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The COVID-19 pandemic has triggered several changes in countries' health purchasing arrangements to accompany the adjustments in service delivery in order to meet the urgent and additional demands for COVID-19-related services. However, evidence on how these adjustments have played out in low- and middle-income countries is scarce. This paper provides a synthesis of a multi-country study of the adjustments in purchasing arrangements for the COVID-19 health sector response in eight middle-income countries (Armenia, Cameroon, Ghana, Kenya, Nigeria, Philippines, Romania and Ukraine). We use secondary data assembled by country teams, as well as applied thematic analysis to examine the adjustments made to funding arrangements, benefits packages, provider payments, contracting, information management systems and governance arrangements as well as related implementation challenges. Our findings show that all countries in the study adjusted their health purchasing arrangements to varying degrees. While the majority of countries expanded their benefit packages and several adjusted payment methods to provide selected COVID-19 services, only half could provide these services free of charge. Many countries also streamlined their processes for contracting and accrediting health providers, thereby reducing administrative hurdles. In conclusion, it was important for the countries to adjust their health purchasing arrangements so that they could adequately respond to the COVID-19 pandemic, but in some countries financing challenges resulted in issues with equity and access. However, it is uncertain whether these adjustments can and will be sustained over time, even where they have potential to contribute to making purchasing more strategic to improve efficiency, quality and equitable access in the long run. [ABSTRACT FROM AUTHOR]

The Covid-19 pandemic is the most recent—and most severe—crisis to face the microfinance/financial inclusion sector, but it was far from the first. From its earliest years, crises have appeared throughout the modern history of microfinance, and the responses they engendered have included some of the most significant reforms and innovations in the sector. In this paper, we describe selected historical crises—Peru in the 1980s, Grameen in the 1990s, and Andhra Pradesh and others in the 2007–2010 period—through their legacy and impact on the sector's activities and priorities. We then examine some of the pressures on institutions during the pandemic, through interview data with MFI leaders from the Sentinel Project conducted during 2021–22. We argue that the resilience of the sector to the unprecedented pressures of the pandemic can be traced to many of these historical post-crisis reforms—and consider what this means for future crisis responses. [ABSTRACT FROM AUTHOR]

Objective We provide a scoping review of Digital Health Interventions (DHIs) that mitigate COVID-19 misinformation and disinformation seeding and spread. Materials and Methods We applied our search protocol to PubMed, PsychINFO, and Web of Science to screen 1666 articles. The 17 articles included in this paper are experimental and interventional studies that developed and tested public consumer-facing DHIs. We examined these DHIs to understand digital features, incorporation of theory, the role of healthcare professionals, end-user experience, and implementation issues. Results The majority of studies (n  =   11) used social media in DHIs, but there was a lack of platform-agnostic generalizability. Only half of the studies (n  =   9) specified a theory, framework, or model to guide DHIs. Nine studies involve healthcare professionals as design or implementation contributors. Only one DHI was evaluated for user perceptions and acceptance. Discussion The translation of advances in online social computing to interventions is sparse. The limited application of behavioral theory and cognitive models of reasoning has resulted in suboptimal targeting of psychosocial variables and individual factors that may drive resistance to misinformation. This affects large-scale implementation and community outreach efforts. DHIs optimized through community-engaged participatory methods that enable understanding of unique needs of vulnerable communities are urgently needed. Conclusions We recommend community engagement and theory-guided engineering of equitable DHIs. It is important to consider the problem of misinformation and disinformation through a multilevel lens that illuminates personal, clinical, cultural, and social pathways to mitigate the negative consequences of misinformation and disinformation on human health and wellness. [ABSTRACT FROM AUTHOR]

Background Early reports on the pandemic nature of coronavirus disease 2019 (COVID-19) directed the nephrology community to develop infection prevention and control (IPC) guidance. We aimed to make an inventory of strategies that dialysis centres followed to prevent infection with COVID-19 in the first pandemic wave. Methods We analyzed IPC measures taken by hemodialysis centres treating patients presenting with COVID-19 between 1 March 2020 and 31 July 2020 and that completed the European Renal Association COVID-19 Database centre questionnaire. Additionally, we made an inventory of guidelines published in European countries to prevent spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in dialysis centres. Results Data from 73 dialysis units located in and bordering Europe were analyzed. All participating centres implemented IPC measures to mitigate the impact of SARS-CoV-2 during the first pandemic wave. Measures mentioned most often included triage with questions before entering the dialysis ward, measuring body temperature, hand disinfection, masking for all patients and staff, and personal protective equipment for staff members. These measures were also recommended in most of the 14 guidelines that were identified in the inventory of national guidelines and were also scored as being among the most important measures by the authors of this paper. Heterogeneity existed between centres and national guidelines regarding the minimal distance between dialysis chairs and recommendations regarding isolation and cohorting. Conclusions Although variation existed, measures to prevent transmission of SARS-CoV-2 were relatively similar across centres and national guidelines. Further research is needed to assess causal relationships between measures taken and spread of SARS-CoV-2. [ABSTRACT FROM AUTHOR]

Through a case study of Kunshan, China, this paper shows how a local state utilised place-based leadership to enhance regional economic resilience under the COVID-19 pandemic crisis. It unpacks how Kunshan effectively mitigated early economic disturbances induced by the COVID-19 pandemic, by two ways of leadership actions, namely, enacting jurisdictional power (that is formal leadership), and mobilising wide official and interpersonal networks (that is network leadership). Four specific local-state-led adaptive resilience processes or strategies are identified: stabilising labour supply, mitigating supply-chain disruptions, alleviating financial strains and reconfiguring market orientations. Through these proactive endeavours, the local state played an enabling role in aligning diverse stakeholders and resources across places, scales and sectors, thereby allaying economic shocks and enhancing regional economic resilience. This study contributes to the resilience literature by developing an agency-centric perspective to understanding regional economic resilience during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

This paper explores the local impact of various forms of fiscal and monetary support for UK-based companies in the context of disruption caused by COVID-19 and associated public health restrictions, including support for household incomes (and therefore private consumption) via the 'furlough' scheme, the Covid Corporate Financing Facility and various national and local business support schemes. It shows that the economic crisis associated with the pandemic has been construed to justify interventions that preserve the spatially uneven status quo of the UK's model of economic development, protecting business from harms arising, apparently, from the public's reaction to the pandemic. To some extent, COVID-19 has been treated as a localised phenomenon that the national economy requires protection from. [ABSTRACT FROM AUTHOR]

We find that firms' financial resources play an important role in mitigating the spread of COVID-19. We study nursing homes—whose residents account for over one-third of all U.S. COVID-19 deaths—at a time when investment in risk mitigation was costly and critical. Facilities with less liquidity and those experiencing more severe cash flow shocks had more cases of COVID-19. The importance of cash flow is further supported by tests exploiting state-level variation in Medicaid reimbursement expansion. Evidence on personal protective equipment supplies suggests a lack of financial resources leads to lower investment in risk mitigation. (JEL G30, G32, I10) Authors have furnished an Internet Appendix , which is available on the Oxford University Press Web site next to the link to the final published paper online. [ABSTRACT FROM AUTHOR]

Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination has decreasing protection from acquiring any infection with emergence of new variants; however, vaccination continues to protect against progression to severe coronavirus disease 2019 (COVID-19). The impact of vaccination status on symptoms over time is less clear. Methods Within a randomized trial on early outpatient COVID-19 therapy testing metformin, ivermectin, and/or fluvoxamine, participants recorded symptoms daily for 14 days. Participants were given a paper symptom diary allowing them to circle the severity of 14 symptoms as none (0), mild (1), moderate (2), or severe (3). This is a secondary analysis of clinical trial data on symptom severity over time using generalized estimating equations comparing those unvaccinated, SARS-CoV-2 vaccinated with primary vaccine series only, or vaccine-boosted. Results The parent clinical trial prospectively enrolled 1323 participants, of whom 1062 (80%) prospectively recorded some daily symptom data. Of these, 480 (45%) were unvaccinated, 530 (50%) were vaccinated with primary series only, and 52 (5%) vaccine-boosted. Overall symptom severity was least for the vaccine-boosted group and most severe for unvaccinated at baseline and over the 14 days (P <.001). Individual symptoms were least severe in the vaccine-boosted group including cough, chills, fever, nausea, fatigue, myalgia, headache, and diarrhea, as well as smell and taste abnormalities. Results were consistent over Delta and Omicron variant time periods. Conclusions SARS-CoV-2 vaccine-boosted participants had the least severe symptoms during COVID-19, which abated the quickest over time. Clinical Trial Registration. NCT04510194. [ABSTRACT FROM AUTHOR]

We congratulate Prof. Jiang, Prof. Zhao and Prof. Shao for their timely and thought-provoking paper on modelling the COVID-19 infection trajectory using a piecewise linear quantile trend model. By letting HT ht for country HT ht and ignoring the covariates HT ht , the MKQR model can be used to model the COVID-19 infection curves with multiple change points. [Extracted from the article]

We based our analysis on the data in Table 2 of Kim et al. 3 which, as Yue et al. correctly note, implicitly assumes that the one patient without data on smoking was a nonsmoker. 2 They note that the paper by Kim et al. 3 only reported smoking status for 27 of the 28 hospitalized COVID-19 patients they studied, but did not report which patient did not have data on smoking status. [Extracted from the article]

Background This paper concerns the spatial determinants of the first two waves of COVID-19 at the neighbourhood level. Methods Using data for the first and second waves of COVID-19 at the neighbourhood level in Barcelona, we analyse whether local characteristics acted in the same way during the two waves and identify typologies of areas depending on such determinants. Univariate and bivariate local Moran's I and count data models are used. Results Some structural effects at the neighbourhood level consistently either boost (e.g. population density) or reduce (e.g. income) COVID-19 cases. Other effects differ between the two waves (i.e. age composition, schools and transport infrastructures). Conclusions Since certain characteristics influenced the virus diffusion in opposite ways between the two pandemic waves, territorial heterogeneity alone is insufficient to explain COVID-19 outbreaks—individual behaviour also needs to be factored in. Consequently, both econometric and spatial analysis techniques are recommended for tracking the spatiotemporal spread of this disease and for monitoring the effectiveness of policy measures across heterogeneous neighbourhoods. [ABSTRACT FROM AUTHOR]

The pandemic situation of COVID-19 blocks many traditional information exchange paths, intensifies the information asymmetry in the implementation of the energy efficiency retrofitting project of existing building and seriously affects the decision-making effect of the energy performance contracting (EPC) subject. Therefore, based on the information-sharing platform, this paper constructs the synergistic incentive framework; designs the computational experimental models from the aspects of system information structure, system organization structure, synergistic communication strategy and subject knowledge structure; and analyzes the influence mechanism and evolution law of information on synergistic incentive performance from the two dimensions of the influence of the synergy cycle on the incentive performance and the influence of the incentive cycle on the synergy degree. The results show that increasing the information redundancy length and the information redundancy width can improve the synergy degree and incentive validity. The concentration of subject number or information dimension in a certain information area can quickly improve the synergy degree and incentive utility in the early stage of the synergistic incentive cycle, but the above situation is opposite in the later stage. Increasing the information communication path is beneficial to the effective information dissemination among subjects and can improve the efficiency of the decision-making of the subjects. Lastly, considering the background of COVID-19 epidemic situation, this paper puts forward the remedial methods and coping strategies make up for the lack of synergistic incentive information between EPC subjects. Research results can provide strong support for the design of synergistic incentive mechanism of EPC subjects. [ABSTRACT FROM AUTHOR]

This paper presents findings of a nation-wide study examining the impact of COVID-19 on researchers. Findings indicate that more than half of researchers experienced personal or family mental strain due to COVID-19 pandemic effects. COVID-19 pandemic is being treated as an opportunity by six out of ten researchers in terms of more time for study and planning future research activities (78 per cent). The majority of researchers (73 per cent) believe that Science and Technology will emerge enhanced from the pandemic in the public sphere. Relating our findings with research outcomes of existed surveys, it appears that COVID-19 had a significant impact on researchers' and workers' psychosocial life. Researchers' and scientists' standpoint suggest that Science and Technology will be upgraded in the public dialogue. Finally, researchers viewed the pandemic as an opportunity for more time for study and planning of future research activities while working time, with respect to other countries, decreased the most. [ABSTRACT FROM AUTHOR]

Since the Alma Ata Declaration of 1978, countries have varied in their progress towards establishing and sustaining comprehensive primary health care (PHC) and realizing its associated vision of 'Health for All'. International health emergencies such as the coronavirus-19 (COVID-19) pandemic underscore the importance of PHC in underpinning health equity, including via access to routine essential services and emergency responsiveness. This review synthesizes the current state of knowledge about PHC impacts, implementation enablers and barriers, and knowledge gaps across the three main PHC components as conceptualized in the 2018 Astana Framework. A scoping review design was adopted to summarize evidence from a diverse body of literature with a modification to accommodate four discrete phases of searching, screening and eligibility assessment: a database search in PubMed for PHC-related literature reviews and multi-country analyses (Phase 1); a website search for key global PHC synthesis reports (Phase 2); targeted searches for peer-reviewed literature relating to specific components of PHC (Phase 3) and searches for emerging insights relating to PHC in the COVID-19 context (Phase 4). Evidence from 96 included papers were analysed across deductive themes corresponding to the three main components of PHC. Findings affirm that investments in PHC improve equity and access, healthcare performance, accountability of health systems and health outcomes. Key enablers of PHC implementation include equity-informed financing models, health system and governance frameworks that differentiate multi-sectoral PHC from more discrete service-focussed primary care, and governance mechanisms that strengthen linkages between policymakers, civil society, non-governmental organizations, community-based organizations and private sector entities. Although knowledge about, and experience in, PHC implementation continues to grow, critical knowledge gaps are evident, particularly relating to country-level, context-specific governance, financing, workforce, accountability and service coordination mechanisms. An agenda to guide future country-specific PHC research is outlined. [ABSTRACT FROM AUTHOR]

The Ascend West and Central Africa programme, funded by the UK Foreign, Commonwealth and Development Office (FCDO) is supporting integrated preventative chemotherapy for up to five neglected tropical diseases (NTDs), including intestinal worms, lymphatic filariasis, river blindness, trachoma and schistosomiasis. The programme is implemented across 13 countries by a consortium of four leading international development partners: Sightsavers, Liverpool School of Tropical Medicine, Schistosomiasis Control Initiative Foundation and Mott Macdonald. This paper presents messages learnt from country assessments that took place prior to the global outbreak of coronavirus disease 2019 (COVID-19). These messages remain relevant post-COVID-19, with greater priority being given to the challenges for national NTD programmes in continuing to deliver mass drug administration (MDA) during the pandemic. Stakeholder coordination from the earliest stages of the pandemic has occurred at two levels: in the first mile with global partners of the NTD Supply Chain Forum and in the last mile with implementing partners in each country. This has been instrumental to manage delayed MDA, including the impact delays have on the shipment of NTD donated drugs and the distribution of stock held in country. The Ascend West and Central Africa programme is supporting countries with the resumption of MDA through a risk assessment and mitigation action (RAMA) process. [ABSTRACT FROM AUTHOR]

The outbreak and pandemic of SARS-CoV-2 in 2019 has caused a severe public health burden and will challenge global health for the future. The discovery and mechanistic investigation of drugs against Coronavirus disease 2019 (COVID-19) is in deadly demand. The paper published by Li and colleagues proposed the hypothesis that vitamin C combined with glycyrrhizic acid in treating COVID-19 and its mechanistic investigation was performed by a database-based network pharmacology. In this letter, we present critical comments on the limitations and insufficiencies involved, from both the perspective of network pharmacology and current evidence on COVID-19. [ABSTRACT FROM AUTHOR]

Summary: The factors responsible for the spectrum of coronavirus 19 (COVID‐19) disease severity and the genesis and nature of protective immunity against COVID‐19 remain elusive. Multiple studies have investigated the immune responses to COVID‐19 in various populations, including those without evidence of COVID‐19 infection. Information regarding innate and adaptive immune responses to the novel severe respiratory syndrome coronavirus 2 (SARS‐CoV‐2) has evolved rapidly. Data are accumulating defining disease phenotypes that aid in rational and informed development of new therapeutic approaches for the treatment of patients infected with SARS‐CoV‐2 and the development of novel vaccines. In this paper, data on important innate immune responses are summarized, including cytokines, specifically interleukin (IL)‐6 and complement, and potential treatments are explored. Adaptive immune responses and derivative therapeutics such as monoclonal antibodies directed at spike proteins are also examined. Finally, data on real‐time assessments of adaptive immune responses are explored, which include CD4+/CD8+ T cells, natural killer (NK) T cells, memory B cells and T follicular cells with specificities for COVID‐19 peptides in infected and normal individuals. Data of two novel vaccines have been released, both showing > 95% efficacy in preventing SARS‐CoV‐2 infection. Analysis of humoral and cellular responses to the vaccines will determine the robustness and durability of protection. In addition, long‐term assessment of SARS‐CoV‐2 memory B and T cell‐mediated immune responses in patients recovering from an infection or those with cross‐reactive immunological memory will help to define risk for future SARS‐CoV infections. Finally, patients recovering from SARS‐CoV‐2 infection may experience prolonged immune activation probably due to T cell exhaustion. This will be an important new frontier for study. This review summarizes published data on the relevant innate and adaptive immune responses to SARS‐CoV‐2. Data characterizing innate and adaptive immune responses have rapidly led to informed therapeutic interventions, including vaccine development and recognition of dysfunctional immune responses that are likely responsible for post‐COVID‐19 autoimmunity. [ABSTRACT FROM AUTHOR]

Chemosensory scientists have been skeptical that reports of COVID-19 taste loss are genuine, in part because before COVID-19 taste loss was rare and often confused with smell loss. Therefore, to establish the predicted prevalence rate of taste loss in COVID-19 patients, we conducted a systematic review and meta-analysis of 376 papers published in 2020–2021, with 235 meeting all inclusion criteria. Drawing on previous studies and guided by early meta-analyses, we explored how methodological differences (direct vs. self-report measures) may affect these estimates. We hypothesized that direct measures of taste are at least as sensitive as those obtained by self-report and that the preponderance of evidence confirms taste loss is a symptom of COVID-19. The meta-analysis showed that, among 138,015 COVID-19-positive patients, 36.62% reported taste dysfunction (95% confidence interval: 33.02%–40.39%), and the prevalence estimates were slightly but not significantly higher from studies using direct (n = 15) versus self-report (n = 220) methodologies (Q = 1.73, df = 1, P = 0.1889). Generally, males reported lower rates of taste loss than did females, and taste loss was highest among middle-aged adults. Thus, taste loss is likely a bona fide symptom of COVID-19, meriting further research into the most appropriate direct methods to measure it and its underlying mechanisms. [ABSTRACT FROM AUTHOR]

Background Age-standardized mortality rates for taxi drivers, chauffeurs, bus and coach drivers show that public transport workers were at high risk at the beginning of the COVID-19 pandemic. Nevertheless, the public transport sector was required to continue services throughout the pandemic. Objectives This paper aims to develop a better understanding of the experiences of organizational leaders and workers within the UK public transport sector (bus, rail, and tram). Specifically, it aims to explore the perceived balance of risk and mitigation of SARS-CoV-2 transmission, report on their perceptions of safety in public transport during the pandemic and in the future, and consider how these perceptions and changes impact on long-term worker health and wellbeing. Methods This study formed part of a larger stakeholder engagement with the public transport sector. Organizational leaders and workers were recruited (n = 18) and semi-structured interviews carried out between January and May 2021. Data were analysed thematically. Results Overarching and subthemes were identified. Themes relating to perceptions and impacts of risk of COVID-19 for employees included: acceptability of risk for workers, perceptions of risk mitigation effectiveness, changes to working practices and their impact on morale and wellbeing, issues with compliance to mitigations such as social distancing and face coverings in passenger and co-worker groups alongside a lack of power to challenge behaviour effectively, and the roles of leadership and messaging. Themes related to long-lasting impacts of COVID-19 on working practices and effects on health and wellbeing included: continuing mitigations, impact of increasing passenger numbers, impact of vaccination programme, and impact of changes to business structure. Conclusions Most public transport employees reported feeling safe, related to the extent to which their role was public-facing. However, data were collected during a time of very low passenger numbers. Current mitigation measures were thought effective in reducing the risk of viral transmission, although measures may have a detrimental effect on worker morale and wellbeing. Issues relating to non-compliance with guidance and 'in-group' behaviour were identified. Impacts on wider business sustainability and individual wellbeing of staff should be considered when developing responses to any future pandemics. Recommendations are made for prioritizing employee engagement with colleagues, and the importance of strong leadership and clear messaging in promoting adherence to behavioural mitigations. [ABSTRACT FROM AUTHOR]

Through a case study of South Korea's tracking infrastructure, this study critically examines new surveillance technologies deployed during the COVID-19 pandemic. I consider the ways that these technologies were widely framed as beneficial and benign, contributing to their widespread acceptance, and normalizing their pervasive and intrusive tracking capacities. By employing cluster criticism analysis of the Korean health authorities' official reports, I argue that Korean health authorities discursively construct their ICT-based tracking infrastructure as democratic technologies of control. They also position Korean citizens as data subjects entitled to the right to know about vitality and caring subjects responsible for the vitality of others through their provision of data, an exchange which this paper terms as vital dataveillance. Through the concept of vital dataveillance, this study illuminates the new types of data governance and data rights of the pandemic. [ABSTRACT FROM AUTHOR]

A novel Corona virus disease 2019 (COVID-19) outbreak is declared as the international public health emergency concern by the World Health Organization in the month of March 2020. This viral disease invented from China in the month of December 2019 has previously caused havoc around the world, including India. In this paper, efficient mathematical models using Gustafson–Kessel fuzzy clustering approach for the transmission of the COVID-19 are developed by considering the actual reported cases in the state of Tamil Nadu, India. The results proved a good concord between the reported data and the estimated data given by the proposed models. Moreover, the developed models are also capable to predict the requirements of beds in hospitals on the month of August 2020 in Tamil Nadu, India. Also, this work suggests strictly implementing/extending the complete lockdown for at least 21 days in the month of August 2020 and immediate separation of infected cases are the positive steps to reduce the spread of novel corona virus in Tamil Nadu state, India. [ABSTRACT FROM AUTHOR]

During the COVID-19 pandemic, music therapists transitioned services from in-person to telehealth due to health and safety concerns. Though online delivery of music therapy services for autistic individuals occurred prior to 2020, the number of North American music therapists using telehealth with autistic clients rose substantially during the pandemic. The current paper's objective was to delineate music therapists' perceptions regarding factors that helped or hindered autistic persons' engagement in online music therapy sessions. In total, 192 participants completed the survey. Qualitative content analysis of an open-ended question identified seven overarching themes regarding the benefits and challenges of telehealth music therapy for autistic clients. Findings were used to create a screening tool to help music therapists evaluate autistic persons' suitability for telehealth and meet the needs of those who can benefit from telehealth music therapy. [ABSTRACT FROM AUTHOR]

The aim of this narrative review was to explore the conditions under which enforcement likely is, or is not, an effective strategy to increase adherence to recommended protective behaviours during COVID-19. Relevant search terms were entered into four key databases (Google, Google Scholar, medXriv, and psyArXiv) to identify both academic and non-academic papers relating to the use of enforcement. Primary research, reviews, blogs, newspaper reports, and theoretical descriptions were included. This review suggests that enforcement is less effective when: it is applied inconsistently; rules are ambiguous; and behaviours are unobservable. Providing food and financial support, creating social norms, and increasing trust are more effective in addressing specific barriers and fostering voluntary adherence. Where enforcement forms part of the strategy for policing COVID-19 regulations, rules must be clear and local responders must be given time and opportunity to plan their response as new rules are implemented. Due to the narrative nature of the review, and the rapidly changing nature of the COVID-19 pandemic, some evidence may have been inadvertently excluded. Findings inform an understanding of the impact of the public narrative of enforcement on adherence and facilitate the development of recommendations for increasing adherence to protective behaviours during COVID-19. Given the importance of public adherence, these recommendations are not only useful in the context of COVID-19 but also for future public health emergencies. This narrative review is the first to explore the circumstances under which enforcement can increase or reduce adherence with COVID-19 guidelines, generating recommendations for improved public adherence. [ABSTRACT FROM AUTHOR]

Reserve systems are a tool to allocate scarce resources when stakeholders do not have a single objective. This paper introduces some basic concepts about reserve systems for pandemic medical resource allocation. At the onset of the Covid-19 pandemic, we proposed that reserve systems can help practitioners arrive at compromises between competing stakeholders. More than a dozen states and local jurisdictions adopted reserve systems in initial phases of vaccine distribution. We highlight several design issues arising in some of these implementations. We also offer suggestions about ways practitioners can take advantage of the flexibility offered by reserve systems. [ABSTRACT FROM AUTHOR]

Pandemics and epidemics pose systemic risks to lives, societies, and to global economic security—and their frequency is expected to increase as rising trade and increased human interaction with animals leads to the emergence of new diseases. The Covid-19 pandemic teaches us that we can and must be better prepared, with scope for much greater global coordination to address the financing, supply-chain, and trade barriers that amplified the pandemic's economic costs and contributed to the emergence of new variants. This paper draws seven early lessons from the Covid-19 pandemic that could inform future policy priorities and help shape a better global response to future crises. [ABSTRACT FROM AUTHOR]

Introduction Healthcare workers' work performance and mental health are associated with positive mental health outcomes and directly related to increased productivity and decreased disability costs. Methods We conducted a systematic review to identify factors associated with work performance of healthcare workers during a pandemic and conducted a meta-analysis of the prevalence of mental health outcomes in this context. Primary papers were collected and analysed using the Population/Intervention/Comparison/Outcome framework and using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. To critically appraise the studies included in the review, we used the AXIS appraisal tool to assess each cross-sectional study's quality. Results The study identified nine factors associated with the work performance and mental health of healthcare workers, including experiencing feelings of depression, anxiety, having inadequate support, experiencing occupational stress, decreased productivity, lack of workplace preparedness, financial concerns associated with changes in income and daily living, fear of transmission and burnout/fatigue. Conclusion There is a rapidly rising need to address the work performance and mental health of healthcare workers providing timely care to patients. Regular and sustained interventions, including the use of information and communication technologies such as telehealth, are warranted. [ABSTRACT FROM AUTHOR]

Recent literature on indicators as technology of global governance has shown the power of numbers in shaping knowledge and policy priorities. But not all indicators have powerful effects; some remain invisible. Are such indicators an obverse of powerful indicators? Are the same process of indirect exercise of power to indirectly achieve social and economic effects at work? This paper explores the case of Sustainable Development Goal (SDG) indicator 3.d.1 for the target to build national capacity for pandemic preparedness (target 3d) as a case study of invisible indicators. This indicator has had little traction, despite its relevance in the context of the Coronavirus disease 2019 (COVID-19) pandemic. The paper explores the reasons that explain this paradox through the framework of epistemic infrastructures. It argues that the indicator--the State Party Self-Assessment Report (SPAR) score--was an inconvenient tool for the powerful actors in the global health community as it turned out to be an extremely poor predictor of COVID-19 response performance. It would have exposed not only the failings of the powerful countries that lead the policy agenda for pandemic preparedness but also the legitimacy of their expertise and the paradigm of global health security as an approach to governing health risks. The analysis highlights the tight relationship between power and the use of indicators in global governance. While indicators are increasingly used by powerful actors to reframe policy narratives, the indicator of pandemic preparedness has been kept invisible to maintain their existing framing. It thus illustrates the resilience of power structures in epistemic infrastructures. [ABSTRACT FROM AUTHOR]

We propose a piecewise linear quantile trend model to analyse the trajectory of the COVID‐19 daily new cases (i.e. the infection curve) simultaneously across multiple quantiles. The model is intuitive, interpretable and naturally captures the phase transitions of the epidemic growth rate via change‐points. Unlike the mean trend model and least squares estimation, our quantile‐based approach is robust to outliers, captures heteroscedasticity (commonly exhibited by COVID‐19 infection curves) and automatically delivers both point and interval forecasts with minimal assumptions. Building on a self‐normalized (SN) test statistic, this paper proposes a novel segmentation algorithm for multiple change‐point estimation. Theoretical guarantees such as segmentation consistency are established under mild and verifiable assumptions. Using the proposed method, we analyse the COVID‐19 infection curves in 35 major countries and discover patterns with potentially relevant implications for effectiveness of the pandemic responses by different countries. A simple change‐adaptive two‐stage forecasting scheme is further designed to generate short‐term prediction of COVID‐19 cumulative new cases and is shown to deliver accurate forecast valuable to public health decision‐making. [ABSTRACT FROM AUTHOR]

Since the onset of COVID-19, scholars have questioned whether the pandemic will alter the fundamentals propelling the growth of global cities. Using a case study of Toronto, the paper examines and analyses changes impacting the city because of the pandemic, with a focus on work, mobility and housing. In assessing pandemic-related disruption, it outlines the experiences of the early phases of recovery and expectations of continued uncertainty. Moving through and beyond COVID-19, Toronto appears unlikely to move up the rankings of global cities. The city's status as a second-tier global city is an enduring competitive advantage, likely to persist post-COVID. [ABSTRACT FROM AUTHOR]

Covid-19 has obliged public authorities to enact several restrictions to citizens' everyday life. Some of them were or will be transitory, while others may result in long-term changes in production organisation. The analysis offered in this paper links the restrictions to the level of economic freedom of the EU members. The aim is to understand whether these two aspects were related, and the potential legacy of the restrictions for economies and cities. Likely, only teleworking will survive the pandemic, but it might entail major changes in the organisation of production, especially for jobs located in cities. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic adversely impacted physical activity, but little is known about how contextual changes following the pandemic declaration impacted either the dynamics of people's physical activity or their responses to micro-interventions for promoting physical activity.Purpose: This paper explored the effect of the COVID-19 pandemic on the dynamics of physical activity responses to digital message interventions.Methods: Insufficiently-active young adults (18-29 years; N = 22) were recruited from November 2019 to January 2020 and wore a Fitbit smartwatch for 6 months. They received 0-6 messages/day via smartphone app notifications, timed and selected at random from three content libraries (Move More, Sit Less, and Inspirational Quotes). System identification techniques from control systems engineering were used to identify person-specific dynamical models of physical activity in response to messages before and after the pandemic declaration on March 13, 2020.Results: Daily step counts decreased significantly following the pandemic declaration on weekdays (Cohen's d = -1.40) but not on weekends (d = -0.26). The mean overall speed of the response describing physical activity (dominant pole magnitude) did not change significantly on either weekdays (d = -0.18) or weekends (d = -0.21). In contrast, there was limited rank-order consistency in specific features of intervention responses from before to after the pandemic declaration.Conclusions: Generalizing models of behavioral dynamics across dramatically different environmental contexts (and participants) may lead to flawed decision rules for just-in-time physical activity interventions. Periodic model-based adaptations to person-specific decision rules (i.e., continuous tuning interventions) for digital messages are recommended when contexts change. [ABSTRACT FROM AUTHOR]

Background: Hand hygiene, facemask wearing, and physical distancing play a crucial role in the prevention of the COVID-19 pandemic. Identifying the key psychosocial determinants of these precautionary behaviors contributes to effective intervention and policymaking for COVID-19 and future pandemics.Purpose: This study aimed to systematically review and meta-analyze available evidence on psychosocial determinants of the general population's practice of three precautionary behaviors, based on the Risk, Attitudes, Norms, Abilities, and Self-regulation (RANAS) framework.Methods: Literature was identified by searching seven databases and relevant review papers. Observational and experimental studies targeting the general population (≥18 years) published between January 2020 to September 2021 were included. Pooled effect sizes were calculated with the inverse-variance method using random-effects models.Results: A total of 51 studies (64 samples) were included in the qualitative synthesis, of which 30 studies (42 samples) were included in the meta-analysis. RANAS-based constructs including knowledge, pros attitudes, and perceived norms were identified as significant determinants of all three behaviors in the meta-analysis. Perceived susceptibility and cons attitudes showed no significant associations with any behaviors. Perceived severity, perceived control, self-efficacy, and behavioral intention were significantly associated with one or two behaviors. Country (western vs. eastern hemispheres) significantly moderated the effects of certain risk and ability factors.Conclusions: More research is needed with respect to the intention-behavior relationship, self-regulatory and reflexive factors of precautionary behaviors, as well as the exploration of the potential moderating effect of sociodemographic factors. [ABSTRACT FROM AUTHOR]

Suicide is a leading cause of death worldwide. Even before the emergence of the novel coronavirus SARS-CoV2 COVID-19 pandemic, suicide continued to be a major public health concern. Globally, someone dies by suicide every 40 s, and for each death, there are 20 more persons attempting suicide. A recently published article rightly stated the need for a 'population-based approach' to suicide prevention to mitigate suicide attempts. This paper further adds that there must be a stronger multi-agency or multi-sectoral approach to suicide prevention, intervention and postvention. This paper concludes with few suggestions on how to address the COVID-19-related suicide cases as the world continues to fight against the double pandemic. [ABSTRACT FROM AUTHOR]

Objectives The high demand of filtering facepiece respirators (FFRs) worldwide during the period of the COVID-19 pandemic has led to a critical situation for decision-makers regarding their supply. After authorizing the use of FFRs certified by other regions of the world, decision-makers in many countries have published alerts, particularly concerning the 'KN95' type. Methods This paper investigated the filtration performance of different FFRs using an experimental setup already employed during several studies on FFRs filtration performance. Its high-resolution measuring devices permit to determine filtration performance according to the normative criteria: the pressure drop and the filtration efficiency. Eight different FFRs have been used: four NIOSH-approved FFRs and four not NIOSH-approved with a 'KN95' shape available during the beginning of the COVID-19 pandemic. Results The data show a high disparity between different FFRs purchased by healthcare establishments, and between those that are NIOSH-approved and those that are not NIOSH-approved. The results confirm that the NIOSH certification offers good protection according to the normative criteria. The 'KN95' types present pressure drops which correspond to the normative value, however their efficiencies are lower than the efficiencies of FFRs certified by NIOSH and lower than 95% at the most penetrate particle size. Conclusions FFRs marking is not sufficient to conclude on the FFRs' efficiency. Visual inspection can not determine which samples are counterfeit or have manufacturing defects. [ABSTRACT FROM AUTHOR]

The article presents the topics of the COVID-19-related research papers that were published in the journal "The Gerontologist" in 2021. These include older adults' experiences with COVID-19, the impact of the pandemic on elderly inmates, and the case of compassionate ageism. Also provided are the Gerontological Society of America's recommendations for research on COVID-19 topics including vaccine development and healthcare practices such as telehealth.

The coronavirus disease 2019 (COVID-19) pandemic, caused by the coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has created an unprecedented threat to public health. The pandemic has been sweeping the globe, impacting more than 200 countries, with more outbreaks still lurking on the horizon. At the time of the writing, no approved drugs or vaccines are available to treat COVID-19 patients, prompting an urgent need to decipher mechanisms underlying the pathogenesis and develop curative treatments. To fight COVID-19, researchers around the world have provided specific tools and molecular information for SARS-CoV-2. These pieces of information can be integrated to aid computational investigations and facilitate clinical research. This paper reviews current knowledge, the current status of drug development and various resources for key steps toward effective treatment of COVID-19, including the phylogenetic characteristics, genomic conservation and interaction data. The final goal of this paper is to provide information that may be utilized in bioinformatics approaches and aid target prioritization and drug repurposing. Several SARS-CoV-2-related tools/databases were reviewed, and a web-portal named OverCOVID (http://bis.zju.edu.cn/overcovid/) is constructed to provide a detailed interpretation of SARS-CoV-2 basics and share a collection of resources that may contribute to therapeutic advances. These information could improve researchers' understanding of SARS-CoV-2 and help to accelerate the development of new antiviral treatments. [ABSTRACT FROM AUTHOR]

The coronavirus disease 2019 (COVID-19) outbreak due to the novel coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been classified as a pandemic disease by the World Health Organization on the 12th March 2020. This world-wide crisis created an urgent need to identify effective countermeasures against SARS-CoV-2. In silico methods, artificial intelligence and bioinformatics analysis pipelines provide effective and useful infrastructure for comprehensive interrogation and interpretation of available data, helping to find biomarkers, explainable models and eventually cures. One class of such tools, pathway enrichment analysis (PEA) methods, helps researchers to find possible key targets present in biological pathways of host cells that are targeted by SARS-CoV-2. Since many software tools are available, it is not easy for non-computational users to choose the best one for their needs. In this paper, we highlight how to choose the most suitable PEA method based on the type of COVID-19 data to analyze. We aim to provide a comprehensive overview of PEA techniques and the tools that implement them. [ABSTRACT FROM AUTHOR]

Objective This study aims at reviewing novel coronavirus disease (COVID-19) datasets extracted from PubMed Central articles, thus providing quantitative analysis to answer questions related to dataset contents, accessibility and citations. Methods We downloaded COVID-19-related full-text articles published until 31 May 2020 from PubMed Central. Dataset URL links mentioned in full-text articles were extracted, and each dataset was manually reviewed to provide information on 10 variables: (1) type of the dataset, (2) geographic region where the data were collected, (3) whether the dataset was immediately downloadable, (4) format of the dataset files, (5) where the dataset was hosted, (6) whether the dataset was updated regularly, (7) the type of license used, (8) whether the metadata were explicitly provided, (9) whether there was a PubMed Central paper describing the dataset and (10) the number of times the dataset was cited by PubMed Central articles. Descriptive statistics about these seven variables were reported for all extracted datasets. Results We found that 28.5% of 12 324 COVID-19 full-text articles in PubMed Central provided at least one dataset link. In total, 128 unique dataset links were mentioned in 12 324 COVID-19 full text articles in PubMed Central. Further analysis showed that epidemiological datasets accounted for the largest portion (53.9%) in the dataset collection, and most datasets (84.4%) were available for immediate download. GitHub was the most popular repository for hosting COVID-19 datasets. CSV, XLSX and JSON were the most popular data formats. Additionally, citation patterns of COVID-19 datasets varied depending on specific datasets. Conclusion PubMed Central articles are an important source of COVID-19 datasets, but there is significant heterogeneity in the way these datasets are mentioned, shared, updated and cited. [ABSTRACT FROM AUTHOR]

The stratification of patients at risk of progression of COVID-19 and their molecular characterization is of extreme importance to optimize treatment and to identify therapeutic options. The bioinformatics community has responded to the outbreak emergency with a set of tools and resource to identify biomarkers and drug targets that we review here. Starting from a consolidated corpus of 27 570 papers, we adopt latent Dirichlet analysis to extract relevant topics and select those associated with computational methods for biomarker identification and drug repurposing. The selected topics span from machine learning and artificial intelligence for disease characterization to vaccine development and to therapeutic target identification. Although the way to go for the ultimate defeat of the pandemic is still long, the amount of knowledge, data and tools generated so far constitutes an unprecedented example of global cooperation to this threat. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has impacted the lives and workplaces of individuals across the world substantially, in ways that are yet largely unknown. This commentary aims to provide an early snapshot of the experiences of pediatric postdoctoral fellows in academic medical settings; specifically, we will explore the impact of the pandemic on developing mastery within several competencies (e.g. research, professional development, clinical, interdisciplinary). These competencies are critical elements to fellowship to prepare for independent practice. Several models of training competencies for professional psychology and pediatric psychology exist, which focus on trainee skill development. Measures taken to minimize the spread of COVID-19 have directly impacted hospital systems and training, requiring programs to adapt competencies in various domains, such as increased familiarity with telehealth and virtual supervision. Additionally, fellows experienced an impact of the pandemic on securing employment following fellowship, conducting research and program development activities, and on cognitive flexibility and self-care. Governing bodies, such as the APA and Council of Chairs of Training Councils, have released statements and guidelines on addressing training of postdoctoral fellows including increasing flexibility of training methods, limiting in-person contact, and adjusting educational and licensing requirements. This paper offers informed commentary and diverse perspectives from current postdoctoral fellows engaged in a variety of clinical and research responsibilities regarding how the COVID-19 pandemic has impacted their training. We hope this paper will provide important insight into the unique experiences of postdoctoral fellows during the capstone year(s) of training prior to independent work and inform recommendations for postdoctoral training programs. [ABSTRACT FROM AUTHOR]

This paper presents simulations of the potential effect of COVID-19-related school closures on schooling and learning outcomes. It considers four scenarios—varying in both the duration of school closures and the effectiveness of any mitigation strategies being deployed by governments. Using data on 174 countries, the analysis finds that the global level of schooling and learning will fall substantially. School closures could result in a loss of between 0.3 and 1.1 years of schooling adjusted for quality, bringing down the effective years of basic schooling that students achieve during their lifetime from 7.8 years to between 6.7 and 7.5 years. Close to 11 million students from primary up to secondary education could drop out due to the income shock of the pandemic alone. Exclusion and inequality will likely be exacerbated if already marginalized and vulnerable groups, such as girls, ethnic minorities, and persons with disabilities, are more adversely affected by school closures. Students from the current cohort could, on average, face a reduction of $366 to $1,776 in yearly earnings. In present value terms, this amounts to between $6,680 and $32,397 dollars in lost earnings over a typical student's lifetime. Globally, a school shutdown of 5 months could generate learning losses that have a present value of $10 trillion. By this measure, the world could stand to lose as much as 16 percent of the investments that governments make in the basic education of this cohort of students. In the pessimistic and very pessimistic scenarios, cumulative losses could add up to between $16 and $20 trillion in present value terms. Unless drastic remedial action is taken, the world could face a substantial setback in achieving the goal of halving the percentage of learning poor by 2030. [ABSTRACT FROM AUTHOR]

This paper reviews the emerging literature on which jobs can be performed from home and presents new estimates of the prevalence of such jobs based on the task content of occupations, their technology requirements and the availability of internet access by country and income groupings. Globally, one of every five jobs can be performed from home. In low-income countries, this ratio drops to one of every 26 jobs. Failing to account for internet access yields upward biased estimates of the resilience of poor countries, lagging regions, and poor workers. Since better paid workers are more likely to be able to work from home, COVID-19 is likely to exacerbate inequality, especially in richer countries where better paid and educated workers are insulated from the shock. The overall labor market burden of COVID-19 is bound to be larger in poor countries, where only a small share of workers can work from home and social protection systems are weaker. Across the globe, young, poorly educated workers and those on temporary contracts are least likely to be able to work from home and more vulnerable to the labor market shocks from COVID-19. [ABSTRACT FROM AUTHOR]

In this paper, a system is proposed which uses blockchain technology in healthcare. In this system, patients can access their health records anytime from anywhere. Moreover, the patients' health records are put into the blockchain anonymously. Whenever a patient visits a healthcare professional, the authorized entity filters patients' medical report out by eliminating the patients' sensitive information. Then, the filtered medical data are put into an off-chain database, while the address of the data is put into the blockchain with an assigned pseudo random identity of the patient. Thus, there are multi pseudo random identities for each patient. Unlike previous studies where the patients' identities/reports were linkable, in the proposed protocol the patients' identities are not linkable. The proposed system can also be used to show patients' health status to some entities when a pandemic happens (e.g. COVID-19). During the COVID-19 pandemic, the patients are required to show their series of vaccinations before they travel internationally/nationally or participate in some social events. To travel or join some events, the patient needs to show only a partial medical history to the security guard without leaking any private information. Furthermore, once the anonymous medical data are put into the off-chain database, the data can be used for data mining and machine learning. [ABSTRACT FROM AUTHOR]

Lao People's Democratic Republic (Lao PDR) aims at graduating from least developed country status by 2026 and must increase the level of domestic financing for health. This paper examines how the government has prepared for the decline of external assistance and how donors have applied their transition approaches. Adapting a World Health Organization (WHO) framework, reflections and lessons were generated based on literature review, informal and formal consultations and focus group discussions with the Lao PDR government and development partners including budget impact discussion. The government has taken three approaches to transition from external to domestic funding: mobilizing domestic resources, increasing efficiency across programs and prioritization with a focus on strengthening primary health care (PHC). The government has increased gradually domestic government health expenditures as a share of the government expenditure from 2.6% in 2013 to 4.9% in 2019. The Ministry of Health has made efforts to design and roll out integrated service delivery of maternal, newborn, child, and adolescent health services, immunization and nutrition; integrated 13 information systems of key health programs into one single District Health Information Software 2; and prioritized PHC, which has led to shifting donors towards supporting PHC. Donors have revisited their aid policies designed to improve sustainability and ownership of the government. However, the government faces challenges in improving cross-programmatic efficiency at the operational level and in further increasing the health budget due to the economic crisis aggravated during Coronavirus disease 2019 (COVID-19). Working to implement donor transition strategies under the current economic situation and country challenges, calls into question the criteria used to evaluate transition. This criterion needs to include more appropriate indicators other than gross national income per capita, which does not reflect a country's readiness and capacity of the health system. There should be a more country-tailored strategy and support for considering the context and system-wide readiness during donor transition. [ABSTRACT FROM AUTHOR]

Background Coronavirus disease 2019 (COVID-19) exposed weaknesses in the health systems of countries such as Nigeria, which affected the effectiveness of the health system response to the pandemic. This paper provides new knowledge on the level of the availability, effectiveness and equity of resources in response to COVID-19 in Nigeria. This is valuable information for improving the delivery of countermeasures against future pandemics. Methods The study was conducted at the federal level and in two states in Nigeria. The states were Lagos in the southwest and Enugu in the southeast. In-depth interviews were undertaken with 34 key informants. NVivo version 12 software was used for coding and thematic analysis. Results There were inadequate, inequitable and suboptimal resources (human, financial, equipment and materials) for the response. In some of the countermeasures, only people that were employed in the formal sector benefitted from the distribution of welfare materials and financial packages; the informal sector, which constitutes the majority of the poor population in Nigeria, was excluded. Conclusions Inequity and suboptimal availability of resources to control COVID-19 led to reduced effectiveness of the health system response to the disease in Nigeria. Such negative factors must be mitigated in future responses to pandemics in the country. [ABSTRACT FROM AUTHOR]

The estimation of unknown parameters in simulations, also known as calibration, is crucial for practical management of epidemics and prediction of pandemic risk. A simple yet widely used approach is to estimate the parameters by minimising the sum of the squared distances between actual observations and simulation outputs. It is shown in this paper that this method is inefficient, particularly when the epidemic models are developed based on certain simplifications of reality, also known as imperfect models which are commonly used in practice. To address this issue, a new estimator is introduced that is asymptotically consistent, has a smaller estimation variance than the least-squares estimator, and achieves the semiparametric efficiency. Numerical studies are performed to examine the finite sample performance. The proposed method is applied to the analysis of the COVID-19 pandemic for 20 countries based on the susceptible-exposed-infectious-recovered model with both deterministic and stochastic simulations. The estimation of the parameters, including the basic reproduction number and the average incubation period, reveal the risk of disease outbreaks in each country and provide insights to the design of public health interventions. [ABSTRACT FROM AUTHOR]

Global public–private partnerships (PPPs) have become prominent in efforts to address global challenges, particularly in the health field. In the scholarly literature, global PPPs have been conceptualized as arenas for voluntary public–private cooperation rather than agents of global governance. This paper challenges this approach, arguing that a sub-class of highly institutionalized partnerships have developed into transnational bureaucracies that, much like international organizations, can draw from their administrative capacities to exercise agency and gain and consolidate authority over time. To substantiate this argument, I present an in-depth analysis of five global health partnerships that played a leading role in the Access to Covid-19 Tools Accelerator (ACT-A), the initiative that sought to coordinate the global response to covid-19. Based on extensive document review and analysis of the ACT-A PPPs —Gavi, the Vaccine Alliance, The Global Fund to Fight AIDS, Tuberculosis and Malaria, The Coalition for Epidemic Preparedness Innovation, Unitaid, and The Foundation for Innovative New Diagnostics — I show how these partnerships' leadership role during the pandemic emerged from a decade long build-up of PPP agency. These organizations gained administrative capacities that enabled them to increase their authority vis-à-vis their donors, boards, and other external actors through three interlinked strategies: (a) developing greater financial autonomy; (b) expanding their mandates (including toward pandemic preparedness and response); and (c) establishing inter-partnership cooperation and mutual representation to other forums. My analysis suggests the need for future research to consider highly institutionalized PPPs as agents of global governance and to explore empirically and theoretically the consequences of their rising authority. [ABSTRACT FROM AUTHOR]

"Global Commissions of Inquiry" have usually been associated with the multilateral initiatives of governments and international organizations. However, various styles of "global commission" have emerged over time. During the COVID-19 pandemic, global commissions have been a key aspect of the COVID-19 international policy landscape, quickly emerging, in 2020 and 2021, to corral knowledge and evidence. These include "formal" commissions, such as the Independent Panel for Pandemic Preparedness and Response and the Global Commission for Post-Pandemic Policy, and "informal" commissions, including the Reform for Resilience and The Lancet Covid Commissions. This paper considers whether these Commissions have been engines for new ideas and global policy knowledge or whether this "chorus" of COVID Commissions represented a "clutter" of ideas at a time when global policy focus was needed. Global Commissions, in general, deserve greater scholarly attention to their design and the construction of their legitimate authority as hybrid and private commissions enter global policy making alongside official commissions. [ABSTRACT FROM AUTHOR]

In response to the spread of COVID-19, governments across the world, with very few exceptions, have enacted sweeping restrictive lockdown policies that impede citizens' freedom to move, work, and assemble. This paper critically responds to the central arguments for restrictive lockdown legislation. We build our critique on the following assumption: public policy that enjoys virtually unanimous support worldwide should be justified by uncontroversial moral principles. We argue that the virtually unanimous support in favor of restrictive lockdowns is not adequately justified by the arguments given in favor of them. Importantly, this is not to say that states ought not impose restrictive lockdown measures, but rather that the extent of the acceptance of these measures is not proportionate to the strength of the arguments for lockdowns. [ABSTRACT FROM AUTHOR]

STUDY QUESTION To what extent is preconception maternal or paternal coronavirus disease 2019 (COVID-19) vaccination associated with miscarriage incidence? SUMMARY ANSWER COVID-19 vaccination in either partner at any time before conception is not associated with an increased rate of miscarriage. WHAT IS KNOWN ALREADY Several observational studies have evaluated the safety of COVID-19 vaccination during pregnancy and found no association with miscarriage, though no study prospectively evaluated the risk of early miscarriage (gestational weeks [GW] <8) in relation to COVID-19 vaccination. Moreover, no study has evaluated the role of preconception vaccination in both male and female partners. STUDY DESIGN, SIZE, DURATION An Internet-based, prospective preconception cohort study of couples residing in the USA and Canada. We analyzed data from 1815 female participants who conceived during December 2020–November 2022, including 1570 couples with data on male partner vaccination. PARTICIPANTS/MATERIALS, SETTING, METHODS Eligible female participants were aged 21–45 years and were trying to conceive without use of fertility treatment at enrollment. Female participants completed questionnaires at baseline, every 8 weeks until pregnancy, and during early and late pregnancy; they could also invite their male partners to complete a baseline questionnaire. We collected data on COVID-19 vaccination (brand and date of doses), history of SARS-CoV-2 infection (yes/no and date of positive test), potential confounders (demographic, reproductive, and lifestyle characteristics), and pregnancy status on all questionnaires. Vaccination status was categorized as never (0 doses before conception), ever (≥1 dose before conception), having a full primary sequence before conception, and completing the full primary sequence ≤3 months before conception. These categories were not mutually exclusive. Participants were followed up from their first positive pregnancy test until miscarriage or a censoring event (induced abortion, ectopic pregnancy, loss to follow-up, 20 weeks' gestation), whichever occurred first. We estimated incidence rate ratios (IRRs) for miscarriage and corresponding 95% CIs using Cox proportional hazards models with GW as the time scale. We used propensity score fine stratification weights to adjust for confounding. MAIN RESULTS AND THE ROLE OF CHANCE Among 1815 eligible female participants, 75% had received at least one dose of a COVID-19 vaccine by the time of conception. Almost one-quarter of pregnancies resulted in miscarriage, and 75% of miscarriages occurred <8 weeks' gestation. The propensity score-weighted IRR comparing female participants who received at least one dose any time before conception versus those who had not been vaccinated was 0.85 (95% CI: 0.63, 1.14). COVID-19 vaccination was not associated with increased risk of either early miscarriage (GW: <8) or late miscarriage (GW: 8–19). There was no indication of an increased risk of miscarriage associated with male partner vaccination (IRR = 0.90; 95% CI: 0.56, 1.44). LIMITATIONS, REASONS FOR CAUTION The present study relied on self-reported vaccination status and infection history. Thus, there may be some non-differential misclassification of exposure status. While misclassification of miscarriage is also possible, the preconception cohort design and high prevalence of home pregnancy testing in this cohort reduced the potential for under-ascertainment of miscarriage. As in all observational studies, residual or unmeasured confounding is possible. WIDER IMPLICATIONS OF THE FINDINGS This is the first study to evaluate prospectively the relation between preconception COVID-19 vaccination in both partners and miscarriage, with more complete ascertainment of early miscarriages than earlier studies of vaccination. The findings are informative for individuals planning a pregnancy and their healthcare providers. STUDY FUNDING/COMPETING INTEREST(S) This work was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the National Institute of Health [R01-HD086742 (PI: L.A.W.); R01-HD105863S1 (PI: L.A.W. and M.L.E.)], the National Institute of Allergy and Infectious Diseases (R03-AI154544; PI: A.K.R.), and the National Science Foundation (NSF-1914792; PI: L.A.W.). The funders had no role in the study design, data collection, analysis and interpretation of data, writing of the report, or the decision to submit the paper for publication. L.A.W. is a fibroid consultant for AbbVie, Inc. She also receives in-kind donations from Swiss Precision Diagnostics (Clearblue home pregnancy tests) and Kindara.com (fertility apps). M.L.E. received consulting fees from Ro, Hannah, Dadi, VSeat, and Underdog, holds stock in Ro, Hannah, Dadi, and Underdog, is a past president of SSMR, and is a board member of SMRU. K.F.H. reports being an investigator on grants to her institution from UCB and Takeda, unrelated to this study. S.H.-D. reports being an investigator on grants to her institution from Takeda, unrelated to this study, and a methods consultant for UCB and Roche for unrelated drugs. The authors report no other relationships or activities that could appear to have influenced the submitted work. TRIAL REGISTRATION NUMBER N/A. [ABSTRACT FROM AUTHOR]