Journal of Preventive Medicine and Public Health

Original Article

SARS-CoV-2 Infection Risk Imposed by Fully-vaccinated Air Travelers Attending an Island-confined Quarantine System Enabling Tourism During the Pandemic: A Retrospective Cohort Study: Thunyaporn Sirijantradilok, Chanapong Rojanaworarit, Isabella Andrade, Worawaran Kallayanasit, Panunda Yodkhunnathum, Somruethai Khamsakhon, Supasit Suerungruang, Nuttawoot Photisan; J Prev Med Public Health. 2024;57(6):552-563. Published online September 23, 2024; DOI: https://doi.org/10.3961/jpmph.24.351

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Abstract Summary PDF: Objectives
This study aimed to identify the incidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among fully vaccinated air travelers participating in an island-confined quarantine system (Phuket Sandbox Program). It also compared the differential risk of SARS-CoV-2 infection across different coronavirus disease 2019 (COVID-19) vaccines and the difference in time-to-detection periods between asymptomatic and symptomatic cases.
Methods
This retrospective cohort study determined the cumulative incidence of SARS-CoV-2 infection among 63 052 air travelers who participated in a quarantine program from July 1, 2021 to October 31, 2021. Using Poisson regression with robust standard errors, we estimated the relative risk of SARS-CoV-2 infection across different brands and types of COVID-19 vaccines, adjusting for relevant covariates. We visualized the time-to-detection periods for SARS-CoV-2 infection using Kaplan-Meier failure curves and compared these curves for asymptomatic and symptomatic travelers using the log-rank test.
Results
The overall incidence of SARS-CoV-2 infection was 0.3%. Individuals vaccinated with Ad26.COV2.S, Gam-COVID-Vac, CoronaVac, and replicating viral vector vaccines faced a significantly higher risk of infection than those who received the BNT162b2 and mRNA vaccines. The time-to-detection periods for asymptomatic and symptomatic cases did not differ significantly.
Conclusions
Despite the relatively low risk of SARS-CoV-2 infection, a risk of breakthrough cases remained with certain vaccines. Given the high proportion of asymptomatic cases, quarantine and intermittent testing should be implemented. The mandatory quarantine system proved effective in managing positive cases without necessitating a complete shutdown of travel. Implementing an island quarantine could be a viable strategy for reintroducing travel and tourism during a future COVID-19 outbreak or a new pandemic.; Summary

Key Message
"This study evaluated the SARS-CoV-2 infection rate among 63,052 fully-vaccinated air travelers participating in the Phuket Sandbox Program in 2021. A breakthrough SARS-CoV-2 infection rate of 0.3% was identified. Travelers vaccinated with Ad26.COV2.S, Gam-COVID-Vac, CoronaVac, and replicating viral vector vaccines exhibited a higher risk of breakthrough infections than those vaccinated with BNT162b2 or other mRNA vaccines. The island-confined quarantine system combined with confirmatory COVID-19 testing effectively identified post-arrival infected travelers, demonstrating its potential as a model enabling safe tourism while preventing importation of cases into communities beyond the island during the pandemic."

Brief Report

Utilization of the Unlinked Case Proportion to Control COVID-19: A Focus on the Non-pharmaceutical Interventional Policies of the Korea and Japan: Yeri Jeong, Sanggu Kang, Boeun Kim, Yong Jin Gil, Seung-sik Hwang, Sung-il Cho; J Prev Med Public Health. 2023;56(4):377-383. Published online June 21, 2023; DOI: https://doi.org/10.3961/jpmph.23.056

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Abstract Summary PDF Supplementary Material: Objectives
Korea and Japan have managed the spread of coronavirus disease 2019 (COVID-19) using markedly different policies, referred to as the “3T” and “3C” strategies, respectively. This study examined these differences to assess the roles of active testing and contact tracing as non-pharmaceutical interventions (NPIs). We compared the proportion of unlinked cases (UCs) and test positivity rate (TPR) as indicators of tracing and testing capacities.
Methods
We outlined the evolution of NPI policies and investigated temporal trends in their correlations with UCs, confirmed cases, and TPR prior to the Omicron peak. Spearman correlation coefficients were reported between the proportion of UCs, confirmed cases, and TPR. The Fisher r-to-z transformation was employed to examine the significance of differences between correlation coefficients.
Results
The proportion of UCs was significantly correlated with confirmed cases (r=0.995, p<0.001) and TPR (r=0.659, p<0.001) in Korea and with confirmed cases (r=0.437, p<0.001) and TPR (r=0.429, p<0.001) in Japan. The Fisher r-to-z test revealed significant differences in correlation coefficients between the proportion of UCs and confirmed cases (z=16.07, p<0.001) and between the proportion of UCs and TPR (z=2.12, p=0.034) in Korea and Japan.
Conclusions
Higher UCs were associated with increases in confirmed cases and TPR, indicating the importance of combining testing and contact tracing in controlling COVID-19. The implementation of stricter policies led to stronger correlations between these indicators. The proportion of UCs and TPR effectively indicated the effectiveness of NPIs. If the proportion of UCs shows an upward trend, more testing and contact tracing may be required.; Summary

Korean summary
“3T”전략과 “3C”전략으로 대표되는 한국과 일본의 코로나 19 유행 시기의 NPI 정책을 비교하고, 접촉자 추적 및 검사 역량의 지표로 감염경로를 알 수 없는 확진자(unlinked case)와 검사 양성률(TPR)의 역할을 평가하였다. 감염경로를 알 수 없는 확진자(UC)는 전체 확진자수 증가 및 검사 양성률의 증가와 관련이 있었으며, 이는 COVID-19 통제에 있어 검사와 접촉자 추적을 적절히 조합하는 것이 중요함을 보여준다.

COVID-19: Original Article

Did the Timing of State Mandated Lockdown Affect the Spread of COVID-19 Infection? A County-level Ecological Study in the United States: Megh M. Trivedi, Anirudha Das; J Prev Med Public Health. 2021;54(4):238-244. Published online July 2, 2021; DOI: https://doi.org/10.3961/jpmph.21.071

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7 Web of Science
7 Crossref

Abstract PDF

Objectives
Previous pandemics have demonstrated that several demographic, geographic, and socioeconomic factors may play a role in increased infection risk. During this current coronavirus disease 2019 (COVID-19) pandemic, our aim was to examine the association of timing of lockdown at the county level and aforementioned risk factors with daily case rate (DCR) in the United States.
Methods
A cross-sectional study using publicly available data was performed including Americans with COVID-19 infection as of May 24, 2020. The United States counties with >100 000 population and >50 cases per 100 000 people were included. The independent variable was the days required from the declaration of lockdown to reach the target case rate (50/100 000 cases) while the dependent (outcome) variable was the DCR per 100 000 on the day of statistical calculation (May 24, 2020) after adjusting for multiple confounding socio-demographic, geographic, and health-related factors. Each independent factor was correlated with outcome variables and assessed for collinearity with each other. Subsequently, all factors with significant association to the outcome variable were included in multiple linear regression models using stepwise method. Models with best R2 value from the multiple regression were chosen.
Results
The timing of mandated lockdown order had the most significant association on the DCR per 100 000 after adjusting for multiple socio-demographic, geographic and health-related factors. Additional factors with significant association with increased DCR include rate of uninsured and unemployment.
Conclusions
The timing of lockdown order was significantly associated with the spread of COVID-19 at the county level in the United States.

Summary

Citations

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COVID-19: Perspective

The Pandemic League of COVID-19: Korea Versus the United States, With Lessons for the Entire World: Alwin Issac, Shine Stephen, Jaison Jacob, Vijay VR, Rakesh Vadakkethil Radhakrishnan, Nadiya Krishnan, Manju Dhandapani; J Prev Med Public Health. 2020;53(4):228-232. Published online May 25, 2020; DOI: https://doi.org/10.3961/jpmph.20.166

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Abstract PDF

Coronavirus disease 2019 (COVID-19) is inflicting a brutal blow on humankind, and no corner of the world has been exempted from its wrath. This study analyzes the chief control measures and the distinctive features of the responses implemented by Korea and the United States to contain COVID-19 with the goal of extracting lessons that can be applied globally. Even though both nations reported their index cases on the same day, Korea succeeded in flattening the curve, with 10 752 cases as of April 28, 2020, whereas the outbreak skyrocketed in the United States, which had more than 1 million cases at the same time. The prudent and timely execution of control strategies enabled Korea to tame the spread of the virus, whereas the United States paid a major price for its delay, although it is too early to render a conclusive verdict. Information pertaining to the number of people infected with the virus and measures instituted by the government to control the spread of COVID-19 was retrieved from the United States Centers for Disease Control and Prevention and the Korea Centers for Disease Control and Prevention websites and press releases. Drawing lessons from both nations, it is evident that the resolution to the COVID-19 pandemic lies in the prudent usage of available resources, proactive strategic planning, public participation, transparency in information sharing, abiding by the regulations that are put into place, and how well the plan of action is implemented.

Summary

Citations

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Special Article

Legal Issues in Quarantine and Isolation for Control of Emerging Infectious Diseases: Cheonsoo Kim; J Prev Med Public Health. 2016;49(1):1-17. Published online January 29, 2016; DOI: https://doi.org/10.3961/jpmph.16.009

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6 Crossref

Abstract PDF Supplementary Material

The Middle East respiratory syndrome coronavirus (MERS-CoV) outbreak in South Korea in 2015 has drawn public attention regarding the legal regulation of infectious disease control in Korea. This paper discusses the interpretive and legislative concerns regarding the Infectious Disease Prevention and Control Act, its ordinance and enforcement regulations, as well as public statements from the relevant administrative agency. Future improvements are also proposed.

Summary

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Perspective

A New Measure for Assessing the Public Health Response to a Middle East Respiratory Syndrome Coronavirus Outbreak: Sung-il Cho; J Prev Med Public Health. 2015;48(6):277-279. Published online November 30, 2015; DOI: https://doi.org/10.3961/jpmph.15.069

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84 Download
3 Crossref

Abstract PDF

Contact monitoring is an essential component of the public health response to a Middle East respiratory syndrome coronavirus outbreak, and is required for an effective quarantine to contain the epidemic. The timeliness of a quarantine is associated with its effectiveness. This paper provides a conceptual framework to describe the process of contact monitoring, and proposes a new measure called the “timely quarantined proportion” as a tool to assess the adequacy of a public health response.

Summary

Citations

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