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Sci Rep ; 12(1): 212, 2022 01 07.
Article in English | MEDLINE | ID: covidwho-1890215


In response to the COVID19 pandemic, many countries have implemented lockdowns in multiple phases to ensure social distancing and quarantining of the infected subjects. Subsequent unlocks to reopen the economies started next waves of infection and imposed an extra burden on quarantine to keep the reproduction number ([Formula: see text]) < 1. However, most countries could not effectively contain the infection spread, suggesting identification of the potential sources weakening the effect of lockdowns could help design better informed lockdown-unlock cycles in the future. Here, through building quantitative epidemic models and analyzing the metadata of 50 countries from across the continents we first found that the estimated value of [Formula: see text], adjusted w.r.t the distribution of medical facilities and virus clades correlates strongly with the testing rates in a country. Since the testing capacity of a country is limited by its medical resources, we investigated if a cost-benefit trade-off can be designed connecting testing rate and extent of unlocking. We present a strategy to optimize this trade-off in a country specific manner by providing a quantitative estimate of testing and quarantine rates required to allow different extents of unlocks while aiming to maintain [Formula: see text]. We further show that a small fraction of superspreaders can dramatically increase the number of infected individuals even during strict lockdowns by strengthening the positive feedback loop driving infection spread. Harnessing the benefit of optimized country-specific testing rates would critically require minimizing the movement of these superspreaders via strict social distancing norms, such that the positive feedback driven switch-like exponential spread phase of infection can be avoided/delayed.

COVID-19/prevention & control , Contact Tracing , Disease Transmission, Infectious/prevention & control , Physical Distancing , Quarantine , SARS-CoV-2/growth & development , Virus Replication , COVID-19/epidemiology , COVID-19/transmission , COVID-19/virology , COVID-19 Testing , Carrier State , Humans , Metadata , SARS-CoV-2/pathogenicity , Time Factors
Infect Dis Clin North Am ; 35(3): 827-839, 2021 09.
Article in English | MEDLINE | ID: covidwho-1778170


Health care-associated infections (HAIs) account for many morbidity and mortality worldwide, with disproportionate adverse effects in low- and middle-income countries (LMIC). Many factors contribute to the impact in LMIC, including lack of infrastructure, inconsistent surveillance, deficiency in trained personnel and infection control programs, and poverty-related factors. Therefore, optimal approaches must be tailored for LMIC and balance effectiveness and cost in the control of HAIs.

Cross Infection/prevention & control , Developing Countries , Disease Transmission, Infectious/prevention & control , Infection Control/methods , Delivery of Health Care , Humans , Population Surveillance , Poverty
PLoS One ; 17(3): e0264232, 2022.
Article in English | MEDLINE | ID: covidwho-1753189


BACKGROUND: Health care workers (HCWs) are particularly exposed to COVID-19 and therefore it is important to study preventive measures in this population. AIM: To investigate socio-demographic factors and professional practice associated with the risk of COVID-19 among HCWs in health establishments in Normandy, France. METHODS: A cross-sectional and 3 case-control studies using bootstrap methods were conducted in order to explore the possible risk factors that lead to SARS-CoV2 transmission within HCWs. Case-control studies focused on risk factors associated with (a) care of COVID-19 patients, (b) care of non COVID-19 patients and (c) contacts between colleagues. PARTICIPANTS: 2,058 respondents, respectively 1,363 (66.2%) and 695 (33.8%) in medical and medico-social establishments, including HCW with and without contact with patients. RESULTS: 301 participants (14.6%) reported having been infected by SARS-CoV2. When caring for COVID-19 patients, HCWs who declared wearing respirators, either for all patient care (ORa 0.39; 95% CI: 0.29-0.51) or only when exposed to aerosol-generating procedures (ORa 0.56; 95% CI: 0.43-0.70), had a lower risk of infection compared with HCWs who declared wearing mainly surgical masks. During care of non COVID-19 patients, wearing mainly a respirator was associated with a higher risk of infection (ORa 1.84; 95% CI: 1.06-3.37). An increased risk was also found for HCWs who changed uniform in workplace changing rooms (ORa 1.93; 95% CI: 1.63-2.29). CONCLUSION: Correct use of PPE adapted to the situation and risk level is essential in protecting HCWs against infection.

COVID-19/prevention & control , Communicable Disease Control/instrumentation , Disease Transmission, Infectious/prevention & control , Health Personnel/classification , Occupational Exposure/prevention & control , Adult , COVID-19/epidemiology , Case-Control Studies , Cross-Sectional Studies , Disease Transmission, Infectious/statistics & numerical data , Female , France , Humans , Male , Middle Aged , Occupational Exposure/statistics & numerical data , Personal Protective Equipment , Professional Practice , Risk Reduction Behavior