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2.
Commun Dis Intell (2018) ; 452021 Jul 22.
Article in English | MEDLINE | ID: covidwho-1524944

ABSTRACT

Abstract: Nationwide surveillance of Creutzfeldt-Jakob disease and other human prion diseases is performed by the Australian National Creutzfeldt-Jakob Disease Registry (ANCJDR). National surveillance encompasses the period since 1 January 1970, with prospective surveillance occurring from 1 October 1993. Over this prospective surveillance period, considerable developments have occurred in pre-mortem diagnostics; in the delineation of new disease subtypes; and in a heightened awareness of prion diseases in healthcare settings. Surveillance practices of the ANCJDR have evolved and adapted accordingly. This report summarises the activities of the ANCJDR during 2020. Since the ANCJDR began offering diagnostic cerebrospinal fluid (CSF) 14-3-3 protein testing in Australia in September 1997, the annual number of referrals has steadily increased. In 2020, 510 domestic CSF specimens were referred for 14-3-3 protein testing and 85 persons with suspected human prion disease were formally added to the national register. As of 31 December 2020, just over half (44 cases) of the 85 suspect case notifications remain classified as 'incomplete'; 27 cases were excluded through either detailed clinical follow-up (9 cases) or neuropathological examination (18 cases); 18 cases were classified as 'definite' and eleven as 'probable' prion disease. For 2020, sixty percent of all suspected human-prion-disease-related deaths in Australia underwent neuropathological examination. No cases of variant or iatrogenic CJD were identified. The SARS-CoV-2 pandemic did not affect prion disease surveillance outcomes in Australia.


Subject(s)
14-3-3 Proteins/cerebrospinal fluid , COVID-19/epidemiology , Creutzfeldt-Jakob Syndrome/epidemiology , Population Surveillance , Prion Diseases/epidemiology , Adult , Aged , Aged, 80 and over , Australia/epidemiology , Creutzfeldt-Jakob Syndrome/cerebrospinal fluid , Creutzfeldt-Jakob Syndrome/pathology , Disease Notification , Epidemiological Monitoring , Female , Humans , Male , Middle Aged , Neuropathology , Prion Diseases/cerebrospinal fluid , Prospective Studies , Registries
3.
MMWR Morb Mortal Wkly Rep ; 70(46): 1603-1607, 2021 Nov 19.
Article in English | MEDLINE | ID: covidwho-1524679

ABSTRACT

During October 3, 2020-January 9, 2021, North Carolina experienced a 400% increase in daily reported COVID-19 cases (1). To handle the increased number of cases and rapidly notify persons receiving a positive SARS-CoV-2 test result (patients), North Carolina state and local health departments moved from telephone call notification only to telephone call plus automated text and email notification (digital notification) beginning on December 24, 2020. Overall, among 200,258 patients, 142,975 (71%) were notified by telephone call or digital notification within the actionable period (10 days from their diagnosis date)* during January 2021, including at least 112,543 (56%) notified within 24 hours of report to North Carolina state and local health departments, a significantly higher proportion than the 25,905 of 175,979 (15%) notified within 24 hours during the preceding month (p<0.001). Differences in text notification by age, race, and ethnicity were observed. Automated digital notification is a feasible, rapid and efficient method to support timely outreach to patients, provide guidance on how to isolate, access resources, inform close contacts, and increase the efficiency of case investigation staff members.


Subject(s)
Automation , COVID-19/diagnosis , Electronic Mail , Text Messaging , Adolescent , Adult , Aged , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Testing , Child , Child, Preschool , Disease Notification/methods , Disease Notification/statistics & numerical data , Humans , Infant , Infant, Newborn , Middle Aged , North Carolina/epidemiology , Time Factors , Young Adult
4.
JMIR Public Health Surveill ; 7(11): e28956, 2021 11 16.
Article in English | MEDLINE | ID: covidwho-1518434

ABSTRACT

BACKGROUND: Digital contact tracing apps have been deployed worldwide to limit the spread of COVID-19 during this pandemic and to facilitate the lifting of public health restrictions. However, due to privacy-, trust-, and design-related issues, the apps are yet to be widely adopted. This calls for an intervention to enable a critical mass of users to adopt them. OBJECTIVE: The aim of this paper is to provide guidelines to design contact tracing apps as persuasive technologies to make them more appealing and effective. METHODS: We identified the limitations of the current contact tracing apps on the market using the Government of Canada's official exposure notification app (COVID Alert) as a case study. Particularly, we identified three interfaces in the COVID Alert app where the design can be improved. The interfaces include the no exposure status interface, exposure interface, and diagnosis report interface. We propose persuasive technology design guidelines to make them more motivational and effective in eliciting the desired behavior change. RESULTS: Apart from trust and privacy concerns, we identified the minimalist and nonmotivational design of exposure notification apps as the key design-related factors that contribute to the current low uptake. We proposed persuasive strategies such as self-monitoring of daily contacts and exposure time to make the no exposure and exposure interfaces visually appealing and motivational. Moreover, we proposed social learning, praise, and reward to increase the diagnosis report interface's effectiveness. CONCLUSIONS: We demonstrated that exposure notification apps can be designed as persuasive technologies by incorporating key persuasive features, which have the potential to improve uptake, use, COVID-19 diagnosis reporting, and compliance with social distancing guidelines.


Subject(s)
COVID-19 , Mobile Applications , COVID-19 Testing , Disease Notification , Humans , SARS-CoV-2
5.
PLoS One ; 16(11): e0258945, 2021.
Article in English | MEDLINE | ID: covidwho-1496519

ABSTRACT

Exposure notification apps have been developed to assist in notifying individuals of recent exposures to SARS-CoV-2. However, in several countries, such apps have had limited uptake. We assessed whether strategies to increase downloads of exposure notification apps should emphasize improving the accuracy of the apps in recording contacts and exposures, strengthening privacy protections and/or offering financial incentives to potential users. In a discrete choice experiment with potential app users in the US, financial incentives were more than twice as important in decision-making about app downloads, than privacy protections, and app accuracy. The probability that a potential user would download an exposure notification app increased by 40% when offered a $100 reward to download (relative to a reference scenario in which the app is free). Financial incentives might help exposure notification apps reach uptake levels that improve the effectiveness of contact tracing programs and ultimately enhance efforts to control SARS-CoV-2. Rapid, pragmatic trials of financial incentives for app downloads in real-life settings are warranted.


Subject(s)
COVID-19 , Mobile Applications , SARS-CoV-2/pathogenicity , Adult , Aged , Clinical Decision-Making , Contact Tracing/methods , Disease Notification , Humans , Middle Aged , Young Adult
6.
Math Biosci ; 338: 108645, 2021 08.
Article in English | MEDLINE | ID: covidwho-1492387

ABSTRACT

With more than 1.7 million COVID-19 deaths, identifying effective measures to prevent COVID-19 is a top priority. We developed a mathematical model to simulate the COVID-19 pandemic with digital contact tracing and testing strategies. The model uses a real-world social network generated from a high-resolution contact data set of 180 students. This model incorporates infectivity variations, test sensitivities, incubation period, and asymptomatic cases. We present a method to extend the weighted temporal social network and present simulations on a network of 5000 students. The purpose of this work is to investigate optimal quarantine rules and testing strategies with digital contact tracing. The results show that the traditional strategy of quarantining direct contacts reduces infections by less than 20% without sufficient testing. Periodic testing every 2 weeks without contact tracing reduces infections by less than 3%. A variety of strategies are discussed including testing second and third degree contacts and the pre-exposure notification system, which acts as a social radar warning users how far they are from COVID-19. The most effective strategy discussed in this work was combining the pre-exposure notification system with testing second and third degree contacts. This strategy reduces infections by 18.3% when 30% of the population uses the app, 45.2% when 50% of the population uses the app, 72.1% when 70% of the population uses the app, and 86.8% when 95% of the population uses the app. When simulating the model on an extended network of 5000 students, the results are similar with the contact tracing app reducing infections by up to 79%.


Subject(s)
COVID-19/prevention & control , Contact Tracing/statistics & numerical data , Disease Notification/standards , Models, Theoretical , Social Network Analysis , Adult , Computer Simulation , Humans , Medical Informatics Applications , Mobile Applications , Quarantine/statistics & numerical data , Students , Young Adult
9.
BMJ Mil Health ; 166(1): 37-41, 2020 Feb.
Article in English | MEDLINE | ID: covidwho-1452951

ABSTRACT

Major disease outbreaks continue to be a significant risk to public health, with pandemic influenza or an emerging infectious disease outbreak at the top of the UK National Risk Register. The risk of deliberate release of a biological agent is lower but remains possible and may only be recognised after casualties seek medical attention. In this context the emergency preparedness, resilience and response (EPRR) process protects the public from high consequence infectious diseases, other infectious disease outbreaks and biological agent release. The core elements of the EPRR response are recognition of an outbreak, isolation of patients, appropriate personal protective equipment for medical staff and actions to minimise further disease spread. The paper discusses how high-threat agents may be recognised by clinicians, the initial actions to be taken on presentation and how the public health system is notified and responds. It draws on the national pandemic influenza plans to describe the wider response to a major disease outbreak and discusses training requirements and the potential role of the military.


Subject(s)
Biohazard Release , Civil Defense , Influenza, Human/prevention & control , Military Personnel , Pandemics/prevention & control , Public Health Practice , Biohazard Release/prevention & control , Civil Defense/education , Communicable Disease Control , Communicable Diseases/diagnosis , Disaster Planning , Disease Notification , Humans , Influenza, Human/therapy , Interinstitutional Relations , Patient Isolation , Personal Protective Equipment , United Kingdom
10.
JAMA Netw Open ; 4(4): e218184, 2021 04 01.
Article in English | MEDLINE | ID: covidwho-1384070

ABSTRACT

Importance: Digital contact tracing (DCT) apps have been released in several countries to help interrupt SARS-CoV-2 transmission chains. However, the effect of DCT on pandemic mitigation remains to be demonstrated. Objective: To estimate key populations and performance indicators along the exposure notification cascade of the SwissCovid DCT app in a clearly defined regional and temporal context. Design, Setting, and Participants: This comparative effectiveness study was based on a simulation informed by measured data from issued quarantine recommendations and positive SARS-CoV-2 test results after DCT exposure notifications in the canton of Zurich. A stochastic model was developed to re-create the DCT notification cascade for Zurich. Population sizes at each cascade step were estimated using triangulation based on publicly available administrative and observational research data for the study duration from September 1 to October 31, 2020. The resultant estimates were checked for internal consistency and consistency with upstream or downstream estimates in the cascade. Stochastic sampling from data-informed parameter distributions was performed to explore the robustness of results. Subsequently, key performance indicators were evaluated to assess the potential contribution of DCT compared with manual contact tracing. Main Outcomes and Measures: Receiving a voluntary quarantine recommendation and/or a positive SARS-CoV-2 test result after exposure notification. Results: In September 2020, 537 app users received a positive SARS-CoV-2 test result in Zurich, 324 of whom received and entered an upload authorization code. This code triggered an app notification for an estimated 1374 (95% simulation interval [SI], 932-2586) proximity contacts and led to 722 information hotline calls, with an estimated 170 callers (95% SI, 154-186) receiving a quarantine recommendation. An estimated 939 (95% SI, 720-1127) notified app users underwent testing for SARS-CoV-2, of whom 30 (95% SI, 23-36) had positive results after an app notification. Key indicator evaluations revealed that the DCT app triggered quarantine recommendations for the equivalent of 5% of all exposed contacts placed in quarantine by manual contact tracing. For every 10.9 (95% SI, 7.6-15.6) upload authorization codes entered in the app, 1 contact had positive test results for SARS-CoV-2 after app notification. Longitudinal indicator analyses demonstrated bottlenecks in the notification cascade, because capacity limits were reached owing to an increased incidence of SARS-CoV-2 infection in October 2020. Conclusions and Relevance: In this simulation study of the notification cascade of the SwissCovid DCT app, receipt of exposure notifications was associated with quarantine recommendations and identification of SARS-CoV-2-positive cases. These findings in notified proximity contacts reflect important intermediary steps toward transmission prevention.


Subject(s)
COVID-19 , Computer Simulation , Contact Tracing , Disease Notification , Disease Transmission, Infectious , Mobile Applications , Adult , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/transmission , Communicable Disease Control/methods , Communicable Disease Control/organization & administration , Contact Tracing/methods , Contact Tracing/statistics & numerical data , Disease Notification/methods , Disease Notification/statistics & numerical data , Disease Transmission, Infectious/prevention & control , Disease Transmission, Infectious/statistics & numerical data , Female , Humans , Male , Quarantine , SARS-CoV-2/isolation & purification , Switzerland/epidemiology
12.
Commun Dis Intell (2018) ; 452021 Jul 22.
Article in English | MEDLINE | ID: covidwho-1329286

ABSTRACT

Abstract: Nationwide surveillance of Creutzfeldt-Jakob disease and other human prion diseases is performed by the Australian National Creutzfeldt-Jakob Disease Registry (ANCJDR). National surveillance encompasses the period since 1 January 1970, with prospective surveillance occurring from 1 October 1993. Over this prospective surveillance period, considerable developments have occurred in pre-mortem diagnostics; in the delineation of new disease subtypes; and in a heightened awareness of prion diseases in healthcare settings. Surveillance practices of the ANCJDR have evolved and adapted accordingly. This report summarises the activities of the ANCJDR during 2020. Since the ANCJDR began offering diagnostic cerebrospinal fluid (CSF) 14-3-3 protein testing in Australia in September 1997, the annual number of referrals has steadily increased. In 2020, 510 domestic CSF specimens were referred for 14-3-3 protein testing and 85 persons with suspected human prion disease were formally added to the national register. As of 31 December 2020, just over half (44 cases) of the 85 suspect case notifications remain classified as 'incomplete'; 27 cases were excluded through either detailed clinical follow-up (9 cases) or neuropathological examination (18 cases); 18 cases were classified as 'definite' and eleven as 'probable' prion disease. For 2020, sixty percent of all suspected human-prion-disease-related deaths in Australia underwent neuropathological examination. No cases of variant or iatrogenic CJD were identified. The SARS-CoV-2 pandemic did not affect prion disease surveillance outcomes in Australia.


Subject(s)
14-3-3 Proteins/cerebrospinal fluid , COVID-19/epidemiology , Creutzfeldt-Jakob Syndrome/epidemiology , Population Surveillance , Prion Diseases/epidemiology , Adult , Aged , Aged, 80 and over , Australia/epidemiology , Creutzfeldt-Jakob Syndrome/cerebrospinal fluid , Creutzfeldt-Jakob Syndrome/pathology , Disease Notification , Epidemiological Monitoring , Female , Humans , Male , Middle Aged , Neuropathology , Prion Diseases/cerebrospinal fluid , Prospective Studies , Registries
14.
PLoS One ; 16(7): e0254012, 2021.
Article in English | MEDLINE | ID: covidwho-1311284

ABSTRACT

BACKGROUND: In response to the spread of the coronavirus disease 2019 (COVID-19), plenty of control measures were proposed. To assess the impact of current control measures on the number of new case indices 14 countries with the highest confirmed cases, highest mortality rate, and having a close relationship with the outbreak's origin; were selected and analyzed. METHODS: In the study, we analyzed the impact of five control measures, including centralized isolation of all confirmed cases, closure of schools, closure of public areas, closure of cities, and closure of borders of the 14 targeted countries according to their timing; by comparing its absolute effect average, its absolute effect cumulative, and its relative effect average. RESULTS: Our analysis determined that early centralized isolation of all confirmed cases was represented as a core intervention in significantly disrupting the pandemic's spread. This strategy helped in successfully controlling the early stage of the outbreak when the total number of cases were under 100, without the requirement of the closure of cities and public areas, which would impose a negative impact on the society and its economy. However, when the number of cases increased with the apparition of new clusters, coordination between centralized isolation and non-pharmaceutical interventions facilitated control of the crisis efficiently. CONCLUSION: Early centralized isolation of all confirmed cases should be implemented at the time of the first detected infectious case.


Subject(s)
COVID-19/prevention & control , Patient Isolation/statistics & numerical data , Quarantine/statistics & numerical data , COVID-19/transmission , Disease Notification/statistics & numerical data , Disease Transmission, Infectious/statistics & numerical data , Humans , Models, Statistical
17.
MMWR Morb Mortal Wkly Rep ; 70(21): 792-793, 2021 May 28.
Article in English | MEDLINE | ID: covidwho-1248455

ABSTRACT

COVID-19 vaccines are a critical tool for controlling the ongoing global pandemic. The Food and Drug Administration (FDA) has issued Emergency Use Authorizations for three COVID-19 vaccines for use in the United States.* In large, randomized-controlled trials, each vaccine was found to be safe and efficacious in preventing symptomatic, laboratory-confirmed COVID-19 (1-3). Despite the high level of vaccine efficacy, a small percentage of fully vaccinated persons (i.e. received all recommended doses of an FDA-authorized COVID-19 vaccine) will develop symptomatic or asymptomatic infections with SARS-CoV-2, the virus that causes COVID-19 (2-8).


Subject(s)
COVID-19 Vaccines/administration & dosage , COVID-19/epidemiology , COVID-19/prevention & control , Adult , Aged , Aged, 80 and over , Centers for Disease Control and Prevention, U.S. , Disease Notification/statistics & numerical data , Female , Humans , Male , Middle Aged , Treatment Failure , United States/epidemiology
18.
Lab Med ; 52(6): 619-625, 2021 Nov 02.
Article in English | MEDLINE | ID: covidwho-1214642

ABSTRACT

Laboratory information systems need to adapt to new demands created by the COVID-19 pandemic, which has set up new normals like containment measures and social distancing. Some of these have negatively impacted the pre- and postanalytical phases of laboratory testing. Here, we present an intriguing finding related to the generation of the accession number/specimen number on the investigation module of a hospital management information system and its impact on the dissemination of reports resulting in the wrong release of reports on a female patient amidst the background of COVID-19 containment measures. We analyze the situation that led to this false reporting and the importance of the proper customization of information software in laboratories along with a robust postanalytical framework of laboratory work culture to avert such untoward incidents. This introspection has made us realize that COVID-19 has been a scientific, medical, and social challenge. We need to redefine our priorities in the days to come because SARS-CoV-2 is here to stay.


Subject(s)
COVID-19 Testing/standards , COVID-19/diagnosis , Diagnostic Errors , SARS-CoV-2/pathogenicity , Specimen Handling/standards , Staining and Labeling/standards , COVID-19/blood , COVID-19/pathology , COVID-19/virology , Clinical Laboratory Information Systems/organization & administration , Clinical Laboratory Services/organization & administration , Disease Notification/methods , Female , Humans , Patient Isolation/organization & administration , Young Adult
19.
Scand J Public Health ; 49(1): 48-56, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-1207572

ABSTRACT

Aim: Research concerning COVID-19 among immigrants is limited. We present epidemiological data for all notified cases of COVID-19 among the 17 largest immigrant groups in Norway, and related hospitalizations and mortality. Methods: We used data on all notified COVID-19 cases in Norway up to 18 October 2020, and associated hospitalizations and mortality, from the emergency preparedness register (including Norwegian Surveillance System for Communicable Diseases) set up by The Norwegian Institute of Public Health to handle the pandemic. We report numbers and rates per 100,000 people for notified COVID-19 cases, and related hospitalizations and mortality in the 17 largest immigrant groups in Norway, crude and with age adjustment. Results: The notification, hospitalization and mortality rates per 100,000 were 251, 21 and five, respectively, for non-immigrants; 567, 62 and four among immigrants; 408, 27 and two, respectively, for immigrants from Europe, North-America and Oceania; and 773, 106 and six, respectively for immigrants from Africa, Asia and South America. The notification rate was highest among immigrants from Somalia (2057), Pakistan (1868) and Iraq (1616). Differences between immigrants and non-immigrants increased when adjusting for age, especially for mortality. Immigrants had a high number of hospitalizations relative to notified cases compared to non-immigrants. Although the overall COVID-19 notification rate was higher in Oslo than outside of Oslo, the notification rate among immigrants compared to non-immigrants was not higher in Oslo than outside. Conclusions: We observed a higher COVID-19 notification rate in immigrants compared to non-immigrants and much higher hospitalization rate, with major differences between different immigrant groups. Somali-, Pakistani- and Iraqi-born immigrants had especially high rates.


Subject(s)
COVID-19/epidemiology , COVID-19/therapy , Disease Notification/statistics & numerical data , Emigrants and Immigrants/statistics & numerical data , Hospitalization/statistics & numerical data , Adolescent , Adult , Aged , COVID-19/mortality , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , Norway/epidemiology , Registries , Young Adult
20.
Front Public Health ; 9: 658544, 2021.
Article in English | MEDLINE | ID: covidwho-1201511

ABSTRACT

During the initial phases of the COVID-19 pandemic, accurate tracking has proven unfeasible. Initial estimation methods pointed toward case numbers that were much higher than officially reported. In the CoronaSurveys project, we have been addressing this issue using open online surveys with indirect reporting. We compare our estimates with the results of a serology study for Spain, obtaining high correlations (R squared 0.89). In our view, these results strongly support the idea of using open surveys with indirect reporting as a method to broadly sense the progress of a pandemic.


Subject(s)
COVID-19/epidemiology , Disease Notification/methods , Pandemics , Humans , Prevalence , Seroepidemiologic Studies , Spain/epidemiology , Surveys and Questionnaires
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