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1. Using Google Health Trends to investigate COVID-19 incidence in Africa

   https://doi.org/10.1371/journal.pone.0269573  

   Fulk, Alexander ; Romero-Alvarez, Daniel ; Abu-Saymeh, Qays ; Saint Onge, Jarron M. ; Peterson, A. Townsend ; Agusto, Folashade B. ( June 2022 , PLOS ONE)

   Aboelhadid, Shawky M (Ed.)

   The COVID-19 pandemic has caused over 500 million cases and over six million deaths globally. From these numbers, over 12 million cases and over 250 thousand deaths have occurred on the African continent as of May 2022. Prevention and surveillance remains the cornerstone of interventions to halt the further spread of COVID-19. Google Health Trends (GHT), a free Internet tool, may be valuable to help anticipate outbreaks, identify disease hotspots, or understand the patterns of disease surveillance. We collected COVID-19 case and death incidence for 54 African countries and obtained averages for four, five-month study periods in 2020–2021. Average case and death incidences were calculated during these four time periods to measure disease severity. We used GHT to characterize COVID-19 incidence across Africa, collecting numbers of searches from GHT related to COVID-19 using four terms: ‘coronavirus’, ‘coronavirus symptoms’, ‘COVID19’, and ‘pandemic’. The terms were related to weekly COVID-19 case incidences for the entire study period via multiple linear and weighted linear regression analyses. We also assembled 72 variables assessing Internet accessibility, demographics, economics, health, and others, for each country, to summarize potential mechanisms linking GHT searches and COVID-19 incidence. COVID-19 burden in Africa increased steadily during the study period. Important increases for COVID-19 death incidence were observed for Seychelles and Tunisia. Our study demonstrated a weak correlation between GHT and COVID-19 incidence for most African countries. Several variables seemed useful in explaining the pattern of GHT statistics and their relationship to COVID-19 including: log of average weekly cases, log of cumulative total deaths, and log of fixed total number of broadband subscriptions in a country. Apparently, GHT may best be used for surveillance of diseases that are diagnosed more consistently. Overall, GHT-based surveillance showed little applicability in the studied countries. GHT for an ongoing epidemic might be useful in specific situations, such as when countries have significant levels of infection with low variability. Future studies might assess the algorithm in different epidemic contexts. 

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2. Toward Achieving a Vaccine-Derived Herd Immunity Threshold for COVID-19 in the U.S.

   https://doi.org/10.3389/fpubh.2021.709369  

   Gumel, Abba B. ; Iboi, Enahoro A. ; Ngonghala, Calistus N. ; Ngwa, Gideon A. ( July 2021 , Frontiers in Public Health)

   A novel coronavirus emerged in December of 2019 (COVID-19), causing a pandemic that inflicted unprecedented public health and economic burden in all nooks and corners of the world. Although the control of COVID-19 largely focused on the use of basic public health measures (primarily based on using non-pharmaceutical interventions, such as quarantine, isolation, social-distancing, face mask usage, and community lockdowns) initially, three safe and highly-effective vaccines (by AstraZeneca Inc., Moderna Inc., and Pfizer Inc.), were approved for use in humans in December 2020. We present a new mathematical model for assessing the population-level impact of these vaccines on curtailing the burden of COVID-19. The model stratifies the total population into two subgroups, based on whether or not they habitually wear face mask in public. The resulting multigroup model, which takes the form of a deterministic system of nonlinear differential equations, is fitted and parameterized using COVID-19 cumulative mortality data for the third wave of the COVID-19 pandemic in the United States. Conditions for the asymptotic stability of the associated disease-free equilibrium, as well as an expression for the vaccine-derived herd immunity threshold, are rigorously derived. Numerical simulations of the model show that the size of the initial proportion of individuals in the mask-wearing group, together with positive change in behavior from the non-mask wearing group (as well as those in the mask-wearing group, who do not abandon their mask-wearing habit) play a crucial role in effectively curtailing the COVID-19 pandemic in the United States. This study further shows that the prospect of achieving vaccine-derived herd immunity (required for COVID-19 elimination) in the U.S., using the Pfizer or Moderna vaccine, is quite promising. In particular, our study shows that herd immunity can be achieved in the U.S. if at least 60% of the population are fully vaccinated. Furthermore, the prospect of eliminating the pandemic in the U.S. in the year 2021 is significantly enhanced if the vaccination program is complemented with non-pharmaceutical interventions at moderate increased levels of compliance (in relation to their baseline compliance). The study further suggests that, while the waning of natural and vaccine-derived immunity against COVID-19 induces only a marginal increase in the burden and projected time-to-elimination of the pandemic, adding the impacts of therapeutic benefits of the vaccines into the model resulted in a dramatic reduction in the burden and time-to-elimination of the pandemic. 

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3. Excess mortality in Ukraine during the course of COVID-19 pandemic in 2020–2021

   https://doi.org/10.1038/s41598-023-33113-2  

   Shishkin, Aleksandr ; Lhewa, Pema ; Yang, Chen ; Gankin, Yuriy ; Chowell, Gerardo ; Norris, Michael ; Skums, Pavel ; Kirpich, Alexander ( April 2023 , Scientific Reports)

   In this work, the COVID-19 pandemic burden in Ukraine is investigated retrospectively using the excess mortality measures during 2020–2021. In particular, the epidemic impact on the Ukrainian population is studied via the standardized both all-cause and cause-specific mortality scores before and during the epidemic. The excess mortality counts during the pandemic were predicted based on historic data using parametric and nonparametric modeling and then compared with the actual reported counts to quantify the excess. The corresponding standardized mortalityP-score metrics were also compared with the neighboring countries. In summary, there were three “waves” of excess all-cause mortality in Ukraine in December 2020, April 2021 and November 2021 with excess of 32%, 43% and 83% above the expected mortality. Each new “wave” of the all-cause mortality was higher than the previous one and the mortality “peaks” corresponded in time to three “waves” of lab-confirmed COVID-19 mortality. The lab-confirmed COVID-19 mortality constituted 9% to 24% of the all-cause mortality during those three peak months. Overall, the mortality trends in Ukraine over time were similar to neighboring countries where vaccination coverage was similar to that in Ukraine. For cause-specific mortality, the excess observed was due to pneumonia as well as circulatory system disease categories that peaked at the same times as the all-cause and lab-confirmed COVID-19 mortality, which was expected. The pneumonias as well as circulatory system disease categories constituted the majority of all cases during those peak times. The seasonality in mortality due to the infectious and parasitic disease category became less pronounced during the pandemic. While the reported numbers were always relatively low, alcohol-related mortality also declined during the pandemic.

    

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4. Childhood adversity during the post‐apartheid transition and COVID ‐19 stress independently predict adult PTSD risk in urban S outh A frica: A biocultural analysis of the stress sensitization hypothesis

   https://doi.org/10.1002/ajpa.24791  

   Kim, Andrew Wooyoung ; Said Mohamed, Rihlat ; Norris, Shane A. ; Naicker, Sara ; Richter, Linda M. ; Kuzawa, Christopher W. ( June 2023 , American Journal of Biological Anthropology)

   The COVID‐19 pandemic in South Africa introduced new societal adversities and mental health threats in a country where one in three individuals are expected to develop a psychiatric condition sometime in their life. Scientists have suggested that psychosocial stress and trauma during childhood may increase one's vulnerability to the mental health consequences of future stressors—a process known as stress sensitization. This prospective analysis assessed whether childhood adversity experienced among South African children across the first 18 years of life, coinciding with the post‐apartheid transition, exacerbates the mental health impacts of psychosocial stress experienced during the 2019 coronavirus (COVID‐19) pandemic (ca. 2020–2021).

   Data came from 88 adults who participated in a follow‐up study of a longitudinal birth cohort study in Soweto, South Africa. Childhood adversity and COVID‐19 psychosocial stress were assessed as primary predictors of adult PTSD risk, and an interaction term between childhood adversity and COVID‐19 stress was calculated to evaluate the potential effect of stress sensitization.

   Fifty‐six percent of adults exhibited moderate‐to‐severe PTSD symptoms. Greater childhood adversity and higher COVID‐19 psychosocial stress independently predicted worse post‐traumatic stress disorder symptoms in adults. Adults who reported greater childhood adversity exhibited non‐significantly worse PTSD symptoms from COVID‐19 psychosocial stress.

   These results highlight the deleterious mental health effects of both childhood trauma and COVID‐19 psychosocial stress in our sample and emphasize the need for greater and more accessible mental health support as the pandemic progresses in South Africa.

    

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5. Excess mortality in Belarus during the COVID-19 pandemic as the case study of a country with limited non-pharmaceutical interventions and limited reporting

   https://doi.org/10.1038/s41598-022-09345-z  

   Kirpich, Alexander ; Shishkin, Aleksandr ; Weppelmann, Thomas A. ; Tchernov, Alexander Perez ; Skums, Pavel ; Gankin, Yuriy ( December 2022 , Scientific Reports)

   Abstract Public health intervention to contain the ongoing COVID-19 pandemic significantly differed by country since the SARS-CoV-2 spread varied regionally in time and in scale. Since vaccinations were not available until the end of 2020 non-pharmaceutical interventions (NPIs) remained the only strategies to mitigate the pandemic spread at that time. Belarus in Europe is one of a few countries with a high Human Development Index where no lockdowns have ever been implemented and only limited NPIs have taken place for a period of time. Therefore, the Belarusian case was evaluated and compared in terms of the mortality burden. Since the COVID-19 mortality was low, the excess overall mortality was studied for Belarus. Since no overall mortality data have been reported past June 2020 the analysis was complemented by the study of Google Trends funeral-related search queries up until August 2021. Depending on the model, the Belarusian mortality for June of 2020 was 29 to 39% higher than otherwise expected with the corresponding estimated excess death was from 2953 to 3690 while the reported COVID-19 mortality for June 2020 was only 157 cases. The Belarusian excess mortality for June 2020 was higher than for all neighboring countries with an excess of 5% for Poland, 5% for Ukraine, 8% for Russia, 11% for Lithuania and 11% for Latvia. The relationship between Google Trends and mortality time series was studied using Granger’s test and the results were statistically significant. The results for Google Trends searches did vary by key phrase with the largest excess of 138% for April 2020 and 148% for September 2020 was observed for a key phrase “coffin”, while the largest excess of 218% for January 2021 was observed for “funeral services”. In summary, there are indications of the excess overall mortality in Belarus, which is larger than the reported COVID-19-related mortality. 

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