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1.
Euro Surveill ; 27(1)2022 01.
Article in English | MEDLINE | ID: covidwho-1613509

ABSTRACT

BackgroundCruise ships provide an ideal setting for transmission of SARS-CoV-2, given the socially dense exposure environment.AimTo provide a comprehensive review of COVID-19 outbreaks on cruise ships.MethodsPubMed was searched for COVID-19 cases associated with cruise ships between January and October 2020. A list of cruise ships with COVID-19 was cross-referenced with the United States Centers for Disease Control and Prevention's list of cruise ships associated with a COVID-19 case within 14 days of disembarkation. News articles were also searched for epidemiological information. Narratives of COVID-19 outbreaks on ships with over 100 cases are presented.ResultsSeventy-nine ships and 104 unique voyages were associated with COVID-19 cases before 1 October 2020. Nineteen ships had more than one voyage with a case of COVID-19. The median number of cases per ship was three (interquartile range (IQR): 1-17.8), with two notable outliers: the Diamond Princess and the Ruby Princess, which had 712 and 907 cases, respectively. The median attack rate for COVID-19 was 0.2% (IQR: 0.03-1.5), although this distribution was right-skewed with a mean attack rate of 3.7%; 25.9% (27/104) of voyages had at least one COVID-19-associated death. Outbreaks involving only crew occurred later than outbreaks involving guests and crew.ConclusionsIn the absence of mitigation measures, COVID-19 can spread easily on cruise ships in a susceptible population because of the confined space and high-density contact networks. This environment can create superspreader events and facilitate international spread.


Subject(s)
COVID-19 , Ships , Centers for Disease Control and Prevention, U.S. , Disease Outbreaks/prevention & control , Humans , SARS-CoV-2 , United States/epidemiology
2.
Front Public Health ; 9: 780039, 2021.
Article in English | MEDLINE | ID: covidwho-1608013

ABSTRACT

Introduction: With the increased emergence of SARS-CoV-2 variants, the impact on schools and preschools remains a matter of debate. To ensure that schools and preschools are kept open safely, the identification of factors influencing the extent of outbreaks is of importance. Aim: To monitor dynamics of COVID-19 infections in schools and preschools and identify factors influencing the extent of outbreaks. Methods: In this prospective observational study we analyzed routine surveillance data of Mecklenburg-Western Pomerania, Germany, from calendar week (CW) 32, 2020 to CW19, 2021 regarding SARS-CoV-2 infection events in schools and preschools considering changes in infection control measures over time. A multivariate linear regression model was fitted to evaluate factors influencing the number of students, teachers and staff tested positive following index cases in schools and preschools. Due to an existing multicollinearity in the common multivariate regression model between the variables "face mask obligation for children" and "face mask obligation for adults", two further separate regression models were set up (Multivariate Model Adults and Multivariate Model Children). Results: We observed a significant increase in secondary cases in preschools in the first quarter of 2021 (CW8 to CW15, 2021), and simultaneously a decrease in secondary cases in schools. In multivariate regression analysis, the strongest predictor of the extent of the outbreaks was the teacher/ caregiver mask obligation (B = -1.9; 95% CI: -2.9 to -1.0; p < 0.001). Furthermore, adult index cases (adult only or child+adult combinations) increased the likelihood of secondary cases (B = 1.3; 95% CI: 0.9 to 1.8; p < 0.001). The face mask obligation for children also showed a significant reduction in the number of secondary cases (B = -0.6; 95% CI: -0.9 to -0.2; p = 0.004. Conclusion: The present study indicates that outbreak events at schools and preschools are effectively contained by an obligation for adults and children to wear face masks.


Subject(s)
COVID-19 , Communicable Disease Control/methods , Schools , Adult , COVID-19/prevention & control , Child , Child, Preschool , Disease Outbreaks/prevention & control , Germany , Humans , Masks , Prospective Studies , SARS-CoV-2
3.
Neuromodulation ; 24(3): 441-447, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1593901

ABSTRACT

OBJECTIVES: Due to the impact of COVID-19 epidemic, face-to-face follow-up treatments for patients with chronic pain and implanted spinal cord stimulation (SCS) devices are forced to be delayed or stopped. This has led to more follow ups being done remotely. Meanwhile, with the development of 4G/5G networks, smartphones, and novel devices, remote programming has become possible. Here, we investigated the demand and utility of remote follow-ups including remote programming for SCS for patients with chronic pain. MATERIALS AND METHODS: A questionnaire including questions on demographic characteristics, pain history, postimplantation life quality, standard follow-up experience, remote follow-up, and remote programming experience was sent to patients diagnosed as chronic intractable pain and treated with SCS during January 2019 to January 2020. RESULTS: A total of 64 participants completed the questionnaire. About 70% of participants expressed demands for remote follow-ups due to the inconvenience, high costs, and time consumption of traditional follow-up visits. Nearly 97% of participants have attempted remote follow-ups, and about 81% of participants have further tried remote programming. Approximately, 96% of them recognized the benefits. CONCLUSIONS: The remote programming was in high demand among participants. Most of the participants have tried remote follow-ups or even remote programming. The remote programming appeared to be more efficient, economic and were widely recognized among participants.


Subject(s)
COVID-19/prevention & control , Chronic Pain/therapy , Disease Outbreaks/prevention & control , Implantable Neurostimulators , Remote Sensing Technology/methods , Spinal Cord Stimulation/methods , Adult , COVID-19/epidemiology , China/epidemiology , Chronic Pain/epidemiology , Female , Follow-Up Studies , Humans , Male , Middle Aged , Pain Measurement/methods
4.
CMAJ Open ; 9(4): E1232-E1241, 2021.
Article in English | MEDLINE | ID: covidwho-1591622

ABSTRACT

BACKGROUND: Limited space and resources are potential obstacles to infection prevention and control (IPAC) measures in in-centre hemodialysis units. We aimed to assess IPAC measures implemented in Quebec's hemodialysis units during the spring of 2020, describe the characteristics of these units and document the cumulative infection rates during the first year of the COVID-19 pandemic. METHODS: For this cross-sectional survey, we invited leaders from 54 hemodialysis units in Quebec to report information on the physical characteristics of the unit and their perceptions of crowdedness, which IPAC measures were implemented from Mar. 1 to June 30, 2020, and adherence to and feasibility of appropriate IPAC measures. Participating units were contacted again in March 2021 to collect information on the number of COVID-19 cases in order to derive the cumulative infection rate of each unit. RESULTS: Data were obtained from 38 of the 54 units contacted (70% response rate), which provided care to 4485 patients at the time of survey completion. Fourteen units (37%) had implemented appropriate IPAC measures by 3 weeks after Mar. 1, and all 38 units had implemented them by 6 weeks after. One-third of units were perceived as crowded. General measures, masks and screening questionnaires were used in more than 80% of units, and various distancing measures in 55%-71%; reduction in dialysis frequency was rare. Data on cumulative infection rates were obtained from 27 units providing care to 4227 patients. The cumulative infection rate varied from 0% to 50% (median 11.3%, interquartile range 5.2%-20.2%) and was higher than the reported cumulative infection rate in the corresponding region in 23 (85%) of the 27 units. INTERPRETATION: Rates of COVID-19 infection among hemodialysis recipients in Quebec were elevated compared to the general population during the first year of the pandemic, and although hemodialysis units throughout the province implemented appropriate IPAC measures rapidly in the spring of 2020, many units were crowded and could not maintain physical distancing. Future hemodialysis units should be designed to minimize airborne and droplet transmission of infection.


Subject(s)
COVID-19/prevention & control , Cross Infection/prevention & control , Disease Outbreaks/prevention & control , Infection Control , Renal Dialysis , COVID-19/epidemiology , Cross-Sectional Studies , Humans , Infection Control/methods , Infection Control/statistics & numerical data , Quebec/epidemiology , Renal Dialysis/adverse effects , Renal Dialysis/methods , Surveys and Questionnaires
5.
Am J Health Behav ; 45(6): 978-992, 2021 11 15.
Article in English | MEDLINE | ID: covidwho-1595142

ABSTRACT

OBJECTIVE: The current study uses the unique setting created by the coronavirus crisis in China during the peak period of the pandemic to examine the behavioral factors affecting the decision of the Chinese people to adopt the precautionary actions recommended by the government. METHODS: Using the social app WeChat, we conducted a cross sectional study of the Chinese people in mid-February 2020. RESULTS: Our results show that higher levels of dispositional optimism and support for the government's actions for managing the epidemic were positively correlated with the compliance level. In addition, women and married participants were more likely to comply with the recommendations. CONCLUSIONS: Optimism and support for government actions should be considered when promoting policies related to health behavior such as social distancing.


Subject(s)
COVID-19 , China/epidemiology , Cross-Sectional Studies , Disease Outbreaks/prevention & control , Female , Humans , SARS-CoV-2
6.
Semin Respir Crit Care Med ; 42(6): 828-838, 2021 12.
Article in English | MEDLINE | ID: covidwho-1585701

ABSTRACT

The past two decades have witnessed the emergence of three zoonotic coronaviruses which have jumped species to cause lethal disease in humans: severe acute respiratory syndrome coronavirus 1 (SARS-CoV-1), Middle East respiratory syndrome coronavirus (MERS-CoV), and SARS-CoV-2. MERS-CoV emerged in Saudi Arabia in 2012 and the origins of MERS-CoV are not fully understood. Genomic analysis indicates it originated in bats and transmitted to camels. Human-to-human transmission occurs in varying frequency, being highest in healthcare environment and to a lesser degree in the community and among family members. Several nosocomial outbreaks of human-to-human transmission have occurred, the largest in Riyadh and Jeddah in 2014 and South Korea in 2015. MERS-CoV remains a high-threat pathogen identified by World Health Organization as a priority pathogen because it causes severe disease that has a high mortality rate, epidemic potential, and no medical countermeasures. MERS-CoV has been identified in dromedaries in several countries in the Middle East, Africa, and South Asia. MERS-CoV-2 causes a wide range of clinical presentations, although the respiratory system is predominantly affected. There are no specific antiviral treatments, although recent trials indicate that combination antivirals may be useful in severely ill patients. Diagnosing MERS-CoV early and implementation infection control measures are critical to preventing hospital-associated outbreaks. Preventing MERS relies on avoiding unpasteurized or uncooked animal products, practicing safe hygiene habits in health care settings and around dromedaries, community education and awareness training for health workers, as well as implementing effective control measures. Effective vaccines for MERS-COV are urgently needed but still under development.


Subject(s)
Middle East Respiratory Syndrome Coronavirus , Animals , Antiviral Agents/administration & dosage , Antiviral Agents/therapeutic use , Camelus/virology , Coronavirus Infections/diagnosis , Coronavirus Infections/drug therapy , Coronavirus Infections/prevention & control , Coronavirus Infections/virology , Disease Outbreaks/prevention & control , Humans , Infection Control/methods , Middle East Respiratory Syndrome Coronavirus/drug effects , Middle East Respiratory Syndrome Coronavirus/pathogenicity
7.
BMJ Glob Health ; 6(12)2021 12.
Article in English | MEDLINE | ID: covidwho-1583125

ABSTRACT

The COVID-19 pandemic taught us many lessons, most critically that its human and economic toll would have been significantly smaller if countries had in place strong layers of defence that would have either prevented the spillover of the SARS-CoV-2 into a human population in the first place, or, failing that, contained the outbreak to avert its global spread. Further, the brunt of COVID-19 impacts on some countries considered 'most prepared' for pandemics underscored the need for an integrated approach to ensure resilience to future epidemics. Consequently, as countries plan ahead to prevent future pandemics, they should give priority to investments that transform their systems, particularly in the precrises phase, to preparedness and response through a multilayered defence. We propose a three-layered approach for post-COVID-19 investments in public health functions and service delivery, particularly at the community and precrises levels. This framework highlights the interventions that enable countries to better prevent, detect and contain epidemic threats, and that strengthen the efficient use of limited resources towards high-impact precrises systems.


Subject(s)
COVID-19 , Pandemics , Disease Outbreaks/prevention & control , Government Programs , Humans , Pandemics/prevention & control , SARS-CoV-2
8.
Front Public Health ; 9: 797808, 2021.
Article in English | MEDLINE | ID: covidwho-1581100

ABSTRACT

The presented deep learning and sensor-fusion based assistive technology (Smart Facemask and Thermal scanning kiosk) will protect the individual using auto face-mask detection and auto thermal scanning to detect the current body temperature. Furthermore, the presented system also facilitates a variety of notifications, such as an alarm, if an individual is not wearing a mask and detects thermal temperature beyond the standard body temperature threshold, such as 98.6°F (37°C). Design/methodology/approach-The presented deep Learning and sensor-fusion-based approach can also detect an individual in with or without mask situations and provide appropriate notification to the security personnel by raising the alarm. Moreover, the smart tunnel is also equipped with a thermal sensing unit embedded with a camera, which can detect the real-time body temperature of an individual concerning the prescribed body temperature limits as prescribed by WHO reports. Findings-The investigation results validate the performance evaluation of the presented smart face-mask and thermal scanning mechanism. The presented system can also detect an outsider entering the building with or without mask condition and be aware of the security control room by raising appropriate alarms. Furthermore, the presented smart epidemic tunnel is embedded with an intelligent algorithm that can perform real-time thermal scanning of an individual and store essential information in a cloud platform, such as Google firebase. Thus, the proposed system favors society by saving time and helps in lowering the spread of coronavirus.


Subject(s)
COVID-19 , Deep Learning , Algorithms , Disease Outbreaks/prevention & control , Humans , Masks
9.
Int J Environ Res Public Health ; 19(1)2021 12 26.
Article in English | MEDLINE | ID: covidwho-1580811

ABSTRACT

In July 2021, breakthrough cases were reported in the outbreak of COVID-19 in Nanjing, sparking concern and discussion about the vaccine's effectiveness and becoming a trending topic on Sina Weibo. In order to explore public attitudes towards the COVID-19 vaccine and their emotional orientations, we collected 1542 posts under the trending topic through data mining. We set up four categories of attitudes towards COVID-19 vaccines, and used a big data analysis tool to code and manually checked the coding results to complete the content analysis. The results showed that 45.14% of the Weibo posts (n = 1542) supported the COVID-19 vaccine, 12.97% were neutral, and 7.26% were doubtful, which indicated that the public did not question the vaccine's effectiveness due to the breakthrough cases in Nanjing. There were 66.47% posts that reflected significant negative emotions. Among these, 50.44% of posts with negative emotions were directed towards the media, 25.07% towards the posting users, and 11.51% towards the public, which indicated that the negative emotions were not directed towards the COVID-19 vaccine. External sources outside the vaccine might cause vaccine hesitancy. Public opinions expressed in online media reflect the public's cognition and attitude towards vaccines and their core needs in terms of information. Therefore, online public opinion monitoring could be an essential way to understand the opinions and attitudes towards public health issues.


Subject(s)
COVID-19 , Social Media , COVID-19 Vaccines , Disease Outbreaks/prevention & control , Humans , SARS-CoV-2
10.
J Med Internet Res ; 23(2): e23400, 2021 02 08.
Article in English | MEDLINE | ID: covidwho-1575940

ABSTRACT

BACKGROUND: The rapid spread of the COVID-19 pandemic in the United States has made people uncertain about their perceptions of the threat of COVID-19 and COVID-19 response measures. To mount an effective response to this epidemic, it is necessary to understand the public's perceptions, behaviors, and attitudes. OBJECTIVE: We aimed to test the hypothesis that people's perceptions of the threat of COVID-19 influence their attitudes and behaviors. METHODS: This study used an open dataset of web-based questionnaires about COVID-19. The questionnaires were provided by Nexoid United Kingdom. We selected the results of a questionnaire on COVID-19-related behaviors, attitudes, and perceptions among the US public. The questionnaire was conducted from March 29 to April 20, 2020. A total of 24,547 people who lived in the United States took part in the survey. RESULTS: In this study, the average self-assessed probability of contracting COVID-19 was 33.2%, and 49.9% (12,244/24,547) of the respondents thought that their chances of contracting COVID-19 were less than 30%. The self-assessed probability of contracting COVID-19 among women was 1.35 times that of males. A 5% increase in perceived infection risk was significantly associated with being 1.02 times (OR 1.02, 95% CI 1.02-1.02; P<.001) more likely to report having close contact with >10 people, and being 1.01 times (OR 1.01, 95% CI 1.01-1.01; P<.001) more likely to report that cohabitants disagreed with taking steps to reduce the risk of contracting COVID-19. However, there was no significant association between participants who lived with more than 5 cohabitants or less than 5 cohabitants (P=.85). Generally, participants who lived in states with 1001-10,000 COVID-19 cases, were aged 20-40 years, were obese, smoked, drank alcohol, never used drugs, and had no underlying medical conditions were more likely to be in close contact with >10 people. Most participants (21,017/24,547, 85.6%) agreed with washing their hands and maintaining social distancing, but only 20.2% (4958/24,547) of participants often wore masks. Additionally, male participants and participants aged <20 years typically disagreed with washing their hands, maintaining social distancing, and wearing masks. CONCLUSIONS: This survey is the first attempt to describe the determinants of the US public's perception of the threat of COVID-19 on a large scale. The self-assessed probability of contracting COVID-19 differed significantly based on the respondents' genders, states of residence, ages, body mass indices, smoking habits, alcohol consumption habits, drug use habits, underlying medical conditions, environments, and behaviors. These findings can be used as references by public health policy makers and health care workers who want to identify populations that need to be educated on COVID-19 prevention and health.


Subject(s)
COVID-19/epidemiology , Disease Outbreaks/prevention & control , Pandemics/prevention & control , Adult , Cross-Sectional Studies , Female , Humans , Male , Perception , SARS-CoV-2/isolation & purification , Surveys and Questionnaires , United States , Young Adult
11.
J Prev Med Hyg ; 62(3): E628-E634, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1575254

ABSTRACT

The number of outbreaks have progressively increased since many years in India. In this era of globalization and rapid international travel, any infectious disease in one country can become a potential threat to the entire globe. Outbreaks of Nipah, Zika, Crimean-Congo Haemorrhagic Fever and Kyasanur Forest Disease have been reported since a decade and now we are facing COVID-19 pandemic. One of the challenges in the prevention of these outbreaks is that as the cases decrease, the felt need declines, the public demand decreases and the mitigation responses get overshadowed by the need of emergency responses elsewhere. The One Health approach is a movement to promote alliance between medicine field, veterinary medicine and environmental sciences to upgrade the health of humans, animals, and ecosystem. The data in this article is compiled from different websites and publications of World Health Organization (WHO), Centre for Disease Control and Prevention (CDC), Integrated Disease Surveillance Programme (IDSP), grey literature and media. There is an urgent need for better surveillance and disease burden assessments in the country and to gain detailed insights into vector biology, factors of environment influencing the diseases, mapping of endemic areas, strengthen intersectoral coordination, infection control practices, and ensure use of Personal Protective Equipment's (PPE) and availability of drugs and vaccines to handle the outbreaks in a better way.


Subject(s)
COVID-19 , Hemorrhagic Fever, Crimean , Zika Virus Infection , Zika Virus , Animals , Disease Outbreaks/prevention & control , Ecosystem , Hemorrhagic Fever, Crimean/epidemiology , Humans , India/epidemiology , Pandemics , SARS-CoV-2
12.
BMC Med ; 19(1): 198, 2021 08 12.
Article in English | MEDLINE | ID: covidwho-1571757

ABSTRACT

BACKGROUND: The COVID-19 pandemic has disrupted the delivery of immunisation services globally. Many countries have postponed vaccination campaigns out of concern about infection risks to the staff delivering vaccination, the children being vaccinated, and their families. The World Health Organization recommends considering both the benefit of preventive campaigns and the risk of SARS-CoV-2 transmission when making decisions about campaigns during COVID-19 outbreaks, but there has been little quantification of the risks. METHODS: We modelled excess SARS-CoV-2 infection risk to vaccinators, vaccinees, and their caregivers resulting from vaccination campaigns delivered during a COVID-19 epidemic. Our model used population age structure and contact patterns from three exemplar countries (Burkina Faso, Ethiopia, and Brazil). It combined an existing compartmental transmission model of an underlying COVID-19 epidemic with a Reed-Frost model of SARS-CoV-2 infection risk to vaccinators and vaccinees. We explored how excess risk depends on key parameters governing SARS-CoV-2 transmissibility, and aspects of campaign delivery such as campaign duration, number of vaccinations, and effectiveness of personal protective equipment (PPE) and symptomatic screening. RESULTS: Infection risks differ considerably depending on the circumstances in which vaccination campaigns are conducted. A campaign conducted at the peak of a SARS-CoV-2 epidemic with high prevalence and without special infection mitigation measures could increase absolute infection risk by 32 to 45% for vaccinators and 0.3 to 0.5% for vaccinees and caregivers. However, these risks could be reduced to 3.6 to 5.3% and 0.1 to 0.2% respectively by use of PPE that reduces transmission by 90% (as might be achieved with N95 respirators or high-quality surgical masks) and symptomatic screening. CONCLUSIONS: SARS-CoV-2 infection risks to vaccinators, vaccinees, and caregivers during vaccination campaigns can be greatly reduced by adequate PPE, symptomatic screening, and appropriate campaign timing. Our results support the use of adequate risk mitigation measures for vaccination campaigns held during SARS-CoV-2 epidemics, rather than cancelling them entirely.


Subject(s)
COVID-19/prevention & control , Disease Outbreaks/prevention & control , Health Personnel , Immunization Programs/organization & administration , SARS-CoV-2 , Vaccination , Brazil , Burkina Faso , COVID-19/epidemiology , Child , Ethiopia , Female , Humans , Male , Pandemics , Personal Protective Equipment
13.
J Infect Dev Ctries ; 15(11): 1625-1629, 2021 11 30.
Article in English | MEDLINE | ID: covidwho-1572705

ABSTRACT

INTRODUCTION: This paper aims to measure the performance of early detection methods, which are usually used for infectious diseases. METHODOLOGY: By using real data of confirmed Coronavirus cases from the Kingdom of Saudi Arabia and Italy, the moving epidemic method (MEM) and the moving average cumulative sums (Mov. Avg Cusum) methods are used in our simulation study. RESULTS: Our results suggested that the CUSUM method outperforms the MEM in detecting the start of the Coronavirus outbreak.


Subject(s)
COVID-19/diagnosis , Diagnostic Tests, Routine , Early Diagnosis , SARS-CoV-2 , Benchmarking , COVID-19/epidemiology , Databases, Factual , Disease Outbreaks/prevention & control , Humans , Italy/epidemiology , Saudi Arabia/epidemiology
14.
Front Public Health ; 9: 779410, 2021.
Article in English | MEDLINE | ID: covidwho-1572343

ABSTRACT

Introduction: The objective of this study is to investigate the COVID-19 outbreak and its successful containment in a long-term care facility, Qatar. Materials and Methods: It was a retrospective case series of 24 COVID-19 positive patients inclusive of elderly, patient attenders, and front-liners from 06th to 18th June 2020. Laboratory, radiological, and treatment findings were assessed from electronic records. Results: The outbreak management team concluded that despite all the pre-existing preventive measures implemented at the start of the pandemic, there was still evidence of lapses in infection control practices such as breach of infection control protocols like improper use of personal protective equipment. The infection prevention and control team promptly reassessed and implemented more stringent infection control methods and practices that successfully contained the outbreak on July 1, 2020. Among the seven elderly patients, the average age was 76.28 years ± SD25.5 and all were females. 57% of the patients were symptomatic. The most common comorbidities were Dementia (57%), Diabetes mellitus (43%), Coronary Artery Disease (43%), and Seizures (43%). Ground glass appearances in the lungs were found in 29% of the patients. Among the three deceased patients, Dementia and Coronary Artery Disease were the common comorbidities. Persistent elevation in blood glucose levels was observed among all patients during this period of infection. Conclusion: Elderlies in long-term care facilities are with certain pre-existing comorbidities which makes them more prone to develop COVID-19 complications. Thus, intensive infection control measures like ongoing education and awareness, staff compliance monitoring, quick contact tracing, visitor policy revision, ongoing patient and caregivers monitoring are inevitable recommendations for effective outbreak prevention and management.


Subject(s)
COVID-19 , Long-Term Care , Aged , Disease Outbreaks/prevention & control , Humans , Nursing Homes , Qatar/epidemiology , Retrospective Studies , SARS-CoV-2
15.
J Theor Biol ; 535: 110983, 2022 02 21.
Article in English | MEDLINE | ID: covidwho-1568886

ABSTRACT

During the COVID-19 pandemic, non-pharmaceutical interventions (NPIs) including school closures, workplace closures and social distancing policies have been employed worldwide to reduce transmission and prevent local outbreaks. However, transmission and the effectiveness of NPIs depend strongly on age-related factors including heterogeneities in contact patterns and pathophysiology. Here, using SARS-CoV-2 as a case study, we develop a branching process model for assessing the risk that an infectious case arriving in a new location will initiate a local outbreak, accounting for the age distribution of the host population. We show that the risk of a local outbreak depends on the age of the index case, and we explore the effects of NPIs targeting individuals of different ages. Social distancing policies that reduce contacts outside of schools and workplaces and target individuals of all ages are predicted to reduce local outbreak risks substantially, whereas school closures have a more limited impact. In the scenarios considered here, when different NPIs are used in combination the risk of local outbreaks can be eliminated. We also show that heightened surveillance of infectious individuals reduces the level of NPIs required to prevent local outbreaks, particularly if enhanced surveillance of symptomatic cases is combined with efforts to find and isolate nonsymptomatic infected individuals. Our results reflect real-world experience of the COVID-19 pandemic, during which combinations of intense NPIs have reduced transmission and the risk of local outbreaks. The general modelling framework that we present can be used to estimate local outbreak risks during future epidemics of a range of pathogens, accounting fully for age-related factors.


Subject(s)
COVID-19 , SARS-CoV-2 , Disease Outbreaks/prevention & control , Humans , Pandemics , Quarantine
18.
Am J Phys Med Rehabil ; 100(11): 1031-1032, 2021 Nov 01.
Article in English | MEDLINE | ID: covidwho-1537604

ABSTRACT

ABSTRACT: This brief report summarizes the comparative experience of an inpatient rehabilitation facility dealing with two episodes of COVID-19 infection, one before and one after the availability of vaccination, which was deployed to staff. The experience exemplifies the high rate of infection and potential for asymptomatic presentation of COVID-19 as well as the protective advantage of the vaccine for healthcare workers in this report. With a significant reduction in the rate of infection, from nearly 30% before vaccination to only 2.5% after vaccination. The data presented should serve as an encouragement for vaccination across all populations.


Subject(s)
COVID-19 Vaccines/administration & dosage , COVID-19/prevention & control , Health Personnel , Infection Control/standards , Pneumonia, Viral/prevention & control , Rehabilitation Centers , Adult , COVID-19/epidemiology , Disease Outbreaks/prevention & control , Female , Guideline Adherence , Humans , Inpatients , Male , Mass Screening , Pennsylvania/epidemiology , Pneumonia, Viral/virology , SARS-CoV-2
19.
Euro Surveill ; 26(46)2021 11.
Article in English | MEDLINE | ID: covidwho-1526748

ABSTRACT

We describe the impact of changing epidemiology and vaccine introduction on characteristics of COVID-19 outbreaks in 330 long-term care facilities (LTCF) in England between November 2020 and June 2021. As vaccine coverage in LTCF increased and national incidence declined, the total number of outbreaks and outbreak severity decreased across the LTCF. The number of infected cases per outbreak decreased by 80.6%, while the proportion of outbreaks affecting staff only increased. Our study supports findings of vaccine effectiveness in LTCF.


Subject(s)
COVID-19 , Vaccines , Disease Outbreaks/prevention & control , Humans , Long-Term Care , SARS-CoV-2
20.
PLoS One ; 16(11): e0259969, 2021.
Article in English | MEDLINE | ID: covidwho-1523443

ABSTRACT

Comprehensive testing schemes, followed by adequate contact tracing and isolation, represent the best public health interventions we can employ to reduce the impact of an ongoing epidemic when no or limited vaccine supplies are available and the implications of a full lockdown are to be avoided. However, the process of tracing can prove feckless for highly-contagious viruses such as SARS-CoV-2. The interview-based approaches often miss contacts and involve significant delays, while digital solutions can suffer from insufficient adoption rates or inadequate usage patterns. Here we present a novel way of modelling different contact tracing strategies, using a generalized multi-site mean-field model, which can naturally assess the impact of manual and digital approaches alike. Our methodology can readily be applied to any compartmental formulation, thus enabling the study of more complex pathogen dynamics. We use this technique to simulate a newly-defined epidemiological model, SEIR-T, and show that, given the right conditions, tracing in a COVID-19 epidemic can be effective even when digital uptakes are sub-optimal or interviewers miss a fair proportion of the contacts.


Subject(s)
COVID-19 , Contact Tracing/methods , Disease Outbreaks/prevention & control , Models, Statistical , COVID-19/epidemiology , COVID-19/prevention & control , Humans
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