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Journal ArticleDOI

Anticipating the impact of COVID19 and comorbidities on the South African healthcare system by agent-based simulations.

TL;DR: Using WHO’s TB and public infrastructure data, it is conservatively estimated that the symptomatic critical case rate is between 8 and 12% due to the interaction of COVID-19 and TB, for a TB population of 0.52% in South Africa.
Abstract: Tuberculosis (TB) is the 10th leading cause of death worldwide, and since 2007 it has been the main cause of death from a single infectious agent, ranking above HIV/AIDS. The current COVID-19 is a pandemic which caused many deaths around the world. The danger is not only a coinfection as observed for TB and HIV for a long time, but that both TB and SARS-CoV-2 affect the respiratory organs and thus potentiate their effect or accelerate the critical course. A key public health priority during the emergence of a novel pathogen is the estimation of the clinical need to assure adequate medical treatment. This requires a correct adjustment to the critical case detection rate and the prediction of possible scenarios based on known patterns. The African continent faces constraining preconditions in regard to healthcare capacities and social welfare which may hinder required countermeasures. However, given the high TB prevalence rates, COVID-19 may show a particular severe course in respective African countries, e.g. South Africa. Using WHO's TB and public infrastructure data, we conservatively estimate that the symptomatic critical case rate, which affects the healthcare system, is between 8 and 12% due to the interaction of COVID-19 and TB, for a TB population of 0.52% in South Africa. This TB prevalence leads to a significant increase in the peak load of critical cases of COVID-19 patients and potentially exceeds current healthcare capacities.

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Journal ArticleDOI
TL;DR: In this article , the authors estimated age-specific and all-age IFR by matching seroprevalence surveys to total COVID-19 mortality rates in a population.

106 citations

Journal ArticleDOI
TL;DR: In this article , Malawian healthcare workers' (HCWs) COVID-19 vaccination and its hypothesized determinants were studied and adjusted multivariable logistic regression models were explored to explore how "what people think and feel" constructs were associated with HCWs' motivation to be vaccinated.

25 citations

Journal Article
TL;DR: The authors in this article show that the health impact of COVID-19 is likely to be far more substantial and longlasting in countries with high incidences of tuberculosis and HIV than in those with low incidences.

14 citations

Journal ArticleDOI
TL;DR: HCWs in Malawi have a high motivation to be vaccinated and a high COVID-19 vaccine uptake, and disseminating vaccine benefits and safety messages via social media and social networks may be persuasive for individuals who are unmotivated to be vaccinating and less likely to accept the COVID the19 vaccine.

13 citations

References
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Journal ArticleDOI
TL;DR: During the first 2 months of the current outbreak, Covid-19 spread rapidly throughout China and caused varying degrees of illness, and patients often presented without fever, and many did not have abnormal radiologic findings.
Abstract: Background Since December 2019, when coronavirus disease 2019 (Covid-19) emerged in Wuhan city and rapidly spread throughout China, data have been needed on the clinical characteristics of...

22,622 citations

Book ChapterDOI
01 Jan 1983
TL;DR: In this paper, an older economist who has lived through many cycles of intellectual fashion (and of general waves of optimism and pessimism) has had more occasion to rethink the ways of approaching the economic problems of the world than those of you who have the enviable misfortune of being younger.
Abstract: I have been asked to sum up my views on the economic outlook of the world in twenty minutes from the point of view of an older economist who has lived through many cycles of intellectual fashion (and of general waves of optimism and pessimism) and thus, if only on account of age, has had more occasion to rethink the ways of approaching the economic problems of the world than those of you who have the enviable misfortune of being younger. The one clear result I have reached is that it is no use applying established ‘models’ or methods of thought when confronted with a new situation that was largely unforeseen. You must start by asking which was the particular feature that your previous method failed to take on board. As Keynes once said, the difficult and the creative part in the progress of thought lies in discarding old ideas, a far more difficult task than inventing new ones.

2,217 citations

Journal ArticleDOI
TL;DR: An estimation of the clinical severity of COVID-19, based on the data available so far, can help to inform the public health response during the ongoing SARS-CoV-2 pandemic.
Abstract: As of 29 February 2020 there were 79,394 confirmed cases and 2,838 deaths from COVID-19 in mainland China. Of these, 48,557 cases and 2,169 deaths occurred in the epicenter, Wuhan. A key public health priority during the emergence of a novel pathogen is estimating clinical severity, which requires properly adjusting for the case ascertainment rate and the delay between symptoms onset and death. Using public and published information, we estimate that the overall symptomatic case fatality risk (the probability of dying after developing symptoms) of COVID-19 in Wuhan was 1.4% (0.9–2.1%), which is substantially lower than both the corresponding crude or naive confirmed case fatality risk (2,169/48,557 = 4.5%) and the approximator1 of deaths/deaths + recoveries (2,169/2,169 + 17,572 = 11%) as of 29 February 2020. Compared to those aged 30–59 years, those aged below 30 and above 59 years were 0.6 (0.3–1.1) and 5.1 (4.2–6.1) times more likely to die after developing symptoms. The risk of symptomatic infection increased with age (for example, at ~4% per year among adults aged 30–60 years). An estimation of the clinical severity of COVID-19, based on the data available so far, can help to inform the public health response during the ongoing SARS-CoV-2 pandemic.

1,205 citations

Journal ArticleDOI
TL;DR: Streamlining of workflows for rapid diagnosis and isolation, clinical management, and infection prevention will matter not only to patients with COVID-19, but also to health-care workers and other patients who are at risk from nosocomial transmission.

1,147 citations

Journal ArticleDOI
TL;DR: A significantly decreased growth rate and increased doubling time of cases was observed, which is most likely due to Chinese lockdown measures, which seem to have a potential to slow down the spread of COVID-19.
Abstract: BACKGROUND With its epicenter in Wuhan, China, the COVID-19 outbreak was declared a Public Health Emergency of International Concern by the World Health Organization (WHO). Consequently, many countries have implemented flight restrictions to China. China itself has imposed a lockdown of the population of Wuhan as well as the entire Hubei province. However, whether these two enormous measures have led to significant changes in the spread of COVID-19 cases remains unclear. METHODS We analyzed the available data on the development of confirmed domestic and international COVID-19 cases before and after lockdown measures. We evaluated the correlation of domestic air traffic to the number of confirmed COVID-19 cases and determined the growth curves of COVID-19 cases within China before and after lockdown as well as after changes in COVID-19 diagnostic criteria. RESULTS Our findings indicate a significant increase in doubling time from 2 days (95% CI: 1.9-2.6) to 4 days (95% CI: 3.5-4.3), after imposing lockdown. A further increase is detected after changing diagnostic and testing methodology to 19.3 (95% CI: 15.1-26.3), respectively. Moreover, the correlation between domestic air traffic and COVID-19 spread became weaker following lockdown (before lockdown: r = 0.98, P < 0.05 vs after lockdown: r = 0.91, P = NS). CONCLUSIONS A significantly decreased growth rate and increased doubling time of cases was observed, which is most likely due to Chinese lockdown measures. A more stringent confinement of people in high risk areas seems to have a potential to slow down the spread of COVID-19.

982 citations

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