The association of intensity and duration of non-pharmacological interventions and implementation of vaccination with COVID-19 infection, death, and excess mortality: Natural experiment in 22 European countries.

The association of intensity and duration of non-pharmacological interventions and implementation of vaccination with COVID-19 infection, death, and excess mortality: Natural experiment in 22 European countries.
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DOI:
10.1016/j.jiph.2022.03.011
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发表时间:
2022-05
影响因子:
6.7
通讯作者:
Zhou XH
Zhou XH
中科院分区:
医学3区
文献类型:
--
作者:
Zhou F;Hu TJ;Zhang XY;Lai K;Chen JH;Zhou XH

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在公众接种疫苗的同时,继续加强国家行动计划的必要性仍然存在一些关键问题。我们评估了欧洲非药物干预(npi)和疫苗的强度和持续时间与COVID-19感染、死亡和超额死亡率之间的关系。数据来自Our Word in Data。我们纳入了2020年1月20日至2021年5月30日期间的22个欧洲国家。在每个国家使用时变约束分布滞后模型,在考虑疫苗接种覆盖率的情况下,估计不同npi强度和持续时间对COVID-19控制的影响。通过荟萃分析汇总了各国的具体效果。本研究发现,在没有疫苗的情况下,高强度和长时间的npi对减少感染有积极的主要作用,特别是在第80百分位数以上的强度和持续7天(RR = 0.93, 95% CI: 0.89-0.98)。然而,对过量死亡率的不利影响也随着持续时间和强度的增加而增加。具体而言,在严格干预(强度高于第80百分位且持续21天)下,它与超额死亡率增加44.16% (RR = 1.44, 95% CI: 1.27-1.64)相关。随着疫苗的推广,严格干预对病例生长速率的抑制作用增强(RR由0.95降至0.87)。同时,接种疫苗也缓解了严格干预对超额死亡率的负面影响(RR由1.44降至1.25)。与弱干预相比,维持严格干预似乎更能减少病例,避免更多的总体死亡负担。我们的研究强调了在疫苗覆盖率低的情况下持续进行高强度非免疫活动的重要性。在疫苗接种覆盖率不足的情况下取消国家行动计划可能导致感染和死亡负担增加。政策制定者应协调npi的强度和持续时间,并在广泛接种疫苗的同时合理分配医疗资源。
Critical questions remain regarding the need for intensity to continue NPIs as the public was vaccinated. We evaluated the association of intensity and duration of non-pharmaceutical interventions (NPIs) and vaccines with COVID-19 infection, death, and excess mortality in Europe. Data comes from Our Word in Data. We included 22 European countries from January 20, 2020, to May 30, 2021. The time-varying constrained distribution lag model was used in each country to estimate the impact of different intensities and duration of NPIs on COVID-19 control, considering vaccination coverage. Country-specific effects were pooled through meta-analysis. This study found that high-intensity and long-duration of NPIs showed a positive main effect on reducing infection in the absence of vaccines, especially in the intensity above the 80th percentile and lasted for 7 days (RR = 0.93, 95% CI: 0.89–0.98). However, the adverse effect on excess mortality also increased with the duration and intensity. Specifically, it was associated with an increase of 44.16% (RR = 1.44, 95% CI: 1.27–1.64) in the excess mortality under the strict intervention (the intensity above the 80th percentile and lasted for 21 days). As the vaccine rollouts, the inhibition of the strict intervention on cases growth rate was increased (RR dropped from 0.95 to 0.87). Simultaneously, vaccination also alleviated the negative impact of the strict intervention on excess mortality (RR decreased from 1.44 to 1.25). Besides, maintaining the strict intervention appeared to more reduce the cases, as well as avoids more overall burden of death compared with weak intervention. Our study highlights the importance of continued high-intensity NPIs in low vaccine coverage. Lifting of NPIs in insufficient vaccination coverage may cause increased infections and death burden. Policymakers should coordinate the intensity and duration of NPIs and allocate medical resources reasonably with widespread vaccination.
非药物干预措施对130个国家和地区的SARS-COV-2传播的影响。
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发表时间: 2021-02-05
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影响因子: 9.3
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影响因子: 29.9
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DOI: 10.1016/j.jinf.2021.06.018
发表时间: 2021-09
期刊: The Journal of infection
影响因子: --
作者:
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DOI: 10.2807/1560-7917.es.2021.26.1.2002023
发表时间: 2021-01
期刊: Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin
影响因子: --
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