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Cogent Medicine ; 8, 2021.
Article in English | EMBASE | ID: covidwho-1617071


Background: There is little data available on vaccine hesitancy rates in Irish parents, particularly in relation to the influenza vaccine (InV). Evidence to date would suggest that the morbidity from COVID-19 is lower in paediatric populations than that from influenza. Vaccination strategies are likely to be required for both infections, and as such, understanding parental perception of both vaccines is essential. Aims: We hoped to identify vaccination hesitancy rates for routine childhood vaccines (RCV) and for the influenza vaccine (InV). We then sought to identify intended uptake rates of the InV and any potential paediatric COVID-19 vaccine and review this data to try to identify trends in vaccination perceptions. Methods: A 10 item anonymised questionnaire was distributed to parents of all patients admitted under the General Paediatric team in a large tertiary centre in Dublin for 4 weeks during November 2020. Results were compiled and analysed, with scoring averages used to determine perceived vaccine efficacy scores (PVES) from a minimum of 1 to a maximum of 5 amongst the population and its subgroups. Results: A total of 214 questionnaires were analysed. The average age was 59.45 months, with the median being 34 months. Of those due to have commenced their RCV schedule, 92.98% were up to date, with 2.7% having received no vaccinations. The average PVES for RCV and the InV was 4.67 and 4.31, respectively. Of those eligible to receive the InV this year (n=143), 37.8% were either very likely or likely to receive the vaccine, with 47.6% unsure, unlikely, or very unlikely. PVES decreased steadily with increasing hesitancy, to a nadir of 4.13 for RCH and 3 for the InV in the very unlikely subgroup. The average likelihood to receive a COVID-19 vaccination, if one were available, was 3.67. Only 23.83% were likely or very likely to vaccinate against influenza and COVID-19 simultaneously. With regards to preferable vaccination, 22.9% would prefer COVID-19 vaccination, 20.56% would prefer Influenza vaccination, 41.59% had equal preference, and 13.55% wanted neither. Discussion: Our study showed high PVES for both RCV and InV as well as high vaccination rates, but comparatively low intended rates of uptake of the Influenza vaccine and a potential COVID-19 vaccination. More research as to the reasoning behind this is needed in order to plan potential vaccination strategies.

United European Gastroenterology Journal ; 9(SUPPL 8):317-318, 2021.
Article in English | EMBASE | ID: covidwho-1490991


Introduction: UBT is the most accurate non-invasive test for H.pylori infection. The orally given urea, labelled with C13, is hydrolysed by the enzyme urease of H.pylori and C13O2 is measured expired in breath. UBT was our gold standard diagnostic test for H.pylori. This practice changed abruptly in March 2020, when our first wave of coronavirus -2 (SARS-CoV-2) started. UBT carries the risk of contamination by SARS-CoV-2 in the aerosol droplets generated by exhaled air. The British Society of Gastroenterology guideline at that time graded UBT as Aerosol Generating Procedure and therefore at high risk for transmission. Only emergency gastroenterology high risk procedures were recommended during restrictions which effectively terminated our standard UBT service. To maintain a non-invasive diagnostic option we developed a novel virtual test. C13 UBT At Home, is performed by patients at home with step by step instructions involving live video conference interaction between the patients and technicians. Aims & Methods: To determine the acceptability and the accuracy of the novel C13 UBT At Home service. Patients on a UBT waiting list were contacted and invited to undergo the alternative virtual breath test. Willing participants were pre assessed over phone to explain the process. Technical aspects (internet, smart phone or laptop requirements), navigation through the video call system attendanywhere and routine clinical parameters including PPI and antibiotic use were discussed. Suitable patients collected a Home UBT kit (Patient information sheet, test documentation, pre and post collection tubes, collection straw, urea tablet and feedback questionnaire) from a drop off point up to a week prior to their scheduled appointment. The test was performed as standard by the patient at home with live interaction for all active steps. The 20 minute rest between samples 1 and 2 collection was offline which allowed technicians to do concurrent cases. Patients were requested to fill in a feedback questionnaire after the test and to return it with the samples to the drop off point within 48 hours for analysis. The questionnaire included 6 questions covering pre procedure, procedure and post procedure domains. In addition to patient satisfaction, positivity rate, sample error rate and activity numbers were compared between UBT at home and a standard UBT cohort which was reinstated in 2021. Results: 300 patients were enrolled, mean age 41 years (range 7-85), 177 female (59%). Overall response rate was 96% (288), 96% (285) rated the entire UBT at home process as either excellent or good. All other parameters except connection to the hospital video call system, which was subject to external factors were also rated excellent/good by >90%. Accuracy between UBT tests was similar: positivity rate 23% (69/299) versus 22% (74/326), sample error rate 0.33% (1/300) versus 0.6% (2/326) for the UBT at home and standard tests respectively. Currently 3 of every 4 UBT's is now virtual despite reduced restrictions. Conclusion: UBT at home is possible and acceptable to patients with equivalent accuracy to standard UBT and should be continued to improve patient choice and satisfaction.

Palliative Medicine ; 35(1 SUPPL):35, 2021.
Article in English | EMBASE | ID: covidwho-1477102


Background: The COVID-19 pandemic has led to excess mortality globally. Understanding change in place of death during the pandemic is needed to help guide resource allocation and support for end-of-life care. Aims: To analyse the patterns of mortality and place of death in UK (England, Wales, Scotland and Northern Ireland) during the COVID-19 pandemic. Methods: Descriptive analysis of UK mortality data between March 2020 and February 2021. The weekly number of deaths in each nation was described by place of death using the following definitions: (1) Average deaths estimated using five years of historical data (2015-19);(2) Baseline deaths up to and including expected deaths but excluding COVID-19 deaths;(3) Deaths where COVID-19 is mentioned on the death certificate;(3) Additional deaths not attributed to COVID-19. Results: During the analysis period, there were 743,172 deaths in the UK, of which 135,716 were COVID-19 related and 17,672 were additional non-COVID deaths. There was variation in mortality between the UK nations with Wales having the highest rate of COVID-19 deaths at 229 per 100,000 population and Northern Ireland the lowest at 141 per 100,000 population. Deaths in care homes increased above baseline levels during the first and second waves of the pandemic but fell below baseline between waves, increasing the most in Wales by 29%. Hospital deaths increased overall by as much as 13% in England but fell by 1% in Scotland. Deaths at home remained above average throughout the study period with an overall increase of between 40-41%. In England and Wales, 15-30% fewer people died in hospices compared to baseline. Discussion: The COVID-19 pandemic has changed where people die in the UK. Notably a sustained increase in deaths at home has been seen, with implications for planning and organisation of palliative care and community services. Examination of place of death in other countries with high COVID-19 mortality is recommended.

Irish Medical Journal ; 114(5), 2021.
Article in English | EMBASE | ID: covidwho-1326537


Presentation A 40-year-old healthcare worker (HCW) presented with cough, headache, sore throat, fatigue and myalgia seven months after primary infection with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Symptoms were milder and recovery was faster on the second episode. Diagnosis Reinfection with phylogenetically distinct SARS-CoV-2 was confirmed by whole-genome sequencing (WGS). Treatment Management involved symptomatic treatment and self-isolation. Discussion The incidence of SARS-CoV-2 reinfection is not well characterised. Infection control precautions may still be required in healthcare facilities, even in previously infected and possibly in vaccinated individuals while SARS-CoV-2 remains in circulation. Further research on the nature and duration of immunity is required to inform public health and infection control policy.