ArticleEpidemics2021
Lessons for preparedness and reasons for concern from the early COVID-19 epidemic in Iran.
Article in Epidemics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Excess mortality during the COVID-19 pandemic in low-and lower-middle-income countries: a systematic review and meta-analysis.BMC public health · 2024Pooled it
- Changes in emergency department visits and mortality during the COVID-19 pandemic: a retrospective analysis of 956 hospitals.Archives of public health = Archives belges de sante publique · 2024Article
- Prevalence of death anxiety and its related factors in the population of eastern Iran: a cross-sectional study in the era of COVID-19.Frontiers in public health · 2024Article
- A quantitative evaluation of the impact of vaccine roll-out rate and coverage on reducing deaths: insights from the first 2 years of COVID-19 epidemic in Iran.BMC medicine · 2023Article
- Do prior neurological comorbidities predict COVID-19 severity and death? A 25-month cross-sectional multicenter study on 7370 patients.Acta neurologica Belgica · 2023Article
- Impact of social and cultural factors on incidence, transmission and control of Coronavirus disease in Iran: a qualitative study.BMC public health · 2022Article
- Estimating SARS-CoV-2 variant fitness and the impact of interventions in England using statistical and geo-spatial agent-based models.Philosophical transactions. Series A, Mathematical, physical, and engineering sciences · 2022Article
- Published Research on COVID-19 in the Eastern Mediterranean Region: Bibliometric Analysis.Interactive journal of medical research · 2022Article
- A framework for reconstructing SARS-CoV-2 transmission dynamics using excess mortality data.Nature communications · 2022Article
- Engaging Religious Institutions and Faith-Based Communities in Public Health Initiatives: A Case Study of the Romanian Orthodox Church During the COVID-19 Pandemic.Frontiers in public health · 2021Article
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Abstract
introductionMany countries with an early outbreak of SARS-CoV-2 struggled to gauge the size and start date of the epidemic mainly due to limited testing capacities and a large proportion of undetected asymptomatic and mild infections. Iran was among the first countries with a major outbreak outside China.
methodsWe constructed a globally representative sample of 802 genomes, including 46 samples from patients inside or with a travel history to Iran. We then performed a phylogenetic analysis to identify clades related to samples from Iran and estimated the start of the epidemic and early doubling times in cases. We leveraged air travel data from 36 exported cases of COVID-19 to estimate the point-prevalence and the basic reproductive number across the country. We also analysed the province-level all-cause mortality data during winter and spring 2020 to estimate under-reporting of COVID-19-related deaths. Finally, we use this information in an SEIR model to reconstruct the early outbreak dynamics and assess the effectiveness of intervention measures in Iran.
resultsBy identifying the most basal clade that contained genomes from Iran, our phylogenetic analysis showed that the age of the root is placed on 2019-12-21 (95 % HPD: 2019-09-07 - 2020-02-14). This date coincides with our estimated epidemic start date on 2019-12-25 (95 %CI: 2019-12-11 - 2020-02-24) based air travel data from exported cases with an early doubling time of 4.0 (95 %CI: 1.4-6.7) days in cases. Our analysis of all-cause mortality showed 21.9 (95 % CI: 16.7-27.2) thousand excess deaths by the end of summer. Our model forecasted the second epidemic peak and suggested that by 2020-08-31 a total of 15.0 (95 %CI: 4.9-25.0) million individuals recovered from the disease across the country.
conclusionThese findings have profound implications for assessing the stage of the epidemic in Iran despite significant levels of under-reporting. Moreover, the results shed light on the dynamics of SARS-CoV-2 transmissions in Iran and central Asia. They also suggest that in the absence of border screening, there is a high risk of introduction from travellers from areas with active outbreaks. Finally, they show both that well-informed epidemic models are able to forecast episodes of resurgence following a relaxation of interventions, and that NPIs are key to controlling ongoing epidemics.
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