Special Issue "Responding to COVID-19 from Local, Regional and Global Perspectives: Challenges and Solutions"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Environmental Health".

Deadline for manuscript submissions: 30 June 2021.

Special Issue Editors

Prof. Dr. Elena N. Naumova
E-Mail Website
Guest Editor
Division of Nutrition Epidemiology and Data Sciences, Freidman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA 02111, USA
Interests: development of statistical, mathematical and computational models for climate-sensitive infectious diseases; the use of big data, novel information sources and tools, including GIS and remote sensing in public health applications and environmental research
Special Issues and Collections in MDPI journals
Dr. Meghan A. Hartwick
E-Mail Website
Guest Editor
Data Scientist, Tufts Initiative for the Forecasting and Modeling of Infectious Diseases, Freidman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA 02111, USA
Interests: development of statistical, mathematical and computational models for zoonotic infectious diseases and antimicrobial resistance; the use of novel approaches, including bioinformatics in public health applications and environmental research

Special Issue Information

The ongoing pandemic of COVID-19 is affecting every aspect of the modern global community. This pandemic has revealed the bare-bones deficiencies of national health systems and unearthed issues many might have thought public health professionals had already resolved. The response to COVID-19 has already raised many questions as to who is affected, when and how these effects might manifest, and what public health interventions and strategies may help to control the infection. The delayed local and regional emergency responses, the crash of the global supply chain, the inequality in access to healthcare for the sick, the inequality in access to protective gear for medical personnel, the discordant and mixed messages of health officials and political leaders in establishing and releasing lockdowns–all aspects of the COVID-19 pandemic deserve serious attention and will be subjects for discussion for many years to come. In addition, there are many more questions which have not yet even been addressed, or which have only just emerged, for example: Will coronavirus-related infections settle into a predictable seasonal pattern? Will the transmission continue as hospital-acquired infections? Why are some communities affected more than others? Which prevention and control strategies are the likely to work in given conditions? What is needed to detect and control infection before it spreads? What can be learned from better understanding viral evolution in the context of emerging coronaviruses?

We hope to stir the discussion on how public health professionals, environmental health researchers, and data scientists, working together with domain experts, understand the challenges and lessons learned from the pandemic to prepare for emerging trends in infectious diseases. We aim to provide a broad range of examples focusing on temporal dynamics, clinical and psychosocial aspects, environmental factors, and socioeconomic determinants of COVID-19. In this context, the editors of the International Journal of Environmental Research and Public Health (IJERPH) have initiated a Special Issue of the journal on COVID-19 in North America, and we encourage the submission of interdisciplinary work and multicountry collaborative research, especially from the pandemic epicenters. We welcome original research papers using different study designs as well as brief reports, systematic reviews, and meta-analysis.

Prof. Elena N. Naumova
Dr. Meghan A. Hartwick
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2300 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • COVID-19 epidemiology
  • Environmental and socioeconomic risk factors
  • Disease modeling and forecasting
  • Preparedness planning
  • Seasonality
  • Disease tracking and monitoring
  • Surveillance systems
  • Public health and environmental policies
  • Coronavirus ecology

Published Papers (17 papers)

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Article
How Trust in Information Sources Influences Preventative Measures Compliance during the COVID-19 Pandemic
Int. J. Environ. Res. Public Health 2021, 18(11), 5867; https://doi.org/10.3390/ijerph18115867 - 30 May 2021
Viewed by 690
Abstract
This paper explores how trust in formal information sources (government and media) and informal information sources (interpersonal) about COVID-19 influences compliance with preventive measures. This cross-sectional study uses convenience sampling of 478 adult participants. Data analyses using structural equation modeling with multigroup comparisons [...] Read more.
This paper explores how trust in formal information sources (government and media) and informal information sources (interpersonal) about COVID-19 influences compliance with preventive measures. This cross-sectional study uses convenience sampling of 478 adult participants. Data analyses using structural equation modeling with multigroup comparisons examine hypothesized relationships between trust in information sources and preventative behaviors and social distancing. Results suggest that understanding of COVID-19 causes is related to trust in formal information sources, but not to trust in informal information. Self-efficacy for prevention is related to trust in informal information sources, but not to trust in formal information sources. Worry about contracting COVID-19 is related to trust in formal information sources, but not to informal ones. Engaging in preventive measures is linked to both self-efficacy for prevention and worry, while social distancing was related only to worry. These findings have important implications for public health policy guidelines centered on clear and truthful media messages. The findings also facilitate comparative analyses of reactions to information sources across a decade of evolving attitudes toward media and government, between two cultures (Hong Kong vs. the USA), and between two different global pandemics. Full article
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Article
The Use of GIS Technology to Optimize COVID-19 Vaccine Distribution: A Case Study of the City of Warsaw, Poland
Int. J. Environ. Res. Public Health 2021, 18(11), 5636; https://doi.org/10.3390/ijerph18115636 - 25 May 2021
Viewed by 414
Abstract
The COVID-19 pandemic is a global challenge, and the key to tackling it is vaccinating a specified percentage of the population to acquire herd immunity. The observed problems with the efficiency of the vaccination campaigns in numerous countries around the world, as well [...] Read more.
The COVID-19 pandemic is a global challenge, and the key to tackling it is vaccinating a specified percentage of the population to acquire herd immunity. The observed problems with the efficiency of the vaccination campaigns in numerous countries around the world, as well as the approach used at the initial stage of the National Immunization Program in Poland, prompted us to analyse the possibility of using GIS technology to optimize the distribution of vaccines to vaccination sites so as to minimize the period needed to vaccinate individual population groups. The research work was carried out on the example of Warsaw, the capital of Poland and the city with the largest population in the country. The analyses were carried out for the 60–70 and 50–60 age groups, in various approaches and for vaccines of different companies (Moderna, BioNTech, AstraZeneca), used to vaccinate people in Poland. The proposed approach to optimize vaccine distribution uses Thiessen’s tessellation to obtain information on the number of people in a given population group living in the area of each vaccination site, and then to estimate the time needed to vaccinate that group. Compared to the originally used vaccination scenario with limited availability of vaccines, the proposed approach allows practitioners to design fast and efficient distribution scenarios. With the developed methodology, we demonstrated ways to achieve uniform vaccination coverage throughout the city. We anticipate that the proposed approach can be easily automated and broadly applied to various urban settings. Full article
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Article
Does COVID-19 Affect the Behavior of Buying Fresh Food? Evidence from Wuhan, China
Int. J. Environ. Res. Public Health 2021, 18(9), 4469; https://doi.org/10.3390/ijerph18094469 - 22 Apr 2021
Viewed by 764
Abstract
COVID-19 first appeared in Wuhan city of Hubei Province in China in December 2019. It has a substantial impact on human life all around the world, especially for citizens. The threat of COVID-19 has resulted in people shopping online to get fresh food [...] Read more.
COVID-19 first appeared in Wuhan city of Hubei Province in China in December 2019. It has a substantial impact on human life all around the world, especially for citizens. The threat of COVID-19 has resulted in people shopping online to get fresh food and reduce outdoor trips. Collecting data from adult internet users in Wuhan, China in 2020, this study aims to explore the influence of COVID-19 on fresh food shopping behavior. In addition, a comparison and ordered logit model are constructed to demonstrate the changes and effects of COVID-19. The results suggest that more citizens in Wuhan city will buy fresh food online and the cost and frequency are also increased. The experience of online shopping for fresh food during the lock-down days has promoted more online shopping. The factors, such as frequency of online shopping before the COVID-19 outbreak, frequency of online shopping during the COVID-19 pandemic, and age, have a negative effect on the proportion of online shopping after the lock-down days, while the proportion of online shopping before the COVID-19 outbreak, the proportion of online shopping during the COVID-19 pandemic, and travel time of in-store shopping before the COVID-19 outbreak have a positive effect. The results provide insights for managers, city planners, and policymakers. Full article
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Article
COVID-19 Pandemic and Quality of Life among Romanian Athletes
Int. J. Environ. Res. Public Health 2021, 18(8), 4065; https://doi.org/10.3390/ijerph18084065 - 12 Apr 2021
Viewed by 903
Abstract
The aim of this study was to analyze athletes’ quality of life during the COVID-19 pandemic. The study involved 249 athletes between 15 and 35 of age, M = 21.22, SD = 5.12. The sample was composed of eight Olympic Games medalists, three [...] Read more.
The aim of this study was to analyze athletes’ quality of life during the COVID-19 pandemic. The study involved 249 athletes between 15 and 35 of age, M = 21.22, SD = 5.12. The sample was composed of eight Olympic Games medalists, three European medalists, 67 international medalists, and 63 national medalists. The instruments used were: (1) COVID-19 Anxiety Scale, (2) Athlete Quality of Life Scale, (3) Impact of Pandemic on Athletes Questionnaire, and (4) International Personality Item Pool (IPIP Anxiety, Depression, and Vulnerability Scales). The results indicate significant differences in COVID-19 anxiety depending on the sport practiced, F (9239) = 3.81, p < 0.01, showing that there were significant differences between sports. The negative impact of the COVID-19 pandemic mediates the relationship between trait anxiety and the athletes’ quality of life. The percentage of mediation was 33.9%, and the indirect effect was −0.11, CI 95% (−0.18, −0.03), Z = −2.82, p < 0.01. Trait anxiety has an increasing effect on the intensity of the negative impact of the COVID-19 pandemic, 0.23, CI 95% (.10, 0.35), Z = 3.56, p < 0.01, and the negative impact of the COVID-19 pandemic has a decreasing effect on quality of life, −0.47, CI 95% (−0.67, −0.27), Z = −4.62, p < 0.01. Gender and age did not moderate the relationship between the negative impact of COVID-19 and athletes’ quality of life. The results of the study highlighted the impact that social isolation and quarantine have on athletes’ affective well-being. Full article
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Article
Effects of Home Confinement on the Intensity of Physical Activity during the COVID-19 Outbreak in Team Handball According to Country, Gender, Competition Level, and Playing Position: A Worldwide Study
Int. J. Environ. Res. Public Health 2021, 18(8), 4050; https://doi.org/10.3390/ijerph18084050 - 12 Apr 2021
Viewed by 800
Abstract
This study investigated effects of home confinement on physical activity (PA) in Team Handball during the COVID-19 outbreak. A total of 1359 handball players participated (age: 23 ± 6 years). Participants from Europe, Western Asia, and North Africa answered an online version of [...] Read more.
This study investigated effects of home confinement on physical activity (PA) in Team Handball during the COVID-19 outbreak. A total of 1359 handball players participated (age: 23 ± 6 years). Participants from Europe, Western Asia, and North Africa answered an online version of the International Physical Activity Questionnaire (IPAQ) considering “before” and “during” confinement. COVID-19 home confinement has had a negative effect on PA (vigorous, moderate, walking, and overall). The largest decrease was in the sum parameter “all PA” (MET (metabolic equivalent of task)-min/week, ηp2 = 0.903; min/week, ηp2 = 0.861). Daily sitting time increased from 2.7 to 5.0 h per weekday (p < 0.001, ηp2 = 0.669). For gender, continent, country, level of handball league, and playing position, no significant differences (group and interaction effects) were observed. The largest change in PA behavior was in walking (minutes per day: ηp2 = 0.755), with males displaying the greatest decrease (from 62 ± 11 to 30 ± 14 min per weekday; d = 2.67). In terms of magnitude, difference between genders was greatest for sitting time (difference in d = 1.20). In conclusion, while COVID-19 measures were essential to preserve public health, PA was compromised and sedentary behavior increased because of these public health measures regardless of gender, playing position, and competition level. Full article
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Article
Effects of COVID-19 Lockdown on Physical Activity, Sedentary Behavior, and Satisfaction with Life in Qatar: A Preliminary Study
Int. J. Environ. Res. Public Health 2021, 18(6), 3093; https://doi.org/10.3390/ijerph18063093 - 17 Mar 2021
Cited by 1 | Viewed by 864
Abstract
This study examined the effects of home confinement on physical activity (PA) and life satisfaction during the COVID-19 outbreak in Qatar. A total of 1144 subjects participated (male: n = 588; female: n = 556; age: 33.1 ± 11.1 years; mass: 76.1 ± [...] Read more.
This study examined the effects of home confinement on physical activity (PA) and life satisfaction during the COVID-19 outbreak in Qatar. A total of 1144 subjects participated (male: n = 588; female: n = 556; age: 33.1 ± 11.1 years; mass: 76.1 ± 16.4 kg; height: 1.70 ± 0.11 m; body mass index (BMI): 26.1 ± 4.44  kg/m2). Online survey questions considered “before” and “during” confinement. Confinement reduced all PA intensities (ηp2 = 0.27–0.67, p < 0.001) and increased daily sitting time from 3.57 ± 1.47 to 6.32 ± 1.33 h per weekday (ηp2 = 0.67, p < 0.001). The largest reduction was detected for the sum parameter all physical activity (minutes per week, ηp2 = 0.67, p < 0.001; MET (metabolic equivalent of task)-minutes/week, ηp2 = 0.69, p < 0.001). Life satisfaction decreased, with the score for “I am satisfied with my life” (ηp2 = 0.76, p < 0.001) decreasing from 28.1 ± 4.81 to 14.2 ± 6.41 arbitrary units (AU). Concerning life satisfaction, the largest change was detected for the statement “the conditions of my life are excellent” (dmale = 7.93). For all parameters, time effects were indicative of large negative effects in both genders. In terms of magnitude, the difference between gender was greatest for the parameter “the conditions of my life are excellent” (difference between groups, d = 4.84). In conclusion, COVID-19 confinement decreased PA, increased sitting time, and decreased life satisfaction in Qatar. These precautionary findings explicate the risk of psychosocial impairment and the potential physical harm of reducing physical activity during early COVID-19 confinement in 2020. Full article
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Article
Experience of the COVID-19 Pandemic in Rural Odisha, India: Knowledge, Preventative Actions, and Impacts on Daily Life
Int. J. Environ. Res. Public Health 2021, 18(6), 2863; https://doi.org/10.3390/ijerph18062863 - 11 Mar 2021
Cited by 1 | Viewed by 783
Abstract
We conducted 131 semi-structured phone interviews with householders in rural Odisha, India to explore participants’ COVID-19 related knowledge, perceptions, and preventative actions, as well as how the pandemic affected their daily life, economic and food security, and the village-level response. Interviews were conducted [...] Read more.
We conducted 131 semi-structured phone interviews with householders in rural Odisha, India to explore participants’ COVID-19 related knowledge, perceptions, and preventative actions, as well as how the pandemic affected their daily life, economic and food security, and the village-level response. Interviews were conducted with 73 heads of household, 37 primary caregivers, and 21 members of village water and sanitation committees from 43 rural villages in Ganjam and Gajapati districts in Odisha state. The study took place between May–July 2020 throughout various lockdown restrictions and at a time when many migrant workers were returning to their villages and cases were rising. Most respondents could name at least one correct symptom of COVID-19 (75%), but there was lower knowledge about causes of the disease and high-risk groups, and overall COVID-19 knowledge was lowest among caregivers. Respondents reported high compliance with important preventative measures, including staying home as much as possible (94%), social distancing (91%), washing hands frequently (96%), and wearing a facial mask (95%). Additionally, many respondents reported job loss (31%), financial challenges (93%), challenges related to staying home whether as a preventative measure or due to lockdowns (57%), changes in types and/or amount of food consumed (61%), and adverse emotional effects as a result of the pandemic and lockdown. We also provide detailed summaries of qualitative responses to allow for deeper insights into the lived experience of villagers during this pandemic. Although the research revealed high compliance with preventative measures, the pandemic and associated lockdowns also led to many challenges and hardships faced in daily life particularly around job loss, economic security, food security, and emotional wellbeing. The results underscore the vulnerability of marginalized populations to the pandemic and the need for measures that increase resilience to large-scale shocks. Full article
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Article
Population Response to Air Pollution and the Risk of Coronavirus Disease in Chinese Cities during the Early Pandemic Period
Int. J. Environ. Res. Public Health 2021, 18(5), 2248; https://doi.org/10.3390/ijerph18052248 - 24 Feb 2021
Viewed by 1155
Abstract
Health behavior is a critical measure in controlling the coronavirus disease 2019 (COVID-19) pandemic. We estimated the effect of health behaviors against air pollution on reducing the risk of COVID-19 during the initial phase of the pandemic. The attack rates of COVID-19 in [...] Read more.
Health behavior is a critical measure in controlling the coronavirus disease 2019 (COVID-19) pandemic. We estimated the effect of health behaviors against air pollution on reducing the risk of COVID-19 during the initial phase of the pandemic. The attack rates of COVID-19 in 159 mainland Chinese cities during the first 2 weeks after the closure of major cities was estimated; air pollution level as a surrogate indicator of the mask-wearing rate. Data on air pollution levels and meteorologic factors 2 weeks prior to the closure were obtained. The attack rate was compared with the level of air pollution using a generalized linear model after adjusting for confounders. When fine particulates (PM2.5) and nitrogen dioxide (NO2) levels increased by one unit of air quality index (AQI), the infection risk decreased by 0.7% and 3.4%, respectively. When PM2.5 levels exceeded 150 (level 4), the infection risk decreased (relative risk, RR = 0.635, 95% confidence interval, CI: 0.442 to 0.912 for level 4; RR = 0.529, 95% CI: 0.337 to 0.830 for level 5; respectively). After controlling for the number of high-speed railway routes, when PM2.5 and NO2 levels increased by one AQI, relative risk for PM2.5 and NO2 was 0.990 (95% CI, 0.984 to 0.997) and 0.946 (95% CI, 0.911 to 0.982), respectively, demonstrating a consistently negative association. It is postulated that, during the early phase of the pandemic, the cities with higher air pollution levels may represent the higher practice of mask-wearing to protect from air pollution, which could have acted as a barrier to the transmission of the virus. This study highlights the importance of health behaviors, including mask-wearing for preventing infections. Full article
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Article
Transformation of a Ferry Ship into a Ship Hospital for COVID-19 Patients
Int. J. Environ. Res. Public Health 2020, 17(23), 8976; https://doi.org/10.3390/ijerph17238976 - 02 Dec 2020
Cited by 1 | Viewed by 1331
Abstract
Liguria is a northwestern region of Italy that, since the WHO has declared COVID-19 as a pandemic (11 March 2020), presented 108 patients hospitalized, 34 of which were in the intensive care unit. Due to this serious epidemiological emergency, the transformation of a [...] Read more.
Liguria is a northwestern region of Italy that, since the WHO has declared COVID-19 as a pandemic (11 March 2020), presented 108 patients hospitalized, 34 of which were in the intensive care unit. Due to this serious epidemiological emergency, the transformation of a long-distance ferry ship into a hospital ship for COVID-19 patients who were still positive after the acute phase of the illness was carried out to free up hospital beds for patients in the acute phase. The ship was moored in the port of Genoa, the capital of Liguria. The conversion was localized to a single deck, where designated healthcare areas were identified. From 23 March to 18 June 2020, 191 patients were admitted onto the ship; they were provided with high-level healthcare guaranteed by the multi-disciplinary nature of clinical competencies available. Patients had a favorable outcome in all cases, confirmed by their recovery and negative swab results. Moreover, no cases of voluntary discharge were recorded. To the best of our knowledge, this is the only example in the world in which a passenger ship was transformed into a ship hospital for COVID patients. Full article
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Article
Model Calculations of Aerosol Transmission and Infection Risk of COVID-19 in Indoor Environments
Int. J. Environ. Res. Public Health 2020, 17(21), 8114; https://doi.org/10.3390/ijerph17218114 - 03 Nov 2020
Cited by 10 | Viewed by 22924
Abstract
The role of aerosolized SARS-CoV-2 viruses in airborne transmission of COVID-19 has been debated. The aerosols are transmitted through breathing and vocalization by infectious subjects. Some authors state that this represents the dominant route of spreading, while others dismiss the option. Here we [...] Read more.
The role of aerosolized SARS-CoV-2 viruses in airborne transmission of COVID-19 has been debated. The aerosols are transmitted through breathing and vocalization by infectious subjects. Some authors state that this represents the dominant route of spreading, while others dismiss the option. Here we present an adjustable algorithm to estimate the infection risk for different indoor environments, constrained by published data of human aerosol emissions, SARS-CoV-2 viral loads, infective dose and other parameters. We evaluate typical indoor settings such as an office, a classroom, choir practice, and a reception/party. Our results suggest that aerosols from highly infective subjects can effectively transmit COVID-19 in indoor environments. This “highly infective” category represents approximately 20% of the patients who tested positive for SARS-CoV-2. We find that “super infective” subjects, representing the top 5–10% of subjects with a positive test, plus an unknown fraction of less—but still highly infective, high aerosol-emitting subjects—may cause COVID-19 clusters (>10 infections). In general, active room ventilation and the ubiquitous wearing of face masks (i.e., by all subjects) may reduce the individual infection risk by a factor of five to ten, similar to high-volume, high-efficiency particulate air (HEPA) filtering. A particularly effective mitigation measure is the use of high-quality masks, which can drastically reduce the indoor infection risk through aerosols. Full article
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Article
Examining the Change of Human Mobility Adherent to Social Restriction Policies and Its Effect on COVID-19 Cases in Australia
Int. J. Environ. Res. Public Health 2020, 17(21), 7930; https://doi.org/10.3390/ijerph17217930 - 29 Oct 2020
Cited by 7 | Viewed by 1311
Abstract
The policy induced decline of human mobility has been recognised as effective in controlling the spread of COVID-19, especially in the initial stage of the outbreak, although the relationship among mobility, policy implementation, and virus spread remains contentious. Coupling the data of confirmed [...] Read more.
The policy induced decline of human mobility has been recognised as effective in controlling the spread of COVID-19, especially in the initial stage of the outbreak, although the relationship among mobility, policy implementation, and virus spread remains contentious. Coupling the data of confirmed COVID-19 cases with the Google mobility data in Australia, we present a state-level empirical study to: (1) inspect the temporal variation of the COVID-19 spread and the change of human mobility adherent to social restriction policies; (2) examine the extent to which different types of mobility are associated with the COVID-19 spread in eight Australian states/territories; and (3) analyse the time lag effect of mobility restriction on the COVID-19 spread. We find that social restriction policies implemented in the early stage of the pandemic controlled the COVID-19 spread effectively; the restriction of human mobility has a time lag effect on the growth rates of COVID-19, and the strength of the mobility-spread correlation increases up to seven days after policy implementation but decreases afterwards. The association between human mobility and COVID-19 spread varies across space and time and is subject to the types of mobility. Thus, it is important for government to consider the degree to which lockdown conditions can be eased by accounting for this dynamic mobility-spread relationship. Full article
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Article
Global to USA County Scale Analysis of Weather, Urban Density, Mobility, Homestay, and Mask Use on COVID-19
Int. J. Environ. Res. Public Health 2020, 17(21), 7847; https://doi.org/10.3390/ijerph17217847 - 26 Oct 2020
Cited by 11 | Viewed by 9366
Abstract
Prior evaluations of the relationship between COVID-19 and weather indicate an inconsistent role of meteorology (weather) in the transmission rate. While some effects due to weather may exist, we found possible misconceptions and biases in the analysis that only consider the impact of [...] Read more.
Prior evaluations of the relationship between COVID-19 and weather indicate an inconsistent role of meteorology (weather) in the transmission rate. While some effects due to weather may exist, we found possible misconceptions and biases in the analysis that only consider the impact of meteorological variables alone without considering the urban metabolism and environment. This study highlights that COVID-19 assessments can notably benefit by incorporating factors that account for urban dynamics and environmental exposure. We evaluated the role of weather (considering equivalent temperature that combines the effect of humidity and air temperature) with particular consideration of urban density, mobility, homestay, demographic information, and mask use within communities. Our findings highlighted the importance of considering spatial and temporal scales for interpreting the weather/climate impact on the COVID-19 spread and spatiotemporal lags between the causal processes and effects. On global to regional scales, we found contradictory relationships between weather and the transmission rate, confounded by decentralized policies, weather variability, and the onset of screening for COVID-19, highlighting an unlikely impact of weather alone. At a finer spatial scale, the mobility index (with the relative importance of 34.32%) was found to be the highest contributing factor to the COVID-19 pandemic growth, followed by homestay (26.14%), population (23.86%), and urban density (13.03%). The weather by itself was identified as a noninfluential factor (relative importance < 3%). The findings highlight that the relation between COVID-19 and meteorology needs to consider scale, urban density and mobility areas to improve predictions. Full article
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Article
Awareness, Risk Perception, and Stress during the COVID-19 Pandemic in Communities of Tamil Nadu, India
Int. J. Environ. Res. Public Health 2020, 17(19), 7177; https://doi.org/10.3390/ijerph17197177 - 30 Sep 2020
Cited by 9 | Viewed by 3127
Abstract
The health and economic consequences of the COVID-19 pandemic is expected to disproportionately impact residents of lower-middle income countries. Understanding the psychological impact of the pandemic is important to guide outreach interventions. In this study, we examined people’s awareness of COVID-19 symptoms, risk [...] Read more.
The health and economic consequences of the COVID-19 pandemic is expected to disproportionately impact residents of lower-middle income countries. Understanding the psychological impact of the pandemic is important to guide outreach interventions. In this study, we examined people’s awareness of COVID-19 symptoms, risk perception, and changes in behaviors and stress levels during the lockdown in peri-urban Tamil Nadu India. Field workers conducted phone call surveys (included n = 2044) in 26 communities from 20–25 May 2020. The majority perceived no (60%) or low (23%) level of risk of personally contracting coronavirus. Common fears were related to health and economic concerns, including loss of income (62%), inability to travel freely (46%), and becoming sick (46%). Residents were well aware of the common symptoms of COVID-19, such as fever (66%) and dry cough (57%), but not the asymptomatic transmission (24%). The majority experienced increased stress about finance (79%) and the lockdown (51%). Our findings emphasize the need to develop context-adequate education and communication programs to raise vigilance about asymptomatic transmission and to sustain preventative behaviors. The evidence on fear and changes in stress levels could inform designing coping strategies and programs focused on mental well-being. Full article
Article
The Role of Illness Perceptions, Coping, and Self-Efficacy on Adherence to Precautionary Measures for COVID-19
Int. J. Environ. Res. Public Health 2020, 17(18), 6540; https://doi.org/10.3390/ijerph17186540 - 08 Sep 2020
Cited by 13 | Viewed by 2090
Abstract
As the novel coronavirus disease 2019 (COVID-19) pandemic continues, engaging the public in adherence to precautionary measures for preventing COVID-19 spread or infection becomes difficult. The present study aims to extend our understanding of how illness perceptions, coping, and self-efficacy affect adherence to [...] Read more.
As the novel coronavirus disease 2019 (COVID-19) pandemic continues, engaging the public in adherence to precautionary measures for preventing COVID-19 spread or infection becomes difficult. The present study aims to extend our understanding of how illness perceptions, coping, and self-efficacy affect adherence to precautionary measures among the public. An online survey was administered between April and June 2020 to a sample of 514 Hong Kong citizens. Variables considered were illness perceptions toward COVID-19, problem-solving, avoidance-based coping, self-efficacy, as well as adherence to precautionary measures including physical distancing, limiting unnecessary travelling, and washing hands regularly with soap and water. Adjusted structural equation model showed that illness perceptions toward COVID-19 had significant direct effect on their adherence to precautionary measures (unstandardized β = 0.50, [95% CI, 0.28, 0.80], p = 0.001), and indirect effects through avoidance-based coping (β = −0.10 [95% CI, −0.26, −0.01], p = 0.016) and self-efficacy (β = −0.10, [95% CI, −0.18, −0.01], p = 0.025). These results imply that apart from emphasizing the health hazards of a novel infectious disease, an effective public health intervention and crisis communication should address avoidance-based coping and self-efficacy of the public in adherence to precautionary measures for COVID-19. Full article
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Article
Effectiveness of Social Measures against COVID-19 Outbreaks in Selected Japanese Regions Analyzed by System Dynamic Modeling
Int. J. Environ. Res. Public Health 2020, 17(17), 6238; https://doi.org/10.3390/ijerph17176238 - 27 Aug 2020
Cited by 4 | Viewed by 2242
Abstract
In Japan’s response to the coronavirus disease 2019 (COVID-19), virus testing was limited to symptomatic patients due to limited capacity, resulting in uncertainty regarding the spread of infection and the appropriateness of countermeasures. System dynamic modelling, comprised of stock flow and infection modelling, [...] Read more.
In Japan’s response to the coronavirus disease 2019 (COVID-19), virus testing was limited to symptomatic patients due to limited capacity, resulting in uncertainty regarding the spread of infection and the appropriateness of countermeasures. System dynamic modelling, comprised of stock flow and infection modelling, was used to describe regional population dynamics and estimate assumed region-specific transmission rates. The estimated regional transmission rates were then mapped against actual patient data throughout the course of the interventions. This modelling, together with simulation studies, demonstrated the effectiveness of inbound traveler quarantine and resident self-isolation policies and practices. A causal loop approach was taken to link societal factors to infection control measures. This causal loop modelling suggested that the only effective measure against COVID-19 transmission in the Japanese context was intervention in the early stages of the outbreak by national and regional governments, and no social self-strengthening dynamics were demonstrated. These findings may contribute to an understanding of how social resilience to future infectious disease threats can be developed. Full article
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Article
Space-Time Patterns, Change, and Propagation of COVID-19 Risk Relative to the Intervention Scenarios in Bangladesh
Int. J. Environ. Res. Public Health 2020, 17(16), 5911; https://doi.org/10.3390/ijerph17165911 - 14 Aug 2020
Cited by 13 | Viewed by 2547
Abstract
The novel coronavirus (COVID-19) pandemic continues to be a significant public health threat worldwide, particularly in densely populated countries such as Bangladesh with inadequate health care facilities. While early detection and isolation were identified as important non-pharmaceutical intervention (NPI) measures for containing the [...] Read more.
The novel coronavirus (COVID-19) pandemic continues to be a significant public health threat worldwide, particularly in densely populated countries such as Bangladesh with inadequate health care facilities. While early detection and isolation were identified as important non-pharmaceutical intervention (NPI) measures for containing the disease spread, this may not have been pragmatically implementable in developing countries due to social and economic reasons (i.e., poor education, less public awareness, massive unemployment). Hence, to elucidate COVID-19 transmission dynamics with respect to the NPI status—e.g., social distancing—this study conducted spatio-temporal analysis using the prospective scanning statistic at district and sub-district levels in Bangladesh and its capital, Dhaka city, respectively. Dhaka megacity has remained the highest-risk “active” cluster since early April. Lately, the central and south eastern regions in Bangladesh have been exhibiting a high risk of COVID-19 transmission. The detected space-time progression of COVID-19 infection suggests that Bangladesh has experienced a community-level transmission at the early phase (i.e., March, 2020), primarily introduced by Bangladeshi citizens returning from coronavirus epicenters in Europe and the Middle East. Potential linkages exist between the violation of NPIs and the emergence of new higher-risk clusters over the post-incubation periods around Bangladesh. Novel insights into the COVID-19 transmission dynamics derived in this study on Bangladesh provide important policy guidelines for early preparations and pragmatic NPI measures to effectively deal with infectious diseases in resource-scarce countries worldwide. Full article
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Review

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Review
Physical Activity Recommendations during COVID-19: Narrative Review
Int. J. Environ. Res. Public Health 2021, 18(1), 65; https://doi.org/10.3390/ijerph18010065 - 24 Dec 2020
Cited by 2 | Viewed by 1675
Abstract
Regular practice of physical activity plays a fundamental role in preventing and treating cardiovascular diseases such as obesity, hypertension, diabetes, and metabolic syndrome. During the pandemic caused by COVID-19 and the lockdown established, people have reduced considerably their mobility and motor activity, which [...] Read more.
Regular practice of physical activity plays a fundamental role in preventing and treating cardiovascular diseases such as obesity, hypertension, diabetes, and metabolic syndrome. During the pandemic caused by COVID-19 and the lockdown established, people have reduced considerably their mobility and motor activity, which has led to an increase in unhealthy lifestyle habits, raising the risk of suffering from diseases. This paper consists of reviewing the existing scientific literature on recommendations of physical activity during the pandemic and to establish specific guidelines according to the type of population to which the activity would be directed. A search strategy has been carried out in the different databases: Embase, PubMed, SCOPUS, SPORTDiscus, and Web of Science (WoS), including all the articles published until 14 May 2020, to find essays with recommendations on aerobic activity, muscle strengthening, flexibility-stretching, meditation-relaxation, and balance exercises. The articles found have been evaluated considering the following criteria: type of publication, proposals for physical exercise, language, and, if it appears, volume of activity, frequency, intensity, and rest. The results obtained 29 articles that discuss patterns of physical activity, although there is no common consensus on such recommendations during confinement, nor are they suitable for all people. From these results, we can conclude that physical activity is widely recommended during the confinement caused by COVID-19, mainly through the performance of aerobic, strength, flexibility, and balance exercises. Full article
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