- Performance of indicators used in regular risk assessments for COVID-19 in association with contextual factors
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Sujin Hong, Jiyoung Oh, Jia Lee, Yongmoon Kim, Bryan Inho Kim, Min Jei Lee, Hyunjung Kim, Sangwoo Tak
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Osong Public Health Res Perspect. 2024;15(5):420-428. Published online October 31, 2024
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DOI: https://doi.org/10.24171/j.phrp.2024.0141
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 Graphical Abstract
 Abstract
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 - Objectives
This study aimed to summarize the results of coronavirus disease 2019 (COVID-19) risk assessments and to examine the associations between risk levels and various indicators, including COVID-19 incidence, risk perception, community mobility, and government policy.
Methods
The results of the risk assessment and the indicators utilized were summarized. From November 2021 to May 2022, the COVID-19 risk level was evaluated on a weekly basis, and its correlation with these indicators was analyzed. Data were obtained from press releases by the Korea Disease Control and Prevention Agency, regular surveys conducted by Hankook Research, and information available on the Google and Oxford websites.
Results
Weekly risk assessments were conducted for 30 weeks, using different indices depending on the phases. Correlation analysis revealed the strongest positive correlation between risk level and risk perception (r=0.841). The risk level from “1-week lead” demonstrated a strong positive correlation with the time-varying reproduction number (Rt). Similarly, the risk level from “week lagged value” showed a strong positive correlation with the number of severe cases in the hospital.
Conclusion
At the time of risk assessment, the Rt precedes the risk level, while severe cases in hospitals follow. Therefore, the assessed risk level functioned as an early warning system. Risk perception demonstrated the strongest correlation with the risk level, suggesting consistency throughout the assessment period. Contextual indicators (e.g., risk perception) that consider time lags and implementation scales, could improve the evaluation of future risk assessment results, particularly when there are challenges in reflecting specific situations in coordinated emergency response.
- Response to the comment of Perone by the corresponding author Kim
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Yongmoon Kim, Bryan Inho Kim, Sangwoo Tak
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Osong Public Health Res Perspect. 2023;14(2):147-147. Published online March 24, 2023
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DOI: https://doi.org/10.24171/j.phrp.2023.0072R
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- Time-series comparison of COVID-19 case fatality rates across 21 countries with adjustment for multiple covariates
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Yongmoon Kim, Bryan Inho Kim, Sangwoo Tak
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Osong Public Health Res Perspect. 2022;13(6):424-434. Published online November 28, 2022
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DOI: https://doi.org/10.24171/j.phrp.2022.0212
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Graphical Abstract
Abstract
PDF
 - Objectives
Although it is widely used as a measure for mortality, the case fatality rate (CFR) ofcoronavirus disease 2019 (COVID-19) can vary over time and fluctuate for many reasons otherthan viral characteristics. To compare the CFRs of different countries in equal measure, weestimated comparable CFRs after adjusting for multiple covariates and examined the mainfactors that contributed to variability in the CFRs among 21 countries.Methods: For statistical analysis, time-series cross-sectional data were collected from OurWorld in Data, CoVariants.org, and GISAID. Biweekly CFRs of COVID-19 were estimated bypooled generalized linear squares regression models for the panel data. Covariates includedthe predominant virus variant, reproduction rate, vaccination, national economic status,hospital beds, diabetes prevalence, and population share of individuals older than age 65. Intotal, 21 countries were eligible for analysis.Results: Adjustment for covariates reduced variation in the CFRs of COVID-19 across countriesand over time. Regression results showed that the dominant spread of the Omicron variant,reproduction rate, and vaccination were associated with lower country-level CFRs, whereasage, the extreme poverty rate, and diabetes prevalence were associated with higher countrylevel CFRs.Conclusion: A direct comparison of crude CFRs among countries may be fallacious, especiallyin a cross-sectional analysis. Our study presents an adjusted comparison of CFRs over timefor a more proper comparison. In addition, our findings suggest that comparing CFRs amongdifferent countries without considering their context, such as the epidemic phase, medicalcapacity, surveillance strategy, and socio-demographic traits, should be avoided.
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Citations
Citations to this article as recorded by  - From mono to multi-causality: Towards a comprehensive perspective on understanding death
Peter Harteloh
Health Policy.2024; 147: 105121. CrossRef - Comments on the article "Time-series comparison of COVID-19 case fatality rates across 21 countries with adjustment for multiple covariates"
Gaetano Perone
Osong Public Health and Research Perspectives.2023; 14(2): 146. CrossRef
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