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1.
Clin Microbiol Infect ; 2022 Jul 14.
Article in English | MEDLINE | ID: covidwho-1936214

ABSTRACT

OBJECTIVES: No studies have examined longitudinal patterns of naturally exhaled SARS-CoV-2 RNA viral load (VL) during acute infection. We report this using facemask sampling (FMS) and assessed the relationship between emitted RNA VL and household transmission. METHODS: Between December 2020 and February 2021, we recruited participants within 24 hours of a positive RT-qPCR on upper respiratory tract sampling (URTS) (day 0). Participants gave FMS (for 1 hour) and URTS (self-taken) on 7 occasions up to day 21. Samples were analysed by RT-qPCR (from sampling matrix strips within the mask) and symptom diaries recorded. Household transmission was assessed through reporting of positive URTS RT-qPCR in household contacts. RESULTS: Analysis of 203 FMS and 190 URTS from 34 participants showed that RNA VL peaked in the first five days following sampling. Concomitant URTS, FMS RNA VL and symptom scores however were poorly correlated, but a higher severity of reported symptoms was associated with FMS positivity up to day 5. Of 28 participants who had household contacts, 12 (43%) reported transmission. Frequency of household transmission was associated with the highest (peak) FMS RNA VL obtained (negative copies/strip: 0% household transmission; 1-1000 copies/strip: 20%; 1001 - 10,000 copies/strip: 57%; >10,000 copies/strip: 75%; p=0.048; age adjusted odds ratio of transmission per log increase in copies/strip: 4.97; 95% CI: 1.20-20.55, p=0.02) but this was not observed with peak URTS RNA VL. CONCLUSIONS: Exhaled RNA VL measured by FMS is highest in early infection, can be positive in symptomatic patients with concomitantly negative URTS and is strongly associated with household transmission.

2.
Pandemic Risk, Response, and Resilience ; : 89-106, 2022.
Article in English | EuropePMC | ID: covidwho-1897832

ABSTRACT

COVID-19 made significant health, economic, and social impact across the world. The situation urgently needs to strengthen disaster risk reduction strategies to reduce risks and enhance resilience. Nevertheless, many instances have evidenced disaster risk governance–related issues. This study examined the United Kingdom's present disaster risk governance system since the country has been hit significantly by the pandemic. The study evaluates the risk governance system in the United Kingdom across the key elements of the International Risk Governance Framework. The study conducted a systematic literature review following a literature review protocol. Documents were selected from the Science Direct, Emerald, and Google Scholar databases. Across the framework elements, several challenges were found within the UK's pandemic risk governance system. The study highlights the strength of the well-developed legal and policy supported the country's risk governance system. Even though the study was conducted at the early stage of the pandemic, the early findings will benefit policymakers and practitioners shaping the pandemic risk governance system in the country for a resilient society.

3.
Pandemic Risk, Response, and Resilience ; : 61-75, 2022.
Article in English | EuropePMC | ID: covidwho-1897762

ABSTRACT

COVID-19 pandemic has given insights into the systemic risks of a hazard, demonstrating the potency of biological hazards to not only render one sector dysfunctional but also fail the entire system. The grave and devastating impacts of the current COVID-19 call for the need to assess the state of global and national preparedness for future pandemics. This chapter provides an outline of Sri Lanka's response to the COVID-19 pandemic while delving into the current status and gaps concerning preparedness for pandemics in the country. The analysis is aimed at providing key recommendations for policymakers to improve national-level preparedness for anticipated pandemic threats. This chapter has drawn on a review of secondary literature and primary data gathered through in-depth interviews conducted with key informants in the disaster management and public health sectors in the country. Findings show that while preparedness planning for biological hazards is predominantly a responsibility of the health sector in the country, there is a pressing need to strengthen such preparedness through a unified legal framework and system of governance that allow for the transfer of relevant expertise, infrastructure, and lessons learned from previous hazards contexts to situations of pandemics;the incorporation of pandemic preparedness into national-level DRR efforts and subnational-level DRR planning;intensifying national focus on building economic and social resilience;emulating a multisectoral approach, enhancing private sector participation, and establishing a national framework to foster preparedness for parallel hazards.

4.
Progress in Disaster Science ; : 100231, 2022.
Article in English | ScienceDirect | ID: covidwho-1851921

ABSTRACT

COVID-19 has showcased the systematic nature of risks. Its effects have spanned beyond the health sector causing severe economic disruptions. Sri Lanka's GDP contracted by 3.6% in 2020 from a 2.3% growth in 2019, reflecting the largest economic downturn recorded in the country's history. Although the COVID-19 pandemic has been largely perceived as unprecedented by most economic sectors and businesses functioning within them, pandemics are not a novel phenomenon given their intermittent occurrence in the past. This study aimed at examining the resilience of four key sectors in Sri Lanka during the COVID-19 pandemic, namely apparel, tourism, agriculture and construction. The study sought to identify the factors that have both enhanced and hindered their resilience during the pandemic and provide recommendations to strengthen their resilience for future pandemics and multi-hazard scenarios featuring pandemics. The study draws upon primary data gathered through four round table discussions carried out with a total of 31 key informants representing the selected sectors. The findings reveal that for economic resilience to be achieved within the selected economic sectors, resilience building measures should be undertaken at three levels, while also recognising the need for consonance and congruence between measures taken at each level: 1) organizational level;2) sectoral level and 3) country level.

5.
Biochem J ; 479(8): 901-920, 2022 04 29.
Article in English | MEDLINE | ID: covidwho-1774010

ABSTRACT

Diagnostic testing continues to be an integral component of the strategy to contain the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) global pandemic, the causative agent of Coronavirus Disease 2019 (COVID-19). The SARS-CoV-2 genome encodes the 3C-like protease (3CLpro) which is essential for coronavirus replication. This study adapts an in vitro colorimetric gold nanoparticle (AuNP) based protease assay to specifically detect the activity of SARS-CoV-2 3CLpro as a purified recombinant protein and as a cellular protein exogenously expressed in HEK293T human cells. We also demonstrate that the specific sensitivity of the assay for SARS-CoV-2 3CLpro can be improved by use of an optimised peptide substrate and through hybrid dimerisation with inactive 3CLpro mutant monomers. These findings highlight the potential for further development of the AuNP protease assay to detect SARS-CoV-2 3CLpro activity as a novel, accessible and cost-effective diagnostic test for SARS-CoV-2 infection at the point-of-care. Importantly, this versatile assay could also be easily adapted to detect specific protease activity associated with other viruses or diseases conditions.


Subject(s)
COVID-19 , Metal Nanoparticles , Antiviral Agents , COVID-19/diagnosis , Colorimetry , Coronavirus 3C Proteases , Gold , HEK293 Cells , Humans , Peptide Hydrolases , Protease Inhibitors , SARS-CoV-2
6.
Prog Disaster Sci ; 14: 100228, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1773686

ABSTRACT

Synergized impacts of simultaneous hazards amidst COVID-19 have called for the need for highly collaborative multi-sectoral approaches for disaster preparedness planning. In such a context, this study aims at evaluating the network of stakeholders in the National Early Warning System of Sri Lanka during preparedness planning. Social Network Analysis was used to visualise the network of stakeholders for selected hazard scenarios. Furthermore, a series of key informant interviews were conducted focusing on disaster preparedness planning during the recent multiple hazard scenarios. The findings highlight the need for a framework to guide the stakeholder coordination in preparedness planning for multiple hazards.

7.
J Infect ; 82(6): 253-259, 2021 06.
Article in English | MEDLINE | ID: covidwho-1152506

ABSTRACT

BACKGROUND: Human to human transmission of SARS-CoV-2 is driven by the respiratory route but little is known about the pattern and quantity of virus output from exhaled breath. We have previously shown that face-mask sampling (FMS) can detect exhaled tubercle bacilli and have adapted its use to quantify exhaled SARS-CoV-2 RNA in patients admitted to hospital with Coronavirus Disease-2019 (COVID-19). METHODS: Between May and December 2020, we took two concomitant FMS and nasopharyngeal samples (NPS) over two days, starting within 24 h of a routine virus positive NPS in patients hospitalised with COVID-19, at University Hospitals of Leicester NHS Trust, UK. Participants were asked to wear a modified duckbilled facemask for 30 min, followed by a nasopharyngeal swab. Demographic, clinical, and radiological data, as well as International Severe Acute Respiratory and emerging Infections Consortium (ISARIC) mortality and deterioration scores were obtained. Exposed masks were processed by removal, dissolution and analysis of sampling matrix strips fixed within the mask by RT-qPCR. Viral genome copy numbers were determined and results classified as Negative; Low: ≤999 copies; Medium: 1000-99,999 copies and High ≥ 100,000 copies per strip for FMS or per 100 µl for NPS. RESULTS: 102 FMS and NPS were collected from 66 routinely positive patients; median age: 61 (IQR 49 - 77), of which FMS was positive in 38% of individuals and concomitant NPS was positive in 50%. Positive FMS viral loads varied over five orders of magnitude (<10-3.3 x 106 genome copies/strip); 21 (32%) patients were asymptomatic at the time of sampling. High FMS viral load was associated with respiratory symptoms at time of sampling and shorter interval between sampling and symptom onset (FMS High: median (IQR) 2 days (2-3) vs FMS Negative: 7 days (7-10), p = 0.002). On multivariable linear regression analysis, higher FMS viral loads were associated with higher ISARIC mortality (Medium FMS vs Negative FMS gave an adjusted coefficient of 15.7, 95% CI 3.7-27.7, p = 0.01) and deterioration scores (High FMS vs Negative FMS gave an adjusted coefficient of 37.6, 95% CI 14.0 to 61.3, p = 0.002), while NPS viral loads showed no significant association. CONCLUSION: We demonstrate a simple and effective method for detecting and quantifying exhaled SARS-CoV-2 in hospitalised patients with COVID-19. Higher FMS viral loads were more likely to be associated with developing severe disease compared to NPS viral loads. Similar to NPS, FMS viral load was highest in early disease and in those with active respiratory symptoms, highlighting the potential role of FMS in understanding infectivity.


Subject(s)
COVID-19 , SARS-CoV-2 , Humans , Masks , Middle Aged , RNA, Viral , Viral Load
8.
Osgoode Hall Law Journal ; 57(3):533, 2020.
Article in English | ProQuest Central | ID: covidwho-1058838

ABSTRACT

In early January of this year, newspapers started reporting on a mysterious new respiratory disease that was spreading in Wuhan, China. At the time, few paid much attention to that nameless disease. A month later, China was effectively in lockdown;most of the rest of the world was cautious but life continued largely as before. In another month, the virus spread across the globe, and with it the eerie images of deserted streets. Our university shut its doors on March 13, 2020, after a week of increasing pandemic anxiety in Toronto. As we write this in December, it is still largely shuttered. The prognosis for the upcoming winter semester remains bleak: Another term where Osgoode remains closed, and the normally bustling and life-affirming hallways, library, cafeteria, offices, classrooms and atrium, stay silent and still.

9.
Osgoode Hall Law Journal ; 57(3):869, 2020.
Article in English | ProQuest Central | ID: covidwho-1058823

ABSTRACT

Canadian courts, in many ways, are neither efficient nor effective. This has been clear for many years. This article looks broadly at how little attention has been paid to court administration in the past, especially during times of crisis, and examines the impact the current pandemic may have on the future of Canadian court administration. In this vein, we examine emergency plans in general before turning to pandemic-specific plans and how, especially in Canada, these have been found wanting during this current crisis. Like most organizations, courts have developed plans – business contingency (BCPs) in Canada and continuity of operation (COOPs) in the United States-laying out policies and processes to follow in an emergency. Yet none of the various disaster plans created by courts in both Canada and the United States highlight the role and importance technology would play. Despite the increasing use of remote access for hearings-there has been a great deal of success in scheduling appeal hearings remotely-most courts have been unable to operate at pre-pandemic levels. In fact, most courts have postponed the majority of their hearings and have had to push dockets forward. Postponing a large portion of the courts' hearings will undoubtedly add to a backlog of cases and increase the administrative burden on operations once physical distancing is removed. But the change in attitude that has taken place over the past few months is arguably greater than the sum of all changes made over the last forty years since Carl Baar's reference to courts being "horse-and-buggy" organizations. The pandemic has provided a perfect occasion-no doubt forced but relatively low-risk-to try new things. Our position is that steps need to be taken to ensure that an increased reliance on "privileged access to technology" during COVID-19 does not lead to an "exacerbation of denial of access to justice."

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