Organized Irresponsibility and Communities of Risk in a Pandemic The Case for Legal Metamorphosis

The paper examines challenges that the global COVID-19 pandemic has created for responsibility frameworks and practices in law. Building on Ulrich Beck's account of the risk society, it argues that the basic qualities of COVID-19 related risks, when juxtaposed with the standard legal framework for responsibility, result in organised irresponsibility in law (OI). Also the most common legal response to current problems, namely liability shields and waivers, contribute to OI. As a result, the paper presents the case for the metamorphosis of the current responsibility framework. Conceptually speaking, the metamorphosis should be based on the commonality of risk experience - on 'shared risk communities'. Possible normative ('common but differentiated responsibility' principle) and institutional consequences (alternative compensation programmes) are discussed in terms of their potential to contribute to metamorphosis. © Franz Steiner Verlag, Stuttgart 2022.

Preventive measures and customs in families not infected by COVID-19 during confinement

Despite the exuberant figures of those infected and deceased by COVID-19, there are families that were not infected. Objective: To describe the preventive measures and customs in families not infected by COVID-19 during confinement. Method: Descriptive qualitative research, 13 mothers from Ferrenafe with no member affected by COVID-19 participated. The data was collected through the semi-structured interview through telephone calls and processed manually, with thematic content analysis. Results: Four categories were obtained: a) Preventive measures when leaving the home: use of a mask, alcohol and social distancing, b) Preventive measures at home: handwashing, disinfection of the home and what enters, c) Restriction of family gatherings and use of social networks, d) Change of eating habits and use of home remedies. Conclusions: The families changed some customs or practices, complied with the confinement, social distancing, restricted family gatherings, used cloth masks, medicinal alcohol, and bleach. In addition, they increased the frequency of hand washing, home hygiene, healthy eating, the use of social networks, together with the use of home remedies commonly used to prevent or treat respiratory diseases.

Changes to infection prevention and control measures used by Canadian paramedics in response to COVID-19

IntroductionCanadian Paramedic services modified infection prevention and control (IPAC) practices in response to COVID-19. These changes may affect risk of exposure to infectious disease agents and can be used to inform future IPAC practices. We characterized COVID-19-related IPAC changes in the provinces of Alberta, British Columbia, Manitoba, Ontario, and Saskatchewan.Materials & MethodsQuestionnaire data (January 2021-Feb 2022) from the national COVID-19 Occupational Risks, Seroprevalence and Immunity among Paramedics (CORSIP) project was used to identify which IPAC practices were in place prior to COVID-19, and which were modified in response to COVID-19, including the timing of changes (March-May 2020;June-Aug 2020;Sept-Nov 2020;Nov 2020-present).Results2939 participants were included (146, 1249, 139, 1317, 88 from Alberta, BC, Manitoba, Ontario, and Saskatchewan, respectively), of whom 2674 (91%) reported receiving IPAC training. IPAC measures that were common prior to COVID-19 included: personal protective equipment (PPE) training, patient screening, hand hygiene, N95/P100 respirators, gowns, impermeable suits, and cleaning/disinfection. COVID-related IPAC changes included: screening staff, social distancing, restricting aerosol generating procedures, masking patients, cloth face coverings, surgical masks, face shields, and elastomeric respirators. Changes were reported for all IPAC measures. Most (71%) of these changes were made early in the COVID-19 pandemic (March-May 2020). Differences in proportions across provinces, community practice settings, and professional regulation status were reported (p < .05) for hand hygiene, PPE training, screening of patients, face shields, and various respirator types.ConclusionCanadian paramedic services were quick to modify available IPAC measures. However, these changes were variable across provinces, regulation status, and setting for specific IPAC measures. Inconsistent IPAC measures across jurisdictions may contribute to variable risk of infectious disease exposure. An evidence-informed and nationally coordinated approach may provide more equitable exposure risk mitigation for paramedic workers.

Czochralski (CZ) process modification with cooling tube in the response to market Global silicon shortage

Recently, the silicon wafer producers, affected by Covid-19 and USA-China competition, looks for new production processes to increase the production. On the other hand, the common parts of CZ puller such as heater, crucible and thermal shield are optimized over time and now the common CZ process is reached to limitation for further improvement. Here, we propose a modified CZ method by adding a cooling tube into the growth zone. The new proposed Cz method is applied to the 8″ crystal growth process. A fully 3D transition model including energy equation, Navier–Stokes equation, surface-to-surface radiation heat transfer, moving mesh and thermal stress equations is implemented. The simulation is performed for both original and new CZ method. It was proved that the new CZ method increases the pulling speed up to 25 %. To ensure about the crystal quality, the thermal stress is compared between original and new proposed CZ method. Although it was found that the thermal stress increases about twice but still the maximum von Mises stress never exceeds the critical value 25 MPa. Additionally, the power consumption is also found to enhance maximum 2 kW under new conditions. To evaluate the model the interface and heater power for the original CZ puller is compared with industrial CZ process and it shows acceptable accuracy. © 2023 Elsevier B.V.

COVID-19 pandemic from an ophthalmology point of view.

Coronavirus disease 2019 (COVID-19) is caused by a highly contagious RNA virus termed as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Ophthalmologists are at high-risk due to their proximity and short working distance at the time of slit-lamp examination. Eye care professionals can be caught unaware because conjunctivitis may be one of the first signs of COVID-19 at presentation, even precluding the emergence of additional symptoms such as dry cough and anosmia. Breath and eye shields as well as N95 masks, should be worn while examining patients with fever, breathlessness, or any history of international travel or travel from any hotspot besides maintaining hand hygiene. All elective surgeries need to be deferred. Adults or children with sudden-onset painful or painless visual loss, or sudden-onset squint, or sudden-onset floaters or severe lid oedema need a referral for urgent care. Patients should be told to discontinue contact lens wear if they have any symptoms of COVID-19. Cornea retrieval should be avoided in confirmed cases and suspects, and long-term preservation medium for storage of corneas should be encouraged. Retinal screening is unnecessary for coronavirus patients taking chloroquine or hydroxychloroquine as the probability of toxic damage to the retina is less due to short-duration of drug therapy. Tele-ophthalmology and artificial intelligence should be preferred for increasing doctor-patient interaction.

Risk assessment for aerosol infection by SARS-CoV-2 and protection by respirators and surgical masks

SARS-CoV-2 is dispersed from patients by talking, coughing, and sneezing. The generated microdroplets aerosols can travel up to 8m, stay suspended for long periods, and preserve viral infectivity for median of 2.7h. An unprotected person exposed to this cloud might inhale a considerable amount of infectious viral doses, which will attach to the ACE two receptors at the respiratory system epithelial, resulting in infection. N95 respirators and surgical masks block 95% and 50%-60%, respectively, of inhalable particles and protect the wearer from infection. Surgical masks and N95 without exhalation valve protect both the wearer and the environment from carriers and sick people. The highest risk of infection is in closed and unventilated spaces. Any kind of respiratory protection will mitigate risk of infection, including cloth masks, but none will protect if there is no good seal around the face. Medical staff and laboratory workers will benefit most by wearing NIOSH approved N95 respirators, while adhering to guidelines and instructions for keeping the seal around the face. N95 with exhale valve protects the wearer but not others. Face shields with combination of masks or respirators provide additional protection from infection, by reducing ocular exposure or contamination of masks or hands, as well as by diverting movement of air around the face. © 2023 Elsevier Inc. All rights reserved.

Rational Development of Hypervalent Glycan Shield-Binding Nanoparticles with Broad-Spectrum Inhibition against Fatal Viruses Including SARS-CoV-2 Variants.

Infectious virus diseases, particularly coronavirus disease 2019, have posed a severe threat to public health, whereas the developed therapeutic and prophylactic strategies are seriously challenged by viral evolution and mutation. Therefore, broad-spectrum inhibitors of viruses are highly demanded. Herein, an unprecedented antiviral strategy is reported, targeting the viral glycan shields with hypervalent mannose-binding nanoparticles. The nanoparticles exhibit a unique double-punch mechanism, being capable of not only blocking the virus-receptor interaction but also inducing viral aggregation, thereby allowing for inhibiting the virus entry and facilitating the phagocytosis of viruses. The nanoparticles exhibit potent and broad-spectrum antiviral efficacy to multiple pseudoviruses, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its major variants (D614G, N501Y, N439K, Δ69-70, Delta, and Omicron; lentiviruses expressing only the spike proteins), as well as other vital viruses (human immunodeficiency virus 1 and Lassa virus), with apparent EC50 values around the 10-9  m level. Significantly, the broad-spectrum inhibition of authentic viruses of both wild-type SARS-CoV-2 and Delta variants is confirmed. Therefore, this hypervalent glycan-shield targeting strategy opens new access to broad-spectrum viral inhibition.

Direct Digital Manufacturing of a Customized Face Mask

Direct Digital Manufacturing (DDM) is considered by many as one of the most promising approaches towards cost- and time-efficient mass customization. Compared to conventional manufacturing systems, DDM systems are not as common and incorporate several distinctive features, such as higher flexibility in product form and structure, lower economies of scale and higher potential for decentralized production network. The initial design phase of a DDM production system, where very important in term of efficiency and quality, decisions are made, is a relatively unexplored topic in the relevant literature. In the present study, the corresponding issues are investigated through a case study involving the direct digital production of a customized reusable face mask (respirator) for medical use. Investigated system design aspects include product, process, and facility design. Based on data generated through manufacturing tests, a preliminary cost analysis is performed and several scenarios regarding production throughput and facility planning are examined. According to the results, DDM of custom-made face masks is, to a large extent, technically and economically feasible. Interestingly, considering the whole process, a large part of production cost is associated with labor and materials. Finally, evidence for a fundamental trade-off between manufacturing cost and speed/flexibility is identified, implying that different implementations of DDM systems can be realized depending on strategic operational objectives.

3D printed devices to avoid hand contact with commonly shared surfaces

In the context of the COVID-19 pandemic, public spaces had to be quickly adapted to the new circumstances especially under the uncertainty of the pandemic development. Door handles are some of the most touched surfaces and so, this point of contagion was chosen to be tackled and two solutions were developed that would prevent direct touch with the handle: a portable and a fixed device. The portable device (HYHOOK + HYTIP) is a hook-like device holding a finger cover, which permits to open doors and push buttons safely. The fixed device (HANDGENIC) is meant to be assembled in door handles to equip buildings, such as universities or schools. With the fixed device, the user can open the door using their forearm which makes them less likely to transfer any particles to eyes, nose or mouth. The 3D printing Fused Filament Fabrication (FFF) process was selected as manufacturing technique, which allows the fast production of prototypes. This work portrays the development process and design iterations taking into consideration the concerns about the functioning of the devices and possible failures or alternative uses. To assure structural integrity of the parts, finite element (FE) analysis was used to verify its mechanical response. As conclusion, it was found that FE analysis indicate that the devices are structurally sound to be used in public spaces and that 3D printing is a useful way to rapidly develop devices while testing several design possibilities.

Technologically Advanced Reusable 3D Face Shield for Health Workers Confronting COVID19

The probability of medical staff to get affected from COVID19 is much higher due to their working environment which is more exposed to infectious diseases. So, as a preventive measure the body temperature monitoring of medical staff at regular intervals is highly recommended. Infrared temperature sensing guns have proved its effectiveness and therefore such devices are used to monitor the body temperature. These devices are either used on hands or forehead. As a result, there are many issues in monitoring the temperature of frontline healthcare professionals. Firstly, these healthcare professionals keep wearing PPE (Personal Protective Equipment) kits during working hours and as a result it would be very difficult to monitor their body temperature. Secondly, these healthcare professionals also wear face shields and in such cases monitoring temperature by exposing forehead needs removal of face shield. Doing so after regular intervals is surely uncomfortable for healthcare professionals. To avoid such issues, this paper is disclosing a technologically advanced face shield equipped with sensors capable of monitoring body temperature instantly without the hassle of removing the face shield. This face shield is integrated with a built-in infrared temperature sensor. A total of 10 such face shields were printed and assembled within the university lab and then handed over to a group of ten members including faculty and students of nursing and health science department. This sequence was repeated four times and as a result 40 healthcare workers participated in the study. Thereafter, feedback analysis was conducted on questionnaire data and found a significant overall mean score of 4.59 out of 5 which indicates that the product is effective and worthy in every facet. Stress analysis is also performed in the simulated environment and found that the device can easily withstand the typically applied forces. The limitations of this product are difficulty in cleaning the product and comparatively high cost due to the deployment of electronic equipment.

Agent-based Modeling of COVID-19 Infection Rate vis-à-vis the Philippine Government Community Quarantine and Face Covering Measures

The COVID-19 pandemic has uprooted the normal lives and routines of Filipinos. Dubbed as the 'new normal,' the wearing of face masks and face shields and adherence to social distancing and the community quarantines have been enforced by the Philippine government to all its citizens. The primary concern is to slow down the spread of SARS-CoV-2 virus absent of widespread and available pharmaceutical interventions such as vaccines and therapies, in the hopes of keeping the overall healthcare system functional. In this study, the researchers use NetLogo, an agent-based modeling software to emulate such government measures on a closed population of agents and observe the effects on the spread of COVID-19. Running different simulation scenarios, the researchers find that the NetLogo model is able to predict long- term trends imposed by these government restrictions. The results show that through increasing the number of people using face coverings and restricting interactions through enforcement of community quarantines, the rise of infections can be decreased substantially. The results of our model are consistent with the Philippine government's collated pandemic data on the effect of the enforcement of restrictions to the ongoing outbreak during certain time periods in the year 2020. © 2021 IEEE.

3D Printing Solutions in the Fight Against Covid-19 Pandemic

The global pandemic, caused by COVID-19, brought the whole world to its knees in 2020. Medical systems worldwide succumbed due to the disease outbreaks while healthcare workers have been fighting at the forefront. Medical supplies were running out in many countries and countless lives were lost because of it. Engineers, inventors, and creators from around the world have teamed up to help this cause through 3D printing solutions. It is additive manufacturing that became a leading light in the fight against the COVID-19 as a go-to method in case of medical supply shortages. © 2021, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Efficacy of personal protective equipment against coronavirus transmission via dental handpieces.

BACKGROUND: This laboratory study was done to evaluate the efficacy of personal protective equipment (PPE) and high-volume evacuation (HVE) against the spread of human coronavirus type 229E (HCoV-229E) during a standard dental procedure. METHODS: Patient and operator manikins were used to recreate a dental setting inside a custom-built class III cabinet-like chamber. The mouth of the patient manikin was inoculated with an HCoV-229E suspension, the viral load of which was similar to that of asymptomatic people infected with severe acute respiratory syndrome coronavirus 2. The dental procedure was performed with an air turbine handpiece and HVE for 10 seconds. The efficacy of surgical masks, N95 (filtering facepiece class 2) and filtering facepiece class 3 respirators, and face shields was tested via quantitative real-time polymerase chain reaction. RESULTS: The wide surface on which the inoculum was spread caused low contamination. Over the external surfaces of masks and respirators, when a face shield was not worn, viral loads ranged from 1.2 through 1.4 log10 mean gene copies per cm2. When the shield was worn, viral loads dropped below the detection limit (< 0.317 log10 gene copies/cm2) for all PPE. On the operator's forehead, viral loads were 0.6 through 0.8 log10 gene copies/cm2. Inside the operator manikin's mouth, viral loads were under the detection limit when using any PPE, with or without the shield. HVE did not significantly change viral loads. CONCLUSIONS: All PPE combinations significantly reduced viral loads in the operator manikin's mouth to below the detection limit, but HVE did not decrease viral contamination. PRACTICAL IMPLICATIONS: Although caution is suggested when removing and disposing of PPE to avoid self-contamination, the combination of PPE and face shields drastically decreases the risk of transmitting human coronavirus during aerosol-generating dental procedures.

Challenges of personal protective equipment use among ophthalmologists during the COVID-19 pandemic: A multicenter international study.

PURPOSE: To explore the possible challenges and difficulties of using Personal Protective Equipment (PPE) in ophthalmic practice during the Coronavirus disease 2019 (COVID-19) pandemic. METHODS: This is a multicenter, international survey among practicing ophthalmologists across different countries. The survey was conducted from September 9th to October 24th, 2020. It included a total of 23 questions that navigated through the currently adopted recommendations in different clinical situations. The survey also assessed the convenience of using various PPE in ophthalmic practice and addressed the clarity of the examination field while using various PPE during clinical or surgical procedures. RESULTS: One hundred and seventy-two ophthalmologists completed the survey (101 from Egypt, 50 from the USA, and 21 from four other countries). The analysis of the responses showed that most ophthalmologists use face masks without significant problems during their examinations, while face shields followed by protective goggles were the most inconvenient PPE in the current ophthalmic practice. Moreover, most of the participants (133, 77.3%) noticed an increase in their examination time when using PPE. Furthermore, a considerable percentage of the respondents (70, 40.7%) stopped using one or more of the PPE due to inconvenience or discomfort. CONCLUSIONS: Due to the unique nature of the ophthalmic examination, certain PPE are not ophthalmologist-friendly. Innovative PPE should be tailored for prompt, more convenient, and clearer ophthalmological practice.

COVID-19: risk of ocular transmission in health care professionals.

INTRODUCTION: The current pandemic of severe acute respiratory symptom coronavirus 2 (SARS-CoV-2) has had a major impact on individuals' lives. Social isolation and the use of personal protective equipment - the latter being especially important for health care workers - emerged as two of the main methods of preventing the spread of the disease. The eye can represent a source of transmission through contaminated tears, as well as a source of infection for respiratory droplets or aerosol particles, which may come into contact with the ocular surface and migrate to the lungs and other parts of the body. OBJECTIVES: To investigate the risk of ocular transmission through a literature review and identify ways of preventing it. METHODS: A search of the scientific literature was conducted in the PubMed and Cochrane databases, using a combination of the following keywords: "COVID-19," "eye," "personal protective equipment," "SARS-CoV-2," "protective goggles," "face shields," and "workers' health." RESULTS: The mechanisms of ocular transmission have not been fully elucidated, but studies have demonstrated the presence of viral RNA in the conjunctival sac and aerosolized secretions of contaminated patients; these droplets may come into contact with the eyes of uninfected bystanders, entering the respiratory system through the nose and gaining access to the lungs. CONCLUSIONS: Studies show that the virus can be effectively transmitted through the eyes, underscoring the importance of protective goggles for health care workers or potential transmitters of the virus, in addition to the need for additional education measures to encourage hand hygiene and discourage touching of the eyes.

Application of 3D printing and distributed manufacturing during the first-wave of COVID-19 pandemic. Our experience at a third-level university hospital.

BACKGROUND: 3D printing and distributed manufacturing represent a paradigm shift in the health system that is becoming critical during the COVID-19 pandemic. University hospitals are also taking on the role of manufacturers of custom-made solutions thanks to 3D printing technology. CASE PRESENTATION: We present a monocentric observational case study regarding the distributed manufacturing of three groups of products during the period of the COVID-19 pandemic from 14 March to 10 May 2020: personal protective equipment, ventilatory support, and diagnostic and consumable products. Networking during this period has enabled the delivery of a total of 17,276 units of products manufactured using 3D printing technology. The most manufactured product was the face shields and ear savers, while the one that achieved the greatest clinical impact was the mechanical ventilation adapters and swabs. The products were manufactured by individuals in 57.3% of the cases, and our hospital acted as the main delivery node in a hub with 10 other hospitals. The main advantage of this production model is the fast response to stock needs, being able to adapt almost in real time. CONCLUSIONS: The role of 3D printing in the hospital environment allows the reconciliation of in-house and distributed manufacturing with traditional production, providing custom-made adaptation of the specifications, as well as maximum efficiency in the working and availability of resources, which is of special importance at critical times for health systems such as the current COVID-19 pandemic.

Experimental Efficacy of the Face Shield and the Mask against Emitted and Potentially Received Particles.

There is currently not sufficient evidence to support the effectiveness of face shields for source control. In order to evaluate the comparative barrier performance effect of face masks and face shields, we used an aerosol generator and a particle counter to evaluate the performance of the various devices in comparable situations. We tested different configurations in an experimental setup with manikin heads wearing masks (surgical type I), face shields (22.5 cm high with overhang under the chin of 7 cm and circumference of 35 cm) on an emitter or a receiver manikin head, or both. The manikins were face to face, 25 cm apart, with an intense particle emission (52.5 L/min) for 30 s. The particle counter calculated the total cumulative particles aspirated on a volume of 1.416 L In our experimental conditions, when the receiver alone wore a protection, the face shield was more effective (reduction factor = 54.8%), while reduction was lower with a mask (reduction factor = 21.8%) (p = 0.002). The wearing of a protective device by the emitter alone reduced the level of received particles by 96.8% for both the mask and face shield (p = NS). When both the emitter and receiver manikin heads wore a face shield, the protection allowed for better results in our experimental conditions: 98% reduction for the face shields versus 97.3% for the masks (p = 0.01). Face shields offered an even better barrier effect than the mask against small inhaled particles (<0.3 µm-0.3 to 0.5 µm-0.5 to 1 µm) in all configurations. Therefore, it would be interesting to include face shields as used in our experimental study as part of strategies to reduce transmission within the community setting.

A Cross University-Led COVID-19 Rapid-Response Effort: Design, Build, and Distribute Drexel AJFlex Face Shields.

The purpose of this article is to demonstrate how a new cross-community leadership team came together, collaborated, coordinated across academic units with external community partners, and executed a joint mission to address the unmet clinical need for medical face shields during these unprecedented times. Key aspects of this success include the ability to forge and leverage new opportunities, overcome challenges, adapt to changing constraints, and serve the significant need across the Philadelphia region and healthcare systems. We teamed to design-build durable face shields (AJFlex Shields). This was accomplished by high-volume manufacturing via injection molding and by 3-D printing the key headband component that supports the protective shield. Partnering with industry collaborators and civic-minded community allies proved to be essential to bolster production and deliver approximately 33,000 face shields to more than 100 organizations in the region. Our interdisciplinary team of engineers, clinicians, product designers, manufacturers, distributors, and dedicated volunteers is committed to continuing the design-build effort and providing Drexel AJFlex Shields to our communities.

Association between universal face shield in a quaternary care center and reduction of SARS-COV2 infections among healthcare personnel and hospitalized patients.

We implemented universal face shield use for all healthcare personnel upon entry to facility in order to counter an increase in SARS-COV2 cases among healthcare personnel and hospitalized patients. There was a marked reduction of infections in both healthcare personnel and hospitalized patients between pre and post intervention. Our results support universal face shield use as part of a multifaceted approach in areas of high SARS-COV2 community transmission.