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      Effects of transport-related COVID-19 policy measures: A case study of six developed countries

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          Abstract

          This study attempts to provide scientifically-sound evidence for designing more effective COVID-19 policies in the transport and public health sectors by comparing 418 policy measures (244 are transport measures) taken in different months of 2020 in Australia, Canada, Japan, New Zealand, the UK, and the US. The effectiveness of each policy is measured using nine indicators of infections and mobilities corresponding to three periods (i.e., one week, two weeks, and one month) before and after policy implementation. All policy measures are categorized based on the PASS approach (P: prepare-protect-provide; A: avoid-adjust; S: shift-share; S: substitute-stop). First, policy effectiveness is compared between policies, between countries, and over time. Second, a dynamic Bayesian multilevel generalized structural equation model is developed to represent dynamic cause-effect relationships between policymaking, its influencing factors and its consequences, within a unified research framework. Third, major policy measures in the six countries are compared. Finally, findings for policymakers are summarized and extensively discussed.

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          Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study

          Xiaobo Yang, Yuan Yu, Jiqian Xu … (2020)
          Summary Background An ongoing outbreak of pneumonia associated with the severe acute respiratory coronavirus 2 (SARS-CoV-2) started in December, 2019, in Wuhan, China. Information about critically ill patients with SARS-CoV-2 infection is scarce. We aimed to describe the clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia. Methods In this single-centered, retrospective, observational study, we enrolled 52 critically ill adult patients with SARS-CoV-2 pneumonia who were admitted to the intensive care unit (ICU) of Wuhan Jin Yin-tan hospital (Wuhan, China) between late December, 2019, and Jan 26, 2020. Demographic data, symptoms, laboratory values, comorbidities, treatments, and clinical outcomes were all collected. Data were compared between survivors and non-survivors. The primary outcome was 28-day mortality, as of Feb 9, 2020. Secondary outcomes included incidence of SARS-CoV-2-related acute respiratory distress syndrome (ARDS) and the proportion of patients requiring mechanical ventilation. Findings Of 710 patients with SARS-CoV-2 pneumonia, 52 critically ill adult patients were included. The mean age of the 52 patients was 59·7 (SD 13·3) years, 35 (67%) were men, 21 (40%) had chronic illness, 51 (98%) had fever. 32 (61·5%) patients had died at 28 days, and the median duration from admission to the intensive care unit (ICU) to death was 7 (IQR 3–11) days for non-survivors. Compared with survivors, non-survivors were older (64·6 years [11·2] vs 51·9 years [12·9]), more likely to develop ARDS (26 [81%] patients vs 9 [45%] patients), and more likely to receive mechanical ventilation (30 [94%] patients vs 7 [35%] patients), either invasively or non-invasively. Most patients had organ function damage, including 35 (67%) with ARDS, 15 (29%) with acute kidney injury, 12 (23%) with cardiac injury, 15 (29%) with liver dysfunction, and one (2%) with pneumothorax. 37 (71%) patients required mechanical ventilation. Hospital-acquired infection occurred in seven (13·5%) patients. Interpretation The mortality of critically ill patients with SARS-CoV-2 pneumonia is considerable. The survival time of the non-survivors is likely to be within 1–2 weeks after ICU admission. Older patients (>65 years) with comorbidities and ARDS are at increased risk of death. The severity of SARS-CoV-2 pneumonia poses great strain on critical care resources in hospitals, especially if they are not adequately staffed or resourced. Funding None.
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            Estimating the effects of non-pharmaceutical interventions on COVID-19 in Europe

            Seth Flaxman, Swapnil Mishra, Axel Gandy … (2020)
            Following the detection of the new coronavirus1 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its spread outside of China, Europe has experienced large epidemics of coronavirus disease 2019 (COVID-19). In response, many European countries have implemented non-pharmaceutical interventions, such as the closure of schools and national lockdowns. Here we study the effect of major interventions across 11 European countries for the period from the start of the COVID-19 epidemics in February 2020 until 4 May 2020, when lockdowns started to be lifted. Our model calculates backwards from observed deaths to estimate transmission that occurred several weeks previously, allowing for the time lag between infection and death. We use partial pooling of information between countries, with both individual and shared effects on the time-varying reproduction number (Rt). Pooling allows for more information to be used, helps to overcome idiosyncrasies in the data and enables more-timely estimates. Our model relies on fixed estimates of some epidemiological parameters (such as the infection fatality rate), does not include importation or subnational variation and assumes that changes in Rt are an immediate response to interventions rather than gradual changes in behaviour. Amidst the ongoing pandemic, we rely on death data that are incomplete, show systematic biases in reporting and are subject to future consolidation. We estimate that-for all of the countries we consider here-current interventions have been sufficient to drive Rt below 1 (probability Rt < 1.0 is greater than 99%) and achieve control of the epidemic. We estimate that across all 11 countries combined, between 12 and 15 million individuals were infected with SARS-CoV-2 up to 4 May 2020, representing between 3.2% and 4.0% of the population. Our results show that major non-pharmaceutical interventions-and lockdowns in particular-have had a large effect on reducing transmission. Continued intervention should be considered to keep transmission of SARS-CoV-2 under control.
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              The effect of travel restrictions on the spread of the 2019 novel coronavirus (COVID-19) outbreak

              Matteo Chinazzi, Jessica Davis, Marco Ajelli … (2020)
              Motivated by the rapid spread of COVID-19 in Mainland China, we use a global metapopulation disease transmission model to project the impact of travel limitations on the national and international spread of the epidemic. The model is calibrated based on internationally reported cases, and shows that at the start of the travel ban from Wuhan on 23 January 2020, most Chinese cities had already received many infected travelers. The travel quarantine of Wuhan delayed the overall epidemic progression by only 3 to 5 days in Mainland China, but has a more marked effect at the international scale, where case importations were reduced by nearly 80% until mid February. Modeling results also indicate that sustained 90% travel restrictions to and from Mainland China only modestly affect the epidemic trajectory unless combined with a 50% or higher reduction of transmission in the community.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Transp Policy (Oxf)
                Journal ID (iso-abbrev): Transp Policy (Oxf)
                Title: Transport Policy
                Publisher: Elsevier Ltd.
                ISSN (Print): 0967-070X
                ISSN (Electronic): 1879-310X
                Publication date PMC-release: 30 May 2021
                Publication date (Print): September 2021
                Publication date (Electronic): 30 May 2021
                Volume: 110
                Pages: 37-57
                Affiliations
                [a ]Graduate School of Advanced Science and Engineering, Graduate School for International Development and Cooperation, Hiroshima University, Japan
                [b ]Research Center for Advanced Science and Technology, The University of Tokyo, Japan
                [c ]College of Architecture and Urban Planning, Tongji University, China; Graduate School of Advanced Science and Engineering, Hiroshima University, Japan
                [d ]Center for Sustainable Development and Global Smart City, Chubu University, Japan
                Author notes
                [∗ ]Corresponding author.
                Article
                Publisher Item ID: S0967-070X(21)00157-8
                DOI: 10.1016/j.tranpol.2021.05.013
                PMC ID: 8481159
                PubMed ID: 34608358
                SO-VID: 9cd0b971-9dd3-451f-8cc7-9feafabf5b78
                Copyright © © 2021 Elsevier Ltd. All rights reserved.
                License:

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                Date received : 3 May 2021
                Date accepted : 21 May 2021
                Categories
                Subject: Article

                Keywords: covid-19,policymaking,transport sector,public health,pass approach,multilevel modeling
                Data availability:
                Keywords: covid-19, policymaking, transport sector, public health, pass approach, multilevel modeling

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