The new Corona virus, should we worry?

MplsGopher

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Go right ahead. I just found it interesting
There is no such person. Nonexistent on Google search.

But not surprising you find made-up things to be interesting, since they support what you want to happen.
 



Go4Broke

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Effectiveness of public health measures in reducing the incidence of Covid-19, SARS-CoV-2 transmission, and Covid-19 mortality

Abstract

Objective To review the evidence on the effectiveness of public health measures in reducing the incidence of covid-19, SARS-CoV-2 transmission, and covid-19 mortality.
Design Systematic review and meta-analysis.
Data sources Medline, Embase, CINAHL, Biosis, Joanna Briggs, Global Health, and World Health Organization COVID-19 database (preprints).
Eligibility criteria for study selection Observational and interventional studies that assessed the effectiveness of public health measures in reducing the incidence of covid-19, SARS-CoV-2 transmission, and covid-19 mortality.

Results

72 studies met the inclusion criteria, of which 35 evaluated individual public health measures and 37 assessed multiple public health measures as a “package of interventions.” Eight of 35 studies were included in the meta-analysis, which indicated a reduction in incidence of covid-19 associated with handwashing (relative risk 0.47, 95% confidence interval 0.19 to 1.12, I2=12%), mask wearing (0.47, 0.29 to 0.75, I2=84%), and physical distancing (0.75, 0.59 to 0.95, I2=87%). Owing to heterogeneity of the studies, meta-analysis was not possible for the outcomes of quarantine and isolation, universal lockdowns, and closures of borders, schools, and workplaces. The effects of these interventions were synthesised descriptively.

Conclusions

This systematic review and meta-analysis suggests that several personal protective and social measures, including handwashing, mask wearing, and physical distancing are associated with reductions in the incidence covid-19
. Public health efforts to implement public health measures should consider community health and sociocultural needs, and future research is needed to better understand the effectiveness of public health measures in the context of covid-19 vaccination.


Figure1

Introduction

Globally, vaccination programmes have proved to be safe and effective and save lives.45 Yet most vaccines do not confer 100% protection, and it is not known how vaccines will prevent future transmission of SARS-CoV-2,6 given emerging variants.789 The proportion of the population that must be vaccinated against covid-19 to reach herd immunity depends greatly on current and future variants.10 This vaccination threshold varies according to the country and population’s response, types of vaccines, groups prioritised for vaccination, and viral mutations, among other factors.6

Until herd immunity to covid-19 is reached, regardless of the already proven high vaccination rates,11 public health preventive strategies are likely to remain as first choice measures in disease prevention,12 particularly in places with a low uptake of covid-19 vaccination. Measures such as lockdown (local and national variant), physical distancing, mandatory use of face masks, and hand hygiene have been implemented as primary preventive strategies to curb the covid-19 pandemic.13

Public health (or non-pharmaceutical) interventions have been shown to be beneficial in fighting respiratory infections transmitted through contact, droplets, and aerosols.1415 Given that SARS-CoV-2 is highly transmissible, it is a challenge to determine which measures might be more effective and sustainable for further prevention.

Substantial benefits in reducing mortality were observed in countries with universal lockdowns in place, such as Australia, New Zealand, Singapore, and China. Universal lockdowns are not, however, sustainable, and more tailored interventions need to be considered; the ones that maintain social lives and keep economies functional while protecting high risk individuals.1617

Previous systematic reviews on the effectiveness of public health measures to treat covid-19 lacked the inclusion of analytical studies,20 a comprehensive approach to data synthesis (focusing only on one measure),21 a rigorous assessment of effectiveness of public health measures,22 an assessment of the certainty of the evidence,23 and robust methods for comparative analysis.24 To tackle these gaps, we performed a systematic review of the evidence on the effectiveness of both individual and multiple public health measures in reducing the incidence of covid-19, SARS-CoV-2 transmission, and covid-19 mortality. When feasible we also did a critical appraisal of the evidence and meta-analysis.

A total of 36 729 studies were initially screened, of which 36 079 were considered irrelevent. After exclusions, 650 studies were eligible for full text review and 72 met the inclusion criteria. Of these studies, 35 assessed individual interventions and were included in the final synthesis of results (fig 1) and 37 assessed multiple interventions as a package and are included in supplementary material 3, tables 2 and 3. The included studies comprised 34 observational studies and one interventional study, eight of which were included in the meta-analysis.

Fig 1


Risk of Bias

According to the ROBINS-I tool,28 the risk of bias was rated as low in three studies,323334 moderate in 24 studies,353637383940414243444546474849505152535455565758 and high to serious in seven studies.59606162636465

Fig 2


Effects of interventions - Personal protective measures


Handwashing and covid-19 incidence—Three studies with a total of 292 people infected with SARS-CoV-2 and 10 345 participants were included in the analysis of the effect of handwashing on incidence of covid-19.366368

Overall pooled analysis suggested an estimated 53% non-statistically significant reduction in covid-19 incidence (relative risk 0.47, 95% confidence interval 0.19 to 1.12, I2=12%) (fig 3). A sensitivity analysis without adjustment showed a significant reduction in covid-19 incidence (0.49, 0.33 to 0.72, I2=12%) (fig 4). Risk of bias across the three studies ranged from moderate3660 to serious or critical63 (fig 2).

Mask wearing and covid-19 incidence—Six studies with a total of 2627 people with covid-19 and 389 228 participants were included in the analysis examining the effect of mask wearing on incidence of covid-19 (table 1).364357606366

Overall pooled analysis showed a 53% reduction in covid-19 incidence (0.47, 0.29 to 0.75), although heterogeneity between studies was substantial (I2=84%) (fig 5). Risk of bias across the six studies ranged from moderate36576066 to serious or critical4363 (fig 2).

Mask wearing and transmission of SARS-CoV-2, covid-19 incidence, and covid-19 mortality—The results of additional studies that assessed mask wearing (not included in the meta-analysis because of substantial differences in the assessed outcomes) indicate a reduction in covid-19 incidence, SARS-CoV-2 transmission, and covid-19 mortality.

Specifically, a natural experiment across 200 countries showed 45.7% fewer covid-19 related mortality in countries where mask wearing was mandatory (table 1).49 Another natural experiment study in the US reported a 29% reduction in SARS-CoV-2 transmission (measured as the time varying reproductive number Rt) (risk ratio 0.71, 95% confidence interval 0.58 to 0.75) in states where mask wearing was mandatory.58

A comparative study in the Hong Kong Special Administrative Region reported a statistically significant lower cumulative incidence of covid-19 associated with mask wearing than in selected countries where mask wearing was not mandatory (table 1).69 Similarly, another natural experiment involving 15 US states reported a 2% statistically significant daily decrease in covid-19 transmission (measured as case growth rate) at ≥21 days after mask wearing became mandatory,50 whereas a cross sectional study reported that a 10% increase in self-reported mask wearing was associated with greater odds for control of SARS-CoV-2 transmission (adjusted odds ratio 3.53, 95% confidence interval 2.03 to 6.43).45 The five studies were rated at moderate risk of bias (fig 2).

Effects of interventions - Environmental measures

Disinfection in household and covid-19 incidence

Only one study, from China, reported the association between disinfection of surfaces and risk of secondary transmission of SARS-CoV-2 within households (table 1).57 The study assessed disinfection retrospectively by asking participants about their “daily use of chlorine or ethanol-based disinfectant in households,” and observed that use of disinfectant was 77% effective at reducing SARS-CoV-2 transmission (odds ratio 0.23, 95% confidence interval 0.07 to 0.84). The study did not collect data on the concentration of the disinfectant used by participants and was rated at moderate risk of bias (fig 2).

Effects of interventions - Social measures

Physical distancing and covid-19 incidence

Five studies with a total of 2727 people with SARS-CoV-2 and 108 933 participants were included in the analysis that examined the effect of physical distancing on the incidence of covid-19.3753576063 Overall pooled analysis indicated a 25% reduction in incidence of covid-19 (relative risk 0.75, 95% confidence interval 0.59 to 0.95, I2=87%) (fig 6). Heterogeneity among studies was substantial, and risk of bias ranged from moderate37535760 to serious or critical63

Physical distancing and transmission of SARS-CoV-2 and covid-19 mortality

Studies that assessed physical distancing but were not included in the meta-analysis because of substantial differences in outcomes assessed, generally reported a positive effect of physical distancing (table 2). A natural experiment from the US reported a 12% decrease in SARS-CoV-2 transmission (relative risk 0.88, 95% confidence interval 0.86 to 0.89),40 and a quasi-experimental study from Iran reported a reduction in covid-19 related mortality (β −0.07, 95% confidence interval −0.05 to −0.10; P<0.001).47

Another comparative study in Kenya also reported a reduction in transmission of SARS-CoV-2 after physical distancing was implemented, reporting 62% reduction in overall physical contacts (reproductive number pre-intervention was 2.64 and post-intervention was 0.60 (interquartile range 0.50 to 0.68)).61 These three studies were rated at moderate risk of bias4061 to serious or critical risk of bias47 (fig 2).

Stay at home or isolation and transmission of SARS-CoV-2

All the studies that assessed stay at home or isolation measures reported reductions in transmission of SARS-CoV-2 (table 2). A retrospective cohort study from the US reported a significant reduction in the odds of having a positive reproductive number (R0) result (odds ratio 0.07, 95% confidence interval 0.01 to 0.37),41 and a natural experiment reported a 51% reduction in time varying reproductive number (Rt) (risk ratio 0.49, 95% confidence interval 0.43 to 0.54).58

A study from the UK reported a 74% reduction in the average daily number of contacts observed for each participant and estimated a decrease in reproductive number: the reproductive number pre-intervention was 3.6 and post-intervention was 0.60 (95% confidence interval 0.37 to 0.89).65

Similarly, an Iranian study projected the reproductive number using serial interval distribution and the number of incidence cases and found a significant decrease: the reproductive number pre-intervention was 2.70 and post-intervention was 1.13 (95% confidence interval 1.03 to 1.25).55 Three of the studies were rated at moderate to serious or critical risk of bias,555865 and one study was rated at low risk of bias41 (fig 2).

Quarantine and incidence and transmission of SARS-CoV-2

Quarantine was assessed in two studies (table 2).3459 A prospective cohort study from Saudi Arabia reported a 4.9% decrease in the incidence of covid-19 at eight weeks after the implementation of quarantine.34 This study was rated at low risk of bias (fig 2).

A retrospective cohort study from India reported a 14 times higher risk of SARS-CoV-2 transmission associated with no quarantine compared with strict quarantine (odds ratio 14.44, 95% confidence interval 2.42 to 86.17).59 This study was rated at moderate risk of bias (fig 2).

School closures and covid-19 incidence and covid-19 mortality

Two studies assessed the effectiveness of school closures on transmission of SARS-CoV-2, incidence of covid-19, or covid-19 mortality (table 2).4448 A US population based longitudinal study reported on the effectiveness of state-wide closure of primary and secondary schools and observed a 62% decrease (95% confidence interval −49% to −71%) in incidence of covid-19 and a 58% decrease (−46% to−68%) in covid-19 mortality.48

Conversely, a natural experiment from Japan reported no effect of school closures on incidence of covid-19 (α coefficient 0.08, 95% confidence interval −0.36 to 0.65).
44 Both studies were rated at moderate risk of bias (fig 2).

School closures and transmission of SARS-CoV-2

Two natural experiments from the US reported a reduction in transmission (ie, reproductive number); with one study reporting a reduction of 13% (relative risk 0.87, 95% confidence interval 0.86 to 0.89)40 and another reporting a 10% (0.90, 0.86 to 0.93) reduction (table 2).58

A Swedish study reported an association between school closures and a small increase in confirmed SARS-CoV-2 infections in parents (odds ratio 1.17, 95% confidence interval 1.03 to 1.32), but observed that teachers in lower secondary schools were twice as likely to become infected than teachers in upper secondary schools (2.01, 1.52 to 2.67).32 All three studies were rated at moderate risk of bias (fig 2).

Business closures and transmission of SARS-CoV-2

Two natural experiment studies assessed business closures across 50 US states and reported reductions in transmission of SARS-CoV-2 (table 2).4058 One of the studies observed a significant reduction in transmission of 12% (relative risk 0.88, 95% confidence interval 0.86 to 0.89)40 and the other reported a significant 16% (risk ratio 0.84, 0.79 to 0.90) reduction.58 Both studies were rated at moderate risk of bias (fig 2).

Lockdown and incidence of covid-19

A natural experiment involving 202 countries suggested that countries that implemented universal lockdown had fewer new cases of covid-19 than countries that did not (β coefficient −235.8 (standard error −11.04), P<0.01) (table 2).52

An Indian quasi-experimental study reported a 10.8% reduction in incidence of covid-19 post-lockdown,56 whereas a South African retrospective cohort study observed a 14.1% reduction in risk after implementation of universal lockdown (table 2).46 These studies were rated at high risk of bias52 and moderate risk of bias4656 (fig 2).

Lockdown and covid-19 mortality

The three studies that assessed universal lockdown and covid-19 mortality generally reported a decrease in mortality (table 2).353842 A natural experiment study involving 45 US states reported a decrease in covid-19 related mortality of 2.0% (95% confidence interval −3.0% to 0.9%) daily after lockdown had been made mandatory.35

A Brazilian quasi-experimental study reported a 27.4% average difference in covid-19 related mortality rates in the first 25 days of lockdown.42 In addition, a natural experiment study reported about 30% and 60% reductions in covid-19 related mortality post-lockdown in Italy and Spain over four weeks post-intervention, respectively.38 All three studies were rated at moderate risk of bias (fig 2).

Lockdown and transmission of SARS-CoV-2

Four studies assessed universal lockdown and transmission of SARS-CoV-2 during the first few months of the pandemic (table 2). The decrease in reproductive number (R0) ranged from 1.27 in Italy (pre-intervention 2.03, post-intervention 0.76)39 to 2.09 in India (pre-intervention 3.36, post-intervention 1.27),64 and 3.97 in China (pre-intervention 4.95, post-intervention 0.98).33

A natural experiment from the US reported that lockdown was associated with an 11% reduction in transmission of SARS-CoV-2 (relative risk 0.89, 95% confidence interval 0.88 to 0.91).
40 All the studies were rated at low risk of bias3339 to moderate risk4064 (fig 2).

Effects of interventions - Travel related measures

Restricted travel and border closures

Border closure was assessed in one natural experiment study involving nine African countries (table 3).62 Overall, the countries recorded an increase in the incidence of covid-19 after border closure. These studies concluded that the implementation of border closures within African countries had minimal effect on the incidence of covid-19. The study had important limitations and was rated at serious or critical risk of bias.

In the US, a natural experiment study reported that restrictions on travel between states contributed about 11% to a reduction in SARS-CoV-2 transmission (table 3).36 The study was rated at moderate risk of bias (fig 2).

Conclusions and policy implications

Current evidence from quantitative analyses indicates a benefit associated with handwashing, mask wearing, and physical distancing in reducing the incidence of covid-19. The narrative results of this review indicate an effectiveness of both individual or packages of public health measures on the transmission of SARS-CoV-2 and incidence of covid-19. Some of the public health measures seem to be more stringent than others and have a greater impact on economies and the health of populations.

When implementing public health measures, it is important to consider specific health and sociocultural needs of the communities and to weigh the potential negative effects of the public health measures against the positive effects for general populations. Further research is needed to assess the effectiveness of public health measures after adequate vaccination coverage has been achieved. It is likely that further control of the covid-19 pandemic depends not only on high vaccination coverage and its effectiveness but also on ongoing adherence to effective and sustainable public health measures.

What is already known on this topic​

  • Public health measures have been identified as a preventive strategy for influenza pandemics
  • The effectiveness of such interventions in reducing the transmission of SARS-CoV-2 is unknown

What this study adds​

  • The findings of this review suggest that personal and social measures, including handwashing, mask wearing, and physical distancing are effective at reducing the incidence of covid-19
  • More stringent measures, such as lockdowns and closures of borders, schools, and workplaces need to be carefully assessed by weighing the potential negative effects of these measures on general populations
  • Further research is needed to assess the effectiveness of public health measures after adequate vaccination coverage

https://www.bmj.com/content/375/bmj-2021-068302

 
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short ornery norwegian

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MN Dept of Health Update - Mon, Nov 22

3,597 confirmed cases & reinfections + 1,121 probable cases = 4,718 total cases

38,310 PCR tests + 12,962 antigen tests = 51,272 total tests

9.2% overall positive test rate

37 deaths reported (25 private residence/11 long-term care/1 hotel-motel)
9,192 total deaths (4,884 long-term care)

Hospitalizations: ICU 330 (-10). Non-ICU 1043 (-31). Total Hospitalized 1,373 (-41).
 

Wally

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Even as an anonymous troll, don't you feel some sense of embarrassment when you post?
Priceless from you....

Actually I think it's hilarious all of the defending Trump for operation warp speed and how he beat Covid.
Totally priceless.
 











Section2

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Which current US mask/vaccine mandates are you guys upset about exactly?
Who could be upset that the measures you tell us we must implement or we are murderers, don’t at all work and might make things worse. Why would we be upset at you calling us murderers?
 

Wally

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What is their death rate compared to ours?

It used to be cases didn't matter, now they really really matter.
Lol....to funny.

The more cases the better.... magical herd immunity should be here any day. I remember a year ago when people were saying we were almost there.
 

Section2

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What is their death rate compared to ours?

It used to be cases didn't matter, now they really really matter.
Lol....to funny.

The more cases the better.... magical herd immunity should be here any day. I remember a year ago when people were saying we were almost there.
If cases don’t matter, why are we implementing vax passports, mask mandates, vax mandates, etc? You want it both ways.
 

Wally

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If cases don’t matter, why are we implementing vax passports, mask mandates, vax mandates, etc? You want it both ways.
Vax doesn't prevent cases so...

Bidens Vax mandate is basically dead. The only mask mandate is pretty much airports and airplanes. So I am really not sure what you're talking about.
 



howeda7

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Who could be upset that the measures you tell us we must implement or we are murderers, don’t at all work and might make things worse. Why would we be upset at you calling us murderers?
So...you're not angry about any current restrictions...you're just angry about old debates and whether you were "right" or not?
 


Section2

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Vax doesn't prevent cases so...

Bidens Vax mandate is basically dead. The only mask mandate is pretty much airports and airplanes. So I am really not sure what you're talking about.
Only because WE fought against them, and predicted things like the vaxx passport and fought against it before it was even a thing, while people like Howie (and this might sound familiar) ripped on us for being overly dramatic and worrying about nothing. Look what’s happening in Australia right now where they’re building literal camps.
 

Spoofin

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So...you're not angry about any current restrictions...you're just angry about old debates and whether you were "right" or not?
Well, seems he was right (no quotes necessary) 🤷‍♂️
 



Wally

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Look what’s happening in Australia right now where they’re building literal camps
I did a cursory search of AU news and didn't see any mention of these "camps"

Who are they locking in these camps?
 

JimmyJamesMD

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Vax doesn't prevent cases so...

Bidens Vax mandate is basically dead. The only mask mandate is pretty much airports and airplanes. So I am really not sure what you're talking about.
It's not dead. The vax mandate is here to stay. The 5th district ruling is only a tempirary ruling
There is an agenda here that is going to get pushed no matter what. Count on it
 





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