Rxivist logo

Rxivist.org combines preprints from bioRxiv and medRxiv with data from Twitter to help you find the papers being discussed in your field.
Currently indexing 150,919 papers from 635,767 authors.

Most downloaded biology preprints, all time

Results 1 through 20 out of 361

in category health policy


1: Multi-organ impairment in low-risk individuals with long COVID

Andrea Dennis, Malgorzata Wamil et al.

79,248 downloads (posted 16 Oct 2020)

BackgroundSevere acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) infection has disproportionately affected older individuals and those with underlying medical conditions. Research has focused on short-term outcomes in hospital, and single organ involvement. Consequently, impact of long COVID (persistent symptoms three months post-infection) across multiple organs in low-risk individuals is yet to be assessed. MethodsAn ongoing prospective, longitudinal, two-centre, observational study was performed in individuals symptomatic after recovery from acute SARS-CoV-2 infection. Symptoms and organ function (heart, lungs, kidneys, liver, pancreas, spleen) were assessed by standardised questionnaires (EQ-5D-5L, Dyspnoea-12), blood investigations and quantitative magnetic resonance imaging, defining single and multi-organ impairment by consensus definitions. FindingsBetween April and September 2020, 201 individuals (mean age 44 (SD 11.0) years, 70% female, 87% white, 31% healthcare workers) completed assessments following SARS-CoV-2 infection (median 140, IQR 105-160 days after initial symptoms). The prevalence of pre-existing conditions (obesity: 20%, hypertension: 6%; diabetes: 2%; heart disease: 4%) was low, and only 18% of individuals had been hospitalised with COVID-19. Fatigue (98%), muscle aches (88%), breathlessness (87%), and headaches (83%) were the most frequently reported symptoms. Ongoing cardiorespiratory (92%) and gastrointestinal (73%) symptoms were common, and 42% of individuals had ten or more symptoms. There was evidence of mild organ impairment in heart (32%), lungs (33%), kidneys (12%), liver (10%), pancreas (17%), and spleen (6%). Single (66%) and multi-organ (25%) impairment was observed, and was significantly associated with risk of prior COVID-19 hospitalisation (p<0.05). InterpretationIn a young, low-risk population with ongoing symptoms, almost 70% of individuals have impairment in one or more organs four months after initial symptoms of SARS-CoV-2 infection. There are implications not only for burden of long COVID but also public health approaches which have assumed low risk in young people with no comorbidities. FundingThis work was supported by the UKs National Consortium of Intelligent Medical Imaging through the Industry Strategy Challenge Fund, Innovate UK Grant 104688, and also through the European Unions Horizon 2020 research and innovation programme under grant agreement No 719445.


2: Demographic science aids in understanding the spread and fatality rates of COVID-19

Jennifer Beam Dowd, Liliana Andriano et al.

15,343 downloads (posted 18 Mar 2020)

Governments around the world must rapidly mobilize and make difficult policy decisions to mitigate the COVID-19 pandemic. Because deaths have been concentrated at older ages, we highlight the important role of demography, particularly how the age structure of a population may help explain differences in fatality rates across countries and how transmission unfolds. We examine the role of age structure in deaths thus far in Italy and South Korea and illustrate how the pandemic could unfold in populations with similar popu...


3: Effects of non-pharmaceutical interventions on COVID-19: A Tale of Three Models

Vincent Chin, John Ioannidis et al.

15,130 downloads (posted 27 Jul 2020)

Objective: To compare the inference regarding the effectiveness of the various non-pharmaceutical interventions (NPIs) for COVID-19 obtained from different SIR models. Study design and setting: We explored two models developed by Imperial College that considered only NPIs without accounting for mobility (model 1) or only mobility (model 2), and a model accounting for the combination of mobility and NPIs (model 3). Imperial College applied models 1 and 2 to 11 European countries and to the USA, respectively. We applied t...


4: Who funded the research behind the Oxford-AstraZeneca COVID-19 vaccine? - Approximating the funding to the University of Oxford for the research and development of the ChAdOx vaccine technology

Samuel Cross, Yeanuk Rho et al.

14,182 downloads (posted 10 Apr 2021)

Objectives: The Oxford-AstraZeneca COVID-19 vaccine (ChAdOx1 nCoV-19 or Vaxzevira) builds on nearly two decades of research and development (R&D) into Chimpanzee adenovirus-vectored vaccine (ChAdOx) technology at the University of Oxford. This study aims to approximate the funding for the R&D of the ChAdOx technology and the Oxford-AstraZeneca vaccine, and assess the transparency of funding reporting mechanisms. Design: We conducted a scoping review and publication history analysis of the principal investigators to reco...


5: State-wise estimates of current hospital beds, intensive care unit (ICU) beds and ventilators in India: Are we prepared for a surge in COVID-19 hospitalizations?

Geetanjali Kapoor, Stephanie Hauck et al.

13,719 downloads (posted 18 Jun 2020)

Background The rapid spread of COVID-19 globally has prompted policymakers to evaluate the capacity of health care infrastructure in their communities. Many hard-hit localities have witnessed a large influx of severe cases that strained existing hospitals. As COVID-19 spreads in India, it is essential to evaluate the country's capacity to treat severe cases. Methods We combined data on public and private sector hospitals in India to produce state level estimates of hospital beds, ICU beds, and mechanical ventilators. Ba...


6: COVID-19 Mitigation Practices and COVID-19 Rates in Schools: Report on Data from Florida, New York and Massachusetts

Emily Oster, Rebecca Jack et al.

10,379 downloads (posted 21 May 2021)

This paper reports on the correlation of mitigation practices with staff and student COVID-19 case rates in Florida, New York, and Massachusetts during the 2020-2021 school year. We analyze data collected by the COVID-19 School Response Dashboard and focus on student density, ventilation upgrades, and masking. We find higher student COVID-19 rates in schools and districts with lower in-person density but no correlations in staff rates. Ventilation upgrades are correlated with lower rates in Florida but not in New York. ...


7: Brazilian Modeling of COVID-19 (BRAM-COD): a Bayesian Monte Carlo approach for COVID-19 spread in a limited data set context

Samy Dana, Alexandre B Simas et al.

10,007 downloads (posted 03 May 2020)

Background: The new coronavirus respiratory syndrome disease (COVID-19) pandemic has become a major health problem worldwide. Many attempts have been devoted to modeling the dynamics of new infection rates, death rates, and the impact of the disease on health systems and the world economy. Most of these modeling concepts use the Susceptible-Infectious-Susceptible (SIS) and Susceptible-Exposed-Infected-Recovered (SEIR) compartmental models; however, wide imprecise outcomes in forecasting can occur with these models in th...


8: Acceptance and Attitudes Toward COVID-19 Vaccines: A Cross-Sectional Study from Jordan

Tamam El-Elimat, Mahmoud M. AbuAlSamen et al.

9,911 downloads (posted 24 Dec 2020)

BackgroundVaccines are effective interventions that can reduce the high burden of diseases globally. However, public vaccine hesitancy is a pressing problem for public health authorities. With the availability of COVID-19 vaccines, little information is available on the public acceptability and attitudes towards the COVID-19 vaccines in Jordan. This study aimed to investigate the acceptability of COVID-19 vaccines and its predictors in addition to the attitudes towards these vaccines among public in Jordan. MethodsAn o...


9: Pandemic Politics: Timing State-Level Social Distancing Responses to COVID-19

Christopher Adolph, Kenya Amano et al.

8,932 downloads (posted 31 Mar 2020)

Social distancing policies are critical but economically painful measures to flatten the curve against emergent infectious diseases. As the novel coronavirus that causes COVID-19 spread throughout the United States in early 2020, the federal government issued social distancing recommendations but left to the states the most difficult and consequential decisions restricting behavior, such as canceling events, closing schools and businesses, and issuing stay-at-home orders. We present an original dataset of state-level so...


10: Risk Stratification tool for Healthcare workers during the CoViD-19 Pandemic; using published data on demographics, co-morbid disease and clinical domain in order to assign biological risk

Janusz Jankowski, Angharad davies et al.

8,633 downloads (posted 09 May 2020)

Healthcare workers have a greater exposure to individuals with confirmed SARS-novel coronavirus 2, and thus a higher probability of contracting coronavirus disease (CoViD)-19, than the general population. Employers have a duty of care to minimise the risk for their employees. Several bodies including the Faculty of Occupational Medicine, NHS Employers, and Public Health England have published a requirement to perform risk assessments for all health care workers, however, with the absence of an objective risk stratificat...


11: Women in power: Female leadership and public health outcomes during the COVID-19 pandemic

Luca Coscieme, Lorenzo Fioramonti et al.

6,963 downloads (posted 15 Jul 2020)

Some countries have been more successful than others at dealing with the COVID-19 pandemic. When we explore the different policy approaches adopted as well as the underlying socio-economic factors, we note an interesting set of correlations: countries led by women leaders have fared significantly better than those led by men on a wide range of dimensions concerning the global health crisis. In this paper, we analyze available data for 35 countries, focusing on the following variables: number of deaths per capita due to ...


12: Markedly heterogeneous COVID-19 testing plans among US colleges and universities

A. Sina Booeshaghi, Fayth Hui Tan et al.

6,298 downloads (posted 11 Aug 2020)

As the COVID-19 pandemic worsens in the United States, colleges that have invited students back for the fall are finalizing mitigation plans to lessen the spread of SARS-CoV-2. Even though students have largely been away from campuses over the summer, several outbreaks associated with colleges have already occurred, foreshadowing the scale of infection that could result from hundreds of thousands of students returning to college towns and cities. While many institutions have released return-to-campus plans designed to r...


13: The Immediate Effect of COVID-19 Policies on Social Distancing Behavior in the United States

Rahi Abouk, Babak Heydari

4,548 downloads (posted 10 Apr 2020)

Anecdotal evidence points to the effectiveness of COVID-19 social distancing policies, however, their effectiveness vis-a-vis what is driven by public awareness and voluntary actions have not been studied. Policy variations across US states create a natural experiment to study the causal impact of each policy. Using a difference-in-differences methodology, location-based mobility, and daily state-level data on COVID-19 tests and confirmed cases, we rank policies based on their effectiveness. We show that statewide stay-...


14: A Model Based Analysis for COVID-19 Pandemic in India: Implications for Health Systems and Policy for Low- and Middle-Income Countries

Shankar Prinja, Pankaj Bahuguna et al.

4,328 downloads (posted 12 Jun 2020)

The authors have withdrawn this manuscript because they do not wish this work to be cited as reference for the project. If you have any questions, please contact the corresponding author.


15: Global Assessment of the Relationship between Government Response Measures and COVID-19 Deaths

Thomas Hale, Andrew J Hale et al.

3,905 downloads (posted 06 Jul 2020)

Objective: To provide an early global assessment of the impact of government stringency measures on the rate of growth in deaths from COVID-19. We hypothesized that the overall stringency of a government's interventions and the speed of implementation would affect the growth and level of deaths related to COVID-19 in that country. Design: Observational study based on an original database of global governmental responses to the COVID-19 pandemic. Daily data was collected on a range of containment and closure policies for...


16: COVID-19 pandemic in the African continent: forecasts of cumulative cases, new infections, and mortality

Tom Achoki, Uzma Alam et al.

3,814 downloads (posted 14 Apr 2020)

Background: The epidemiology of COVID-19 remains speculative in Africa. To the best of our knowledge, no study, using robust methodology provides its trajectory for the region or accounts for the local context. This paper is the first systematic attempt to provide prevalence, incidence, and mortality estimates across Africa. Methods: Caseloads and incidence forecasts are from a co-variate-based instrumental variable regression model. Fatality rates from Italy and China were applied to generate mortality estimates after ...


17: Corona Epidemic in Indian context: Predictive Mathematical Modelling

Jyoti Bhola, Vandana Revathi Venkateswaran et al.

3,680 downloads (posted 07 Apr 2020)

The novel Coronavirus pathogen Covid-19 is a cause of concern across the world as the human-to-human infection caused by it is spreading at a fast pace. The virus that first manifested in Wuhan, China has travelled across continents. The increase in number of deaths in Italy, Iran, USA, and other countries has alarmed both the developed and developing countries. Scientists are working hard to develop a vaccine against the virus, but until now no breakthrough has been achieved. India, the second most populated country in...


18: The impact of lockdown measures on COVID-19: a worldwide comparison

Dimitris I Papadopoulos, Ivo Donkov et al.

3,411 downloads (posted 26 May 2020)

Objective We aimed to determine which aspects of the COVID-19 national response are independent predictors of COVID-19 mortality and case numbers. Design Comparative observational study between nations using publically available data Setting Worldwide Participants Covid-19 patients Interventions Stringency of 11 lockdown policies recorded by the Blavatnik School of Government database and earliness of each policy relative to first recorded national cases Main outcome measures Association with log10 National deaths (LogD...


19: Impact of policy interventions and social distancing on SARS-CoV-2 transmission in the United States

Nickolas Dreher, Zachary Spiera et al.

3,109 downloads (posted 06 May 2020)

Background: Policymakers have employed various non-pharmaceutical interventions (NPIs) such as stay-at-home orders and school closures to limit the spread of Coronavirus disease (COVID-19). However, these measures are not without cost, and careful analysis is critical to quantify their impact on disease spread and guide future initiatives. This study aims to measure the impact of NPIs on the effective reproductive number (Rt) and other COVID-19 outcomes in U.S. states. Methods: In order to standardize the stage of disea...


20: World governments should protect their population from COVID-19 pandemic using Italy and Lombardy as precursor

M. Supino, A. d’Onofrio et al.

3,035 downloads (posted 27 Mar 2020)

The COVID-19 pandemic is spreading worldwide. Italy emerged early on as the country with the largest outbreak outside Asia. The outbreak in Northern Italy demonstrates that it is fundamental to contain the virus spread at a very early stage of diffusion. At later stages, no containment measure, even if strict, can prevent the saturation of the hospitals and of the intensive care units in any country. Here we show that it is possible to predict when the intensive care units will saturate, within a few days from the first...