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3.
BMC Fam Pract ; 22(1): 36, 2021 02 14.
Article in English | MEDLINE | ID: covidwho-1081417

ABSTRACT

BACKGROUND: The COVID-19 pandemic has shaken the world in early 2020. In France, General Practitioners (GPs) were not involved in the care organization's decision-making process before and during the first wave of the COVID-19 pandemic. This omission could have generated stress for GPs. We aimed first to estimate the self-perception of stress as defined by the 10-item Perceived Stress Score (PSS-10), at the beginning of the pandemic in France, among GPs from the Auvergne-Rhône-Alpes, a french administrative area severely impacted by COVID-19. Second, we aimed to identify factors associated with a self-perceived stress (PSS-10 ≥ 27) among socio-demographic characteristics of GPs, their access to reliable information and to personal protective equipment during the pandemic, and their exposure to well established psychosocial risk at work. METHODS: We conducted an online cross-sectional survey between 8th April and 10th May 2020. The self-perception of stress was evaluated using the PSS-10, so to see the proportion of "not stressed" (≤20), "borderline" (21 ≤ PSS-10 ≤ 26), and "stressed" (≥27) GPs. The agreement to 31 positive assertions related to possible sources of stress identified by the scientific study committee was measured using a 10-point numeric scale. In complete cases, factors associated with stress (PSS-10 ≥ 27) were investigated using logistic regression, adjusted on gender, age and practice location. A supplementary analysis of the verbatims was made. RESULTS: Overall, 898 individual answers were collected, of which 879 were complete. A total of 437 GPs (49%) were stressed (PSS-10 ≥ 27), and 283 GPs (32%) had a very high level of stress (PSS-10 ≥ 30). Self-perceived stress was associated with multiple components, and involved classic psychosocial risk factors such as emotional requirements. However, in this context of health crisis, the primary source of stress was the diversity and quantity of information from diverse sources (614 GPs (69%, OR = 2.21, 95%CI [1.40-3.50], p < 0.001). Analysis of verbatims revealed that GPs felt isolated in a hospital-based model. CONCLUSION: The first wave of the pandemic was a source of stress for GPs. The diversity and quantity of information received from the health authorities were among the main sources of stress.


Subject(s)
Communicable Disease Control , General Practitioners , Occupational Exposure , Occupational Health/trends , Self Concept , Stress, Psychological , Adult , Attitude of Health Personnel , /prevention & control , Communicable Disease Control/instrumentation , Communicable Disease Control/organization & administration , Cross-Sectional Studies , Diagnostic Self Evaluation , Disease Transmission, Infectious/prevention & control , Female , France/epidemiology , General Practitioners/psychology , General Practitioners/statistics & numerical data , Humans , Male , Occupational Exposure/adverse effects , Occupational Exposure/prevention & control , Personal Protective Equipment/supply & distribution , Stress, Psychological/diagnosis , Stress, Psychological/epidemiology , Stress, Psychological/etiology
4.
N Z Med J ; 134(1529): 26-38, 2021 02 05.
Article in English | MEDLINE | ID: covidwho-1080082

ABSTRACT

AIM: We aimed to estimate the risk of COVID-19 outbreaks in a COVID-19-free destination country (New Zealand) associated with shore leave by merchant ship crews who were infected prior to their departure or on their ship. METHODS: We used a stochastic version of the SEIR model CovidSIM v1.1 designed specifically for COVID-19. It was populated with parameters for SARS-CoV-2 transmission, shipping characteristics and plausible control measures. RESULTS: When no control interventions were in place, we estimated that an outbreak of COVID-19 in New Zealand would occur after a median time of 23 days (assuming a global average for source country incidence of 2.66 new infections per 1,000 population per week, crews of 20 with a voyage length of 10 days and 1 day of shore leave per crew member both in New Zealand and abroad, and 108 port visits by international merchant ships per week). For this example, the uncertainty around when outbreaks occur is wide (an outbreak occurs with 95% probability between 1 and 124 days). The combination of PCR testing on arrival, self-reporting of symptoms with contact tracing and mask use during shore leave increased this median time to 1.0 year (14 days to 5.4 years, or a 49% probability within a year). Scenario analyses found that onboard infection chains could persist for well over 4 weeks, even with crews of only 5 members. CONCLUSION: This modelling work suggests that the introduction of SARS-CoV-2 through shore leave from international shipping crews is likely, even after long voyages. But the risk can be substantially mitigated by control measures such as PCR testing and mask use.


Subject(s)
Communicable Diseases, Imported/prevention & control , Disease Transmission, Infectious , Naval Medicine , Quarantine/methods , Ships , /diagnosis , /prevention & control , /methods , Communicable Disease Control/instrumentation , Communicable Disease Control/methods , Computer Simulation , Disease Transmission, Infectious/prevention & control , Disease Transmission, Infectious/statistics & numerical data , Humans , Masks , Naval Medicine/methods , Naval Medicine/statistics & numerical data , New Zealand/epidemiology
5.
N Z Med J ; 134(1529): 10-25, 2021 02 05.
Article in English | MEDLINE | ID: covidwho-1080064

ABSTRACT

AIMS: We developed a model, updated daily, to estimate undetected COVID-19 infections exiting quarantine following selectively opening New Zealand's borders to travellers from low-risk countries. METHODS: The prevalence of infectious COVID-19 cases by country was multiplied by expected monthly passenger volumes to predict the rate of arrivals. The rate of undetected infections entering the border following screening and quarantine was estimated. Level 1, Level 2 and Level 3 countries were defined as those with an active COVID-19 prevalence of up to 1/105, 10/105 and 100/105, respectively. RESULTS: With 65,272 travellers per month, the number of undetected COVID-19 infections exiting quarantine is 1 every 45, 15 and 31 months for Level 1, Level 2 and Level 3 countries, respectively. The overall rate of undetected active COVID-19 infections exiting quarantine is expected to increase from the current 0.40 to 0.50 per month, or an increase of one extra infection every 10 months. CONCLUSIONS: Loosening border restrictions results in a small increase in the rate of undetected COVID-19 infections exiting quarantine, which increases from the current baseline by one infection every 10 months. This information may be useful in guiding decision-making on selectively opening of borders in the COVID-19 era.


Subject(s)
Communicable Disease Control , Communicable Diseases, Imported , Disease Transmission, Infectious , International Health Regulations , Quarantine , /epidemiology , /transmission , Communicable Disease Control/methods , Communicable Disease Control/organization & administration , Communicable Diseases, Imported/epidemiology , Communicable Diseases, Imported/prevention & control , Communicable Diseases, Imported/transmission , Disease Transmission, Infectious/prevention & control , Disease Transmission, Infectious/statistics & numerical data , Forecasting , Global Health , Humans , International Health Regulations/organization & administration , International Health Regulations/trends , New Zealand/epidemiology , Prevalence , Public Policy , Quarantine/organization & administration , Quarantine/statistics & numerical data , Travel/legislation & jurisprudence , Travel/statistics & numerical data
7.
BMC Med Res Methodol ; 21(1): 30, 2021 02 10.
Article in English | MEDLINE | ID: covidwho-1079210

ABSTRACT

BACKGROUND: In infectious disease transmission dynamics, the high heterogeneity in individual infectiousness indicates that few index cases generate large numbers of secondary cases, which is commonly known as superspreading events. The heterogeneity in transmission can be measured by describing the distribution of the number of secondary cases as a negative binomial (NB) distribution with dispersion parameter, k. However, such inference framework usually neglects the under-ascertainment of sporadic cases, which are those without known epidemiological link and considered as independent clusters of size one, and this may potentially bias the estimates. METHODS: In this study, we adopt a zero-truncated likelihood-based framework to estimate k. We evaluate the estimation performance by using stochastic simulations, and compare it with the baseline non-truncated version. We exemplify the analytical framework with three contact tracing datasets of COVID-19. RESULTS: We demonstrate that the estimation bias exists when the under-ascertainment of index cases with 0 secondary case occurs, and the zero-truncated inference overcomes this problem and yields a less biased estimator of k. We find that the k of COVID-19 is inferred at 0.32 (95%CI: 0.15, 0.64), which appears slightly smaller than many previous estimates. We provide the simulation codes applying the inference framework in this study. CONCLUSIONS: The zero-truncated framework is recommended for less biased transmission heterogeneity estimates. These findings highlight the importance of individual-specific case management strategies to mitigate COVID-19 pandemic by lowering the transmission risks of potential super-spreaders with priority.


Subject(s)
Binomial Distribution , /transmission , Computer Simulation , Disease Transmission, Infectious/statistics & numerical data , Humans , Infectious Disease Medicine/statistics & numerical data , Likelihood Functions , Pandemics , Population Surveillance , Selection Bias
8.
J Orthop Surg (Hong Kong) ; 29(1): 2309499020988176, 2021.
Article in English | MEDLINE | ID: covidwho-1079201

ABSTRACT

PURPOSE: In this study we investigated on the personal protective equipment (PPE) usage, recycling, and disposal among spine surgeons in the Asia Pacific region. METHODS: A cross-sectional survey was carried out among spine surgeons in Asia Pacific. The questionnaires were focused on the usage, recycling and disposal of PPE. RESULTS: Two hundred and twenty-two surgeons from 19 countries participated in the survey. When we sub-analysed the differences between countries, the provision of adequate PPE by hospitals ranged from 37.5% to 100%. The usage of PPE was generally high. The most used PPE were surgical face masks (88.7%), followed by surgical caps (88.3%), gowns (85.6%), sterile gloves (83.3%) and face shields (82.0%). The least used PPE were powered air-purifying respirators (PAPR) (23.0%) and shoes/boots (45.0%). The commonly used PPE for surgeries involving COVID-19 positive patients were N95 masks (74.8%), sterile gloves (73.0%), gowns (72.1%), surgical caps (71.6%), face shields (64.4%), goggles (64.0%), shoe covers (58.6%), plastic aprons (45.9%), shoes/boots (45.9%), surgical face masks (36.5%) and PAPRs (21.2%). Most PPE were not recycled. Biohazard bins were the preferred method of disposal for all types of PPE items compared to general waste. CONCLUSIONS: The usage of PPE was generally high among most countries especially for surgeries involving COVID-19 positive patients except for Myanmar and Nepal. Overall, the most used PPE were surgical face masks. For surgeries involving COVID-19 positive patients, the most used PPE were N95 masks. Most PPE were not recycled. Biohazard bins were the preferred method of disposal for all types of PPE.


Subject(s)
/epidemiology , Disease Transmission, Infectious/prevention & control , Orthopedics , Personal Protective Equipment/statistics & numerical data , Societies, Medical , Spinal Diseases/surgery , Asia , Comorbidity , Cross-Sectional Studies , Humans , Pandemics , Spinal Diseases/epidemiology , Surveys and Questionnaires
10.
J Hand Surg Asian Pac Vol ; 26(1): 127-129, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-1072799

ABSTRACT

Coronavirus disease-19 has affected million of people worldwide, constituting the biggest social, economic, and health crisis since World War 2. During this pandemic, the hospitals have become hot zones for the treatment of patients. Therefore, it is important to take the appropriate protective measures and ensure the physician's health and, especially, those who work in the intensive care units and in operating rooms. In this letter, we are trying to make a discussion regarding the measures that should be considered by the healthcare workers who are facing this invisible enemy during their effort to provide their services in the surgery rooms.


Subject(s)
/prevention & control , Infection Control/methods , Air Filters , Disease Transmission, Infectious/prevention & control , Humans , Intubation, Intratracheal , Medical Waste Disposal , Pandemics , Personal Protective Equipment
11.
Epidemiol Prev ; 44(5-6 Suppl 2): 152-159, 2020.
Article in English | MEDLINE | ID: covidwho-1068135

ABSTRACT

The determinants of the risk of becoming infected by SARS-CoV-2, contracting COVID-19, and being affected by the more serious forms of the disease have been generally explored in merely qualitative terms. It seems reasonable to argue that the risk patterns for COVID-19 have to be usefully studied in quantitative terms too, whenever possible applying the same approach to the relationship 'dose of the exposure vs pathological response' commonly used for chemicals and already followed for several biological agents to SARS-CoV-2, too. Such an approach is of particular relevance in the fields of both occupational epidemiology and occupational medicine, where the identification of the sources of a dangerous exposure and of the web of causation of a disease is often questionable and questioned: it is relevant when evaluating the population risk, too. Specific occupational scenarios, basically involving health workers, exhibit important proportions of both subjects simply infected by SARS-CoV-2 and of ill subjects with, respectively, mild, moderate, and severe disease. Similar patterns have been described referring to various circumstances of community exposure, e.g., standing in crowded public places, travelling on crowded means of transport, living in accommodation or care homes, living in the same household as a COVID-19 case. The hypothesis that these findings are a consequence not only of high probabilities of exposure, but also of high doses (as a product of both intensity and duration, with possible autonomous effects of peaks of exposure) deserves to be systematically tested, in order to reconstruct the web of causation of COVID-19 individual and clustered cases and to cope with situations at critical risk for SARS-CoV-2, needing to be identified, mapped, and dealt with at the right time. A limited but consistent set of papers supporting these assumptions has been traced in the literature. Under these premises, the creation of a structured inventory of both values of viral concentrations in the air (in case and if possible, of surface contaminations too) and of viral loads in biological matrixes is proposed, with the subsequent construction of a scenario-exposure matrix. A scenario-exposure matrix for SARS-CoV-2 may represent a useful tool for research and practical risk management purposes, helping to understand the possibly critical circumstances for which no direct exposure measure is available (this is an especially frequent case, in contexts of low socio-economic level) and providing guidance to determine evidence-based public health strategies.


Subject(s)
/virology , Environmental Exposure , Viral Load , Viremia/virology , Aerosols , Air Microbiology , Air Pollution, Indoor , /epidemiology , Cross Infection/epidemiology , Cross Infection/transmission , Cross Infection/virology , Crowding , Disease Transmission, Infectious , Environmental Monitoring , Family Characteristics , Fomites/virology , Humans , Infectious Disease Transmission, Patient-to-Professional , Institutionalization , Occupational Exposure , Risk , Risk Assessment , Time Factors , Transportation
12.
Jt Dis Relat Surg ; 32(1): 3-9, 2021.
Article in English | MEDLINE | ID: covidwho-1067912

ABSTRACT

OBJECTIVES: This study aims to investigate the effectiveness of a screening questionnaire to identify high-risk patients for novel coronavirus-2019 (COVID-19) among those undergoing elective orthopedic surgery. PATIENTS AND METHODS: Between May 4th, 2020 and June 11th, 2020, a total of 1,021 consecutive patients (492 males, 529 females; mean age: 62.3±15.1 years; range, 13 to 91 years) who were scheduled for elective orthopedic surgery were included. A screening questionnaire was applied to all patients. The patients admitted to hospital were also tested for COVID-19 infection through reverse transcription-polymerase chain reaction of the nasopharyngeal swab. RESULTS: Of the patients, 1,003 (98.2%) underwent elective surgery as planned. The screening questionnaire classified 30 patients as high-risk for COVID-19. A total of 18 procedures (n=18, 1.8%) were postponed due to the high risk of possible transmission of COVID-19. None of 991 low-risk patients were tested positive for COVID-19. CONCLUSION: The use of guiding principles for resuming elective orthopedic surgery is safe without a higher risk for complications in selected cases.


Subject(s)
Arthroplasty/statistics & numerical data , Elective Surgical Procedures/statistics & numerical data , Hospitalization , Adolescent , Adult , Aged , Aged, 80 and over , Disease Transmission, Infectious/prevention & control , Female , Germany/epidemiology , Hospitals, High-Volume , Humans , Male , Middle Aged , Pandemics , Retrospective Studies , Risk Assessment , Surveys and Questionnaires , Young Adult
13.
Euro Surveill ; 26(5)2021 02.
Article in English | MEDLINE | ID: covidwho-1067624

ABSTRACT

In June-November 2020, SARS-CoV-2-infected mink were detected in 290 of 1,147 Danish mink farms. In North Denmark Region, 30% (324/1,092) of people found connected to mink farms tested SARS-CoV-2-PCR-positive and approximately 27% (95% confidence interval (CI): 25-30) of SARS-CoV-2-strains from humans in the community were mink-associated. Measures proved insufficient to mitigate spread. On 4 November, the government ordered culling of all Danish mink. Farmed mink constitute a potential virus reservoir challenging pandemic control.


Subject(s)
Animals, Wild/virology , /veterinary , Disease Outbreaks/veterinary , Disease Reservoirs/veterinary , Disease Transmission, Infectious/veterinary , Mink/virology , Pandemics/veterinary , /isolation & purification , /transmission , Animals , /virology , Denmark/epidemiology , Disease Outbreaks/statistics & numerical data , Disease Reservoirs/virology , Farms , Genes, Viral , Humans , Incidence , Polymerase Chain Reaction , Public Health , RNA, Viral/analysis , RNA, Viral/genetics , /virology , Whole Genome Sequencing , Zoonoses/transmission , Zoonoses/virology
14.
Hosp Pediatr ; 11(2): 198-207, 2021 02.
Article in English | MEDLINE | ID: covidwho-1067458

ABSTRACT

OBJECTIVES: The coronavirus disease 2019 (COVID-19) pandemic is an unprecedented event in modern medicine. In this study, we evaluate pediatric faculty and trainee attitudes and perspectives related to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and their roles in the COVID-19 pandemic. METHODS: We surveyed a pediatric hospital's faculty and trainees (n = 701) in April 2020 about their concerns related to SARS-CoV-2, trust in current recommendations, and attitudes toward trainee roles. We used descriptive statistics to analyze results and compared across sex and roles using logistic regression. RESULTS: Among 320 respondents (46% response rate), 73% were concerned with personal risk of SARS-CoV-2 infection and 88% were concerned with loved ones' risk. Twenty-four percent were concerned because of personal risk factors. Nearly half expressed concerns as their family's major provider and about salary changes (48% and 46%). Seventy-nine percent were concerned about lack of personal protective equipment and 43% about redeployment. Respondents endorsed varying levels of trust in recommendations related to COVID-19. Nearly three-fourths (72%) felt trainees are essential personnel. The majority were receptive to returning to usual patient care and training as the pandemic progresses. Significant differences exist across sex and roles related to levels of concern, trust, and trainee roles. CONCLUSIONS: In this study, we assess the concerns and perspectives of pediatric faculty and trainees related to the COVID-19 pandemic. Most view trainees as essential personnel and recognize the importance of direct patient care in their training. These results can be used to inform policy changes and trainee roles as the COVID-19 pandemic progresses.


Subject(s)
Attitude of Health Personnel , Disease Transmission, Infectious/prevention & control , Faculty/psychology , Pandemics , Pediatrics/education , Personal Protective Equipment , Adolescent , Child , Female , Humans , Male , United States/epidemiology
15.
PLoS One ; 16(1): e0244819, 2021.
Article in English | MEDLINE | ID: covidwho-1067402

ABSTRACT

BACKGROUND: The U.S. has experienced an unprecedented number of orders to shelter in place throughout the ongoing COVID-19 pandemic. We aimed to ascertain whether social distancing; difficulty with daily activities; and levels of concern regarding COVID-19 changed after the March 16, 2020 announcement of the nation's first shelter-in-place orders (SIPO) among individuals living in the seven affected counties in the San Francisco Bay Area. METHODS: We conducted an online, cross-sectional social media survey from March 14 -April 1, 2020. We measured changes in social distancing behavior; experienced difficulties with daily activities (i.e., access to healthcare, childcare, obtaining essential food and medications); and level of concern regarding COVID-19 after the March 16 shelter-in-place announcement in the San Francisco Bay Area versus elsewhere in the U.S. RESULTS: In this non-representative sample, the percentage of respondents social distancing all of the time increased following the shelter-in-place announcement in the Bay Area (9.2%, 95% CI: 6.6, 11.9) and elsewhere in the U.S. (3.4%, 95% CI: 2.0, 5.0). Respondents also reported increased difficulty obtaining hand sanitizer, medications, and in particular respondents reported increased difficulty obtaining food in the Bay Area (13.3%, 95% CI: 10.4, 16.3) and elsewhere (8.2%, 95% CI: 6.6, 9.7). We found limited evidence that level of concern regarding the COVID-19 crisis changed following the announcement. CONCLUSION: This study characterizes early changes in attitudes, behaviors, and difficulties. As states and localities implement, rollback, and reinstate shelter-in-place orders, ongoing efforts to more fully examine the social, economic, and health impacts of COVID-19, especially among vulnerable populations, are urgently needed.


Subject(s)
Activities of Daily Living/psychology , Patient Isolation/psychology , Social Media/statistics & numerical data , Adult , /prevention & control , Cross-Sectional Studies , Disease Transmission, Infectious/prevention & control , Female , Humans , Male , Middle Aged , Pandemics , Patient Isolation/trends , San Francisco/epidemiology , United States/epidemiology
16.
Br J Community Nurs ; 26(2): 76-80, 2021 Feb 02.
Article in English | MEDLINE | ID: covidwho-1063515

ABSTRACT

COVID-19 has changed the landscape of healthcare in the UK since the first confirmed case in January 2020. Most of the resources have been directed towards reducing transmission in the hospital and clinical environment, but little is known about what community nurses can do to reduce the risk when they nurse people in their own homes? This article looks at what COVID-19 is, how it is spread and how health professionals are at an increased risk from aerosol-generating procedures (AGPs). There is also a discussion on the benefit of mask usage. It defines what AGPs are, which clinical procedures are AGPs, including ones performed in the community setting, and which identified clinical practices that have been mistaken for AGPs. There is also a discussion on the suitability of performing cardiopulmonary resuscitation (CPR). It also describes how to reduce the risk by the use of full personal protective equipment (PPE) and other strategies when AGPs are performed in a patient's home. It ends with general advice about managing the risk of COVID-19 transmission with patients in their homes.


Subject(s)
/prevention & control , Communicable Disease Control , Home Care Services , Personal Protective Equipment , /pathogenicity , Aerosols , Disease Transmission, Infectious/prevention & control , Humans , United Kingdom
17.
Medicine (Baltimore) ; 100(5): e23925, 2021 Feb 05.
Article in English | MEDLINE | ID: covidwho-1062935

ABSTRACT

ABSTRACT: The World Health Organization (WHO) classified the spread of COVID-19 (Coronavirus Disease 2019) as a global pandemic in March. Scholars predict that the pandemic will continue into the coming winter and will become a seasonal epidemic in the following year. Therefore, the identification of effective control measures becomes extremely important. Although many reports have been published since the COVID-19 outbreak, no studies have identified the relative effectiveness of a combination of control measures implemented in Wuhan and other areas in China. To this end, a retrospective analysis by the collection and modeling of an unprecedented number of epidemiology records in China of the early stage of the outbreaks can be valuable.In this study, we developed a new dynamic model to describe the spread of COVID-19 and to quantify the effectiveness of control measures. The transmission rate, daily close contacts, and the average time from onset to isolation were identified as crucial factors in viral spreading. Moreover, the capacity of a local health-care system is identified as a threshold to control an outbreak in its early stage. We took these factors as controlling parameters in our model. The parameters are estimated based on epidemiological reports from national and local Center for Disease Control (CDCs).A retrospective simulation showed the effectiveness of combinations of 4 major control measures implemented in Wuhan: hospital isolation, social distancing, self-protection by wearing masks, and extensive medical testing. Further analysis indicated critical intervention conditions and times required to control an outbreak in the early stage. Our simulations showed that South Korea has kept the spread of COVID-19 at a low level through extensive medical testing. Furthermore, a predictive simulation for Italy indicated that Italy would contain the outbreak in late May under strict social distancing.In our general analysis, no single measure could contain a COVID-19 outbreak once a health-care system is overloaded. Extensive medical testing could keep viral spreading at a low level. Wearing masks functions as favorably as social distancing but with much lower socioeconomic costs.


Subject(s)
Communicable Disease Control , Hospitalization/statistics & numerical data , Outcome Assessment, Health Care/methods , /isolation & purification , /economics , /prevention & control , China/epidemiology , Communicable Disease Control/methods , Communicable Disease Control/organization & administration , Communicable Disease Control/standards , Contact Tracing/statistics & numerical data , Disease Transmission, Infectious/prevention & control , Disease Transmission, Infectious/statistics & numerical data , Humans , Models, Theoretical , Mortality , Systems Analysis , Time-to-Treatment/statistics & numerical data
18.
Ital J Pediatr ; 47(1): 23, 2021 Feb 02.
Article in English | MEDLINE | ID: covidwho-1061200

ABSTRACT

BACKGROUND: During the first SARS-CoV-2 pandemic phase, the sudden closure of schools was one of the main measures to minimize the spread of the virus. In the second phase, several safety procedures were implemented to avoid school closure. To evaluate if the school is a safe place, students and staff of two school complexes of Rome were monitored to evaluate the efficacy of prevention measures inside the school buildings. METHODS: Oral secretions specimens were collected from 1262 subjects for a total of 3431 samples, collected over a 3 months period. Detection of Coronavirus SARS-CoV-2 was performed by real-time PCR. Target genes were represented by E gene, RdRP/S gene and N gene. RESULTS: Among the 3431 samples analyzed, just 16 sample resulted as positive or low positive: 1 sample in the first month, 12 samples in the second month and 3 in the third month. In each period of evaluation, all positive children attended different classes. CONCLUSIONS: Even if the school has the potential for spreading viruses, our preliminary results show the efficacy of the implementations undertaken in this setting to minimize virus diffusion. Our evidence suggests that school does not act as an amplifier for transmission of SARS-CoV-2 and can be really considered a safe place for students.


Subject(s)
/prevention & control , Disease Transmission, Infectious/prevention & control , Infection Control/methods , Pneumonia, Viral/prevention & control , School Health Services/organization & administration , Adolescent , /transmission , Child , Female , Humans , Italy/epidemiology , Male , Pandemics , Pneumonia, Viral/virology
19.
Phys Rev Lett ; 126(3): 034502, 2021 Jan 22.
Article in English | MEDLINE | ID: covidwho-1060608

ABSTRACT

To quantify the fate of respiratory droplets under different ambient relative humidities, direct numerical simulations of a typical respiratory event are performed. We found that, because small droplets (with initial diameter of 10 µm) are swept by turbulent eddies in the expelled humid puff, their lifetime gets extended by a factor of more than 30 times as compared to what is suggested by the classical picture by Wells, for 50% relative humidity. With increasing ambient relative humidity the extension of the lifetimes of the small droplets further increases and goes up to around 150 times for 90% relative humidity, implying more than 2 m advection range of the respiratory droplets within 1 sec. Employing Lagrangian statistics, we demonstrate that the turbulent humid respiratory puff engulfs the small droplets, leading to many orders of magnitude increase in their lifetimes, implying that they can be transported much further during the respiratory events than the large ones. Our findings provide the starting points for larger parameter studies and may be instructive for developing strategies on optimizing ventilation and indoor humidity control. Such strategies are key in mitigating the COVID-19 pandemic in the present autumn and upcoming winter.


Subject(s)
Body Fluids/chemistry , Body Fluids/virology , Models, Biological , Aerosols/chemistry , Air Microbiology , Air Movements , Computer Simulation , Disease Transmission, Infectious , Exhalation , Humans , Pandemics , /isolation & purification
20.
Viruses ; 13(1)2021 Jan 19.
Article in English | MEDLINE | ID: covidwho-1059930

ABSTRACT

In December 2019, the emergence of SARS-CoV-2 virus in China led to a pandemic. Since both Influenza Like Illness (ILI) and COVID-19 case definitions overlap, we re-investigated the ILI cases using PCR for the presence of SARS-CoV-2 in 739 nasopharyngeal swabs collected from November 2019 to March 2020. SARS-CoV-2 RNA was found in 37 samples (5%) collected mostly during February 2020. It was followed by confirmation of evolutionary and spatial relationships using next generation sequencing (NGS). We observed that the overall incidence of ILI cases during 2019-2020 influenza season was considerably higher than previous years and was gradually replaced with SARS-CoV-2, which indicated a silent transmission among ambulatory patients. Sequencing of representative isolates confirmed independent introductions and silent transmission earlier than previously thought. Evolutionary and spatial analyses revealed clustering in the GH clade, characterized by three amino acid substitutions in spike gene (D614G), RdRp (P323L) and NS3 (Q57H). P323L causes conformational change near nsp8 binding site that might affect virus replication and transcription. In conclusion, assessment of the community transmission among patients with mild COVID-19 illness, particularly those without epidemiological link for acquiring the virus, is of utmost importance to guide policy makers to optimize public health interventions. The detection of SARS-CoV-2 in ILI cases shows the importance of ILI surveillance systems and warrants its further strengthening to mitigate the ongoing transmission of SARS-CoV-2. The effect of NS3 substitutions on oligomerization or membrane channel function (intra- and extracellular) needs functional validation.


Subject(s)
/epidemiology , /metabolism , Spike Glycoprotein, Coronavirus/metabolism , /metabolism , Adult , Disease Transmission, Infectious , Epidemiological Monitoring , Female , Humans , Male , Protein Structure, Secondary , RNA, Viral , /isolation & purification , Spike Glycoprotein, Coronavirus/genetics , /genetics
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