Decline in Traffic Congestion Increased Crash Severity in the Wake of COVID-19.

Highway fatalities are a leading cause of death in the U.S. and other industrialized countries. Using highly detailed crash, speed, and flow data, we show highway travel and motor vehicle crashes fell substantially in California during the response to the COVID-19 pandemic. However, we also show the frequency of severe crashes increased owing to lower traffic congestion and higher highway speeds. This "speed effect" is largest in counties with high pre-existing levels of congestion, and we show it partially or completely offsets the "VMT effect" of reduced vehicle miles traveled on total fatalities. During the first eleven weeks of the COVID-19 response, highway driving decreased by approximately 22% and total crashes decreased by 49%. While average speeds increased by a modest 2 to 3 mph across the state, they increased between 10 and 15 mph in several counties. The proportion of severe crashes increased nearly 5 percentage points, or 25%. While fatalities decreased initially following restrictions, increased speeds mitigated the effect of lower vehicle miles traveled on fatalities, yielding little to no reduction in fatalities later in the COVID period.

Research Paper Fuzzy Logic-based Risk Analysis of COVID-19 Infection: A Case Study in Healthcare Facilities

Background: The gravity point of all management systems in the new approach of global worldwide standards includes management and assessment of risks and opportunities. Although the spread of COVID-19 as a global pandemic has threatened the health of the workforce and caused catastrophic human and economic consequences, the occurrence of this global challenge has also created opportunities to pay more attention to the risk assessment of biological harmful agents in the workplace. Therefore, this study was designed and implemented to analyze the risk of COVID-19 based on fuzzy logic. Materials and Methods: This cross-sectional and descriptive-analytical study was conducted in 5 hospitals and health-treatment centers in Qom City, Iran (2019). The study sample included 247 employees of these medical centers. The risk assessment of COVID-19 is based on the rapid COVID-19 hazard analysis (RCHA) technique in which the risk level is calculated based on the three components of disease probability, consequence severity, and health belief level. Also, the data were analyzed using fuzzy logic. Results: The results of the fuzzy analysis of COVID-19 risk in these medical centers showed that the studied subjects were placed in five risk levels, including 10.5, 16.25, 26.75, 38.5, and 56.0. These results revealed that the group of nurses is at the highest risk of COVID-19 compared to the other seven groups working in medical centers. The definite risk of COVID-19 among people in this group was calculated at four levels equal to 16.25, 26.75, 38.5, and 56.0. Conclusion: The results of fuzzy analysis of COVID-19 risk indicated that the three groups of nurses, patient carriers, and ward services have the highest risk, respectively. Therefore, these groups should be prioritized in providing suitable solutions to prevent this disease. © 2022, Negah Institute for Scientific Communication. All rights reserved.

Assessment of COVID-19 barrier effectiveness using process safety techniques.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes a respiratory illness called the novel coronavirus 2019 (COVID-19). COVID-19 was declared a pandemic on March 11, 2020. Bow tie analysis (BTA) was applied to analyze the hazard of SARS-CoV-2 for three receptor groups: patient or family member at the IWK Health Centre in acute care, staff member at a British Columbia Forest Safety Council (BCFSC) wood pellet facility, and staff member at the Suncor refinery in Sarnia, Ontario. An inherently safer design (ISD) protocol for BTA was used as a guide for evaluating COVID-19 barriers, and additional COVID-19 controls were recommended. Two communication tools were developed from the IWK bow tie diagram to disseminate the research findings. This research provides lessons learned about the barriers implemented to protect people from contracting COVID-19, and about the use of bow tie diagrams as communication tools. This research has also developed additional example-based guidance that can be used for the COVID-19 pandemic or future respiratory illness pandemics. Recommended future work is the application of BTA to additional industries, the consideration of ISD principles in other control types in the hierarchy of controls (HOC), and further consideration of human and organizational factors (HOF) in BTA.

Efficacy and hazards of 425 nm oral cavity light dosing to inactivate SARS-CoV-2.

OBJECTIVE: Using a battery of preclinical tests to support development of a light-based treatment for COVID-19, establish a range of 425 nm light doses that are non-hazardous to the tissues of the oral cavity and assess whether a 425 nm light dose in this non-hazardous range can inactivate SARS-CoV-2 in artificial saliva. METHODS: The potential hazards to oral tissues associated with a range of acute 425 nm light doses were assessed using a battery of four preclinical tests: (1) cytotoxicity, using well-differentiated human large airway and buccal epithelial models; (2) toxicity to commensal oral bacteria, using a panel of model organisms; (3) light-induced histopathological changes, using ex vivo porcine esophageal tissue, and (4) thermal damage, by dosing the oropharynx of intact porcine head specimens. Then, 425 nm light doses established as non-hazardous using these tests were evaluated for their potential to inactivate SARS-CoV-2 in artificial saliva. RESULTS: A dose range was established at which 425 nm light is not cytotoxic in well-differentiated human large airway or buccal epithelial models, is not cytotoxic to a panel of commensal oral bacteria, does not induce histopathological damage in ex vivo porcine esophageal tissue, and does not induce thermal damage to the oropharynx of intact porcine head specimens. Using these tests, no hazards were observed for 425 nm light doses less than 63 J/cm2 delivered at irradiance less than 200 mW/cm2. A non-hazardous 425 nm light dose in this range (30 J/cm2 at 50 mW/cm2) was shown to inactivate SARS-CoV-2 in vitro in artificial saliva. CONCLUSION: Preclinical hazard assessments and SARS-CoV-2 inactivation efficacy testing were combined to guide the development of a 425 nm light-based treatment for COVID-19. CLINICAL SIGNIFICANCE: The process used here to evaluate the potential hazards associated with 425 nm acute light dosing of the oral cavity to treat COVID-19 can be extended to other wavelengths, anatomical targets, and therapeutic applications to accelerate the development of novel photomedicine treatments.

Analyzing National Responses to COVID-19 Pandemic using STPA.

The unprecedented COVID-19 pandemic has affected most aspects of human life, including the ways in which organizations are operating. Minimizing the spread of coronavirus and its economic consequences, and creating a new and safe lifestyle has now become the common goals of governments all over the world. Although governments have responded to the COVID-19 pandemic by implementing various rules while interacting with relevant organizations to provide health service, vaccine research, and production of essential items, the complexities in the interactions between various stakeholders have proved to be challenging to have efficient and timely outputs. When different stakeholders (i.e. governments, organizations, and the public) are interacting with each other, a systems thinking process needs to be applied to capture the nuances of the interactions and the subsequent emergent behavior to effectively contribute to the system output (i.e. a safer way of life). This paper applied a system-thinking-inspired process called System Theoretic Process Analysis (STPA) to analyze the current response to the COVID-19 pandemic. The analysis treated various stakeholders as a part of the system, and it focused on the interactions among different stakeholders (i.e. functional blocks) within the system - i.e. 'Government', 'Foreign Governments', 'Organizations', and 'General Public', as well as the interactions with 'W.H.O'. The STPA analysis found 236 potential Unsafe Control Actions (UCAs) (or unsafe interactions) among the stakeholder interactions, each of the UCAs was then further analyzed. In total 1440 causal factors of the UCAs were identified, and 2880 requirements were proposed to avoid such unsafe interactions.

A systematic risk-based strategy to select personal protective equipment for infectious diseases.

BACKGROUND: Personal protective equipment (PPE) is a primary strategy to protect health care personnel (HCP) from infectious diseases. When transmission-based PPE ensembles are not appropriate, HCP must recognize the transmission pathway of the disease and anticipate the exposures to select PPE. Because guidance for this process is extremely limited, we proposed a systematic, risk-based approach to the selection and evaluation of PPE ensembles to protect HCP against infectious diseases. METHODS: The approach used in this study included the following 4 steps: (1) job hazard analysis, (2) infectious disease hazard analysis, (3) selection of PPE, and (4) evaluation of selected PPE. Selected PPE should protect HCP from exposure, be usable by HCP, and fit for purpose. RESULTS: The approach was demonstrated for the activity of intubation of a patient with methicillin-resistant Staphylococcus aureus or Severe Acute Respiratory Syndrome coronavirus. As expected, the approach led to the selection of different ensembles of PPE for these 2 pathogens. DISCUSSION: A systematic risk-based approach to the selection of PPE will help health care facilities and HCP select PPE when transmission-based precautions are not appropriate. Owing to the complexity of PPE ensemble selection and evaluation, a team with expertise in infectious diseases, occupational health, the health care activity, and related disciplines, such as human factors, should be engaged. CONCLUSIONS: Participation, documentation, and transparency are necessary to ensure the decisions can be communicated, critiqued, and understood by HCP.