Experience of volunteer medical students assisting in the healthcare worker influenza vaccine program at a tertiary hospital during the COVID-19 pandemic

Introduction: For a more rapid rollout of staff influenza vaccination, medical student assistance with a vaccination program was sought during a time when the healthcare workforce was facing unprecedented pressures. This study explored the experience of both the students and supervising nursing staff involved.Innovation: Volunteer medical students were recruited to assist nurse immunisers in a staff influenza vaccination program. The education of medical students involved three components: an online educational session, written and video resources and direct supervision by trained nursing staff.Evaluation and outcomes: Qualitative data was collected from online surveys completed by medical students and structured interviews conducted with students and supervising nursing staff. The interviews underwent thematic analysis. Seventy-four percent (17/23) of medical students completed the survey. Three students and two supervising nurses completed interviews. Ninety-four percent of students strongly agreed they were confident in performing intramuscular injections after participating in the program compared with only 12% prior to participation. The interviews identified that medical students were motivated by gaining clinical experience, feeling useful during the pandemic and an altruistic desire to assist the healthcare workforce. Nursing staff displayed some initial hesitation working with medical students, which was alleviated after their competence was demonstrated.What's next? Clinical opportunities that allow medical students to learn or refine skills, whilst also assisting in areas of need, serve a dual purpose in the setting of the pandemic. This program highlights the benefits to students of participating in a staff vaccination program and provides evidence for their involvement in the ongoing rollout of the COVID-19 vaccine in Australia.

Thoracic surgery in the COVID-19 era: an Italian university hospital experience

BackgroundAims of this study were to assess the results of anti-COVID19 measures applied to maintain thoracic surgery activity at an Italian University institution through a 12-month period and to assess the results as compared with an equivalent non-pandemic time span.MethodsData and results of 646 patients operated on at the department of Thoracic Surgery of the Tor Vergata University Policlinic in Rome between February 2019 and March 2021 were retrospectively analyzed. Patients were divided in 2 groups: one operated on during the COVID-19 pandemic (pandemic group) and another during the previous non-pandemic 12 months (non-pandemic group). Primary outcome measure was COVID-19 infection-free rate.ResultsThree patients developed mild COVID-19 infection early after surgery resulting in an estimated COVID-19 infection-free rate of 98%. At intergroup comparisons (non-pandemic vs. pandemic group), a greater number of patients was operated before the pandemic (352 vs. 294, p = 0.0013). In addition, a significant greater thoracoscopy/thoracotomy procedures rate was found in the pandemic group (97/151 vs. 82/81, p = 0.02) and the total number of chest drainages (104 vs. 131, p = 0.0001) was higher in the same group. At surgery, tumor size was larger (19.5 13 vs. 28.2 +/- 21;p < 0.001) and T3-T4/T1-T2 ratio was higher (16/97 vs. 30/56;p < 0.001) during the pandemic with no difference in mortality and morbidity. In addition, the number of patients lost before treatment was higher in the pandemic group (8 vs. 15;p = 0.01). Finally, in 7 patients admitted for COVID-19 pneumonia, incidental lung (N = 5) or mediastinal (N = 2) tumors were discovered at the chest computed tomography.Conclusions Estimated COVID-19 infection free rate was 98% in the COVID-19 pandemic group;there were less surgical procedures, and operated lung tumors had larger size and more advanced stages than in the non-pandemic group. Nonetheless, hospital stay was reduced with comparable mortality and morbidity. Our study results may help implement efficacy of the everyday surgical care.

SARS-CoV-2 accumulation in sewer biofilms and Outbreak Surveillance through Wastewater-Based Epidemiology

Wastewater based epidemiology grew in popularity during the COVID-19 pandemic showing particular utility where individual testing was infeasible due to the cost, lack of testing supplies, non-compliance, and other challenges. Here, a monitoring study was performed across four wastewater collection systems with varying size and design (e.g., two combined sewer systems compared to two separate sanitary sewer systems). Generally, correlations between the previous week’s testing results correlated best with N1 gene copies observed in the sewage. To understand the potential for attenuation and accumulation of SARS-CoV-2 gene copies in sewer biofilms, swabs were collected from select pipes and an annular biofilm reactor was used to simulate the loading and shear in sewer pipes. SARS-CoV-2 was above detection in the simulated sewer biofilm when cases were too low to quantify in the wastewater and accumulated over the second wave of cases in the study region. Results presented here can provide insight into interpretation of wastewater-based epidemiology data. Copyright © 2021 Water Environment Federation

Accumulation of SARS-CoV-2 RNA in Sewer Biofilms

Wastewater-based epidemiology is a useful tool to exist for normalizing wastewater virus concentrations to the flow and number of people in the sewershed, less information is available regarding the potential for in-sewer processes to impact these observations. The aim of this research was to evaluate SARSCoV-2 accumulation in simulated sewer biofilms. An annular biofilm reactor was continuously fed with raw wastewater from a separate sanitary sewer during periods of high and low COVID-19 incidence. Periodic biofilm samples were collected, and SARSCoV-2 and pepper mottle virus gene copies were quantified via RT-qPCR. During the period of low COVID-19 incidence, SARSCoV-2 was below detection or below the quantitation limit in the sewer biofilms. During the period of high COVID-19 incidence, SARS-CoV-2 gene copies increased in the sewer biofilm across the 4-week study period. Accumulation of similar to 700 genome copies/cm(2) was observed in the biofilm and correlated with cumulative cases in the county. During both study periods, the pepper mottle virus plateaued after 1 week. These results provide insight into the potential for SARS-CoV-2 retardation in sewer biofilms, which may be of interest for interpreting wastewater-based epidemiology data, protecting utility workers, and monitoring infections.