Effets du confinement lie a la COVID-19 chez les patients atteints de maladies chroniques

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Lessons Learned from Teaching in Person Cadaveric Anatomy During the COVID19 Pandemic

In March 2020, TTUHSC opened a new 20,000sf Institute of Anatomical Sciences for human gross anatomy. When the COVID-19 pandemic struck and many schools shifted from in person to online teaching, we hypothesized that if safety measures were used, in person cadaveric anatomy could be safely taught without a decrease in student performance. To test this, we reduced onsite attendance to less than 25% of room capacity. Masks were required at all times and students were instructed to social distance. Six students were assigned per cadaver, but only two students dissected at a time. The other four students reviewed and completed dissections and/or reviewed in groups of two at other allotted times. Thus, students dissected only every third lab. Dissection and lab review attendance was mandatory and students were nearly 100% compliant. Teaching assistants recorded dissected prosections reviews, and these videos were uploaded to password protected course files for independent learning. Students were provided iPads in the laboratory and access to three software packages for use on and off site. All students had access to multiple formative quizzes and exams, and three new online practice practical exams were created. To help reduce testing anxiety, a pass/fail system replaced categorical grading. However, all written and practical exams were conducted on site and in person. At TTUHSC, we have developed an exam question database to track historical student performance including a 25-question optional pre-block practice exam used to assess incoming student anatomical aptitude. In 2020, 90% of incoming students (93% in 2019) took the pre-block exam and scored an average of 28% (24% in 2019). In 2020, despite vastly different content delivery approaches (>80% of lectures were on Zoom) and reduced in-person dissection requirements, students modestly outperformed their 2019 counterparts. Overall exam averages were 89% in 2020 compared to 87% in 2019. If a categorical system was in place, 66% of students would have earned Honors or High Pass in 2020 compared to 61% in 2019. Our formative assessments were highly predictive of summative exam performance, and students reported that they reduced exam stress. Furthermore, summative exam averages correlated strongly with NBME performance (p<0.0001, r =0.63). TTUHSC medical students estimated that a majority of their peers at other medical schools did not have any in person dissection in 2020. Our students ranked in person laboratory dissection as the most useful learning activity, 88% reported that our COVID-19 preparations were very good to outstanding, and 97% were satisfied with the quality of their anatomy education. We conclude that 1) When using appropriate precautions, in person cadaveric anatomy can be taught safely during a pandemic;2) cadaveric dissection is essential for mastery of anatomical concepts;and 3) coupling online learning modalities with rigorous formative assessments prevented a modest reduction in cadaveric dissection opportunities from negatively impacting student performance. 2.

Imported SARS-CoV-2 Variants of Concern Drove Spread of Infections across Kenya during the Second Year of the Pandemic

Using classical and genomic epidemiology, we tracked the COVID-19 pandemic in Kenya over 23 months to determine the impact of SARS-CoV-2 variants on its progression. SARS-CoV-2 surveillance and testing data were obtained from the Kenya Ministry of Health, collected daily from 306 health facilities. COVID-19-associated fatality data were also obtained from these health facilities and communities. Whole SARS-CoV-2 genome sequencing were carried out on 1241 specimens. Over the pandemic duration (March 2020–January 2022), Kenya experienced five waves characterized by attack rates (AR) of between 65.4 and 137.6 per 100,000 persons, and intra-wave case fatality ratios (CFR) averaging 3.5%, two-fold higher than the national average COVID-19 associated CFR. The first two waves that occurred before emergence of global variants of concerns (VoC) had lower AR (65.4 and 118.2 per 100,000). Waves 3, 4, and 5 that occurred during the second year were each dominated by multiple introductions each, of Alpha (74.9% genomes), Delta (98.7%), and Omicron (87.8%) VoCs, respectively. During this phase, government-imposed restrictions failed to alleviate pandemic progression, resulting in higher attack rates spread across the country. In conclusion, the emergence of Alpha, Delta, and Omicron variants was a turning point that resulted in widespread and higher SARS-CoV-2 infections across the country.

COVID-19 Pandemic Analysis by the Volterra Integral Equation Models: A Preliminary Study of Brazil, Italy, and South Africa

The COVID-19 pandemic has affected many people throughout the world. The objective of this research project was to find numerical solutions through the Gaussian Quadrature Method for the Volterra Integral Equation Model. The non-homogenous Volterra Integral Equation of the second kind is used to capture a broader range of disease distributions. Volterra Integral equation models are used in the context of applied mathematics, public health, and evolutionary biology. The mathematical models of this integral equation gave valid convergence results for the COVID-19 data for 3 countries Italy, South Africa and Brazil. The modeling of these countries was done using the Volterra Integral Equation, using the Gaussian Quadrature nodes. Inspired by the COVID-19 pandemic, the IRCD model included the number of initially infected individuals, the rate of infection, contact rate, death rate, fraction of recovered individuals, and the mean time an individual remains infected. This research investigated the feasibility of obtaining accurate convergence results for two models of the Volterra Integral Equation for the geographic locations of Italy, South Africa and Brazil. The IRCD model accounted for the infected rate, number of recovered, contact rate, and the death rate. The first 365 days of the pandemic were analyzed for the IRCD model. The ISR model accounted for the number of initially infected individuals, susceptible individuals, removed individuals, number of contacts per person, the recovery rate, and the total population. The ISR model specifically looked at COVID-19 in Brazil and South Africa for the first 300 days of the pandemic. Both models are mathematically and epidemiologically well posed. © 2022, IAENG International Journal of Applied Mathematics. All Rights Reserved.

Imported SARS-COV-2 Variants of Concern Drove Spread of Infections Across Kenya During the Second Year of the Pandemic (preprint)

Background. Using classical and genomic epidemiology, we tracked the COVID-19 pandemic in Kenya over 23 months to determine the impact of SARS-CoV-2 variants on its progression. Methods. SARS-CoV-2 surveillance and testing data were obtained from the Kenya Ministry of Health, collected daily from 306 health facilities. COVID-19-associated fatality data were also obtained from these health facilities and communities. Whole SARS-CoV-2 genome sequencing were carried out on 1241 specimens. Results. Over the pandemic duration (March 2020 - January 2022) Kenya experienced five waves characterized by attack rates (AR) of between 65.4 and 137.6 per 100,000 persons, and intra-wave case fatality ratios (CFR) averaging 3.5%, two-fold higher than the national average COVID-19 associated CFR. The first two waves that occurred before emergence of global variants of concerns (VoC) had lower AR (65.4 and 118.2 per 100,000). Waves 3, 4, and 5 that occurred during the second year were each dominated by multiple introductions each, of Alpha (74.9% genomes), Delta (98.7%), and Omicron (87.8%) VoCs, respectively. During this phase, government-imposed restrictions failed to alleviate pandemic progression, resulting in higher attack rates spread across the country. Conclusions. The emergence of Alpha, Delta, and Omicron variants was a turning point that resulted in widespread and higher SARS-CoV-2 infections across the country.