Teamwork Management and Benefit of Telemedicine in COVID-19 Outbreak Control on an Offshore Vessel in the Gulf of Thailand, Songkhla Province, Thailand: A Case Report.

In May 2021, there was a COVID-19 outbreak on board a construction support ship traveling from India to Thailand. Controlling the outbreak on this offshore vessel from 11 May to 2 June 2021 was applied. This case report describes the teamwork management of COVID-19 control on the vessel in the Gulf of Thailand. We summarized the COVID-19 outbreak control process on board, including active COVID-19-infected cases (CoIC) and close contacts (CoCC) identification, isolation, quarantine, treatment, and clinical monitoring using telemedicine to report their health measurements twice daily, including emergency conditions if they occurred. Active COVID-19 cases were identified by two rounds of reverse transcription polymerase chain reaction (RT-PCR) tests in all crew members, in which 7 of 29 (24.1%) showed positive results. Both the CoIC and CoCC were strictly and absolutely isolated and quarantined on the vessel. No serious medical conditions were reported during the monitoring. The third-round RT-PCR tests were conducted, and all tested negative one week later. Teamwork management in proactive COVID-19 case identification, isolation, comprehensive treatment, and close monitoring of health conditions using telemedicine devices is beneficial for controlling the COVID-19 outbreak on board.

An improved method of global dynamics: Analyzing the COVID-19 model with time delays and exposed infection.

Considering the transmission characteristics of the coronavirus disease 2019 (COVID-19), there are certain time delays in the transition from susceptible individuals to exposed individuals after contact with exposed, symptomatically infected, and asymptomatically infected individuals. A COVID-19 model with time delays and exposed infection is developed and then the global dynamics of this model is investigated by an improved method; moreover, the numerical simulations are carried out. It is shown that the COVID-19-free equilibrium T0 is globally asymptotically stable (GAS) if and only if the control reproduction number Rc≤1, while T0 is unstable and the COVID-19 equilibrium T∗ is GAS if and only if Rc>1. The numerical results reveal that strengthening quarantine measures is helpful to control the COVID-19 epidemic in India. Furthermore, when Rc<1, the numbers of symptomatically infected, asymptomatically infected, and quarantined individuals eventually tend to the zero equilibrium state, and with the increase in the time delay, the three kinds of variables change faster and their peaks become larger; when Rc>1, the three kinds of variables eventually tend to the positive equilibrium state, which are oscillatory and the amplitudes of the oscillation enlarge as the value of time delay increases. The numerical results show that when Rc<1, the smaller the value of time delay, the smaller the final epidemic size. In short, the longer it takes time for susceptible individuals to transform exposed individuals, the harder COVID-19 will be controlled.

A Novel Social Distancing Approach for Limiting the Number of Vehicles in Smart Buildings Using LiFi Hybrid-Network.

The coronavirus (COVID-19) has arisen as one of the most severe problems due to its ongoing mutations as well as the absence of a suitable cure for this virus. The virus primarily spreads and replicates itself throughout huge groups of individuals through daily touch, which regretfully can happen in several unanticipated way. As a result, the sole viable attempts to constrain the spread of this new virus are to preserve social distance, perform contact tracing, utilize suitable safety gear, and enforce quarantine measures. In order to control the virus's proliferation, scientists and officials are considering using several social distancing models to detect possible diseased individuals as well as extremely risky areas to sustain separation and lockdown procedures. However, models and systems in the existing studies heavily depend on the human factor only and reveal serious privacy vulnerabilities. In addition, no social distancing model/technique was found for monitoring, tracking, and scheduling vehicles for smart buildings as a social distancing approach so far. In this study, a new system design that performs real-time monitoring, tracking, and scheduling of vehicles for smart buildings is proposed for the first time named the social distancing approach for limiting the number of vehicles (SDA-LNV). The proposed model employs LiFi technology as a wireless transmission medium for the first time in the social distance (SD) approach. The proposed work is considered as Vehicle-to-infrastructure (V2I) communication. It might aid authorities in counting the volume of likely affected people. In addition, the proposed system design is expected to help reduce the infection rate inside buildings in areas where traditional social distancing techniques are not used or applicable.

'Put in a room and left': a qualitative study exploring the lived experiences of COVID-19 isolation and quarantine among rehabilitation inpatients.

BACKGROUND: The SARS-CoV-2 (COVID-19) pandemic has resulted in significant changes to health care delivery and the patient's experience in hospital. Changes for those who contracted COVID-19 or were close contacts included isolation and quarantine, visitor restrictions and changes to usual models of care to reduce viral transmission. Traditional models of inpatient rehabilitation utilise communal spaces (e.g. shared gyms and dining rooms) and involve a multidisciplinary team interacting with the patient daily. OBJECTIVES: To report the experience of COVID-19 related isolation and quarantine among rehabilitation inpatients and their family members who experienced a nosocomial outbreak and to make recommendations for rehabilitation units. METHODS: A qualitative phenomenological methodology using semi-structured telephone interviews. RESULTS: 19 semi-structured interviews were conducted comprising of 13 general rehabilitation inpatients and 6 family members. Five themes were established: (1) the impact of social and physical isolation; (2) boredom and limited access to therapy; (3) the impact of technology; (4) inadequate information sharing and (5) positive experiences and things done well. Several novel insights were identified including: the desire for increased social interaction from staff to compensate for a lack of visitors; the impact of physical and cognitive deficits on a patient's ability to reach basic items around their room or call for help, and the unique impact of isolation and quarantine on individuals who have a history of trauma, discrimination or mental illness. CONCLUSIONS: This study establishes key areas that should be considered by rehabilitation units globally to adjust traditional models which are not suitable in this pandemic. Strategies to mitigate the impact of isolation include providing training to increase use of technologies such as tablet devices, increased staff social engagement to reduce isolation and tailoring the environment to suit specific patient groups.KEY MESSAGESCOVID-19 related isolation and quarantine has a significant and unique impact on patients with cognitive and physical impairments such as those in inpatient rehabilitation. Patients who are required to isolate in inpatient settings expressed a desire for compensatory increased social interaction from staff and required specific assistance with basic daily tasks while isolated. The study makes key recommendations for other rehabilitation units to integrate into their approach for managing patients required to isolate or quarantine.

Evaluating the COVID-19 Containment Protocol in Greek Universities for the Academic Year 2021-2022.

The COVID-19 pandemic severely disrupted European universities' educational process. With the vaccination rollout, in-class instruction broadly resumed beginning in September 2021. In order to mitigate the risks of SARS-CoV-2 transmission, European universities apply COVID-19 containment protocols. The aim of this paper is to evaluate the COVID-19 containment protocol that Greek universities implemented in order to fully reopen in the fall of 2021 and for the entire academic year 2021-2022. A case study was conducted at the Department of Industrial Management and Technology, University of Piraeus (Athens' port), Greece. Data were collected from November 2021 to July 2022 and a quantitative statistical analysis (descriptive and inferential) was performed. A total of 330 unique (and 43 reinfections) COVID-19 cases were confirmed, including 241 undergraduate students, 73 postgraduate, and 2 doctoral students, 10 faculty, and 4 administrative personnel. Contact tracing reported four confirmed and eight potential cases of in-classroom transmission. The person in charge of implementing the COVID-19 containment protocol in the department ordered more than 6000 rapid tests during this period. The Department of Industrial Management and Technology at the University of Piraeus used a rigorously monitored and coordinated strategy of vaccine promotion, screening/testing, contact tracing, isolation, and quarantine in order to control COVID-19 transmission. The results show, on one hand, that the protocol's implementation is effective and leads to in-classroom transmission minimization and, on the other hand, verify the hypothesis that the department's confirmed COVID-19 cases are less (with a mean percentage difference of 50%) than the community's respective 18-39 age group.

A scoping review of the literature on the impact of the COVID-19 quarantine on the psychological wellbeing of medical students.

BACKGROUND: The goal of this study was to identify the nature and extent of the available published research on the impact of social isolation, on the psychological wellbeing of medical students, who had to quarantine due to the COVID-19 pandemic. METHODS: Design. Scoping review. SEARCH STRATEGY: The PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews), guideline, was used to structure this study. A search strategy was carried out across six bibliographic databases. PubMed, Embase, ERIC, Scopus, Cochrane Database of Systematic Reviews and Web of Science. The following search terms were used, "medical student*" AND "impact" AND "quarantine" AND "COVID-19". Searches were initially confined to articles published (excluding conference abstracts) between 1 January 2019- 21 August 2021 but updated in September 2022 with the original search terms expanded to include "isolation" or "lockdown" as well as "quarantine" and the period of search extended to 21 August 2022. A search of secondary references was conducted. Data from the selected studies were extracted, and the following variables recorded; first author and year of publication, country of study, study design, sample size, participants, mode of analysing impact of quarantine from COVID-19 on mental health and results of the studies. RESULTS: A total of 223 articles were identified in the original search in 2021 and 387 articles, in the updated search in 2022. Following the exclusion of duplicates and application of the agreed inclusion and exclusion criteria, 31 full-text articles were identified for the final review, most of which were cross sectional studies. Sample sizes ranged from 13 to 4193 students and most studies used a variety of self-administered questionnaires to measure psychological wellbeing. Overall, 26 of the 31 articles showed that quarantine had a negative impact on the psychological well-being of medical students. However, two studies showed no impact, and three studies showed an improvement. CONCLUSION: The evidence is growing. Quarantine because of the COVID-19 pandemic may have had a negative impact on the psychological wellbeing of medical students, but this is not certain. There is therefore a need for more studies to further evaluate this research question.

De-escalation strategies for non-pharmaceutical interventions following infectious disease outbreaks: a rapid review and a proposed dynamic de-escalation framework.

BACKGROUND: The severity of COVID-19, as well as the speed and scale of its spread, has posed a global challenge. Countries around the world have implemented stringent non-pharmaceutical interventions (NPI) to control transmission and prevent health systems from being overwhelmed. These NPI have had profound negative social and economic impacts. With the timeline to worldwide vaccine roll-out being uncertain, governments need to consider to what extent they need to implement and how to de-escalate these NPI. This rapid review collates de-escalation criteria reported in the literature to provide a guide to criteria that could be used as part of de-escalation strategies globally. METHODS: We reviewed literature published since 2000 relating to pandemics and infectious disease outbreaks. The searches included Embase.com (includes Embase and Medline), LitCovid, grey literature searching, reference harvesting and citation tracking. Over 1,700 documents were reviewed, with 39 documents reporting de-escalation criteria included in the final analysis. Concepts retrieved through a thematic analysis of the included documents were interlinked to build a conceptual dynamic de-escalation framework. RESULTS: We identified 52 de-escalation criteria, the most common of which were clustered under surveillance (cited by 43 documents, 10 criteria e.g. ability to actively monitor confirmed cases and contact tracing), health system capacity (cited by 30 documents, 11 criteria, e.g. ability to treat all patients within normal capacity) and epidemiology (cited by 28 documents, 7 criteria, e.g. number or changes in case numbers). De-escalation is a gradual and bi-directional process, and resurgence of infections or emergence of variants of concerns can lead to partial or full re-escalation(s) of response and control measures in place. Hence, it is crucial to rely on a robust public health surveillance system. CONCLUSIONS: This rapid review focusing on de-escalation within the context of COVID-19 provides a conceptual framework and a guide to criteria that countries can use to formulate de-escalation plans.

Environmental surface testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during prolonged isolation of an asymptomatic carrier.

Environmental surface testing was performed to search for evidence of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) environmental contamination by an asymptomatic SARS-CoV-2 carrier with persistently high viral loads under isolation. No evidence of environmental contamination was found. Further studies are needed to measure environmental contamination by SARS-CoV-2 carriers and to determine reasonable isolation periods.

A Survey of COVID-19 Preparedness Among Hospitals in Idaho.

BACKGROUND: SARS-CoV-2 has been implicated in the largest recorded coronavirus outbreak to date. Initially, most COVID-19 cases were in China, but the virus has spread to more than 184 countries worldwide, and the United States currently has more cases than any other country. OBJECTIVE: With person-to-person spread expanding in the United States, we describe hospital preparedness for managing suspected and confirmed COVID-19 patients. DESIGN: Cross-sectional survey focused on various elements of respiratory disease preparedness. SETTING: Critical access hospitals (CAHs) and acute-care hospitals (ACHs) in Idaho. METHODS: The electronic survey was sent to infection preventionists (IPs) and nurse administrators in 44 hospitals in Idaho. RESULTS: Overall, 32 (73%) hospitals responded to the survey. Participating facilities reported their preparedness with respect to existing, formalized structures for managing infectious disease incidents-specifically COVID-19-as well as availability of resources, such as isolation rooms and personal protective equipment, for safely managing suspected and confirmed COVID-19 cases. CONCLUSIONS: Hospitals covered by the survey had varying levels of preparedness for managing COVID-19 cases, with differences across the various categories of interest in this study. Although the study reveals strengths, including in application of emergency management and infection control frameworks, it also suggests that other areas, such as consistent implementation of federal guidelines and requirements for infection prevention, are potential areas for strengthening preparedness for SARS-CoV-2 and other respiratory pathogens with pandemic potential.

The association between peritraumatic distress, perceived stress, depression in pregnancy, and NR3C1 DNA methylation among Chinese pregnant women who experienced COVID-19 lockdown.

Prenatal stress can affect pregnant women in an epigenetic way during the critical period of conception of their offspring. The study aims to investigate the relationship between peritraumatic distress, prenatal perceived stress, depression, and glucocorticoid receptor (NR3C1) DNA methylation among pregnant women who experienced COVID-19 lockdown in China. Study data were collected from 30 pregnant women in Wuhan and Huanggang, China. The Peritraumatic Distress Inventory was used to measure peritraumatic distress, the Edinburgh Postnatal Depression Scale was used to measure depressive symptoms, and the Perceived Stress Scale was used to measure perceived stress. DNA methylation in the exon 1F promoter region of NR3C1 gene from the venous blood mononuclear cell genome was characterized by bisulfite sequencing. Correlation and linear regression were used for data analysis. The mean level of peritraumatic distress, perceived stress, and depression was 6.30 (SD = 5.09), 6.50 (SD = 5.41), and 6.60 (SD = 4.85), respectively, with 23.33% of pregnant women being depressed. The mean NR3C1 methylation was 0.65 (SD = 0.22). Prenatal depression was positively correlated with the degree of methylation in venous blood from the mother (r = 0.59, p = 0.001), and depression predicted methylation of NR3C1 gene at the CpG 8 site (ß = 0.05, p = 0.03). No association was found between peritraumatic distress as well as perceived stress and methylation of NR3C1. NR3C1 gene was susceptible to epigenetic modification of DNA methylation in the context of prenatal stress, and maternal depression was associated with increased NR3C1 methylation among women who experienced COVID-19 lockdown.

Non-adherence to COVID-19 lockdown: who are they? A cross-sectional study in Portugal.

OBJECTIVES: The SARS-CoV-2 virus has spread worldwide, leading governments to implement mitigation measures. Understanding the reluctance to adhere to non-pharmacological interventions might help promote adherence to these measures. This study aimed to identify factors associated with non-adherence to the first lockdown in Portugal. STUDY DESIGN: Cross-sectional study. METHODS: This study used data from a Portuguese community-based survey entitled 'COVID-19 Barometer: Social Opinion'. Data were collected on risk perception, health status and social experiences using a snowball sampling technique. The event of interest corresponded to participants who reported not staying home during the lockdown period, serving as a proxy for non-adherence to lockdown. Logistic regression was used to identify factors associated with non-adherence to the first lockdown. RESULTS: Responses from 133,601 individual questionnaires that were completed during the first week of the first lockdown in 2020 were analysed. A minority of participants (5.6%) reported non-adherence to lockdown (i.e. leaving home for reasons other than essential situations). Working in the workplace was the factor with the strongest association of non-adherence to the lockdown. Several other factors were also associated with non-adherence to the first lockdown; namely, being a man, being a student, having a low level of education, having a low income, living alone or with a high-infection-risk professional (e.g. doctor, nurse, pharmaceutical, health technician, firefighter, police officer, military, essential services worker), perceiving the risk of getting COVID-19 to be high, not having social support in case of infection, feeling agitated, sad or anxious every day, and considering the preventive measures to be unimportant or inadequate. CONCLUSIONS: Non-adherence to lockdown was associated with socio-economic, trust and perception factors. Future research should investigate the mechanisms underlying these associations to help identify the population groups who are most at risk of non-adherence.

Digital contact tracing and network theory to stop the spread of COVID-19 using big-data on human mobility geolocalization.

The spread of COVID-19 caused by the SARS-CoV-2 virus has become a worldwide problem with devastating consequences. Here, we implement a comprehensive contact tracing and network analysis to find an optimized quarantine protocol to dismantle the chain of transmission of coronavirus with minimal disruptions to society. We track billions of anonymized GPS human mobility datapoints to monitor the evolution of the contact network of disease transmission before and after mass quarantines. As a consequence of the lockdowns, people's mobility decreases by 53%, which results in a drastic disintegration of the transmission network by 90%. However, this disintegration did not halt the spreading of the disease. Our analysis indicates that superspreading k-core structures persist in the transmission network to prolong the pandemic. Once the k-cores are identified, an optimized strategy to break the chain of transmission is to quarantine a minimal number of 'weak links' with high betweenness centrality connecting the large k-cores.

A Remote Questionnaire-Based Study to Compare Alcohol Use in 1030 Final-Year High School Students in Split-Dalmatia County, Croatia Before and During the National Lockdown Due to the COVID-19 Pandemic.

BACKGROUND The COVID-19 pandemic affected drinking behaviors among adolescents. This remote questionnaire-based study aimed to compare alcohol use in 1030 final-year high school students in Split-Dalmatia County (SDC), Croatia before and during the national lockdown due to the COVID-19 pandemic. MATERIAL AND METHODS An online self-reported questionnaire survey was conducted among 1030 final-year high school students (57.96% female; mean age 17.71 years, SD=0.66) in SDC. The data were collected from June 6 to July 20, 2020 and from October 12 to December 28, 2020. Differences in drinking habits between groups were detected with the chi-squared (χ²) test and before and during the COVID-19 lockdown using the Z test. RESULTS Before the lockdown, 84.66% of students were consuming alcohol, most frequently with friends (78.64%) and "to feel better" (29.51%), while during the lockdown, 44.76% of them were drinking, most frequently with friends (34.37%) and due to boredom (17.48%). Drinking alone (P=0.005) and with family members (P=0.003) significantly increased during the lockdown. No difference in drinking between girls and boys was found before the lockdown, but boys were drinking more during the lockdown (P<0.001). There was no difference in drinking prevalence in different schools before the lockdown, but during the lockdown, more students from vocational schools were drinking (P<0.001) and with higher frequency (P=0.002). Among 53.98% of students during the lockdown, a reduction in frequency of drinking was found (P<0.001), most significantly on islands (P=0.05). CONCLUSIONS During the lockdown due to the COVID-19 pandemic, alcohol consumption by final-year high school students in SDC significantly decreased, particularly in girls and in gymnasium/private school students.

Is large-scale rapid CoV-2 testing a substitute for lockdowns?

BACKGROUND: Various forms of contact restrictions have been adopted in response to the Covid-19 pandemic. Around February 2021, rapid testing appeared as a new policy instrument. Some claim it may serve as a substitute for contact restrictions. We study the strength of this argument by evaluating the effects of a unique policy experiment: In March and April 2021, the city of Tübingen set up a testing scheme while relaxing contact restrictions. METHODS: We compare case rates in Tübingen county to an appropriately identified control unit. We employ the synthetic control method. We base interpretations of our findings on an extended SEIR model. FINDINGS: The experiment led to an increase in the reported case rate. This increase is robust across alternative statistical specifications. This is also due to more testing leading initially to more reported cases. An epidemiological model that corrects for 'more cases due to more testing' and 'reduced testing and reporting during the Easter holiday' confirms that the overall effect of the experiment led to more infections. INTERPRETATION: The number of rapid tests were not sufficiently high in this experiment to compensate for more contacts and thereby infections caused by relaxing contact restrictions.