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1.
PLoS One ; 16(10): e0259037, 2021.
Article in English | MEDLINE | ID: covidwho-1496524

ABSTRACT

Epidemiological simulations as a method are used to better understand and predict the spreading of infectious diseases, for example of COVID-19. This paper presents an approach that combines a well-established approach from transportation modelling that uses person-centric data-driven human mobility modelling with a mechanistic infection model and a person-centric disease progression model. The model includes the consequences of different room sizes, air exchange rates, disease import, changed activity participation rates over time (coming from mobility data), masks, indoors vs. outdoors leisure activities, and of contact tracing. It is validated against the infection dynamics in Berlin (Germany). The model can be used to understand the contributions of different activity types to the infection dynamics over time. It predicts the effects of contact reductions, school closures/vacations, masks, or the effect of moving leisure activities from outdoors to indoors in fall, and is thus able to quantitatively predict the consequences of interventions. It is shown that these effects are best given as additive changes of the reproduction number R. The model also explains why contact reductions have decreasing marginal returns, i.e. the first 50% of contact reductions have considerably more effect than the second 50%. Our work shows that is is possible to build detailed epidemiological simulations from microscopic mobility models relatively quickly. They can be used to investigate mechanical aspects of the dynamics, such as the transmission from political decisions via human behavior to infections, consequences of different lockdown measures, or consequences of wearing masks in certain situations. The results can be used to inform political decisions.


Subject(s)
COVID-19/prevention & control , Communicable Disease Control/methods , Contact Tracing/methods , Berlin , COVID-19/metabolism , Cell Phone/trends , Computer Simulation , Germany , Hand Disinfection/trends , Humans , Masks/trends , Models, Theoretical , Physical Distancing , Population Dynamics/trends , SARS-CoV-2/pathogenicity , Systems Analysis
2.
PLoS One ; 16(10): e0258662, 2021.
Article in English | MEDLINE | ID: covidwho-1496511

ABSTRACT

We aimed to apply the Systems Engineering Initiative for Patient Safety (SEIPS) model to increase effectiveness and sustainability of the World Health Organization's (WHOs) hand hygiene (HH) guidelines within healthcare systems. Our cross-sectional, mixed-methods study took place at Jimma University Medical Center (JUMC), a tertiary care hospital in Jimma, Ethiopia, between November 2018 and August 2020 and consisted of three phases: baseline assessment, intervention, and follow-up assessment. We conducted questionnaires addressing HH knowledge and attitudes, interviews to identify HH barriers and facilitators within the SEIPS framework, and observations at the WHO's 5 moments of HH amongst healthcare workers (HCWs) at JUMC. We then implemented HH interventions based on WHO guidelines and results from our baseline assessment. Follow-up HH observations were conducted months later during the Covid-19 pandemic. 250 HCWs completed questionnaires with an average knowledge score of 61.4% and attitude scores indicating agreement that HH promotes patient safety. Interview participants cited multiple barriers to HH including shortages and location of HH materials, inadequate training, minimal Infection Prevention Control team presence, and high workload. We found an overall baseline HH compliance rate of 9.4% and a follow-up compliance rate of 72.1%. Drastically higher follow-up compared to baseline compliance rates were likely impacted by our HH interventions and Covid-19. HCWs showed motivation for patient safety despite low HH knowledge. Utilizing the SEIPS model helped identify institution-specific barriers that informed targeted interventions beyond WHO guidelines aimed at increasing effectiveness and sustainability of HH efforts.


Subject(s)
Hand Disinfection/methods , Hand Disinfection/trends , Hand Hygiene/methods , Adult , COVID-19/prevention & control , Cross Infection/prevention & control , Cross-Sectional Studies , Ethiopia , Female , Guideline Adherence/statistics & numerical data , Hand Hygiene/trends , Health Knowledge, Attitudes, Practice , Health Personnel/psychology , Humans , Infection Control/methods , Male , Pandemics/prevention & control , SARS-CoV-2/pathogenicity , Surveys and Questionnaires , Tertiary Care Centers
3.
PLoS One ; 16(5): e0251694, 2021.
Article in English | MEDLINE | ID: covidwho-1225817

ABSTRACT

The main strategy for combatting SARS-CoV-2 infections in 2020 consisted of behavioural regulations including contact reduction, maintaining distance, hand hygiene, and mask wearing. COVID-19-related risk perception and knowledge may influence protective behaviour, and education could be an important determinant. The current study investigated differences by education level in risk perception, knowledge and protective behaviour regarding COVID-19 in Germany, exploring the development of the pandemic over time. The COVID-19 Snapshot Monitoring study is a repeated cross-sectional online survey conducted during the pandemic in Germany from 3 March 2020 (waves 1-28: 27,957 participants aged 18-74). Differences in risk perception, knowledge and protective behaviour according to education level (high versus low) were analysed using linear and logistic regression. Time trends were accounted for by interaction terms for education level and calendar week. Regarding protective behaviour, interaction terms were tested for all risk perception and knowledge variables with education level. The strongest associations with education level were evident for perceived and factual knowledge regarding COVID-19. Moreover, associations were found between low education level and higher perceived severity, and between low education level and lower perceived probability. Highly educated men were more worried about COVID-19 than those with low levels of education. No educational differences were observed for perceived susceptibility or fear. Higher compliance with hand washing was found in highly educated women, and higher compliance with maintaining distance was found in highly educated men. Regarding maintaining distance, the impact of perceived severity differed between education groups. In men, significant moderation effects of education level on the association between factual knowledge and all three protective behaviours were found. During the pandemic, risk perception and protective behaviour varied greatly over time. Overall, differences by education level were relatively small. For risk communication, reaching all population groups irrespective of education level is critical.


Subject(s)
COVID-19/psychology , Health Knowledge, Attitudes, Practice/ethnology , Risk Reduction Behavior , Adult , Aged , Anxiety/epidemiology , Cross-Sectional Studies , Educational Status , Fear/psychology , Female , Germany/epidemiology , Hand Disinfection/trends , Hand Hygiene/methods , Hand Hygiene/trends , Health Risk Behaviors , Humans , Male , Middle Aged , Pandemics/prevention & control , Perception , Risk Assessment/methods , SARS-CoV-2/pathogenicity , Surveys and Questionnaires
4.
Infect Dis Poverty ; 10(1): 37, 2021 Mar 24.
Article in English | MEDLINE | ID: covidwho-1150428

ABSTRACT

BACKGROUND: The COVID-19 has caused significant toll over the globe. Pregnant women are at risk of infection. The present study examined the frequency of washing hands with soap and wearing face mask when going out, prevalence of depression and anxiety, and identified their associated factors among pregnant women during the early phase of COVID-19 outbreak in China. METHODS: A cross-sectional online survey was conducted between 24 February and 3 March 2020. A total of 15 428 pregnant women who were using maternal health care services in China completed a questionnaire which assessed their socio-demographic and pregnancy-related characteristics, contextual, cognitive and social factors related to COVID-19, frequency of washing hands and wearing face masks, and depression and anxiety. Logistics regression analyses were performed to identify the associated factors of preventive behaviours and mental health. RESULTS: The prevalence of probable anxiety and depression was 28.2% and 43.6% respectively. 19.8% reported always wearing face mask when going out, and 19.1% reported washing hands with soap for more than 10 times per day. Results from logistic regression analyses showed that older age was associated with lower levels of depression and anxiety (OR = 0.42-0.67) and higher frequency of washing hands (OR = 1.57-3.40). Higher level of education level was associated with probable depression (OR = 1.31-1.45) and higher frequency of wearing face mask (OR = 1.50-1.57). After adjusting for significant socio-demographic and pregnancy-related factors, place of residence being locked down (aOR = 1.10-1.11), being quarantined (aOR = 1.42-1.57), personally knowing someone being infected with COVID-19 (aOR = 1.80-1.92), perception that COVID-19 would pose long term physical harm to human (aOR = 1.25-1.28) were associated with higher levels of depression and anxiety, while the perception that the disease will be under control in the coming month was associated with lower levels of depression and anxiety (aOR = 0.59-0.63) and lower tendency of always wearing face mask (aOR = 0.85). Social support was associated with lower levels of depression and anxiety (aOR = 0.86-0,87) and higher frequency of washing hands (aOR = 1.06). CONCLUSIONS: The mental health and preventive behaviours of pregnant women during COVID-19 outbreak was associated with a range of socio-demographic, pregnancy-related, contextual, cognitive and social factors. Interventions to mitigate their mental health problems and to promote preventive behaviours are highly warranted.


Subject(s)
COVID-19/prevention & control , COVID-19/psychology , Health Behavior , Mental Health , Pregnancy Complications, Infectious/prevention & control , SARS-CoV-2 , Adult , Age Factors , China , Depression/epidemiology , Educational Status , Female , Hand Disinfection/trends , Humans , Logistic Models , Maternal Health Services/statistics & numerical data , Odds Ratio , Personal Protective Equipment , Pregnancy , Pregnancy Complications, Infectious/psychology , Prenatal Care , Prevalence , Risk Factors , Social Support , Surveys and Questionnaires , Young Adult
5.
Am J Infect Control ; 49(1): 30-33, 2021 01.
Article in English | MEDLINE | ID: covidwho-722966

ABSTRACT

BACKGROUND: Achieving high levels of hand hygiene compliance of health care personnel has been an ongoing challenge. The objective of this study was to examine the impact of the COVID-19 pandemic on hand hygiene performance (HHP) rates in acute care hospitals. METHODS: HHP rates were estimated using an automated hand hygiene monitoring system installed in 74 adult inpatient units in 7 hospitals and 10 pediatric inpatient units in 2 children's hospitals. A segmented regression model was used to estimate the trajectory of HHP rates in the 10 weeks leading up to a COVID-19-related milestone event (eg, school closures) and for 10 weeks after. RESULTS: Three effects emerged, all of which were significant at P < .01. Average HHP rates increased from 46% to 56% in the months preceding pandemic-related school closures. This was followed by a 6% upward shift at the time school closures occurred. HHP rates remained over 60% for 4 weeks before declining to 54% at the end of the study period. CONCLUSIONS: Data from an automated hand hygiene monitoring system indicated that HHP shifted in multiple directions during the early stages of the pandemic. We discuss possible reasons why HHP first increased as the pandemic began and then decreased as it progressed.


Subject(s)
COVID-19/epidemiology , Guideline Adherence/trends , Hand Disinfection/trends , Health Personnel , Infection Control/trends , Automation , COVID-19/prevention & control , Hand Disinfection/standards , Hand Hygiene/standards , Hand Hygiene/trends , Hand Sanitizers , Hospitals , Humans , Infection Control/standards , SARS-CoV-2 , Soaps , United States/epidemiology
6.
Contact Dermatitis ; 83(2): 108-114, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-378147

ABSTRACT

BACKGROUND: As a result of the COVID-19 outbreak, hygiene regulations have been revised and hand sanitation has been intensified. OBJECTIVE: To investigate the onset of hand eczema during the COVID-19 pandemic in healthcare workers (HCWs) directly involved in intensive care of COVID-19 patients and HCWs without direct contact with COVID-19 patients. Hereby, we aim at increasing awareness about occupational hand eczema and preventive measures that can be adopted. METHOD: A survey was distributed amongst 114 HCWs at a single surgical centre and at a COVID-19 intensive care unit of the university hospital Ludwig Maximilian University Munich, Germany. Participants were questioned about the daily frequency of hand hygiene prior to and during the pandemic. Participants self-reported the onset of hand eczema and associated symptoms. RESULTS: Our study revealed a significant increase in hand washing, disinfection, and use of hand cream across all participants (P-value <.001), regardless of having direct contact with COVID-19 patients. A high prevalence of symptoms associated with acute hand dermatitis of 90.4% was found across all HCWs, whereas hand eczema itself was underreported (14.9%). CONCLUSION: The increase in hand sanitation during the COVID-19 pandemic impairs the skin of the hands across all HCWs, independent of direct intensive care of affected patients.


Subject(s)
Coronavirus Infections/prevention & control , Dermatitis, Occupational/epidemiology , Eczema/epidemiology , Hand Dermatoses/epidemiology , Hand Disinfection/trends , Hand Sanitizers/therapeutic use , Health Personnel/statistics & numerical data , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Skin Cream/therapeutic use , Adult , Asthma/epidemiology , Betacoronavirus , COVID-19 , Comorbidity , Coronavirus Infections/therapy , Dermatitis, Atopic/epidemiology , Female , Germany/epidemiology , Humans , Hypersensitivity, Delayed/epidemiology , Intensive Care Units , Male , Middle Aged , Nurses/statistics & numerical data , Physicians/statistics & numerical data , Pneumonia, Viral/therapy , Prevalence , Rhinitis, Allergic/epidemiology , SARS-CoV-2
7.
Cont Lens Anterior Eye ; 43(3): 208-210, 2020 06.
Article in English | MEDLINE | ID: covidwho-102206

ABSTRACT

PURPOSE: The aim of this project was to evaluate which personal protective equipment (PPE) eye care practitioners (ECP) will use during the next months and also what they will ask the patient to use in clinical practice. METHODS: A social-media survey was carried out, asking 257 optometrists and opticians in Germany, Austria and Switzerland (i) which PPE they intended to use in the future (after lockdown and before herd immunity and / or vaccine availability) and (ii) what they would ask the patient to do in terms of this. RESULTS: 75 % of the ECPs planned on wearing masks during refractions and 69 % when fitting contact lens. 62 % of the ECPs also expected their patients to wear masks in these tasks. This number is higher than for distance tasks such as fitting frames. Around 90 % of the ECPs would, in addition to hand washing, disinfect their hands and around 80 % expected their patients to do so too. Less than one third of ECPs favoured wearing safety spectacles, gloves and / or protective facial shields. 73 % planed on disinfecting frames after they would have been tried on by customers. CONCLUSIONS: In summary, most ECPs planed on continuing to use higher standards of PPE. Those, who intended to wear masks themselves, would ask their patients to also do so, combined with hand disinfection.


Subject(s)
Betacoronavirus , Coronavirus Infections/prevention & control , Infection Control/methods , Optometrists/trends , Pandemics/prevention & control , Personal Protective Equipment/trends , Pneumonia, Viral/prevention & control , Professional Practice/trends , COVID-19 , Coronavirus Infections/epidemiology , Cross Infection/prevention & control , Disease Transmission, Infectious/prevention & control , Eye Protective Devices/statistics & numerical data , Hand Disinfection/trends , Health Surveys , Humans , Masks/statistics & numerical data , Optometrists/statistics & numerical data , Personal Protective Equipment/statistics & numerical data , Pneumonia, Viral/epidemiology , Professional Practice/statistics & numerical data , SARS-CoV-2
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