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3.
JMIR Mhealth Uhealth ; 8(8): e19857, 2020 08 28.
Article in English | MEDLINE | ID: covidwho-769046

ABSTRACT

BACKGROUND: The COVID-19 pandemic is the greatest public health crisis of the last 100 years. Countries have responded with various levels of lockdown to save lives and stop health systems from being overwhelmed. At the same time, lockdowns entail large socioeconomic costs. One exit strategy under consideration is a mobile phone app that traces the close contacts of those infected with COVID-19. Recent research has demonstrated the theoretical effectiveness of this solution in different disease settings. However, concerns have been raised about such apps because of the potential privacy implications. This could limit the acceptability of app-based contact tracing in the general population. As the effectiveness of this approach increases strongly with app uptake, it is crucial to understand public support for this intervention. OBJECTIVE: The objective of this study is to investigate the user acceptability of a contact-tracing app in five countries hit by the pandemic. METHODS: We conducted a largescale, multicountry study (N=5995) to measure public support for the digital contact tracing of COVID-19 infections. We ran anonymous online surveys in France, Germany, Italy, the United Kingdom, and the United States. We measured intentions to use a contact-tracing app across different installation regimes (voluntary installation vs automatic installation by mobile phone providers) and studied how these intentions vary across individuals and countries. RESULTS: We found strong support for the app under both regimes, in all countries, across all subgroups of the population, and irrespective of regional-level COVID-19 mortality rates. We investigated the main factors that may hinder or facilitate uptake and found that concerns about cybersecurity and privacy, together with a lack of trust in the government, are the main barriers to adoption. CONCLUSIONS: Epidemiological evidence shows that app-based contact tracing can suppress the spread of COVID-19 if a high enough proportion of the population uses the app and that it can still reduce the number of infections if uptake is moderate. Our findings show that the willingness to install the app is very high. The available evidence suggests that app-based contact tracing may be a viable approach to control the diffusion of COVID-19.


Subject(s)
Contact Tracing/methods , Coronavirus Infections/prevention & control , Intention , Mobile Applications , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Adolescent , Adult , Aged , Coronavirus Infections/epidemiology , Cross-Cultural Comparison , Female , France/epidemiology , Germany/epidemiology , Humans , Italy/epidemiology , Male , Middle Aged , Pneumonia, Viral/epidemiology , Surveys and Questionnaires , United Kingdom/epidemiology , United States/epidemiology , Young Adult
4.
JMIR Public Health Surveill ; 6(3): e20572, 2020 09 01.
Article in English | MEDLINE | ID: covidwho-749048

ABSTRACT

BACKGROUND: To track and reduce the spread of COVID-19, apps have been developed to identify contact with individuals infected with SARS-CoV-2 and warn those who are at risk of having contracted the virus. However, the effectiveness of these apps depends highly on their uptake by the general population. OBJECTIVE: The present study investigated factors influencing app use intention, based on the health belief model. In addition, associations with respondents' level of news consumption and their health condition were investigated. METHODS: A survey was administered in Flanders, Belgium, to 1500 respondents, aged 18 to 64 years. Structural equation modeling was used to investigate relationships across the model's constructs. RESULTS: In total, 48.70% (n=730) of respondents indicated that they intend to use a COVID-19 tracing app. The most important predictor was the perceived benefits of the app, followed by self-efficacy and perceived barriers. Perceived severity and perceived susceptibility were not related to app uptake intention. Moreover, cues to action (ie, individuals' exposure to [digital] media content) were positively associated with app use intention. As the respondents' age increased, their perceived benefits and self-efficacy for app usage decreased. CONCLUSIONS: Initiatives to stimulate the uptake of contact tracing apps should enhance perceived benefits and self-efficacy. A perceived barrier for some potential users is privacy concerns. Therefore, when developing and launching an app, clarification on how individuals' privacy will be protected is needed. To sustain perceived benefits in the long run, supplementary options could be integrated to inform and assist users.


Subject(s)
Coronavirus Infections , Mobile Applications , Pandemics , Pneumonia, Viral , Smartphone , Adolescent , Adult , Belgium , Betacoronavirus , Contact Tracing , Humans , Middle Aged , Privacy , Young Adult
6.
Rev Peru Med Exp Salud Publica ; 37(2): 195-202, 2020.
Article in Spanish, English | MEDLINE | ID: covidwho-740608

ABSTRACT

OBJECTIVES: To determine the probability of controlling the outbreak of COVID-19 in Peru, in a pre- and post-quarantine scenario using mathematical simulation models. MATERIALS AND METHODS: Outbreak si mulations for the COVID-19 pandemic are performed, using stochastic equations under the following assumptions: a pre-quarantine population R0 of 2.7 or 3.5, a post-quarantine R0 of 1.5, 2 or 2.7, 18% or 40%, of asymptomatic positives and a maximum response capacity of 50 or 150 patients in the intensive care units. The success of isolation and contact tracing is evaluated, no other mitigation measures are included. RESULTS: In the pre-quarantine stage, success in controlling more than 80% of the simulations occurred only if the isolation of positive cases was implemented from the first case, after which there was less than 40% probability of success. In post-quarantine, with 60 positive cases it is necessary to isolate them early, track all of their contacts and decrease the R0 to 1.5 for outbreak control to be successful in more than 80% of cases. Other scenarios have a low probability of success. CONCLUSIONS: The control of the outbreak in Peru during pre-quarantine stage demanded requirements that were difficult to comply with, therefore quarantine was necessary; to successfully suspend it would require a significant reduction in the spread of the disease, early isolation of positives and follow-up of all contacts of positive patients.


Subject(s)
Computer Simulation , Coronavirus Infections/epidemiology , Disease Outbreaks/prevention & control , Pneumonia, Viral/epidemiology , Contact Tracing/methods , Coronavirus Infections/prevention & control , Humans , Intensive Care Units/statistics & numerical data , Models, Theoretical , Pandemics/prevention & control , Peru/epidemiology , Pneumonia, Viral/prevention & control , Probability , Quarantine
7.
Rev Soc Bras Med Trop ; 53: e20200494, 2020.
Article in English | MEDLINE | ID: covidwho-740419

ABSTRACT

Diagnosing cases of coronavirus disease (COVID-19) with only non-respiratory symptoms has been challenging. We reported the diagnosis of a child who tested positive for COVID-19 with abdominal pain/diarrhea and tracked his family cluster. One member of the family tested positive for COVID-19 on real-time reverse-transcription polymerase chain reaction assay and three other family members had anti-SARS-CoV-2 antibodies.


Subject(s)
Coronavirus Infections/diagnosis , Coronavirus/isolation & purification , Diarrhea/diagnosis , Pandemics , Pneumonia, Viral/diagnosis , Abdominal Pain/etiology , Betacoronavirus , Child, Preschool , Clinical Laboratory Techniques , Cluster Analysis , Contact Tracing , Diarrhea/etiology , Fever/etiology , Humans , Male , Pharyngitis/etiology
9.
Emerg Infect Dis ; 26(8): 1671-1678, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-737802

ABSTRACT

We describe the contact investigation for an early confirmed case of coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), in the United States. Contacts of the case-patient were identified, actively monitored for symptoms, interviewed for a detailed exposure history, and tested for SARS-CoV-2 infection by real-time reverse transcription PCR (rRT-PCR) and ELISA. Fifty contacts were identified and 38 (76%) were interviewed, of whom 11 (29%) reported unprotected face-to-face interaction with the case-patient. Thirty-seven (74%) had respiratory specimens tested by rRT-PCR, and all tested negative. Twenty-three (46%) had ELISA performed on serum samples collected ≈6 weeks after exposure, and none had detectable antibodies to SARS-CoV-2. Among contacts who were tested, no secondary transmission was identified in this investigation, despite unprotected close interactions with the infectious case-patient.


Subject(s)
Betacoronavirus/pathogenicity , Contact Tracing/statistics & numerical data , Coronavirus Infections/epidemiology , Pandemics , Pneumonia, Viral/epidemiology , Adolescent , Adult , Aged , Betacoronavirus/genetics , Child , Child, Preschool , Clinical Laboratory Techniques/methods , Coronavirus Infections/diagnosis , Enzyme-Linked Immunosorbent Assay , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , Pneumonia, Viral/diagnosis , Public Health/methods , Reverse Transcriptase Polymerase Chain Reaction , Travel , Washington/epidemiology
10.
J Korean Med Sci ; 35(34): e314, 2020 Aug 31.
Article in English | MEDLINE | ID: covidwho-736660

ABSTRACT

A 14-day quarantine is implemented in many countries in response to the coronavirus disease pandemic. Korea implemented a mandatory quarantine for those who had close contact with infected patients and those returning from abroad. The present study explored the implications of mandatory coronavirus disease 2019 testing before releasing individuals from the 14-day quarantine in Incheon, Korea. From February 11 to July 5, 2020, 19,296 people were self-quarantined, and 56 (0.3%) of them were confirmed cases of COVID-19. Twenty (35.7%) were identified through the reporting of symptoms during quarantine, and 32 (57.1%) were identified using mandatory pre-release RT-PCR tests. Among the 32, 14 (25%) individuals reported mild symptoms and 18 (32.1%) were asymptomatic. It is suggested that mandatory diagnostic testing prior to release and the symptom-based surveillance after the 14-day quarantine may help control delayed or asymptomatic COVID-19 cases.


Subject(s)
Clinical Laboratory Techniques , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Infection Control/legislation & jurisprudence , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Public Health/legislation & jurisprudence , Adolescent , Adult , Aged , Aged, 80 and over , Betacoronavirus/isolation & purification , Contact Tracing , Female , Humans , Infection Control/methods , Male , Middle Aged , Pandemics , Quarantine , Republic of Korea/epidemiology , Reverse Transcriptase Polymerase Chain Reaction/methods , Young Adult
11.
Mayo Clin Proc ; 95(9): 1898-1905, 2020 09.
Article in English | MEDLINE | ID: covidwho-735304

ABSTRACT

OBJECTIVE: To model and compare effect of digital contact tracing versus shelter-in-place on severe acute respiratory syndrome - coronavirus 2 (SARS-CoV-2) spread. METHODS: Using a classical epidemiologic framework and parameters estimated from literature published between February 1, 2020, and May 25, 2020, we modeled two non-pharmacologic interventions - shelter-in-place and digital contact tracing - to curb spread of SARS-CoV-2. For contact tracing, we assumed an advanced automated contact tracing (AACT) application that sends alerts to individuals advising self-isolation based on individual exposure profile. Model parameters included percentage population ordered to shelter-in-place, adoption rate of AACT, and percentage individuals who appropriately follow recommendations. Under influence of these variables, the number of individuals infected, exposed, and isolated were estimated. RESULTS: Without any intervention, a high rate of infection (>10 million) with early peak is predicted. Shelter-in-place results in rapid decline in infection rate at the expense of impacting a large population segment. The AACT model achieves reduction in infected and exposed individuals similar to shelter-in-place without impacting a large number of individuals. For example, a 50% AACT adoption rate mimics a shelter-in-place order for 40% of the population and results in a greater than 90% decrease in peak number of infections. However, as compared to shelter-in-place, with AACT significantly fewer individuals would be isolated. CONCLUSION: Wide adoption of digital contact tracing can mitigate infection spread similar to universal shelter-in-place, but with considerably fewer individuals isolated.


Subject(s)
Communicable Disease Control/methods , Contact Tracing/methods , Coronavirus Infections/prevention & control , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Software , Automation , Betacoronavirus , Coronavirus Infections/transmission , Humans , Models, Theoretical , Pneumonia, Viral/transmission , Social Isolation
12.
PLoS Pathog ; 16(8): e1008756, 2020 08.
Article in English | MEDLINE | ID: covidwho-732987

ABSTRACT

This Pearl article recounts the story of a US corporation, Lennar, the nation's leading homebuilder, an essential function in the US (not allowed to lock down), when faced with the coronavirus disease 2019 (COVID-19) pandemic at the end of February 2020. The culture of the company, which allowed it to proceed safely, is one of cohesion, trust, teamwork, and respect for fellow humans. Theirs is a culture in which the safety, wellness, and health of the associates (employees) and the communities they serve is the number one priority. All associates wear a name badge with first name only, and all name badges share the same family name, Lennar. At Lennar, individual success means nothing, and collective success means everything. This is the story of how Lennar took control of the COVID-19 pandemic, metamorphosed itself into an even stronger organization, better suited to deal with COVID-19, and more importantly, optimally suited for the 21st century. The lessons learned not only were instrumental to Lennar but could also apply to any company eager to reopen their business.


Subject(s)
Coronavirus Infections/epidemiology , Organizational Culture , Pneumonia, Viral/epidemiology , Primary Prevention/methods , Professional Corporations , Betacoronavirus , Contact Tracing/methods , Hand Hygiene/methods , Humans , Mass Screening/methods , Pandemics , Personal Protective Equipment/supply & distribution , Social Distance , United States/epidemiology
13.
MMWR Morb Mortal Wkly Rep ; 69(34): 1170-1172, 2020 Aug 28.
Article in English | MEDLINE | ID: covidwho-732629

ABSTRACT

On June 1, 2020, with declines in coronavirus disease 2019 (COVID-19) cases and hospitalizations in Rhode Island,* child care programs in the state reopened after a nearly 3-month closure implemented as part of mitigation efforts. To reopen safely, the Rhode Island Department of Human Services (RIDHS) required licensed center- and home-based child care programs to reduce enrollment, initially to a maximum of 12 persons, including staff members, in stable groups (i.e., staff members and students not switching between groups) in physically separated spaces, increasing to a maximum of 20 persons on June 29. Additional requirements included universal use of masks for adults, daily symptom screening of adults and children, and enhanced cleaning and disinfection according to CDC guidelines.† As of July 31, 666 of 891 (75%) programs were approved to reopen, with capacity for 18,945 children, representing 74% of the state's January 2020 child care program population (25,749 children).


Subject(s)
Child Care , Coronavirus Infections/diagnosis , Coronavirus Infections/transmission , Pneumonia, Viral/diagnosis , Pneumonia, Viral/transmission , Adult , Betacoronavirus/isolation & purification , Child , Child Care/organization & administration , Child, Preschool , Clinical Laboratory Techniques , Contact Tracing , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Female , Guideline Adherence/statistics & numerical data , Humans , Infant , Male , Middle Aged , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Rhode Island/epidemiology , Young Adult
15.
Euro Surveill ; 25(33)2020 08.
Article in English | MEDLINE | ID: covidwho-727369

ABSTRACT

We report three clusters related with potential pre-symptomatic transmission of coronavirus disease (COVID-19) between January and February 2020 in Shanghai, China. Investigators interviewed suspected COVID-19 cases to collect epidemiological information, including demographic characteristics, illness onset, hospital visits, close contacts, activities' trajectories between 14 days before illness onset and isolation, and exposure histories. Respiratory specimens of suspected cases were collected and tested for SARS-CoV-2 by real-time reverse-transcriptase polymerase chain reaction (rRT-PCR) assay. The interval between the onset of illness in the primary case and the last contact of the secondary case with the primary case in our report was 1 to 7 days. In Cluster 1 (five cases), illness onset in the five secondary cases was 2 to 5 days after the last contact with the primary case. In Cluster 2 (five cases) and Cluster 3 (four cases), the illness onset in secondary cases occurred prior to or on the same day as the onset in the primary cases. The study provides empirical evidence for transmission of COVID-19 during the incubation period and indicates that pre-symptomatic person-to-person transmission can occur following sufficient exposure to confirmed COVID-19 cases. The potential pre-symptomatic person-to-person transmission puts forward higher requirements for prevention and control measures.


Subject(s)
Clinical Laboratory Techniques/methods , Contact Tracing , Coronavirus Infections/diagnosis , Coronavirus/isolation & purification , Pandemics/prevention & control , Adult , Aged , Aged, 80 and over , Betacoronavirus , China/epidemiology , Coronavirus/genetics , Coronavirus Infections/epidemiology , Female , Fever/etiology , Humans , Male , Middle Aged , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Real-Time Polymerase Chain Reaction , Reverse Transcriptase Polymerase Chain Reaction
20.
Gac Med Mex ; 156(4): 294-297, 2020.
Article in English | MEDLINE | ID: covidwho-723219

ABSTRACT

Introduction: The COVID-19 pandemic has brought about a paradigm shift in healthcare. Objective: To evaluate the utility of a strategy to comprehensively address the pandemic in a health area that covers 42,000 people. Method: Between March 10 and May 15, 2020, the COVID Unit was created in the corresponding regional hospital, and an independent circuit was established for the diagnosis and management of patients with suspected or confirmed COVID-19; social health centers were monitored with PCR testing. Results: Eighteen COVID-19-positive patients (age 72.9 ± 13.2 years) were admitted, out of which 66% were males. All these patients had pneumonia and 67% had respiratory distress syndrome; no one required mechanical ventilation. Mean hospital stay was 9.4 ± 5.3 days, and mortality, 11%. PCR tests were applied to all hospital residents (n = 827) and workers (n = 519), 1,044 phone calls were made and 36 hospital admissions were avoided. Only 50 patients required close follow-up, out of which four (0.48%) were positive for COVID-19. Conclusion: Clinical monitoring at the hospital and social health centers showed that patient profile was like that documented in the literature and that the incidence of COVID-19 was low in social health centers.


Subject(s)
Clinical Laboratory Techniques , Contact Tracing , Coronavirus Infections/therapy , Hospitalization , Pneumonia, Viral/therapy , Aged , Aged, 80 and over , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Female , Humans , Incidence , Length of Stay/statistics & numerical data , Male , Middle Aged , Pandemics , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Polymerase Chain Reaction , Respiration, Artificial/statistics & numerical data , Spain
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