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1.
J Travel Med ; 27(3)2020 05 18.
Article in English | MEDLINE | ID: covidwho-688204

ABSTRACT

BACKGROUND: A key purpose of the International Health Regulations (IHR) is to prevent unwarranted interruptions to trade and travel during large and/or transnational infectious disease outbreaks. Nevertheless, such outbreaks continue to disrupt the travel industry. This aspect of the IHR has received little attention in the academic literature despite its considerable impact on affected States and commercial activity. This article outlines the challenges and gaps in knowledge regarding the relationship between outbreaks and the travel sector and discusses the opportunities for further research and policy work to overcome these challenges. METHODOLOGY: We conducted a literature review on the relationship between outbreaks and travel restrictions, with a particular focus on the 2014-16 Ebola epidemic in West Africa. This review was complemented by an expert roundtable at Chatham House and further supported by case studies and qualitative interviews. RESULTS: Numerous travel stakeholders are affected by, and affect, large-scale infectious disease outbreaks. These stakeholders react in different ways: peer pressure plays an important role for both governments and the travel sector, and the reactions of the media and public influence and are influenced by these stakeholders. While various data sources on travel are available, and World Health Organization is mandated to work with States, there is no recognized coordinating body to disseminate timely, consistent, reliable and authoritative information and best practices to all stakeholders. CONCLUSION: This article highlights the interdependent relationship between various travel stakeholders. The reasons for interruption of travel during the 2014-16 Ebola outbreak were complex, with decisions by States only partly contributing to the cessation. Decisions by non-state actors, particularly the travel industry itself, contributed significantly and were based on a variety of factors. Further research, analysis and policy development are required to mitigate the health and economic consequences of infectious disease outbreaks. Any further research will also need to take account of COVID-19 travel-related issues.


Subject(s)
Communicable Disease Control/methods , Disease Outbreaks/prevention & control , Hemorrhagic Fever, Ebola/epidemiology , Travel , Africa, Western , Aircraft , Betacoronavirus , Communication , Coronavirus Infections , Decision Making , Hemorrhagic Fever, Ebola/history , History, 21st Century , Humans , Industry , Mass Media , Pandemics , Pneumonia, Viral
2.
Nat Genet ; 52(6): 549, 2020 06.
Article in English | MEDLINE | ID: covidwho-624840
5.
Emerg Infect Dis ; 26(8): 1671-1678, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-737802

ABSTRACT

We describe the contact investigation for an early confirmed case of coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), in the United States. Contacts of the case-patient were identified, actively monitored for symptoms, interviewed for a detailed exposure history, and tested for SARS-CoV-2 infection by real-time reverse transcription PCR (rRT-PCR) and ELISA. Fifty contacts were identified and 38 (76%) were interviewed, of whom 11 (29%) reported unprotected face-to-face interaction with the case-patient. Thirty-seven (74%) had respiratory specimens tested by rRT-PCR, and all tested negative. Twenty-three (46%) had ELISA performed on serum samples collected ≈6 weeks after exposure, and none had detectable antibodies to SARS-CoV-2. Among contacts who were tested, no secondary transmission was identified in this investigation, despite unprotected close interactions with the infectious case-patient.


Subject(s)
Betacoronavirus/pathogenicity , Contact Tracing/statistics & numerical data , Coronavirus Infections/epidemiology , Pandemics , Pneumonia, Viral/epidemiology , Adolescent , Adult , Aged , Betacoronavirus/genetics , Child , Child, Preschool , Clinical Laboratory Techniques/methods , Coronavirus Infections/diagnosis , Enzyme-Linked Immunosorbent Assay , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , Pneumonia, Viral/diagnosis , Public Health/methods , Reverse Transcriptase Polymerase Chain Reaction , Travel , Washington/epidemiology
6.
Ann Glob Health ; 86(1): 79, 2020 07 07.
Article in English | MEDLINE | ID: covidwho-730147

ABSTRACT

Background: Workers whose occupations put them in contact with infected persons and the public are at increased risk of COVID-19 infection. Recommendations: The Collegium Ramazzini calls on governments at all levels to protect worker health by strengthening public health systems; maintaining comprehensive social insurance systems; establishing policies that presume all COVID-19 infections in high-risk workers are work-related; enforcing all occupational health standards; and developing pandemic preparedness plans. The Collegium Ramazzini calls on all employers - large and small, public and private - to protect the health of all workers by developing disease preparedness plans; implementing basic infection control measures; establishing disease identification and isolation policies; reducing hazardous exposures; supporting personal protective equipment (PPE) programs; and restricting unnecessary travel. Conclusion: Governments and employers have legal obligations to protect worker health. They are not relieved of these duties during pandemics.


Subject(s)
Coronavirus Infections/prevention & control , Infection Control/organization & administration , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Occupational Health , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Betacoronavirus , Coronavirus Infections/transmission , Global Health , Humans , Personal Protective Equipment , Pneumonia, Viral/transmission , Societies, Medical , Travel
7.
J Travel Med ; 27(5)2020 08 20.
Article in English | MEDLINE | ID: covidwho-729174

ABSTRACT

BACKGROUND: Wastewater-based epidemiology (WBE) for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can be an important source of information for coronavirus disease 2019 (COVID-19) management during and after the pandemic. Currently, governments and transportation industries around the world are developing strategies to minimize SARS-CoV-2 transmission associated with resuming activity. This study investigated the possible use of SARS-CoV-2 RNA wastewater surveillance from airline and cruise ship sanitation systems and its potential use as a COVID-19 public health management tool. METHODS: Aircraft and cruise ship wastewater samples (n = 21) were tested for SARS-CoV-2 using two virus concentration methods, adsorption-extraction by electronegative membrane (n = 13) and ultrafiltration by Amicon (n = 8), and five assays using reverse-transcription quantitative polymerase chain reaction (RT-qPCR) and RT-droplet digital PCR (RT-ddPCR). Representative qPCR amplicons from positive samples were sequenced to confirm assay specificity. RESULTS: SARS-CoV-2 RNA was detected in samples from both aircraft and cruise ship wastewater; however concentrations were near the assay limit of detection. The analysis of multiple replicate samples and use of multiple RT-qPCR and/or RT-ddPCR assays increased detection sensitivity and minimized false-negative results. Representative qPCR amplicons were confirmed for the correct PCR product by sequencing. However, differences in sensitivity were observed among molecular assays and concentration methods. CONCLUSIONS: The study indicates that surveillance of wastewater from large transport vessels with their own sanitation systems has potential as a complementary data source to prioritize clinical testing and contact tracing among disembarking passengers. Importantly, sampling methods and molecular assays must be further optimized to maximize detection sensitivity. The potential for false negatives by both wastewater testing and clinical swab testing suggests that the two strategies could be employed together to maximize the probability of detecting SARS-CoV-2 infections amongst passengers.


Subject(s)
Aircraft , Betacoronavirus/isolation & purification , Coronavirus Infections , Pandemics , Pneumonia, Viral , RNA, Viral/isolation & purification , Ships , Waste Water/virology , Humans , Real-Time Polymerase Chain Reaction , Sensitivity and Specificity , Travel
8.
Infect Dis Poverty ; 9(1): 116, 2020 Aug 24.
Article in English | MEDLINE | ID: covidwho-727301

ABSTRACT

BACKGROUND: In December 2019, an outbreak of coronavirus disease (later named as COVID-19) was identified in Wuhan, China and, later on, detected in other parts of China. Our aim is to evaluate the effectiveness of the evolution of interventions and self-protection measures, estimate the risk of partial lifting control measures and predict the epidemic trend of the virus in the mainland of China excluding Hubei province based on the published data and a novel mathematical model. METHODS: A novel COVID-19 transmission dynamic model incorporating the intervention measures implemented in China is proposed. COVID-19 daily data of the mainland of China excluding Hubei province, including the cumulative confirmed cases, the cumulative deaths, newly confirmed cases and the cumulative recovered cases between 20 January and 3 March 2020, were archived from the National Health Commission of China (NHCC). We parameterize the model by using the Markov Chain Monte Carlo (MCMC) method and estimate the control reproduction number (Rc), as well as the effective daily reproduction ratio- Re(t), of the disease transmission in the mainland of China excluding Hubei province. RESULTS: The estimation outcomes indicate that Rc is 3.36 (95% CI: 3.20-3.64) and Re(t) has dropped below 1 since 31 January 2020, which implies that the containment strategies implemented by the Chinese government in the mainland of China are indeed effective and magnificently suppressed COVID-19 transmission. Moreover, our results show that relieving personal protection too early may lead to a prolonged disease transmission period and more people would be infected, and may even cause a second wave of epidemic or outbreaks. By calculating the effective reproduction ratio, we prove that the contact rate should be kept at least less than 30% of the normal level by April, 2020. CONCLUSIONS: To ensure the pandemic ending rapidly, it is necessary to maintain the current integrated restrict interventions and self-protection measures, including travel restriction, quarantine of entry, contact tracing followed by quarantine and isolation and reduction of contact, like wearing masks, keeping social distance, etc. People should be fully aware of the real-time epidemic situation and keep sufficient personal protection until April. If all the above conditions are met, the outbreak is expected to be ended by April in the mainland of China apart from Hubei province.


Subject(s)
Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Models, Statistical , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Betacoronavirus/isolation & purification , China/epidemiology , Coronavirus Infections/prevention & control , Disease Transmission, Infectious/prevention & control , Humans , Markov Chains , Monte Carlo Method , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Travel
10.
Curr Opin Pulm Med ; 26(3): 197-202, 2020 05.
Article in English | MEDLINE | ID: covidwho-726094

ABSTRACT

PURPOSE OF REVIEW: Mass gathering events bring people from across all continents increasing the risk of spread of aerosol transmissible respiratory tract infections. Respiratory tract infections for instance in pilgrims attending the world's largest recurring annual pilgrimage, the Hajj are common. We review recent literature on viral and bacterial infectious diseases with special focus on the Hajj. RECENT FINDINGS: The prevalence of bacterial and viral infections continue to increase, because of the acquisition of rhinovirus, coronaviruses (229E, HKU1, OC43), influenza A H1N1, Streptococcus pneumoniae, Haemophilus influenzae and Staphylococcus aureus during Hajj. Whilst MERS-CoV continues to circulate in the Middle East, no cases of MERS-CoV have yet been identified in pilgrims during Hajj. SUMMARY: Respiratory tract infections are a major cause of morbidity in pilgrims attending mass gathering events. The management of severe respiratory infections should consider investigation and empirical coverage for the most likely agents based on syndromic surveillance data from hosting country and /or other relevant exposure history during events. Pneumococcal and Pertussis vaccines should be recommended for Hajj pilgrims.


Subject(s)
Coronavirus Infections/transmission , Influenza, Human/transmission , Islam , Measles/transmission , Pneumonia, Pneumococcal/transmission , Respiratory Tract Infections/transmission , Travel , Tuberculosis/transmission , Bacterial Infections/epidemiology , Bacterial Infections/transmission , Coronavirus , Coronavirus Infections/epidemiology , Haemophilus Infections/epidemiology , Haemophilus Infections/transmission , Humans , Influenza A Virus, H1N1 Subtype , Influenza, Human/epidemiology , Influenza, Human/prevention & control , Measles/epidemiology , Measles/prevention & control , Middle East/epidemiology , Picornaviridae Infections/epidemiology , Picornaviridae Infections/transmission , Pneumococcal Vaccines/therapeutic use , Pneumonia, Pneumococcal/epidemiology , Pneumonia, Pneumococcal/prevention & control , Prevalence , Respiratory Tract Infections/epidemiology , Respiratory Tract Infections/prevention & control , Streptococcus pneumoniae , Tuberculosis/epidemiology , Virus Diseases/epidemiology , Virus Diseases/transmission , Whooping Cough/epidemiology , Whooping Cough/prevention & control , Whooping Cough/transmission
11.
Sci Rep ; 10(1): 14015, 2020 08 19.
Article in English | MEDLINE | ID: covidwho-724730

ABSTRACT

The fourth outbreak of the Coronaviruses, known as the COVID-19, has occurred in Wuhan city of Hubei province in China in December 2019. We propose a time-varying sparse vector autoregressive (VAR) model to retrospectively analyze and visualize the dynamic transmission routes of this outbreak in mainland China over January 31-February 19, 2020. Our results demonstrate that the influential inter-location routes from Hubei have become unidentifiable since February 4, 2020, whereas the self-transmission in each provincial-level administrative region (location, hereafter) was accelerating over February 4-15, 2020. From February 16, 2020, all routes became less detectable, and no influential transmissions could be identified on February 18 and 19, 2020. Such evidence supports the effectiveness of government interventions, including the travel restrictions in Hubei. Implications of our results suggest that in addition to the origin of the outbreak, virus preventions are of crucial importance in locations with the largest migrant workers percentages (e.g., Jiangxi, Henan and Anhui) to controlling the spread of COVID-19.


Subject(s)
Betacoronavirus , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Models, Statistical , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Quarantine/methods , China/epidemiology , Cities , Coronavirus Infections/prevention & control , Coronavirus Infections/virology , Humans , Pandemics/prevention & control , Personal Protective Equipment , Pneumonia, Viral/prevention & control , Pneumonia, Viral/virology , Public Health , Retrospective Studies , Time Factors , Transients and Migrants , Travel
12.
J Infect Dev Ctries ; 14(7): 732-736, 2020 Jul 31.
Article in English | MEDLINE | ID: covidwho-721545

ABSTRACT

Bangladesh reported the first three laboratory-confirmed COVID-19 cases on March 8, 2020 in Dhaka and Narayanganj cities. As of April 8, 2020, 218 confirmed cases across the country, they have mostly detected from Dhaka (56.4%) and Narayanganj (21%) cities where the hotspots of an outbreak of COVID-19 disease. There were 6 cases in Dhaka district excluding metropolitan areas and rest of 43 (20%) cases in the 19 other regions. Local government-enforced completely shut down the hotspots areas on April 8 2020. However, peoples from hotspots travelled openly to the other districts. We aimed to understand the risk of open movement from hotspots. We studied 40 individuals who were infected with SARS-CoV-2 virus later at their destination. We developed a route map and density maps using Geographic Information System (GIS). Among the studied people, the average distance was 140.1 (75.1) kilometers (Km), and the range of distance was from 20.3 to 321.7 kilometers. Among them, 42.5% traveled <100 Km, 40.0% traveled between 100 and 200 Km and 17.5% traveled above 200 Km. Case numbers were increased 13.5 times more on April 20 than the cases as of April 8, 2020. Our analysis suggests that relaxed travel restriction could play an important role to spread COVID-19 transmission domestically. To reduce further spread of COVID-19, the government should closely monitor the public health intervention to stop the casual movement.


Subject(s)
Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Travel/legislation & jurisprudence , Bangladesh/epidemiology , Coronavirus Infections/prevention & control , Disease Outbreaks , Geographic Information Systems , Humans , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Transients and Migrants , Travel-Related Illness
13.
Infect Dis Poverty ; 9(1): 115, 2020 Aug 19.
Article in English | MEDLINE | ID: covidwho-721344

ABSTRACT

BACKGROUND: The emerging infectious disease, coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), poses a serious threat in China and worldwide. Challenged by this serious situation, China has taken many measures to contain its transmission. This study aims to systematically review and record these special and effective practices, in hope of benefiting for fighting against the ongoing worldwide pandemic. METHODS: The measures taken by the governments was tracked and sorted on a daily basis from the websites of governmental authorities (e.g. National Health Commission of the People's Republic of China). And the measures were reviewed and summarized by categorizations, figures and tables, showing an ever-changing process of combating with an emerging infectious disease. The population shift levels, daily local new diagnosed cases, daily mortality and daily local new cured cases were used for measuring the effect of the measures. RESULTS: The practices could be categorized into active case surveillance, rapid case diagnosis and management, strict follow-up and quarantine of persons with close contacts, and issuance of guidance to help the public understand and adhere to control measures, plus prompt and effective high-level policy decision, complete activation of the public health system, and full involvement of the society. Along with the measures, the population shift levels, daily local new diagnosed cases, and mortality were decreased, and the daily local new cured cases were increased in China. CONCLUSIONS: China's practices are effective in controlling transmission of SARS-CoV-2. Considering newly occurred situations (e.g. imported cases, work resumption), the control measures may be adjusted.


Subject(s)
Communicable Diseases, Emerging/prevention & control , Coronavirus Infections/prevention & control , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Population Surveillance , China/epidemiology , Communicable Diseases, Emerging/diagnosis , Communicable Diseases, Emerging/epidemiology , Communicable Diseases, Emerging/therapy , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Coronavirus Infections/therapy , Health Policy , Humans , Masks , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Pneumonia, Viral/therapy , Time Factors , Travel
14.
BMC Med ; 18(1): 259, 2020 08 19.
Article in English | MEDLINE | ID: covidwho-721300

ABSTRACT

BACKGROUND: To contain the spread of COVID-19, a cordon sanitaire was put in place in Wuhan prior to the Lunar New Year, on 23 January 2020. We assess the efficacy of the cordon sanitaire to delay the introduction and onset of local transmission of COVID-19 in other major cities in mainland China. METHODS: We estimated the number of infected travellers from Wuhan to other major cities in mainland China from November 2019 to February 2020 using previously estimated COVID-19 prevalence in Wuhan and publicly available mobility data. We focused on Beijing, Chongqing, Hangzhou, and Shenzhen as four representative major cities to identify the potential independent contribution of the cordon sanitaire and holiday travel. To do this, we simulated outbreaks generated by infected arrivals in these destination cities using stochastic branching processes. We also modelled the effect of the cordon sanitaire in combination with reduced transmissibility scenarios to simulate the effect of local non-pharmaceutical interventions. RESULTS: We find that in the four cities, given the potentially high prevalence of COVID-19 in Wuhan between December 2019 and early January 2020, local transmission may have been seeded as early as 1-8 January 2020. By the time the cordon sanitaire was imposed, infections were likely in the thousands. The cordon sanitaire alone did not substantially affect the epidemic progression in these cities, although it may have had some effect in smaller cities. Reduced transmissibility resulted in a notable decrease in the incidence of infection in the four studied cities. CONCLUSIONS: Our results indicate that sustained transmission was likely occurring several weeks prior to the implementation of the cordon sanitaire in four major cities of mainland China and that the observed decrease in incidence was likely attributable to other non-pharmaceutical, transmission-reducing interventions.


Subject(s)
Betacoronavirus , Coronavirus Infections/prevention & control , Health Policy , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Travel , China/epidemiology , Cities , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Humans , Incidence , Models, Theoretical , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Prevalence
15.
Sci Rep ; 10(1): 13764, 2020 08 13.
Article in English | MEDLINE | ID: covidwho-720848

ABSTRACT

We develop a minimalist compartmental model to study the impact of mobility restrictions in Italy during the Covid-19 outbreak. We show that, while an early lockdown shifts the contagion in time, beyond a critical value of lockdown strength the epidemic tends to restart after lifting the restrictions. We characterize the relative importance of different lockdown lifting schemes by accounting for two fundamental sources of heterogeneity, i.e. geography and demography. First, we consider Italian Regions as separate administrative entities, in which social interactions between age classes occur. We show that, due to the sparsity of the inter-Regional mobility matrix, once started, the epidemic spreading tends to develop independently across areas, justifying the adoption of mobility restrictions targeted to individual Regions or clusters of Regions. Second, we show that social contacts between members of different age classes play a fundamental role and that interventions which target local behaviours and take into account the age structure of the population can provide a significant contribution to mitigate the epidemic spreading. Our model aims to provide a general framework, and it highlights the relevance of some key parameters on non-pharmaceutical interventions to contain the contagion.


Subject(s)
Betacoronavirus , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Interpersonal Relations , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Quarantine/methods , Social Behavior , Adolescent , Adult , Age Factors , Aged , Child , Child, Preschool , Coronavirus Infections/transmission , Coronavirus Infections/virology , Humans , Infant , Infant, Newborn , Italy/epidemiology , Middle Aged , Models, Statistical , Pneumonia, Viral/transmission , Pneumonia, Viral/virology , Time Factors , Travel , Young Adult
19.
Elife ; 92020 08 13.
Article in English | MEDLINE | ID: covidwho-714074

ABSTRACT

As of 1 May 2020, there had been 6808 confirmed cases of COVID-19 in Australia. Of these, 98 had died from the disease. The epidemic had been in decline since mid-March, with 308 cases confirmed nationally since 14 April. This suggests that the collective actions of the Australian public and government authorities in response to COVID-19 were sufficiently early and assiduous to avert a public health crisis - for now. Analysing factors that contribute to individual country experiences of COVID-19, such as the intensity and timing of public health interventions, will assist in the next stage of response planning globally. We describe how the epidemic and public health response unfolded in Australia up to 13 April. We estimate that the effective reproduction number was likely below one in each Australian state since mid-March and forecast that clinical demand would remain below capacity thresholds over the forecast period (from mid-to-late April).


Subject(s)
Betacoronavirus , Coronavirus Infections/epidemiology , Pandemics , Pneumonia, Viral/epidemiology , Adolescent , Adult , Age Distribution , Aged , Aged, 80 and over , Australia/epidemiology , Child , Child, Preschool , Communicable Disease Control/methods , Communicable Disease Control/organization & administration , Communicable Disease Control/statistics & numerical data , Coronavirus Infections/prevention & control , Female , Forecasting , Geography, Medical , Hospitalization/statistics & numerical data , Humans , Infant , Infant, Newborn , Male , Middle Aged , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Public Health , Quarantine , Travel , Young Adult
20.
J Med Microbiol ; 69(8): 1114-1123, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-713623

ABSTRACT

Introduction. Coronavirus disease 2019 (COVID-19) is an infectious disease caused by Severe Acute Respiratory Corona Virus-2 (SARS-CoV-2). The disease was first identified in December 2019 in Wuhan, the capital of China's Hubei province, and has since spread globally, resulting in the ongoing 2019-2020 corona virus pandemic. SARS-CoV-2 is closely related to the original SARS-CoV. It is thought to have a zoonotic origin. The virus is primarily spread between people during close contact, often via small droplets produced by coughing, sneezing or talking. People may also become infected by touching a contaminated surface and then touching their face. COVID-19 patients currently remain the primary source of infection. An epidemiological survey indicated that the general population is susceptible to SARS-CoV-2. The spectrum of this disease ranges from mild to life-threatening. Fever is the most common symptom, although older people and those with comorbidities may experience fever later in the disease. Other common symptoms include cough, loss of appetite, fatigue, shortness of breath, sputum production, and muscle and joint pains. Symptoms such as nausea, vomiting and diarrhea have been observed in varying percentages. Some cases might progress promptly to acute respiratory distress syndrome (ARDS) and/or multiple organ function failure. Asymptomatic carriers and those in the incubation period may also be infectious.Aim. To determine the epidemiological and clinical characteristics of patients presenting with COVID-19 at the screening clinic of a tertiary care hospital in Peshawar, Pakistan.Methodology. In this descriptive study, we analysed data of patients presenting to a newly established Covid-19 screening clinic in Rehman Medical Institute. Anyone who reported with new onset fever and/or cough was tested for SARS-CoV-2 in the screening clinic. We documented and analysed demographic, epidemiological and clinical characteristics, which included age, sex, travel history, clinical features, comorbidities and laboratory data of patients confirmed by real-time reverse-transcription (RT)-PCR at Rehman Medical Institute, Peshawar, Pakistan from 15 March till 21 April 2020. Paired specimens of throat swabs and nasal swabs were obtained from 845 patients, ribonucleic acid (RNA) was extracted and tested for SARS-CoV-2 by the RT-PCR assay.Results. A total of 845 specimens were taken as described above. The positive rate for SARS-CoV-2 was about 14.3%. Male and older population had a significantly higher positive rate. Of the 121 patients infected with SARS-CoV-2, the mean age was 43.19 years (sd, 17.57) and the infections were more frequent among male gender accounting for 85 (70.25 %) patients. Common symptoms included fever (88 patients, 72 %), cough (72 patients, 59.5 %) and shortness of breath (69 patients, 57 %). Twenty-two (18 %) patients had recent travel history outside Pakistan in the previous 14 days, the majority of whom had returned back from Saudi Arabia.Conclusion. In this single-centre, prospective, descriptive study, fever, cough and shortness of breath were the most common symptoms. Old age (>50 years), chronic underlying comorbidities and travel history may be risk factors. Therefore, we concluded that viral nucleic acid amplification tests (NAAT) played an important role in identifying SARS-CoV-2 infection in a screening clinic, which helped with isolation and cohorting of these patients.


Subject(s)
Betacoronavirus , Coronavirus Infections/epidemiology , Disease Outbreaks , Pneumonia, Viral/epidemiology , Adolescent , Adult , Age Distribution , Aged , Aged, 80 and over , Betacoronavirus/genetics , Betacoronavirus/isolation & purification , Child , Child, Preschool , Comorbidity , Coronavirus Infections/diagnosis , DNA, Complementary/genetics , Female , Humans , Infant , Male , Mass Screening , Middle Aged , Pandemics , Pneumonia, Viral/diagnosis , Prospective Studies , RNA, Viral/genetics , RNA, Viral/isolation & purification , Real-Time Polymerase Chain Reaction , Risk Factors , Sex Distribution , Travel , Young Adult
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