Characteristics and Occurrence Scenarios of Staff Exposed to SARS-CoV-2 Omicron in Shanghai Lingang Fangcang Shelter Hospital, CHINA.

Objective: To analyze the characteristics and occurrence scenarios of occupational exposure of staff in the Shanghai Lingang Fangcang Shelter Hospital. Methods: We collected the data of 80 staff with occupational exposure (including doctors, nurses, cleaning, security guards, and maintenance staff) in the Shanghai Lingang Fangcang Shelter Hospital from April 5 to May 20, 2022. The basic information of occupational exposure, factors influencing different occupational exposure types, ways to discover occupational exposure, discovery places of occupational exposure, and specific occurrence scenarios were compiled and analyzed among these data. Results: Occupational exposure mainly occurred in nurses (37, 46.25%), and cleaning (21, 26.25%). After the occurrence of occupational exposure, 20 staff (25%) did not know the occurrence time. Moreover, occupational exposure types were listed from high to low proportion as follows: broken protective clothing (56, 70%), mask loosening or displacement (13, 16.25%), skin exposure (6, 7.5%), and sharp object injuries (5, 6.25%). Occupational exposure was discovered mainly through self-discovery (56, 70%), while other discovery ways were majorly colleague discovery (12, 15%) and infection control supervisor discovery (12, 15%). Furthermore, occupational exposure was discovered principally in the public area (53.75%) and the office area (25%) of the cabin, but the proportion of mask loosening or displacement (38.46%) and skin exposure (50%) was also high in the first unloading area. Broken protective clothing occurred in the following scenarios: scratching while working in the cabin (37, 66.07%) and not knowing its occurrence time (25%). The occurrence scenarios of mask loosening or displacement were mainly not knowing its occurrence time (6, 46.15%), self-discovery (3, 23.08%), and at the time of removal (3, 23.08%). Conclusion: Targeted training and prevention of occupational exposure should be performed to decrease infection risk and ensure staff safety in Fangcang shelter hospitals.

Current situation of construction and management of infectious diseases department and fever clinics in medical institutions in Jiangsu Province

OBJECTIVE: To analyze theconstruction of infectious diseases departments and fever clinics in medical institutions at all levels in Jiangsu Province after the COVID-19 epidemic, and to provide a basis for promoting their standardized construction. METHODS: A questionnaire survey was conducted on the construction of infectious diseases departments and fever clinics in 429 medical institutions of Jiangsu Province from July to December 2020, including the overview of medical institutions, the construction status of infectious diseases departments, the construction status and future construction plans of fever clinics, etc. RESULTS: The construction rate of infectious diseases department and fever clinics in medical institutions of Jiangsu province were 33.3% and 75.3% respectively. Ventilation by opening window for was the main form of airflow organization in infectious diseases department and fever clinics, and independent ICUs and negative pressure wards were not set up in most of infectious diseases departments. The setting rate of "three zones and two channels" in fever clinics was high(96.9%), but most of them were not equipped with special CT for fever clinics patients. The proportion of air conditioning and ventilation system without air disinfection devices in the of fever clinics of medical institutions at all levels was higher than 90%. Considering the both hardware construction and quality management, the situation in tertiary medical institutions were superior to secondary medical institutions, and secondary medical institutions were superior to primary medical institutions. Various construction indicators and management systems failed to fully meet the requirements of documents and standards. CONCLUSION: Jiangsu province actively promotes the construction of infectious diseases department and fever clinic layout, but there is still a gap with the construction standard, which is necessary to further promote standardized construction. We should mend the shortages, strengthen the weakness, expand the bases, comprehensively improve the service and anti-epidemic capacity of infectious diseases departments, fever clinics and even the entire medical and health system, so as to better serve the health and life safety of the people.

Effect Analysis of "Four-Step" Training and Assessment Tool in the Prevention and Control of COVID-19.

Purpose: To improve the ability of infection prevention and control (IPC) of medical staff during the COVID-19 epidemic period, the "four-step" mode of whole staff training and assessment was used. Methods: During the period from March 9 to March 18, 2020, 5425 medical staff from The First Affiliated Hospital of Nanjing Medical University were selected as the objects of this study. There are four stages in the training assessment mode. The first stage is the basic assessment stage; the second stage releases the electronic version of the knowledge point manual; the third stage conducts online exercises; the fourth stage conducts the final assessment. Results: In the first stage, the participation rate of medical staff was 95.04%. In the fourth stage, the participation rate of medical staff was 98.01%. The average score of female medical staff in the first stage and the fourth stage was higher than that of males (P< 0.001). The average score of medical staff under 30 years old in the first stage and the fourth stage was higher than that of other age groups (P< 0.05). In the fourth stage, the correct rate of each part of exercises in the knowledge points of IPC was higher than that in the first stage (P< 0.001). In the two stages, the two parts of "COVID-19 prevention and control" and "multi-drug resistant bacteria prevention and control" had the highest accuracy, while the "disinfection and sterilization" and "infectious disease management" had the lowest accuracy (P< 0.001). Conclusion: The "four-step" infection control training assessment mode has realized "full participation" and "effective training", and the level of medical staff's IPC has been significantly improved.

Analysis of influenza trend and impact of COVID-19 in Kezhou, Xinjiang for 8 consecutive years.

To study the trend of influenza and the impact of coronavirus disease 2019 (COVID-19) in Kezhou, Xinjiang from 2013 to 2020. The data of influenza in Kezhou, Xinjiang from January 1, 2013, to December 31, 2020, were collected by the China Influenza Surveillance Information System to study the trend of ILI proportion, the distribution of influenza-like cases in different age groups, the positive cases and positive rate of influenza, and the trend of different influenza subtypes, and to analyze the impact of COVID-19 epidemic on influenza. The proportion of ILI in the Xinjiang Kezhou area was mainly children under 15 years old, and children under 5 years old accounted for the largest proportion. The proportion of ILI, the number of influenza-positive cases, and the influenza-positive proportion were mainly in winter and spring, especially in December and January each year. At the same time, this study found that the overall trend of H3N2 influenza in this region was on the rise, and the outbreaks in 2018 and 2019 were dominated by novel H1N1 and H3N2, respectively. The trend of influenza in Kezhou, Xinjiang is on the rise, and the prevention and control measures of COVID-19 have significantly reduced the data of influenza. It is necessary to strengthen the vaccination work and maintain the basic prevention and control measures of respiratory infectious diseases to prevent and control influenza more effectively.

Effect of training of all staff and influencing factors in Huangshi, Hubei Province during prevention and control of COVID-19 in March 2020

Objective: To understand the status of acquisition of knowledge of infection control and observe the effect of training and influencing factors in Huangshi, Hubei province during prevention and control of COVID-19.

Environmental sampling of the severe acute respiratory syndrome coronavirus 2 Delta variant in the inpatient wards of a hospital in Nanjing.

BACKGROUND: Little is known about severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Delta variant of concern (VOC)-contaminated environmental surfaces and air in hospital wards admitting COVID-19 cases. Our study was designed to identify high-risk areas of Delta VOC contamination in the hospital and provide suggestions to in-hospital infection control. We analyzed the SARS-CoV-2 Delta VOC contamination in the air and environmental surface samples collected from a hospital in Nanjing, China. METHODS: We collected data on clinical features, laboratory tests, swab tests, and hospital wards, identified the factors associated with environmental contamination, and analyzed patients' hygiene behaviors during hospitalization. RESULTS: A total of 283 environmental surface and air samples were collected from a hospital admitting 36 COVID-19 patients. Twelve swab samples from ten patients were positive. Toilet seats had the highest contamination rate (11.8%), followed by bedside tables (8.2%), garbage bins (5.9%), and bedrails (1.6%). The median time of symptom onset to surface sampling was shorter in the positive environment group than in the negative environment group (11 vs. 18 days; P=0.001). The results indicated that environmental surface contamination was associated with positive anal swabs [odds ratio (OR) 27.183; 95% CI: 2.359-226.063; P=0.003] and the time from symptom onset to surface sampling (OR 0.801; 95% CI: 0.501-0.990; P=0.046). The survey revealed that 33.3% of the patients never cleaned or disinfected their bedside tables or toilets, and 8.3% of them only cleaned their bedside tables or toilets. More than half of the patients often (25%) or always (30.6%) put the used masks on their bedside tables. Only 16.7% of the patients threw the masks into the specific garbage bin for used masks. CONCLUSIONS: The SARS-CoV-2 Delta VOC was detected on environmental surfaces, especially toilet seats and bedside tables, within a median time of 11 days after symptom onset. Our study provided potential predictors for environmental surface contamination, including positive anal swabs and the time from symptom onset to sampling. Disinfecting high-risk environmental surfaces should be emphasized in hospital wards, especially for patients in the early stage of COVID-19.

Three types of massive screening for body temperature during prevention and control of COVID-19

OBJECTIVE: To study three different large-scale body temperature screening methods during the prevention and control period of COVID-19, so as to select appropriate body temperature screening methods for medical institutions. METHODS: Body temperatures of 874 pre-diagnosed patients was screened by infrared thermography, frontal thermography (forehead measurement) and aural thermography. Each patient was measured once independently by three methods, and gender and body temperature were recorded. The screening effect of three methods on fever patients with different genders and at different environment temperatures were analyzed. RESULTS: The average body temperatures detected by thermal imager, ear thermometer and frontal thermometer were as the following: ear thermometer> frontal thermometer > thermal imager. The coefficient of variation was frontal thermometer (1.359%) > ear thermometer(1.186%) > thermal imager (1.090%). The difference between the three methods was significant (P < 0.001). When ear thermometer and frontal thermometer were used to screen body temperature, the body temperature of male was higher than that of female, and the difference was significant (P<0.001). Among the three methods of temperature measurement, the average body temperature of group C (outdoor temperature 6-19 degrees C) was significantly higher than that of group A(outdoor temperature 1-6 degrees C) and group B (outdoor temperature 1-10 degrees C). The difference was statistically significant (P < 0.001). Ten suspected febrile patients were screened by thermal imager, but no suspected febrile patients were detected by frontal thermometer and ear thermometer, and the difference was significant (P < 0.05). CONCLUSION: The thermal imager has higher stability and accuracy and less affected by sex and outdoor temperature, and it should be used in large-scale body temperature screening for febrile patients.