Study of Pharmacists' Awareness Regarding Coronavirus Disease (COVID-19) in Ukraine

Objectives: Data showed that during the SOVID-19 pandemic the pharmacy is the first place for patient care. The purpose was to study the awareness of pharmacists about the COVID-19 for 2021-2022 in Ukraine to provide complete and quality care. Method(s): Survey was developed to determine the level of knowledge of pharmacists regarding the main symptoms, methods of diagnosis, treatment and prevention of uncomplicated forms of the COVID-19 by using Google form. The heads of pharmacies, pharmacists in eight regions of Ukraine were involved. The research period was December 2021 - December 2022. Result(s): We received, 725 completed questionnaires from 8 regions of Ukraine, of which 69.7% were pharmacy managers, 12.0% were pharmacists, and 18.3% were intern- pharmacists. Of the surveyed pharmacists, 95% called the method of airborne transmission, but 4.7% believe that the coronavirus is transmitted by the contact-household method, and 0.3% - transmissible. We found that 100% of respondents correctly named the main indicators of the condition of a patient with the COVID-19. However, only 95.4% of pharmacists correctly defined the concept of saturation, which requires improvement of information support. For the symptomatic treatment of uncomplicated forms, 91.7% of respondents correctly determined that Paracetamol, Ibuprofen are for the symptomatic treatment of uncomplicated forms, but 8.3% of pharmacists named other drugs. Assessing the need to take antibiotics, 88.5% of pharmacists gave the correct answer, but 5.5% believe that the reason for prescribing antibiotics is an increase in body temperature, and 5.4% named a decrease in saturation, 0.6% - dry a cough, that does not meet the requirements of thee national guideleines Covid-19. Conclusion(s): We found that pharmacists are 100% well-informed with the symptoms and causes of the Covid-19. However, it is necessary to improve the provision of information about the requirements for the treatment of uncomplicated forms of Covid-19 and the dispensing of antibiotics from pharmacies.Copyright © 2023

Monkeypox (mpox) is a new problem on a global scale for humanity.

Purpose - to draw attention to an infection that was little known, but has now become a global problem for society;to familiarize readers with the peculiarities of the 2022 monkeypox outbreak and to increase the level of alertness of doctors to this disease. Monkeypox is a global problem because the disease is spreading rapidly, covering 111 countries. Three cases were diagnosed in Ukraine. It is predominantly a self-limited infection, but there are severe and deadly complications. The lethality of this disease ranges from 0% to 11%. The course of the disease is more severe in children and people with reduced immunity. Vertical transmission of the virus from mother to child is possible, resulting in congenital monkeypox. Monkeypox is a zoonotic disease and its natural reservoir is not exactly known, but rodents are most likely to act. In most cases, person-to-person transmission of the virus occurs through close skin to skin contact, often during sexual intercourse. At the beginning of the outbreak 98% of cases of disease were was diagnosed in homo- and bisexuals. Airborne transmission is also possible. Infection is possible through close contact with infectious skin lesions. Clinically, the initial period resembles influenza, but lymphadenopathy is characteristic, which is considered a pathognomonic symptom of mpox. The rash is similar to that of chickenpox, but with more prevalent location on palms and soles than in chickenpox. In the presence of a vesicular rash in a patient, it is necessary to exclude monkeypox. PCR diagnostics of the virus in samples of vesicles or crusts has the greatest diagnostic value. Hygienic skin care is important. Antiviral drugs (tecovirimat, brincidofovir) are recommended only in severe cases. To reduce the spread of infection, international rules apply as for other infections, such as COVID-19. The monkeypox virus vaccine is recommended primarily for groups at risk of infection, including medical personnel who may come into contact with the patient or samples for laboratory testing. Being aware for this infection, following international health regulations, it is possible to prevent the further spread of monkeypox.Copyright © 2023 Tomsk State University. All rights reserved.

Do Large Ears Have an Advantage in Preventing Airborne Transmission?

Although double masking provides better protection against COVID-19 than single masking, the exact number of masks needed to achieve the most significant protection has not been determined to date. The present study investigated the changes in leakage with the use of surgical masks in a healthy person in terms of the number of masks. When the number of masks reached the upper limit that could be worn on the ears, large plastic ear attachments were used for each ear. The leakage rate related to the use of a single mask was approximately 50%, and with two masks, it was significantly reduced to approximately 30%. However, the leakage rate increased to approximately 45% with the use of three and four masks. When more than four masks were worn, the rate gradually decreased. Conversely, the rate for three-seven masks was not significantly lower than that for two masks. Although individuals with large ears might be able to wear more than five masks, the use of more than two masks would not be significantly better than the use of two masks.

Coronavirus Disease 2019 and Airborne Transmission: Science Rejected, Lives Lost. Can Society Do Better?

This is an account that should be heard of an important struggle: the struggle of a large group of experts who came together at the beginning of the COVID-19 pandemic to warn the world about the risk of airborne transmission and the consequences of ignoring it. We alerted the World Health Organization about the potential significance of the airborne transmission of SARS-CoV-2 and the urgent need to control it, but our concerns were dismissed. Here we describe how this happened and the consequences. We hope that by reporting this story we can raise awareness of the importance of interdisciplinary collaboration and the need to be open to new evidence, and to prevent it from happening again. Acknowledgement of an issue, and the emergence of new evidence related to it, is the first necessary step towards finding effective mitigation solutions.

SARS-CoV-2 airborne infection probability estimated by using indoor carbon dioxide.

Airborne transmission is one of the main routes of SARS-CoV-2 spread. It is important to determine the circumstances under which the risk of airborne transmission is increased as well as the effective strategy to reduce such risk. This study aimed to develop a modified version of the Wells-Riley model with indoor CO2 to estimate the probability of airborne transmission of SARS-CoV-2 Omicron strains with a CO2 monitor and to evaluate the validity of this model in actual clinical practices. We used the model in three suspected cases of airborne transmission presented to our hospital to confirm its validity. Next, we estimated the required indoor CO2 concentration at which R0 does not exceed 1 based on the model. The estimated R0 (R0, basic reproduction number) based on the model in each case were 3.19 in three out of five infected patients in an outpatient room, 2.00 in two out of three infected patients in the ward, and 0.191 in none of the five infected patients in another outpatient room. This indicated that our model can estimate R0 with an acceptable accuracy. In a typical outpatient setting, the required indoor CO2 concentration at which R0 does not exceed 1 is below 620 ppm with no mask, 1000 ppm with a surgical mask and 16000 ppm with an N95 mask. In a typical inpatient setting, on the other hand, the required indoor CO2 concentration is below 540 ppm with no mask, 770 ppm with a surgical mask, and 8200 ppm with an N95 mask. These findings facilitate the establishment of a strategy for preventing airborne transmission in hospitals. This study is unique in that it suggests the development of an airborne transmission model with indoor CO2 and application of the model to actual clinical practice. Organizations and individuals can efficiently recognize the risk of SARS-CoV-2 airborne transmission in a room and thus take preventive measures such as maintaining good ventilation, wearing masks, or shortening the exposure time to an infected individual by simply using a CO2 monitor.

Insisting with mask or demanding for more: Plights of the transmission of airborne diseases

Airborne transmission is worldwide popular topic with numerous discussion and researches since influenza pandemic could cost the global economy a lot. In this part of research, we mainly focus on the mechanisms of airborne transmission, together with some determinant factors that influence the spread of aerosols like temperature, humidity and particle size. Finally with several existed cases, insisting masks wearing, especially with three-layer masks wearing are necessary in nowadays for efficiently preventing the transmission of airborne diseases up to 90%. Other possible infection control measures like 2m social distancing are also needed as hygiene measures. © 2023 SPIE.

Near-field exposure of pathogen-laden respiratory particles based on statistical evaluation of one emitting person indoors

Risk assessment models typically assume ideal mixing, in which the pathogen-laden aerosol particles emitted by a person are evenly distributed in the room. This study points out the local deviation from this idealized assumption and a correlation between the level of pathogen concentration and the distance from the emitter. For this purpose, several numerical studies (CFD) were analyzed, and a validation experiment was performed. Statistical evaluation of the spatial pathogen distribution was used to determine the potential exposure to elevated pathogen concentrations. Compared to an ideally mixed room, at a distance of 1.5 m, the mixing ventilation cases show a 25% risk of being exposed to twice the amount of pathogens and a 5% risk to more than 5 times the assumed value. For displacement ventilation there is a 75% chance of being exposed to less pathogens than in complete mixing at a distance of 1 m. The measurement values agree with the simulation results. © 2022 17th International Conference on Indoor Air Quality and Climate, INDOOR AIR 2022. All rights reserved.

Human exposure against airborne pathogens in an office environment

Airborne exposure has been highlighted during the COVID-19 pandemic as a probable infection route. This experimental study investigates different protection methods at an office workstation, where the concentration characteristics are studied under the mixing ventilation conditions. The protection methods were the room air purifier, personal air purifier, face mask, and workstation partition panels. In experiments, the breathing machine, nebulizer, and syringe pump was used to generate an aerosol distribution of paraffin oil into the room. The breathing thermal manikin and the thermal dummy simulated the exposed and infected person, respectively. The concentration characteristics were measured from the manikin breathing zone. The temporal concentration characteristics were measured from zero concentration to steady-state conditions. The study provides insights into the effects of different protection methods for occupational health and safety decision-making for office indoor environments. © 2022 17th International Conference on Indoor Air Quality and Climate, INDOOR AIR 2022. All rights reserved.

The effect of ventilation performance on risk of indoor airborne transmission of SARS-CoV-2

Ventilation performance plays a significant role in distributing contaminants and airborne infections indoors. Thus, poorly ventilated public spaces may be at high risk due to the presence of both infectious and susceptible people. Adapting HVAC ventilation systems to mitigate virus transmission requires considering ventilation rate, airflow patterns, air balancing, occupancy, and feature placement. The study aims to identify poorly ventilated spaces where airborne transmission of pathogens such as SARS-CoV-2 could be critical. This study is focused on evaluating the ventilation performance of the building stock and the safety of using the facilities based on measured indoor CO2. The results revealed the spaces with the potential risk of indoor airborne transmission of COVID-19. The study proposes recommendations for utilising air ventilation systems in different use cases. © 2022 17th International Conference on Indoor Air Quality and Climate, INDOOR AIR 2022. All rights reserved.

COVID-19 airborne transmission risk calculation using CO2 concentrations in a 3D office environment

The ongoing COVID-19 pandemic has caused millions of deaths worldwide along with detrimental socioeconomic consequences. Existing evidence suggests that the rate of indoor transmission is directly linked with the Indoor Air Quality (IAQ) conditions. Most of the existing methodologies for virus transmissibility risk estimation are based on the well-known Wells-Riley equation and assume well-mixed, uniform conditions;so spatiotemporal variations within the indoor space are not captured. In this work, a novel fine-grained methodology for real-time virus transmission risk estimation is developed using a 3D model of a real office room with 31 occupants. CONTAM-CFD0 software is used to compute the airflow vectors and the resulting 3D CO2 concentration map (attributed to the exhalations from the occupants). Simulation results are also provided that demonstrate the efficacy of using CO2 sensors for estimating the infection risk in real-time in the 3D office environment. © 2022 17th International Conference on Indoor Air Quality and Climate, INDOOR AIR 2022. All rights reserved.

A simple dilution model of the expired jet

Short-range exposure to expired aerosols or droplet nuclei has been considered as the predominant route for SARS-CoV-2. The observed effect of mask wearing, and social distancing suggests the importance of expired jet in the spread of COVID-19. The well-known steady-state dilution model is no longer valid for the interrupted expiratory jet. We reanalysed the existing interrupted jet data and proposed a simple dilution model of expired jet using the two-stage jet model. The interrupted jet consists of two stages, i.e., the jet-like and puff-like stage. Results show dilution factor grows linearly with the distance at the jet-like stage but increases with the cubic of the increasing distance in the puff-like stage. Dilution factor at any distance for the puff-like stage decreases as the activity intensifies, which is still much larger than that estimated via the steady jet model. The findings can be further applied into the short-range airborne exposure assessment. © 2022 17th International Conference on Indoor Air Quality and Climate, INDOOR AIR 2022. All rights reserved.

Under what circumstances would airborne transmission of SARS-CoV-2 occur?

To find out the circumstances under which airborne transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) would happen, we conducted mechanistic and systematic modelling of two Coronavirus disease 2019 (COVID-19) outbreaks, i.e., Hunan 2-bus outbreak and Luk Chuen House outbreak (the horizontal cluster). Computational fluid dynamics (CFD) simulations, multi-zone airflow modelling, multi-route mechanistic modelling, and dose-response estimation were carried out selectively according to the transmission characteristics in each outbreak. Our results revealed that poorly ventilated bus indoor environments bred the Hunan 2-bus outbreak in which airborne transmission predominates;prevailing easterly background wind and probable door opening behaviour led to the secondary infections across the corridor in Luk Chuen House outbreak. Measures to facilitate sufficient ventilation indoors and positive pressure in the housing building corridor may help minimise infection risk. © 2022 17th International Conference on Indoor Air Quality and Climate, INDOOR AIR 2022. All rights reserved.

Carbon Dioxide Monitoring in Refuse Collection Vehicle Cabins to Reduce the Risk of SARS-CoV-2 Airborne Transmission

During the COVID-19 pandemic, essential workers such as waste collection crews continued to provide services in the UK, but due to their small size, maintaining social distancing inside waste collection vehicle cabins is impossible. Ventilation in cabins of 11 vehicles operating in London was assessed by measuring air supply flow rates and carbon dioxide (CO2) in the driver's cabin, a proxy for exhaled breath. The indoor CO2 indicated that air quality in the cabins was mostly good throughout a working day. However, short episodes of high CO2 levels above 1500 ppm did occur, mainly at the beginning of a shift when driving towards the start of their collection routes. This data indicated that the ventilation systems on the vehicles were primarily recirculating air and the fresh air supply made up only 10-20 % of the total airflow. Following recommendations to partly open windows during shifts and to maintain ventilation systems, a second monitoring campaign was carried out, finding on average, an improvement in ventilation on board the vehicles. © 2022 17th International Conference on Indoor Air Quality and Climate, INDOOR AIR 2022. All rights reserved.

Transient zonal modeling of SARS-CoV-2 airborne infection risk for incomplete mixing air distribution methods

A widely used analytical model to quantitatively assess airborne infection risk is the Wells-Riley model based on the assumption of complete air mixing in a single zone. This study aimed to extend the Wells-Riley model so that the infection risk can be calculated in spaces where complete mixing is not present. This is done by evaluating the time-dependent distribution of infectious quanta in each zone and by solving the coupled system of differential equations based on the zonal quanta concentrations. In conclusion, this study shows that using the Wells-Riley model based on the assumption of completely mixing air may overestimate the long-range airborne infection risk compared to some high-efficiency ventilation systems such as displacement ventilation, but also underestimate the infection risk in a room heated with warm air supplied from the ceiling. © 2022 17th International Conference on Indoor Air Quality and Climate, INDOOR AIR 2022. All rights reserved.

Multizone Modelling of SARS-CoV-2 Airborne Transmission in Mechanically Ventilated Buildings

This study contributes to a better understanding of the airborne transmission risks in multizone, mechanically ventilated buildings and how to reduce infection risk. A novel modeling approach combining the Wells-Riley and the US National Institute of Standards and Technology (NIST) CONTAM models was applied to a multizone whole building to simulate exposure and assess the effectiveness of different mitigation measures. A case study for the US Department of Energy large office prototype building was conducted to illustrate the approach. © 2022 17th International Conference on Indoor Air Quality and Climate, INDOOR AIR 2022. All rights reserved.

Predicting the infection probability distribution due to airborne and droplet transmission

In this study, a method was proposed to predict the infection probability distribution rather than the room-averaged value. The infection probability by airborne transmission was predicted based on the CO2 concentration. The infection probability by droplet transmission was predicted based on occupant position information. Applying the proposed method to an actual office confirmed that it could be used for quantitatively predicting the infection probability by integrating the ventilation efficiency and distance between occupants. The infection probability by airborne transmission was relatively high in a zone where the amount of outdoor air supply was relatively small. The infection probability by droplet transmission varied with the position of the occupants. The ability of the proposed method to analyze the relative effectiveness of countermeasures for airborne transmission and droplet transmission was verified in this study. © 2022 17th International Conference on Indoor Air Quality and Climate, INDOOR AIR 2022. All rights reserved.

Performance of in-duct bipolar ionization devices on pollutant removal and potential byproduct formation in indoor environments

The COVID-19 pandemic has highlighted the importance of indoor air quality (IAQ) since SARS-CoV-2 may be transmitted through virus-laden aerosols in poorly ventilated spaces. Multiple air cleaning technologies have been developed to mitigate airborne transmission risk and improve IAQ. In-duct bipolar ionization technology is an air cleaning technology that can generate ions for inactivating airborne pathogens and increasing particle deposition and removal while without significant byproducts generated. Many commercial in-duct ionization systems have been developed but their practical performance on pollutant removal and potential formation of byproducts have not been investigated comprehensively. The results in this study showed that the in-duct bipolar ionization technology can significantly improve the particle removal efficiency of the regular filter, while no significant ozone and ion were released to the indoor air. © 2022 17th International Conference on Indoor Air Quality and Climate, INDOOR AIR 2022. All rights reserved.

Using CO2 as a Ventilation Clue in Classrooms

In the era of COVID19, we need to quickly find and fix classrooms that have inadequate ventilation to reduce long-range airborne transmission of diseases. Historically, the limited available data has shown classrooms in the United States to be under ventilated in relation to consensus standard ventilation values that do not consider airborne infectious disease risk. Carbon dioxide (CO2) is a reasonable proxy of emissions from humans. This presentation will discuss the assumptions and uncertainties in using carbon dioxide concentrations as a proxy for ventilation in classrooms. Specifically, the influence of student density and activity level on carbon dioxide concentration will be modeled for a range of student ages and activities. This analysis shows classrooms with high carbon dioxide concentrations (above 2, 000 ppmv) are unlikely to be meeting United States ventilation standards. However, uncertainties mean conclusions cannot be easily made about ventilation rates in classrooms with lower carbon dioxide concentrations. © 2022 17th International Conference on Indoor Air Quality and Climate, INDOOR AIR 2022. All rights reserved.

Indoor Air Quality Improvements to Reduce Global Catastrophic Biological Risk

The importance of indoor air quality (IAQ) to reduce infectious disease transmission has become clear during the COVID-19 pandemic. In addition to SARS-CoV-2, other diseases, including RSV and influenza, are spread by airborne transmission, and often indoors-where most people spend over 90% of their lives. Given the importance of indoor environments in the spread of infectious disease, ventilation and filtration to improve IAQ should play a major role in preparing for a global catastrophic biological risk event (GCBR). This study involves performing a review of peer-reviewed literature and reports about improving indoor air quality in public spaces and interviewing technical experts in the fields of indoor air, building ownership, IAQ policy, and disease transmission control. The goal of the study is to identify and develop near and long-term policy actions for improving IAQ aimed to reduce GCBRs and other infectious diseases at various levels, including local and national. © 2022 17th International Conference on Indoor Air Quality and Climate, INDOOR AIR 2022. All rights reserved.