Evaluation of risk factors associated with SARS-CoV-2 transmission.

OBJECTIVE: Coronavirus disease 2019 (COVID-19) has caused high morbidity and mortality worldwide. Since there is not enough evidence of risk factors of SARS-CoV-2 transmission, this study aimed to evaluate them. METHODS: This survey-based study was conducted across 66 countries from May to November 2020 among suspected and confirmed individuals with COVID-19. The stepwise AIC method was utilized to determine the optimal multivariable logistic regression to explore predictive factors of SARS-CoV-2 transmission. RESULTS: Among 2372 respondents who participated in the study, there were 1172 valid responses. The profession of non-healthcare-worker (OR: 1.77, 95%CI: 1.04-3.00, p = .032), history of SARS-CoV or MERS-CoV infection (OR: 4.78, 95%CI: 2.34-9.63, p < .001), higher frequency of contact with colleagues (OR: 1.17, 95%CI: 1.01-1.37, p = .041), and habit of hugging when greeting (OR: 1.25, 95%CI: 1.00-1.56, p = .049) were associated with an increased risk of contracting COVID-19. Current smokers had a lower likelihood of having COVID-19 compared to former smokers (OR: 5.41, 95%CI: 1.93-17.49, p = .002) or non-smokers (OR: 3.69, 95%CI: 1.48-11.11, p = .01). CONCLUSIONS: Our study suggests several risk factors for SARS-CoV-2 transmission including the profession of non-healthcare workers, history of other coronavirus infections, frequent close contact with colleagues, the habit of hugging when greeting, and smoking status.

Since there is not enough evidence of risk factors of SARS-CoV-2 transmission, this study aimed to evaluate them. The risk of SARS-CoV-2 infection was higher among non-healthcare workers and among those who had a history of being tested positive for SARS-CoV or MERS-CoV before the COVID-19 outbreak. The habit of frequent contact with colleagues or hugging when greeting significantly increased the risk of being infected with SARS-CoV-2. The current smokers had a lower risk of getting infected with SARS-CoV-2 than others who had a habit of smoking tobacco in the past or who had never smoked.

Awareness and preparedness of healthcare workers against the first wave of the COVID-19 pandemic: A cross-sectional survey across 57 countries.

BACKGROUND: Since the COVID-19 pandemic began, there have been concerns related to the preparedness of healthcare workers (HCWs). This study aimed to describe the level of awareness and preparedness of hospital HCWs at the time of the first wave. METHODS: This multinational, multicenter, cross-sectional survey was conducted among hospital HCWs from February to May 2020. We used a hierarchical logistic regression multivariate analysis to adjust the influence of variables based on awareness and preparedness. We then used association rule mining to identify relationships between HCW confidence in handling suspected COVID-19 patients and prior COVID-19 case-management training. RESULTS: We surveyed 24,653 HCWs from 371 hospitals across 57 countries and received 17,302 responses from 70.2% HCWs overall. The median COVID-19 preparedness score was 11.0 (interquartile range [IQR] = 6.0-14.0) and the median awareness score was 29.6 (IQR = 26.6-32.6). HCWs at COVID-19 designated facilities with previous outbreak experience, or HCWs who were trained for dealing with the SARS-CoV-2 outbreak, had significantly higher levels of preparedness and awareness (p<0.001). Association rule mining suggests that nurses and doctors who had a 'great-extent-of-confidence' in handling suspected COVID-19 patients had participated in COVID-19 training courses. Male participants (mean difference = 0.34; 95% CI = 0.22, 0.46; p<0.001) and nurses (mean difference = 0.67; 95% CI = 0.53, 0.81; p<0.001) had higher preparedness scores compared to women participants and doctors. INTERPRETATION: There was an unsurprising high level of awareness and preparedness among HCWs who participated in COVID-19 training courses. However, disparity existed along the lines of gender and type of HCW. It is unknown whether the difference in COVID-19 preparedness that we detected early in the pandemic may have translated into disproportionate SARS-CoV-2 burden of disease by gender or HCW type.

Universal checklist for COVID-19 control measures: consensus via a Delphi method

Declaration/announcement of emergency status Launching a public website for guidelines and information Establishing a 'coronavirus task force'/ expert board Conducting training programmes Government financial assistance for citizens/taxpayers Equal protection for immigrants/foreigners Regulation and stabilisation of food prices and daily necessities Require company to pay full salary to quarantined/isolated people Financial support to frontline cleaners, toilet attendants and security employees Free testing Free treatment Production/procurement of supplies (such as surgical masks, gloves, ventilators, or goods) Enhance production of sanitisers Enhancing hospital capacities (beds) Designating which hospitals can receive COVID-19 patients Equipping university housings, hotels, sports stadiums or building temporary hospitals to be ready to receive patients Guidelines for treatment of COVID-19 Application of telemedicine Research: Established in-house PCR assay Development of quick test kits Successfully identifying SARS-CoV-2 genes Launching clinical trial treatment of COVID-19 Launching vaccination development Call for research related to epidemiology, prevention and control measures Call for development or reuse of efficient low cost of PPE and medical devices such as ventilators Call for development of a new treatment or new drug discovery, PPE and medical devices such as ventilators Call for non-academic industries to join the research or give funds Box 1. Prohibition of group gathering more than (x) number of people in public places Physical distancing from each other in public (2 metres between individuals) Closure of schools Working from home Shelter in place Closure of public areas Closure of services Closure of public transport Closure of city/area hotspots (separating areas, restriction of movement) Protection of vulnerable people (elderly, people with suppressed immunities or relevant comorbidities: hypertension, heart disease, kidney disease, liver disease, chronic respiratory disease, diabetes, obesity) Supporting e-learning for students/tele-workplace Preventive and containment measures: Universal checklist of COVID-19 control measures (Continued) Using a medical declaration when having respiratory symptoms or close contact with a new confirmed patient Isolation for all confirmed cases (F0) Disinfect the workplace of the newly detected patient Closure of workplace of the newly detected patient Isolation/quarantine for patients with respiratory symptoms (flu-like illness) Isolation/quarantine for suspected cases with negative RT-PCR (who had contact with confirmed patients or came from hotspots) Protection of hospitals at outpatient units Protection of healthcare workers Guidelines for each type of health worker to prevent crosstransmission Guidelines for performing aerosol generation Guidelines regarding reuse of masks/PPE for healthcare workers Guidelines on disposal of dead bodies Guidelines for home care Guidelines for community service (public transportation, food delivery, postal, volunteer services) Additional items: