COVID-19 Tests and International Travel: How Long Will You Test Positive for SAR-CoV-2?

Coronavirus diseases, from SARS to MERS and now COVID-19, have major implications for the aviation industry and international travels. Although many cities and countries are adopting 'live with COVID' strategies, various rules and regulations are still in place. Documents demonstrating COVID-19 vaccination or recovery from the disease have now become a basic re-quirement to enter many travel destinations, while some still require pre-entry and/or post-arrival testing of COVID-19. Recently, the author's household became COVID-19 positive in late March 2022, as diagnosed by rapid antigen test (RAT), in Singapore whilst enroute to Hong Kong. This had an immediate knock-on impact on hotel quarantine and travel arrangements. Rapid antigen test (RAT) and Polymerase Chain Reaction (PCR) based tests have been used for quarantine, isolation and international travel purposes. The implications and issues of these tests are discussed. Ideally, a COVID-19 test that is fit for purpose should aim at identifying individuals who are infectious with risk of transmission only. Frequent surveillance with an effective RAT may be a more practical so-lution to normalize international travel without compromising public safety. Meanwhile, physicians have an important role in counselling anxious and often confused travelers before and during international travels. International travelers should be aware of the implications of these COVID-19 testing results, and plan, schedule and have travel insurance accordingly.Copyright © 2023 Bentham Science Publishers.

Elimination, containment, and mitigation of COVID-19: A personal story about international travels.

BACKGROUND: The author and his wife report their unique experience of international travels during the COVID-19 pandemic, and discuss issues encountered in various countries. METHODS: Narrated discussion of issues encountered during the COVID-19 pandemic. DISCUSSION: "Zero-COVID" versus "Living with COVID-19" strategies are compared. Children have unique issues with COVID-19 pandemic. Evaluation of efficacy of the approaches in pandemic with time should consider the main types of interventions (e.g., border management/quarantine; physical distancing; mask use; case isolation, testing and contract tracing; vaccination). The key metrics that can be used to compare the impacts of different strategies between the cities (e.g., cumulative case rate, cumulative mortality rate, case fatality risk, stringency index, economic performance) should be identified. Research in these approaches can help manage future pandemics in coronaviruses and emerging infections. The UK started with very loose mitigation ('herd immunity') and then switched to a suppression approach for periods, whereas HK has stuck with elimination throughout. In between, countries like Singapore, Australia and New Zealand have shifted from zero-COVID strategy. It is easier to have effective social control measures in Hong Kong because it has clear borders and an authoritarian government, but it did not have a clear exit policy when Omicron spread.

[Autoimmune encephalitis in pediatric population]

Autoimmune encephalitis can be defined as central nervous system inflammation, secondary to multiple causes, where we can possibly identify the formation of auto-antibody against neurotransmitter receptors or neuronal surface proteins. Approximately 50% of patients are seropositive;the auto-antibody against N-methyl-D-aspartate receptor (NMDAR) are the most common. In the pediatric population, the clinical presentation is characterized by movement disorders and seizures, psychiatric manifestations are more commonly found in young adults. An early intervention is associated with a better prognosis in these patients. In contrast to the seropositive group, seronegative autoimmune encephalitis is linked with less movement alterations and is related with a worse cognitive outcome. Much remains to be discovered about possible etiologies, molecular processes, detection, and interaction of yet undescribed antibodies,as well as increasing our knowledge about clinical manifestations in early disease and new diagnostic techniques that could improve the diagnosis of autoimmune encephalitis. The main goal of this document is to review the updates of the molecular field about the antibody against GluK2 and its clinical presentation in pediatric population;COVID-19 as a possible cause of autoimmune encephalitis;recognize the importance of psychiatric manifestation in early disease, especially catatonia as a marker of severity;additionally consider new imaging diagnostic method such as positron emission tomography (PET), which has shown to be more sensible than MRI (goal standard).

Psychosocial impact of the COVID-19 pandemic on paediatric healthcare workers

INTRODUCTION: Frontline healthcare workers (HCWs) exposed to coronavirus disease 2019 (COVID-19) are at risk of psychological distress. This study evaluates the psychological impact of COVID-19 pandemic on HCWs in a national paediatric referral centre. METHODS: This was a survey-based study that collected demographic, work environment and mental health data from paediatric HCWs in the emergency, intensive care and infectious disease units. Psychological impact was measured using the Depression, Anxiety, Stress Scale-21. Multivariate regression analysis was performed to identify risk factors associated with psychological distress. RESULTS: The survey achieved a response rate of 93.9% (430 of 458). Of the 430 respondents, symptoms of depression, anxiety and stress were reported in 168 (39.1%), 205 (47.7%) and 106 (24.7%), respectively. Depression was reported in the mild (47, 10.9%), moderate (76, 17.7%), severe (23, 5.3%) and extremely severe (22, 5.1%) categories. Anxiety (205, 47.7%) and stress (106, 24.7%) were reported in the mild category only. Collectively, regression analysis identified female sex, a perceived lack of choice in work scope/environment, lack of protection from COVID-19, lack of access to physical activities and rest, the need to perform additional tasks, and the experience of stigma from the community as risk factors for poor psychological outcome. CONCLUSION: A high prevalence of depression, anxiety and stress was reported among frontline paediatric HCWs during the COVID-19 pandemic. Personal psychoneuroimmunity and organisational prevention measures can be implemented to lessen psychiatric symptoms. At the national level, involving mental health professionals to plan and coordinate psychological intervention for the country should be considered.

COVID-19 in Hong Kong - Public health, food safety, and animal vectors perspectives.

The coronavirus disease 2019 (COVID-19) pandemic, caused by infection with a novel coronavirus (severe acute respiratory syndrome coronavirus 2, SARS-CoV-2), has led to escalating morbidity and mortality in all nations and cities. SARS-CoV-2 lies within the same coronavirus family as SARS-CoV (2003) and MERS-CoV (2012), though there are genetic and epidemiological differences between the viruses, as well as different clinical presentations in the patients. Despite this, Hong Kong has so far managed to control the pandemic very successfully. Here we offer a Hong Kong perspective on different aspects of the pandemic virus (SARS-CoV-2) and the disease : public health (diagnosis and control), food safety (reducing transmission in the workplace) and animal vectors (controlling potential reservoirs of the virus and their movements).

Airway management in children with COVID-19.

The novel coronavirus disease (COVID-19) may result in acute respiratory distress syndrome and respiratory failure, necessitating mechanical respiratory support. Healthcare professionals are exposed to a particularly high risk of contracting the virus while providing resuscitation and respiratory support, which may in turn result in grave consequences and even death. Although COVID-19 has been shown to cause milder disease in children, paediatricians and intensivists who provide care for children must be prepared to provide optimal respiratory support without putting themselves or other medical, nursing, and paramedical staff at undue risk. We propose an airway management approach that is especially relevant in the current COVID-19 pandemic and provides instructions for: (1) Elective intubation for respiratory failure; and (2) Emergency intubation during cardiopulmonary resuscitation. To minimise risk, intubation methods must be kept as straightforward as possible and should include the provision of appropriate personal protection and equipment to healthcare workers. We identify two key considerations: that bag-mask ventilation should be avoided if possible and that bacterial and viral filters should be placed in the respiratory circuit. Our novel approach provides a framework for airway management that could benefit paediatric critical care practitioners who provide care for any children with a novel viral illness, with a focus on infection prevention during high-risk airway management procedures.