ABSTRACT
Background. With the spread of the SARS-CoV-2 pandemic in 2020 and the attendant global precautions such as masking, travel restrictions and social distancing, the WHO FluNet data indicated a decline in flu rates. The CDC data for the 2020-2021 season showed the same decline in US flu as well as other respiratory viruses. Two hypotheses to explain the observed phenomenon are the impact of non pharmaceutical interventions (NPI) to prevent SARS-CoV-2 infection and suppression of other respiratory viruses by SARS-CoV-2 through a form of resource competition. Methods. We conducted a study using the EPIC Slicer Dicer analytics tool and the Yale Internal Medicine COVID-19 Database to retrieve data from the Yale New Haven Health System (YNHHS). We tabulated the total number of positive and negative tests for SARS-CoV-2 and a panel of respiratory viruses from September 2, 2018 to April 30, 2022 to cover pre- and peri-pandemic periods. These results were divided into three age groups: <=12, 13-59, and >=60. Epidemic curves of each virus with respect to each other, the season, and the introduction of NPIs were constructed to help differentiate between the two hypotheses. Results. Pre-pandemic data from 09/2018 to 02/2020 revealed seasonal spikes in influenza A and B with 254 positive weekly influenza A/B tests from 11/2018 to 02/2019 for a positivity rate of 7.97% and 481 positive weekly tests (10.53% positivity rate [PR]) from November 2019 to February 2020. There were only 0.35 positive weekly influenza A/B tests (0.05% PR) from 11/2020 to 02/2021 with 2018 positive weekly tests (6.45% PR) for SARS-CoV-2 over the same period. From 11/2020 to 02/2021, there were 56 positive weekly influenza A/B tests (1.44% PR) and 4347 positive weekly SARS-CoV-2 tests (10.35% PR). From 07/ 2021 to 11/2021, there was an increased rate of positive RSV tests (82 per week, 15.76% PR) and rhinovirus tests (58 per week, 18.73% PR). There were 803 positive weekly tests (2.53% positivity rate) for SARS-CoV-2 over this same period. Conclusion. Since the start of the SARS-CoV-2 pandemic, the number of positive tests for influenza A/B and seasonal respiratory viruses have not reached prepandemic levels across the YNHHS. However, rates of influenza and other respiratory viruses have increased since the relaxation of NPIs.
Subject(s)
Cyclonic Storms , Neoplasms , Humans , Neoplasms/epidemiology , Neoplasms/therapy , ClimateABSTRACT
Background: This study aimed to determine the sensitivity and specificity of reverse transcription PCR (RT-PCR) testing of upper respiratory tract (URT) samples from hospitalised patients with coronavirus disease 2019 (COVID-19), compared to the gold standard of a clinical diagnosis.
ABSTRACT
Background: Deuterium dilution is the criterion method to quantify total body water (TBW) in humans and to estimate body composition and hydration. Dilution of deuterated water in the body can be estimated from saliva, urine, or blood samples. The gold standard for quantifying isotope fractions is isotope ratio mass spectroscopy (IRMS);Fourier Transfer Infrared Spectroscopy (FTIR) is another less validated method that is more accessible. Few studies compare the precision and accuracy of TBW where samples are analyzed at different laboratories using different techniques and/or types of samples. In this study, we compare results from three laboratories using blinded duplicate samples of either saliva or urine measured using either FTIR or IRMS. Methods: The DaKine study recruited 80 athletes for multiple body composition measures. Each participant had 9 ml of both urine and saliva collected at baseline, 3 and 4-hour time points following the International Atomic Energy Agency protocol. The samples were aliquoted into 30 divisions providing blindedduplicate samples to three laboratories for both urine and saliva. Lab1 used IRMS for urine. Lab2 used IRMS to process saliva and urine, while Lab3 used FTIR to process saliva and urine. Results: Because of the temporary closure of the laboratories due to Covid-19, urine samples from only 24 of the 80 subjects have been processed by the laboratories so far. The test-retest RMSE (%CV) for urine was as follows: Lab1=0.25 L (0.55%);Lab2=0.24 L (0.60%);Lab3=pending. For saliva, the precision was: Lab1=unavailable;Lab2=0.26 L (0.63%);Lab3=pending. The accuracy between laboratories for urine measures was Lab2=0.98Lab1 -.024, R2=0.98, RMSE=1.31. Intra-laboratory comparison of urine and saliva was Lab2(urine)=1.01Lab2-.08, R2=0.98, RMSE=1.2. Conclusions: We conclude that inter-lab urine samples using IRMS are highly accurate (R2 = 0.98) to one another with precisions less than 1%. Intralab lab saliva and urine comparisons had similar accuracy and precision.
ABSTRACT
BACKGROUND: Few studies have documented rural community pharmacy disaster preparedness. OBJECTIVES: To: (1) describe rural community pharmacies' preparedness for and responses to COVID-19 and (2) examine whether responses vary by level of pharmacy rurality. METHODS: A convenience sample of rural community pharmacists completed an online survey (62% response rate) that assessed: (a) demographic characteristics; (b) COVID-19 information source use; (c) interest in COVID-19 testing; (d) infection control procedures; (e) disaster preparedness training, and (f) medication supply impacts. Descriptive statistics were calculated and differences by pharmacy rurality were explored. RESULTS: Pharmacists used the CDC (87%), state health departments (77%), and state pharmacy associations (71%) for COVID-19 information, with half receiving conflicting information. Most pharmacists (78%) were interested in offering COVID-19 testing but needed personal protective equipment and training to do so. Only 10% had received disaster preparedness training in the past five years. Although 73% had disaster preparedness plans, 27% were deemed inadequate for the pandemic. Nearly 70% experienced negative impacts in medication supply. There were few differences by rurality level. CONCLUSION: Rural pharmacies may be better positioned to respond to pandemics if they had disaster preparedness training, updated disaster preparedness plans, and received regular policy guidance from professional bodies.