Diaries: The lockdown narratives of individuals

This chapter reveals the challenges and opportunities in data collection during the first COVID-19 lockdown in Romania. Thechapter argues in favour of adopting an interpretive approach to analysing qualitative data and aims to provide a list of suggestions that will help social researchers collect data in challenging circumstances when physical access to participants is limited or notpossible. Moreover, the data collected online from 16 participants through the use of the diary method provides an insight into the participants' understanding of their new social context, proving to be a good alternative method for data collection. Results show that there are other alternative methods of collecting qualitative data with similar or even better results than the traditional methods, such as interviews or focus groups. © 2022 selection and editorial matter, Katarzyna Kopecka-Piech and Bartłomiej Łódzki;individual chapters, the contributors.

Impact of Mask Mandate Timing on Community Transmission of SARS-CoV-2 in the St. Louis Metropolitan Area

Background. Mask mandates have been a widely used public health tool during the COVID-19 pandemic, but how to optimize their impact in the setting of concurrent but spontaneous population-level behavior changes due to rising case counts is not known. This study aimed to examine how earlier or later mask mandate implementation in the context of spontaneous behavior change would have affected transmission of SARS-CoV-2 and severe COVID-19 outcomes in the St. Louis, Missouri area. Methods. Our model utilized aggregated hospitalization and death data for St. Louis city and county residents admitted to nearly all hospitals in the metropolitan area. We first fit a real-life model to estimate changes in transmission after the July 3, 2020 mask mandate, and then created counterfactual scenarios in which 1) 10%, 25%, and 50% of the changes were attributed to the mandate (as opposed to spontaneous behavior change) and 2) the mandate was implemented 3 or 7 days earlier, or 7 or 14 days later. We used an SEIR (Susceptible-Exposed-Infectious-Recovered) model framework and fit models in R. Results. Assuming that 50% of increased masking was due to the mandate, implementing a mandate 7 days earlier was associated with a reduction from 12,685 (IQR: 10,463-16,560) to 12,294 (10,296-15,205) cumulative hospitalizations by September 30, while a 2-week delay was associated with an increase to 13,277 (10,808-17,908) hospitalizations. Trends were similar, but with reduced magnitude, when assuming that 10% or 25% of increased masking was due to the mandate (Figure). Depending on whether 10%, 25%, or 50% of increased masking was due to the mandate, implementing the mandate 1 week early was associated with a return to baseline (June 26) hospital census 1-7 days earlier, while delaying the mandate by 2 weeks led to a 2-12 day delay in return to baseline. Hospital census and cumulative deaths in the real-life (baseline) model and under 12 counterfactual scenarios which vary mask mandate timing (3 or 7 days earlier, or 7 or 14 days delayed) and percentage of increase in masking that is attributed to the mask mandate (Panels A-B: 10%, Panels C-D: 25%, and Panels E-F: 50%). As more of the increase in masking is attributed to the mandate, the costs of delaying the mandate and the benefits of earlier implementation increase. While differences in hospital census are most apparent several weeks after the mandate, differences in deaths gradually become more apparent over time. Conclusion. Impact of a mask mandate depends on both timing and percent of increased masking that is attributed to the mandate. Implementing a mandate even a few days earlier is associated with fewer cumulative hospitalizations and earlier return to baseline, but the overall duration of implementation is slightly longer. Given wide variations in public behavior, locally-tailored models are essential for estimating the impact of interventions and informing the local public health response.

Multidrug resistant Gram-negative bacilli infection in critically ill patients with Coronavirus disease 2019

Purpose Rapid spread of multidrug resistant Gram-negative bacilli (MDR-GNB) infection in Coronavirus disease (COVID-19) critically ill patients was observed even in those without underlying diseases and in all age groups. We conducted a prospective cohort study to assess the risk factors for acquisition of MDR-GNB infection in COVID-19 patients and its impact on patients´ outcome. Methods & Materials We included 43 consecutive patients with COVID-19 from a total of 8874 patients with COVID-19 admitted into the ICU of Aleman Hospital, Argentina, from May 1st 2020 to June 30th 2021. Followed up until death or 30 days after hospital discharge. We divided them into 4 groups: colonized with MDR-GNB (G1), colonized with MDR-GNB and infected with non-carbapenem resistant bacteria (G2), colonized and infected with MDR-GNB (G3), and infected with MDR-GNB without previous colonization (G4). Microbiological sampling was performed according to patient's conditions or epidemiological surveillance. Outcomes considered were length of hospital stay (LOS), mortality and readmission rate. Results Seven, five, six and twenty five patients were distributed respectively in G1, G2, G3 and G4. Male/female ratio was 2:1 with a median age of 68 years (IQR 62–75). Chronic pulmonary disease (18.6%) was the main comorbidity. Mean LOS was 40.16 days (P=0.79). Prolonged biomedical devices used were observed in 93% of patients (P=0.33). Ventilator associated pneumonia (n:15/36) and catheter-related bloodstream infection (n:16/36) were the most frequent infections (P=0.29, P=0.69). The most common carbapenem-resistant pathogens were Klebsiella pneumoniae (n: 38/60) and Pseudomonas aeruginosa (n:8/60). All patients were exposed to antibiotics before MDR-GNB was diagnosed. The first isolation of MDR-GNB was on average 14 days after hospital admission (P=0,84). Time between MDR-GNB colonization and infection was twice as much between G2 and G3 (8.4 Vs. 4 days, P=0.83). We observed no difference in all-cause mortality rate and readmission rate between the groups (P=0.75, P=0.97). Conclusion Prolonged ICU hospitalizations in addition to use of invasive devices and antibiotics exposure correlate with a higher risk of developing MDR-GNB colonization and infection in COVID-19 critically ill patients.

Resilience in the Home Office through a Scaled-down Microgrid

Having power sources close to the end user establishes resilience in the event of power outages. In order to effectively mitigate any risk of losing power and productivity, major office buildings usually have some sort of backup generation to sustain a business. Homes generally do not have a robust back-up power system, so when a person is working from home and the power goes out, productivity stops. Therefore, a new power grid solution is needed. Coming from the metric prefix atto, meaning 10-18, an atto-grid provides power to a singular room or section of room which makes it even smaller than a picogrid. This atto-grid powers the typical load of a standard, single-person office: a printer, a laptop, a phone, and a lamp. The atto-grid project was proposed by Dr. Robert Kerestes from the Electrical and Computer Engineering department at the University of Pittsburgh as part of a senior design course, and required distributed generation, connection to the building electrical grid, and a monitoring system for volts, amps, and watts. With these requirements in mind, the senior design team was able to design the atto-grid with two types of distributed generation, an inverter, manual switches and contactors for isolation, and accessible outlet receptacles for users to supply power to their at-home office load. An economic cost-benefit analysis was conducted as well for the purpose of determining the atto-grid's availability to different income levels. For hardware, results of tests on power quality and uptime will be presented;for software, metrics covering response time and accuracy will be analyzed and discussed. Finally, the budget, timeline, and expectations from the department faculty and domain advisors are discussed. Throughout the design process and semester, the design team learned technical and practical lessons that were brought up due to the semester coinciding with the COVID-19 pandemic. Despite technical and practical challenges, the team delivered on all requirements from the senior design curriculum, as well as the technical requirements based on the project proposal. The team acknowledges ways to improve the design if constraints were different, such as time, budget, and skillset. Finally, this paper will discuss feedback received from faculty and domain advisors throughout the semester, as well as reflect on progress and achievements for the atto-grid project. © American Society for Engineering Education, 2021

Poor Outcomes of COVID-19 in Lung Transplant Recipients. Cohort Study in a Single Center

Purpose The world SARS-CoV-2 pandemic has affected global health, including the health of lung transplant recipients. There is very little data reported on the outcomes of SARS-CoV-2 on this gruop of patients Methods Retrospective cohort study approved of all LTx recipients with symptoms consistent with COVID-19 investigated with naso-pharyngeal swabs and reverse PCR for SARS-COV-2. Postive test for SARS-COV-2 Inserted to our cohort and investigated their files. We also conducted pooled analysis of published cases of covid 19 cases of lung transplant recipients Results We identified eleven cases of COVID-19 among a cohort of 348 LTx recipients. All but two patients were hospitalized. Seven patients required intensive care and six died (55% mortality). Non-survivors had lower baseline FEV1 than survivors and worse and/or deteriorating chest radiographic scores during admission. No effect of medical therapy including steroids and remdesivir could be determined. This mortality rate compared poorly general hospitalized COVID-19 patients at our institution (13%) and national mortality rate of 0.3% in the general population. Incidence of COVID-19 was similar to the general population (0.3%). In a pooled analysis of published cases, we determined mortality of 28% across different reports of lung transplant patients with COVID-19. Conclusion COVID-19 disease is very severe in lung transplant recipients. In the absence of effective therapy and vaccination, transplant physicians should concentrate their efforts on prevention of disease and encourage meticulous preventative behavior by recipients under their care.