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1.
BMC Public Health ; 22(1): 1361, 2022 07 15.
Article in English | MEDLINE | ID: covidwho-1938302

ABSTRACT

BACKGROUND: COVID-19 has caused over 305 million infections and nearly 5.5 million deaths globally. With complete eradication unlikely, organizations will need to evaluate their risk and the benefits of mitigation strategies, including the effects of regular asymptomatic testing. We developed a web application and R package that provides estimates and visualizations to aid the assessment of organizational infection risk and testing benefits to facilitate decision-making, which combines internal and community information with malleable assumptions. RESULTS: Our web application, covidscreen, presents estimated values of risk metrics in an intuitive graphical format. It shows the current expected number of active, primarily community-acquired infections among employees in an organization. It calculates and explains the absolute and relative risk reduction of an intervention, relative to the baseline scenario, and shows the value of testing vaccinated and unvaccinated employees. In addition, the web interface allows users to profile risk over a chosen range of input values. The performance and output are illustrated using simulations and a real-world example from the employee testing program of a pediatric oncology specialty hospital. CONCLUSIONS: As the COVID-19 pandemic continues to evolve, covidscreen can assist organizations in making informed decisions about whether to incorporate covid test based screening as part of their on-campus risk-mitigation strategy. The web application, R package, and source code are freely available online (see "Availability of data and materials").


Subject(s)
COVID-19 , Mobile Applications , COVID-19/diagnosis , COVID-19/prevention & control , COVID-19 Testing , Child , Humans , Mass Screening , Pandemics/prevention & control
2.
Comput Methods Biomech Biomed Engin ; : 1-17, 2022 Jun 09.
Article in English | MEDLINE | ID: covidwho-1882899

ABSTRACT

On 19 September 2020, the Centers for Disease Control and Prevention (CDC) recommended that asymptomatic individuals, those who have close contact with infected person, be tested. Also, American society for biological clinical comments on testing of asymptomatic individuals. So, we proposed a new mathematical model for evaluating the population-level impact of contact rates (social-distancing) and the rate at which asymptomatic people are hospitalized (isolated) following testing due to close contact with documented infected people. The model is a deterministic system of nonlinear differential equations that is fitted and parameterized by least square curve fitting using COVID-19 pandemic data of Pakistan from 1 October 2020 to 30 April 2021. The fractional derivative is used to understand the biological process with crossover behavior and memory effect. The reproduction number and conditions for asymptotic stability are derived diligently. The most common non-integer Caputo derivative is used for deeper analysis and transmission dynamics of COVID-19 infection. The fractional-order Adams-Bashforth method is used for the solution of the model. In light of the dynamics of the COVID-19 outbreak in Pakistan, non-pharmaceutical interventions (NPIs) in terms of social distancing and isolation are being investigated. The reduction in the baseline value of contact rates and enhancement in hospitalization rate of symptomatic can lead the elimination of the pandemic.

3.
JMIR Form Res ; 6(8): e34422, 2022 Aug 04.
Article in English | MEDLINE | ID: covidwho-1879370

ABSTRACT

BACKGROUND: Mass asymptomatic testing for COVID-19 was piloted for the first time in the United Kingdom in Liverpool in November 2020. There is limited evidence on uptake of mass testing, and previously where surge testing has been deployed, uptake has been low. OBJECTIVE: There was an urgent need to rapidly evaluate acceptance of asymptomatic testing, specifically identifying barriers and facilitators to taking part. METHODS: As part of the wider evaluation, we conducted a rapid thematic analysis of local community narratives on social media to provide insights from people unlikely to engage in testing or other standard evaluation techniques, such as surveys or interviews. We identified 3 publicly available data sources: the comments section of a local online newspaper, the city council Facebook page, and Twitter. Data were collected between November 2, 2020, and November 8, 2020, to cover the period between announcement of mass testing in Liverpool and the first week of testing. Overall, 1096 comments were sampled: 219 newspaper comments, 472 Facebook comments, and 405 tweets. Data were analyzed using an inductive thematic approach. RESULTS: Key barriers were accessibility, including site access and concerns over queuing. Queues were also highlighted as a concern due to risk of transmission. Consequences of testing, including an increase in cases leading to further restrictions and financial impact of the requirement for self-isolation, were also identified as barriers. In addition, a lack of trust in authorities and the test (including test accuracy and purpose of testing) was identified. Comments coded as indicative of lack of trust were coded in some cases as indicative of strong collective identity with the city of Liverpool and marginalization due to feeling like test subjects. However, other comments coded as identification with Liverpool were coded as indicative of motivation to engage in testing and encourage others to do so; for this group, being part of a pilot was seen as a positive experience and an opportunity to demonstrate the city could successfully manage the virus. CONCLUSIONS: Our analysis highlights the importance of promoting honest and open communication to encourage and harness existing community identities to enhance the legitimacy of asymptomatic testing as a policy. In addition, adequate and accessible financial support needs to be in place prior to the implementation of community asymptomatic testing to mitigate any concerns surrounding financial hardship. Rapid thematic analysis of social media is a pragmatic method to gather insights from communities around acceptability of public health interventions, such as mass testing or vaccination uptake.

4.
Open Forum Infect Dis ; 9(5): ofac135, 2022 May.
Article in English | MEDLINE | ID: covidwho-1860895

ABSTRACT

We found no significant difference in cycle threshold values between vaccinated and unvaccinated persons infected with severe acute respiratory syndrome coronavirus 2 Delta, overall or stratified by symptoms. Given the substantial proportion of asymptomatic vaccine breakthrough cases with high viral levels, interventions, including masking and testing, should be considered in settings with elevated coronavirus disease 2019 transmission.

5.
J Public Health (Oxf) ; 2022 Feb 04.
Article in English | MEDLINE | ID: covidwho-1684779

ABSTRACT

BACKGROUND: Twice weekly lateral flow tests (LFTs) for secondary school children was UK Government policy from 8 March 2021. We evaluate use of LFTs (both supervised at test centres, and home test kits) in school-aged children in Cheshire and Merseyside. METHODS: We report (i) number of LFT positives (ii) proportion of LFT positive with confirmatory reverse transcription polymerase chain reaction (PCR) test within 2 days, and (iii) agreement between LFT-positive and confirmatory PCR, and dependence of (i-iii) on COVID-19 prevalence. FINDINGS: 1 248 468 LFTs were taken by 211 255 12-18 years old, and 163 914 by 52 116 5-11 years old between 6 November 2020 and 31 July 2021. Five thousand three hundred and fourteen (2.5%) 12-18 years old and 1996 (3.8%) 5-11 years old returned LFT positives, with 3829 (72.1%) and 1535 (76.9%) confirmatory PCRs, and 3357 (87.7%) and 1383 (90.1%) confirmatory PCR-positives, respectively.Monthly proportions of LFT positive with PCR negative varied between 4.7% and 35.3% in 12-18 years old (corresponding proportion of all tests positive: 9.7% and 0.3%).Deprivation and non-White ethnicity were associated with reduced uptake of confirmatory PCR. INTERPRETATION: Substantial inequalities in confirmatory testing need more attention to avoid further disadvantage through education loss. When prevalence is low additional measures, including confirmatory testing, are needed. Local Directors of Public Health taking more control over schools testing may be needed. FUNDING: DHSC, MRC, NIHR, EPSRC.

6.
Ecancermedicalscience ; 15: 1269, 2021.
Article in English | MEDLINE | ID: covidwho-1354826

ABSTRACT

BACKGROUND: The coronavirus disease (COVID-19) pandemic has had enormous consequences in Brazil and worldwide. Patients with cancer affected by COVID-19 are at a higher risk of developing complications and worse outcomes compared to the non-cancer population, particularly the ones on active systemic treatment. Considering the COVID-19's high transmissibility in asymptomatic and pre-symptomatic patients, we sought to determine the prevalence of COVID-19 infection in patients with solid cancers receiving systemic therapy in a Brazilian public health hospital. Furthermore, we studied whether socio-economic status was associated with prevalence. METHODS: Consecutive asymptomatic patients undergoing treatment for solid tumours at the chemotherapy and infusion centre of Hospital de Base were enrolled. Patients were prospectively tested for severe acute respiratory syndrome coronavirus 2 RNA real-time polymerase chain reaction with nasal and oropharyngeal swabs immediately prior to treatment. A socio-economic survey was carried out prior to testing. Demographic and socio-economic characteristics were summarised in means, medians and proportions. RESULTS: From 6 to 13 October 2020, 148 asymptomatic patients were identified. Of those, 41 were excluded, leaving 107 eligible patients. The mean age of the population was 58 years (SD ± 12.6); 54% were female and 90% were self-identified as White. The most common cancer sites were gastrointestinal tract (36%) and breast (25%). Most patients had a metastatic disease (59%) and were on anticancer treatment involving chemotherapy (95%). Regarding socio-economic status, 46% of our population had either primary school or illiterate as their highest educational level. In terms of monthly income, 92% had a personal income inferior to U$380 and 88% a household income inferior to U$585. Of the 107 patients tested, only 1 (0.9%) was positive for COVID-19. This is a 48-year-old man living in an urban area, with primary school educational level and a monthly personal income inferior to U$390. CONCLUSION: Despite a high prevalence of COVID-19 in Brazil, our cohort demonstrated a low prevalence of COVID-19 (0.9%) amongst asymptomatic patients with cancer. We hypothesise that patients with cancer, independent of their socio-economic status, are aware of the increased risk of developing a severe disease and are adherent to physical distancing, masking and hygiene measures.

7.
J Am Med Inform Assoc ; 28(2): 377-383, 2021 02 15.
Article in English | MEDLINE | ID: covidwho-915883

ABSTRACT

Assuring the safety of both patients and healthcare workers (HCWs) in hospitals has been the primary focus of every healthcare organization during the COVID 19 pandemic. This article discusses the NIH Clinical Center's interdisciplinary approach to deploying an organizational Asymptomatic Staff Testing System.


Subject(s)
Asymptomatic Diseases , COVID-19 Testing/methods , COVID-19/diagnosis , Electronic Health Records , Health Personnel , Medical Informatics Applications , Public Health Surveillance/methods , Humans , Internet , National Institutes of Health (U.S.) , Software , United States
8.
J Clin Microbiol ; 59(1)2020 12 17.
Article in English | MEDLINE | ID: covidwho-835433

ABSTRACT

On 24 August 2020, the Centers for Disease Control and Prevention (CDC) updated its website to highlight that asymptomatic individuals, even those with exposure to a COVID-19-positive contact, do not necessarily need to be tested unless they have medical conditions associated with increased risk of severe illness from COVID-19. The CDC subsequently updated its guidance on 19 September 2020 to support testing of asymptomatic persons, including close contacts of persons with documented SARS-CoV-2 infection. In this editorial, the American Society for Microbiology Clinical and Public Health Microbiology Committee's Subcommittee on Laboratory Practices comments on testing of asymptomatic individuals relative to current medical knowledge of the virus and mitigation measures. Specific points are provided concerning such testing when undertaking contact tracing and routine surveillance. Limitations to consider when testing asymptomatic persons are covered, including the need to prioritize testing of contacts of positive COVID-19 cases. We urge the CDC to consult with primary stakeholders of COVID-19 testing when making such impactful changes in testing guidance.


Subject(s)
Asymptomatic Diseases , COVID-19 Testing/methods , COVID-19/diagnosis , Carrier State/diagnosis , Chronic Disease Indicators , Contact Tracing/methods , Female , Humans , Male , SARS-CoV-2/isolation & purification
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