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Leal J, Farkas B, Mastikhina L, Flanagan J, Skidmore B, Salmon C, Dixit D, Smith S, Tsekrekos S, Lee B, Vayalumkal J, Dunn J, Harrison R, Cordoviz M, Dubois R, Chandran U, Clement F, Bush K, Conly J, Larios O. Risk of transmission of respiratory viruses during aerosol-generating medical procedures (AGMPs) revisited in the COVID-19 pandemic: a systematic review. Antimicrob Resist Infect Control 2022; 11:102. [PMID: 35953854 PMCID: PMC9366810 DOI: 10.1186/s13756-022-01133-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 06/27/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND In many jurisdictions healthcare workers (HCWs) are using respirators for aerosol-generating medical procedures (AGMPs) performed on adult and pediatric populations with all suspect/confirmed viral respiratory infections (VRIs). This systematic review assessed the risk of VRIs to HCWs in the presence of AGMPs, the role respirators versus medical/surgical masks have on reducing that risk, and if the risk to HCWs during AGMPs differed when caring for adult or pediatric patient populations. MAIN TEXT We searched MEDLINE, EMBASE, Cochrane Central, Cochrane SR, CINAHL, COVID-19 specific resources, and MedRxiv for English and French articles from database inception to September 9, 2021. Independent reviewers screened abstracts using pre-defined criteria, reviewed full-text articles, selected relevant studies, abstracted data, and conducted quality assessments of all studies using the ROBINS-I risk of bias tool. Disagreements were resolved by consensus. Thirty-eight studies were included; 23 studies on COVID-19, 10 on SARS, and 5 on MERS/ influenza/other respiratory viruses. Two of the 16 studies which assessed associations found that HCWs were 1.7 to 2.5 times more likely to contract COVID-19 after exposure to AGMPs vs. not exposed to AGMPs. Eight studies reported statistically significant associations for nine specific AGMPs and transmission of SARS to HCWS. Intubation was consistently associated with an increased risk of SARS. HCWs were more likely (OR 2.05, 95% CI 1.2-3.4) to contract human coronaviruses when exposed to an AGMP in one study. There were no reported associations between AGMP exposure and transmission of influenza or in a single study on MERS. There was limited evidence supporting the use of a respirator over a medical/surgical mask during an AGMP to reduce the risk of viral transmission. One study described outcomes of HCWs exposed to a pediatric patient during intubation. CONCLUSION Exposure to an AGMP may increase the risk of transmission of COVID-19, SARS, and human coronaviruses to HCWs, however the evidence base is heterogenous and prone to confounding, particularly related to COVID-19. There continues to be a significant research gap in the epidemiology of the risk of VRIs among HCWs during AGMPs, particularly for pediatric patients. Further evidence is needed regarding what constitutes an AGMP.
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Affiliation(s)
- Jenine Leal
- Infection Prevention and Control, Alberta Health Services, Calgary, AB, Canada.
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada.
- Department of Microbiology, Immunology, and Infectious Diseases, University of Calgary, Calgary, AB, Canada.
- O'Brien Institute of Public Health, University of Calgary, Calgary, AB, Canada.
| | - Brenlea Farkas
- Health Technology Assessment Unit, University of Calgary, Calgary, AB, Canada
| | - Liza Mastikhina
- Health Technology Assessment Unit, University of Calgary, Calgary, AB, Canada
| | - Jordyn Flanagan
- Health Technology Assessment Unit, University of Calgary, Calgary, AB, Canada
| | - Becky Skidmore
- Health Technology Assessment Unit, University of Calgary, Calgary, AB, Canada
| | - Charleen Salmon
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
- O'Brien Institute of Public Health, University of Calgary, Calgary, AB, Canada
- Health Technology Assessment Unit, University of Calgary, Calgary, AB, Canada
| | - Devika Dixit
- Department of Pediatrics, University of Calgary and Alberta Health Services, Calgary, AB, Canada
- Workplace Health & Safety, Alberta Health Services, Calgary, AB, Canada
| | - Stephanie Smith
- Infection Prevention and Control, Alberta Health Services, Calgary, AB, Canada
- Department of Medicine (Infectious Diseases), University of Alberta, Edmonton, AB, Canada
| | - Stephen Tsekrekos
- Department of Medicine (Infectious Diseases), University of Alberta, Edmonton, AB, Canada
- Workplace Health & Safety, Alberta Health Services, Edmonton, Canada
| | - Bonita Lee
- Infection Prevention and Control, Alberta Health Services, Calgary, AB, Canada
- Department of Pediatrics (Infectious Diseases), University of Alberta, Edmonton, AB, Canada
| | - Joseph Vayalumkal
- Infection Prevention and Control, Alberta Health Services, Calgary, AB, Canada
- Department of Pediatrics, University of Calgary and Alberta Health Services, Calgary, AB, Canada
| | - Jessica Dunn
- Department of Pediatrics, University of Calgary and Alberta Health Services, Calgary, AB, Canada
| | - Robyn Harrison
- Department of Medicine (Infectious Diseases), University of Alberta, Edmonton, AB, Canada
- Workplace Health & Safety, Alberta Health Services, Edmonton, Canada
| | - Melody Cordoviz
- Infection Prevention and Control, Alberta Health Services, Calgary, AB, Canada
| | - Roberta Dubois
- Provincial Respiratory Services, Alberta Health Services, Edmonton, Canada
| | - Uma Chandran
- Infection Prevention and Control, Alberta Health Services, Calgary, AB, Canada
- Department of Medicine (Infectious Diseases), University of Alberta, Edmonton, AB, Canada
| | - Fiona Clement
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
- O'Brien Institute of Public Health, University of Calgary, Calgary, AB, Canada
- Health Technology Assessment Unit, University of Calgary, Calgary, AB, Canada
| | - Kathryn Bush
- Infection Prevention and Control, Alberta Health Services, Calgary, AB, Canada
| | - John Conly
- Infection Prevention and Control, Alberta Health Services, Calgary, AB, Canada
- Department of Microbiology, Immunology, and Infectious Diseases, University of Calgary, Calgary, AB, Canada
- O'Brien Institute of Public Health, University of Calgary, Calgary, AB, Canada
- Department of Pathology & Laboratory Medicine, University of Calgary and Alberta Health Services, Calgary, AB, Canada
- Department of Medicine (Infectious Diseases), University of Calgary and Alberta Health Services, Calgary, AB, Canada
- Synder Institute for Chronic Diseases, University of Calgary and Alberta Health Services, Calgary, AB, Canada
| | - Oscar Larios
- Infection Prevention and Control, Alberta Health Services, Calgary, AB, Canada
- Department of Medicine (Infectious Diseases), University of Calgary and Alberta Health Services, Calgary, AB, Canada
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Zhang Y, Hui FKP, Duffield C, Saeed AM. A review of facilities management interventions to mitigate respiratory infections in existing buildings. BUILDING AND ENVIRONMENT 2022; 221:109347. [PMID: 35782231 PMCID: PMC9238148 DOI: 10.1016/j.buildenv.2022.109347] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 05/01/2022] [Accepted: 06/23/2022] [Indexed: 06/15/2023]
Abstract
The Covid-19 pandemic reveals that the hazard of the respiratory virus was a secondary consideration in the design, development, construction, and management of public and commercial buildings. Retrofitting such buildings poses a significant challenge for building owners and facilities managers. This article reviews current research and practices in building operations interventions for indoor respiratory infection control from the perspective of facilities managers to assess the effectiveness of available solutions. This review systematically selects and synthesises eighty-six articles identified through the PRISMA process plus supplementary articles identified as part of the review process, that deal with facilities' operations and maintenance (O&M) interventions. The paper reviewed the context, interventions, mechanisms, and outcomes discussed in these articles, concluding that interventions for respiratory virus transmission in existing buildings fall into three categories under the Facilities Management (FM) discipline: Hard services (HVAC and drainage system controls) to prevent aerosol transmissions, Soft Services (cleaning and disinfection) to prevent fomite transmissions, and space management (space planning and occupancy controls) to eliminate droplet transmissions. Additionally, the research emphasised the need for FM intervention studies that examine occupant behaviours with integrated intervention results and guide FM intervention decision-making. This review expands the knowledge of FM for infection control and highlights future research opportunities.
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Affiliation(s)
- Yan Zhang
- Department of Infrastructure Engineering, University of Melbourne, Level 6, Building 290, 700 Swanston Street, Carlton, Victoria, Australia
| | - Felix Kin Peng Hui
- Department of Infrastructure Engineering, University of Melbourne, Australia
| | - Colin Duffield
- Department of Infrastructure Engineering, University of Melbourne, Australia
| | - Ali Mohammed Saeed
- Department of Jobs, Regions and Precincts, Level 13, 1 Spring Street, Melbourne, Victoria, Australia
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Effect of the COVID-19 Pandemic on Lower Respiratory Tract Infection Determinants in Thai Hospitalized Children: National Data Analysis 2015-2020. Trop Med Infect Dis 2022; 7:tropicalmed7080151. [PMID: 36006243 PMCID: PMC9414978 DOI: 10.3390/tropicalmed7080151] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 07/23/2022] [Accepted: 07/26/2022] [Indexed: 12/28/2022] Open
Abstract
Background: The COVID-19 outbreak emerged in January 2020 and remains present in 2022. During this period, nonpharmaceutical interventions (NPIs) have been used to reduce the spread of COVID-19 infection. Nationwide data analysis should be pushed as the new standard to demonstrate the impact of COVID-19 infection on other respiratory illnesses and the reliability of NPIs during treatment. Objective: This study aims to identify and compare the incidence of lower respiratory tract infections (LRTIs) among children in Thailand before and after the emergence of COVID-19. Methods: A retrospective study was carried out in hospitalized children under the age of 18 in Thailand from October 2015 to September 2020. The International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Thai Modification, was used to identify patient diagnoses (ICD-10-TM). The data were extracted from the Universal Coverage Health Security Scheme Database. Results: A total of 1,610,160 admissions were attributed to LRTIs. The most common diagnosis was pneumonia (61.9%). Compared to the 2019 fiscal year, the number of hospitalizations due to LRTIs decreased by 33.9% in the 2020 fiscal year (COVID-19 period) (282,590 vs. 186,651). The incidence of all three diagnostic groupings was substantially lower in the pre- and post-COVID-19 eras, with a decrease of 28% in the pneumonia group (incidence rate ratio (IRR) = 0.72; 95% confidence interval (CI): 0.71 to 0.72), 44% in the bronchiolitis group (IRR = 0.56; 95% CI: 0.55 to 0.57), and 34% in the bronchitis group (IRR = 0.66; 95% CI: 0.65 to 0.67). Between fiscal years 2019 and 2020, the overall monthly cost of all hospitalizations for LRTIs decreased considerably (p value < 0.001). Conclusions: NPIs may decrease the number of pediatric hospitalizations related to LRTIs. All policies designed to prevent the spread of COVID-19 must be continually utilized to maintain the prevention of LRTIs.
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Correia TSP, Martins MMFPS, Barroso FF, Pinho LG, Fonseca C, Valentim O, Lopes M. The Implications of Family Members’ Absence from Hospital Visits during the COVID-19 Pandemic: Nurses’ Perceptions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19158991. [PMID: 35897362 PMCID: PMC9330113 DOI: 10.3390/ijerph19158991] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 07/21/2022] [Accepted: 07/22/2022] [Indexed: 12/20/2022]
Abstract
Background: In response to the COVID-19 pandemic, several measures were taken to prevent the transmission of infection in the hospital environment, including the restriction of visits. Little is known about the consequences of these directives, but it is expected that they will have various implications. Thus, this study aimed to understand the consequences of measures to restrict visits to hospitalized individuals. Methods: A qualitative interpretive study was conducted through semistructured interviews with 10 nurses chosen by convenience. Content analysis was performed using Atlas.ti software, version 22 (Berlin, Germany). Results: Twenty-two categories and eight subcategories were identified and grouped according to their scope: implications for the patient, implications for the family, and implications for care practice. Conclusions: The identified categories of implications of restricting hospital visits (implications for patients, relatives, and care practices) are incomparably more negative than positive and have a strong potential to cause safety events in the short to long term, also jeopardizing the quality of care. There is the risk of stagnation and even setback due to this removal of families from the hospital environment, not only in terms of safety and quality of care but also with regard to person- and family-centered care.
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Affiliation(s)
- Tânia Sofia Pereira Correia
- Instituto de Ciências Biomédicas Abel Salazar (ICBAS), Universidade do Porto (UP), 4050-313 Porto, Portugal
- CINTESIS (Centro de Investigação em Tecnologias e Serviços de Saúde)—NursID (Innovation & Development in Nursing), 4050-313 Porto, Portugal; (M.M.F.P.S.M.); (O.V.)
- Escola Superior de Saúde Ribeiro Sanches (ERISA), Instituto Politécnico da Lusofonia(IPLUSO), 1950-396 Lisboa, Portugal
- Nursing Department, Universidade de Évora, 7000-811 Évora, Portugal; (L.G.P.); (C.F.); (M.L.)
- Correspondence:
| | - Maria Manuela F. P. S. Martins
- CINTESIS (Centro de Investigação em Tecnologias e Serviços de Saúde)—NursID (Innovation & Development in Nursing), 4050-313 Porto, Portugal; (M.M.F.P.S.M.); (O.V.)
- Escola Superior de Enfermagem do Porto (ESEP), 4050-313 Porto, Portugal
| | | | - Lara G. Pinho
- Nursing Department, Universidade de Évora, 7000-811 Évora, Portugal; (L.G.P.); (C.F.); (M.L.)
- Comprehensive Health Research Centre (CHRC), Universidade de Évora, 7000-811 Évora, Portugal
| | - César Fonseca
- Nursing Department, Universidade de Évora, 7000-811 Évora, Portugal; (L.G.P.); (C.F.); (M.L.)
- Comprehensive Health Research Centre (CHRC), Universidade de Évora, 7000-811 Évora, Portugal
| | - Olga Valentim
- CINTESIS (Centro de Investigação em Tecnologias e Serviços de Saúde)—NursID (Innovation & Development in Nursing), 4050-313 Porto, Portugal; (M.M.F.P.S.M.); (O.V.)
- Escola Superior de Saúde Ribeiro Sanches (ERISA), Instituto Politécnico da Lusofonia(IPLUSO), 1950-396 Lisboa, Portugal
- Escola Superior de Saúde de Leiria (ESSLei), Instituto Politécnico de Leiria (IPLeiria), 2411-901 Leiria, Portugal
| | - Manuel Lopes
- Nursing Department, Universidade de Évora, 7000-811 Évora, Portugal; (L.G.P.); (C.F.); (M.L.)
- Comprehensive Health Research Centre (CHRC), Universidade de Évora, 7000-811 Évora, Portugal
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Leal J, Jefferson T, Conly J. SARS-CoV-2 Exposures of Healthcare Workers and Acquisition of COVID-19. Clin Microbiol Infect 2022; 28:1403-1405. [PMID: 35870713 PMCID: PMC9297694 DOI: 10.1016/j.cmi.2022.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/12/2022] [Accepted: 07/14/2022] [Indexed: 11/28/2022]
Affiliation(s)
- J Leal
- Departments of Community Health Sciences, Microbiology, Immunology, and Infectious Diseases; O'Brien Institute for Public Health, University of Calgary and Alberta Health Services, Calgary, AB, Canada
| | - T Jefferson
- Department of Continuing Education, University of Oxford, Rewley House, 1 Wellington Square, Oxford OX1 2JA, UK
| | - J Conly
- Departments of Medicine, Pathology and Laboratory Medicine, Microbiology, and Immunology and Infectious Diseases; O'Brien Institute for Public Health, Snyder Institute for Chronic Diseases, University of Calgary and Alberta Health Services, Calgary, AB, Canada.
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Greenhalgh T, Fisman D, Cane DJ, Oliver M, Macintyre CR. Adapt or die: how the pandemic made the shift from EBM to EBM+ more urgent. BMJ Evid Based Med 2022; 27:bmjebm-2022-111952. [PMID: 35853682 PMCID: PMC9510422 DOI: 10.1136/bmjebm-2022-111952] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/05/2022] [Indexed: 12/12/2022]
Abstract
Evidence-based medicine (EBM's) traditional methods, especially randomised controlled trials (RCTs) and meta-analyses, along with risk-of-bias tools and checklists, have contributed significantly to the science of COVID-19. But these methods and tools were designed primarily to answer simple, focused questions in a stable context where yesterday's research can be mapped more or less unproblematically onto today's clinical and policy questions. They have significant limitations when extended to complex questions about a novel pathogen causing chaos across multiple sectors in a fast-changing global context. Non-pharmaceutical interventions which combine material artefacts, human behaviour, organisational directives, occupational health and safety, and the built environment are a case in point: EBM's experimental, intervention-focused, checklist-driven, effect-size-oriented and deductive approach has sometimes confused rather than informed debate. While RCTs are important, exclusion of other study designs and evidence sources has been particularly problematic in a context where rapid decision making is needed in order to save lives and protect health. It is time to bring in a wider range of evidence and a more pluralist approach to defining what counts as 'high-quality' evidence. We introduce some conceptual tools and quality frameworks from various fields involving what is known as mechanistic research, including complexity science, engineering and the social sciences. We propose that the tools and frameworks of mechanistic evidence, sometimes known as 'EBM+' when combined with traditional EBM, might be used to develop and evaluate the interdisciplinary evidence base needed to take us out of this protracted pandemic. Further articles in this series will apply pluralistic methods to specific research questions.
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Affiliation(s)
- Trisha Greenhalgh
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - David Fisman
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Danielle J Cane
- Coalition for Healthcare Acquired Infection Reduction, Cambridge, Ontario, Canada
| | - Matthew Oliver
- Association of Professional Engineers and Geoscientists, Edmonton, Alberta, Canada
| | - Chandini Raina Macintyre
- The Biosecurity Program, Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
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Gozdzielewska L, Kilpatrick C, Reilly J, Stewart S, Butcher J, Kalule A, Cumming O, Watson J, Price L. The effectiveness of hand hygiene interventions for preventing community transmission or acquisition of novel coronavirus or influenza infections: a systematic review. BMC Public Health 2022; 22:1283. [PMID: 35780111 PMCID: PMC9250256 DOI: 10.1186/s12889-022-13667-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 06/14/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Novel coronaviruses and influenza can cause infection, epidemics, and pandemics. Improving hand hygiene (HH) of the general public is recommended for preventing these infections. This systematic review examined the effectiveness of HH interventions for preventing transmission or acquisition of such infections in the community. METHODS PubMed, MEDLINE, CINAHL and Web of Science databases were searched (January 2002-February 2022) for empirical studies related to HH in the general public and to the acquisition or transmission of novel coronavirus infections or influenza. Studies on healthcare staff, and with outcomes of compliance or absenteeism were excluded. Study selection, data extraction and quality assessment, using the Cochrane Effective Practice and Organization of Care risk of bias criteria or Joanna Briggs Institute Critical Appraisal checklists, were conducted by one reviewer, and double-checked by another. For intervention studies, effect estimates were calculated while the remaining studies were synthesised narratively. The protocol was pre-registered (PROSPERO 2020: CRD42020196525). RESULTS Twenty-two studies were included. Six were intervention studies evaluating the effectiveness of HH education and provision of products, or hand washing against influenza. Only two school-based interventions showed a significant protective effect (OR: 0.64; 95% CI 0.51, 0.80 and OR: 0.40; 95% CI 0.22, 0.71), with risk of bias being high (n = 1) and unclear (n = 1). Of the 16 non-intervention studies, 13 reported the protective effect of HH against influenza, SARS or COVID-19 (P < 0.05), but risk of bias was high (n = 7), unclear (n = 5) or low (n = 1). However, evidence in relation to when, and how frequently HH should be performed was inconsistent. CONCLUSIONS To our knowledge, this is the first systematic review of effectiveness of HH for prevention of community transmission or acquisition of respiratory viruses that have caused epidemics or pandemics, including SARS-CoV-1, SARS-CoV-2 and influenza viruses. The evidence supporting the protective effect of HH was heterogeneous and limited by methodological quality; thus, insufficient to recommend changes to current HH guidelines. Future work is required to identify in what circumstances, how frequently and what product should be used when performing HH in the community and to develop effective interventions for promoting these specific behaviours in communities during epidemics.
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Affiliation(s)
- Lucyna Gozdzielewska
- Department of Nursing and Community Health, Research Centre for Health, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA, Scotland, UK.
| | | | - Jacqui Reilly
- Department of Nursing and Community Health, Research Centre for Health, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA, Scotland, UK
| | - Sally Stewart
- Department of Nursing and Community Health, Research Centre for Health, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA, Scotland, UK
| | - John Butcher
- Department of Nursing and Community Health, Research Centre for Health, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA, Scotland, UK
| | - Andrew Kalule
- Department of Nursing and Community Health, Research Centre for Health, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA, Scotland, UK
| | - Oliver Cumming
- Department of Disease Control, Faculty of Infectious Tropical Disease, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Julie Watson
- Department of Disease Control, Faculty of Infectious Tropical Disease, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Lesley Price
- Department of Nursing and Community Health, Research Centre for Health, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA, Scotland, UK
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Williamson S, Dennison L, Greenwell K, Denison-Day J, Mowbray F, Richards-Hall S, Smith D, Bradbury K, Ainsworth B, Little P, Geraghty AWA, Yardley L. Using nasal sprays to prevent respiratory tract infections: a qualitative study of online consumer reviews and primary care patient interviews. BMJ Open 2022; 12:e059661. [PMID: 35772824 PMCID: PMC9247325 DOI: 10.1136/bmjopen-2021-059661] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 06/09/2022] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES Nasal sprays could be a promising approach to preventing respiratory tract infections (RTIs). This study explored lay people's perceptions and experiences of using nasal sprays to prevent RTIs to identify barriers and facilitators to their adoption and continued use. DESIGN Qualitative research. Study 1 thematically analysed online consumer reviews of an RTI prevention nasal spray. Study 2 interviewed patients about their reactions to and experiences of a digital intervention that promotes and supports nasal spray use for RTI prevention (reactively: at 'first signs' of infection and preventatively: following possible/probable exposure to infection). Interview transcripts were analysed using thematic analysis. SETTING Primary care, UK. PARTICIPANTS 407 online customer reviews. 13 purposively recruited primary care patients who had experienced recurrent infections and/or had risk factors for severe infections. RESULTS Both studies identified various factors that might influence nasal spray use including: high motivation to avoid RTIs, particularly during the COVID-19 pandemic; fatalistic views about RTIs; beliefs about alternative prevention methods; the importance of personal recommendation; perceived complexity and familiarity of nasal sprays; personal experiences of spray success or failure; tolerable and off-putting side effects; concerns about medicines; and the nose as unpleasant and unhygienic. CONCLUSIONS People who suffer disruptive, frequent or severe RTIs or who are vulnerable to RTIs are interested in using a nasal spray for prevention. They also have doubts and concerns and may encounter problems. Some of these may be reduced or eliminated by providing nasal spray users with information and advice that addresses these concerns or helps people overcome difficulties.
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Affiliation(s)
- Sian Williamson
- Centre for Clinical and Community Applications of Health Psychology, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - Laura Dennison
- Centre for Clinical and Community Applications of Health Psychology, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - Kate Greenwell
- Centre for Clinical and Community Applications of Health Psychology, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - James Denison-Day
- Centre for Clinical and Community Applications of Health Psychology, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - Fiona Mowbray
- Centre for Clinical and Community Applications of Health Psychology, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - Samantha Richards-Hall
- Centre for Clinical and Community Applications of Health Psychology, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - Deb Smith
- Centre for Clinical and Community Applications of Health Psychology, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - Katherine Bradbury
- Centre for Clinical and Community Applications of Health Psychology, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - Ben Ainsworth
- Centre for Clinical and Community Applications of Health Psychology, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
- Department of Psychology, University of Bath, Bath, UK
| | - Paul Little
- Primary Care and Population Science, University of Southampton, Southampton, UK
| | - Adam W A Geraghty
- Primary Care and Population Science, University of Southampton, Southampton, UK
| | - Lucy Yardley
- Centre for Clinical and Community Applications of Health Psychology, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
- School of Health Sciences, University of Bristol, Bristol, UK
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Bianchi FP, Stefanizzi P, Brescia N, Lattanzio S, Martinelli A, Tafuri S. COVID-19 vaccination hesitancy in Italian healthcare workers: a systematic review and meta-analysis. Expert Rev Vaccines 2022; 21:1289-1300. [PMID: 35757890 DOI: 10.1080/14760584.2022.2093723] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
INTRODUCTION As for other vaccines, vaccination hesitancy may be a determining factor in the success (or otherwise) of the COVID-19 immunization campaign in healthcare workers (HCWs). AREAS COVERED To estimate the proportion of HCWs in Italy who expressed COVID-19 vaccine hesitancy, we conducted a systematic review of the relevant literature and a meta-analysis. Determinants of vaccine compliance and options suggested by these studies to address vaccine hesitancy among HCWs were also analyzed. Seventeen studies were included in the meta-analysis and systematic review, selected from scientific articles available in the MEDLINE/PubMed, Google Scholar and Scopus databases between January 1, 2020 and January 25, 2022. The vaccine hesitancy rate among HCWs was 13.1% (95%CI: 6.9-20.9%). The vaccine hesitancy rate among HCWs investigated before and during the vaccination campaign was 18.2% (95%CI=12.8-24.2%) and 8.9% (95%CI=3.4-16.6%), respectively. That main reasons for vaccine hesitation were lack of information about vaccination, opinion that the vaccine is unsafe, and fear of adverse events. EXPERT OPINION Despite strategies to achieve a greater willingness to immunize in this category, mandatory vaccination appears to be one of the most important measures that can guarantee the protection of HCWs and the patients they care for.
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Affiliation(s)
| | - Pasquale Stefanizzi
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari
| | - Nazario Brescia
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari
| | - Sabrina Lattanzio
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari
| | - Andrea Martinelli
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari
| | - Silvio Tafuri
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari
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Wang X, Wu T, Oliveira LFS, Zhang D. Sheet, Surveillance, Strategy, Salvage and Shield in global biodefense system to protect the public health and tackle the incoming pandemics. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 822:153469. [PMID: 35093353 PMCID: PMC8799268 DOI: 10.1016/j.scitotenv.2022.153469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 01/23/2022] [Accepted: 01/23/2022] [Indexed: 06/14/2023]
Abstract
The pandemic of COVID-19 challenges the global health system and raises our concerns on the next waves of other emerging infectious diseases. Considering the lessons from the failure of world's pandemic warning system against COVID-19, many scientists and politicians have mentioned different strategies to improve global biodefense system, among which Sheet, Surveillance, Strategy, Salvage and Shield (5S) are frequently discussed. Nevertheless, the current focus is mainly on the optimization and management of individual strategy, and there are limited attempts to combine the five strategies as an integral global biodefense system. Sheet represents the biosafety datasheet for biohazards in natural environment and human society, which helps our deeper understanding on the geographical pattern, transmission routes and infection mechanism of pathogens. Online surveillance and prognostication network is an environmental Surveillance tool for monitoring the outbreak of pandemic diseases and alarming the risks to take emergency actions, targeting aerosols, waters, soils and animals. Strategy is policies and legislations for social distancing, lockdown and personal protective equipment to block the spread of infectious diseases in communities. Clinical measures are Salvage on patients by innovating appropriate medicines and therapies. The ultimate defensive Shield is vaccine development to protect healthy crowds from infection. Fighting against COVID-19 and other emerging infectious diseases is a long rocky journey, requiring the common endeavors of scientists and politicians from all countries around the world. 5S in global biodefense system bring a ray of light to the current darkest and future road from environmental and geographical perspectives.
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Affiliation(s)
- Xinzi Wang
- School of Environment, Tsinghua University, Beijing 100084, PR China
| | - Tianyun Wu
- Research Institute for Environmental Innovation (Tsinghua-Suzhou), Suzhou 215163, PR China
| | - Luis F S Oliveira
- Departamento de Ingeniería Civil y Arquitectura, Universidad de Lima, Avenida Javier Prado Este 4600, Santiago de Surco 1503, Peru; Department of Civil and Environmental, Universidad de la Costa, Calle 58 #55-66, 080002 Barranquilla, Atlántico, Colombia
| | - Dayi Zhang
- College of New Energy and Environment, Jilin University, Changchun 130021, PR China.
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Kim KM, Rhee HS. Influential factors for COVID-19 related distancing in daily life: a distinct focus on ego-gram. BMC Public Health 2022; 22:939. [PMID: 35538466 PMCID: PMC9090118 DOI: 10.1186/s12889-022-13336-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 04/29/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) has necessitated that individuals comply with personal quarantine rules in daily life. South Korea is implementing the concept of "distancing in daily life" to raise awareness on personal quarantine measures, which is communicated through various media channels and platforms. The continued rise in COVID-19 cases demands that all individuals strictly adhere to personal quarantine rules. It is worth paying particular attention to the college student group, which has the highest percentage of confirmed cases among all age groups in South Korea. This group understands and practices "distancing in daily life" but with drastic variations among individuals. Previous studies have reported that the level of adherence to social norms is different according to each ego stated, and media exposure level is reported as a major influencing factor. Therefore, this study examined the media exposure level to COVID-19 prevention rules and its effect on the observance of distancing in daily life; it also verified the moderating effect of ego-gram on the relationship between media exposure level and distancing in daily life. METHODS The participants comprised Korean university students (men = 143, women = 188, N = 331) aged 18-30 years, who were recruited through an online survey. The survey was conducted over 20 days from January 27 to February 15, 2021. Data were analyzed using SAS (version 9.4) to calculate hierarchical regression. RESULTS First, media exposure level and distancing in daily life among Korean university students was above average. Second, media exposure level (β = .161, P < .01) was identified as the most influential factor for distancing in daily life. Third, ego-grams had a moderating effect (β = .136, P < .05) on the relationship between media exposure levels and distancing in daily life. CONCLUSIONS This study examined the policy implications related to the development of diverse quarantine-related programs while considering influential factors and differences in how individuals' compliance with quarantine rules were presented. Considering the situation in which new infectious diseases such as COVID-19 occur every 4-5 years, this study serves as a preparation for future pandemics and is an important framework to enhance the level of personal quarantine.
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Affiliation(s)
- Kyu-Min Kim
- Department of Public Healthcare Sciences, Graduate School, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, South Korea.,BK21FOUR R&E Center for Learning Health Systems, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, South Korea
| | - Hyun-Sill Rhee
- School of Health Policy and Management, College of Public Health Science, Korea university, 145 Anam-ro, Seongbuk-gu, Seoul, South Korea.
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Pizarro AB, Persad E, Durao S, Nussbaumer-Streit B, Engela-Volker JS, McElvenny D, Rhodes S, Stocking K, Fletcher T, Martin C, Noertjojo K, Sampson O, Verbeek JH, Jørgensen KJ, Bruschettini M. Workplace interventions to reduce the risk of SARS-CoV-2 infection outside of healthcare settings. Cochrane Database Syst Rev 2022; 5:CD015112. [PMID: 35514111 PMCID: PMC9073086 DOI: 10.1002/14651858.cd015112.pub2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Although many people infected with SARS-CoV-2 (severe acute respiratory syndrome coronavirus-2) experience no or mild symptoms, some individuals can develop severe illness and may die, particularly older people and those with underlying medical problems. Providing evidence-based interventions to prevent SARS-CoV-2 infection has become more urgent with the spread of more infectious SARS-CoV-2 variants of concern (VoC), and the potential psychological toll imposed by the coronavirus disease 2019 (COVID-19) pandemic. Controlling exposures to occupational hazards is the fundamental method of protecting workers. When it comes to the transmission of viruses, such as SARS-CoV-2, workplaces should first consider control measures that can potentially have the most significant impact. According to the hierarchy of controls, one should first consider elimination (and substitution), then engineering controls, administrative controls, and lastly, personal protective equipment (PPE). OBJECTIVES To assess the benefits and harms of interventions in non-healthcare-related workplaces to reduce the risk of SARS-CoV-2 infection relative to other interventions, or no intervention. SEARCH METHODS We searched MEDLINE, Embase, Web of Science, Cochrane COVID-19 Study Register, the Canadian Centre for Occupational Health and Safety (CCOHS), Clinicaltrials.gov, and the International Clinical Trials Registry Platform to 14 September 2021. We will conduct an update of this review in six months. SELECTION CRITERIA We included randomised control trials (RCT) and planned to include non-randomised studies of interventions. We included adult workers, both those who come into close contact with clients or customers (e.g. public-facing employees, such as cashiers or taxi drivers), and those who do not, but who could be infected by co-workers. We excluded studies involving healthcare workers. We included any intervention to prevent or reduce workers' exposure to SARS-CoV-2 in the workplace, defining categories of intervention according to the hierarchy of hazard controls, i.e. elimination; engineering controls; administrative controls; personal protective equipment. DATA COLLECTION AND ANALYSIS We used standard Cochrane methods. Our primary outcomes were incidence rate of SARS-CoV-2 infection (or other respiratory viruses), SARS-CoV-2-related mortality, adverse events, and absenteeism from work. Our secondary outcomes were all-cause mortality, quality of life, hospitalisation, and uptake, acceptability, or adherence to strategies. We used the Cochrane RoB 2 tool to assess the risk of bias, and GRADE methods to assess the certainty of evidence for each outcome. MAIN RESULTS Elimination of exposure interventions We included one study examining an intervention that focused on elimination of hazards. This study is an open-label, cluster-randomised, non-inferiority trial, conducted in England in 2021. The study compared standard 10-day self-isolation after contact with an infected person to a new strategy of daily rapid antigen testing and staying at work if the test is negative (test-based attendance). The trialists hypothesised that this would lead to a similar rate of infections, but lower COVID-related absence. Staff (N = 11,798) working at 76 schools were assigned to standard isolation, and staff (N = 12,229) at 86 schools to the test-based attendance strategy. The results between test-based attendance and standard 10-day self-isolation were inconclusive for the rate of symptomatic PCR-positive SARS-COV-2 infection rate ratio ((RR) 1.28, 95% confidence interval (CI) 0.74 to 2.21; 1 study, very low-certainty evidence)). The results between test-based attendance and standard 10-day self-isolation were inconclusive for the rate of any PCR-positive SARS-COV-2 infection (RR 1.35, 95% CI 0.82 to 2.21; 1 study, very low-certainty evidence). COVID-related absenteeism rates were 3704 absence days in 566,502 days-at-risk (6.5 per 1000 days at risk) in the control group and 2932 per 539,805 days-at-risk (5.4 per 1000 days at risk) in the intervention group (RR 0.83; 95% CI 0.55 to 1.25). The certainty of the evidence was downgraded to low, due to imprecision. Uptake of the intervention was 71 % in the intervention group, but not reported for the control intervention. The trial did not measure other outcomes, SARS-CoV-2-related mortality, adverse events, all-cause mortality, quality of life, and hospitalisation. We found one ongoing RCT about screening in schools, using elimination of hazard strategies. Personal protective equipment We found one ongoing non-randomised study on the effects of closed face shields to prevent COVID-19 transmission. Other intervention categories We did not find studies in the other intervention categories. AUTHORS' CONCLUSIONS We are uncertain whether a test-based attendance policy affects rates of PCR-postive SARS-CoV-2 infection (any infection; symptomatic infection) compared to standard 10-day self-isolation amongst school and college staff. Test-based attendance policy may result in little to no difference in absence rates compared to standard 10-day self-isolation. As a large part of the population is exposed in the case of a pandemic, an apparently small relative effect that would not be worthwhile from the individual perspective may still affect many people, and thus, become an important absolute effect from the enterprise or societal perspective. The included study did not report on any other primary outcomes of our review, i.e. SARS-CoV-2-related mortality and adverse events. No completed studies were identified on any other interventions specified in this review, but two eligible studies are ongoing. More controlled studies are needed on testing and isolation strategies, and working from home, as these have important implications for work organisations.
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Affiliation(s)
| | - Emma Persad
- Cochrane Austria, Department for Evidence-based Medicine and Evaluation, Danube University Krems, Krems, Austria
| | - Solange Durao
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
| | - Barbara Nussbaumer-Streit
- Cochrane Austria, Department for Evidence-based Medicine and Evaluation, Danube University Krems, Krems, Austria
| | - Jean S Engela-Volker
- Division of Population Medicine, Cardiff University School of Medicine, Cardiff, UK
| | - Damien McElvenny
- Centre for Occupational and Environmental Health, University of Manchester, Manchester, UK
| | - Sarah Rhodes
- Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
| | - Katie Stocking
- Centre for Biostatistics, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Tony Fletcher
- Epidemiology Department, Public Health England Centre for Radiation Chemical and Environmental Hazards (CRCE), London, UK
| | | | | | | | | | - Karsten Juhl Jørgensen
- Centre for Evidence-Based Medicine Odense (CEBMO) and Cochrane Denmark, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Matteo Bruschettini
- Cochrane Sweden, Lund University, Skåne University Hospital, Lund, Sweden
- Department of Clinical Sciences Lund, Paediatrics, Lund University, Skåne University Hospital, Lund, Sweden
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Quraishi N, Ray M, Srivastava R, Ray J, Quraishi MS. A multicentre retrospective cohort study on COVID-19-related physical interventions and adult hospital admissions for ENT infections. Eur Arch Otorhinolaryngol 2022; 279:2671-2678. [PMID: 34807284 PMCID: PMC8607061 DOI: 10.1007/s00405-021-07180-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 11/06/2021] [Indexed: 02/06/2023]
Abstract
PURPOSE To report changes in adult hospital admission rates for acute ENT infections following the introduction of COVID-19-related physical interventions such as hand washing, use of face masks and social distancing of 2-m in the United Kingdom. METHODS Retrospective cohort study comparing adult admissions with acute tonsillitis, peritonsillar abscess, epiglottitis, glandular fever, peri-orbital cellulitis, acute otitis media, acute mastoiditis, retropharyngeal abscess and parapharyngeal abscess in the 1-year period after the introduction of COVID-related physical interventions (2020-2021) with a 1-year period before this (2019-2020) in three UK secondary care ENT departments. RESULTS In total, there were significantly fewer admissions for ENT infections (n = 1073, 57.56%, p < 0.001; RR 2.36, 95% CI [2.17, 2.56]) in the 2020-2021 period than in the 2019-2020 period. There were significant reductions in admissions for tonsillitis (64.4%; p < 0.001), peritonsillar abscess (60.68%; p < 0.001), epiglottitis (66.67%; p < 0.001), glandular fever (38.79%; p = 0.001), acute otitis media (26.85%; p = 0.01) and retropharyngeal and/or parapharyngeal abscesses (45.45%; p = 0.04). CONCLUSION Our study demonstrates a sizeable reduction in adult admissions for ENT infections since the introduction of COVID-19-related physical interventions. There is evidence to support the use of physical interventions in the prevention of viral transmission of respiratory disease. Preventing ENT infections requiring admission through simple physical interventions could be of great benefit to the quality of life of patients and economical benefit to healthcare systems.
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Affiliation(s)
| | | | | | - Jaydip Ray
- Sheffield Teaching Hospitals, Sheffield, UK
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64
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Smirnov VS, Lyalina LV, Milichkina AM, Khamitova IV, Zueva EV, Ivanov VA, Zaguzov VS, Totolian AA. Longitudinal Randomized Cohort Study of SARS-CoV-2 Antibody Seroprevalence in the St. Petersburg Population. Viruses 2022; 14:913. [PMID: 35632653 PMCID: PMC9146723 DOI: 10.3390/v14050913] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/17/2022] [Accepted: 04/25/2022] [Indexed: 02/01/2023] Open
Abstract
Introduction. Since the detection of the first COVID-19 patient, 2 years have passed, during which more than 287,862,000 people have fallen ill globally, of which about 1.9% died. The implementation of SARS-CoV-2 control programs required efforts from almost all countries. An important direction in the fight against COVID-19 has been the formation of herd immunity, the main tool for managing the pandemic. Study goal. The aim of the study was to assess the seroprevalence of antibodies (Abs) to SARS-CoV-2 nucleocapsid (Nc) and receptor binding domain (RBD) in the St. Petersburg population during the COVID-19 pandemic. Materials and methods. A longitudinal cohort randomized monitoring study of Ab seroprevalence (SARS-CoV-2 Nc, RBD) was organized and conducted according to a unified methodology developed by Rospotrebnadzor with the participation of the St. Petersburg Pasteur Institute. For this purpose, a cohort was formed of 1000 volunteers who participated in all five stages of seromonitoring. The cohort was divided into seven age groups: 1−17; 18−29; 30−39; 40−49; 50−59; 60−69; 70; and older (70+) years. Seropositivity levels (Nc, RBD) were assessed by quantitative and qualitative enzyme immunoassays. During the second year of monitoring, some volunteers were vaccinated with the GamCOVIDVac (84%) or EpiVacCorona (11.6%) vaccines approved in Russia. Statistical processing was carried out using Excel 2010. Confidence intervals for shares and percentages (95% CI) were calculated using the method of A. Wald and J. Wolfowitz with adjustment (A. Agresti, B.A. Coull). The statistical significance of differences was calculated by z-test, using the appropriate online calculator (p < 0.05) unless indicated. Results. There was a trend toward an increase in Nc seropositivity in stages 1−3 of seromonitoring, with a decrease in stages 4−5 among children and adults. The share of RBD seropositive steadily increased during all five stages of seromonitoring. The most frequent finding was low anti-RBD Abs levels (22.6−220 BAU/mL). High Ab levels were recorded statistically significantly less frequently. Asymptomatic forms were observed in 84−88% of SARS-CoV-2 seropositive volunteers. By the fifth stage of monitoring, this indicator significantly decreased to 69.8% (95% CI: 66.1−73.4). The monitoring revealed a statistically significant increase in anti-RBD Abs alongside a statistically significant decrease in the proportion of Nc seropositives. This dynamic was especially characteristic of persons vaccinated with GamCOVIDVac. Conclusion. Prior to the use of specific vaccines, a seroprevalence of anti-Nc Abs was noted. After the introduction of the GamCOVIDVac vaccine in adults, a decrease in the level of anti-Nc Abs was noted due to an increase in the proportion of RBD seropositive persons.
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Affiliation(s)
- Vyacheslav S. Smirnov
- Saint Petersburg Pasteur Institute, 197101 St. Petersburg, Russia; (L.V.L.); (A.M.M.); (I.V.K.); (E.V.Z.); (V.A.I.); (V.S.Z.); (A.A.T.)
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65
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Ye Z, Ling Y, Yang M, Xu Y, Zhu L, Yan Z, Chen PY. A Breathable, Reusable, and Zero-Power Smart Face Mask for Wireless Cough and Mask-Wearing Monitoring. ACS NANO 2022; 16:5874-5884. [PMID: 35298138 DOI: 10.1021/acsnano.1c11041] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
We herein introduce a lightweight and zero-power smart face mask, capable of wirelessly monitoring coughs in real time and identifying proper mask wearing in public places during a pandemic. The smart face mask relies on the compact, battery-free radio frequency (RF) harmonic transponder, which is attached to the inner layer of the mask for detecting its separation from the face. Specifically, the RF transponder composed of miniature antennas and passive frequency multiplier is made of spray-printed silver nanowires (AgNWs) coated with a poly(3,4-ethylenedioxythiophene):poly(styrenesulfonate) (PEDOT:PSS) passivation layer and the recently discovered multiscale porous polystyrene-block-poly(ethylene-ran-butylene)-block-polystyrene (SEBS) substrate. Unlike conventional on-chip or on-board wireless sensors, the SEBS-AgNWs/PEDOT:PSS-based RF transponder is lightweight, stretchable, breathable, and comfortable. In addition, this wireless device has excellent resilience and robustness in long-term and repeated usages (i.e., repeated placement and removal of the soft transponder on the mask). We foresee that this wireless smart face mask, providing simultaneous cough and mask-wearing monitoring, may mitigate virus-transmissive events by tracking the potential contagious person and identifying mask-wearing conditions. Moreover, the ability to wirelessly assess cough frequencies may improve diagnosis accuracy for dealing with several diseases, such as chronic obstructive pulmonary disease.
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Affiliation(s)
- Zhilu Ye
- Department of Electrical and Computer Engineering, University of Illinois at Chicago, Chicago, Illinois 60607, United States
| | - Yun Ling
- Department of Mechanical and Aerospace Engineering, University of Missouri, Columbia, Missouri 65211, United States
| | - Minye Yang
- Department of Electrical and Computer Engineering, University of Illinois at Chicago, Chicago, Illinois 60607, United States
| | - Yadong Xu
- Department of Biomedical, Biological, and Chemical Engineering, University of Missouri, Columbia, Missouri 65211, United States
| | - Liang Zhu
- Department of Electrical and Computer Engineering, University of Illinois at Chicago, Chicago, Illinois 60607, United States
| | - Zheng Yan
- Department of Mechanical and Aerospace Engineering, University of Missouri, Columbia, Missouri 65211, United States
- Department of Biomedical, Biological, and Chemical Engineering, University of Missouri, Columbia, Missouri 65211, United States
| | - Pai-Yen Chen
- Department of Electrical and Computer Engineering, University of Illinois at Chicago, Chicago, Illinois 60607, United States
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Dennison L, Williamson S, Greenwell K, Handcock M, Bradbury K, Vennik J, Yardley L, Little P, Geraghty AWA. Patient perceptions of vulnerability to recurrent respiratory tract infections and prevention strategies: a qualitative study. BMJ Open 2022; 12:e055565. [PMID: 35443952 PMCID: PMC9021765 DOI: 10.1136/bmjopen-2021-055565] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES Respiratory tract infections (RTIs) are extremely common, usually self-limiting, but responsible for considerable work sickness absence, reduced quality of life, inappropriate antibiotic prescribing and healthcare costs. Patients who experience recurrent RTIs and those with certain comorbid conditions have higher personal impact and healthcare costs and may be more likely to suffer disease exacerbations, hospitalisation and death. We explored how these patients experience and perceive their RTIs to understand how best to engage them in prevention behaviours. DESIGN A qualitative interview study. SETTING Primary care, UK. METHODS 23 participants who reported recurrent RTIs and/or had relevant comorbid health conditions were interviewed about their experiences of RTIs. Interviews took place as the COVID-19 pandemic began. Data were analysed using inductive thematic analysis. RESULTS Three themes were developed: Understanding causes and vulnerability, Attempting to prevent RTIs, Uncertainty and ambivalence about prevention, along with an overarching theme; Changing experiences because of COVID-19. Participants' understandings of their susceptibility to RTIs were multifactorial and included both transmission via others and personal vulnerabilities. They engaged in various approaches to try to prevent infections or alter their progression yet perceived they had limited personal control. The COVID-19 pandemic had improved their understanding of transmission, heightened their concern and motivation to avoid RTIs and extended their repertoire of protective behaviours. CONCLUSIONS Patients who experience frequent or severe RTIs are likely to welcome and benefit from advice and support regarding RTI prevention. To engage people effectively, those developing interventions or delivering health services must consider their beliefs and concerns about susceptibility and prevention.
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Affiliation(s)
- Laura Dennison
- Centre for Clinical and Community Applications of Health Psychology, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - Sian Williamson
- Centre for Clinical and Community Applications of Health Psychology, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - Kate Greenwell
- Centre for Clinical and Community Applications of Health Psychology, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - Molly Handcock
- School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Katherine Bradbury
- Centre for Clinical and Community Applications of Health Psychology, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
- NIHR Applied Research Collaboration (ARC) Wessex, Southampton, UK
| | - Jane Vennik
- School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Lucy Yardley
- Centre for Clinical and Community Applications of Health Psychology, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Paul Little
- School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Adam W A Geraghty
- School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK
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Abstract
Masking was the single most common non-pharmaceutical intervention in the course of the coronavirus disease 2019 (COVID-19) pandemic. Most countries have implemented recommendations or mandates regarding the use of masks in public spaces. The aim of this short study was to analyse the correlation between mask usage against morbidity and mortality rates in the 2020-2021 winter in Europe. Data from 35 European countries on morbidity, mortality, and mask usage during a six-month period were analysed and crossed. Mask usage was more homogeneous in Eastern Europe than in Western European countries. Spearman's correlation coefficients between mask usage and COVID-19 outcomes were either null or positive, depending on the subgroup of countries and type of outcome (cases or deaths). Positive correlations were stronger in Western than in Eastern European countries. These findings indicate that countries with high levels of mask compliance did not perform better than those with low mask usage.
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Affiliation(s)
- Beny Spira
- Microbiology, Universidade de São Paulo, São Paulo, BRA
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68
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Rahman MZ, Hoque ME, Alam MR, Rouf MA, Khan SI, Xu H, Ramakrishna S. Face Masks to Combat Coronavirus (COVID-19)-Processing, Roles, Requirements, Efficacy, Risk and Sustainability. Polymers (Basel) 2022; 14:1296. [PMID: 35406172 PMCID: PMC9003287 DOI: 10.3390/polym14071296] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 02/26/2022] [Accepted: 03/14/2022] [Indexed: 02/04/2023] Open
Abstract
Increasingly prevalent respiratory infectious diseases (e.g., COVID-19) have posed severe threats to public health. Viruses including coronavirus, influenza, and so on can cause respiratory infections. A pandemic may potentially emerge owing to the worldwide spread of the virus through persistent human-to-human transmission. However, transmission pathways may vary; respiratory droplets or airborne virus-carrying particles can have a key role in transmitting infections to humans. In conjunction with social distancing, hand cleanliness, and other preventative measures, the use of face masks is considered to be another scientific approach to combat ubiquitous coronavirus. Different types of face masks are produced using a range of materials (e.g., polypropylene, polyacrylonitrile, polycarbonate, polyurethane, polystyrene, polyester and polyethylene) and manufacturing techniques (woven, knitted, and non-woven) that provide different levels of protection to the users. However, the efficacy and proper disposal/management of the used face masks, particularly the ones made of non-biodegradable polymers, pose great environmental concerns. This review compiles the recent advancements of face masks, covering their requirements, materials and techniques used, efficacy, challenges, risks, and sustainability towards further enhancement of the quality and performance of face masks.
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Affiliation(s)
- Md Zillur Rahman
- Department of Mechanical Engineering, Ahsanullah University of Science and Technology (AUST), Dhaka 1208, Bangladesh
| | - Md Enamul Hoque
- Department of Biomedical Engineering, Military Institute of Science and Technology (MIST), Dhaka 1216, Bangladesh;
| | - Md Rubel Alam
- Department of Knitwear Manufacturing and Technology, BGMEA University of Fashion and Technology (BUFT), Dhaka 1230, Bangladesh; (M.R.A.); (M.A.R.)
| | - Md Abdur Rouf
- Department of Knitwear Manufacturing and Technology, BGMEA University of Fashion and Technology (BUFT), Dhaka 1230, Bangladesh; (M.R.A.); (M.A.R.)
| | - Saiful Islam Khan
- Department of Biomedical Engineering, Military Institute of Science and Technology (MIST), Dhaka 1216, Bangladesh;
| | - Huaizhong Xu
- Department of Biobased Materials Science, Kyoto Institute of Technology (KIT), Matsugasaki Hashikamicho 1, Sakyoku, Kyoto 606-8585, Japan
| | - Seeram Ramakrishna
- Department of Mechanical Engineering, National University of Singapore (NUS), Singapore 117575, Singapore;
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Fountoulakis KN, Breda J, Arletou MP, Charalampakis AI, Karypidou MG, Kotorli KS, Koutsoudi CG, Ladia ES, Mitkani CA, Mpouri VN, Samara AC, Stravoravdi AS, Tsiamis IG, Tzortzi A, Vamvaka MA, Zacharopoulou CN, Prezerakos PE, Koupidis SA, K Fountoulakis N, Tsapakis EM, Konsta A, Theodorakis PN. Adherence to facemask use in public places during the autumn-winter 2020 COVID-19 lockdown in Greece: observational data. Ann Gen Psychiatry 2022; 21:9. [PMID: 35264198 PMCID: PMC8905561 DOI: 10.1186/s12991-022-00386-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 02/22/2022] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Wearing facemasks is of proven efficacy as a public health protective measure against COVID-19. Currently there are no observational data concerning the wearing of facemasks and the adherence to guidelines concerning their handling. METHODS Registration of the way passers-by were wearing facemasks at 26 different locations of five major cities in Greece. The results were correlated with the rate of COVID-19 deaths in the region. RESULTS In total, 119,433 passers-by were registered, 57,043 females (47.8%) and 62,390 males (52.2%). From the total sample, 81.1% were wearing the mask properly, 10.8% had their nose out, 6.2% were wearing it under the jaw, and 1.9% had no mask at all . There was a significant difference between males and females concerning any use of mask. Inappropriate use of was correlated with COVID-19 death rate in the studied region. CONCLUSION Our findings suggest that under conditions of mandatory wearing and in central locations of major cities, during walking, proper use of masks is suboptimal, but still contributes with some protection. Fear and risk perception seem to be strong factors contributing to adherence to proper mask wearing.
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Affiliation(s)
- Konstantinos N Fountoulakis
- Department of Psychiatry, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 6, Odysseos str, 55535, Thessaloniki, Greece
| | - Joao Breda
- WHO Athens Quality of Care Office, WHO Regional Office for Europe, Athens, Greece
| | - Marianna P Arletou
- School of Medicine, Faculty of Health Sciences, Clinical Mental Health, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Anastasios I Charalampakis
- School of Medicine, Faculty of Health Sciences, Clinical Mental Health, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Maria G Karypidou
- School of Medicine, Faculty of Health Sciences, Clinical Mental Health, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Konstantina S Kotorli
- School of Medicine, Faculty of Health Sciences, Clinical Mental Health, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Christina G Koutsoudi
- School of Medicine, Faculty of Health Sciences, Clinical Mental Health, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eleftheria S Ladia
- School of Medicine, Faculty of Health Sciences, Clinical Mental Health, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Calypso A Mitkani
- School of Medicine, Faculty of Health Sciences, Clinical Mental Health, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vasiliki N Mpouri
- School of Medicine, Faculty of Health Sciences, Clinical Mental Health, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Anastasia C Samara
- School of Medicine, Faculty of Health Sciences, Clinical Mental Health, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Aikaterini S Stravoravdi
- School of Medicine, Faculty of Health Sciences, Clinical Mental Health, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis G Tsiamis
- School of Medicine, Faculty of Health Sciences, Clinical Mental Health, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Aphrodite Tzortzi
- School of Medicine, Faculty of Health Sciences, Clinical Mental Health, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Maria A Vamvaka
- School of Medicine, Faculty of Health Sciences, Clinical Mental Health, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Charikleia N Zacharopoulou
- School of Medicine, Faculty of Health Sciences, Clinical Mental Health, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Panagiotis E Prezerakos
- Department of Nursing, Laboratory of Integrated Health Care, University of Peloponnese, Tripoli, Greece
| | - Sotirios A Koupidis
- Occupational & Environmental Health Sector, Public Health Policy Department, School of Public Health, University of West Attica, Athens, Greece
| | | | | | - Anastasia Konsta
- Department of Psychiatry, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 6, Odysseos str, 55535, Thessaloniki, Greece
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Jędrzejek MJ, Mastalerz-Migas A, Janicka P. Incidence of Influenza Virus Infection among Wroclaw's Healthcare Workers in Pre-COVID-19 2019-2020 Influenza Season Using Novel Flu SensDx Device. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063159. [PMID: 35328847 PMCID: PMC8954534 DOI: 10.3390/ijerph19063159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 02/25/2022] [Accepted: 02/26/2022] [Indexed: 02/04/2023]
Abstract
Background: Healthcare workers (HCWs) are more exposed to influenza infection, and the influenza vaccination is recommended each year, to reduce the risk of influenza infection and prevent influenza transmission. This study is a cross-sectional study and the objectives were to determine the rate of influenza virus infection among HCWs in the 2019−2020 influenza season. Methods: Between January and March 2020, a survey was carried out in 2 hospitals and 15 primary health-care settings (PHCS) in Wroclaw (Poland). The novel point-of-care testing Flu SensDx device was used, which detects the M1 protein of the influenza virus using electrochemical impedance spectroscopy from biological material (throat/nasal swabs). Results: A total of 150 samples were collected. The majority of participating HCWs by profession were 83 physicians (55.3%) and half (51.3%) of the participating HCWs worked in PHCS. Influenza vaccination coverage was 61.3% in 2019−2020 and 46.0% in the 2018−2019 season for all participants. Of the participating HCWs, 44.0% were positive tested by the Flu SensDx device. There were no statistically significant differences among the positive tested HCWs, their influenza immunization history, and the presence of symptoms of influenza-like illness (p > 0.05). Conclusion: Although the results of the present study suggest that influenza vaccination does not reduce the frequency of influenza virus detection by Flu SensDx testing in the HCWs participants, larger studies are needed to estimate the incidence of influenza virus infection among HCWs to understand the underlying mechanism and fine-tune policies aimed at reducing nosocomial infections.
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Affiliation(s)
- Michał Jacek Jędrzejek
- Department of Family Medicine, Wroclaw Medical University, W. Syrokomli 1, 51-141 Wroclaw, Poland;
- Correspondence:
| | | | - Paulina Janicka
- Department of Pathology, Wroclaw University of Environmental and Life Sciences, Norwida 31, 50-375 Wroclaw, Poland;
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Hanratty J, Keenan C, O'Connor S, Miller S, Bradley D, Dempster M. PROTOCOL: Psychological and psychosocial determinants of COVID Health Related Behaviours (COHeRe): A suite of systematic reviews and an evidence and gap map. CAMPBELL SYSTEMATIC REVIEWS 2022; 18:e1219. [PMID: 35465105 PMCID: PMC8812813 DOI: 10.1002/cl2.1219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
This is the protocol for a Campbell systematic review. The objectives are as follows: we intend to identify and synthesise the existing evidence (published and unpublished) on malleable psychological and psychosocial factors that determine uptake and adherence to behaviours that can reduce the risk of infection or transmission of COVID-19.
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Affiliation(s)
| | | | | | - Sarah Miller
- School of Social Sciences, Education and Social WorkQueen's UniversityBelfastUK
| | - Declan Bradley
- School of Medicine, Dentistry and Biomedical SciencesQueens UniversityBelfastUK
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Nasa P, Azoulay E, Chakrabarti A, Divatia JV, Jain R, Rodrigues C, Rosenthal VD, Alhazzani W, Arabi YM, Bakker J, Bassetti M, De Waele J, Dimopoulos G, Du B, Einav S, Evans L, Finfer S, Guérin C, Hammond NE, Jaber S, Kleinpell RM, Koh Y, Kollef M, Levy MM, Machado FR, Mancebo J, Martin-Loeches I, Mer M, Niederman MS, Pelosi P, Perner A, Peter JV, Phua J, Piquilloud L, Pletz MW, Rhodes A, Schultz MJ, Singer M, Timsit JF, Venkatesh B, Vincent JL, Welte T, Myatra SN. Infection control in the intensive care unit: expert consensus statements for SARS-CoV-2 using a Delphi method. THE LANCET. INFECTIOUS DISEASES 2022; 22:e74-e87. [PMID: 34774188 PMCID: PMC8580499 DOI: 10.1016/s1473-3099(21)00626-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 09/16/2021] [Accepted: 09/16/2021] [Indexed: 02/07/2023]
Abstract
During the current COVID-19 pandemic, health-care workers and uninfected patients in intensive care units (ICUs) are at risk of being infected with SARS-CoV-2 as a result of transmission from infected patients and health-care workers. In the absence of high-quality evidence on the transmission of SARS-CoV-2, clinical practice of infection control and prevention in ICUs varies widely. Using a Delphi process, international experts in intensive care, infectious diseases, and infection control developed consensus statements on infection control for SARS-CoV-2 in an ICU. Consensus was achieved for 31 (94%) of 33 statements, from which 25 clinical practice statements were issued. These statements include guidance on ICU design and engineering, health-care worker safety, visiting policy, personal protective equipment, patients and procedures, disinfection, and sterilisation. Consensus was not reached on optimal return to work criteria for health-care workers who were infected with SARS-CoV-2 or the acceptable disinfection strategy for heat-sensitive instruments used for airway management of patients with SARS-CoV-2 infection. Well designed studies are needed to assess the effects of these practice statements and address the remaining uncertainties.
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Affiliation(s)
- Prashant Nasa
- NMC Speciality Hospital, Dubai, United Arab Emirates
| | - Elie Azoulay
- Saint-Louis Teaching Hospital, APHP, University of Paris, Paris, France
| | | | | | - Ravi Jain
- Mahatma Gandhi Medical College and Hospital, Jaipur, India
| | - Camilla Rodrigues
- PD Hinduja National Hospital and Medical Research Centre, Mumbai, India
| | | | | | - Yaseen M Arabi
- King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Jan Bakker
- New York University Grossman School of Medicine, New York, NY, USA; Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA; Erasmus University Medical Center, Rotterdam, Netherlands; Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Matteo Bassetti
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | | | - George Dimopoulos
- Attikon University Hospital, Athens, Greece; National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Bin Du
- State Key Laboratory of Rare, Complex and Critical Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Sharon Einav
- Shaare Zedek Medical Center, Jerusalem, Israel; Faculty of Medicine, Hebrew University, Jerusalem, Israel
| | | | - Simon Finfer
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia; Imperial College London, London, UK
| | - Claude Guérin
- University de Lyon, Lyon, France; Institut Mondor de Recherches Biomédicales, Créteil, France
| | - Naomi E Hammond
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia; Malcolm Fisher Department of Intensive Care, Royal North Shore Hospital, Newton, Adelaide, SA, Australia
| | - Samir Jaber
- Hôpital Saint-Éloi, Montpellier University Hospital, Montpellier, France
| | - Ruth M Kleinpell
- Vanderbilt University School of Nursing, Vanderbilt University, Nashville, TN, USA
| | - Younsuck Koh
- College of Medicine, University of Ulsan College of Medicine, University of Ulsan, Seoul, South Korea
| | - Marin Kollef
- Washington University School of Medicine, Washington University, St Louis, MO, USA
| | - Mitchell M Levy
- Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Flavia R Machado
- Hospital Sao Paulo, Universidade Federal de São Paulo, São Paulo, Brazil
| | | | | | - Mervyn Mer
- Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa; Faculty of Health Sciences University of the Witwatersrand, Johannesburg, South Africa
| | | | - Paolo Pelosi
- IRCCS for Oncology and Neurosciences, San Martino Policlinico Hospital, Genoa, Italy; University of Genoa, Genoa, Italy
| | - Anders Perner
- Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | | | - Jason Phua
- Alexandra Hospital, National University Health System, Singapore; National University Hospital, National University Health System, Singapore
| | - Lise Piquilloud
- University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Mathias W Pletz
- Institute of Infectious Diseases and Infection Control, Jena University Hospital, Jena, Germany
| | - Andrew Rhodes
- St George's University Hospitals NHS Foundation Trust, London, UK
| | - Marcus J Schultz
- Amsterdam University Medical Centers, Locatie AMC, Amsterdam, Netherlands; Mahidol Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand; Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | | | | | | | | | - Tobias Welte
- German Center of Lung Research, Hannover, Germany
| | - Sheila N Myatra
- Department of Anaesthesia, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India.
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Lamichhane DK, Shrestha S, Kim HC. District-Level Risk Factors for COVID-19 Incidence and Mortality in Nepal. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052659. [PMID: 35270351 PMCID: PMC8910479 DOI: 10.3390/ijerph19052659] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 02/22/2022] [Accepted: 02/22/2022] [Indexed: 02/01/2023]
Abstract
The recent global pandemic of the novel coronavirus disease 2019 (COVID-19) is affecting the entire population of Nepal, and the outcome of the epidemic varies from place to place. A district-level analysis was conducted to identify socio-demographic risk factors that drive the large variations in COVID-19 mortality and related health outcomes, as of 22 January 2021. Data on COVID-19 extracted from relevant reports and websites of the Ministry of Health and Population of Nepal, and the National Population and Housing Census and the Nepal Demographic and Health Survey were the main data sources for the district-level socio-demographic characteristics. We calculated the COVID-19 incidence, recovered cases, and deaths per 100,000 population, then estimated the associations with the risk factors using regression models. COVID-19 outcomes were positively associated with population density. A higher incidence of COVID-19 was associated with districts with a higher percentage of overcrowded households and without access to handwashing facilities. Adult literacy rate was negatively associated with the COVID-19 incidence. Increased mortality was significantly associated with a higher obesity prevalence in women and a higher smoking prevalence in men. Access to health care facilities reduced mortality. Population density was the most important driver behind the large variations in COVID-19 outcomes. This study identifies critical risk factors of COVID-19 outcomes, including population density, crowding, education, and hand hygiene, and these factors should be considered to address inequities in the burden of COVID-19 across districts.
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Affiliation(s)
- Dirga Kumar Lamichhane
- Department of Occupational and Environmental Medicine, School of Medicine, Inha University, Incheon 22212, Korea;
- Correspondence:
| | - Sabina Shrestha
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan;
| | - Hwan-Cheol Kim
- Department of Occupational and Environmental Medicine, School of Medicine, Inha University, Incheon 22212, Korea;
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Smith LE, Potts HW, Amlȏt R, Fear NT, Michie S, Rubin GJ. Worry and behaviour at the start of the COVID-19 outbreak: Results from three UK surveys (the COVID-19 rapid survey of Adherence to Interventions and responses [CORSAIR] study). Prev Med Rep 2022; 25:101686. [PMID: 34976599 PMCID: PMC8711138 DOI: 10.1016/j.pmedr.2021.101686] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 12/22/2021] [Accepted: 12/26/2021] [Indexed: 12/31/2022] Open
Abstract
We aimed to describe worry and uptake of behaviours that prevent the spread of infection (respiratory and hand hygiene, distancing) in the UK at the start of the COVID-19 outbreak (January and February 2020) and to investigate factors associated with worry and adopting protective behaviours. Three cross-sectional online surveys of UK adults (28 to 30 January, n = 2016; 3 to 6 February, n = 2002; 10 to 13 February 2020, n = 2006) were conducted. We used logistic regressions to investigate associations between outcome measures (worry, respiratory and hand hygiene behaviour, distancing behaviour) and explanatory variables. 19.8% of participants (95% CI 18.8% to 20.8%) were very or extremely worried about COVID-19. People from minoritized ethnic groups were particularly likely to feel worried. 39.9% of participants (95% CI 37.7% to 42.0%) had completed one or more hand or respiratory hygiene behaviour more than usual in the last seven days. Uptake was associated with greater worry, perceived effectiveness of individual behaviours, self-efficacy for engaging in them, and having heard more information about COVID-19. 13.7% (95% CI 12.2% to 15.2%) had reduced the number of people they had met. This was associated with greater worry, perceived effectiveness, and self-efficacy. At the start of novel infectious disease outbreaks, communications should emphasise perceived effectiveness of behaviours and the ease with which they can be carried out.
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Affiliation(s)
- Louise E. Smith
- King’s College London, Institute of Psychiatry, Psychology and Neuroscience, UK
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, UK
| | | | - Richard Amlȏt
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, UK
- UK Health Security Agency, Behavioural Science and Insights Unit, UK
| | - Nicola T. Fear
- King’s College London, Institute of Psychiatry, Psychology and Neuroscience, UK
- King’s Centre for Military Health Research and Academic Department of Military Mental Health, King’s College London, UK
| | - Susan Michie
- University College London, Centre for Behaviour Change, UK
| | - G. James Rubin
- King’s College London, Institute of Psychiatry, Psychology and Neuroscience, UK
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, UK
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Anti-SARS-CoV-2 antibody levels and kinetics of vaccine response: potential role for unresolved inflammation following recovery from SARS-CoV-2 infection. Sci Rep 2022; 12:385. [PMID: 35013457 PMCID: PMC8749002 DOI: 10.1038/s41598-021-04344-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 12/20/2021] [Indexed: 12/18/2022] Open
Abstract
The immune response after SARS-CoV-2 vaccine administration appears to be characterized by high inter-individual variation, even in SARS-CoV-2 positive subjects, who could have experienced different post-infection, unresolved conditions. We monitored anti-SARS-CoV-2 IgG levels and kinetics along with circulating biomarkers in a cohort of 175 healthcare workers during early immunization with COVID-19 mRNA-LNP BNT162b2 vaccine, to identify the associated factors. Subjects with a previous SARS-CoV-2 infection were characterized by higher BMI and CRP levels and lower neutrophil count with respect to naïve subjects. Baseline IgG levels resulted associated with CRP independently on BMI and inflammatory diseases. Among 137 subjects undergoing vaccination and monitored after the first and the second dose, three kinetic patterns were identified. The pattern showing a rapid growth was characterized by higher IgG levels at baseline and higher CRP and MCHC levels than negative subjects. Subjects previously exposed to SARS-CoV-2 showed higher levels of CRP, suggesting persistence of unresolved inflammation. These levels are the main determinant of IgG levels at baseline and characterized subjects belonging to the best performing, post-vaccine antibody kinetic pattern.
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76
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Reychler G, Standaert M, Audag N, Caty G, Robert A, Poncin W. Effects of surgical facemasks on perceived exertion during submaximal exercise test in healthy children. Eur J Pediatr 2022; 181:2311-2317. [PMID: 35239031 PMCID: PMC8892819 DOI: 10.1007/s00431-022-04430-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 02/23/2022] [Accepted: 02/26/2022] [Indexed: 02/02/2023]
Abstract
Only a few data associated to wearability of facemask during exercise are available in children. The aim of the study was to evaluate the effect of wearing a facemask on perceived exertion (primary aim), dyspnea, physical performance, and cardiorespiratory response during a submaximal exercise test in children aged between 8 and 12 years. This study was performed in 2021 in healthy volunteer children from 8 to 12 years. They performed prospectively two 1-min sit-to-stand tests (STST), with or without a surgical facemask. The perceived exertion (modified Borg scale), dyspnea (Dalhousie scale), heart rate, and pulsed oxygen saturation were recorded before and after STST. The STST measured the submaximal performance. Thirty-eight healthy children were recruited (8-9 years: n = 19 and 10-11 years: n = 19). After the STST, the perceived exertion increased with or without a facemask (8-9 years group: + 1 [0.6; 1.4] and + 1.6 [1.0; 2.1] - 10-11 years group: + 1.3 [0.7; 1.8] and + 1.9 [1.3; 2.6]) and it was higher with the facemask. The difference between the two conditions in perceived exertion was not clinically relevant in any group (mBorgf: 0.56 pts and 0.68 pts, respectively). The different domains of dyspnea assessed with Dalhousie scale were not influenced by the facemask. The submaximal performance measured by the STST was not changed by the mask whatever the age group. The cardio-respiratory demand was not clinically modified.Conclusion: The surgical facemask had no impact on dyspnea, cardiorespiratory parameters, and exercise performance during a short submaximal exercise in healthy children.
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Affiliation(s)
- Gregory Reychler
- Institut de Recherche Expérimentale Et Clinique (IREC), Pôle de Pneumologie, ORL Et Dermatologie, Université Catholique de Louvain, Avenue Hippocrate 55, 1200 Brussels, Belgium
- Service de Pneumologie, Cliniques Universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Brussels, Belgium
- Secteur de Kinésithérapie Et Ergothérapie, Cliniques Universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Brussels, Belgium
- Département de Kinésithérapie, Haute École Léonard de Vinci, Parnasse-ISEI, Brussels, Belgium
| | - Marie Standaert
- Département de Kinésithérapie, Haute École Léonard de Vinci, Parnasse-ISEI, Brussels, Belgium
| | - Nicolas Audag
- Institut de Recherche Expérimentale Et Clinique (IREC), Pôle de Pneumologie, ORL Et Dermatologie, Université Catholique de Louvain, Avenue Hippocrate 55, 1200 Brussels, Belgium
- Service de Pneumologie, Cliniques Universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Brussels, Belgium
- Secteur de Kinésithérapie Et Ergothérapie, Cliniques Universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Brussels, Belgium
- Département de Kinésithérapie, Haute École Léonard de Vinci, Parnasse-ISEI, Brussels, Belgium
| | - Gilles Caty
- Service de Médecine Physique, Centre Hospitalier Wallonie Picarde (CHWAPI), Tournai, Belgium
| | - Annie Robert
- Pôle Epidémiologie Et Biostatistique, Institut de Recherche Expérimentale Et Clinique, UCLouvain, Brussels, Belgium
| | - William Poncin
- Institut de Recherche Expérimentale Et Clinique (IREC), Pôle de Pneumologie, ORL Et Dermatologie, Université Catholique de Louvain, Avenue Hippocrate 55, 1200 Brussels, Belgium
- Service de Pneumologie, Cliniques Universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Brussels, Belgium
- Secteur de Kinésithérapie Et Ergothérapie, Cliniques Universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Brussels, Belgium
- Département de Kinésithérapie, Haute École Léonard de Vinci, Parnasse-ISEI, Brussels, Belgium
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Lawless M, Burgess M, Bourke S. Impact of COVID-19 on Hospital Admissions for COPD Exacerbation: Lessons for Future Care. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58010066. [PMID: 35056374 PMCID: PMC8778793 DOI: 10.3390/medicina58010066] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 12/21/2021] [Accepted: 12/30/2021] [Indexed: 12/24/2022]
Abstract
Background and Objectives: Chronic obstructive pulmonary disease (COPD) is a leading cause of death worldwide. Acute exacerbations (AECOPD) are common and often triggered by viral infection. During the COVID-19 pandemic social restrictions, including ‘shielding’ and ‘lockdowns’, were mandated. Multiple, worldwide studies report a reduction in AECOPD admissions during this period. This study aims to assess the effect of the pandemic and Lockdown on the rates of admission with AECOPD and severity of hospitalised exacerbations in the North-East of England. Materials and Methods: Data were extracted for patients presenting with a diagnosis of AECOPD or respiratory failure secondary to AECOPD during the ‘COVID-19 period’ (26/3/20–31/12/20) and a date-matched control period from the year previous. We present descriptive statistics and regression analysis of the effects of the COVID-19 period on the rates of hospital admission. Results: Compared to the matched control period, the COVID-19 period was associated with fewer AECOPD admissions (COVID-19 = 719, control = 1257; rate ratio 0.57, p < 0.001) and shorter length of stay (COVID-19 = 3.9 ± 0.2, control = 4.78 ± 0.2 days; p = 0.002), with similar in-hospital plus 30-day post-discharge mortality. Demographics were similar between periods. Only six patients had a positive COVID-19 PCR test. Conclusion: During the COVID-19 period there was a substantial reduction in AECOPD admissions, but no increase in overall severity of exacerbations or mortality. Rather than fear driving delayed hospital presentation, physical and behavioural measures taken during this period to limit transmission of COVID-19 are likely to have reduced transmission of other respiratory viruses. This has important implications for control of future AECOPD.
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Hrudey SE, Bischel HN, Charrois J, Chik AHS, Conant B, Delatolla R, Dorner S, Graber TE, Hubert C, Isaac-Renton J, Pons W, Safford H, Servos M, Sikora C. Wastewater Surveillance for SARS-CoV-2 RNA in Canada. Facets (Ott) 2022. [DOI: 10.1139/facets-2022-0148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Wastewater surveillance for SARS-CoV-2 RNA is a relatively recent adaptation of long-standing wastewater surveillance for infectious and other harmful agents. Individuals infected with COVID-19 were found to shed SARS-CoV-2 in their faeces. Researchers around the world confirmed that SARS-CoV-2 RNA fragments could be detected and quantified in community wastewater. Canadian academic researchers, largely as volunteer initiatives, reported proof-of-concept by April 2020. National collaboration was initially facilitated by the Canadian Water Network. Many public health officials were initially skeptical about actionable information being provided by wastewater surveillance even though experience has shown that public health surveillance for a pandemic has no single, perfect approach. Rather, different approaches provide different insights, each with its own strengths and limitations. Public health science must triangulate among different forms of evidence to maximize understanding of what is happening or may be expected. Well-conceived, resourced, and implemented wastewater-based platforms can provide a cost-effective approach to support other conventional lines of evidence. Sustaining wastewater monitoring platforms for future surveillance of other disease targets and health states is a challenge. Canada can benefit from taking lessons learned from the COVID-19 pandemic to develop forward-looking interpretive frameworks and capacity to implement, adapt, and expand such public health surveillance capabilities.
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Affiliation(s)
- Steve E. Hrudey
- Professor Emeritus, Analytical & Environmental Toxicology, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB T6G 2G3 Canada
| | - Heather N. Bischel
- Associate Professor, Department of Civil & Environmental Engineering, University of California, Davis, Davis, CA 95616 USA
| | - Jeff Charrois
- Senior Manager, Analytical Operations and Process Development Teams, EPCOR Water Services Inc, Edmonton, AB T5K 0A5 Canada
| | - Alex H. S. Chik
- Project Manager, Wastewater Surveillance Initiative, Ontario Clean Water Agency, Mississauga, ON L5A 4G1 Canada
| | - Bernadette Conant
- Past Chief Executive Officer, Canadian Water Network, Waterloo, ON N2L 3G1 Canada
| | - Rob Delatolla
- Professor, Civil Engineering, University of Ottawa, Ottawa, ON K1N 6N5 Canada
| | - Sarah Dorner
- Professor, Civil, Geological & Mining Engineering, Polytechnique Montréal, Montréal, PQ H3T 1J4 Canada
| | - Tyson E. Graber
- Associate Scientist, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON, K1H 8L1 Canada
| | - Casey Hubert
- Professor, Campus Alberta Innovates Program Chair in Geomicrobiology, Department of Biological Sciences, University of Calgary, Calgary, AB T2N 1N4 Canada
| | - Judy Isaac-Renton
- Professor Emerita, Dept. Pathology and Laboratory Medicine, Faculty of Medicine, University of British Columbia, Calgary, AB, T2N 3V9 Canada
| | - Wendy Pons
- Professor, Bachelor of Environmental Health Program Conestoga College Institute of Technology and Advanced Learning, Kitchener, ON N2P 2N6 Canada
| | - Hannah Safford
- Associate Director of Science Policy, Federation of American Scientists, Arlington, VA 22205 USA
| | - Mark Servos
- Professor & Canada Research Chair, Department of Biology, University of Waterloo, Waterloo, ON N2L 3G1 Canada
| | - Christopher Sikora
- Medical Officer of Health, Edmonton Region, Alberta Health Services, Edmonton, AB T5J 3E4 Canada
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Yu H, Ni C, Xia Y, Li J, Hang B, Han C, Xu Z, Luo M, Rong X, Zhu J, Chu M. Characteristics of Kawasaki Disease Before and After the COVID-19 Pandemic in a Large Pediatric Heart Disease Center. Front Pediatr 2022; 10:895408. [PMID: 35656374 PMCID: PMC9152138 DOI: 10.3389/fped.2022.895408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 04/18/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Kawasaki disease (KD) is an acute febrile systemic vasculitis of unknown etiology. After the pandemic of coronavirus disease 2019 (COVID-19), some children infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) showed clinical symptoms similar to KD, indicating a close relationship between KD and SARS-CoV-2. Therefore, we designed this retrospective study to analyze the characteristics of KD patients before and after the COVID-19 pandemic. METHODS We retrospectively collected demographic and laboratory data of KD patients in Yuying Children's Hospital of Wenzhou Medical University from 1 January 2015 to 31 December 2020. Yuying Children's Hospital of Wenzhou Medical University is located in eastern China and is the largest pediatric heart disease center in the region, which includes a population of nearly 10 million. We studied the characteristics of KD patients and analyzed the changes in these characteristics before and after the emergence of SARS-CoV-2 in this area. RESULTS The analysis revealed the following novel features: (1) Under the influence of the COVID-19 pandemic, the onset age of Kawasaki disease became younger. (2) After the occurrence of COVID-19, the hospitalization days of KD patients were shorter than before the pandemic. (3) After the occurrence of COVID-19, the albumin of KD patients was higher than before the pandemic. (4) The COVID-19 pandemic did not have a significant effect on the incidence of coronary artery lesions (CALs) in Kawasaki disease. CONCLUSION After the COVID-19 outbreak, the characteristics of KD patients showed a younger trend of age, shorter hospitalization days and higher levels of albumin, but the incidence of CALs did not change significantly.
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Affiliation(s)
- Huan Yu
- Department of Pediatrics, Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Chao Ni
- Department of Pediatrics, Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yuhan Xia
- Department of Pediatrics, Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Jie Li
- Department of Pediatrics, Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Biyao Hang
- Department of Pediatrics, Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Cheng Han
- Department of Pediatrics, Guangyuan Central Hospital, Guangyuan, China
| | - Zhipeng Xu
- Department of Pediatrics, Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Ming Luo
- Department of Pediatrics, Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xing Rong
- Department of Pediatrics, Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Jinshun Zhu
- Department of Pediatrics, Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Maoping Chu
- Department of Pediatrics, Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
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Wolszczak-Biedrzycka B, Bieńkowska A, Dorf J. Assessment of Post-Vaccination Antibody Response Eight Months after the Administration of BNT1622b2 Vaccine to Healthcare Workers with Particular Emphasis on the Impact of Previous COVID-19 Infection. Vaccines (Basel) 2021; 9:1508. [PMID: 34960254 PMCID: PMC8704861 DOI: 10.3390/vaccines9121508] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 12/14/2021] [Accepted: 12/17/2021] [Indexed: 12/25/2022] Open
Abstract
At the end of 2020, COVID-19 vaccination programs were initiated in many countries, including Poland. The first vaccine approved in Poland was the BNT162b2 mRNA preparation (Pfizer/BioNTech), and the first vaccinated group were healthcare workers. The aim of the present study was to evaluate post-vaccine antibody titers 8 months after the second vaccine dose had been administered to a group of employees of the Hospital of the Ministry of the Interior and Administration in Olsztyn (Poland). The employees were divided into two groups: persons who had COVID-19 in the fourth quarter of 2020 and were vaccinated in January-February 2021, and persons without a history of COVID-19 who were vaccinated during the same period. The analyzed material was venous blood serum collected from 100 hospital employees on 23-28 September 2021. The level of anti-SARS-CoV-2 S antibodies was measured with a Roche Cobas e411 analyzer using the electrochemiluminescence (ECLIA) method. The study demonstrated that persons with a history of SARS-CoV-2 infection had significantly higher antibody levels (taking into account gender, age, type of work performed, and severity of post-vaccination symptoms) than employees without a history of COVID-19. The study also revealed that the type of work, age, gender, and the course of SARS-CoV-2 infection can influence the humoral immune response. The presented results may prove helpful in the context of administering additional vaccine doses.
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Affiliation(s)
- Blanka Wolszczak-Biedrzycka
- Department of Psychology and Sociology of Health and Public Health, University of Warmia and Mazury in Olsztyn, Warszawska 30, 10-082 Olsztyn, Poland;
- The Oncology Center of the Region of Warmia and Mazury in Olsztyn, Hospital of the Ministry of the Interior and Administration, Wojska Polskiego 37, 10-228 Olsztyn, Poland
| | - Anna Bieńkowska
- Department of Psychology and Sociology of Health and Public Health, University of Warmia and Mazury in Olsztyn, Warszawska 30, 10-082 Olsztyn, Poland;
- The Oncology Center of the Region of Warmia and Mazury in Olsztyn, Hospital of the Ministry of the Interior and Administration, Wojska Polskiego 37, 10-228 Olsztyn, Poland
| | - Justyna Dorf
- Department of Clinical Laboratory Diagnostics, Medical University of Białystok, Waszyngtona 15A, 15-269 Bialystok, Poland;
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Mun SK, Yang BR, Chang M. Changes in respiratory diseases in South Korea during the COVID-19 pandemic: an interrupted time series study. BMJ Glob Health 2021; 6:bmjgh-2021-006912. [PMID: 34887303 PMCID: PMC8662586 DOI: 10.1136/bmjgh-2021-006912] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 10/27/2021] [Indexed: 01/23/2023] Open
Abstract
INTRODUCTION In South Korea, non-pharmaceutical interventions such as mask-wearing, hand washing and social distancing were strictly implemented to prevent the spread of COVID-19 after a national crisis alert was raised to the highest level early in the pandemic (23 February 2020). We aimed to investigate changes in the occurrence of respiratory diseases at the national level after the COVID-19 outbreak. METHODS The study period was from 1 January to 1 August 2019 (213 days) and from 1 January to 31 July 2020 (213 days). Based on the National Health Insurance Service data, we analysed changes in the numbers of patients treated for respiratory diseases. The changes in the numbers of individuals using public transportation and visiting the theatre were investigated to assess the effect of social distancing after the national crisis alert was raised. Differences in daily cumulative numbers (DDCNs) in 2020 were calculated as follows: (daily cumulative number in 2020)-(cumulative number for that day in 2019). A change over time in DDCNs of <0 was taken as indication that the numbers decreased from 2019 to 2020. Segmented regression analyses were performed using generalised least squares method to identify changes in trends of DDCNs of patients treated for respiratory diseases and individuals using public transportation and visiting the theatre. RESULTS After the national crisis alert was raised to the highest level, DDCNs of patients treated for respiratory diseases, individuals using public transportation, and those visiting the theatre exhibited a significant daily decline by 53.18 per 10 000 inhabitants (95% CI -65.86 to -40.49), 48.19 per 1000 inhabitants (95% CI -62.05 to -34.32) and 25.30 per 5000 inhabitants (95% CI -36.30 to -14.30), respectively, compared with before the national crisis alert was raised. CONCLUSION Non-pharmaceutical interventions to prevent the spread of COVID-19 significantly reduce the incidence of respiratory diseases.
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Affiliation(s)
- Seog-Kyun Mun
- Department of Otorhinolaryngology-Head and Neck Surgery, Chung-Ang University College of Medicine, Seoul, South Korea
| | - Bo Ram Yang
- College of Pharmacy, Chungnam National University, Daejeon, South Korea
| | - Munyoung Chang
- Department of Otorhinolaryngology-Head and Neck Surgery, Chung-Ang University College of Medicine, Seoul, South Korea
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Rivers JK, Arlette JP, DeKoven J, Guenther LC, Muhn C, Richer V, Rosen N, Tremblay JF, Wiseman MC, Zip C, Zloty D. Skin care and hygiene among healthcare professionals during and after the SARS-CoV-2 pandemic. SAGE Open Med 2021; 9:20503121211062795. [PMID: 34917384 PMCID: PMC8669117 DOI: 10.1177/20503121211062795] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 11/08/2021] [Indexed: 12/23/2022] Open
Abstract
The severe acute respiratory syndrome coronavirus 2 pandemic has necessitated enhanced protection against viral transmission among healthcare professionals, particularly relating to handwashing and personal protective equipment. Some of these requirements may persist for years to come. They bring associated concerns around skin hygiene and general care, with damage to the face and hands now a well-documented consequence among healthcare professionals. This review assesses optimal skin care during the severe acute respiratory syndrome coronavirus 2 pandemic and in the "new normal" that will follow, identifies current knowledge gaps, and provides practical advice for the clinical setting. Regular, systematic hand cleaning with soap and water or an alcohol-based hand rub (containing 60%-90% ethanol or isopropyl alcohol) remains essential, although the optimal quantity and duration is unclear. Gloves are a useful additional barrier; further studies are needed on preferred materials. Moisturization is typically helpful and has proven benefits in mitigating damage from frequent handwashing. It may be best practiced using an alcohol-based hand rub with added moisturizer and could be particularly important among individuals with pre-existing hand dermatoses, such as psoriasis and eczema. Face moisturization immediately prior to donning a mask, and the use of dressings under the mask to reduce friction, can be helpful dermatologically, but more work is required to prove that these actions do not affect seal integrity. Nonetheless, such measures could play a role in institutional plans for mitigating the dermatologic impact of transmission control measures as we exit the pandemic.
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Affiliation(s)
- Jason K Rivers
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada
- Pacific Derm, Vancouver, BC, Canada
| | - John P Arlette
- Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Joel DeKoven
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Lyn C Guenther
- Division of Dermatology, Western University, London, ON, Canada
- Guenther Research Inc., London, ON, Canada
| | - Channy Muhn
- Division of Dermatology, Department of Medicine, McMaster University, Hamilton, ON, Canada
- Dermetics, Burlington, ON, Canada
| | - Vincent Richer
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada
- Pacific Derm, Vancouver, BC, Canada
| | | | | | - Marni C Wiseman
- Section of Dermatology, Department of Medicine, University of Manitoba, Winnipeg, MB, Canada
- Skinwise Dermatology, Winnipeg, MB, Canada
| | | | - David Zloty
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada
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Ye Q, Liu H. Impact of non-pharmaceutical interventions during the COVID-19 pandemic on common childhood respiratory viruses - A epidemiological study based on hospital data. Microbes Infect 2021; 24:104911. [PMID: 34871774 PMCID: PMC8641407 DOI: 10.1016/j.micinf.2021.104911] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 11/05/2021] [Accepted: 11/14/2021] [Indexed: 12/16/2022]
Abstract
Considering common childhood respiratory viruses and SARS-CoV-2 share similar transmission routes, non-pharmaceutical interventions (NPIs) to prevent SARS-CoV-2 may affect the epidemiology of respiratory viruses. Therefore, our study aimed to observe the epidemiologic characteristics of common childhood respiratory viruses in 2020 (after the pandemic) compared with 2019 (before the pandemic) in Hangzhou, China. The data were compared between 2019 and 2020 based on age and month, respectively. One or more viruses were detected in 3135/21452 (14.61%) specimens in 2019, which was significantly lower in 1110/8202 (13.53%) specimens in 2020. Respiratory syncytial virus (RSV) was the most commonly detected virus in 2019 and 2020. The positive rate of adenovirus (ADV), parainfluenza virus (PIV)1, PIV2, and PIV3 in 2020 was significantly decreased in 2019. In 2020, RSV replaced ADV as the most predominant virus in children aged 1–6 years, and the positive rate of influenza virus A (FluA), influenza virus B (FluB), PIV1, and PIV2 was not correlated to age. FluA, FluB, and PIV2 were not almost detected from February 2020. The positive rates of ADV and PIV1 were uncorrelated to the month in 2020. By strict NPIs, besides controlling the COVID-19 pandemic, incredible progress has been made to reduce the prevalence of common childhood respiratory viruses.
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Affiliation(s)
- Qing Ye
- The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, 310052, China.
| | - Huihui Liu
- The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, 310052, China
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Trends in non-pharmaceutical intervention (NPI) related community practice for the prevention of COVID-19 in Addis Ababa, Ethiopia. PLoS One 2021; 16:e0259229. [PMID: 34813617 PMCID: PMC8610281 DOI: 10.1371/journal.pone.0259229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 10/18/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has affected Ethiopia since March 13, 2020, when the first case was detected in Addis Ababa. Since then, the incidence of cases has continued to increase day by day. As a result, the health sector has recommended universal preventive measures to be practiced by the public. However, studies on adherence to these preventive measures are limited. OBJECTIVE To monitor the status of preventive practices of the population related to hand washing, physical distancing, and respiratory hygiene practices at selected sites within the city of Addis Ababa. METHODS Weekly cross-sectional non-participatory observations were done during the period of April-June, 2020. Data was collected using the Open Data Kit (ODK) tool in ten public sites involving eight public facilities targeted for individual observations. Ten individuals were randomly observed at each facility over two days a week at peak hours of public services. WHO operational definitions of the preventive behaviors were adopted for this study. Observations were conducted anonymously at gates or entrances of public facilities and places. RESULTS A total of 12,056 individual observations with 53% males and 82% in an estimated age range of 18-50 years age group were involved in this study. There was an increase in the practice of respiratory hygiene from 14% in week one to 77% in week 10, while those of hand hygiene and physical distancing changed little over the weeks from their baseline of 24% and 34%, respectively. Overall, respiratory hygiene demonstrated an increased rate of 6% per week, while hand hygiene and physical distancing had less than a 1% change per week, Females and the estimated age group of 18-50 years had practice changes in respiratory hygiene with no difference in hand hygiene and physical distancing practices. Respiratory hygiene took about six weeks to reach a level of 77% from its baseline of 24%, making an increment of about 9% per week. CONCLUSION The public practice of respiratory hygiene improved threefold whereas hand hygiene and physical distancing revealed no change. Regularly sustained public mobilization and mass education are required to sustain the achievements gained in respiratory hygiene and further hand hygiene and physical distancing.
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Maffoni M, Torlaschi V, Gabanelli P, Abelli P, Pierobon A. The CO-MAsk Approach: Tips for Fostering Mask Use Among Older Adults During the COVID-19 Pandemic. EUROPES JOURNAL OF PSYCHOLOGY 2021; 17:257-263. [PMID: 35136445 PMCID: PMC8768468 DOI: 10.5964/ejop.6815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Face masks are effective at limiting contagion of the coronavirus. However, adherence to face mask use among the older adult population is often unsatisfactory due to cognitive impairment, misconceptions, and difficulty in retrieving face masks. This brief note provides healthcare professionals with simple suggestions about how to improve face mask adoption in the older adults, in particular if they suffer from mild cognitive impairment. Thus, clinical reflections and psychoeducational suggestions are summarized into a simple mental roadmap. Specifically, the CO-MAsk approach underlines the necessity to consider the following factors: Cognition (possible cognitive impairment), Occasions (real chances to access correct information and proper protection equipment), Motivation (individual motivation towards sanitary prescriptions) and Assumptions (personal beliefs and understandings). Possible obstacles and practical suggestions for are also discussed. It is of paramount importance that healthcare professionals pay attention to emotional, cognitive and psychological aspects to effectively improve the face masks adherence among older adults, specifically when cognitive decline is present.
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Affiliation(s)
- Marina Maffoni
- Istituti Clinici Scientifici Maugeri IRCCS, Psychology Unit of Montescano Institute, Montescano (PV), Italy
| | - Valeria Torlaschi
- Istituti Clinici Scientifici Maugeri IRCCS, Psychology Unit of Montescano Institute, Montescano (PV), Italy
| | - Paola Gabanelli
- Istituti Clinici Scientifici Maugeri IRCCS, Psychology Unit of Pavia Institute, Pavia (PV), Italy
| | - Paola Abelli
- Istituti Clinici Scientifici Maugeri, Health Administration of Montescano Institute, Montescano (PV), Italy
| | - Antonia Pierobon
- Istituti Clinici Scientifici Maugeri IRCCS, Psychology Unit of Montescano Institute, Montescano (PV), Italy
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86
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McBride DL. The Impact of Visiting Restrictions During the COVID-19 Pandemic on Pediatric Patients. J Pediatr Nurs 2021; 61:436-438. [PMID: 34538537 PMCID: PMC8423989 DOI: 10.1016/j.pedn.2021.09.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 09/03/2021] [Indexed: 11/22/2022]
Abstract
Visitor restriction policies have been implemented on many hospital units as a result of the Covid-19 pandemic. These policies are integral to the strategies that hospitals are using to limit exposure risks during the pandemic. However, visitor restriction policies disproportionally affect hospitalized children. The trauma caused by lack of family at the bedside of adult patients during the Covid-19 pandemic has been studied but there is a lack of primary research on the impact of the Covid-19 visiting policy restrictions on pediatric patients. Long term studies are needed to understand the effect of this separation on children and their caregivers.
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87
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Haddad C, Bou Malhab S, Malaeb D, Sacre H, Saadeh D, Mourtada V, Salameh P. Stigma toward people with COVID-19 among the Lebanese population: a cross-sectional study of correlates and mediating effects. BMC Psychol 2021; 9:164. [PMID: 34686218 PMCID: PMC8532089 DOI: 10.1186/s40359-021-00646-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 09/04/2021] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Stigma develops during outbreaks such as the COVID-19 pandemic due to the human fear that arises from the anxiety about a disease of an unknown etiology, with the associated detrimental consequences on both the individual and society. This study was conducted to assess if knowledge about COVID-19, attitude, practice and behavior regarding preventive measures against COVID-19, fear, and anxiety towards COVID-19 will affect the level of stigma and evaluate the mediating effect of fear, anxiety, and diagnosis of COVID-19 on stigma. METHODS A cross-sectional online survey conducted between December 20, 2020, and January 05, 2021, enrolled 405 participants recruited from the Lebanese population. Two scales were created and adapted to the Lebanese context to measure the current stigma (stigma discrimination scale, self-stigma scale) toward COVID-19. RESULTS More than half of the sample had moderate to severe stigma discrimination (62%) and self-stigma (65.9%). The multivariable analysis showed that higher fear of COVID-19 scale (Beta = .143) was significantly associated with a higher stigma discrimination scale. Whereas, higher knowledge score (Beta = -.153) was significantly associated with a lower stigma discrimination scale. Fear of COVID-19, anxiety from COVID-19, being diagnosed with COVID-19, and having a family member with COVID-19 partially mediated the association between knowledge and stigma discrimination scale. No mediation effect of fear and anxiety scale was found between the knowledge and self-stigma score. CONCLUSION Our main findings indicate that a considerable proportion of the Lebanese population has stigma discrimination behaviors toward COVID-19 patients and that those who were infected with the virus experienced COVID-19-related stigmatization.
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Affiliation(s)
- Chadia Haddad
- Research Department, Psychiatric Hospital of the Cross, P.O. Box 60096, Jal Eddib, Lebanon.
- INSERM, Univ. Limoges, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France.
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon.
| | - Sandrella Bou Malhab
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
| | - Diana Malaeb
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Hala Sacre
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
| | - Danielle Saadeh
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
- Faculty of Public Health, Lebanese University, Beirut, Lebanon
| | - Vanessa Mourtada
- Faculty of Letters and Human Sciences, Lebanese University, Fanar, Lebanon
| | - Pascale Salameh
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
- Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
- University of Nicosia Medical School, Nicosia, Cyprus
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Smith LE, Potts HWW, Amlȏt R, Fear NT, Michie S, Rubin GJ. Holding a stigmatizing attitude at the start of the COVID-19 outbreak: A cross-sectional survey. Br J Health Psychol 2021; 27:588-604. [PMID: 34606149 PMCID: PMC8646234 DOI: 10.1111/bjhp.12564] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 09/24/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVES To identify the prevalence of a stigmatizing attitude towards people of Chinese origin at the start of the COVID-19 outbreak in the UK population and investigate factors associated with holding the stigmatizing attitude. DESIGN Online cross-sectional survey conducted 10-13 February 2020 (n = 2006, people aged 16 years or over and living in the UK). METHODS We asked participants to what extent they agreed it was best to avoid areas heavily populated by Chinese people because of the COVID-19 outbreak. Survey materials also asked about: worry, perceived risk, knowledge, information receipt, perception of government response to COVID-19, and personal characteristics. We ran binary logistic regressions to investigate associations between holding a stigmatizing attitude, personal characteristics, and psychological and contextual factors. RESULTS 26.1% people (95% CI 24.2-28.0%, n = 524/2006) agreed it was best to avoid areas heavily populated by Chinese people. Holding a stigmatizing attitude was associated with greater worry about COVID-19, greater perceived risk of COVID-19, and poorer knowledge about COVID-19. CONCLUSIONS At the start of the COVID-19 pandemic, a large percentage of the UK public endorsed avoiding areas in the UK heavily populated by people of Chinese origin. This attitude was associated with greater worry about, and perceived risk of, the COVID-19 outbreak as well as poorer knowledge about COVID-19. At the start of future novel infectious disease outbreaks, proactive communications from official sources should provide context and facts to reduce uncertainty and challenge stigmatizing attitudes, to minimize harms to affected communities.
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Affiliation(s)
- Louise E Smith
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, UK.,NIHR Health Protection Research Unit in Emergency Preparedness and Response, UK
| | - Henry W W Potts
- University College London, Institute of Health Informatics, UK
| | - Richard Amlȏt
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, UK.,Emergency Response Department Science and Technology, Public Health England, Behavioural Science Team, UK
| | - Nicola T Fear
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, UK.,Academic Department of Military Mental Health, King's Centre for Military Health Research, UK
| | - Susan Michie
- Centre for Behaviour Change, University College London, UK
| | - G James Rubin
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, UK.,NIHR Health Protection Research Unit in Emergency Preparedness and Response, UK
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89
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Collins AP, Service BC, Gupta S, Mubarak N, Zeini IM, Osbahr DC, Romeo AA. N95 respirator and surgical mask effectiveness against respiratory viral illnesses in the healthcare setting: A systematic review and meta-analysis. J Am Coll Emerg Physicians Open 2021; 2:e12582. [PMID: 34746923 PMCID: PMC8552225 DOI: 10.1002/emp2.12582] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 06/30/2021] [Accepted: 08/06/2021] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE To examine the results, level of evidence, and methodologic quality of original studies regarding surgical mask effectiveness in minimizing viral respiratory illness transmission, and, in particular, the performance of the N95 respirator versus surgical mask. METHODS Meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines with use of PubMed, MEDLINE, and the Cochrane Library databases. RESULTS Eight studies (9164 participants) were included after screening 153 articles. Analyses showed statistically significant differences between N95 respirator versus surgical mask use to prevent influenza-like-illness (risk ratio [RR] = 0.81, 95% confidence interval [CI] = 0.68-0.94, P < 0.05), non-influenza respiratory viral infection (RR = 0.62, 95% CI = 0.52-0.74, P < 0.05), respiratory viral infection (RR = 0.73, 95% CI = 0.65-0.82, P < 0.05), severe acute respiratory syndrome coronavirus (SARS-CoV) 1 and 2 virus infection (RR = 0.17, 95% CI = 0.06-0.49, P < 0.05), and laboratory-confirmed respiratory viral infection (RR = 0.75, 95% CI = 0.66-0.84, P < 0.05). Analyses did not indicate statistically significant results against laboratory-confirmed influenza (RR = 0.87, CI = 0.74-1.03, P > 0.05). CONCLUSIONS N95 respirator use was associated with fewer viral infectious episodes for healthcare workers compared with surgical masks. The N95 respirator was most effective in reducing the risk of a viral infection in the hospital setting from the SARS-CoV 1 and 2 viruses compared to the other viruses included in this investigation. Methodologic quality, risk of biases, and small number of original studies indicate the necessity for further research to be performed, especially in front-line healthcare delivery settings.
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Affiliation(s)
| | | | - Sunny Gupta
- Department of OrthopedicsUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Naser Mubarak
- University of Central Florida College of MedicineOrlandoFloridaUSA
| | | | - Daryl C. Osbahr
- Orthopaedic Surgery, Rothman Orthopaedic Institute FloridaOrlandoFloridaUSA
| | - Anthony A. Romeo
- DuPage Medical Group Musculoskeletal InstituteChicagoIllinoisUSA
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90
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Kraus CK. Mask effectiveness against viral illnesses in health care professionals. J Am Coll Emerg Physicians Open 2021; 2:e12583. [PMID: 34746924 PMCID: PMC8549016 DOI: 10.1002/emp2.12583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 10/06/2021] [Accepted: 10/06/2021] [Indexed: 11/06/2022] Open
Affiliation(s)
- Chadd K. Kraus
- Department of Emergency MedicineGeisinger Medical CenterDanvillePennsylvaniaUSA
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91
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Dembek ZF, Schwartz-Watjen KT, Swiatecka AL, Broadway KM, Hadeed SJ, Mothershead JL, Chekol T, Owens AN, Wu A. Coronavirus Disease 2019 on the Heels of Ebola Virus Disease in West Africa. Pathogens 2021; 10:1266. [PMID: 34684215 PMCID: PMC8537256 DOI: 10.3390/pathogens10101266] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 09/27/2021] [Accepted: 09/29/2021] [Indexed: 01/08/2023] Open
Abstract
This study utilized modeling and simulation to examine the effectiveness of current and potential future COVID-19 response interventions in the West African countries of Guinea, Liberia, and Sierra Leone. A comparison between simulations can highlight which interventions could have an effect on the pandemic in these countries. An extended compartmental model was used to run simulations incorporating multiple vaccination strategies and non-pharmaceutical interventions (NPIs). In addition to the customary categories of susceptible, exposed, infected, and recovered (SEIR) compartments, this COVID-19 model incorporated early and late disease states, isolation, treatment, and death. Lessons learned from the 2014-2016 Ebola virus disease outbreak-especially the optimization of each country's resource allocation-were incorporated in the presented models. For each country, models were calibrated to an estimated number of infections based on actual reported cases and deaths. Simulations were run to test the potential future effects of vaccination and NPIs. Multiple levels of vaccination were considered, based on announced vaccine allocation plans and notional scenarios. Increased vaccination combined with NPI mitigation strategies resulted in thousands of fewer COVID-19 infections in each country. This study demonstrates the importance of increased vaccinations. The levels of vaccination in this study would require substantial increases in vaccination supplies obtained through national purchases or international aid. While this study does not aim to develop a model that predicts the future, it can provide useful information for decision-makers in low- and middle-income nations. Such information can be used to prioritize and optimize limited available resources for targeted interventions that will have the greatest impact on COVID-19 pandemic response.
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Affiliation(s)
- Zygmunt F. Dembek
- Battelle Memorial Institute, Support to DTRA Technical Reachback, Columbus, OH 43201, USA; (Z.F.D.); (A.L.S.); (S.J.H.); (T.C.)
| | - Kierstyn T. Schwartz-Watjen
- Applied Research Associates (ARA), Support to DTRA Technical Reachback, Albuquerque, NM 87110, USA; (K.T.S.-W.); (J.L.M.)
| | - Anna L. Swiatecka
- Battelle Memorial Institute, Support to DTRA Technical Reachback, Columbus, OH 43201, USA; (Z.F.D.); (A.L.S.); (S.J.H.); (T.C.)
| | - Katherine M. Broadway
- Defense Sciences, Inc. (DSI), Support to DTRA Technical Reachback, San Antonio, TX 78230, USA;
| | - Steven J. Hadeed
- Battelle Memorial Institute, Support to DTRA Technical Reachback, Columbus, OH 43201, USA; (Z.F.D.); (A.L.S.); (S.J.H.); (T.C.)
| | - Jerry L. Mothershead
- Applied Research Associates (ARA), Support to DTRA Technical Reachback, Albuquerque, NM 87110, USA; (K.T.S.-W.); (J.L.M.)
| | - Tesema Chekol
- Battelle Memorial Institute, Support to DTRA Technical Reachback, Columbus, OH 43201, USA; (Z.F.D.); (A.L.S.); (S.J.H.); (T.C.)
| | - Akeisha N. Owens
- Defense Threat Reduction Agency (DTRA), Fort Belvoir, VA 22060, USA;
| | - Aiguo Wu
- Defense Threat Reduction Agency (DTRA), Fort Belvoir, VA 22060, USA;
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92
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Lee YS, Kang M, Cho J, Kang D, Min KH, Suh GY, Shim JJ, Jeon K. Nationwide Social Distancing and the Epidemiology of Severe Acute Respiratory Infections. Yonsei Med J 2021; 62:954-957. [PMID: 34558876 PMCID: PMC8470571 DOI: 10.3349/ymj.2021.62.10.954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 07/12/2021] [Accepted: 07/26/2021] [Indexed: 11/27/2022] Open
Abstract
Nonpharmaceutical interventions (e.g., social distancing) are recommended to prevent the spread of respiratory viruses. However, few epidemiological studies have assessed whether social distancing in actual settings reduces the disease burden of severe acute respiratory infections (SARIs) in the general population. Accordingly, we aimed to assess associations between nationwide social distancing for coronavirus disease 2019 (COVID-19) and non-COVID-19 SARIs. We collected data on SARI epidemiologic characteristics recorded from January 2018 through December 2020 from the nationwide sentinel SARI surveillance data maintained by the Korea Disease Control and Prevention Agency. The number of SARIs per 1000 hospitalized patients decreased significantly to 18.61, 18.15, and 6.25 in 2018, 2019, and 2020 (p<0.001), respectively, during the surveillance period of 3 years. The number of intensive care unit admissions associated with SARIs per 1000 hospitalized patients was 0.83, 0.69, and 0.54 in 2018, 2019, and 2020 (p<0.001), respectively, and the number of SARI-associated mortalities per 1000 patients was 0.42, 0.29, and 0.27 in 2018, 2019, and 2020 (p<0.001), respectively. Moreover, SARIs had two peak seasons in 2 years of the surveillance period (2018 and 2019). However, seasonality was not observed since social distancing was initiated. Our sentinel surveillance data demonstrated a remarkable reduction in SARI disease burden and a change in seasonality following the implementation of nationwide social distancing. Accordingly, we suggest that social distancing could be effective in forthcoming seasonal epidemics of non-COVID19 origin, although the impact thereof on other aspects of society needs to be carefully considered.
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Affiliation(s)
- Young Seok Lee
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, KoreaUniversity Guro Hospital, Seoul, Korea
| | - Minwoong Kang
- Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Korea
| | - Juhee Cho
- Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Korea
| | - Danbee Kang
- Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Korea
| | - Kyung Hoon Min
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, KoreaUniversity Guro Hospital, Seoul, Korea
| | - Gee Young Suh
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Jeong Shim
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, KoreaUniversity Guro Hospital, Seoul, Korea
| | - Kyeongman Jeon
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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93
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Mihai AM, Barben J, Dipanda M, Vovelle J, Nuss V, Baudin-Senegas C, Putot A, Manckoundia P. Analysis of COVID-19 in Professionals Working in Geriatric Environment: Multicenter Prospective Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189735. [PMID: 34574660 PMCID: PMC8470596 DOI: 10.3390/ijerph18189735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 09/10/2021] [Accepted: 09/14/2021] [Indexed: 11/24/2022]
Abstract
Healthcare workers (HCWs) are exposed to a higher risk of coronavirus disease (COVID-19) contamination. This prospective multicenter study describes the characteristics of HCWs tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) while working in a geriatric environment. We also compared HCWs with a positive reverse transcription polymerase chain reaction (RTPCR) assay (RTPCR+ group) and those with a negative test result (RTPCR− group). Between 15/5/2020 and 15/9/2020, 258 HCWs, employed in the acute geriatric unit (AGU), geriatric rehabilitation unit (GRU) or nursing home of three hospitals in Burgundy (France) were invited to complete an online survey. Among the 171 respondents, 83 participants, with mean age 42 years and 87.9% female, were tested for SARS-CoV-2 infection. Among these 83 participants, COVID-19 was confirmed in 38 cases (RTPCR+ group) of which 36 were symptomatic, and the RTPCR assay was negative in 45 cases (RTPCR− group) of which 20 participants were symptomatic. A total of 22.9% (of 83) had comorbidities, 21.7% were active smokers, and 65.1% had received the flu vaccine. A total of 37.3% worked in AGU, 19.3% in GRU and 16.9% in nursing homes. The most common symptom described was headache (23.2%), followed by fatigue or cough (12.5% each), and fever or myalgia (10.7% each). There were more participants with normal body mass index (p = 0.03) in the RTPCR+ group. In contrast, there were more users of non-steroidal anti-inflammatory drugs (p = 0.01), active smokers (p = 0.03) and flu vaccinated (p = 0.01) in the RTPCR− group. No difference was found between the two groups for the type of work (p = 0.20 for physicians and p = 0.18 for nurses). However, acquiring COVID-19 was significantly associated with working in AGU (p < 0.001) and nursing homes (p = 0.001). There were significantly more users of surgical masks (p = 0.035) in the RTPCR+ group and more filtering facepiece-2 mask users (p = 0.016) in the RTPCR− group. Our results reflect the first six months of the COVID-19 pandemic in France. Further studies are needed to evaluate and track the risks and consequences of COVID-19 in HCWs.
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Affiliation(s)
- Anca-Maria Mihai
- “Pôle Personnes Âgées”, Hospital of Champmaillot, University Hospital, 21079 Dijon, France; (A.-M.M.); (J.B.); (M.D.); (J.V.); (V.N.); (C.B.-S.); (A.P.)
| | - Jérémy Barben
- “Pôle Personnes Âgées”, Hospital of Champmaillot, University Hospital, 21079 Dijon, France; (A.-M.M.); (J.B.); (M.D.); (J.V.); (V.N.); (C.B.-S.); (A.P.)
| | - Mélanie Dipanda
- “Pôle Personnes Âgées”, Hospital of Champmaillot, University Hospital, 21079 Dijon, France; (A.-M.M.); (J.B.); (M.D.); (J.V.); (V.N.); (C.B.-S.); (A.P.)
| | - Jérémie Vovelle
- “Pôle Personnes Âgées”, Hospital of Champmaillot, University Hospital, 21079 Dijon, France; (A.-M.M.); (J.B.); (M.D.); (J.V.); (V.N.); (C.B.-S.); (A.P.)
| | - Valentine Nuss
- “Pôle Personnes Âgées”, Hospital of Champmaillot, University Hospital, 21079 Dijon, France; (A.-M.M.); (J.B.); (M.D.); (J.V.); (V.N.); (C.B.-S.); (A.P.)
| | - Camille Baudin-Senegas
- “Pôle Personnes Âgées”, Hospital of Champmaillot, University Hospital, 21079 Dijon, France; (A.-M.M.); (J.B.); (M.D.); (J.V.); (V.N.); (C.B.-S.); (A.P.)
| | - Alain Putot
- “Pôle Personnes Âgées”, Hospital of Champmaillot, University Hospital, 21079 Dijon, France; (A.-M.M.); (J.B.); (M.D.); (J.V.); (V.N.); (C.B.-S.); (A.P.)
| | - Patrick Manckoundia
- “Pôle Personnes Âgées”, Hospital of Champmaillot, University Hospital, 21079 Dijon, France; (A.-M.M.); (J.B.); (M.D.); (J.V.); (V.N.); (C.B.-S.); (A.P.)
- INSERM U-1093, Cognition, Action and Sensorimotor Plasticity, University of Burgundy Franche-Comté, 21000 Dijon, France
- Correspondence: ; Tel.: +33-380-29-39-70; Fax: +33-380-29-36-21
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94
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Johansson B. Challenges and Controversies in COVID-19: Masking the General Population may Attenuate This Pandemic's Outbreak. Front Public Health 2021; 9:643991. [PMID: 34568248 PMCID: PMC8455895 DOI: 10.3389/fpubh.2021.643991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 06/22/2021] [Indexed: 11/13/2022] Open
Abstract
SARS-CoV-2, the virus that causes COVID-19, spreads i. a., by respiratory droplets. The use of masks in preventing spread is controversial; masks are considered useless by many, while being mandated in some locations. Here, the effect of masking the general population on a COVID-19-like epidemic is estimated by computer simulation using three separate types of software. The main questions are whether mask use by the general population can limit the spread of SARS-CoV-2 in a country and how to identify opportunities when mask use is cost-effective and safe. To address these questions, the protective effects of different types of masks, the side-effects of masks, and avenues for improvements of masks and masking are addressed. Main results: (i) Any type of mask, even simple home-made ones, may be of value, even if the protective effect of each mask (here dubbed "one mask-protection") is low. Strict adherence to mask use does not appear to be critical but increasing one mask-protection to >50% was found to be advantageous. (ii) Masks do seem to reduce the number of new cases even if introduced at a late stage in an epidemic, but early implementation helps reduce the cumulative and total number of cases. (iii) The simulations suggest that it might be possible to eliminate a COVID-19 outbreak by widespread mask use during a limited period. There is a brief discussion of why the reported effect size of masking varies widely, and is expected to do so, because of different filtration abilities of different masks, differences in compliance and fitting, other routes of transmission, pre-existing immunity, and because a system of interconnected, disease-prone individuals has non-linear properties. A software solution to visualize infection spread is presented. The results from these simulations are encouraging, but do not necessarily represent the real-life situation, so it is suggested that clinical trials of masks are now carried out while continuously monitoring effects and side-effects. As mask use is not without risks and costs, it is suggested that governments and scientists have an important role in advising the public about the sensible use of masks.
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Affiliation(s)
- Björn Johansson
- Theme Aging, Karolinska University Hospital, Stockholm, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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95
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A cross-sectional study of COVID-19-related bullying in a sample of Lebanese adults: scale validation, correlates, and mediating effect of fear and anxiety. BMC Psychol 2021; 9:137. [PMID: 34496963 PMCID: PMC8425023 DOI: 10.1186/s40359-021-00643-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 08/18/2021] [Indexed: 11/30/2022] Open
Abstract
Background The COVID-19 pandemic has led to prolonged exposure to stress and anxiety, raising concerns about a large spectrum of psychological side effects. The primary objective of the study was to validate the COVID-19 Bullying Scale (CBS-11). The second objective was to explore factors associated with COVID-19-related bullying and evaluate the mediating effect of fear and anxiety between knowledge and COVID-19-related bullying.
Methods A cross-sectional online survey conducted between December 20, 2020, and January 5, 2021, recruited 405 Lebanese adults using a snowball sampling technique. The CBS-11, an 11-item tool specifically created for this study, was used to measure bullying behaviors towards COVID-19 patients. Results All items of the CBS-11 converged over a 1-factor solution with an eigenvalue over 1, accounting for a variance of 75.16%. The scale has a high Cronbach’s alpha (.974), indicating excellent reliability. A positive correlation was found between the COVID-19 bullying scale and fear, anxiety, and stigma discrimination. The logistic regression showed that higher fear of COVID-19 (ORa = 1.04), a positive attitude toward COVID-19 preventive measures and hygiene recommendations (ORa = 1.18), higher stigma discrimination scores (ORa = 1.09), and having a health professional family member (ORa = 2.42) were significantly associated with bullying. Conclusion Our main findings showed that the CBS-11 could be an efficient tool to measure bullying behaviors toward COVID-19 patients. Stigma discrimination and fear from COVID-19 were associated with higher bullying attitudes. Future prospective studies are needed to understand better the factors related to bullying among adults during a pandemic, such as COVID-19. Supplementary Information The online version contains supplementary material available at 10.1186/s40359-021-00643-1.
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96
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Laupland KB, Collignon PJ, Schwartz IS. Sleeping with the enemy: Will the COVID-19 pandemic turn the tide of antimicrobial-resistant infections? JOURNAL OF THE ASSOCIATION OF MEDICAL MICROBIOLOGY AND INFECTIOUS DISEASE CANADA = JOURNAL OFFICIEL DE L'ASSOCIATION POUR LA MICROBIOLOGIE MEDICALE ET L'INFECTIOLOGIE CANADA 2021; 6:177-180. [PMID: 36337755 PMCID: PMC9615466 DOI: 10.3138/jammi-2021-05-28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 05/28/2022] [Indexed: 06/16/2023]
Affiliation(s)
- Kevin B Laupland
- Department of Medicine, Royal Inland Hospital, Kamloops, British Columbia, Canada
- Department of Intensive Care Services, Royal Brisbane and Women’s Hospital, Brisbane, Queensland, Australia
- Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Peter J Collignon
- Department of Infectious Diseases and Microbiology, Canberra Hospital, Garran, Australian Capital Territory, Australia
- Department of Infectious Disease, Medical School, Australian National University, Acton, Australian Capital Territory, Australia
| | - Ilan S Schwartz
- Division of Infectious Diseases, Department of Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
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97
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Conly J, Chou R, Schwaber MJ, Voss A. Revisiting the evidence for physical distancing, face masks, and eye protection. Lancet 2021; 398:660. [PMID: 34419198 PMCID: PMC8376239 DOI: 10.1016/s0140-6736(21)01741-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 07/22/2021] [Indexed: 12/21/2022]
Affiliation(s)
- John Conly
- University of Calgary and Alberta Health Services, Calgary, AB T2N 4N1, Canada.
| | - Roger Chou
- Oregon Health & Science University Portland, Portland, OR, USA
| | - Mitchell J Schwaber
- National Center for Infection Control, Israel Ministry of Health, Tel Aviv, Israel
| | - Andreas Voss
- Canisus Wilhelmina Ziekenhuis, Nijmegen, Netherlands
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98
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Hoffmann T, Bakhit M, Krzyzaniak N, Del Mar C, Scott AM, Glasziou P. Soap versus sanitiser for preventing the transmission of acute respiratory infections in the community: a systematic review with meta-analysis and dose-response analysis. BMJ Open 2021; 11:e046175. [PMID: 34408031 PMCID: PMC8375726 DOI: 10.1136/bmjopen-2020-046175] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE To compare the effectiveness of hand hygiene using alcohol-based hand sanitiser to soap and water for preventing the transmission of acute respiratory infections (ARIs) and to assess the relationship between the dose of hand hygiene and the number of ARI, influenza-like illness (ILI) or influenza events. DESIGN Systematic review and meta-analysis. DATA SOURCES Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Embase, Cumulative Index of Nursing and Allied Health Literature (CINAHL) and trial registries were searched in April 2020. INCLUSION CRITERIA We included randomised controlled trials that compared a community-based hand hygiene intervention (soap and water, or sanitiser) with a control, or trials that compared sanitiser with soap and water, and measured outcomes of ARI, ILI or laboratory-confirmed influenza or related consequences. DATA EXTRACTION AND ANALYSIS Two review authors independently screened the titles and abstracts for inclusion and extracted data. RESULTS Eighteen trials were included. When meta-analysed, three trials of soap and water versus control found a non-significant increase in ARI events (risk ratio (RR) 1.23, 95% CI 0.78 to 1.93); six trials of sanitiser versus control found a significant reduction in ARI events (RR 0.80, 95% CI 0.71 to 0.89). When hand hygiene dose was plotted against ARI relative risk, no clear dose-response relationship was observable. Four trials were head-to-head comparisons of sanitiser and soap and water but too heterogeneous to pool: two found a significantly greater reduction in the sanitiser group compared with the soap group and two found no significant difference between the intervention arms. CONCLUSIONS Adequately performed hand hygiene, with either soap or sanitiser, reduces the risk of ARI virus transmission; however, direct and indirect evidence suggest sanitiser might be more effective in practice.
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Affiliation(s)
- Tammy Hoffmann
- Institute for Evidence-Based Healthcare, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Mina Bakhit
- Institute for Evidence-Based Healthcare, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Natalia Krzyzaniak
- Institute for Evidence-Based Healthcare, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Chris Del Mar
- Institute for Evidence-Based Healthcare, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Anna Mae Scott
- Institute for Evidence-Based Healthcare, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Paul Glasziou
- Institute for Evidence-Based Healthcare, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
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99
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Stöcker A, Demirer I, Gunkel S, Hoffmann J, Mause L, Ohnhäuser T, Scholten N. Stockpiled personal protective equipment and knowledge of pandemic plans as predictors of perceived pandemic preparedness among German general practitioners. PLoS One 2021; 16:e0255986. [PMID: 34383827 PMCID: PMC8360569 DOI: 10.1371/journal.pone.0255986] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 07/28/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic significantly changed the work of general practitioners (GPs). At the onset of the pandemic in March 2020, German outpatient practices had to adapt quickly. Pandemic preparedness (PP) of GPs may play a vital role in their management of a pandemic. OBJECTIVES The study aimed to examine the association in the stock of seven personal protective equipment (PPE) items and knowledge of pandemic plans on perceived PP among GPs. METHODS Three multivariable linear regression models were developed based on an online cross-sectional survey for the period March-April 2020 (the onset of the pandemic in Germany). Data were collected using self-developed items on self-assessed PP and knowledge of a pandemic plan and its utility. The stock of seven PPE items was queried. For PPE items, three different PPE scores were compared. Control variables for all models were gender and age. RESULTS In total, 508 GPs were included in the study; 65.16% believed that they were very poorly or poorly prepared. Furthermore, 13.83% of GPs were aware of a pandemic plan; 40% rated those plans as beneficial. The stock of FFP-2/3 masks, protective suits, face shields, safety glasses, and medical face masks were mostly considered completely insufficient or insufficient, whereas disposable gloves and disinfectants were considered sufficient or completely sufficient. The stock of PPE was significantly positively associated with PP and had the largest effect on PP; the association of the knowledge of a pandemic plan was significant but small. PPE scores did not vary considerably in their explanatory power. The assessment of a pandemic plan as beneficial did not significantly affect PP. CONCLUSION The stock of PPE seems to be the determining factor for PP among German GPs; for COVID-19, sufficient masks are the determining factor. Knowledge of a pandemic plans play a secondary role in PP.
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Affiliation(s)
- Arno Stöcker
- Faculty of Human Sciences, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Ibrahim Demirer
- Faculty of Human Sciences, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Sophie Gunkel
- Faculty of Human Sciences, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Jan Hoffmann
- Faculty of Human Sciences, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Laura Mause
- Faculty of Human Sciences, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Tim Ohnhäuser
- Faculty of Human Sciences, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Nadine Scholten
- Faculty of Human Sciences, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
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Ford N, Holmer HK, Chou R, Villeneuve PJ, Baller A, Van Kerkhove M, Allegranzi B. Mask use in community settings in the context of COVID-19: A systematic review of ecological data. EClinicalMedicine 2021; 38:101024. [PMID: 34308320 PMCID: PMC8287197 DOI: 10.1016/j.eclinm.2021.101024] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 06/28/2021] [Accepted: 06/28/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The wearing of medical and non-medical masks by the general public in community settings is one intervention that is important for the reduction of SARS-CoV-2 transmission, and has been the subject of considerable research, policy, advocacy and debate. Several observational studies have used ecological (population-level) data to assess the effect of masks on transmission, hospitalization, and mortality at the region or community level. METHODS We undertook this systematic review to summarize the study designs, outcomes, and key quality indicators of using ecological data to evaluate the association between mask wearing and COVID-19 outcomes. We searched the World Health Organization (WHO) COVID-19 global literature database up to 5 March 2021 for studies reporting the impact of mask use in community settings on outcomes related to SARS-CoV-2 transmission using ecological data. FINDINGS Twenty one articles were identified that analysed ecological data to assess the protective effect of policies mandating community mask wearing. All studies reported SARS-CoV-2 benefits in terms of reductions in either the incidence, hospitalization, or mortality, or a combination of these outcomes. Few studies assessed compliance to mask wearing policies or controlled for the possible influence of other preventive measures such as hand hygiene and physical distancing, and information about compliance to these policies was lacking. INTERPRETATION Ecological studies have been cited as evidence to advocate for the adoption of universal masking policies. The studies summarized by this review suggest that community mask policies may reduce the population-level burden of SARS-CoV-2. Methodological limitations, in particular controlling for the actual practice of mask wearing and other preventive policies make it difficult to determine causality. There are several important limitations to consider for improving the validity of ecological data.
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Affiliation(s)
- Nathan Ford
- Guidelines Review Committee, World Health Organization, Geneva, Switzerland
- Corresponding author.
| | - Haley K. Holmer
- Center to Improve Veteran Involvement in Care (CIVIC), VA Portland Health Care System, Portland, OR, United States
| | - Roger Chou
- Pacific Northwest Evidence-based Practice Center and Oregon Health & Science University, Portland, OR, United States
| | - Paul J. Villeneuve
- School of Mathematics and Statistics and Department of Neuroscience, Faculty of Science Carleton University, Ottawa, Canada
| | - April Baller
- Health Emergencies Programme, World Health Organization, Geneva, Switzerland
| | - Maria Van Kerkhove
- Health Emergencies Programme, World Health Organization, Geneva, Switzerland
| | - Benedetta Allegranzi
- Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, World Health Organization, Geneva, Switzerland
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