Impact of personal protective equipment on the clarity of vision among trachoma survey graders and trichiasis surgeons in the context of COVID-19

Background/aimsThe COVID-19 pandemic necessitated the use of personal protective equipment for those involved in trachoma survey grading and trichiasis surgery. We sought to determine which configuration of a face shield would be less likely to impact grading accuracy and ability to conduct trichiasis surgery. The research also included assessment of comfort, ease of cleaning and robustness.MethodsThere were three research phases. In phase 1, assessment of four potential face shield configurations was undertaken with principal trachoma graders and trichiasis surgeon trainers to decide which two options should undergo further testing. In phase 2, clarity of vision and comfort (in a classroom environment) of the two configurations were assessed compared with no face shield (control), while grading trachomatous inflammation—follicular (TF). The second phase also included the assessment of impact of the configurations while performing trichiasis surgery using a training model. In phase 3, face shield ease of use was evaluated during routine surgical programmes.ResultsIn phase 2, 124 trachoma graders and 28 trichiasis surgeons evaluated the 2 face shield configurations selected in phase 1. TF agreement was high (kappa=0.83 and 0.82) for both configurations compared with not wearing a face shield. Comfort was reported as good by 51% and 32% of graders using the two configurations. Trichiasis skill scores were similar for both configurations.ConclusionThe face shield configuration that includes a cut-out for mounting the 2.5× magnifying loupes does not appear to impact the ability or comfort of trachoma graders or trichiasis surgeons to carry out their work.

Estimating the effect of non-pharmaceutical interventions to mitigate COVID-19 spread in Saudi Arabia.

BACKGROUND: The Kingdom of Saudi Arabia (KSA) quickly controlled the spread of SARS-CoV-2 by implementing several non-pharmaceutical interventions (NPIs), including suspension of international and national travel, local curfews, closing public spaces (i.e., schools and universities, malls and shops), and limiting religious gatherings. The KSA also mandated all citizens to respect physical distancing and to wear face masks. However, after relaxing some restrictions during June 2020, the KSA is now planning a strategy that could allow resuming in-person education and international travel. The aim of our study was to evaluate the effect of NPIs on the spread of the COVID-19 and test strategies to open schools and resume international travel. METHODS: We built a spatial-explicit individual-based model to represent the whole KSA population (IBM-KSA). The IBM-KSA was parameterized using country demographic, remote sensing, and epidemiological data. A social network was created to represent contact heterogeneity and interaction among age groups of the population. The IBM-KSA also simulated the movement of people across the country based on a gravity model. We used the IBM-KSA to evaluate the effect of different NPIs adopted by the KSA (physical distancing, mask-wearing, and contact tracing) and to forecast the impact of strategies to open schools and resume international travels. RESULTS: The IBM-KSA results scenarios showed the high effectiveness of mask-wearing, physical distancing, and contact tracing in controlling the spread of the disease. Without NPIs, the KSA could have reported 4,824,065 (95% CI: 3,673,775-6,335,423) cases by June 2021. The IBM-KSA showed that mandatory mask-wearing and physical distancing saved 39,452 lives (95% CI: 26,641-44,494). In-person education without personal protection during teaching would have resulted in a high surge of COVID-19 cases. Compared to scenarios with no personal protection, enforcing mask-wearing and physical distancing in schools reduced cases, hospitalizations, and deaths by 25% and 50%, when adherence to these NPIs was set to 50% and 70%, respectively. The IBM-KSA also showed that a quarantine imposed on international travelers reduced the probability of outbreaks in the country. CONCLUSIONS: This study showed that the interventions adopted by the KSA were able to control the spread of SARS-CoV-2 in the absence of a vaccine. In-person education should be resumed only if NPIs could be applied in schools and universities. International travel can be resumed but with strict quarantine rules. The KSA needs to keep strict NPIs in place until a high fraction of the population is vaccinated in order to reduce hospitalizations and deaths.

Use of Twitter social media activity as a proxy for human mobility to predict the spatiotemporal spread of COVID-19 at global scale.

As of February 27, 2020, 82,294 confirmed cases of coronavirus disease (COVID-19) have been reported since December 2019, including 2,804 deaths, with cases reported throughout China, as well as in 45 international locations outside of mainland China. We predict the spatiotemporal spread of reported COVID- 19 cases at the global level during the first few weeks of the current outbreak by analyzing openly available geolocated Twitter social media data. Human mobility patterns were estimated by analyzing geolocated 2013-2015 Twitter data from users who had: i) tweeted at least twice on consecutive days from Wuhan, China, between November 1, 2013, and January 28, 2014, and November 1, 2014, and January 28, 2015; and ii) left Wuhan following their second tweet during the time period under investigation. Publicly available COVID-19 case data were used to investigate the correlation among cases reported during the current outbreak, locations visited by the study cohort of Twitter users, and airports with scheduled flights from Wuhan. Infectious Disease Vulnerability Index (IDVI) data were obtained to identify the capacity of countries receiving travellers from Wuhan to respond to COVID-19. Our study cohort comprised 161 users. Of these users, 133 (82.6%) posted tweets from 157 Chinese cities (1,344 tweets) during the 30 days after leaving Wuhan following their second tweet, with a median of 2 (IQR= 1-3) locations visited and a mean distance of 601 km (IQR= 295.2-834.7 km) traveled. Of our user cohort, 60 (37.2%) traveled abroad to 119 locations in 28 countries. Of the 82 COVID-19 cases reported outside China as of January 30, 2020, 54 cases had known geolocation coordinates and 74.1% (40 cases) were reported less than 15 km (median = 7.4 km, IQR= 2.9-285.5 km) from a location visited by at least one of our study cohort's users. Countries visited by the cohort's users and which have cases reported by January 30, 2020, had a median IDVI equal to 0.74. We show that social media data can be used to predict the spatiotemporal spread of infectious diseases such as COVID-19. Based on our analyses, we anticipate cases to be reported in Saudi Arabia and Indonesia; additionally, countries with a moderate to low IDVI (i.e. ≤0.7) such as Indonesia, Pakistan, and Turkey should be on high alert and develop COVID- 19 response plans as soon as permitting.