Health Policy and Technology最新文献

Background

Countries have adopted different COVID-19 policies to contain the transmission of the disease and to prepare for vaccination rollout. Countries’ political context, vaccine policy history, and health systems’ responses impacted COVID-19 health outcomes.

Objective

This study focused on synthesizing and examining COVID-19 non-pharmaceutical interventions in Brazil and Portugal, understanding the enablers and barriers to COVID-19 vaccination access and distribution, and health and non-health outcomes across three time-points: before vaccination, during mass vaccination, and after the declaration of endemicity.

Methods

Extensive qualitative document analysis of secondary sources published in Portuguese and English over the past three years, and examination of primary publicly available epidemiological data since the beginning of the pandemic.

Results

In the first year of the pandemic, the COVID-19 government response between the two countries was dissimilar; effective coordination, trust in the government response and political alignment in Portugal contrasted the political denial of the pandemic, lack of coordination between the various levels of government, at the same time the Brazilian population engaged in protective behaviours and distrusted the government. The COVID-19 vaccination had a good response from the public, associated with a primary care level network of distribution, low vaccine hesitancy, and strong childhood immunization programs before the pandemic in both countries. Vaccine manufacturing in Brazil and the strong support from the European Union to Portugal on vaccine acquisition have also aided these countries in achieving high COVID-19 vaccination coverage.

Conclusion

Future policies to promote a well-functioning and resilient health system should consider medical and nursing workforce sustainability, equity in all policies, building public trust, strengthening health system governance, and improving preparedness and surveillance.

Objective

This study aims to examine the interplay between high policy stringency, vaccination rates and epidemiological outcomes to develop insights on COVID-19 policy transition in Singapore

Methods

The CPTI (Categorising Policy & Technology Interventions) framework was used to classify reported interventions from January 2021 to October 2022. To analyse the impact of vaccine measures, an additional category was created. The highest monthly proportion of de-escalated measures was used as a basis to define the periods that mark the policy transition in Singapore i.e. Phase 2 and 3. Proportions of significantly escalated measures were calculated and analysed against full and booster vaccination rates, alongside epidemiological indicators – monthly total number of infections and deaths, and monthly average active hospitalisation and ICU cases.

Results

Implementation of highly stringent policies were observed to have reduced in intensity as vaccination rates picked up from Phase 2 to 3. Containment measures were the most frequently and consistently adopted beside vaccine policies. Epidemiological indicators appeared to be generally lower in Phase 3 than Phase 2. Specifically, despite reduced intensity of stringent polices, hospitalisation and ICU cases were observed to remain relatively low when vaccination rates were correspondingly higher in Phase 3 compared to Phase 2.

Conclusion

The descriptive analysis of COVID-19 policy shift in Singapore based on selected indicators preliminarily suggested its successful transition from the pandemic to endemic phase in its response strategies. A policy transition plan should consider the significance of vaccination rates in an exit strategy that protects the population against worse health outcomes.

Objective

Little is known about the relative effectiveness of COVID-19 vaccination and its interaction with non-pharmaceutical interventions (NPIs) in reducing infections, deaths, COVID-19 reproduction rate, and job losses. This study examined the relative effectiveness of vaccination and NPIs on COVID-19 infection, deaths, reproduction rate, and unemployment rate in the US.

Methods

Retrospective US data at the national level were obtained from the Oxford COVID-19 Government Response Tracker (OxCGRT dataset). Unemployment rate data were obtained from the US Bureau of Labor Statistics. Time-trend analyses of the policy variables and epidemiological outcomes were performed. A regression discontinuity in time was used to investigate the effects of policy variables on health outcomes and unemployment rate.

Results

Based on time-trend analyses, the number of people vaccinated increased starting in March 2021, while the stringency index had steadily declined since early January 2021. A decrease in new COVID-19 cases and deaths was observed during this period. However, despite higher vaccination coverage, new COVID-19 cases and deaths peaked in late 2021 and early 2022. We found that the interaction between treatment effects (vaccinations) and stringency measures was negatively associated with total COVID-19 cases and deaths, implying that some restrictions might be required to reduce rising infections during vaccination campaigns. We also found a negative association between vaccinations and the unemployment rate.

Conclusion

The study findings suggested that vaccinations alone were insufficient to reduce virus spread and deaths, and that some NPIs might be required during the vaccination campaigns.

Introduction

The COVID-19 pandemic has presented global challenges in the health, economy, society, and political sector for the past three years. For the Netherlands, the dynamic nature of the pandemic can be divided into three phases. The initial phase exclusively relied on non-pharmaceutical interventions (NPIs). The second phase was characterized by the introduction of vaccines alongside the continuation of stringent NPIs. Finally, the third phase marks the post-vaccine and booster stage, characterized by minimal or absent NPIs. This paper examines the interplay between the mitigation policies, the vaccination rollout, health outcomes, and economic indicators in the Netherlands in these three phases.

Methods

This analysis used national real-time data on COVID-19-related health outcomes, health service utilization, vaccination rollout, and economic indicators. Our descriptive analysis applied the “Categorising Policy & Technology Interventions (CPTI)” framework.

Results

The number of daily deaths, hospital admission and ICU admission experienced the highest peak in the first phase, while the number of daily cases first spiked in the third phase. The containment measures reached a very significant level twice, resulting in a full lockdown twice. In the first two phases, the peak in stringency of the CPTI containment category was parallel with the peaks in health outcomes. Conversely, in the third phase, the containment measures were scaled down prior to the peak in daily cases.

Conclusions

Our findings suggest that the Dutch three-phased COVID-19 mitigation strategy managed to fulfil its aim and protect vulnerable individuals, prevent healthcare institutions from overload, and move from the pandemic to the endemic phase.

Objectives

This study evaluates the effects of COVID-19 lockdowns, differentiated by their stringency, on the sales of Chilean businesses across various size categories and industries throughout 2020 and 2021. It also explores the role of the vaccination campaign and the implementation of the Mobility Pass in mitigating the negative economic effects of stringent containment measures.

Methods

The study uses administrative data from the Chilean Internal Revenue Service (SII), examining sales across different business sizes and industries, from March 2020 to December 2021. Through an econometric analysis, we estimate the effects of lockdowns on business sales during two distinct periods: initial reliance on dynamic non-pharmaceutical interventions (NPIs) pre-vaccine, and a subsequent stage characterized by high vaccine uptake and reduced NPI stringency.

Results

Lockdowns significantly reduced sales across all business sizes and most industries during the first period, with microenterprises and certain service sectors experiencing the highest decline. The national vaccination campaign and the introduction of the Mobility Pass in the second period appears to have mitigated the negative effects of lockdowns, primarily benefiting micro and small firms.

Conclusions

The study highlights the trade-offs between health and economic outcomes during the pandemic, stressing the importance to alleviate mobility restrictions post-vaccine rollout to ease the economic strain on businesses. The findings call for targeted support measures for MSMEs and vulnerable industries affected by NPIs.

Abstract

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