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PLoS One ; 16(3): e0249391, 2021.
Article in English | MEDLINE | ID: covidwho-1167114


BACKGROUND: Households are important sites for transmission of SARS-CoV-2 and preventive measures are recommended. This study aimed to 1) investigate the impact of living with a person infected with SARS-CoV-2; 2) understand how household members implemented infection control recommendations in their home; and 3) identify the information and support needs of household members. METHODS: For this observational mixed-methods study, households with a person with confirmed SARS-CoV-2 infection were recruited via drive-through testing sites of Municipal Health Services, healthcare worker screening or hospital emergency visits in the University Medical Centre Utrecht, the Netherlands and via primary care physicians, hospital emergency visits or preoperative screening in the University Hospital of Antwerp, Belgium. We recorded household characteristics, including characteristics of all household members, together with their views on prevention measures. In a subset of households one adult household member was asked to participate in an interview investigating their views on preventive measures. Survey data were analysed using descriptive statistics and interview data by rapid framework analysis. A triangulation protocol was used to integrate findings. RESULTS: Thirty-four households (120 household members) were included in the quantitative survey. Twenty-two households were invited to be interviewed, of which 18 completed an interview (response 81.8%). Survey data showed that almost all households implemented some preventive measures, the use of face masks being least frequently reported. Measures taken depended on what was physically possible, the perceived severity of illness of the index patient and to what extent household members were willing to limit social interaction. Respondents did not believe in the effectiveness of wearing face masks within the house, and from the interviews this was explained by media coverage of face masks, impracticality and the stigma associated with wearing masks. Interviewees reported that quarantine had a high emotional burden and wished to have more information about the exact duration of quarantine, their own COVID-19 status, symptoms and when to seek medical help. CONCLUSION: People were willing to implement prevention measures, however actual adherence depended on perceived severity of illness and the perceived risk of becoming infected. Homes are social environments and recommendations for infection prevention should account for this context. Incorporating our findings into policy making could provide households with more relevant and actionable advice.

COVID-19/epidemiology , Housing , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19/prevention & control , COVID-19/transmission , Child , Child, Preschool , Female , Health Knowledge, Attitudes, Practice , Humans , Infant , Infant, Newborn , Male , Masks , Middle Aged , Quarantine , Young Adult
Eur J Pediatr ; 180(4): 1299-1305, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-866209


Between February and May 2020, during the first wave of the COVID-19 pandemic, paediatric emergency departments in 12 European countries were prospectively surveyed on their implementation of SARS-CoV-2 disease (COVID-19) testing and infection control strategies. All participating departments (23) implemented standardised case definitions, testing guidelines, early triage and infection control strategies early in the outbreak. Patient testing criteria initially focused on suspect cases and later began to include screening, mainly for hospital admissions. Long turnaround times for test results likely put additional strain on healthcare resources.Conclusion: Shortening turnaround times for SARS-CoV-2 tests should be a priority. Specific paediatric testing criteria are needed. What is Known: • WHO and public health authorities issued case definitions, testing and infection control recommendations for COVID-19 in January. • SARS-CoV-2 testing was made available across Europe in February. What is New: • Paediatric emergency departments implemented COVID-19-specific procedures rapidly, including case definitions, testing guidelines and early triage. • A third of surveyed departments waited more than 24 h for SARS-CoV-2 test to be reported, resulting in additional strain on resources.

COVID-19 Testing/methods , COVID-19/diagnosis , COVID-19/prevention & control , Emergency Service, Hospital , Infection Control/methods , Pandemics/prevention & control , Adolescent , COVID-19 Testing/standards , COVID-19 Testing/statistics & numerical data , Child , Child, Preschool , Clinical Protocols , Emergency Service, Hospital/standards , Emergency Service, Hospital/statistics & numerical data , Europe/epidemiology , Female , Health Care Surveys , Humans , Infant , Infant, Newborn , Infection Control/standards , Infection Control/statistics & numerical data , Male , Pediatrics , Practice Guidelines as Topic , Prospective Studies , Triage/methods , Triage/standards , Triage/statistics & numerical data
Lancet Infect Dis ; 20(10): e261-e267, 2020 10.
Article in English | MEDLINE | ID: covidwho-662911


Health-care workers are crucial to any health-care system. During the ongoing COVID-19 pandemic, health-care workers are at a substantially increased risk of becoming infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and could come to considerable harm as a result. Depending on the phase of the pandemic, patients with COVID-19 might not be the main source of SARS-CoV-2 infection and health-care workers could be exposed to atypical patients, infected family members, contacts, and colleagues, or live in communities of active transmission. Clear strategies to support and appropriately manage exposed and infected health-care workers are essential to ensure effective staff management and to engender trust in the workplace. These management strategies should focus on risk stratification, suitable clinical monitoring, low-threshold access to diagnostics, and decision making about removal from and return to work. Policy makers need to support health-care facilities in interpreting guidance during a pandemic that will probably be characterised by fluctuating local incidence of SARS-CoV-2 to mitigate the impact of this pandemic on their workforce.

Coronavirus Infections/diagnosis , Coronavirus Infections/prevention & control , Health Personnel , Pandemics/prevention & control , Pneumonia, Viral/diagnosis , Pneumonia, Viral/prevention & control , Betacoronavirus , COVID-19 , Coronavirus Infections/epidemiology , Guidelines as Topic , Health Services Accessibility , Humans , Infection Control/standards , Occupational Exposure/prevention & control , Occupational Exposure/statistics & numerical data , Pneumonia, Viral/epidemiology , Return to Work , Risk Management , SARS-CoV-2