the effectiveness of public health interventions. In both outbreaks, extensive contact tracing, quarantine, and staged vaccination campaigns were initiated, and the outbreaks were controlled within 15 months and 3 months, respectively. In Edinburgh, the number of fatalities associated with vaccination exceeded the number of deaths from the disease. In Liverpool, ambulatory, vaccine-modified cases and misdiagnosis as chickenpox resulted in problems with outbreak control. The relatively slow spread of smallpox, as exemplified by the report from Liverpool, allowed for effective implementation of targeted intervention methods. Targeted surveillance and containment interventions have been successful in the past and should be explored as alternatives to mass vaccination.
Project description:ObjectivesThis study examines recently revised Korean government legislation addressing global infectious disease control for public health emergency situations, with the aim of proposing more rational, effective and realistic interpretations and applications for improvement of law.MethodsThe Korea reported its first laboratory-confirmed case of Middle East Respiratory Syndrome (MERS) coronavirus on May 20, 2015. Since the first indexed case, Korean public health authorities enforced many public health measures that were not authorized in the law; the scope of the current law was too limited to cover MERS. Korea has three levels of government: the central government, special self-governing provinces, and si/gun/gu. Unfortunately, the Infectious Disease Control and Prevention Act does not designate the specific roles of each level of government, and does not state how these governmental branches should be vertically integrated in a state of emergency.ResultsWhen thinking about these policy questions, we should be especially concerned about introducing a new act that deals with all matters relevant to emerging infectious diseases. The aim would be to develop a structure that specifies the roles of each level of government, and facilitates the close collaboration among them, then enacting this in law for the prevention and response of infectious disease.ConclusionsTo address this problem, after analyzing the national healthcare infrastructure along with the characteristics of emerging infectious diseases, we propose the revision of the relevant law(s) in terms of governance aspects, emergency medical countermeasure aspects, and the human rights aspect.