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

Interior Design Aspects Affecting Infection Rate: A Systematic Review of Possible Interventions

In light of the COVID-19 pandemic, getting infected through the built environment is being studied. The measures that should be taken to reduce infection through the built environment are essential;not only for COVID-19, but this idea is present at all times of widespread diseases.The purpose of this research is to systematically review the relationship between the built environment and the spread of infection to create a potential guideline to reduce the transmission rate. Articles and studies on the relationship between infectious disease and the built environment were reviewed.Articles matching the selection criteria were identified. Most articles described peer reviews, consensus statements, and reports. The articles have provided data that can be used as guidance for reducing the transmission of infection within the built environment. It was found that evidence has been created such as ventilation, buffer spaces, flooring, and surfaces that can reduce the infection of COVID-19.

Dynamic Insulation Systems to Control Airborne Transmission of Viruses in Classrooms: A Review of 'Airhouse' Concept

The discovery of the Covid-19 virus in China at the end of 2019 has drastically altered the global landscape. The virus, which has now become a pandemic, has wrought devastation on the world, infecting over 500 million people and killing over 6 million. The virus's mutation into a few variations, however, has enabled the world's alarming situation to continue until now. Airborne particles and viruses including the new Covid-19 variant -Omricon, is not only extremely contagious but also can be transferred by airborne transmission, putting vulnerable people like children at risk, particularly in classrooms. Amongst the strategies to control airborne transmission of viruses and to improve indoor thermal and air quality is using ventilation strategies -such as dynamic insulation. Thus, this paper will review at how dynamic insulation systems in conventional farming and residential buildings, cleanrooms and other controlled environments work to reduce airborne viruses and particles in a room. An innovative "Airhouse" concept that combines with activated carbon has been researched and investigated with regard to the dynamic insulation systems.This system has a high potential to reduce the air temperature, humidity, and airborne viruses including Covid-19 whilst maintaining a steady airflow rate in a normal room. Therefore, it has a great deal of potential to decrease or eliminate concerns about the transmission of airborne viruses and adapt ventilation systems to new pandemic threats.

A Computational Approach for the Characterization of Airborne Pathogen Transmission in Turbulent Molecular Communication Channels

Airborne pathogen transmission mechanisms play a key role in the spread of infectious diseases such as COVID-19. In this work, we propose a computational fluid dynamics (CFD) approach to model and statistically characterize airborne pathogen transmission via pathogen-laden particles in turbulent channels from a molecular communication viewpoint. To this end, turbulent flows induced by coughing and the turbulent dispersion of droplets and aerosols are modeled by using the Reynolds-averaged Navier-Stokes equations coupled with the realizable k-model and the discrete random walk model, respectively. Via simulations realized by a CFD simulator, statistical data for the number of received particles are obtained. These data are post-processed to obtain the statistical characterization of the turbulent effect in the reception and to derive the probability of infection. Our results reveal that the turbulence has an irregular effect on the probability of infection, which shows itself by the multi-modal distribution as a weighted sum of normal and Weibull distributions. Furthermore, it is shown that the turbulent MC channel is characterized via multi-modal, i.e., sum of weighted normal distributions, or stable distributions, depending on the air velocity. Crown

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 sporting events amplify airborne virus transmission? Causal evidence from US professional team sports

We analyze the impact of professional sporting events on local seasonal influenza mortality to develop evidence on the role played by spectator attendance at sporting events in airborne virus transmission. Results from a difference-in-differences model applied to data from a sample of US cities that gained new professional sports teams over the period 1962–2016 show that the presence of games in these cities increased local influenza mortality by between 4% and 24%, depending on the sport, relative to cities with no professional sports teams and relative to mortality in those cities before a new team arrived. Influenza mortality fell in cities with teams in some years when work stoppages occurred in sports leagues. Health policy decisions, and decisions about the subsidization of professional sports, should take into account the role played by sporting events in increasing airborne virus transmission and local influenza and coronavirus mortality.

Coronavirus Label-Free Immunosensor: Preliminary Results

Real-time detection of airborne infection agents present in human breath and environmental airways, such as the human respiratory Coronavirus, is important for public health. For this, a model label-free immunosensor, based on multi-walled nanotubes (MWNT)-based screen-printed graphite electrodes (SPEs), was proposed and studied. For sensing applications, MWNTs have many advantages such as small size with larger surface area, excellent electron transfer promoting ability when used for antibody immobilization, with retention of its selectivity for potential immunosensors development. In order to verify the selectivity of the selected primary antibody (anti-CoV 229E antibody) and the effective immunocomplex formation (antigen-antibody), an in-depth voltammetric characterization of MWNT-SPEs interface was carried out during the multistep fabrication of CoV immunosensor using [Fe(CN)6]3−/4− as an electroactive probe.After that, the analytical robustness of the performances of these immunosensing platforms was estimated and verified. Indeed, a nanomolar range detection limit (180 TCID50/mL)g/mL) with excellent reproducibility (RSD% = 8%) was obtained. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2023.

Personal Protective Equipment Protocols Lead to a Delayed Initiation of Patient Assessment in Mountain Rescue Operations.

van Veelen, Michiel J., Giulia Roveri, Ivo B. Regli, Tomas Dal Cappello, Anna Vögele, Michela Masè, Marika Falla, and Giacomo Strapazzon. Personal protective equipment protocols lead to a delayed initiation of patient assessment in mountain rescue operations. High Alt Med Biol. 24:127-131, 2023. Introduction: Mountain rescue operations can be challenging in austere environmental conditions and remote settings. Airborne infection prevention measures include donning of personal protective equipment (PPE), potentially delaying the approach to a patient. We aimed to investigate the time delay caused by these prevention measures. Methods: This randomized crossover trial consisted of 24 rescue simulation trials intended to be as realistic as possible, performed by mountain rescue teams in difficult terrain. We analyzed the time needed to perform an airborne infection prevention protocol during the approach to a patient. Time delays in scenarios involving patients already wearing versus not wearing face masks and gloves were compared using a linear mixed model Results: The airborne infection prevention measures (i.e., screening questionnaire, hand antisepsis, and donning of PPE) resulted in a time delay of 98 ± 48 (26-214) seconds on initiation of patient assessment. There was a trend to a shorter time to perform infection prevention measures if the simulated patient was already wearing PPE consisting of face mask and gloves (p = 0.052). Conclusion: Airborne infection prevention measures may delay initiation of patient assessment in mountain rescue operations and could impair clinical outcomes in time-sensitive conditions. Trial registration number 0105095-BZ Ethics Committee review board of Bolzano.

Real-Life Assessment of the Ability of an Ultraviolet C Lamp (SanificaAria 200, Beghelli) to Inactivate Airborne Microorganisms in a Healthcare Environment.

Airborne-mediated microbial diseases represent one of the major challenges to public health. Ultraviolet C radiation (UVC) is among the different sanitation techniques useful to reduce the risk of infection in healthcare facilities. Previous studies about the germicidal activity of UVC were mainly performed in artificial settings or in vitro models. This study aimed to assess the sanitizing effectiveness of a UVC device (SanificaAria 200, Beghelli, Valsamoggia, Bologna, Italy) in 'real-life' conditions by evaluating its ability to reduce microbial loads in several hospital settings during routine daily activities. The efficacy of the UVC lamp in reducing the bacterial component was evaluated by microbial culture through the collection of air samples in different healthcare settings at different times (30 min-24 h) after turning on the device. To assess the anti-viral activity, air samplings were carried out in a room where a SARS-CoV-2-positive subject was present. The UVC device showed good antibacterial properties against a wide range of microbial species after 6 h of activity. It was effective against possible multi-drug resistant microorganisms (e.g., Pseudomonas spp., Acinetobacter spp.) and spore-forming bacteria (e.g., Bacillus spp.). In addition, the UVC lamp was able to inactivate SARS-CoV-2 in just one hour. Thanks to its effectiveness and safety, SanificaAria 200 could be useful to inactivate airborne pathogens and reduce health risks.

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.

Recent progress in online detection methods of bioaerosols

The aerosol transmission of coronavirus disease in 2019, along with the spread of other respiratory diseases, caused significant loss of life and property;it impressed upon us the importance of real-time bioaerosol detection. The complexity, diversity, and large spatiotemporal variability of bioaerosols and their external/internal mixing with abiotic components pose challenges for effective online bioaerosol monitoring. Traditional methods focus on directly capturing bioaerosols before subsequent time-consuming laboratory analysis such as culture-based methods, preventing the high-resolution time-based characteristics necessary for an online approach. Through a comprehensive literature assessment, this review highlights and discusses the most commonly used real-time bioaerosol monitoring techniques and the associated commercially available monitors. Methods applied in online bioaerosol monitoring, including adenosine triphosphate bioluminescence, laser/light-induced fluorescence spectroscopy, Raman spectroscopy, and bioaerosol mass spectrometry are summarized. The working principles, characteristics, sensitivities, and efficiencies of these real-time detection methods are compared to understand their responses to known particle types and to contrast their differences. Approaches developed to analyze the substantial data sets obtained by these instruments and to overcome the limitations of current real-time bioaerosol monitoring technologies are also introduced. Finally, an outlook is proposed for future instrumentation indicating a need for highly revolutionized bioaerosol detection technologies.

Large-eddy simulation of buoyant airflow in an airborne pathogen transmission scenario

Indoor airflow patterns and the spreading of respiratory air were studied using the large-eddy simulation (LES) computational fluid dynamics (CFD) approach. A large model room with mixing ventilation was investigated. The model setup was motivated by super-spreading of the SARS-CoV-2 virus with a particular focus on a known choir practice setup where one singer infected all the other choir members. The room was heated with radiators at two opposite walls in the cold winter time. The singers produced further heat generating buoyancy in the room. The Reynolds number of the inflow air jets was set to Re=2750, corresponding to an air-changes-per-hour (ACH) value of approximately 3.5. The CFD solver was first validated after which a thorough grid convergence study was performed for the full numerical model room with heat sources. The simulations were then executed over a time of t=20 min to account for slightly more than one air change timescale for three model cases: (1) full setup with heat sources (radiators+singers) in the winter scenario, (2) setup without radiators in a summer scenario, and (3) theoretical setup without buoyancy (uniform temperature). The main findings of the paper are as follows. First, the buoyant flow structures were noted to be significant. This was observed by comparing cases 1/2 with case 3. Second, the dispersion of the respiratory aerosol concentration, modeled as a passive scalar, was noted to be significantly affected by the buoyant flow structures in cases 1–2. In particular, the aerosol cloud was noted to either span the whole room (cases 1–2) or accumulate in the vicinity of the infected singer (case 3). Turbulence was clearly promoted by the interaction of the upward/downward moving warmer/cooler air currents which significantly affected the dispersion of the respiratory aerosols in the room. The study highlights the benefits of high-resolution, unsteady airflow modeling (e.g. LES) for interior design which may consequently also impact predictions on exposure to potentially infectious respiratory aerosols.

The size distribution of SARS-CoV-2 genetic material in airborne particles sampled in hospital and home care environments occupied by COVID-19 positive subjects.

Characterizing the size distribution of airborne particles carrying SARS-CoV-2 virus is essential for understanding and predicting airborne transmission and spreading of COVID-19 disease in hospitals as well as public and home indoor settings. Nonetheless, few data are currently available on virus-laden particle size distribution. Thus, the aim of this study is reporting the total concentrations and size distributions of SARS-CoV-2- genetic material in airborne particles sampled in hospital and home environments. A nanoMOUDI R122 cascade impactor (TSI, USA) was used to collect size-segregated aerosol down to the sub-micron range in home and in three different hospital environments in presence of infected patients in order to provide the concentration of airborne SARS-CoV-2 genetic material for each particle size range at different sampling locations. Providing one of the largest datasets of detailed size-fractionated airborne SARS-CoV-2 RNA to date, we found that 45.2 % of the total sub- and super-micrometric fractions were positive for SARS-CoV-2 with its genetic material being present in 17.7 % of sub-micrometric (0.18-1 µm) and 81.9 % of super-micrometric (>1 µm) fractions. The highest concentration of SARS-CoV-2 genetic material in total suspended particles (5.6 ± 3.4 RNA copies m-3) was detected in the room occupied with patients with more severe COVID-19 symptoms collected during the patients' high flow nasal oxygen therapy. The highest concentration at certain particle size fraction strongly depends on the sampling environment. However, the contribution of SARS-CoV-2 genetic material was in favour of super-micrometric compared to sub-micrometric particle size range. The evaluation of the individual risk of infection was carried out on the basis of the obtained data considering a hypothetical exposure scenario. The obtained results indicate the necessity of the protective masks in presence of infected subjects, especially while staying for longer period of time in the hospital environments.

Numerical Analysis of the Impact of the Use of Personal Protective Equipment on the Face in the Process of Pollutants Spreading Emitted During Breathing

The study presents the results of a numerical analysis of the effectiveness of the use of personal protective equipment of various designs on the spread of pollutants marked with CO2 emitted during human breathing. In the study of 3D geometry the upper part of the human torso and head was developed. The simulated person was supplied with different personal protective equipment covering the human face (PPE). Two types of face shields worn at a different distance from the face and one fabric face mask was analysed. The reference geometry with no personal protective equipment was also analysed. Transient calculation with full breathing model including breath-in and breath-out and species transport were simulated. The results showed that different PPE generates different airflow patterns in the vicinity of the human face. The most efficient in reducing infection risk is by wearing a face mask or face shields at a small distance from the face, as they most effectively reduce CO2 concentration in the surrounding air. However, they also increase the re-inhalation risk of high CO2 concentration which affects human well-being.

Can 10× cheaper, lower-efficiency particulate air filters and box fans complement High-Efficiency Particulate Air (HEPA) purifiers to help control the COVID-19 pandemic?

Public health departments such as CDC and California Department of Public Health (CA-DPH) advise HEPA-purifiers to limit transmission of SARS-CoV-2 indoor spaces. CA-DPH recommends air exchanges per hour (ACH) of 4-6 air for rooms with marginal ventilation and 6-12 in classrooms often necessitating multiple HEPA-purifiers per room, unaffordable in under-resourced community settings. Pressure to seek cheap, rapid air filtration resulted in proliferation of lower-cost, Do-It-Yourself (DIY) air purifiers whose performance is not well characterized compared to HEPA-purifiers. Primary metrics are clean air delivery rate (CADR), noise generated (dBA), and affordability ($$). CADR measurement often requires hard-to-replicate laboratory experiments with generated aerosols. We use simplified, low-cost measurement tools of ambient aerosols enabling scalable evaluation of aerosol filtration efficiencies (0.3 to 10 µm), estimated CADR, and noise generation to compare 3 HEPA-purifiers and 9 DIY purifier designs. DIY purifiers consist of one or two box fans coupled to single MERV 13-16 filters (1″-5″ thick) or quad filters in a cube. Accounting for reduced filtration efficiency of MERV 13-16 filters (versus HEPA) at the most penetrating particle size of 0.3 µm, estimated CADR of DIY purifiers using 2″ (67%), 4″ (66%), and 5″ (85%) filters at lowest fan speed was 293 cfm ($35), 322 cfm ($58), and 405 cfm ($120) comparable to best-in-class, low-noise generating HEPA-purifier running at maximum speed with at 282 cfm ($549). Quad filter designs, popularly known Corsi-Rosenthal boxes, achieved gains in estimated CADR below 80% over single filter designs, less than the 100% gain by adding a second DIY purifier. Replacing one of the four filters with a second fan resulted in gains of 125%-150% in estimated CADR. Tested DIY alternatives using lower-efficiency, single filters compare favorably to tested HEPA-purifiers in estimated CADR, noise generated at five to ten times lower cost, enabling cheap, rapid aerosol removal indoors.

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.