Lessons Learned from Contact Tracing COVID-19 cases in Dental Settings in East Scotland.

INTRODUCTION: Dental settings were considered high risk settings for COVID-19. A Dental Public Health Team in East Scotland worked to risk assess each situation timeously to break chains of transmission. AIM: To present learning from routine data collected from contact tracing COVID-19 cases in the dental setting. DESIGN: Retrospective analysis of a routine data set of COVID-19 cases associated with a dental setting reported via the national contact tracing system for two health board areas in the East of Scotland. METHODS: Descriptive statistics summarise the data collected over a 13-month period (Oct 2020-Dec 2021) during which all included COVID-19 cases were confirmed by PCR. A narrative presents output from contact tracing of all cases and includes themes identified during contact tracing that led to transmission within a dental setting. A case study illustrates impact of transmission. RESULTS: 752 cases are included. No evidence of staff to patient transmission or vice versa was found in this study. Staff to staff transmission occurred in non-clinical areas contributing to 33% of total staff cases with the remainder assessed to result from community transmission. CONCLUSION: Transmission of COVID-19 in a dental setting, in the context of this study, appears to be confined to non-clinical areas with the majority of staff cases resulting from community transmission. Future pandemic plans should include tools to aid with implementation of guidance in non-clinical areas.

Lessons Learned from Contact Tracing COVID-19 cases in Dental Settings in East Scotland.

INTRODUCTION: Dental settings were considered high risk settings for COVID-19. A Dental Public Health Team in East Scotland worked to risk assess each situation timeously to break chains of transmission. AIM: To present learning from routine data collected from contact tracing COVID-19 cases in the dental setting. DESIGN: Retrospective analysis of a routine data set of COVID-19 cases associated with a dental setting reported via the national contact tracing system for two health board areas in the East of Scotland. METHODS: Descriptive statistics summarise the data collected over a 13-month period (Oct 2020-Dec 2021) during which all included COVID-19 cases were confirmed by PCR. A narrative presents output from contact tracing of all cases and includes themes identified during contact tracing that led to transmission within a dental setting. A case study illustrates impact of transmission. RESULTS: 752 cases are included. No evidence of staff to patient transmission or vice versa was found in this study. Staff to staff transmission occurred in non-clinical areas contributing to 33% of total staff cases with the remainder assessed to result from community transmission. CONCLUSION: Transmission of COVID-19 in a dental setting, in the context of this study, appears to be confined to non-clinical areas with the majority of staff cases resulting from community transmission. Future pandemic plans should include tools to aid with implementation of guidance in non-clinical areas.

SARS-CoV-2 Circulation in the School Setting: A Systematic Review and Meta-Analysis.

The contribution of children to viral spread in schools is still debated. We conducted a systematic review and meta-analysis of studies to investigate SARS-CoV-2 transmission in the school setting. Literature searches on 15 May 2021 yielded a total of 1088 publications, including screening, contact tracing, and seroprevalence studies. MOOSE guidelines were followed, and data were analyzed using random-effects models. From screening studies involving more than 120,000 subjects, we estimated 0.31% (95% confidence interval (CI) 0.05-0.81) SARS-CoV-2 point prevalence in schools. Contact tracing studies, involving a total of 112,622 contacts of children and adults, showed that onward viral transmission was limited (2.54%, 95% CI 0.76-5.31). Young index cases were found to be 74% significantly less likely than adults to favor viral spread (odds ratio (OR) 0.26, 95% CI 0.11-0.63) and less susceptible to infection (OR 0.60; 95% CI 0.25-1.47). Lastly, from seroprevalence studies, with a total of 17,879 subjects involved, we estimated that children were 43% significantly less likely than adults to test positive for antibodies (OR 0.57, 95% CI 0.49-0.68). These findings may not applied to the Omicron phase, we further planned a randomized controlled trial to verify these results.

Well-Being Data Gathering during COVID-19: Exploring the Feasibility of a Contact Tracing and Community Well-Being Safeguarding Framework.

Given the need for real time data to aid in decision-making at the community level, contact tracing applications (apps) are explored as a potential method of gauging overall community well-being. The context of contact tracing effectiveness and integration with artificial intelligence is provided, as well as ideas and suggestions for how to expand for use as a community-wide data gathering approach. This commentary seeks to explore dimensions around the use of such apps to help manage in times of crisis given the widespread and destructive impacts the pandemic has on community well-being, including negative economic impacts and social declines. By connecting with community well-being, the idea of a contact tracing framework would enable communities to track data and make decisions to help foster well-being across public health, economic and social domains.

CoviChain: A Blockchain Based Framework for Nonrepudiable Contact Tracing in Healthcare Cyber-Physical Systems During Pandemic Outbreaks.

With the world facing the new virus SARS-CoV-2, many countries have introduced instant Internet applications to identify people carrying the infection. Internet-of-Medical-Things (IoMT) have proven useful in collecting medical data as well in tracing an individual carrying the virus. The data collected or traced belongs to an individual and should be revealed to themselves and hospital providers, but not to any third-party unauthorized agencies. In this paper we use an off-chain distributed storage solution for loading large medical data sets and a blockchain implementation to securely transfer the data from the infected person to the hospital system using the edge infrastructure, and call it CoviChain. The Coronavirus Disease (COVID-19) statistics are loaded on to the edge, and moved to InterPlanetary File Systems (IPFS) storage to retrieve the hash of the data file. Once the hash is obtained, it is moved to the blockchain by means of smart contracts. As the information is being hashed twice, CoviChain addresses the security and privacy issues and avoid exposing individuals' data while achieving larger data storage on the blockchain with reduced cost and time.

Sustainable border control policy in the COVID-19 pandemic: A math modeling study.

BACKGROUND: Imported COVID-19 cases, if unchecked, can jeopardize the effort of domestic containment. We aim to find out what sustainable border control options for different entities (e.g., countries, states) exist during the reopening phases, given their own choice of domestic control measures. METHODS: We propose a SUIHR model, which has built-in imported risk and (1-tier) contact tracing to study the cross-border spreading and control of COVID-19. Under plausible parameter assumptions, we examine the effectiveness of border control policies, in combination with internal measures, to confine the virus and avoid reverting back to more restrictive life styles again. RESULTS: When the basic reproduction number R0 of COVID-19 exceeds 2.5, even 100% effective contact tracing alone is not enough to contain the spreading. For an entity that has completely eliminated the virus domestically, and resumes "normal", without mandatory institutional quarantine, even very strict border control measures combined with effective contact tracing can only delay another outbreak by 6 months. For entities employing a confining domestic control policy, non-increasing net imported cases is sufficient to remain open. CONCLUSIONS: Extremely strict border control in entities, where domestic spreading is currently eliminated (e.g., China), is justifiable. However such harsh measure are not necessary for other places. Entities successfully confining the virus by internal measures can open up to similar entities without additional border controls so long as the imported risk stays non-increasing. Opening the borders to entities lacking sufficient internal control of the virus should be exercised in combination with pre-departure screening and tests upon arrival.

Mitigating COVID-19 Transmission in Schools With Digital Contact Tracing.

Precision mitigation of COVID-19 is in pressing need for postpandemic time with the absence of pharmaceutical interventions. In this study, the effectiveness and cost of digital contact tracing (DCT) technology-based on-campus mitigation strategy are studied through epidemic simulations using high-resolution empirical contact networks of teachers and students. Compared with traditional class, grade, and school closure strategies, the DCT-based strategy offers a practical yet much more efficient way of mitigating COVID-19 spreading in the crowded campus. Specifically, the strategy based on DCT can achieve the same level of disease control as rigid school suspensions but with significantly fewer students quarantined. We further explore the necessary conditions to ensure the effectiveness of DCT-based strategy and auxiliary strategies to enhance mitigation effectiveness and make the following recommendation: social distancing should be implemented along with DCT, the adoption rate of DCT devices should be assured, and swift virus tests should be carried out to discover asymptomatic infections and stop their subsequent transmissions. We also argue that primary schools have higher disease transmission risks than high schools and, thereby, should be alerted when considering reopenings.

Contact Tracing for Imported Case of Middle East Respiratory Syndrome, China, 2015.

Confirmation of an imported case of infection with Middle East respiratory syndrome coronavirus in China triggered intensive contact tracing and mandatory monitoring. Using a hotline and surveillance video footage was effective for tracing all 110 identified contacts. Contact monitoring detected no secondary transmission of infection in China.

Contact tracing of in-flight measles exposures: lessons from an outbreak investigation and case series, Australia, 2010

OBJECTIVE: To describe a 2010 outbreak of nine cases of measles in Australia possibly linked to an index case who travelled on an international flight from South Africa while infectious. METHODS: Three Australian state health departments, Victoria, Queensland and New South Wales, were responsible for the investigation and management of this outbreak, following Australian public health guidelines. Results: An outbreak of measles occurred in Australia after an infectious case arrived on a 12-hour flight from South Africa. Only one of four cases in the first generation exposed to the index case en route was sitting within the two rows recommended for contact tracing in Australian and other guidelines. The remaining four cases in subsequent generations, including two health care workers, were acquired in health care settings. Seven cases were young adults. Delays in diagnosis and notification hampered disease control and contact tracing efforts. CONCLUSION: Review of current contact tracing guidelines following in-flight exposure to an infectious measles case is required. Alternative strategies could include expanding routine contact tracing beyond the two rows on either side of the case’s row or expansion on a case-by-case basis depending on cabin layout and case and contact movements in flight. Releasing information about the incident by press release or providing generic information to everyone on the flight using e-mail or text messaging information obtained from the relevant airline, may also be worthy of consideration. Disease importation, inadequately vaccinated young adults and health care-related transmission remain challenges for measles control in an elimination era.