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1.
Drug Alcohol Depend ; 232: 109263, 2022 Mar 01.
Article in English | MEDLINE | ID: covidwho-1719618

ABSTRACT

BACKGROUND: COVID-19 has likely affected the delivery of interventions to prevent blood-borne viruses (BBVs) among people who inject drugs (PWID). We examined the impact of the first wave of COVID-19 in Scotland on: 1) needle and syringe provision (NSP), 2) opioid agonist therapy (OAT) and 3) BBV testing. METHODS: An interrupted time series study design; 23rd March 2020 (date of the first 'lockdown') was chosen as the key date. RESULTS: The number of HIV tests and HCV tests in drug services/prisons, and the number of needles/syringes (N/S) distributed decreased by 94% (RR=0.062, 95% CI 0.041-0.094, p < 0.001), 95% (RR=0.049, 95% CI 0.034-0.069, p < 0.001) and 18% (RR = 0.816, 95% CI 0.750-0.887, p < 0.001), respectively, immediately after lockdown. Post-lockdown, an increasing trend was observed relating to the number of N/S distributed (0.6%; RR = 1.006, 95% CI 1.001-1.012, p = 0.015), HIV tests (12.1%; RR = 1.121, 95% CI 1.092-1.152, p < 0.001) and HCV tests (13.2%; RR = 1.132, 95 CI 1.106-1.158, p < 0.001). Trends relating to the total amount of methadone prescribed remained stable, but a decreasing trend in the number of prescriptions (2.4%; RR = 0.976, 95% CI 0.959-0.993, p = 0.006) and an increasing trend in the quantity prescribed per prescription (2.8%; RR = 1.028, 95% CI 1.013-1.042, p < 0.001) was observed post-lockdown. CONCLUSIONS: COVID-19 impacted the delivery of BBV prevention services for PWID in Scotland. While there is evidence of service recovery; further effort is likely required to return some intervention coverage to pre-pandemic levels in the context of subsequent waves of COVID-19.


Subject(s)
COVID-19 , Drug Users , HIV Infections , Pharmaceutical Preparations , Substance Abuse, Intravenous , COVID-19/epidemiology , COVID-19/prevention & control , Communicable Disease Control , HIV Infections/epidemiology , HIV Infections/prevention & control , Humans , Interrupted Time Series Analysis , SARS-CoV-2 , Scotland/epidemiology , Substance Abuse, Intravenous/epidemiology , Substance Abuse, Intravenous/rehabilitation
3.
J Infect Dis ; 223(6): 971-980, 2021 03 29.
Article in English | MEDLINE | ID: covidwho-1155782

ABSTRACT

Identifying drivers of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exposure and quantifying population immunity is crucial to prepare for future epidemics. We performed a serial cross-sectional serosurvey throughout the first pandemic wave among patients from the largest health board in Scotland. Screening of 7480 patient serum samples showed a weekly seroprevalence ranging from 0.10% to 8.23% in primary and 0.21% to 17.44% in secondary care, respectively. Neutralization assays showed that highly neutralizing antibodies developed in about half of individuals who tested positive with enzyme-linked immunosorbent assay, mainly among secondary care patients. We estimated the individual probability of SARS-CoV-2 exposure and quantified associated risk factors. We show that secondary care patients, male patients, and 45-64-year-olds exhibit a higher probability of being seropositive. The identification of risk factors and the differences in virus neutralization activity between patient populations provided insights into the patterns of virus exposure during the first pandemic wave and shed light on what to expect in future waves.


Subject(s)
COVID-19/immunology , SARS-CoV-2/immunology , Adolescent , Adult , Aged , Antibodies, Neutralizing/blood , Antibodies, Viral/blood , COVID-19/diagnosis , COVID-19/epidemiology , Cell Line , Cross-Sectional Studies , Delivery of Health Care , Demography , Enzyme-Linked Immunosorbent Assay , Female , Humans , Immunity , Male , Middle Aged , Pandemics , Risk Factors , Scotland/epidemiology , Seroepidemiologic Studies , Young Adult
4.
J Infect Dis ; 223(6): 971-980, 2021 03 29.
Article in English | MEDLINE | ID: covidwho-998363

ABSTRACT

Identifying drivers of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exposure and quantifying population immunity is crucial to prepare for future epidemics. We performed a serial cross-sectional serosurvey throughout the first pandemic wave among patients from the largest health board in Scotland. Screening of 7480 patient serum samples showed a weekly seroprevalence ranging from 0.10% to 8.23% in primary and 0.21% to 17.44% in secondary care, respectively. Neutralization assays showed that highly neutralizing antibodies developed in about half of individuals who tested positive with enzyme-linked immunosorbent assay, mainly among secondary care patients. We estimated the individual probability of SARS-CoV-2 exposure and quantified associated risk factors. We show that secondary care patients, male patients, and 45-64-year-olds exhibit a higher probability of being seropositive. The identification of risk factors and the differences in virus neutralization activity between patient populations provided insights into the patterns of virus exposure during the first pandemic wave and shed light on what to expect in future waves.


Subject(s)
COVID-19/immunology , SARS-CoV-2/immunology , Adolescent , Adult , Aged , Antibodies, Neutralizing/blood , Antibodies, Viral/blood , COVID-19/diagnosis , COVID-19/epidemiology , Cell Line , Cross-Sectional Studies , Delivery of Health Care , Demography , Enzyme-Linked Immunosorbent Assay , Female , Humans , Immunity , Male , Middle Aged , Pandemics , Risk Factors , Scotland/epidemiology , Seroepidemiologic Studies , Young Adult
5.
J Infect Dis ; 222(4): 696-698, 2020 07 23.
Article in English | MEDLINE | ID: covidwho-857632
6.
J Infect Dis ; 222(1): 17-25, 2020 06 16.
Article in English | MEDLINE | ID: covidwho-599715

ABSTRACT

Public health preparedness for coronavirus (CoV) disease 2019 (COVID-19) is challenging in the absence of setting-specific epidemiological data. Here we describe the epidemiology of seasonal CoVs (sCoVs) and other cocirculating viruses in the West of Scotland, United Kingdom. We analyzed routine diagnostic data for >70 000 episodes of respiratory illness tested molecularly for multiple respiratory viruses between 2005 and 2017. Statistical associations with patient age and sex differed between CoV-229E, CoV-OC43, and CoV-NL63. Furthermore, the timing and magnitude of sCoV outbreaks did not occur concurrently, and coinfections were not reported. With respect to other cocirculating respiratory viruses, we found evidence of positive, rather than negative, interactions with sCoVs. These findings highlight the importance of considering cocirculating viruses in the differential diagnosis of COVID-19. Further work is needed to establish the occurrence/degree of cross-protective immunity conferred across sCoVs and with COVID-19, as well as the role of viral coinfection in COVID-19 disease severity.


Subject(s)
Betacoronavirus , Coronavirus 229E, Human/genetics , Coronavirus Infections/epidemiology , Coronavirus NL63, Human/genetics , Coronavirus OC43, Human/genetics , Pandemics , Pneumonia, Viral/epidemiology , Seasons , Adolescent , Adult , Aged , COVID-19 , Child , Child, Preschool , Coinfection , Coronavirus Infections/virology , Female , Humans , Infant , Male , Middle Aged , Pneumonia, Viral/virology , Real-Time Polymerase Chain Reaction , SARS-CoV-2 , Scotland/epidemiology , Young Adult
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