The prevention paradox describes the seemingly contradictory situation where the majority of cases of a disease come from a population at low or moderate risk of that disease, and only a minority of cases come from the high risk population (of the same disease). This is because the number of people at high risk is small. The prevention paradox was first formally described in 1981 [1] by the epidemiologist Geoffrey Rose.
Especially during the COVID-19 pandemic of 2020, the term "prevention paradox" was also used to describe the apparent paradox of people questioning steps to prevent the spread of the pandemic because the prophesied spread did not occur. [2] This however is instead an example of a self-defeating prophecy [3] or a preparedness paradox.
For example, Rose describes the case of Down syndrome where maternal age is a risk factor. Yet, most cases of Down syndrome will be born to younger, low risk mothers (this is true at least in populations where most women have children at a younger age). This situation is paradoxical because it is common and logical to equate high-risk populations with making up the majority of the burden of disease.
Another example could be seen in terms of reducing overall alcohol problems in a population. Although less serious, most alcohol problems are not found among dependent drinkers. Greater societal gain will be obtained by achieving a small reduction in alcohol misuse within a far larger group of "risky" drinkers with less serious problems than by trying to reduce problems among a smaller number of dependent drinkers.
Alcoholism is, broadly, any drinking of alcohol that results in significant mental or physical health problems. Because there is disagreement on the definition of the word alcoholism, it is not a recognized diagnostic entity, and the use of alcoholism terminology is discouraged due to its heavily stigmatized connotations. Predominant diagnostic classifications are alcohol use disorder (DSM-5) or alcohol dependence (ICD-11); these are defined in their respective sources.
A pandemic is an epidemic of an infectious disease that has spread across a large region, for instance multiple continents or worldwide, affecting a substantial number of individuals. Widespread endemic diseases with a stable number of infected individuals such as recurrences of seasonal influenza are generally excluded as they occur simultaneously in large regions of the globe rather than being spread worldwide.
The long-term heavy consumption of alcohol can cause severe detrimental effects. Health effects associated with alcohol intake in large amounts include an increased risk of developing an alcohol use disorder, malnutrition, chronic pancreatitis, erectile dysfunction, heart failure, atrial fibrillation, gastritis, stomach ulcers, alcoholic liver disease, certain types of dementia, and several types of cancer. In addition, damage to the central nervous system and peripheral nervous system can occur from chronic heavy alcohol consumption. There is also an increased risk for accidental injuries, for example, those sustained in traffic accidents and falls. Studies show that individuals with heavy substance use have a much higher risk of having other disorders. A cross-sectional observational study found evidence that people who used substances had the highest risk for five of the disorders studied. However, even light and moderate alcohol consumption increase the risk for developing certain types of cancer. Among women, light drinkers have a four percent increase risk of breast cancer, while moderate drinkers have a 23 percent increase in risk of the disease.
Excessive alcohol intake is associated with an elevated risk of alcoholic liver disease (ALD), heart failure, some cancers, and accidental injury, and is a leading cause of preventable death in industrialized countries. Some studies have suggested that one drink per day may have cardiovascular benefits. However, these studies are controversial, and the common view is that no level of alcohol consumption improves health. There is far more evidence for the harmful effects of alcohol than for any beneficial effects. It is also recognized that the alcohol industry may promote the unsubstantiated benefits of moderate drinking.
Alcohol has a number of effects on health. Short-term effects of alcohol consumption include intoxication and dehydration. Long-term effects of alcohol include changes in the metabolism of the liver and brain, several types of cancer and alcohol use disorder. Alcohol intoxication affects the brain, causing slurred speech, clumsiness, and delayed reflexes. Alcohol consumption can cause hypoglycemia in diabetics on certain medications, such as insulin or sulfonylurea, by blocking gluconeogenesis. There is an increased risk of developing an alcohol use disorder for teenagers while their brain is still developing. Adolescents who drink have a higher probability of injury including death.
Globalization, the flow of information, goods, capital, and people across political and geographic boundaries, allows infectious diseases to rapidly spread around the world, while also allowing the alleviation of factors such as hunger and poverty, which are key determinants of global health. The spread of diseases across wide geographic scales has increased through history. Early diseases that spread from Asia to Europe were bubonic plague, influenza of various types, and similar infectious diseases.
Binge drinking, or heavy episodic drinking, is drinking alcoholic beverages with an intention of becoming intoxicated by heavy consumption of alcohol over a short period of time, but definitions vary considerably.
A public health emergency of international concern is a formal declaration by the World Health Organization (WHO) of "an extraordinary event which is determined to constitute a public health risk to other States through the international spread of disease and to potentially require a coordinated international response", formulated when a situation arises that is "serious, sudden, unusual, or unexpected", which "carries implications for public health beyond the affected state's national border" and "may require immediate international action". Under the 2005 International Health Regulations (IHR), states have a legal duty to respond promptly to a PHEIC. The declaration is publicized by an IHR Emergency Committee (EC) of international experts, which was developed following the 2002–2004 SARS outbreak.
The 2018 Middle East respiratory syndrome outbreak was a set of infections of Middle East respiratory syndrome (MERS-CoV). The cases were most numerous in, and are believed to have originated from, Saudi Arabia.
Coronavirus disease 2019 (COVID-19) is a contagious disease caused by a virus, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The first known case was identified in Wuhan, China, in December 2019. The disease quickly spread worldwide, resulting in the COVID-19 pandemic.
Hazard controls for COVID-19 in workplaces are the application of occupational safety and health methodologies for hazard controls to the prevention of COVID-19. Vaccination is the most effective way to protect against severe illness or death from COVID-19. Multiple layers of controls are recommended, including measures such as remote work and flextime, increased ventilation, personal protective equipment (PPE) and face coverings, social distancing, and enhanced cleaning programs.
Pandemic prevention is the organization and management of preventive measures against pandemics. Those include measures to reduce causes of new infectious diseases and measures to prevent outbreaks and epidemics from becoming pandemics.
COVID-19 surveillance involves monitoring the spread of the coronavirus disease in order to establish the patterns of disease progression. The World Health Organization (WHO) recommends active surveillance, with focus of case finding, testing and contact tracing in all transmission scenarios. COVID-19 surveillance is expected to monitor epidemiological trends, rapidly detect new cases, and based on this information, provide epidemiological information to conduct risk assessment and guide disease preparedness.
Allison Joan McGeer is a Canadian infectious disease specialist in the Sinai Health System, and a professor in the Department of Laboratory Medicine and Pathobiology at the University of Toronto. She also appointed at the Dalla Lana School of Public Health and a Senior Clinician Scientist at the Lunenfeld-Tanenbaum Research Institute, and is a partner of the National Collaborating Centre for Infectious Diseases. McGeer has led investigations into the severe acute respiratory syndrome outbreak in Toronto and worked alongside Donald Low. During the COVID-19 pandemic, McGeer has studied how SARS-CoV-2 survives in the air and has served on several provincial committees advising aspects of the Government of Ontario's pandemic response.
COVID-19 affects men and women differently both in terms of the outcome of infection and the effect of the disease upon society. The mortality due to COVID-19 is higher in men. Slightly more men than women contract COVID with a ratio of 10:9.
The World Health Organization (WHO) is a leading organisation involved in the global coordination for mitigating the COVID-19 pandemic within the broader United Nations response to the pandemic.
In epidemiology, a non-pharmaceutical intervention (NPI) is any method used to reduce the spread of an epidemic disease without requiring pharmaceutical drug treatments. Examples of non-pharmaceutical interventions that reduce the spread of infectious diseases include wearing a face mask and staying away from sick people.
A systematic review notes that children with COVID-19 have milder effects and better prognoses than adults. However, children are susceptible to "multisystem inflammatory syndrome in children" (MIS-C), a rare but life-threatening systemic illness involving persistent fever and extreme inflammation following exposure to the SARS-CoV-2 virus.
The COVID-19 pandemic has had an unequal impact on different racial and ethnic groups in the United States, resulting in new disparities of health outcomes as well as exacerbating existing health and economic disparities.
The preparedness paradox is the proposition that if a society or individual acts effectively to mitigate a potential disaster such as a pandemic, natural disaster or other catastrophe so that it causes less harm, the avoided danger will be perceived as having been much less serious because of the limited damage actually caused. The paradox is the incorrect perception that there had been no need for careful preparation as there was little harm, although in reality the limitation of the harm was due to preparation. Several cognitive biases can consequently hamper proper preparation for future risks.
