Epidemiol Prev
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The determinants of the risk of becoming infected by SARS-CoV-2, contracting COVID-19, and being affected by the more serious forms of the disease have been generally explored in merely qualitative terms. It seems reasonable to argue that the risk patterns for COVID-19 have to be usefully studied in quantitative terms too, whenever possible applying the same approach to the relationship 'dose of the exposure vs pathological response' commonly used for chemicals and already followed for several biological agents to SARS-CoV-2, too. Such an approach is of particular relevance in the fields of both occupational epidemiology and occupational medicine, where the identification of the sources of a dangerous exposure and of the web of causation of a disease is often questionable and questioned: it is relevant when evaluating the population risk, too. ⋯ A limited but consistent set of papers supporting these assumptions has been traced in the literature. Under these premises, the creation of a structured inventory of both values of viral concentrations in the air (in case and if possible, of surface contaminations too) and of viral loads in biological matrixes is proposed, with the subsequent construction of a scenario-exposure matrix. A scenario-exposure matrix for SARS-CoV-2 may represent a useful tool for research and practical risk management purposes, helping to understand the possibly critical circumstances for which no direct exposure measure is available (this is an especially frequent case, in contexts of low socio-economic level) and providing guidance to determine evidence-based public health strategies.
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Comparative Study
COVID-19 in Africa: the little we know and the lot we ignore.
COVID has stirred up an information deluge that challenges our capacity to absorb and make sense of data. In this unrelenting flow of information, Africa has been largely off the radar, escaping the attention of the scientific literature and the media. International agencies have been the exception: despite the still low numbers of cases and deaths, they have voiced concerns, often in catastrophic terms, on the health, economic and social impacts of COVID in African countries. ⋯ The paper concludes with the recommendation that affected communities should be engaged in the response, to maintain or build trust. A lesson from the Ebola outbreak of a few years ago was that epidemiologists and community leaders learned, after initial difficulties, how to dialogue and work together. A summary update of the pandemic has been added, in view of its fast evolution.
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about two months after the end of the lockdown imposed for the containment of the SARS-CoV-2 epidemic, the contagion dynamics in the Tuscany Region (Central Italy) have been assessed from the beginning of the emergency to the end of June through a compartmental model, and future medium-long term projections have been produced. ⋯ the estimated trend of R0(t) is suggestive of a strong effect of the lockdown in Tuscany and of a mild increase of the contagion potentially attributable to the easing of the containment measures. Medium-long term projections unequivocally indicate that the danger of a new epidemic wave has not been averted.
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the first confirmed cases of COVID-19 in WHO European Region was reported at the end of January 2020 and, from that moment, the epidemic has been speeding up and rapidly spreading across Europe. The health, social, and economic consequences of the pandemic are difficult to evaluate, since there are many scientific uncertainties and unknowns. ⋯ despite the variety of approaches to calculate excess mortality, this study provides an original methodological approach to profile municipalities with excess deaths accounting for spatial and temporal uncertainty.
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to describe the overall mortality increase in the provinces of Milan and Lodi - area covered by the Agency for Health Protection of Milan - during the COVID-19 epidemic in the first four months of 2020, compare it with the same time period in the years 2016-2019, and evaluate to what extent the mortality can be directly attributed to the outbreak. ⋯ evaluation of overall mortality in the provinces of Milan and Lodi during the first wave of the Covid-19 epidemic showed a significant excess compared to the first 4 months of the years 2016-2019, mainly in the population over 60 years of age. However, this excess cannot be completely attributed directly to COVID-19 itself. This phenomenon was more intense in the Lodi ASST, with daily deaths up to 5 times higher than expected.