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1.
PLoS One ; 15(10): e0240578, 2020.
Article in English | MEDLINE | ID: covidwho-881157

ABSTRACT

The initial phase dynamics of an epidemic without containment measures is commonly well modelled using exponential growth models. However, in the presence of containment measures, the exponential model becomes less appropriate. Under the implementation of an isolation measure for detected infectives, we propose to model epidemic dynamics by fitting a flexible growth model curve to reported positive cases, and to infer the overall epidemic dynamics by introducing information on the detection/testing effort and recovery and death rates. The resulting modelling approach is close to the Susceptible-Infectious-Quarantined-Recovered model framework. We focused on predicting the peaks (time and size) in positive cases, active cases and new infections. We applied the approach to data from the COVID-19 outbreak in Italy. Fits on limited data before the observed peaks illustrate the ability of the flexible growth model to approach the estimates from the whole data.


Subject(s)
Betacoronavirus , Containment of Biohazards/methods , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Models, Statistical , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Quarantine/methods , Coronavirus Infections/virology , Humans , Incidence , Italy/epidemiology , Pneumonia, Viral/virology , Retrospective Studies , Time Factors
2.
J Forensic Leg Med ; 76: 102036, 2020 Nov.
Article in English | MEDLINE | ID: covidwho-863229

ABSTRACT

The COVID-19 pandemic has forced forensic practitioners to consider how we perform our normal duties, especially when those duties involve humans. The potential for contracting the virus from working in close contact with living sufferers is high, and we have yet to fully determine the risk of infection from the deceased. In an attempt to support the community, the Journal of Forensic & Legal Medicine has drawn together three articles which underline the importance of continued forensic medical practice during the pandemic and highlight some factors to consider in a Roadmap towards safe practice. Our Roadmap has intentionally taken an international perspective and supports other work we have published in the Journal on our collective response to the COVID-19 crisis.


Subject(s)
Betacoronavirus , Coronavirus Infections/pathology , Infection Control/organization & administration , Mortuary Practice/organization & administration , Personal Protective Equipment/statistics & numerical data , Pneumonia, Viral/pathology , Containment of Biohazards/methods , Coronavirus Infections/prevention & control , Forensic Medicine/organization & administration , Humans , Pandemics/prevention & control , Pneumonia, Viral/prevention & control
3.
Curr Med Sci ; 40(5): 985-988, 2020 Oct.
Article in English | MEDLINE | ID: covidwho-802087

ABSTRACT

At the end of 2019, the novel coronavirus infection outbroke in Wuhan, Hubei Province. On Feb. 2, 2020, Wuhan, as the worst-hit region, began to build "shelter hospital" rapidly to treat patients with mild illness. The shelter hospital has multiple functions such as emergency treatment, surgical treatment and clinical test, which can adapt to emergency medical rescue tasks. Based on the characteristics that shelter hospital only treats patients with mild illness, tests of shelter laboratory, including coronavirus nucleic acid detection, IgM/IgG antibody serology detection, monitoring and auxiliary diagnosis and/or a required blood routine, urine routine, C-reactive protein, calcitonin original, biochemical indicators (liver enzymes, myocardial enzymes, renal function, etc.) and blood coagulation function test etc, were used to provide important basis for the diagnosis and treatment of the disease. In order to ensure laboratory biosafety, it is necessary to first evaluate the harm level of various specimens. In the laboratory biosafety management, the harm level assessment of microorganisms is the core work of biosafety, which is of great significance to guarantee biosafety. As an emergency deployment affected by the environment, shelter laboratory must possess strong mobility. This paper will explore how to combine the biosafety model of traditional laboratory with the particularity of shelter laboratory to carry out effective work in response to the current epidemic.


Subject(s)
Betacoronavirus/pathogenicity , Containment of Biohazards/methods , Coronavirus Infections/virology , Pneumonia, Viral/virology , China , Containment of Biohazards/instrumentation , Disease Outbreaks/prevention & control , Hospitals/standards , Humans , Pandemics
4.
Viruses ; 12(7)2020 07 07.
Article in English | MEDLINE | ID: covidwho-639283

ABSTRACT

Standard precautions to minimize the risk of SARS-CoV-2 transmission implies that infected cell cultures and clinical specimens may undergo some sort of inactivation to reduce or abolish infectivity. We evaluated three heat inactivation protocols (56 °C-30 min, 60 °C-60 min and 92 °C-15 min) on SARS-CoV-2 using (i) infected cell culture supernatant, (ii) virus-spiked human sera (iii) and nasopharyngeal samples according to the recommendations of the European norm NF EN 14476-A2. Regardless of the protocol and the type of samples, a 4 Log10 TCID50 reduction was observed. However, samples containing viral loads > 6 Log10 TCID50 were still infectious after 56 °C-30 min and 60 °C-60 min, although infectivity was < 10 TCID50. The protocols 56 °C-30 min and 60 °C-60 min had little influence on the RNA copies detection, whereas 92 °C-15 min drastically reduced the limit of detection, which suggests that this protocol should be avoided for inactivation ahead of molecular diagnostics. Lastly, 56 °C-30 min treatment of serum specimens had a negligible influence on the results of IgG detection using a commercial ELISA test, whereas a drastic decrease in neutralizing titers was observed.


Subject(s)
Betacoronavirus , Containment of Biohazards/methods , Coronavirus Infections/virology , Pneumonia, Viral/virology , Serologic Tests/methods , Virus Inactivation , Antibodies, Neutralizing/immunology , Betacoronavirus/immunology , Containment of Biohazards/standards , Coronavirus Infections/diagnosis , Coronavirus Infections/prevention & control , Enzyme-Linked Immunosorbent Assay , Hot Temperature , Humans , Neutralization Tests , Pandemics/prevention & control , Pneumonia, Viral/diagnosis , Pneumonia, Viral/prevention & control , Serologic Tests/standards
5.
Indian J Pathol Microbiol ; 63(3): 350-357, 2020.
Article in English | MEDLINE | ID: covidwho-706335

ABSTRACT

Declared as a pandemic by WHO on March 11, 2020, COVID-19 has brought about a dramatic change in the working of different laboratories across the country. Diagnostic laboratories testing different types of samples play a vital role in the treatment management. Irrespective of their size, each laboratory has to follow strict biosafety guidelines. Different sections of the laboratory receive samples that are variably infectious. Each sample needs to undergo a proper and well-designed processing system so that the personnel involved are not infected and also their close contacts. It takes a huge effort so as to limit the risk of exposure of the working staff during the collection, processing, reporting or dispatching of biohazard samples. Guidelines help in preventing the laboratory staff and healthcare workers from contracting the disease which has a known human to human route of transmission and high rate of mortality. A well-knit approach is the need of the hour to combat this fast spreading disease. We anticipate that the guidelines described in this article will be useful for continuing safe work practices by all the laboratories in the country.


Subject(s)
Containment of Biohazards/methods , Coronavirus Infections/prevention & control , Coronavirus Infections/transmission , Occupational Exposure/prevention & control , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Pneumonia, Viral/transmission , Specimen Handling/methods , Betacoronavirus , Disinfection/methods , Guidelines as Topic , Hazardous Substances , Health Personnel/standards , Humans , Laboratories/standards , Pathologists/standards , Waste Management/methods
7.
J Gen Intern Med ; 35(9): 2732-2737, 2020 09.
Article in English | MEDLINE | ID: covidwho-640978

ABSTRACT

Hospitalists are well poised to serve in key leadership roles and in frontline care in particular when facing a pandemic such as the SARS-CoV-2 (COVID-19) infection. Much of the disaster planning in hospitals around the country addresses overcrowded emergency departments and decompressing these locations; however, in the case of COVID-19, intensive care units, emergency departments, and medical wards ran the risk of being overwhelmed by a large influx of patients needing high-level medical care. In a matter of days, our Division of Hospital Medicine, in partnership with our hospital, health system, and academic institution, was able to modify and deploy existing disaster plans to quickly care for an influx of medically complex patients. We describe a scaled approach to managing hospitalist clinical operations during the COVID-19 pandemic.


Subject(s)
Betacoronavirus , Capacity Building/methods , Coronavirus Infections/prevention & control , Disaster Planning/methods , Hospitalists , Hospitals , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Capacity Building/trends , Containment of Biohazards/methods , Containment of Biohazards/trends , Coronavirus Infections/epidemiology , Disaster Planning/trends , Hospitalists/trends , Hospitals/trends , Humans , Intersectoral Collaboration , Pneumonia, Viral/epidemiology
8.
mSphere ; 5(3)2020 06 24.
Article in English | MEDLINE | ID: covidwho-616597

ABSTRACT

The contamination of patients' surroundings by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains understudied. We sampled the surroundings and the air of six negative-pressure non-intensive care unit (non-ICU) rooms in a designated isolation ward in Chengdu, China, that were occupied by 13 laboratory-confirmed coronavirus disease 2019 (COVID-19) patients who had returned from overseas travel, including 2 asymptomatic patients. A total of 44 of 112 (39.3%) surface samples were positive for SARS-CoV-2 as detected by real-time PCR, suggesting extensive contamination, although all of the air samples were negative. In particular, in a single room occupied by an asymptomatic patient, four sites were SARS-CoV-2 positive, highlighting that asymptomatic COVID-19 patients do contaminate their surroundings and impose risks for others with close contact. Placement of COVID-19 patients in rooms with negative pressure may bring a false feeling of safety, and the importance of rigorous environment cleaning should be emphasized.IMPORTANCE Although it has been well recognized that the virus SARS-CoV-2, the causative agent of COVID-19, can be acquired by exposure to fomites, surprisingly, the contamination of patients' surroundings by SARS-CoV-2 is largely unknown, as there have been few studies. We performed an environmental sampling study for 13 laboratory-confirmed COVID-19 patients and found extensive contamination of patients' surroundings. In particular, we found that asymptomatic COVID-19 patients contaminated their surroundings and therefore imposed risks for other people. Environment cleaning should be emphasized in negative-pressure rooms. The findings may be useful to guide infection control practice to protect health care workers.


Subject(s)
Asymptomatic Infections/epidemiology , Betacoronavirus/isolation & purification , Coronavirus Infections/epidemiology , Environmental Exposure , Environmental Microbiology , Pneumonia, Viral/epidemiology , Containment of Biohazards/methods , Coronavirus Infections/pathology , Environment , Humans , Pandemics , Pneumonia, Viral/pathology
9.
J Pak Med Assoc ; 70(Suppl 3)(5): S48-S51, 2020 May.
Article in English | MEDLINE | ID: covidwho-609380

ABSTRACT

COVID-19 poses a great challenge to clinical and diagnostic services around the world. The need of biosafety practices can never be emphasised more than under current circumstances. The four pillars of biosafety namely, leadership, standard operating procedures, personal protective equipment (PPE) and engineering controls must be employed for effective and safe practices in the clinical setting in general and laboratory settings in particular. Risk assessment must be carried out before meeting up the diagnostic challenge for COVID-19 and essential biorisk management measures are required to be taken. In our resource-poor settings, we need to adapt safe but cost-effective and improvised solutions to ensure safe handling of clinical samples from COVID-19 patients in the laboratories. The correct use of PPE and their suitable alternatives are available for selection and use. Disinfection of the lab areas and safe disposal of the clinical samples from such patients is also of paramount importance.


Subject(s)
Betacoronavirus , Clinical Laboratory Techniques/standards , Containment of Biohazards , Coronavirus Infections , Pandemics , Pneumonia, Viral , Containment of Biohazards/methods , Containment of Biohazards/standards , Coronavirus Infections/diagnosis , Coronavirus Infections/prevention & control , Humans , Infection Control/standards , Laboratories/standards , Pandemics/prevention & control , Personal Protective Equipment , Pneumonia, Viral/diagnosis , Pneumonia, Viral/prevention & control , Risk Assessment
10.
Health Secur ; 18(3): 232-236, 2020.
Article in English | MEDLINE | ID: covidwho-595971

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the pathogen that causes coronavirus disease 2019 (COVID-19), which was first detected in Wuhan, China. Recent studies have updated the epidemiologic and clinical characteristics of COVID-19 continuously. In China, diagnostic tests and laboratory tests of specimens from persons under investigation are usually performed in a biosafety level 2 environment. Laboratory staff may be at greater risk of exposure due to a higher concentration and invasiveness of emerging pathogens. Current infection prevention strategies are based on lessons learned from severe acute respiratory syndrome, expert judgments, and related regulations. This article summarizes biosafety prevention and control measures performed in severe acute respiratory syndrome coronavirus 2 testing activities and provides practical suggestions for laboratory staff to avoid laboratory-acquired infections in dealing with public health emergencies.


Subject(s)
Clinical Laboratory Techniques/methods , Containment of Biohazards/methods , Coronavirus Infections/blood , Laboratory Infection/prevention & control , Personal Protective Equipment/statistics & numerical data , Pneumonia, Viral/blood , Betacoronavirus , China , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Disinfection/organization & administration , Female , Humans , Laboratories/organization & administration , Male , Occupational Health , Pandemics , Pneumonia, Viral/epidemiology , Specimen Handling/methods
11.
Viruses ; 12(6)2020 06 08.
Article in English | MEDLINE | ID: covidwho-574875

ABSTRACT

Clinical samples collected in coronavirus disease 19 (COVID-19), patients are commonly manipulated in biosafety level 2 laboratories for molecular diagnostic purposes. Here, we tested French norm NF-EN-14476+A2 derived from European standard EN-14885 to assess the risk of manipulating infectious viruses prior to RNA extraction. SARS-CoV-2 cell-culture supernatant and nasopharyngeal samples (virus-spiked samples and clinical samples collected in COVID-19 patients) were used to measure the reduction of infectivity after 10 minute contact with lysis buffer containing various detergents and chaotropic agents. A total of thirteen protocols were evaluated. Two commercially available formulations showed the ability to reduce infectivity by at least 6 log 10, whereas others proved less effective.


Subject(s)
Betacoronavirus/drug effects , Coronavirus Infections/virology , Pneumonia, Viral/virology , Virus Inactivation/drug effects , Animals , Betacoronavirus/genetics , Betacoronavirus/isolation & purification , Betacoronavirus/physiology , Cell Culture Techniques/methods , Chlorocebus aethiops , Containment of Biohazards/methods , Containment of Biohazards/standards , Humans , Nasopharynx/virology , Pandemics , RNA, Viral/isolation & purification , Specimen Handling/methods , Vero Cells , Viral Load/methods
12.
In Vivo ; 34(3 Suppl): 1675-1680, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-542896

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) is now a global pandemic. It is unclear to radiotherapy practitioners how to carry out radiotherapy during the epidemic. PATIENTS AND METHODS: After the outbreak of COVID-19, our Institute established measures for the prevention and control of COVID-19, and continues to treat patients according to these measures. The Radiotherapy Department has been divided into a clean zone and a semi-contaminated zone, and corresponding personal protective equipment is used in these zones. The temperature of patients and their escorts, and history of fever are assessed daily. Special procedures are performed during radiotherapy setup and intracavitary brachytherapy. RESULTS: Over a period of 2 months, 655 patients were treated in the Department. Sixteen patients with fever were identified and no patient undergoing radiotherapy or medical staff have been infected with COVID-19. CONCLUSION: Our protective measures were found to be effective and can be used as a reference in places where COVID-19 situations are not markedly serious.


Subject(s)
Coronavirus Infections/prevention & control , Infection Control/methods , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Radiology Department, Hospital/organization & administration , Radiotherapy/methods , Adult , Beijing , Child , Clinical Laboratory Techniques/methods , Containment of Biohazards/methods , Coronavirus Infections/diagnosis , Coronavirus Infections/transmission , Disinfection , Equipment Contamination/prevention & control , Fever/etiology , Health Personnel/education , Humans , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Neoplasms/radiotherapy , Pneumonia, Viral/diagnosis , Pneumonia, Viral/transmission , Procedures and Techniques Utilization , Protective Devices , Symptom Assessment , Thermometry
13.
Cytometry A ; 97(7): 674-680, 2020 07.
Article in English | MEDLINE | ID: covidwho-505930

ABSTRACT

In response to the recent COVID-19 pandemic, many laboratories are involved in research supporting SARS-CoV-2 vaccine development and clinical trials. Flow cytometry laboratories will be responsible for a large part of this effort by sorting unfixed antigen-specific lymphocytes. Therefore, it is critical and timely that we have an understanding of risk assessment and established procedures of infectious cell sorting. Here we present procedures covering the biosafety aspects of sorting unfixed SARS-CoV-2-infected cells and other infectious agents of similar risk level. These procedures follow the ISAC Biosafety Committee guidelines and were recently approved by the National Institutes of Health Institutional Biosafety Committee for sorting SARS-CoV-2-infected cells. © 2020 International Society for Advancement of Cytometry.


Subject(s)
Betacoronavirus/isolation & purification , Containment of Biohazards/methods , Coronavirus Infections/prevention & control , Flow Cytometry/methods , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Specimen Handling/methods , Coronavirus Infections/diagnosis , Humans , Laboratories/standards , Medical Laboratory Personnel/standards , Pneumonia, Viral/diagnosis , Risk Assessment
15.
Ann Fam Med ; 18(3): 259-261, 2020 05.
Article in English | MEDLINE | ID: covidwho-257952

ABSTRACT

Coronavirus disease 2019 (COVID-19) is a rapidly progressing global pandemic against which nations are struggling for containment. Singapore is known to have promptly instituted aggressive public health and containment measures. A key pillar sustaining this is the response of its primary health care network. It is important for health care systems worldwide to recognize the value of a strong coordinated response to this crisis from a primary health perspective. There are best practices for early isolation and containment of suspect cases while protecting health care workers and limiting cross infections that are transferable across nations. We describe our framework for how our primary care clinics respond to this pandemic in the hope others may find solutions to their unique needs. Moving forward, there is a pressing need for more studies to enhance our understanding of the response of primary care during these public health crises.


Subject(s)
Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Primary Health Care/organization & administration , Community Networks/organization & administration , Containment of Biohazards/methods , Humans , Infection Control/methods , Singapore/epidemiology
16.
Clin Chem Lab Med ; 58(7): 1053-1062, 2020 06 25.
Article in English | MEDLINE | ID: covidwho-245500

ABSTRACT

Coronavirus disease 2019 (COVID-19) is the third coronavirus outbreak that has emerged in the past 20 years, after severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). One important aspect, highlighted by many global health organizations, is that this novel coronavirus outbreak may be especially hazardous to healthcare personnel, including laboratory professionals. Therefore, the aim of this document, prepared by the COVID-19 taskforce of the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC), is to provide a set of recommendations, adapted from official documents of international and national health agencies, on biosafety measures for routine clinical chemistry laboratories that operate at biosafety levels 1 (BSL-1; work with agents posing minimal threat to laboratory workers) and 2 (BSL-2; work with agents associated with human disease which pose moderate hazard). We believe that the interim measures proposed in this document for best practice will help minimazing the risk of developing COVID-19 while working in clinical laboratories.


Subject(s)
Containment of Biohazards/methods , Coronavirus Infections/prevention & control , Coronavirus Infections/transmission , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Pneumonia, Viral/transmission , Betacoronavirus/pathogenicity , Clinical Laboratory Services , Coronavirus/pathogenicity , Disease Outbreaks/prevention & control , Humans , Laboratories , Laboratory Personnel
19.
Am J Med Genet A ; 182(6): 1302-1308, 2020 06.
Article in English | MEDLINE | ID: covidwho-108928

ABSTRACT

In the midst of the COVID-19 pandemic, it is appropriate that our focus is on patient care and preparation. However, the genetics community is well poised to fill in the educational gap created by medical students transitioning to limiting patient contact, creation of telemedicine patient care, and online learning modules. Our history of agility in learning and teaching is now only inhibited by the time constraints of current clinical demands on the genetics community. This publication is designed to offer ideas and resources for quickly transitioning our education to meet the current demands in the time of a pandemic. Not only will this allow us to continue our strong history of education, it will enhance our strong commitment to using modern educational techniques and tools to address the genetics workforce issues that have defined the recent past. We have the opportunity to aggressively educate for trainees that now have the capacity to learn, and to lead the way in showing how the genetics community rallies together no matter the challenge.


Subject(s)
Betacoronavirus/pathogenicity , Coronavirus Infections/epidemiology , Education, Distance/organization & administration , Education, Medical, Graduate/organization & administration , Genetics, Medical/education , Pandemics , Pneumonia, Viral/epidemiology , Audiovisual Aids/supply & distribution , Containment of Biohazards/methods , Coronavirus Infections/diagnosis , Coronavirus Infections/psychology , Coronavirus Infections/transmission , Genetic Diseases, Inborn/diagnosis , Genetic Diseases, Inborn/epidemiology , Humans , Pneumonia, Viral/diagnosis , Pneumonia, Viral/psychology , Pneumonia, Viral/transmission , Public Health/methods , Students, Medical/psychology , Telemedicine/methods
20.
J Med Microbiol ; 69(5): 653-656, 2020 May.
Article in English | MEDLINE | ID: covidwho-108843

ABSTRACT

Much has happened here since the local news media trumpeted the first Australian COVID-19 fatality, and stirred up a medieval fear of contagion. We now need to take a step back to examine the logic underlying the use of our limited COVID-19 countermeasures. Emerging infectious diseases by their nature, pose new challenges to the diagnostic-treatment-control nexus, and push our concepts of causality beyond the limits of the conventional Koch-Henle approach to aetiology. We need to use contemporary methods of assessing causality to ensure that clinical, laboratory and public health measures draw on a rational, evidence-based approach to argumentation. The purpose of any aetiological hypothesis is to derive actionable insights into this latest emerging infectious disease. This review is an introduction to a conversation with medical microbiologists, which will be supported by a moderated blog.


Subject(s)
Betacoronavirus/pathogenicity , Communicable Diseases, Emerging/epidemiology , Containment of Biohazards/methods , Coronavirus Infections/epidemiology , Hygiene/education , Pneumonia, Viral/epidemiology , Amino Acid Substitution , Betacoronavirus/genetics , Betacoronavirus/growth & development , Causality , China , Communicable Diseases, Emerging/diagnosis , Communicable Diseases, Emerging/immunology , Communicable Diseases, Emerging/therapy , Coronavirus Infections/diagnosis , Coronavirus Infections/immunology , Coronavirus Infections/therapy , Diagnostic Imaging/methods , Europe , Humans , Pandemics , Pneumonia, Viral/diagnosis , Pneumonia, Viral/immunology , Pneumonia, Viral/therapy , Public Health/trends , Reverse Transcriptase Polymerase Chain Reaction , Viral Vaccines/biosynthesis , Viral Vaccines/immunology
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