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1.
Strahlentherapie und Onkologie ; 2022.
Article in English | EMBASE | ID: covidwho-1820911

ABSTRACT

Purpose: Modern medical education demands innovative, competence-orientated concepts. The forced digital transfer of teaching due to the coronavirus pandemic also affected radiation oncology (RO). The following analysis investigates whether the attractivity of RO teaching at our faculty could be maintained during the pandemic and which possibilities exist to involve students (in active learning). The latter aspect is further elaborated on a broader scale by a systemic review of the literature on competence-orientated digital education. Methods: Evaluation results and participation rates of clinical lectures in radiation oncology (RO) were analyzed between the winter semester 2018/2019 and the summer semester 2021. A systemic review of the literature on digital education in RO for medical students was conducted. Results: Concerning evaluation results, a significant improvement for the 7th and 9th semesters was observed in comparison between the pre-pandemic and pandemic semesters (p = 0.046 and p = 0.05, respectively). Overall participation rates did not differ. However, the number of students attending > 75% of classes in the respective semester increased significantly between the pre-pandemic and pandemic period (median values: 38 vs. 79%, p = 0.046;44 vs. 73%, p = 0.05;45 vs. 64%, p = 0.05;41 vs. 77%, p = 0.05;41 vs. 71%, p = 0.05, for the 6th to 10th semester, respectively). Conclusion: The analysis demonstrates the possibility of efficient digital transfer of a core curriculum in RO to the digital era, with a more continuous participation of students. This transfer may enable amelioration of teaching quality and the introduction of innovative and interactive concepts in accordance with the literature.

2.
Public Health ; 2022.
Article in English | ScienceDirect | ID: covidwho-1819587

ABSTRACT

The COVID-19 pandemic that emerged in December 2019 brought human life to a standstill. With over two-year since the pandemic originated from Wuhan, SARS-CoV-2 has caused more than 6 million deaths worldwide. With the emergence of mutant strains and COVID-19 surge waves, it becomes critically important to conduct epidemiological studies that allow us to understand the role of various environmental factors on SARS-CoV-2 infectivity. Our earlier study reported a strong negative correlation of temperature and COVID-19 incidence. This study is basically an extension to our previous study with global analysis of COVID-19 in northern hemisphere countries. This study aimed to see the correlation of temperature, sunlight and humidity with new cases of COVID-19 in northern hemisphere countries from March 2020 to February 2022. Month-wise univariate analysis indicated a strong negative correlation of temperature and sunlight with SARS-CoV-2 infectivity while inconsistencies were observed in correlation analysis in the case of humidity in winter months. Moreover, strong negative correlation between average temperature of winter months and COVID-19 cases exists as evidenced by Pearson, Spearman and Kendall analysis. In addition, correlation pattern between monthly temperature and COVID-19 cases of a country mimics to that of sunlight of a country. This pilot study proposes that low temperatures and low sunlight might be additional risk factors for SARS-CoV-2 infectivity mostly in northern hemisphere countries.

3.
Chinese Journal of Zoonoses ; 37(12):1135-1140, 2021.
Article in Chinese | GIM | ID: covidwho-1818310

ABSTRACT

This study aimed to evaluate the etiological and clinical characteristics of acute upper respiratory tract infections in children from GuangZhou, China. A total of 2 665 nose swabs specimen collected from children with acute upper respiratory tract infections from Zhujiang Hospital, Southern Medical University, Guangzhou, China during November 2009 to September 2015 were enrolled in this study. There were 1 566 virus positive responses were detected in samples from 2665 child patients with acute upper respiratory infections, with the positive rate of 58.8%. The positive rates were 22.5% for respiratory sycytial virus (RSV), 13.0% for rhinovirus (HRV), 9.0% for influenza virus (FLU), 7.6% for parainfluenza virus (PIV), 6.1% for adenovirus (AdV), 4.0% for human metapneumovirus (HMPV), 3.7% for human coronavirus (HCOV), 3.5% for human Bocavirus (HBOV). There was statistical significant in the detection rates of 8 respiratory viruses in different seasons, with the highest in spring, followed by summer and winter, and lowest in autumn. The respiratory virus infection rate of children gradually decreased with age, with a positive detection rate of 67.0% between children aged 0-3 years. And the respiratory virus detection rate of boys was significantly higher than that of girls. The co-infection rates were higher in child patients aged 0-3 years, and were higher during spring and summer than that of autumn and winter. Cough is the main clinical symptom of acute upper respiratory virus infection, followed by sputum and runny nose. The clinical symptoms are different in children between 8 respiratory virus infections. This study increases our knowledge of the etiological and clinical characteristics of these 8 common respiratory viruses among children with respiratory tract infections. Which might also provide relevant data to guide clinical treatment and prevention.

4.
Vaccines ; 10(3), 2022.
Article in English | EMBASE | ID: covidwho-1818228

ABSTRACT

Background: Several countries are implementing COVID-19 booster vaccination campaigns. The objective of this study was to model the impact of different primary and booster vaccination strategies. Methods: We used a compartmental model fitted to hospital admission data in France to analyze the impact of primary and booster vaccination strategies on morbidity and mortality, assuming waning of immunity and various levels of virus transmissibility during winter. Results: Strategies prioritizing primary vaccinations were systematically more effective than strategies prioritizing boosters. Regarding booster strategies targeting different age groups, their effectiveness varied with immunity and virus transmissibility levels. If the waning of immunity affects all adults, people aged 30 to 49 years should be boosted in priority, even for low transmissibility levels. Conclu-sions: Increasing the primary vaccination coverage should remain a priority. If a plateau has been reached, boosting the immunity of younger adults could be the most effective strategy, especially if SARS-CoV-2 transmissibility is high.

5.
Respirology ; 27(SUPPL 1):179, 2022.
Article in English | EMBASE | ID: covidwho-1816641

ABSTRACT

Introduction: COVID-19 lockdown measures implemented in March 2020 markedly reduced hospitalisations of infants with respiratory infections at Kidz First Hospital. There was no characteristic winter peak of respiratory infections with only three hospitalisations during 1 March-31 August with a positive PCR result for RSV and one for influenza. The commencement of quarantine-free travel between Australia and New Zealand started in April 2021 and within 2 weeks there was a positive PCR panel for RSV at Kidz First, the first RSV positive test for over a year with case numbers steadily increasing thereafter. Methods: To confirm the return of the winter peak we examined respiratory viral PCR test results and infant lower respiratory tract infection (LRTI) hospitalization data from 1 January 2015, through 31 July 2021. All specimens submitted by Kidz First clinicians for respiratory viral PCR testing were identified. ICD codes were used to identify infants <2 years of age hospitalized for >3 h with a LRTI. Results: During the months of March-July the number of inpatient hospitalisations at Kidz First varied from 944 in 2015 to 706 in 2018. There was a dramatic reduction to 144 hospitalisations in 2020 but this has rebounded back to 730 in 2021. The number of positive PCR panels for RSV increased to 803(52%) with a much higher percentage than any previous year. There were no PCR positive tests for influenza A or B. The percentage of positive PCR panels for adenovirus (7%), parainfluenza (4%) and rhinovirus/ enterovirus (53%) have remained similar to previous years. Clinician-directed investigation of infants with respiratory infections has increased in response to COVID-19. Conclusion: Easing of COVID-19 restrictions and commencement of quarantine-free travel with Australia has likely resulted in the return of RSV and LRTI hospitalisations rates similar to previous winter peaks.

6.
Atmospheric Environment ; 278, 2022.
Article in English | EMBASE | ID: covidwho-1814146

ABSTRACT

Air pollution during the COVID-19 epidemic in Beijing and its surrounding regions has received substantial attention. We collected observational data, including air pollutant concentrations and meteorological parameters, during January and February from 2018 to 2021. A statistical and a numerical model were applied to identify the formation of air pollution and the impact of emission reduction on air quality. Relative humidity, wind speed, SO2, NO2, and O3 had nonlinear effects on the PM2.5 concentration in Beijing, among which the effects of relative humidity, NO2, and O3 were prominent. During the 2020 epidemic period, high pollution concentrations were closely related to adverse meteorological conditions, with different parameters having different effects on the three pollution processes. In general, the unexpected reduction of anthropogenic emissions reduced the PM2.5 concentration, but led to an increase in the O3 concentration. Multi-scenario simulation results showed that anthropogenic emission reduction could reduce the average PM2.5 concentration after the Chinese Spring Festival, but improvement during days with heavy pollution was limited. Considering that O3 enhances the PM2.5 levels, to achieve the collaborative improvement of PM2.5 and O3 concentrations, further research should explore the collaborative emission reduction scheme with VOCs and NOx to achieve the collaborative improvement of PM2.5 and O3 concentrations. The conclusions of this study provide a basis for designing a plan that guarantees improved air quality for the 2022 Winter Olympics and other international major events in Beijing.

7.
Morbidity and Mortality Weekly Report ; 70(35):1220-1222, 2021.
Article in English | GIM | ID: covidwho-1813125

ABSTRACT

In this study, a total of 463 school-associated cases were reported among students attending public TK 12 schools in person and 3927 among staff members working on-site from 1 September, 2020 to 31 March, 2021. During the same period, 105,577 cases among children and adolescents aged 5-17 years and 771,409 cases among adults aged 18-79 years were reported in LAC. School-associated case rates remained low among students, ranging from 110 per 100,000 in September to 859 in December 2020. Case rates among all children and adolescents aged 5-17 years in the county were higher during most of the period, ranging from 167 per 100,000 in September to 2938 in December 2020. School-associated case rates among staff members were lowest in September 2020, peaked in December 2020, and fell sharply through March 2021. These rates reflected the trend among all adults aged 18 79 years in the county (319 per 100,000 in September 2020;4624 in December 2020;and 181 in March 2021) but were lower for most of the period. The findings suggest that implementing recommended prevention measures might protect children, adolescents, and adults from COVID-19 in TK 12 schools. The level of protection appears to be higher in children and adolescents than in adults. In schools with safety protocols in place for prevention and containment, case rates in children and adolescents were 3.4 times lower during the winter peak compared with rates in the community. This analysis reflects transmission patterns before the more transmissible SARS-CoV-2 B.1.617.2 (Delta) variant became predominant in the United States.

8.
International Journal of Environmental Research and Public Health ; 19(8):4886, 2022.
Article in English | ProQuest Central | ID: covidwho-1809884

ABSTRACT

Plastic debris contamination in marine environments is a global problem that poses a considerable threat to the sustainability and health of coastal ecosystems. Marine beaches, as the key zones where terrestrial plastic debris reach coastal waters, are faced with the increasing pressures of human activities. In this study, we explored the distribution, composition, and inventory of plastic debris over seasonal and tidal zones at the Yugang Park Beach (YPB) in Zhanjiang Bay, South China Sea, to provide a baseline for plastic debris on a marine beach. The results showed mean abundance of plastic debris in summer (6.00 ± 2.10 items/m2) was significantly greater than that in winter (3.75 ± 2.12 items/m2). In addition, the composition of plastic debris ranged in size mainly from 1 to 5 mm and 0.5 to 2.5 cm in winter and summer, respectively. In terms of composition, white plastic debris was the most common (81.1%), and foam was the most abundant (64.4%). Moreover, there was a significant relationship between the abundance of plastic debris and sand grain size fraction (p < 0.05), implying the abundances of microplastic debris were more easily impacted by sand grain size (>2 mm). In total inventory, there were about 1.18 × 105 and 2.95 × 105 items of plastic debris on the YPB in winter and summer, respectively. The tidal variation and human activities are responsible for the plastic debris accumulation. This study provided a method to quantify the inventory of plastic debris on a beach and could be helpful to consider regional tidal variations and critical source areas for effective plastic debris clean-up.

9.
Disease Surveillance ; 37(1):7-11, 2022.
Article in Chinese | CAB Abstracts | ID: covidwho-1789480

ABSTRACT

Objective: To assess the risk of public health emergencies, both the indigenous ones and the imported ones, which might occur in the mainland of China in January 2022.

10.
Disease Surveillance ; 37(1):67-71, 2022.
Article in Chinese | GIM | ID: covidwho-1789474

ABSTRACT

Objective: To analyze the epidemiologic characteristics of common respiratory virus infection in hospitalized children in Wuhan Children's Hospital from January to December 2019, and provide evidence for clinical diagnosis and treatment.

11.
Jorjani Biomedicine Journal ; 10(1):67-83, 2022.
Article in English | CAB Abstracts | ID: covidwho-1787065

ABSTRACT

Vitamin A is fat-soluble compounds of retinoid derivate, consisting of retinol, retinal, and retinyl esters. Vitamin A also affects cell growth and differentiation, playing a critical role in the normal formation and function of the heart, lungs, kidneys, and other organs. According to the role of vitamin A in enhancing immune function, it is known as an anti-inflammatory agent. Also, vitamin A supplementation by reducing morbidity and mortality in different infectious diseases, such as measles, diarrheal disease, measles-related pneumonia, human immunodeficiency virus infection, and malaria considered as a crucial factor against infection. So vitamin A deficiency can be life-threatening, because of impairing the response to infection and significant risk of development of severe respiratory infections in infants and young children. In this paper, we have discussed the effects of vitamin A in modulating immune responses in viral infections and the direct effects of this vitamin on viral replication by comparing its role during different types of viral infections.

12.
Atmospheric Chemistry and Physics ; 22(7):4615-4703, 2022.
Article in English | ProQuest Central | ID: covidwho-1786220

ABSTRACT

This review provides a community's perspective on air quality research focusing mainly on developments over the past decade. The article provides perspectives on current and future challenges as well as research needs for selected key topics. While this paper is not an exhaustive review of all research areas in the field of air quality, we have selected key topics that we feel are important from air quality research and policy perspectives. After providing a short historical overview, this review focuses on improvements in characterizing sources and emissions of air pollution, new air quality observations and instrumentation, advances in air quality prediction and forecasting, understanding interactions of air quality with meteorology and climate, exposure and health assessment, and air quality management and policy. In conducting the review, specific objectives were (i) to address current developments that push the boundaries of air quality research forward, (ii) to highlight the emerging prominent gaps of knowledge in air quality research, and (iii) to make recommendations to guide the direction for future research within the wider community. This review also identifies areas of particular importance for air quality policy. The original concept of this review was borne at the International Conference on Air Quality 2020 (held online due to the COVID 19 restrictions during 18–26 May 2020), but the article incorporates a wider landscape of research literature within the field of air quality science. On air pollution emissions the review highlights, in particular, the need to reduce uncertainties in emissions from diffuse sources, particulate matter chemical components, shipping emissions, and the importance of considering both indoor and outdoor sources. There is a growing need to have integrated air pollution and related observations from both ground-based and remote sensing instruments, including in particular those on satellites. The research should also capitalize on the growing area of low-cost sensors, while ensuring a quality of the measurements which are regulated by guidelines. Connecting various physical scales in air quality modelling is still a continual issue, with cities being affected by air pollution gradients at local scales and by long-range transport. At the same time, one should allow for the impacts from climate change on a longer timescale. Earth system modelling offers considerable potential by providing a consistent framework for treating scales and processes, especially where there are significant feedbacks, such as those related to aerosols, chemistry, and meteorology. Assessment of exposure to air pollution should consider the impacts of both indoor and outdoor emissions, as well as application of more sophisticated, dynamic modelling approaches to predict concentrations of air pollutants in both environments. With particulate matter being one of the most important pollutants for health, research is indicating the urgent need to understand, in particular, the role of particle number and chemical components in terms of health impact, which in turn requires improved emission inventories and models for predicting high-resolution distributions of these metrics over cities. The review also examines how air pollution management needs to adapt to the above-mentioned new challenges and briefly considers the implications from the COVID-19 pandemic for air quality. Finally, we provide recommendations for air quality research and support for policy.

13.
Arabian Journal of Geosciences ; 15(8), 2022.
Article in English | ProQuest Central | ID: covidwho-1782987

ABSTRACT

Indian cities are highly vulnerable to atmospheric pollution in recent years, due to exponential growth in urbanisation and industrialisation, and the increased pollution has been made to focus on the temporal variation analysis and forecasting of air pollutants over major Indian cities like Delhi and Bangalore. PM2.5 concentrations are nearly 60.5% less than the annual average value during monsoon season while 76.3% more during the winter months. Ozone concentrations increase during the summer months (~ 46.3% more than the annual average) in Delhi, whereas in Bangalore, ozone concentrations are more (~ 75% more than the annual average) during the winter months. Variations of carbon monoxide and nitrogen oxides are significantly less comparatively. COVID-19 lockdown has a substantial positive impact on air pollution. Air pollutant concentrations are reduced during phase I and phase II of the lockdown. Pollutants, especially NOx and PM2.5 concentrations, are drastically reduced compared to the previous years. NOx concentrations are reduced by ~ 20% in Bangalore, whereas ~ 50% in Delhi. PM2.5 concentrations are reduced by ~ 41% in Delhi and ~ 55% in Bangalore. Forecasting of pollutants will be helpful in providing the valuable information for the optimal air pollution control strategies. It has been observed that linear model gives better results compared to ARIMA and Exponential Smoothening models. By forecasting, the concentration of NO2 is 115.288 µg/m3, the ozone is 30.636 µg/m3, SO2 is 11.798 µg/m3, and CO is 2.758 mg/m3 over Delhi in 2021. All the pollutants during forecasting showed a rising trend except sulphur dioxide.

14.
Front Public Health ; 10: 842452, 2022.
Article in English | MEDLINE | ID: covidwho-1776050

ABSTRACT

The Beijing 2022 Winter Olympics will begin soon, which is mainly focused on winter sports. Athletes from different countries will arrive in Beijing one after another for training and competition. The health protection of athletes of winter sports is very important in training and competition. The occurrence of sports injury is characterized by multiple factors, uncertainty, and accidents. This paper mainly pays attention to the head injury with the highest severity. Athletes' high safety awareness is a part of reducing injury, but safety awareness cannot effectively reduce the occurrence of injury in competition, and timely treatment of injured athletes is particularly important. After athletes are injured, a telemedicine image acquisition system can be built, so that medical experts can identify athletes' injuries in time and provide the basis for further diagnosis and treatment. In order to improve the accuracy of medical image processing, a C-support vector machine (SVM) medical image segmentation method combining the Chan-Vese (CV) model and SVM is proposed in this paper. After segmentation, the edge and detail features of the image are more prominent, which meet the requirements of high precision for medical image segmentation. Meanwhile, a high-precision registration algorithm of brain functional time-series images based on machine learning (ML) is proposed, and the automatic optimization of high-precision registration of brain function time-series images is performed by ML algorithm. The experimental results show that the proposed algorithm has higher segmentation accuracy above 80% and less registration time below 40 ms, which can provide a reference for doctors to quickly identify the injury and shorten the time.


Subject(s)
Athletic Injuries , Diagnostic Imaging , Support Vector Machine , Athletes , Athletic Injuries/diagnostic imaging , Athletic Injuries/epidemiology , Humans , Seasons
15.
Aerosol and Air Quality Research ; 21(2), 2021.
Article in English | ProQuest Central | ID: covidwho-1771366

ABSTRACT

Bioaerosols are a major source of pollution in indoor environments, where people spend approximately 90% of their time, and the microorganisms adhered to PM2.5 adversely affect human health. However, most research has focused on the concentration of these aerosols and the factors that influence it rather than the correlation between microbial activity and air quality. Thus, this study used a modified technique of fluorescein diacetate (FDA) hydrolysis to evaluate the activity of microorganisms in the PM2.5 during three seasons (summer, autumn and winter) in Beijing. 0.155–5.388 ng m–3 and 0.091–5.740 ng m–3 of sodium fluorescein, a marker of microbial activity, were measured indoors and outdoors, respectively;thus, no significant difference in concentration between the two environments was detected, but the indoor activity was affected by outdoor conditions to an extent. The most active season was autumn, followed by winter and summer. Furthermore, the highest activity in summer and autumn was observed during conditions of excellent air quality, and in summer, the activity during conditions of good air quality also obviously exceeded that during conditions of slight pollution. Additionally, the microbial activity in a room varied according to the room’s ventilation (or lack thereof), suggesting a strong association between these parameters. In general, when the air quality was excellent, 20 minutes of ventilation achieved the optimal air exchange, but this duration should be reduced during polluted conditions. Our results provide new insights into evaluating the indoor air quality based on the microbial activity.

16.
Veterinary Practitioner ; 22(2):165-171, 2021.
Article in English | EMBASE | ID: covidwho-1766725

ABSTRACT

An attempt was made to analyze the impact of seasonal changes, disease scare situations and festivals on the prices of broilers across India. Prices of broilers were collected for the period from 2017 to 2021 from the various secondary sources like Karnataka Poultry Farmers and Breeders Association (KPFBA), TS AP Broiler Co-Ordination Committee (TSAPBCC), Poultry Bazaar etc. The seasonal index analysis for the last 10 years data revealed that the average broiler prices had grown significantly from 2011 to 2014, later prices gradually declined in 2015 due to the outbreak of Highly Pathogenic Avian Influenza (H5N1) in the month of February, 2015. Prices bounced back and increased from 2016 to 2019. Again there was decline of prices in the middle of January 2020 due to outbreak of Highly Pathogenic Avian Influenza (H5N1)) and Covid-19 pandemic. The prices of broilers have been recovering and gradually increasing since March, 2021 onwards. The consumption of chicken during winter season is high and this led to high prices in the market. Whereas the demand for chicken during hot climate months of March, April and May become slack in all the market centers of India resulting lowest price for chicken. Also, the increased demand on account of festivals viz., Christmas and New Year attributed to the rise in prices in the months of November and December.

17.
ARPN Journal of Engineering and Applied Sciences ; 16(23):2557-2566, 2021.
Article in English | Scopus | ID: covidwho-1749265

ABSTRACT

The methods of time series analysis are one of the most important statistical methods used in this field, as the study of a phenomenon over a period of time and identification of its pattern and behavior alongside with the factors affecting, predicting it as well, the future values of the phenomenon under study and contributing to the formulation of future policies and the development of plans could build a service system that addresses the negative aspects of the studied case and raise the level of services provided by the state. The study aims to determine the best model for predicting the levels of infection with the COVID 19 pandemic and the preferred model, among those models was the Grey Verhulst model according to the predictive measures MAPE and RMSE, where the lowest values of these measures were for the GVM (1,1) model which indicates a high predictive efficiency and the possibility of adopting its predictions to determine the future levels of the numbers of people infected with the COVID 19 pandemic. The study also indicated that the rest of the models were statistically acceptable, but they were not of high predictive efficiency compared to the GVM model (1,1) © 2006-2021 Asian Research Publishing Network (ARPN). All rights reserved

18.
Journal of Risk Research ; 24(3/4):267-293, 2021.
Article in English | CAB Abstracts | ID: covidwho-1747023

ABSTRACT

European lockdown strategies over the winter of 2020 have brought into sharp relief the need for effective strategies to reduce the rate of COVID-19 transmission and lower the rate of hospitalisations and deaths. Understanding exactly how European nations have arrived at this point, and the process by which they have done this, is key to learning constructive lessons for future pandemic risk management. Bringing together experience from across five European nations (the UK, France, Germany, Sweden and Switzerland), this paper outlines what has occurred between September 2020 and mid-January 2021. Our analysis draws out several themes important to understanding the different national risk management approaches adopted, namely: the extent to which lessons were learned or overlooked from the first wave of the pandemic;the relationship between science and policy;the speed and responsiveness of policy decisions;and differing levels of reliance on individual responsibility for safeguarding public health. Subsequently, we recommended that: there is more involvement of decision scientists and risk analysts in COVID-19 decision making, who have largely been absent thus far;the epidemiological science should be followed where possible, but when value judgments are made this should be clearly and transparently communicated;proactive measures avoiding policy delay should be followed to reduce the rate of infection and excess deaths;governments must avoid confusing or inconsistent regional implementation and communication of interventions;rebuilding public trust is key to promoting public compliance and support for COVID-19 health measures;overreliance on individual responsibility as the focus of non-pharmaceutical interventions should be avoided;public compliance with COVID-19 restrictions requires pre-tested simple messages;open and consistent engagement with local leaders and officials should become a mainstay of government efforts to help ensure consistent adoption of nationwide COVID-19 policy measures.

19.
Open Forum Infectious Diseases ; 8(SUPPL 1):S31-S32, 2021.
Article in English | EMBASE | ID: covidwho-1746797

ABSTRACT

Background. The threat of surging COVID-19 cases prompted many hospitals in the United States to preemptively suspend elective procedures throughout the pandemic. Utilizing samples from a large hospital in Los Angeles, we sought to determine if temporal trends in SARS-CoV-2 Cycle threshold (Ct) values (proxy for viral RNA loads) were predictive for the number of future COVID-19 cases. Methods. Nasopharyngeal specimens on symptomatic patients and asymptomatic admissions were tested using the Xpert Xpress SARS-CoV-2 and SARS-CoV-2/ Flu/RSV assays (Cepheid). Ct values for all SARS-CoV-2 detections between October 2020 to March 2021 were compiled for analysis. Results. A total of 2,114 SARS-CoV-2-positive samples were included. The number of tests performed per week increased dramatically in December peaking the first week of January before returning to pre-surge numbers by Mid-February. Ct values fell during this same period with values in December and January (25.6±7.8 and 27±7.9, respectively) significantly lower than those of the other months (30±9.3 to 37.7±6.3). Average weekly Ct values for all patients were significantly, negatively correlated with the number of tests run the following week (R= -0.71, P< 0.001) and two weeks later (R= -0.75, P< 0.0001). Ct values for patients who were asymptomatic at the time of testing most strongly correlated with total number of tests performed one month later (R= -0.86, P< 0.0001). Average weekly Ct values and number of test run As cases (light grey) increased during December and January, there was a significant decrease in Ct values (dark grey) during that same time period. Average Ct values are a leading indicator of cases Average weekly Ct values for all patients (light grey) were significantly, negatively correlated with the number of tests run the following week (R= -0.71, P<0.001) and two weeks later (R= -0.75, P<0.0001). Ct values for patients who were asymptomatic at the time of testing (dark grey) most strongly correlated with total number of tests performed one month later (R= -0.86, P<0.0001). Conclusion. Lower Ct values, representing higher levels of viral RNA, have been associated with risk of intubation and infectivity. During the winter surge, we observed significantly lower Ct values suggesting that the increased transmission and morbidity of COVID-19 was temporarily associated with higher viral loads. Interestingly, Ct values for asymptomatic patients were most strongly associated with number of cases observed 1 months in the future, suggesting that asymptomatic viral load may be a leading indicator for forthcoming outbreaks. Given this association, Ct values may be a useful tool for predicting regional outbreaks of COVID-19 and more judicious cessation of elective procedures.

20.
Open Forum Infectious Diseases ; 8(SUPPL 1):S32, 2021.
Article in English | EMBASE | ID: covidwho-1746796

ABSTRACT

Background. OC is the 6th largest U.S. county with 70 NHs. Universal decolonization (chlorhexidine for routine bathing, and twice daily nasal iodophor Mon-Fri every other week) was adopted in 24 NHs prior to the COVID-19 pandemic, and 12 NHs (11 of those adopting decolonization) participated in a COVID prevention training program with a rolling launch from July-Sept 2020. We evaluated the impact of these initiatives on staff and resident COVID cases. Methods. We conducted a quasi-experimental study of the impact of decolonization and COVID prevention training on staff and resident COVID cases during the CA winter surge (11/16/20-1/31/21), when compared to non-participating NHs. Decolonization NHs received weekly visits for encouraging adherence during the pandemic, and NHs in the COVID training program received 3 in-person training sessions for all work shifts plus weekly feedback about adherence to hand hygiene, masking, and breakroom safety using video monitoring. We calculated incident 1) staff COVID cases, 2) resident COVID cases, and 3) resident COVID deaths adjusting for NH average daily census. We assessed impact of initiatives on these outcomes using linear mixed effects models testing the interaction between any training participation and calendar date when clustering by NH. Because of the overlap of the two initiatives, we evaluated 'any training' vs 'no training.' Results. 63 NHs had available data. 24 adopted universal decolonization, 12 received COVID training (11 of which participated in decolonization), and 38 were not enrolled in either. During the winter surge, the 63 NHs experienced 1867 staff COVID cases, 2186 resident COVID cases, and 251 resident deaths due to COVID, corresponding to 29.6, 34.7, and 4.0 events per NH, respectively. In NHs participating in either initiative, staff COVID cases were reduced by 31% (OR=0.69 (0.52, 0.92), P=0.01), resident COVID cases were reduced by 43% (OR=0.57 (0.39, 0.82), P=0.003), and resident deaths were reduced (non-significantly) by 26% (OR=0.74 (0.46, 1.21), P=0.23). The grey box represents the California COVID-19 winter surge (11/16/20-1/31/21). Incident and cumulative COVID-19 cases and deaths for each nursing home were divided by the nursing home's average daily census and multiplied by 100, representing events per 100 beds, which were aggregated across groups. Conclusion. NHs are vulnerable to COVID-19 outbreaks. A universal decolonization and COVID prevention training initiative in OC, CA significantly reduced staff and resident COVID cases in this high-risk care setting.

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