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1.
MMWR Morb Mortal Wkly Rep ; 70(4): 118-122, 2021 Jan 29.
Article in English | MEDLINE | ID: covidwho-1112897

ABSTRACT

Institutions of higher education adopted different approaches for the fall semester 2020 in response to the coronavirus disease 2019 (COVID-19) pandemic. Approximately 45% of colleges and universities implemented online instruction, more than one fourth (27%) provided in-person instruction, and 21% used a hybrid model (1). Although CDC has published COVID-19 guidance for institutions of higher education (2-4), little has been published regarding the response to COVID-19 outbreaks on college and university campuses (5). In August 2020, an Indiana university with approximately 12,000 students (including 8,000 undergraduate students, 85% of whom lived on campus) implemented various public health measures to reduce transmission of SARS-CoV-2, the virus that causes COVID-19. Despite these measures, the university experienced an outbreak involving 371 cases during the first few weeks of the fall semester. The majority of cases occurred among undergraduate students living off campus, and several large off-campus gatherings were identified as common sources of exposure. Rather than sending students home, the university switched from in-person to online instruction for undergraduate students and instituted a series of campus restrictions for 2 weeks, during which testing, contact tracing, and isolation and quarantine programs were substantially enhanced, along with educational efforts highlighting the need for strict adherence to the mitigation measures. After 2 weeks, the university implemented a phased return to in-person instruction (with 85% of classes offered in person) and resumption of student life activities. This report describes the outbreak and the data-driven, targeted interventions and rapid escalation of testing, tracing, and isolation measures that enabled the medium-sized university to resume in-person instruction and campus activities. These strategies might prove useful to other colleges and universities responding to campus outbreaks.


Subject(s)
/prevention & control , Disease Outbreaks/prevention & control , Universities/organization & administration , /epidemiology , Contact Tracing , Humans , Indiana/epidemiology , Patient Isolation , Quarantine
2.
MMWR Morb Mortal Wkly Rep ; 70(4): 109-113, 2021 Jan 29.
Article in English | MEDLINE | ID: covidwho-1112895

ABSTRACT

On March 19, 2020, the governor of California issued a statewide stay-at-home order to contain the spread of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19).* The order reduced accessibility to and patient attendance at outpatient medical visits,† including preventive services such as cervical cancer screening. In-person clinic visits increased when California reopened essential businesses on June 12, 2020.§ Electronic medical records of approximately 1.5 million women served by Kaiser Permanente Southern California (KPSC), a large integrated health care system, were examined to assess cervical cancer screening rates before, during, and after the stay-at-home order. KPSC policy is to screen women aged 21-29 years every 3 years with cervical cytology alone (Papanicolaou [Pap] test); those aged 30-65 years were screened every 5 years with human papillomavirus (HPV) testing and cytology (cotesting) through July 15, 2020, and after July 15, 2020, with HPV testing alone, consistent with the latest recommendations from U.S. Preventive Services Task Force.¶ Compared with the 2019 baseline, cervical cancer screening rates decreased substantially during the stay-at-home order. Among women aged 21-29 years, cervical cytology screening rates per 100 person-months declined 78%. Among women aged 30-65 years, HPV test screening rates per 100 person-months decreased 82%. After the stay-at-home order was lifted, screening rates returned to near baseline, which might have been aided by aspects of KPSC's integrated, organized screening program (e.g., reminder systems and tracking persons lost to follow-up). As the pandemic continues, groups at higher risk for developing cervical cancers and precancers should be evaluated first. Ensuring that women receive preventive services, including cancer screening and appropriate follow-up in a safe and timely manner, remains important.


Subject(s)
/prevention & control , Delivery of Health Care, Integrated , Early Detection of Cancer/statistics & numerical data , Quarantine/legislation & jurisprudence , Uterine Cervical Neoplasms/prevention & control , Adult , Aged , California/epidemiology , Female , Humans , Middle Aged , Young Adult
3.
Ann Intern Med ; 174(2): JC14, 2021 02.
Article in English | MEDLINE | ID: covidwho-1110692

ABSTRACT

SOURCE CITATION: Lynch JB, Davitkov P, Anderson DJ, et al. Infectious Diseases Society of America guidelines on infection prevention for health care personnel caring for patients with suspected or known COVID-19. Clin Infect Dis. 2020. [Epub ahead of print.] 32716496.


Subject(s)
/prevention & control , Infection Control/standards , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Occupational Health , Personal Protective Equipment , Practice Guidelines as Topic , Humans , Societies, Medical , United States
5.
Intern Med ; 60(3): 457-461, 2021 Feb 01.
Article in English | MEDLINE | ID: covidwho-1110169

ABSTRACT

We herein report a case of severe coronavirus disease 2019 (COVID-19) in which high-dose intravenous immunoglobulin (IVIg) treatment achieved significant clinical improvement of deterioration of pulmonary inflammation after temporary clinical improvement. In the present case, clinical and radiological deterioration occurred despite a decrease in viral load, suggesting that deterioration was caused by reactivation of proinflammatory factors, such as tumor necrosis factor-α and interleukin-6, rather than direct viral effects. IVIg treatment may provide not only immunosuppressive effects but also inhibition of proinflammatory cytokines, indicating that treatment including IVIg may be effective by inhibiting cytokine storm in severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection.


Subject(s)
/therapy , Immunoglobulins, Intravenous/administration & dosage , Respiratory Insufficiency/therapy , /isolation & purification , /complications , Cytokine Release Syndrome/prevention & control , Cytokines/drug effects , Humans , Ivermectin/therapeutic use , Lung/diagnostic imaging , Lung/pathology , Male , Middle Aged , Radiography, Thoracic , Viral Load
7.
Holist Nurs Pract ; 35(2): 98-107, 2021.
Article in English | MEDLINE | ID: covidwho-1101897

ABSTRACT

This study was conducted to analyze health care personnel's attitudes toward traditional and complementary medicine (TCM) and life satisfaction due to coronavirus disease-2019 (COVID-19) pandemic. This cross-sectional descriptive study was conducted between April 2 and 9, 2020. The Questionnaire form was sent to health care personnel online. A total of 560 individuals who answered the questionnaires were included in the study. The data were collected by using the Personal Information Form, Holistic Complementary and Alternative Medicine Questionnaire (HCAMQ), and Life Satisfaction Scale (LSS). Average age of the participants was 30.88 ± 7.68 years, 82.5% were male, and 65.5% were working as nurses. It was found that 45.5% of the participants used TCM methods for COVID-19 during the last month; 48.7% of the health care personnel stated that they used TCM methods to strengthen their immune system. The HCAMQ total average score was 27.96 ± 5.49; the holistic health subdimension total average score was 9.59 ± 3.04; the complementary and alternative medicine subdimension total average score was 18.37 ± 3.58; and the LSS total average score was 20.78 ± 6.32. A positive weak statistically significant association was found between the HCAMQ and complementary and alternative medicine subdimension and the LSS (P < .05). Participants had moderately positive attitudes toward TCM and life satisfaction. As the participants' positive attitudes toward TCM increased, their life satisfaction was also found to increase.


Subject(s)
Attitude of Health Personnel , Complementary Therapies/psychology , Health Personnel/psychology , Personal Satisfaction , Adult , /psychology , Complementary Therapies/standards , Cross-Sectional Studies , Female , Health Personnel/statistics & numerical data , Humans , Male , Middle Aged , Pandemics/prevention & control
8.
J Infect Dis ; 223(2): 189-191, 2021 02 03.
Article in English | MEDLINE | ID: covidwho-1101844

ABSTRACT

Developers of severe acute respiratory syndrome coronavirus 2 vaccines should consider some of the lessons from a "new" vaccine introduced in 1921, namely bacille Calmette-Guérin.


Subject(s)
BCG Vaccine/immunology , /prevention & control , /immunology , Animals , BCG Vaccine/administration & dosage , /virology , Humans , Pandemics/prevention & control , Randomized Controlled Trials as Topic , Tuberculosis/immunology , Tuberculosis/prevention & control
10.
BMJ Open ; 11(2): e043837, 2021 02 22.
Article in English | MEDLINE | ID: covidwho-1096994

ABSTRACT

OBJECTIVES: Healthcare personnel (HCP) are at an increased risk of acquiring COVID-19 infection especially in resource-restricted healthcare settings, and return to homes unfit for self-isolation, making them apprehensive about COVID-19 duty and transmission risk to their families. We aimed at implementing a novel multidimensional HCP-centric evidence-based, dynamic policy with the objectives to reduce risk of HCP infection, ensure welfare and safety of the HCP and to improve willingness to accept and return to duty. SETTING: Our tertiary care university hospital, with 12 600 HCP, was divided into high-risk, medium-risk and low-risk zones. In the high-risk and medium-risk zones, we organised training, logistic support, postduty HCP welfare and collected feedback, and sent them home after they tested negative for COVID-19. We supervised use of appropriate personal protective equipment (PPE) and kept communication paperless. PARTICIPANTS: We recruited willing low-risk HCP, aged <50 years, with no comorbidities to work in COVID-19 zones. Social distancing, hand hygiene and universal masking were advocated in the low-risk zone. RESULTS: Between 31 March and 20 July 2020, we clinically screened 5553 outpatients, of whom 3012 (54.2%) were COVID-19 suspects managed in the medium-risk zone. Among them, 346 (11.4%) tested COVID-19 positive (57.2% male) and were managed in the high-risk zone with 19 (5.4%) deaths. One (0.08%) of the 1224 HCP in high-risk zone, 6 (0.62%) of 960 HCP in medium-risk zone and 23 (0.18%) of the 12 600 HCP in the low-risk zone tested positive at the end of shift. All the 30 COVID-19-positive HCP have since recovered. This HCP-centric policy resulted in low transmission rates (<1%), ensured satisfaction with training (92%), PPE (90.8%), medical and psychosocial support (79%) and improved acceptance of COVID-19 duty with 54.7% volunteering for re-deployment. CONCLUSION: A multidimensional HCP-centric policy was effective in ensuring safety, satisfaction and welfare of HCP in a resource-poor setting and resulted in a willing workforce to fight the pandemic.


Subject(s)
Infectious Disease Transmission, Patient-to-Professional , Medical Staff, Hospital , Occupational Diseases , Adult , /prevention & control , /transmission , Developing Countries , Female , Hospitals, University/organization & administration , Humans , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Male , Medical Staff, Hospital/statistics & numerical data , Models, Organizational , Occupational Diseases/epidemiology , Occupational Diseases/prevention & control , Organizational Policy , Personal Protective Equipment , Prospective Studies , Risk Assessment , Tertiary Care Centers/organization & administration
11.
Lancet ; 397(10270): 186, 2021 01 16.
Article in English | MEDLINE | ID: covidwho-1093256
13.
Nat Commun ; 12(1): 1147, 2021 02 19.
Article in English | MEDLINE | ID: covidwho-1091490

ABSTRACT

Within a short period of time, COVID-19 grew into a world-wide pandemic. Transmission by pre-symptomatic and asymptomatic viral carriers rendered intervention and containment of the disease extremely challenging. Based on reported infection case studies, we construct an epidemiological model that focuses on transmission around the symptom onset. The model is calibrated against incubation period and pairwise transmission statistics during the initial outbreaks of the pandemic outside Wuhan with minimal non-pharmaceutical interventions. Mathematical treatment of the model yields explicit expressions for the size of latent and pre-symptomatic subpopulations during the exponential growth phase, with the local epidemic growth rate as input. We then explore reduction of the basic reproduction number R0 through specific transmission control measures such as contact tracing, testing, social distancing, wearing masks and sheltering in place. When these measures are implemented in combination, their effects on R0 multiply. We also compare our model behaviour to the first wave of the COVID-19 spreading in various affected regions and highlight generic and less generic features of the pandemic development.


Subject(s)
/prevention & control , Communicable Disease Control/methods , Models, Theoretical , Pandemics/prevention & control , Basic Reproduction Number , Contact Tracing , Humans , Likelihood Functions , Masks , Quarantine
14.
Genet Test Mol Biomarkers ; 25(2): 85-101, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-1091280

ABSTRACT

Coronavirus disease 2019 (COVID-19) displays a broad spectrum of clinical presentations ranging from lack of symptoms to severe multiorgan system complications and death. Various laboratory assays have been employed in the diagnosis of COVID-19, including: nucleic acid-based tests; antigen tests; and serum testing for anti-severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) antibodies. The disease can also be diagnosed based on suggestive clinical features and radiological findings. Until now, remdesivir is the only medication approved for the treatment of COVID-19 by the U.S. Food and Drug Administration (FDA); however, it is anticipated that several anti-SARS-CoV-2 monoclonal antibodies will gain soon approval. Other methods of treatment include supportive care directed toward treating the symptoms. Nevertheless, many studies have recently emerged, showing controversial preliminary results with the off-label medication hydroxychloroquine. Given that all results are still preliminary, including those seen by remdesivir, additional evidence and research are required to identify effective medications that are broadly effective and well tolerated. Importantly, two RNA-based vaccines have recently gained approval from Pfizer and Moderna, with many others still in clinical trials. This article reviews various aspects of COVID-19, including its epidemiology; its evolution and mutational spectrum; and its clinical dynamics, symptoms and complications, diagnosis, and treatment.


Subject(s)
Global Burden of Disease/statistics & numerical data , Pandemics/statistics & numerical data , /pathogenicity , Adenosine Monophosphate/analogs & derivatives , Adenosine Monophosphate/therapeutic use , Alanine/analogs & derivatives , Alanine/therapeutic use , Antiviral Agents/therapeutic use , /drug therapy , /therapy , /methods , Clinical Trials as Topic , Evolution, Molecular , Humans , Hydroxychloroquine/therapeutic use , Mutation , Off-Label Use , Pandemics/prevention & control , RNA, Viral/genetics , RNA, Viral/isolation & purification , /immunology , Severity of Illness Index
15.
BMJ Open ; 11(2): e041880, 2021 02 18.
Article in English | MEDLINE | ID: covidwho-1090935

ABSTRACT

OBJECTIVES: To explore the association between N95 respirator wearing and device-related pressure injury (DRPI) and to provide a basis for protecting medical staff from skin injuries. DESIGN: A cross-sectional, multicentre study. SETTING AND PARTICIPANTS: Medical staff of 60 hospitals were selected from 145 designated medical institutions located in the epidemic area where the patients with COVID-19 were treated in China. RESULTS: In total, 1761 respondents wore N95 respirators (use alone 20.8%; combination use 79.2%), and the prevalence of DRPI was 59.2% (95% CI 56.93 to 61.53). A daily wearing time of >4 hours (OR 1.62, 95% CI 1.11 to 2.35), wearing a N95 respirator in combination with goggles both with the presence of sweating (OR 13.40, 95% CI 7.34 to 23.16) and without the presence of sweating (OR 0.80, 95% CI 0.56 to 1.14) and wearing only a N95 respirator with the presence of sweating (OR 9.60, 95% CI 7.00 to 13.16) were associated with DRPI. A correspondence analysis indicated that if there was no sweating, regardless of whether the N95 respirator was worn by itself or in combination with goggles, single-site DRPI mainly occurred on the nose bridge, cheek and auricle. If there was sweating present, regardless of whether the N95 was worn by itself or in combination with goggles, multiple DRPI sites occurred more often on the face. CONCLUSIONS: The prevalence of DRPI among medical staff caused by N95 respirators was very high, which was mainly associated with a longer daily wearing time and interaction with sweating. The nasal bridge, cheeks and auricles were the primary protection locations found.


Subject(s)
/prevention & control , Occupational Exposure/prevention & control , Occupational Injuries/epidemiology , Adult , China/epidemiology , Cross-Sectional Studies , Female , Humans , Male , Pressure , Sweating
16.
Trials ; 22(1): 153, 2021 Feb 18.
Article in English | MEDLINE | ID: covidwho-1090626

ABSTRACT

BACKGROUND: The sharing of individual participant-level data from COVID-19 trials would allow re-use and secondary analysis that can help accelerate the identification of effective treatments. The sharing of trial data is not the norm, but the unprecedented pandemic caused by SARS-CoV-2 may serve as an impetus for greater data sharing. We sought to assess the data sharing intentions of interventional COVID-19 trials as declared in trial registrations and publications. METHODS: We searched ClinicalTrials.gov and PubMed for COVID-19 interventional trials. We analyzed responses to ClinicalTrials.gov fields regarding intent to share individual participant level data and analyzed the data sharing statements in eligible publications. RESULTS: Nine hundred twenty-four trial registrations were analyzed. 15.7% were willing to share, of which 38.6% were willing to share immediately upon publication of results. 47.6% declared they were not willing to share. Twenty-eight publications were analyzed representing 26 unique COVID-19 trials. Only seven publications contained data sharing statements; six indicated a willingness to share data whereas one indicated that data was not available for sharing. CONCLUSIONS: At a time of pressing need for researchers to work together to combat a global pandemic, intent to share individual participant-level data from COVID-19 interventional trials is limited.


Subject(s)
/therapy , Clinical Trials as Topic/statistics & numerical data , Information Dissemination , Publications/statistics & numerical data , Research Design/statistics & numerical data , /epidemiology , Humans , Intention , Pandemics/prevention & control
17.
Rev Bras Enferm ; 74Suppl 1(Suppl 1): e20200576, 2021.
Article in English, Portuguese | MEDLINE | ID: covidwho-1090510

ABSTRACT

OBJECTIVE: Reflect, in the light of the Health Belief Model, on the adoption of behavioral measures in the context of COVID-19. METHODS: Theoretical-reflective essay, based on the Health Belief Model, to reflect on adherence to preventive behaviors in the pandemic of COVID-19. RESULTS: Adherence to preventive behaviors is strongly influenced by socioeconomic, territorial, political and individual factors in the face of critical health situations. In addition, the spread of false news modulates the thinking and execution of behavioral actions in the population. FINAL CONSIDERATIONS: It is necessary to understand the importance of health communication processes and the use of tools aimed at responsible human behavior and engaged in the adoption of a preventive posture.


Subject(s)
Attitude to Health , /psychology , Guideline Adherence/statistics & numerical data , Health Behavior , Pandemics/prevention & control , Patient Participation/psychology , Adult , Aged , Aged, 80 and over , Brazil , Female , Humans , Male , Middle Aged , Surveys and Questionnaires
18.
Euro Surveill ; 26(7)2021 02.
Article in English | MEDLINE | ID: covidwho-1090444

ABSTRACT

To evaluate the effect of physical distancing and school reopening in Brussels between August and November 2020, we monitored changes in the number of reported contacts per SARS-CoV-2 case and associated SARS-CoV-2 transmission. The second COVID-19 pandemic wave in Brussels was the result of increased social contact across all ages following school reopening. Physical distancing measures including closure of bars and restaurants, and limiting close contacts, while primary and secondary schools remained open, reduced social mixing and controlled SARS-CoV-2 transmission.


Subject(s)
/prevention & control , Pandemics , Schools , Belgium/epidemiology , Humans , Pandemics/prevention & control
19.
Wiad Lek ; 73(12 cz 2): 2773-2779, 2020.
Article in English | MEDLINE | ID: covidwho-1089505

ABSTRACT

OBJECTIVE: The aim: To suggest the ways and means for ensuring respect for human rights and freedoms in the context of introduction of states' measures to combat the COVID-19 pandemic based on the generalization of European experience and systematization of recommendations of international and European institutions. PATIENTS AND METHODS: Materials and methods: In thise research we applied a complex of philosophical and ideological approaches, general scientific and special methods of scientific cognition, in particular civilizational and axiological approaches as well as dialectical, comparative legal and statistical methods. The empirical basis of the study is represented by the statistical data of the healthcare sector of European countries, generalization of the practice of countering the pandemic spread. In this study we used international and European regulatory legal acts and documents in the field of human rights, national legislations of foreign countries. CONCLUSION: Conclusions: Derogation from the provisions of the European Convention on Human Rights in the context of introduction of measures to combat the СOVID-19 pandemic is a common problem for European countries, which requires emergency measures introduction by the governments of these countries; the measures introduced should be legal, necessary, non-discriminatory, with a certain specific focus and duration; ensuring respect for human rights and freedoms requires deliberate, timely and effective legal, organizational forms and methods of states' activities and international cooperation.


Subject(s)
Pandemics , Europe/epidemiology , Freedom , Human Rights , Humans , Pandemics/prevention & control
20.
Wiad Lek ; 73(12 cz 2): 2768-2772, 2020.
Article in English | MEDLINE | ID: covidwho-1089451

ABSTRACT

OBJECTIVE: The aim: Theoretical and methodological substantiation of the impact of COVID-19 on the implementation of state policy on the protection of human right to health in terms of improving the legal framework in the field of demographic security. PATIENTS AND METHODS: Materials and methods: The main research materials are the norms of the International Covenant on Economic, Social and Cultural Rights, the Conventions for the Protection of Human Rights and Fundamental Freedoms and the legal framework of the countries that have adopted temporary quarantine measures. This research is based on empiricaland analytical data from WHO, Bloomberg's financial information provider. During the research, the following methods have been used: statistical, system-structural analysis, content-analysis, comparison, grouping and forecasting. CONCLUSION: Conclusions: Under the conditions of pandemic, attention should be paid to strengthening both administrative and criminal liability for violating quarantine, which will serve as a prerequisite for improving the legal mechanism of combating threats to the country's demographic security. The protection of the right to health requires the state to create conditions to prevent the risk of occupational diseases among health care workers and others involved in the response to COVID-19.


Subject(s)
Pandemics , Human Rights , Humans , Pandemics/prevention & control , Right to Health
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