Epidemiology and Global Health

eLife assessment

The authors convincingly demonstrate that, in the absence of any shutdowns, the Danish colorectal cancer screening program experienced only minor decreases in program participation during the COVID-19 pandemic period. This likely ensured ongoing program effectiveness in detecting early colorectal cancers and precancerous polyps. The evidence is solid, as the national screening database was used and only a small proportion of participants were excluded.

eLife assessment

This paper provides important evidence for the impact of the COVID-19 pandemic on cancer screening for breast, cervix, and colorectal cancer in Italy. The authors compared Invitation and examination coverage, as well as conducted telephone interviews, investigated the population screening test coverage, before and during the pandemic, according to educational attainment, perceived economic difficulties and citizenship. Their findings convincingly show that the lockdown and pandemic restrictions caused delays in screening activities but particularly increased the pre-existing individual and geographical inequalities in access.

Evaluation Summary:

This paper is mainly for an audience of genetic epidemiologists interested in the evaluation and portability of polygenic scores. The authors show that a polygenic risk score to predict prostate cancer risk is very informative for individuals that are classified on three different ancestry categories. The authors show that the polygenic risk score can be used to predict the risk to develop prostate cancer as a function of age. This paper provides evidence that genetic information could be used to provide guidance to clinicians on when to perform screenings to detect prostate cancer in patients.

(This preprint has been reviewed by eLife. We include the public reviews from the reviewers here; the authors also receive private feedback with suggested changes to the manuscript. Reviewer #2 agreed to share their name with the authors.)

eLife assessment

This is a valuable study characterizing seasonal deviations in indoor activity at the county level in the United States with relevance to respiratory disease transmission. Whereas the data are compelling, some of the main claims are only partially supported and need more work. This study and its results are of potential interest to those people constructing more evidence-based infectious disease transmission models.

Evaluation Summary:

The authors examine the impacts of the COVID-19 pandemic on excess mortality in the US up to April 30, 2021. The authors separate direct impacts (caused by COVID-19, coded as such or not) of the pandemic from indirect impacts (disruptions), finding that most excess deaths (90%) are due to direct impacts. Importantly, the authors find that the official COVID-19 death tally is an undercount of these deaths. Moreover, the authors also find that excess deaths due to other causes are the main driver of excess mortality among younger populations. The paper is interesting and well written, although we have some concerns, particularly around the estimation of direct vs. indirect impacts.

(This preprint has been reviewed by eLife. We include the public reviews from the reviewers here; the authors also receive private feedback with suggested changes to the manuscript. The reviewers remained anonymous to the authors.)

Evaluation Summary:

This manuscript explores the establishment and spread of antimalarial drug-resistant P. falciparum parasites using a combination of transmission modeling and model emulation. The authors add an important component to the broader understanding by jointly considering multiple factors driving drug resistance.

(This preprint has been reviewed by eLife. We include the public reviews from the reviewers here; the authors also receive private feedback with suggested changes to the manuscript. The reviewers remained anonymous to the authors.)

eLife assessment

This paper provides valuable evidence for a weakening of the association between cognitive ability and height from 1957 to 2018 in the UK. The authors find the strength of the association declined over this time frame. These associations were further attenuated after accounting for proxy measures of social class. This paper is a solid contribution to debates about how genetic, environmental, and social factors have affected the joint distribution of height and cognitive ability over the last 60 years.

Evaluation Summary:

This randomized clinical trial is based on 8,998 participants from the U.S. and the U.K. to examine the association between risk-framing nudges and the willingness to get a Covid vaccine. This manuscript would be of interest to behavioral scientists, particularly behavioral economists. Findings from this work reveal that (1) nudging can substantially increase the likelihood of Covid vaccination; (2) using different nudging frames matters and may produce different results.

(This preprint has been reviewed by eLife. We include the public reviews from the reviewers here; the authors also receive private feedback with suggested changes to the manuscript. Reviewer #1 agreed to share their name with the authors.)

Evaluation Summary:

This paper uses a new statistical approach called within family Mendelian randomization and asserts that claims of childhood BMI affecting a range of psychiatric traits are unfounded and were mainly caused by confounders that this new approach is able to better identify and control for. They do find a role for maternal BMI on a child's risk for developing depression. The main issue raised is that they do not convincingly show if they do not replicate the old association of childhood BMI with a range of psychiatric traits due to their technique simply having lower power to detect the signal or due to a true lack of this effect.

(This preprint has been reviewed by eLife. We include the public reviews from the reviewers here; the authors also receive private feedback with suggested changes to the manuscript. Reviewer #2 agreed to share their name with the authors.)

eLife assessment

This article shows how the COVID-19 pandemic affected cervical cancer screening participation in the organized screening program of Denmark. Through registry data covering the entire population, the study shows that while short-term (90 days) participation after invitation dropped, long-term (365 days) participation remained stable. These results will be of interest to public health specialists and researchers working on pandemic recovery efforts related to cancer screening worldwide.

eLife assessment

This paper is of broad interest to infer the causal effect of exposures on outcomes. It proposed an interesting idea for the identification of risk factors amongst highly correlated traits in a Mendelian randomization paradigm. The intuition for this method is clearly presented. However, critical details about implementation are missing and its application is not sufficiently demonstrated in the current form.

eLife assessment

This large-scale collaborative study is a timely contribution that will be of interest to researchers working in the fields of infectious disease forecasting and epidemic control. This paper provides a comprehensive evaluation of the predictive skills of real-time COVID-19 forecasting models in Europe. The conclusions of the paper are well supported by the data and are consistent with findings from studies in other countries.

eLife assessment

This manuscript provides a valuable and policy-relevant contribution to our understanding of SARS-CoV-2 viral kinetics in the Omicron era. The authors exploit a rich and unique dataset from the National Basketball Association to describe post-infection viral kinetics and explore evidence for differential kinetics by immune history and demographics. The authors show (as others have) that most people remain with high viral loads 5 days post positive test (though less so in groups who are tested in a more realistic manner), and that older individuals and those who were boosted (but had a poor initial response to the primary vaccine series) were more likely to remain with high viral loads longer after an Omicron infection, while also describing rebound frequencies after Omicron infections.

Evaluation Summary:

This is a useful quantification of the links of vascular disease on the development of subsequent mental health issues. It uses a robust dataset to quantify this association. Further work to focus the analyses, ensure claims are supported by the data, and consider alternative explanations is needed.

(This preprint has been reviewed by eLife. We include the public reviews from the reviewers here; the authors also receive private feedback with suggested changes to the manuscript. Reviewer #2 agreed to share their name with the authors.)

eLife assessment

This paper provides evidence that an unhealthy lifestyle during adolescence accelerates epigenetic age in adulthood, and that these associations are largely explained by the effect of shared genetic influences. The main strengths of this valuable paper are the relatively large sample size, longitudinal assessment of lifestyle factors, and sophisticated statistical analyses. The paper is methodologically compelling and will be of interest for a broad audience, including individuals working on methylation, epidemiology, and/or ageing.

Evaluation Summary:

This manuscript compares COVID-19 mortality during the pre-Omicron and Omicron emergence periods in several countries and finds evidence suggesting the Omicron variant was associated with lower mortality than previous dominant variants. This paper will be of interest to infectious disease scientists both for its content and its methods, as it validates that population-level variant frequency can be a good proxy for individual-level variant data to derive insights on variant biology with population data.

(This preprint has been reviewed by eLife. We include the public reviews from the reviewers here; the authors also receive private feedback with suggested changes to the manuscript. Reviewer #3 agreed to share their name with the authors.)

Evaluation Summary:

This study used 2017-2018 Afrobarometer surveys of more than 45,000 individuals to examine the association between the ownership of mobile phones and proximity to a health clinic in 33 African countries. Findings show that about 40% of people own smartphones and those who live closer to health clinics are more likely to own a mobile phone. This manuscript will be of interest to all people who are involved in the design and implementation of mHealth interventions in Africa.

(This preprint has been reviewed by eLife. We include the public reviews from the reviewers here; the authors also receive private feedback with suggested changes to the manuscript. Reviewer #1 and Reviewer #2 agreed to share their names with the authors.)

Evaluation Summary:

This paper provides evidence on public opinion from six European countries on key attributes according to which they believe COVID-19 vaccines should be prioritized. The paper presents significant and valuable findings supported by solid evidence.

(This preprint has been reviewed by eLife. We include the public reviews from the reviewers here; the authors also receive private feedback with suggested changes to the manuscript. The reviewer remained anonymous to the authors)

Evaluation Summary:

This manuscript is of broad interest to readers in the fields of vitamin D and obesity. It utilises a Mendelian randomization framework to separate the genetically predicted effects of adiposity at two timepoints in the lifecourse, childhood and adulthood. The key claims of the manuscript are well supported by the data. Higher childhood body size had a direct effect on lower vitamin D levels in early life, while in midlife, childhood body size impacted on adult obesity to result in lower vitamin D levels.

(This preprint has been reviewed by eLife. We include the public reviews from the reviewers here; the authors also receive private feedback with suggested changes to the manuscript. Reviewer #1 agreed to share their name with the authors.)

Evaluation Summary:

The authors present an analysis of SARS-CoV-2 variant of concern movements into and within the Netherlands. The primary finding is that flight bans (in conjunction with other NPIs) were grossly insufficient at stopping the invasion of new variants into The Netherlands over a one-year period. Although consistent with similar analyses of other regions early in the pandemic, this manuscript provides additional evidence of the inadequacy of flight bans at stopping the spread of variants that are already widespread globally, especially (but not only) when importations continue via ground travel. The reviewers have questioned the rigor of the statistical models and the presentation of the main result, including analyses that were included but do not appear to contribute to the main argument.

(This preprint has been reviewed by eLife. We include the public reviews from the reviewers here; the authors also receive private feedback with suggested changes to the manuscript. The reviewers remained anonymous to the authors.)