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1.
Indian Journal of Community Health ; 34(3):374-380, 2022.
Article in English | Scopus | ID: covidwho-2081597

ABSTRACT

Background: Lockdown imposed to limit the spread of COVID 19 may have had a significant effect on the time to care, demography, injury causation, injury characteristics, volume and nature of admission, management and outcome of paediatric orthopaedic trauma patients. Objective: To document the effect of lockdown on the time to care at KGMU, use of ambulance, volume and type of admissions, demography, injury causation, injury characteristics, management and outcome of paediatric orthopaedic trauma patients. Methods:. This record review compared age, sex, type of admission, mechanism of injury, injury characteristics, type of treatment, vehicle used for transport, and outcome among patients admitted in pre-lockdown, lockdown and post lockdown. Results: Lockdown was associated with decrease in the number of cases (p<0.01), increase in the time since injury to reception (p<0.040), a rise in the share of referred admission (p<0.040), time since reception at KGMU, time to definitive care (p<0.001), high energy falls (p<0.001), injuries at home (p<0.001), higher ISS (p<0.001), non operative treatment (p=0.038) and greater use of ambulance (p=0.003). Conclusion: Lockdown resulted in a significant change in the causation and management of injury, significant delays in timeliness of care, reduction in the volume of admissions, an increase in injury severity and share of referral admissions. © 2022, Indian Association of Preventive and Social Medicine. All rights reserved.

2.
Sci Rep ; 12(1): 13490, 2022 08 05.
Article in English | MEDLINE | ID: covidwho-2077088

ABSTRACT

The ribonucleic acid (RNA) of the severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) is detectable in municipal wastewater as infected individuals can shed the virus in their feces. Viral concentration in wastewater can inform the severity of the COVID-19 pandemic but observations can be noisy and sparse and hence hamper the epidemiological interpretation. Motivated by a Canadian nationwide wastewater surveillance data set, unlike previous studies, we propose a novel Bayesian statistical framework based on the theories of functional data analysis to tackle the challenges embedded in the longitudinal wastewater monitoring data. By employing this framework to analyze the large-scale data set from the nationwide wastewater surveillance program covering 15 sampling sites across Canada, we successfully detect the true trends of viral concentration out of noisy and sparsely observed viral concentrations, and accurately forecast the future trajectory of viral concentrations in wastewater. Along with the excellent performance assessment using simulated data, this study shows that the proposed novel framework is a useful statistical tool and has a significant potential in supporting the epidemiological interpretation of noisy viral concentration measurements from wastewater samples in a real-life setting.


Subject(s)
COVID-19 , SARS-CoV-2 , Bayes Theorem , COVID-19/epidemiology , Canada , Humans , Pandemics , RNA, Viral , Waste Water , Wastewater-Based Epidemiological Monitoring
4.
Indian Journal of Environmental Protection ; 42(5):573-580, 2022.
Article in English | Scopus | ID: covidwho-1904551

ABSTRACT

Governments across the world are making considerable efforts in confronting COVID-19, from nationwide lockdowns to hygiene measures and maintaining social distancing. But at the same time, role of aerosols or/and the high concentrations of fine particulate matter or/and AQI levels in infection transmission and increasing the prevalence, morbidity and mortality of pandemic has been largely unexplored specifically in India where pollution attains peak in October and November every year. In the present study, we collected data regarding air quality index and COVID-19 determinants of four Indian cities : Bangalore, Delhi, Mumbai and Shillong from 1 October 2020 to 16 November 2020. We performed an analysis of variance on the regression model to estimate and quantify the strength of relationship between COVID-19 determinants and air pollution index (AQI). Results show that AQI has a significant impact on both response variables, that is COVID-19 cases as well as mortality (p < 0.05 at 95% confidence level) in Delhi, Mumbai and Bangalore (p < 0.05) but in Shillong no impact of AQI on COVID-19 cases and AQI (p = 0.343), as well as deaths (p = 0.664), was observed. We conclude that it is both conceivable and reasonable to suspect the role of increased AQI levels in aggravating COVID-19 morbidity and mortality. Thus, we recommend that critical meteorological conditions, like haze/smog caused by factors, like stubble burning or firing crackers should be predicted and monitored more systematically as they may lead to deterioration of respiratory problems. As the whole world is striving to fight against the deadly pandemic, it is extremely imperative to focus not only on human health as a part of response but also on global planetary health. Short term measures that can minimize supplementary risks, like adverse weather situations including pollution, poor air quality should be considered more meticulously and judiciously so that new flares of COVID-19 morbidity and mortality can be restricted. © 2022 - Kalpana Corporation.

5.
Nonlinear Studies ; 29(2):511-528, 2022.
Article in English | Scopus | ID: covidwho-1888071

ABSTRACT

In this manuscript, we study a fractional order time delay SEIR model of COVID-19 disease. Some conditions on stability and Hopf bifurcation have been derived for the model by using Laplace transformation. Further numerical simulation has been carried out for the purpose of better understanding of our results. © CSP - Cambridge, UK, I&S - Florida, USA, 2022

6.
medrxiv; 2022.
Preprint in English | medRxiv | ID: ppzbmed-10.1101.2022.06.26.22276912

ABSTRACT

Wastewater-based surveillance (WBS) of SARS-CoV-2 offers a complementary tool for clinical surveillance to detect and monitor Coronavirus Disease 2019 (COVID-19). Since both symptomatic and asymptomatic individuals infected with SARS-CoV-2 can shed the virus through the fecal route, WBS has the potential to measure community prevalence of COVID-19 without restrictions from healthcare-seeking behaviors and clinical testing capacity. During the Omicron wave, the limited capacity of clinical testing to identify COVID-19 cases in many jurisdictions highlighted the utility of WBS to estimate disease prevalence and inform public health strategies. However, there is a plethora of in-sewage, environmental and laboratory factors that can influence WBS outputs. The implementation of WBS therefore requires a comprehensive framework to outline an analysis pipeline that accounts for these complex and nuanced factors. This article reviews the framework of the national WBS conducted at the Public Health Agency of Canada to present WBS methods used in Canada to track and monitor SARS-CoV-2. In particular, we focus on five Canadian cities - Vancouver, Edmonton, Toronto, Montreal and Halifax - whose wastewater signals are analyzed by a mathematical model to provide case forecasts and reproduction number estimates. This work provides insights on approaches to implement WBS at the national scale in an accurate and efficient manner. Importantly, the national WBS system has implications beyond COVID-19, as a similar framework can be applied to monitor other infectious disease pathogens or antimicrobial resistance in the community.

7.
8.
International Journal of Instruction ; 15(2):847-860, 2022.
Article in English | Scopus | ID: covidwho-1789920

ABSTRACT

The recent outbreak of the global pandemic COVID-19 required Fiji National University offer fully online courses, which is a new form of pedagogy for many students. This new form of learning benefitted many students but created obstacles for others. The purpose of this study was to investigate student perceptions of the advantages and disadvantages of fully online courses due to the COVID-19 pandemic. An online survey in the form of a semi-structured questionnaire was used to gather data from 138 students. Data were analysed using thematic analysis. The study found that fully online learning suits students during pandemics, natural disasters (flooding, cyclones), and political upheavals. Fully online learning also helps students who have permanent employment and have difficulty getting time off to attend face-to-face classes. It also helps maritime or remote students who have limited access to the main centre or helps lecturer/facilitator deliver instructions when he/she is out of a country or is far away. The study also confirmed that fully online learning requires robust internet connectivity and a sustainable power supply allowing students to assess course materials from the comfort of their homes at their own pace. The student's safety in terms of travel and transmission of diseases are maintained. Fully online learning classes also assist students in saving fuel costs and rushing to the classes. © 2022 Eskisehir Osmangazi University. All rights reserved.

9.
Epidemics ; 39: 100560, 2022 06.
Article in English | MEDLINE | ID: covidwho-1778119

ABSTRACT

The COVID-19 pandemic has stimulated wastewater-based surveillance, allowing public health to track the epidemic by monitoring the concentration of the genetic fingerprints of SARS-CoV-2 shed in wastewater by infected individuals. Wastewater-based surveillance for COVID-19 is still in its infancy. In particular, the quantitative link between clinical cases observed through traditional surveillance and the signals from viral concentrations in wastewater is still developing and hampers interpretation of the data and actionable public-health decisions. We present a modelling framework that includes both SARS-CoV-2 transmission at the population level and the fate of SARS-CoV-2 RNA particles in the sewage system after faecal shedding by infected persons in the population. Using our mechanistic representation of the combined clinical/wastewater system, we perform exploratory simulations to quantify the effect of surveillance effectiveness, public-health interventions and vaccination on the discordance between clinical and wastewater signals. We also apply our model to surveillance data from three Canadian cities to provide wastewater-informed estimates for the actual prevalence, the effective reproduction number and incidence forecasts. We find that wastewater-based surveillance, paired with this model, can complement clinical surveillance by supporting the estimation of key epidemiological metrics and hence better triangulate the state of an epidemic using this alternative data source.


Subject(s)
COVID-19 , SARS-CoV-2 , COVID-19/epidemiology , Canada/epidemiology , Cities/epidemiology , Humans , Pandemics , RNA, Viral , Waste Water
10.
medrxiv; 2022.
Preprint in English | medRxiv | ID: ppzbmed-10.1101.2022.04.12.22273761

ABSTRACT

Wastewater-based surveillance (WBS) has become an effective tool around the globe for indirect monitoring of COVID-19 in communities. Quantities of viral fragments of SARS-CoV-2 in wastewater are related to numbers of clinical cases of COVID-19 reported within the corresponding sewershed. Variants of Concern (VOCs) have been detected in wastewater by use of reverse transcription quantitative polymerase chain reaction (RT-qPCR) or sequencing. A multiplex RT-qPCR assay to detect and estimate the prevalence of multiple VOCs, including Omicron/Alpha, Beta, Gamma, and Delta, in wastewater RNA extracts was developed and validated. The probe-based multiplex assay, named N200, focuses on amino acids 199-202, a region of the N gene that contains several mutations that are associated with variants of SARS-CoV-2 within a single amplicon. Each of the probes in the N200 assay are specific to the targeted mutations and worked equally well in single- and multi-plex modes. To estimate prevalence of each VOC, the abundance of the targeted mutation was compared with a non-mutated region within the same amplified region. The N200 assay was applied to monitor frequencies of VOCs in wastewater extracts from six sewersheds in Ontario, Canada collected between December 1, 2021, and January 4, 2022. Using the N200 assay, the replacement of the Delta variant along with the introduction and rapid dominance of the Omicron variant were monitored in near real-time, as they occurred nearly simultaneously at all six locations. The N200 assay is robust and efficient for wastewater surveillance can be adopted into VOC monitoring programs or replace more laborious assays currently being used to monitor SARS-CoV-2 and its VOCs.

11.
18th IEEE India Council International Conference, INDICON 2021 ; 2021.
Article in English | Scopus | ID: covidwho-1752409

ABSTRACT

The high potency and spread of the coronavirus pandemic has rapidly swept over a global scale, causing a large number of deaths and devastation. Its mutants have exaggerated the situation further, which has become a serious concern and a challenge for scientists, especially medical practitioners, to devise some advanced remedial actions. This paper intends to address this by developing a model based on deep learning for segmenting the affected regions in the lungs using CT-scan images. We propose a novel segmentation model based on UNet using Xception-Net in the encoder stage to detect covid-19 infection in CT-scans with two main aspects. It combines the local residual connections in the decoder unit of UNet with the typical global residual connections that lead to better performance. Also, the encoder component uses a pre-trained state-of-the-art feature extraction model that helps the system converge to the optimal value precisely due to the pre-trained weights. We apply a contrast-limited version of the adaptive histogram equalization in the data preparation stage to make the frequency of image pixels uniformly distributed. This decreases the biasedness in the model towards specific sections of CT-scans images. Our proposed model outperformed some existing counterparts, including TV-UNet, Inf-Net, ED-CNN. © 2021 IEEE.

13.
Appl Environ Microbiol ; 88(5): e0174021, 2022 03 08.
Article in English | MEDLINE | ID: covidwho-1604444

ABSTRACT

Throughout the coronavirus disease 2019 (COVID-19) pandemic, wastewater surveillance has been used to monitor trends in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) prevalence in the community. A major challenge in establishing wastewater surveillance programs, especially in remote areas, is the need for a well-equipped laboratory for sample analysis. Currently, no options exist for rapid, sensitive, mobile, and easy-to-use wastewater tests for SARS-CoV-2. The performance of the GeneXpert system, which offers cartridge-based, rapid molecular clinical testing for SARS-CoV-2 in a portable platform, was evaluated using wastewater as the input. The GeneXpert demonstrated a SARS-CoV-2 limit of detection in wastewater below 32 copies/mL with a sample processing time of less than an hour. Using wastewater samples collected from multiple sites across Canada during February and March 2021, a high overall agreement (97.8%) was observed between the GeneXpert assay and laboratory-developed tests regarding the presence or absence of SARS-CoV-2. Additionally, with the use of centrifugal filters, the detection threshold of the GeneXpert system was improved to <10 copies/mL in wastewater. Finally, to support on-site wastewater surveillance, GeneXpert testing was implemented in Yellowknife, a remote community in Northern Canada, where its use successfully alerted public health authorities to undetected transmission of COVID-19. The identification of SARS-CoV-2 in wastewater triggered clinical testing of recent travelers and identification of new COVID-19 cases/clusters. Taken together, these results suggest that GeneXpert is a viable option for surveillance of SARS-CoV-2 in wastewater in locations that do not have access to established testing laboratories. IMPORTANCE Wastewater-based surveillance is a powerful tool that provides an unbiased measure of COVID-19 prevalence in a community. This work describes a sensitive wastewater rapid test for SARS-CoV-2 based on a widely distributed technology, the GeneXpert. The advantages of an easy-to-use wastewater test for SARS-CoV-2 are clear: it supports surveillance in remote communities, improves access to testing, and provides faster results allowing for an immediate public health response. The application of wastewater rapid testing in a remote community facilitated the detection of a COVID-19 cluster and triggered public health action, clearly demonstrating the utility of this technology. Wastewater surveillance will become increasingly important in the postvaccination pandemic landscape as individuals with asymptomatic/mild infections continue transmitting SARS-CoV-2 but are unlikely to be tested.


Subject(s)
COVID-19 , SARS-CoV-2 , COVID-19/diagnosis , COVID-19/epidemiology , Humans , Pandemics , Waste Water , Wastewater-Based Epidemiological Monitoring
14.
Sci Total Environ ; 810: 151283, 2022 Mar 01.
Article in English | MEDLINE | ID: covidwho-1510283

ABSTRACT

SARS-CoV-2 variants of concern (VoC) have been increasingly detected in clinical surveillance in Canada and internationally. These VoC are associated with higher transmissibility rates and in some cases, increased mortality. In this work we present a national wastewater survey of the distribution of three SARS-CoV-2 mutations found in the B.1.1.7 (alpha), B.1.351 (beta), and P.1 (gamma) VoC, namely the S-gene 69-70 deletion, N501Y mutation, and N-gene D3L. RT-qPCR allelic discrimination assays were sufficiently sensitive and specific for detection and relative quantitation of SARS-CoV-2 variants in wastewater to allow for rapid population-level screening and surveillance. We tested 261 samples collected from 5 Canadian cities (Vancouver, Edmonton, Toronto, Montreal, and Halifax) and 6 communities in the Northwest Territories from February 16th to March 28th, 2021. VoC were not detected in the Territorial communities, suggesting the absence of VoC SARS-CoV-2 cases in those communities. Percentage of variant remained low throughout the study period in the majority of the sites tested, however the Toronto sites showed a marked increase from ~25% to ~75% over the study period. The results of this study highlight the utility of population level molecular surveillance of SARS-CoV-2 VoC using wastewater. Wastewater monitoring for VoC can be a powerful tool in informing public health responses, including monitoring trends independent of clinical surveillance and providing early warning to communities.


Subject(s)
SARS-CoV-2 , Waste Water/virology , COVID-19 , Canada , Humans , Mutation , SARS-CoV-2/genetics , SARS-CoV-2/isolation & purification
15.
Journal of Experimental Biology and Agricultural Sciences ; 9(2):172-182, 2021.
Article in English | Scopus | ID: covidwho-1404145

ABSTRACT

The people of India have a wide variety of eating habits that vary according to ethnicity, geography, and culture. The consumption of meat primarily covers the protein requirement of the Indians, and three out of four are non-vegetarians. There is a need to understand the impact of the COVID-19 pandemic and the associated countrywide lockdown on the meat consumption pattern of the Indian non-vegetarians. A countrywide survey was conducted among the consumers to study the impact of COVID-19 on the meat consumption pattern using a self-administered electronic questionnaire distributed through emails and online social networking platforms. A total of 416 responses were collected from the consumers belonging to different states and union territories. The data were analyzed as per the standard procedure. The meat consumption pattern of the non-vegetarians was found to be altered during the COVID-19 pandemic and the lockdown period. The majority of the consumers could not obtain a sufficient quantity of meat and meat products during the lockdown period due to various reasons such as the increased cost and decreased availability of livestock. The myths and rumors associated with meat consumption and the emergence of SARS-CoV-2 further weakened the meat trade in certain areas. Based on the findings of this survey, it is safe to confirm that the meat consumption pattern among Indian consumers was affected badly during the countrywide lockdown. © 2021, Editorial board of Journal of Experimental Biology and Agricultural Sciences. All rights reserved.

16.
medrxiv; 2021.
Preprint in English | medRxiv | ID: ppzbmed-10.1101.2021.08.13.21262039

ABSTRACT

Throughout the COVID-19 pandemic, wastewater surveillance has been used to monitor trends in SARS-CoV-2 prevalence in the community. A major challenge in establishing wastewater surveillance programs, especially in remote areas, is the need for a well-equipped laboratory for sample analysis. Currently, no options exist for rapid, sensitive, mobile, and easy-to-use wastewater tests for SARS-CoV-2. The performance of the GeneXpert System, which offers cartridge-based, rapid molecular clinical testing for SARS-CoV-2 in a portable platform, was evaluated using wastewater as the input. The GeneXpert demonstrated a SARS-CoV-2 limit of detection in wastewater below 32 copies/mL with a sample processing time of less than an hour. Using wastewater samples collected from multiple sites across Canada during February and March 2021, a high overall agreement (97.8%) was observed between the GeneXpert assay and laboratory-developed tests regarding the presence or absence of SARS-CoV-2. Additionally, with the use of centrifugal filters the detection threshold of the GeneXpert system was improved to <10 copies/mL in wastewater. Finally, to support on-site wastewater surveillance, GeneXpert testing was implemented in Yellowknife, a remote community in Northern Canada where its use successfully alerted public health authorities to undetected transmission of COVID-19. The identification of SARS-CoV-2 in wastewater triggered clinical testing of recent travelers and identification of new COVID-19 cases/clusters. Taken together, these results suggest the GeneXpert is a viable option for surveillance of SARS-CoV-2 in wastewater in locations that do not have access to established testing laboratories.

17.
Indian Journal of Medical Specialities ; 12(3):161-164, 2021.
Article in English | Web of Science | ID: covidwho-1350358

ABSTRACT

Majority hospital admission in COVID-19 is because of pneumonia. Few develop progressive and permanent pulmonary fibrosis. Here, we present three patients of severe COVID-19 pneumonia requiring intensive care unit care. Computed tomography (CT) of the chest of these patients revealed multiple areas of lung involvement at the 4th week of illness. Follow-up CT scan and pulmonary function test were done after 5 months to look for residual changes. Pulmonary fibrosis induced by COVID-19 is being documented. We need long-term follow-up studies to observe the clinical and radiological course of fibrosis. Corticosteroids and antifibrotic agents in such cases are being looked into.

18.
Journal of Young Pharmacists ; 13(2):91-96, 2021.
Article in English | Web of Science | ID: covidwho-1346681

ABSTRACT

The novel coronavirus was renamed as coronavirus disease 2019 (COVID-19) by the world health organization, began its spread in December 2019, in the city of Wuhan, China. Global bodies and governments weren't prepared to handle the impact of the virus on society. Nepal's landlocked nation encountered its incident confirmed case of COVID-19 during the first week of January, with the primary host being a student with a travel history from its place of inception. The nation is deficient in its health resources. The country mainly focused on the stringent implementation of washing of hands, wearing masks, restricting general movement, and maintaining social distancing in public. The disease transmission reached to the third stage, which began within three months after the confirmation of the first case of COVID-19. The lack of tropical hospitals, laboratory and diagnostic facilities added to the challenges faced by the country. This paper is a comprehensive review of the overall preparation and steps taken by the federal system of Nepal to combat the virus's effects till the third stage of transmission. It concludes with the practical limitations faced by the governing authorities of the nation while implementing these measures.

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