ABSTRACT
BACKGROUND: The arrival of the Delta variant of SARS-CoV-2 was associated with increased transmissibility and illness of greater severity. Reports of nosocomial outbreaks of Delta variant COVID-19 in acute care hospitals have been described but control measures varied widely. AIM: Epidemiological investigation of a linked two-ward COVID-19 Delta variant outbreak was conducted to elucidate its source, risk factors, and control measures. METHODS: Investigations included epidemiologic analysis, detailed case review serial SARS-CoV-2 reverse transcriptase-polymerase chain reaction (RT-PCR) testing of patients and healthcare workers (HCWs), viral culture, environmental swabbing, HCW-unaware personal protective equipment (PPE) audits, ventilation assessments, and the use of whole genome sequencing (WGS). FINDINGS: This linked two-ward outbreak resulted in 17 patient and 12 HCW cases, despite an 83% vaccination rate. In this setting, suboptimal adherence and compliance to PPE protocols, suboptimal hand hygiene, multi-bedded rooms, and a contaminated vital signs cart with potential fomite or spread via the hands of HCWs were identified as significant risk factors for nosocomial COVID-19 infection. Sudden onset of symptoms, within 72 h, was observed in 79% of all Ward 2 patients, and 93% of all cases (patients and HCWs) on Ward 2 occurred within one incubation period, consistent with a point-source outbreak. RT-PCR assays showed low cycle threshold (CT) values, indicating high viral load from environmental swabs including the vital signs cart. WGS results with ≤3 SNP differences between specimens were observed. CONCLUSION: Outbreaks on both wards settled rapidly, within 3 weeks, using a `back-to-basics' approach without extraordinary measures or changes to standard PPE requirements. Strict adherence to recommended PPE, hand hygiene, education, co-operation from HCWs, including testing and interviews, and additional measures such as limiting movement of patients and staff temporarily were all deemed to have contributed to prompt resolution of the outbreak.
ABSTRACT
The immediate and new challenges of the current Covid-19 pandemic have made it hard for all of us;in this work in progress as an innovative practice, we look to both leverage the challenges and share our work so that others might see some benefit to these times and improve their courses. In particular, our focus is on creating automated tools to physically create exams and sample code for Digital Systems and Computer Architecture courses. Additionally, we focus on shifting, traditional in-person labs to online, personalized formats for Digital Systems and Embedded Systems so that both educator and learner can still provide/experience virtual computer engineering education. We focus on three courses (Digital System Design, Computer Architecture/Organization, and Embedded System Design) as they are fundamentally driven by the implementation and execution of "algorithms". From this starting point, we have created tools to generate sample code and exams, and have found means to virtualize labs and hands-on activities. In particular, we have created Python tools that allow educators to personalize code and problems, create these codes/problems (as text files or incorporated in word documents), and email these documents to students. This provides the means to create problems and code examples that are different from their peers and can be assessed on a per individual basis to alleviate some of the challenges with live and proctored exams. Additionally, we have found tools and methods for students to virtually perform the hands-on portion of these three subjects without the need for traditional lab equipment. This requires students to spend less than 100 USD worth of equipment and software. Our goal is to share these resources and our methodologies to help in this time of crisis. Additionally, these tools and methods have forced us to innovate our teaching, and we will, likely, use these tools and methods in the future. We share these tools in hope that the computer engineering education community will join this process to help us all improve our student's education.