101
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Hedworth HA, Karam M, McConnell J, Sutherland JC, Saad T. Mitigation strategies for airborne disease transmission in orchestras using computational fluid dynamics. SCIENCE ADVANCES 2021; 7:eabg4511. [PMID: 34162550 PMCID: PMC8221623 DOI: 10.1126/sciadv.abg4511] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 05/07/2021] [Indexed: 06/09/2023]
Abstract
The COVID-19 pandemic forced performing arts groups to cancel shows and entire seasons due to safety concerns for the audience and performers. It is unclear to what extent aerosols generated by wind instruments contribute to exposure because their fate is dependent on the airflow onstage. We use transient, second-order accurate computational fluid dynamics (CFD) simulations and quantitative microbial risk assessment to estimate aerosol concentrations and the associated risk and assess strategies to mitigate exposure in two distinct concert venues. Mitigation strategies involved rearranging musicians and altering the airflow by changing HVAC settings, opening doors, and introducing flow-directing geometries. Our results indicate that the proposed mitigation strategies can reduce aerosol concentrations in the breathing zone by a factor of 100, corresponding to a similar decrease in the probability of infection.
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Affiliation(s)
- Hayden A Hedworth
- Department of Chemical Engineering, University of Utah Salt Lake City, UT 84112, USA
| | - Mokbel Karam
- Department of Chemical Engineering, University of Utah Salt Lake City, UT 84112, USA
| | - Josh McConnell
- Department of Chemical Engineering, University of Utah Salt Lake City, UT 84112, USA
| | - James C Sutherland
- Department of Chemical Engineering, University of Utah Salt Lake City, UT 84112, USA
| | - Tony Saad
- Department of Chemical Engineering, University of Utah Salt Lake City, UT 84112, USA.
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102
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Le XTT, Nguyen QT, Onyango B, Nguyen QN, Pham QT, Ta NTK, Nguyen TT, Le HT, Vu LG, Hoang MT, Vu GT, Latkins CA, Ho RCM, Ho CSH. Perception Toward Exposure Risk of COVID-19 Among Health Workers in Vietnam: Status and Correlated Factors. Front Public Health 2021; 9:589317. [PMID: 34113595 PMCID: PMC8185209 DOI: 10.3389/fpubh.2021.589317] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 04/28/2021] [Indexed: 12/20/2022] Open
Abstract
Background: Hospital staff are at the frontline for the prevention and control of COVID-19. Understanding their perception of exposure risk is, therefore, important during the early phase of this pandemic. In this study, we evaluated the perception regarding risk of exposure to COVID-19 among Vietnamese hospital staff in Vietnam. Method: A cross-sectional online study was carried out to collect demographic data and risk exposure perception during the second week of the national lockdown in April 2020 in Vietnam. Seven hundred and forty two hospital staff were recruited using the snowball sampling to answer 5-point Likert scale questions regarding their risk exposure perception. Exploratory factor analysis (EFA) was used to examine the construct validity of the questionnaire. Pearson coefficient analysis and multivariable regression models were applied to identify factors associated with the perceived COVID-19 exposure risk. Results: Participants perceived a high risk of being infected with SARS-CoV-2 (score = 3.4, SD = 0.8). They also perceived the workplace response to COVID-19 as inadequate (score = 2.0, SD = 0.5). In particular, participants who worked in the emergency or intensive care departments were more likely to perceive an exposure risk, compared to those in infectious disease control departments (Coef. = −0.38, 95%CI: −0.74; −0.02). Participants from central regions perceived a lower risk of exposure to COVID-19 than those from northern regions (OR = 0.52, 95%CI: 0.28–0.96). Nurses were less likely than doctors to report being at risk of exposure to COVID-19 (OR = 0.56, 95%CI: 0.33–0.95). Conclusions: We identified a high level of perceived risk regarding COVID-19 exposure among hospital staff during the unprecedented lockdown period in Vietnam. A comprehensive approach, incorporating improved risk communications, safety training and psychological support programs, for all hospital staff, including nurses and those residing in high population density areas, might further strengthen the national effort to control the pandemic.
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Affiliation(s)
- Xuan Thi Thanh Le
- School of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Quynh Thi Nguyen
- School of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Brenda Onyango
- Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Quang Nhat Nguyen
- Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Quan Thi Pham
- School of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Nhung Thi Kim Ta
- School of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Thao Thanh Nguyen
- School of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Huong Thi Le
- School of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Linh Gia Vu
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam.,Faculty of Medicine, Duy Tan University, Da Nang, Vietnam
| | - Men Thi Hoang
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam.,Faculty of Medicine, Duy Tan University, Da Nang, Vietnam
| | - Giang Thu Vu
- Center of Excellence in Evidence-Based Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | - Carl A Latkins
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Roger C M Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore, Singapore
| | - Cyrus S H Ho
- Department of Psychological Medicine, National University Health System, Singapore, Singapore
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103
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How to address SARS-CoV-2 airborne transmission to ensure effective protection of healthcare workers? A review of the literature. Infect Dis Now 2021; 51:410-417. [PMID: 34029759 PMCID: PMC8139431 DOI: 10.1016/j.idnow.2021.05.005] [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: 05/05/2021] [Accepted: 05/12/2021] [Indexed: 12/09/2022]
Abstract
SARS-CoV-2 mainly infects the respiratory tract, and presents significantly higher active replication in the upper airways. To remain viable and infectious, the SARS-CoV-2 virion must be complete and integral, which is not easily demonstrated in the environment by positive reverse transcriptase PCR results. Real-life conditions in healthcare settings may be conducive to SARS-CoV-2 RNA dissemination in the environment but without evidence of its viability and infectiveness in air. Theoretically, SARS-CoV-2 shedding and dissemination nonetheless appears to be air-mediated, and a distinction between “air” and “droplet” transmission is too schematic to reflect the reality of the respiratory particles emitted by patients, between which a continuum exists. Airborne transmission is influenced by numerous environmental conditions that are not transposable between different viral agents and situations in healthcare settings or in the community. Even though international guidelines on “droplet” versus “air” precautions and personal protective equipment (surgical versus respirator masks) are under discussion, the existing literature underscores the effectiveness of “droplet” precautions as a means of protecting healthcare workers. Differentiation in guidelines between healthcare venues, community settings and, more generally, confined environments is of paramount importance, especially insofar as it underlines the abiding pandemic-related need for systematic mask wearing by the general population.
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104
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Zaman S, Seligman H, Lloyd FH, Patel KT, Chappell D, O'Hare D, Cole GD, Francis DP, Petraco R, Linton NW. Aerosolised fluorescein can quantify FFP mask faceseal leakage: a cost-effective adaptation to the existing point of care fit test. Clin Med (Lond) 2021; 21:e263-e268. [PMID: 34001582 DOI: 10.7861/clinmed.2020-0982] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND A qualitative fit test using bitter-tasting aerosols is the commonest way to determine filtering face-piece (FFP) mask leakage. This taste test is subjective and biased by placebo. We propose a cheap, quantitative modification of the taste test by measuring the amount of fluorescein stained filter paper behind the mask using image analysis. METHODS A bitter-tasting fluorescein solution was aerosolised during mask fit tests, with filter paper placed on masks' inner surfaces. Participants reported whether they could taste bitterness to determine taste test 'pass' or 'fail' results. Filter paper photographs were digitally analysed to quantify total fluorescence (TF). RESULTS Fifty-six healthcare professionals were fit tested; 32 (57%) 'passed' the taste test. TF between the taste test 'pass' and 'fail' groups was significantly different (p<0.001). A cut-off (TF = 5.0 × 106 units) was determined at precision (78%) and recall (84%), resulting in 5/56 participants (9%) reclassified from 'pass' to 'fail' by the fluorescein test. Seven out of 56 (12%) reclassified from 'fail' to 'pass'. CONCLUSION Fluorescein is detectable and sensitive at identifying FFP mask leaks. These low-cost adaptations can enhance exiting fit testing to determine 'pass' and 'fail' groups, protecting those who 'passed' the taste test but have high fluorescein leak, and reassuring those who 'failed' the taste test despite having little fluorescein leak.
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Affiliation(s)
| | | | | | - Keval T Patel
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | | | | | | | - Darrel P Francis
- Imperial College London, London, UK and Imperial College Healthcare NHS Trust, London, UK
| | - Ricardo Petraco
- Imperial College London, London, UK and Imperial College Healthcare NHS Trust, London, UK
| | - Nick Wf Linton
- Imperial College London, London, UK and Imperial College Healthcare NHS Trust, London, UK
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105
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Costantino C, Cannizzaro E, Verso MG, Tramuto F, Maida CM, Lacca G, Alba D, Cimino L, Conforto A, Cirrincione L, Graziano G, Palmeri S, Pizzo S, Restivo V, Casuccio A, Vitale F, Mazzucco W. SARS-CoV-2 Infection in Healthcare Professionals and General Population During "First Wave" of COVID-19 Pandemic: A Cross-Sectional Study Conducted in Sicily, Italy. Front Public Health 2021; 9:644008. [PMID: 34055716 PMCID: PMC8155294 DOI: 10.3389/fpubh.2021.644008] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 03/08/2021] [Indexed: 12/31/2022] Open
Abstract
On December 31, 2019, an outbreak of lower respiratory infections was documented in Wuhan caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Since the beginning, SARS-CoV-2 has caused many infections among healthcare workers (HCWs) worldwide. Aims of this study were: a. to compare the distribution among the HCWs and the general population of SARS-CoV-2 infections in Western Sicily and Italy; b. to describe the characteristics of HCWs infected with SARS-CoV-2 in the western Sicilian healthcare context during the first wave of the epidemic diffusion in Italy. Incidence and mean age of HCWs infected with SARS-CoV-2 were comparable in Western Sicily and in the whole Italian country. The 97.6% of infections occurred in HCWs operating in non-coronavirus disease 2019 (COVID-19) working environments, while an equal distribution of cases between hospital and primary care services context was documented. Nurses and healthcare assistants, followed by physicians, were the categories more frequently infected by SARS-CoV-2. The present study suggests that healthcare workers are easily infected compared to the general population but that often infection could equally occur in hospital and non-hospital settings. Safety of HCWs in counteracting the COVID-19 pandemic must be strengthened in hospital [adequate provision of personal protective equipment (PPE), optimization of human resources, implementation of closed and independent groups of HCWs, creation of traffic control building and dedicated areas in every healthcare context] and non-hospital settings (influenza vaccination, adequate psychophysical support, including refreshments during working shifts, adequate rest, and family support).
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Affiliation(s)
- Claudio Costantino
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) "G. D'Alessandro," University of Palermo, Palermo, Italy.,COVID-19 Surveillance Western Sicily Reference Laboratory, Palermo University Hospital, Palermo, Italy
| | - Emanuele Cannizzaro
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) "G. D'Alessandro," University of Palermo, Palermo, Italy
| | - Maria Gabriella Verso
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) "G. D'Alessandro," University of Palermo, Palermo, Italy
| | - Fabio Tramuto
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) "G. D'Alessandro," University of Palermo, Palermo, Italy.,COVID-19 Surveillance Western Sicily Reference Laboratory, Palermo University Hospital, Palermo, Italy
| | - Carmelo Massimo Maida
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) "G. D'Alessandro," University of Palermo, Palermo, Italy.,COVID-19 Surveillance Western Sicily Reference Laboratory, Palermo University Hospital, Palermo, Italy
| | - Guido Lacca
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) "G. D'Alessandro," University of Palermo, Palermo, Italy
| | - Davide Alba
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) "G. D'Alessandro," University of Palermo, Palermo, Italy
| | - Livia Cimino
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) "G. D'Alessandro," University of Palermo, Palermo, Italy
| | - Arianna Conforto
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) "G. D'Alessandro," University of Palermo, Palermo, Italy
| | - Luigi Cirrincione
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) "G. D'Alessandro," University of Palermo, Palermo, Italy
| | - Giorgio Graziano
- COVID-19 Surveillance Western Sicily Reference Laboratory, Palermo University Hospital, Palermo, Italy
| | - Sara Palmeri
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) "G. D'Alessandro," University of Palermo, Palermo, Italy
| | - Stefano Pizzo
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) "G. D'Alessandro," University of Palermo, Palermo, Italy
| | - Vincenzo Restivo
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) "G. D'Alessandro," University of Palermo, Palermo, Italy.,COVID-19 Surveillance Western Sicily Reference Laboratory, Palermo University Hospital, Palermo, Italy
| | - Alessandra Casuccio
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) "G. D'Alessandro," University of Palermo, Palermo, Italy
| | - Francesco Vitale
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) "G. D'Alessandro," University of Palermo, Palermo, Italy.,COVID-19 Surveillance Western Sicily Reference Laboratory, Palermo University Hospital, Palermo, Italy
| | - Walter Mazzucco
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) "G. D'Alessandro," University of Palermo, Palermo, Italy.,COVID-19 Surveillance Western Sicily Reference Laboratory, Palermo University Hospital, Palermo, Italy
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106
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Haftom M, Petrucka PM. Determinants of Face Mask Utilization to Prevent Covid-19 Pandemic among Quarantined Adults in Tigrai Region, Northern Ethiopia, 2020. Clin Nurs Res 2021; 30:1107-1112. [PMID: 33955280 PMCID: PMC8950710 DOI: 10.1177/10547738211013219] [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] [Indexed: 12/28/2022]
Abstract
A face mask is a vital component of personal protective equipment to prevent potentially contagious respiratory infections. There was a lack of evidence showing the proportion and determinants of face mask use in Ethiopia. Therefore, this study aimed to identify face mask utilization determinants to prevent spread of the Covid-19 pandemic among quarantined adults in Tigrai region, northern Ethiopia. A total of 331 participants selected using a systematic random sampling method were included in the study. An interviewer-administered questionnaire was employed. After describing the variables using frequencies, means, and standard deviations, multivariable logistic regression determined factors associated with face mask utilization to prevent COVID-19 spread. The study participants were primarily males (70%) and mean age was 30.5 (SD = 11) years. Nearly half of the participants reported they did not wear a face mask when leaving home. Face mask utilization was significantly associated with knowledge score, employment status, gender, age, and educational status of the study participants.
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107
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Duscha BD, Johnson JL, Bennett WC, Ball KN, Mae Fos LB, Reaves MA, Kraus WE. Cardiopulmonary Exercise Testing in the Coronavirus Disease - 2019 Era: Safety and Protocol Considerations. Curr Sports Med Rep 2021; 20:259-265. [PMID: 33908913 DOI: 10.1249/jsr.0000000000000843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
ABSTRACT Cardiopulmonary exercise testing (CPX) is a valuable tool in both clinical practice and research settings. Therefore, it is advantageous for human performance laboratories to continue operating during the coronavirus disease 2019 (COVID-19) pandemic. All institutions should adhere to general COVID-19 guidelines provided by the Centers for Disease Control. Because of the testing environment, CPX laboratories must consider additional precautionary safety measures. This article provides recommendations for modifying the CPX protocol to ensure safety for all stakeholders during the pandemic. These modifications are universal across all populations, types of institutions and testing modalities. Preliminary measures include careful review of federal, local, and institutional mandates. The description outlines how to evaluate a testing environment and alter workflow. Guidelines are provided on what specific personal protective equipment should be acquired; as well as necessary actions before, during, and after the CPX test. These precautions will limit the possibility of both clients and staff from contracting or spreading the disease while maintaining testing volume in the laboratory.
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108
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Arias Uribe JI. Impacto de la introducción del cubrebocas contra el COVID-19: una revisión narrativa. Rev Salud Publica (Bogota) 2021. [DOI: 10.15446/rsap.v23n3.92258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
El objetivo de este trabajo fue identificar el impacto de la introducción del cubrebocas contra el COVID-19: qué características tiene y cómo se ha introducido alrededor del mundo. Para ello, se realizó una revisión de la literatura disponible en una base de datos especializada, PUBMED, la cual se ajustó a las directrices enmarcadas en la metodología PRISMA . Se definieron ecuaciones de búsqueda bajo los términos MeSH: humans, COVID-19, severe acute respiratory síndrome coronavirus 2, masks y equipment design, utilizando el carácter booleano AND. Con estas ecuaciones se buscaron artículos publicados en 2020, recuperando 676 registros en total, eligiendo 82 que abordan el tema de interés e incluyendo en la revisión final 49 artículos que cumplían con todos los criterios de inclusión y exclusión definidos. Los resultados sugieren que la introducción de mascarillas tuvo un impacto positivo para reducir el riesgo de COVID-19 y el uso inadecuado del cubrebocas es un factor de riesgo.
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109
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Dargahi A, Jeddi F, Ghobadi H, Vosoughi M, Karami C, Sarailoo M, Hadisi A, Mokhtari SA, Haghighi SB, Sadeghi H, Alighadri M. Evaluation of masks' internal and external surfaces used by health care workers and patients in coronavirus-2 (SARS-CoV-2) wards. ENVIRONMENTAL RESEARCH 2021; 196:110948. [PMID: 33684411 PMCID: PMC7935683 DOI: 10.1016/j.envres.2021.110948] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 02/08/2021] [Accepted: 02/25/2021] [Indexed: 05/22/2023]
Abstract
One of the simplest and most effective individual measures is to wear a mask to prevent the spread of respiratory droplets from carriers to healthy people and patients admitted to corona wards and their staff. This research aimed to investigate the contamination of internal and external surfaces of various masks used by patients and staff with SARS coronavirus, as well as the possibility of airborne transmission in Imam Khomeini Hospital, Ardabil. For this purpose, twenty-five staff members and ten patients participated voluntarily in this cross-sectional study. Sampling was performed using swaps on both sides (inside and outside) of various surgical masks, N-95, and filtering face piece FFP2 through standard methods in compliance with the relevant conditions and from a surface of at least 5 cm2. Next, the collected samples were immediately transferred to a laboratory and analyzed by real-time PCR method to detect the presence of SARS-CoV-2 virus after viral genome extraction. Based on the obtained results, from a total of 30 collected samples (25 of personnel masks plus 5 samples of hospitalized patients' masks). A total of 60 masks were sampled. For every collected sample, the researchers studied both inside and outside of the mask. Upon analyzing the data, it was showed that 6 mask samples were positive for the presence of coronavirus. Nonetheless, all samples taken from both inside and outside of the personnel masks (N-95 and FFP2 types of masks) were negative. Among the 6 positive samples, four cases were related to the internal part, one case to the outer part of the three-layer surgical masks, and one to the outer part of the N-95 masks in hospitalized patients. As masks reduce the concentration of virus particles, they can play an important role in creating immunity.
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Affiliation(s)
- Abdollah Dargahi
- Social Determinants of Health Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Farhad Jeddi
- Department of Genetics and Pathology, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Hassan Ghobadi
- Department of Internal Medicine, School of Medicine and Allied Medical Sciences, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Mehdi Vosoughi
- Social Determinants of Health Research Center, Ardabil University of Medical Sciences, Ardabil, Iran; Department of Environmental Health Engineering, School of Health, Ardabil University of Medical Sciences, Ardabil, Iran.
| | - Chiman Karami
- Department of Microbiology, Parasitology and Immunology, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran; Digestive Diseases Research Center, Ardabil University of Medical Sciences, Ardabil, Iran.
| | - Mehdi Sarailoo
- Student Research Committee, Department of Public Health, School of Health, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Aidin Hadisi
- Department of Microbiology, Parasitology and Immunology, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - S Ahamad Mokhtari
- Department of Environmental Health Engineering, School of Health, Ardabil University of Medical Sciences, Ardabil, Iran
| | | | - Hadi Sadeghi
- Department of Environmental Health Engineering, School of Health, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Morteza Alighadri
- Department of Environmental Health Engineering, School of Health, Ardabil University of Medical Sciences, Ardabil, Iran
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110
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Gu T, Yao L, Meng X, Graff JC, Thomason D, Li J, Dong W, Jiao Y, Aleya L, Maida M, Wang CY, Zangerl B, Genini S, Ray K, Goldman E, Ji J, Alexandrov AV, Sun D, Gu W, Wang Y. A cost-effective plan for global testing - an infection rate stratified, algorithm guided, multiple-level, continuously pooled testing strategy. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 765:144251. [PMID: 33387925 PMCID: PMC7833620 DOI: 10.1016/j.scitotenv.2020.144251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 11/23/2020] [Accepted: 11/25/2020] [Indexed: 05/05/2023]
Abstract
The most effective measure to prevent or stop the spread of infectious diseases is the early identification and isolation of infected individuals through comprehensive screening. At present, in the COVID-19 pandemic, such screening is often limited to isolated regions as determined by local governments. Screening of potentially infectious individuals should be conducted through coordinated national or global unified actions. Our current research focuses on using resources to conduct comprehensive national and regional regular testing with a risk rate based, algorithmic guided, multiple-level, pooled testing strategy. Here, combining methodologies with mathematical logistic models, we present an analytic procedure of an overall plan for coordinating state, national, or global testing. The proposed plan includes three parts 1) organization, resource allocation, and distribution; 2) screening based on different risk levels and business types; and 3) algorithm guided, multiple level, continuously screening the entire population in a region. This strategy will overcome the false positive and negative results in the polymerase chain reaction (PCR) test and missing samples during initial tests. Based on our proposed protocol, the population screening of 300,000,000 in the US can be done weekly with between 15,000,000 and 6,000,000 test kits. The strategy can be used for population screening for current COVID-19 and any future severe infectious disease when drugs or vaccines are not available.
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Affiliation(s)
- Tianshu Gu
- College of Graduate Health Sciences, University of Tennessee Health Science Center, Memphis, TN 38103, USA; Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, PR China
| | - Lan Yao
- Health Outcomes and Policy Research, College of Graduate Health Sciences, University of Tennessee Health Science Center, Memphis, TN 38103, USA; Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Key Laboratory of Etiologic Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health [23618104], 157 Baojian Road, Harbin, Heilongjiang 150081, PR China
| | - Xia Meng
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, PR China
| | - J Carolyn Graff
- College of Nursing, University of Tennessee Health Science Center, Memphis, TN 38105, USA
| | - Donald Thomason
- Department of Physiology and Biophysics, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Jing Li
- Department of Orthopedic Surgery and Biomedical Engineering-Campbell Clinic, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Wei Dong
- Department of Orthopedic Surgery and Biomedical Engineering-Campbell Clinic, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Yan Jiao
- Department of Orthopedic Surgery and Biomedical Engineering-Campbell Clinic, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Lotfi Aleya
- Chrono-Environnement Laboratory, UMR CNRS 6249, Bourgogne Franche-Comté University, F-25030 Besançon Cedex, France
| | - Marcello Maida
- Gastroenterology and Endoscopy Unit, S. Elia-Raimondi Hospital, 93100 Caltanissetta, Italy
| | - Cong-Yi Wang
- The Center for Biomedical Research, Department of Respiratory and Critical Care Medicine, NHC Key Laboratory of Respiratory Diseases, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, PR China
| | - Barbara Zangerl
- Centre for Eye Health and School of Optometry and Vision Science, UNSW Sydney, Sydney, NSW, Australia
| | - Sem Genini
- Unione Contadini Ticinesi, via Gorelle 7, 6592 S. Antonino, Switzerland
| | - Kunal Ray
- Academy of Scientific & Innovative Research [AcSIR], CSIR - HRDC Campus, Ghaziabad, Uttar Pradesh 201002, India
| | - Emanuel Goldman
- Department of Microbiology, Biochemistry and Molecular Genetics, New Jersey Medical School, Rutgers University, Newark, NJ 07103, USA
| | - Jiafu Ji
- Beijing Cancer Hospital and Key Laboratory of Carcinogenesis and Translational Research, Department of Gastrointestinal Surgery, Peking University Cancer Hospital and Institute, Beijing, PR China
| | - Andrei V Alexandrov
- Department of Neurology, The University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Dianjun Sun
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Key Laboratory of Etiologic Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health [23618104], 157 Baojian Road, Harbin, Heilongjiang 150081, PR China
| | - Weikuan Gu
- Department of Orthopedic Surgery and Biomedical Engineering-Campbell Clinic, University of Tennessee Health Science Center, Memphis, TN 38163, USA; Research Service, Memphis VA Medical Center, 1030 Jefferson Avenue, Memphis, TN 38104, USA.
| | - Yongjun Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, PR China.
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SARS-CoV-2 Ig G among Healthcare Workers and the General Population. Pathogens 2021; 10:pathogens10040465. [PMID: 33921459 PMCID: PMC8069640 DOI: 10.3390/pathogens10040465] [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: 03/17/2021] [Revised: 04/07/2021] [Accepted: 04/07/2021] [Indexed: 11/17/2022] Open
Abstract
It is assumed that healthcare workers are at the highest risk to be infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, few data from healthcare workers who do not primarily take care of patients with SARS-CoV-2 infection support this assumption. We investigated the prevalence of immunoglobulin G (Ig G) against SARS-CoV-2 among healthcare workers who do not primarily take care of patients with SARS-CoV-2 infection and the general population in a well-defined geographical area. The first part of the study was conducted in May 2020 in Val Mesolcina (Southern Switzerland), a valley with ~8000 inhabitants. All healthcare workers were invited. All participants (n = 488) of the Swiss Longitudinal Cohort Study (SWICOS), a cohort representative of the general population, were also invited. Circulating Ig G against spike protein subunit 1 of SARS-CoV-2 were tested in each subject. Subjects with positive Ig G were tested again after 6 months. The condition of being a healthcare worker, rather than a part of the general population, was tested as a predictor of seroprevalence positivity by both simple and multiple (adjusted for age and sex) logistic regression. Eleven (2.6%) of the 423 SWICOS participants and 46 (16%) out of 289 healthcare workers were positive for antibodies against SARS-CoV-2. The seroprevalence OR was 7.01 (95% CI: 3.53–15.47) for healthcare workers as compared to SWICOS participants. After adjusting for age and gender, the seroprevalence OR was 5.13 (95% CI: 2.54–10.40). About three quarters of the subjects in the SWICOS (73%) and in healthcare (79%) group with a previous positive serology still presented positive Ig G against the SARS-CoV-2 after 6 months. The present seroprevalence data point out that the SARS-CoV-2 infection is seven times higher among healthcare workers than in the general population of Val Mesolcina. Efforts to effectively protect all the healthcare personnel are needed.
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Çınar D, Kılıç Akça N, Zorba Bahçeli P, Bağ Y. Perceived stress and affecting factors related to COVID-19 pandemic of emergency nurses in Turkey. J Nurs Manag 2021; 29:1916-1923. [PMID: 33837591 PMCID: PMC8250339 DOI: 10.1111/jonm.13329] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 03/17/2021] [Accepted: 04/06/2021] [Indexed: 01/10/2023]
Abstract
Aim To examine the perceived stress and affecting factors related to the COVID‐19 pandemic of emergency nurses at the first stage of the pandemic. Background During pandemic process, nurses reported to experience stress due to a very high risk of being infected and hard work. Method A descriptive study. The sample of the study consisted of 169 emergency nurses. To collect data, a personal information form was used together with the Perceived Stress Scale. Results The factors that significantly affect the perceived stress score of emergency nurses during the COVID‐19 pandemic included applying respiratory isolation, changing the way of life, not being able to access protective equipment, insufficient nurses in the unit and thinking that COVID‐19 will be transmitted to oneself. Conclusion Nearly half of the emergency nurses perceived stress above average during pandemic, and their working conditions affected this situation. Implications for Nursing Management Meeting physiological needs and applying psychological guidance and counselling interventions in the stress management of emergency nurses may contribute to the reduction of their stress levels. Effective infection control, reducing workload, increasing the number of nurses and strengthening the coping mechanisms can minimize the perceived stress level of emergency nurses.
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Affiliation(s)
- Derya Çınar
- Department of Nursing, Faculty of Health Sciences, University of İzmir Bakırçay, İzmir, Turkey
| | - Nazan Kılıç Akça
- Department of Nursing, Faculty of Health Sciences, University of İzmir Bakırçay, İzmir, Turkey
| | - Pınar Zorba Bahçeli
- Department of Nursing, Faculty of Health Sciences, University of İzmir Bakırçay, İzmir, Turkey
| | - Yaşar Bağ
- Emergency Service, Atatürk Training and Research Hospital, İzmir, Turkey
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Hemmer CJ, Hufert F, Siewert S, Reisinger E. Protection From COVID-19. DEUTSCHES ARZTEBLATT INTERNATIONAL 2021; 118:59-65. [PMID: 33785117 DOI: 10.3238/arztebl.m2021.0119] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 10/26/2020] [Accepted: 01/07/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Since the beginning of 2020 the SARS-CoV-2 virus has spread to nearly every country in the world. The mainly airborne pathogen has led to large numbers of deaths, principally in elderly and vulnerable segments of the population. Protective vaccines have recently become available, but it is not yet clear whether and when population-wide immunity will be achieved. The existence of evidence for the protective effect of masks covering the mouth and nose is a topic of public debate. METHODS A selective literature search was carried out in PubMed. Data from the German Robert Koch Institute and the Centers for Disease Control and Prevention were also taken into account. RESULTS When talking, as many as 20 000 droplets ranging in size from 20 to 500 μM are released every second. According to PCR tests, the amount of virus exhaled is highest immediately before the onset of symptoms. No randomized trials have been conducted on the effect of masks covering the mouth and nose. A metaanalysis of 29 studies on infection with SARS-CoV-2, SARS, or MERS revealed that type N-95 masks (corresponding approximately to FFP-2), surgical masks, or similar multilayer cotton masks can greatly reduce the infection risk for the wearers (RR 0.34 [0.26; 0.45], with moderate heterogeneity [I2 = 48%]). Model experiments and case reports suggest that masks covering the mouth and nose afford considerable protection against transmission of SARS-CoV-2 and other airborne diseases by reducing release of and exposure to potentially infectious droplets; in addition, infections that do occur take a milder course. A limitation of the studies analyzed is that in most cases, this effect cannot be viewed in isolation from the protective impact of other measures (distancing, hygiene precautions). CONCLUSION It can plausibly be assumed that consistent use of masks covering the mouth and nose can play an important role in containing the spread of SARSCoV- 2.
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Affiliation(s)
- Christoph Josef Hemmer
- Department of Tropical Medicine and Infectious Diseases, Rostock University Medical CenterDepartment of Microbiology & Virology, Brandenburg Medical School Theodor FontaneInstitute for Implant Technology and Biomaterials (IIB); Rostock University Medical Center
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Knowledge and Perception of COVID-19 Pandemic during the First Wave (Feb-May 2020): A Cross-Sectional Study among Italian Healthcare Workers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073767. [PMID: 33916577 PMCID: PMC8038455 DOI: 10.3390/ijerph18073767] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 04/01/2021] [Accepted: 04/01/2021] [Indexed: 01/08/2023]
Abstract
Italy was the first country in Europe to face the coronavirus pandemic. The aim of the study was to analyze healthcare workers’ (HCWs) level of information, practice, and risk perception towards COVID-19. We set up a cross-sectional study through SurveyMonkey® and distributed the link through Facebook and Whatsapp closed groups. The research instrument was a 31 items questionnaire distributed using Facebook and Whatsapp. It was conducted in Italy from February to May 2020. The study participants were general practitioners, pediatricians and other health professionals. A total of 958 participants were included: 320 (33.4%) general practitioners, 248 (25.9%) pediatricians and 390 (40.7%) other health professionals. The highest response rate was from Northern Italy (48.1%), followed by Central Italy (29.9%) and Southern Italy (22.0%). Less than a half (46%) of respondents felt they had a good level of information of COVID-19 case definition and of national prevention guidelines. Respondents reported to have changed their clinical practice; particularly, they increased the use of masks (87.1%, p < 0.001), disinfection and sanitization of doctors’ offices (75.8%, p < 0.001), the use of protective glasses (71.2%, p < 0.001), alcoholic hand solution (71.2%, p < 0.001), and hand washing (31.8%, p = 0.028). HCWs are at high risk of infection; less than a half of them felt adequately prepared to face COVID-19 pandemic, so they need extensive information and awareness of the disease to take adequate precautionary measures, and they are crucial to disseminate good practices.
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Santana López BN, Santana-Padilla YG, González-Martín JM, Santana-Cabrera L. Attitudes and beliefs of Spanish healthcare professionals during the COVID-19 pandemic. Sci Prog 2021; 104:368504211003775. [PMID: 33848209 PMCID: PMC10454773 DOI: 10.1177/00368504211003775] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
During the COVID-19 pandemic, healthcare professionals are taking the risk of becoming infected or infecting their families. Spain is the country with the highest number of infected healthcare professionals worldwide. Our aim was to study the attitudes and beliefs of these professionals during the current pandemic. Descriptive study conducted by using an online questionnaire-based on an earlier one-which was sent to healthcare professionals at the national level, during the week March 20-27, 2020. Healthcare professionals returned 971 completed questionnaires. A total of 803 (82.7%) participants thought that they did not have suitable PPEs (Personal Protective Equipment) to protect them from infection with COVID-19. In addition, even 229 (23.58%) agreed to go on working even if they were not. In spite of this, 606 (62.4%) of them were ready to work, even with a higher-than-usual risk of becoming infected at work and getting ill. Remarkably high professional commitment has been observed among Spanish healthcare workers in the current pandemic. They were ready to work even when many of them considered that they did not have suitable PPEs, and were thus taking a higher than usual infection risk. However, they put the health of their relatives before their duties at work.
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Affiliation(s)
- Borja Nicolás Santana López
- Intensive Care Unit, Complejo Hospitalario Universitario Insular Materno Infantil de Gran Canaria, Las Palmas de Gran Canaria, Canarias, Spain
| | - Yeray G. Santana-Padilla
- Surgery Unit, Complejo Hospitalario Universitario Insular Materno Infantil de Gran Canaria, Las Palmas de Gran Canaria, Islas Canarias, Spain
| | - Jesús M. González-Martín
- Research Support, Complejo Hospitalario Universitario Insular Materno Infantil de Gran Canaria, Las Palmas de Gran Canaria, Canarias, Spain
| | - Luciano Santana-Cabrera
- Intensive Care Unit, Complejo Hospitalario Universitario Insular Materno Infantil de Gran Canaria, Las Palmas de Gran Canaria, Canarias, Spain
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Morris CR, Sullivan P, Mantus G, Sanchez T, Zlotorzynska M, Hanberry B, Iyer S, Heilman S, Camacho-Gonzalez A, Figueroa J, Manoranjithan S, Leake D, Mendis R, Cleeton R, Chen C, Krieger R, Bush P, Hughes T, Little WK, Suthar MS, Wrammert J, Vos MB. Prevalence of SARS-CoV-2 antibodies in pediatric healthcare workers. Int J Infect Dis 2021; 105:474-481. [PMID: 33722686 PMCID: PMC7952267 DOI: 10.1016/j.ijid.2021.03.017] [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: 01/17/2021] [Revised: 02/28/2021] [Accepted: 03/08/2021] [Indexed: 01/08/2023] Open
Abstract
Objectives To determine SARS-CoV-2-antibody prevalence in pediatric healthcare workers (pHCWs). Design Baseline prevalence of anti-SARS-CoV-2-IgG was assessed in a prospective cohort study from a large pediatric healthcare facility. Prior SARS-CoV-2 testing history, potential risk factors and anxiety level about COVID-19 were determined. Prevalence difference between emergency department (ED)-based and non-ED-pHCWs was modeled controlling for those covariates. Chi-square test-for-trend was used to examine prevalence by month of enrollment. Results Most of 642 pHCWs enrolled were 31-40years, female and had no comorbidities. Half had children in their home, 49% had traveled, 42% reported an illness since January, 31% had a known COVID-19 exposure, and 8% had SARS-CoV-2 PCR testing. High COVID-19 pandemic anxiety was reported by 71%. Anti-SARS-CoV-2-IgG prevalence was 4.1%; 8.4% among ED versus 2.0% among non-ED pHCWs (p < 0.001). ED-work location and known COVID-19 exposure were independent risk factors. 31% of antibody-positive pHCWs reported no symptoms. Prevalence significantly (p < 0.001) increased from 3.0% in April–June to 12.7% in July–August. Conclusions Anti-SARS-CoV-2-IgG prevalence was low in pHCWs but increased rapidly over time. Both working in the ED and exposure to a COVID-19-positive contact were associated with antibody-seropositivity. Ongoing universal PPE utilization is essential. These data may guide vaccination policies to protect front-line workers.
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Affiliation(s)
- Claudia R Morris
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States; Children's Healthcare of Atlanta, Atlanta, GA, United States; Center for Clinical and Translational Research, of Children's Healthcare of Atlanta and Emory University, Atlanta, GA, United States.
| | - Patrick Sullivan
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Grace Mantus
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States
| | - Travis Sanchez
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Maria Zlotorzynska
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Bradley Hanberry
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States
| | - Srikant Iyer
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States; Children's Healthcare of Atlanta, Atlanta, GA, United States
| | - Stacy Heilman
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States
| | - Andres Camacho-Gonzalez
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States; Children's Healthcare of Atlanta, Atlanta, GA, United States; Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and Emory University, Atlanta, GA, United States
| | - Janet Figueroa
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States
| | | | - Deborah Leake
- Children's Healthcare of Atlanta, Atlanta, GA, United States
| | - Reshika Mendis
- Children's Healthcare of Atlanta, Atlanta, GA, United States
| | - Rebecca Cleeton
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States
| | - Christie Chen
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States
| | - Rachel Krieger
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States
| | - Patricia Bush
- Children's Healthcare of Atlanta, Atlanta, GA, United States
| | - Tiffany Hughes
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States
| | - Wendalyn K Little
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States; Children's Healthcare of Atlanta, Atlanta, GA, United States
| | - Mehul S Suthar
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States; Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and Emory University, Atlanta, GA, United States
| | - Jens Wrammert
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States; Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and Emory University, Atlanta, GA, United States
| | - Miriam B Vos
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States; Children's Healthcare of Atlanta, Atlanta, GA, United States; Center for Clinical and Translational Research, of Children's Healthcare of Atlanta and Emory University, Atlanta, GA, United States
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Abstract
Purpose: The aim of the current study was to investigate the prevalence of face mask wearing among different groups of people in south Iran. We also investigated the associations between mask wearing hesitancy and various factors. Methods: We surveyed a sample (convenience sampling) of 5 groups of people: general population, people with epilepsy, people with diabetes mellitus (DM), people with cardiac problems, and people with psychiatric problems. The survey included 4 general questions (age, sex, education, and medical/psychiatric problem) and 4 coronavirus disease 2019 (COVID-19)-specific questions (contracting COVID-19, relatives with COVID-19, wearing a face mask while in crowded places, and the frequency of daily hand washings). Results: A total of 582 people (153 people with epilepsy, 127 patients with DM, 98 people with cardiac problems, 96 patients with psychiatric disorders, and 108 healthy individuals) participated. Twenty-eight (4.8%) people expressed that they do not wear a face mask when at crowded places. A lower education and less frequent daily hand washings had associations with mask wearing hesitancy. Conclusions: Mask wearing hesitancy is a concern during a respiratory viral disease pandemic. Paying attention to personal variables, especially if they are modifiable (eg, education and hygiene), is probably productive and practical in promoting mask wearing culture.
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Mastropasqua L, Lanzini M, Brescia L, D'Aloisio R, Nubile M, Ciancaglini M, D'Amario C, Agnifili L, Mastropasqua R. Face Mask-Related Ocular Surface Modifications During COVID-19 Pandemic: A Clinical, In Vivo Confocal Microscopy, and Immune-Cytology Study. Transl Vis Sci Technol 2021; 10:22. [PMID: 34003957 PMCID: PMC7991958 DOI: 10.1167/tvst.10.3.22] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 02/14/2021] [Indexed: 01/09/2023] Open
Abstract
Purpose The purpose of this study was to describe the face mask (FM)-related ocular surface changes using clinical tests, in vivo confocal microscopy (IVCM) and impression cytology (IC), and to investigate the Dry Eye-related Quality of life Score (DEQS). Methods Sixty-six patients with dry eye disease (DED) and 62 healthy subjects (group 2) using FM were enrolled. Groups were divided into: groups 1A and 2A: < 3 hours of FM wear; groups 1B and 2B: 3 to 6 hours; and groups 1C and 2C: > 6 hours. Patients underwent DEQS questionnaire, break-up time (BUT), Schirmer test I (STI), fluorescein and lissamine staining (FS and LS), IVCM to determine corneal dendritic cell density (DCD) and goblet cell density (GCD), and IC to measure HLA-DR, at baseline and after 3 months. Results FM use duration before enrollment was 27 ± 2.3 and 30 ± 4.1 (days ± SD) for groups 1 and 2 (P > 0.05). After 3 months, DEQS worsened in groups 1B and 1C, STI in groups 1A to 1C, FS and LS in group 1C (P < 0.05); in controls, BUT and FS worsened only in group 2C (P < 0.05). DCD significantly increased in groups 1A to 1C and HLA-DR in groups 1B and 1C (P < 0.05), whereas GCD did not significantly change. DCD and HLA-DR increased only in group 2C (P < 0.05). DEQS significantly correlated with DCD (P = 0.05, r = 0.698; P < 0.001, r = 0.832) and HLA-DR (P = 0.043, r = -0.687; P < 0.001, r = 0.861) at baseline and 3 months. Conclusions Use of FM increases ocular surface inflammation and negatively impacts the quality of life in patients with DED. Translational Relevance The study of the prolonged use of FM effects may be relevant to managing DED.
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Affiliation(s)
- Leonardo Mastropasqua
- Ophthalmology Clinic, Department of Medicine and Aging Science, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Manuela Lanzini
- Ophthalmology Clinic, Department of Medicine and Aging Science, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Lorenza Brescia
- Ophthalmology Clinic, Department of Medicine and Aging Science, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Rossella D'Aloisio
- Ophthalmology Clinic, Department of Medicine and Aging Science, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Mario Nubile
- Ophthalmology Clinic, Department of Medicine and Aging Science, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Marco Ciancaglini
- Eye Clinic, San Salvatore Hospital, University of L'Aquila, L'Aquila, Italy
| | | | - Luca Agnifili
- Ophthalmology Clinic, Department of Medicine and Aging Science, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Rodolfo Mastropasqua
- Institute of Ophthalmology, University of Modena and Reggio Emilia, Modena, Italy
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Narayanan SR, Yang S. Airborne transmission of virus-laden aerosols inside a music classroom: Effects of portable purifiers and aerosol injection rates. PHYSICS OF FLUIDS (WOODBURY, N.Y. : 1994) 2021; 33:033307. [PMID: 33746493 PMCID: PMC7978150 DOI: 10.1063/5.0042474] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 01/18/2021] [Indexed: 05/04/2023]
Abstract
The ongoing COVID-19 pandemic has shifted attention to the airborne transmission of exhaled droplet nuclei within indoor environments. The spread of aerosols through singing and musical instruments in music performances has necessitated precautionary methods such as masks and portable purifiers. This study investigates the effects of placing portable air purifiers at different locations inside a classroom and the effects of different aerosol injection rates (e.g., with and without masks, different musical instruments, and different injection modes). Aerosol deposition, airborne concentration, and removal are analyzed in this study. It was found that using purifiers could help in achieving ventilation rates close to the prescribed values by the World Health Organization, while also achieving aerosol removal times within the Center of Disease Control and Prevention recommended guidelines. This could help in deciding break periods between classroom sessions, which was around 25 min through this study. Moreover, proper placement of purifiers could offer significant advantages in reducing airborne aerosol numbers (offering several orders of magnitude higher aerosol removal when compared to nearly zero removal when having no purifiers), and improper placement of the purifiers could worsen the situation. This study suggests the purifier to be placed close to the injector to yield a benefit and away from the people to be protected. The injection rate was found to have an almost linear correlation with the average airborne aerosol suspension rate and deposition rate, which could be used to predict the trends for scenarios with other injection rates.
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Affiliation(s)
- Sai Ranjeet Narayanan
- Department of Mechanical Engineering, University of Minnesota–Twin
Cities, Minneapolis, Minnesota 55455, USA
| | - Suo Yang
- Department of Mechanical Engineering, University of Minnesota–Twin
Cities, Minneapolis, Minnesota 55455, USA
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Benzian H, Beltrán-Aguilar E, Niederman R. Systemic Management of Pandemic Risks in Dental Practice: A Consolidated Framework for COVID-19 Control in Dentistry. Front Med (Lausanne) 2021; 8:644515. [PMID: 33718412 PMCID: PMC7943457 DOI: 10.3389/fmed.2021.644515] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 02/08/2021] [Indexed: 12/12/2022] Open
Abstract
Dental teams and their workplaces are among the most exposed to airborne and bloodborne infectious agents, and therefore at the forefront of pandemic-related changes to how dental care is organized and provided to patients. The increasing complexity of guidelines makes is challenging for clinicians to navigate the multitude of COVID-19 guidelines issued by different agencies. A comparative analysis of guidance issued for managing COVID-19 in dental settings leading U.S. agencies was conducted, including documents of the Occupational Safety and Health Administration (OSHA), an agency of the U.S. Secretary of Labor, and of the U.S. Centers for Disease Prevention and Control (CDC), an agency of the U.S. Secretary of Health and Human Services. Details of infection control and other risk mitigation measures were reviewed for consistency, overlaps and similarities, then clustered according to thematic areas covering all domains of managing a dental healthcare setting. The analysis revealed five distinct areas of pandemic control, comprising (1) planning and protocols, (2) patient screening, (3) preparation of facilities, (4) PPE and infection control, and (5) procedures and aerosol control; thereby covering systematically all aspects requiring adaptation in a pandemic context. The "Pandemic-5 Framework for COVID-19 Control in Dentistry" provides an opportunity to simplify comprehensive decision-making from a clinical practitioner perspective. The framework supports a comprehensive systems-driven approach by using dental clinics as a setting to integrate pandemic clinical responses with the implementation of appropriate infection control protocols. Traditionally these two aspects are addressed independently from each other in separate concepts.
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Affiliation(s)
- Habib Benzian
- Department Epidemiology and Health Promotion, World Health Organization Collaborating Center Quality Improvement and Evidence-Based Dentistry, College of Dentistry, New York University, New York, NY, United States
- Global Health Center, Geneva Graduate Institute for Policy Studies, Geneva, Switzerland
| | - Eugenio Beltrán-Aguilar
- Department Epidemiology and Health Promotion, World Health Organization Collaborating Center Quality Improvement and Evidence-Based Dentistry, College of Dentistry, New York University, New York, NY, United States
| | - Richard Niederman
- Department Epidemiology and Health Promotion, College of Dentistry, New York University, New York, NY, United States
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Markey AL, Leong SC, Vaughan C. Droplet and bone dust contamination from high-speed drilling during mastoidectomy. Clin Otolaryngol 2021; 46:614-618. [PMID: 33533176 DOI: 10.1111/coa.13725] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 01/05/2021] [Accepted: 01/16/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The aim of this study was to examine contamination from otolaryngologic procedures involving high-speed drilling, specifically mastoid surgery, and to assess the adequacy of PPE in such procedures. DESIGN AND SETTING Mastoid surgery was simulated in a dry laboratory using a plastic temporal bone, microscope and handheld drill with irrigation and suction. Comparisons of distance of droplet and bone dust contamination and surgeon contamination were made under differing conditions. Irrigation speed, use of microscope and drill burr size and type were compared. MAIN OUTCOME MEASURES Measurement of the distance of field contamination while performing simulated mastoidectomy and location of surgeon contamination. RESULTS There was a greater distance field contamination and surgeon contamination without the use of the microscope. Contamination was reduced by using a smaller drill burr and by using a diamond burr when compared to a cutting burr. The use of goggles and a face mask provided good protection for the surgeon. However, the microscope alone may provide sufficient protection to negate the need for goggles. CONCLUSIONS While the risks of performing mastoid surgery during the coronavirus pandemic cannot be completely removed, they can be mitigated. Such factors include using the microscope for all drilling, using smaller size drill burrs and creating a safe zone around the operating table.
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Affiliation(s)
- Anne L Markey
- Liverpool Head and Neck Centre, Royal Liverpool and Broadgreen University Hospital, Liverpool University Hospitals Foundation Trust, Liverpool, UK
| | - Samuel C Leong
- Liverpool Head and Neck Centre, Aintree University Hospital, Liverpool University Hospitals Foundation Trust, Liverpool, UK.,Department of Clinical Sciences, Liverpool School of tropical Medicine, Liverpool, UK
| | - Casey Vaughan
- Liverpool Head and Neck Centre, Royal Liverpool and Broadgreen University Hospital, Liverpool University Hospitals Foundation Trust, Liverpool, UK
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Moreno T, Pintó RM, Bosch A, Moreno N, Alastuey A, Minguillón MC, Anfruns-Estrada E, Guix S, Fuentes C, Buonanno G, Stabile L, Morawska L, Querol X. Tracing surface and airborne SARS-CoV-2 RNA inside public buses and subway trains. ENVIRONMENT INTERNATIONAL 2021; 147:106326. [PMID: 33340987 PMCID: PMC7723781 DOI: 10.1016/j.envint.2020.106326] [Citation(s) in RCA: 82] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 12/02/2020] [Accepted: 12/03/2020] [Indexed: 05/03/2023]
Abstract
Given the widespread concern but general lack of information over the possibility of SARS-CoV-2 infection in public transport, key issues such as passenger personal hygiene, efficient air circulation systems, and the effective disinfection of frequently touched surfaces need to be evaluated to educate the public and diminish the risk of viral transmission as we learn to live with the ongoing pandemic. In this context we report on a study involving the collection of 99 samples taken from inside Barcelona buses and subway trains in May to July 2020. From this sample group 82 (58 surface swabs, 9 air conditioning (a/c) filters, 3 a/c dust, 12 ambient air) were selected to be analysed by RT-PCR for traces of the SARS-CoV-2 virus. Thirty of these selected samples showed evidence for one or more of 3 target RNA gene regions specific for this virus (IP2, IP4, E). Most (24) of these 30 samples showed positivity for only 1 of the 3 RNA targets, 4 samples yielded 2 targets, and 2 samples provided evidence for all 3 targets. RNA remnants were more common in surface swabs from support bars (23 out of 58) than in ambient air inside the vehicles (3 out of 12), with relatively higher concentrations of viral RNA fragments in buses rather than in trains. Whereas subway train a/c filters examined were all virus-free, 4 of the 9 bus a/c filter/dust samples yielded evidence for viral RNA. After nocturnal maintenance and cleaning most buses initially yielding positive results subsequently showed elimination of the RT-PCR signal, although signs of viral RNA remained in 4 of 13 initially positive samples. The presence of such remnant viral traces however does not demonstrate infectivity, which in the present study is considered unlikely given the fragmentary nature of the gene targets detected. Nevertheless, best practice demands that close attention to ventilation systems and regular vehicle disinfection in public transport worldwide need to be rigorously applied to be effective at eliminating traces of the virus throughout the vehicle, especially at times when COVID-19 cases are peaking. Additionally, infectivity tests should be implemented to evaluate the efficiency of disinfection procedures to complement the information resulting from RT-PCR analysis. Modelling the probability of infection whilst travelling in buses under different scenarios indicates that forced ventilation greatly reduces the risk.
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Affiliation(s)
- Teresa Moreno
- Institute of Environmental Assessment and Water Research (IDAEA), Spanish Research Council (CSIC), C/Jordi Girona 18-26, 08034 Barcelona, Spain
| | - Rosa María Pintó
- Enteric Virus Laboratory, Dep. Genetics, Microbiology and Statistics, University of Barcelona, Avda. Diagonal 643, 08028 Barcelona, Spain
| | - Albert Bosch
- Enteric Virus Laboratory, Dep. Genetics, Microbiology and Statistics, University of Barcelona, Avda. Diagonal 643, 08028 Barcelona, Spain
| | - Natalia Moreno
- Institute of Environmental Assessment and Water Research (IDAEA), Spanish Research Council (CSIC), C/Jordi Girona 18-26, 08034 Barcelona, Spain
| | - Andrés Alastuey
- Institute of Environmental Assessment and Water Research (IDAEA), Spanish Research Council (CSIC), C/Jordi Girona 18-26, 08034 Barcelona, Spain
| | - María Cruz Minguillón
- Institute of Environmental Assessment and Water Research (IDAEA), Spanish Research Council (CSIC), C/Jordi Girona 18-26, 08034 Barcelona, Spain
| | - Eduard Anfruns-Estrada
- Enteric Virus Laboratory, Dep. Genetics, Microbiology and Statistics, University of Barcelona, Avda. Diagonal 643, 08028 Barcelona, Spain
| | - Susana Guix
- Enteric Virus Laboratory, Dep. Genetics, Microbiology and Statistics, University of Barcelona, Avda. Diagonal 643, 08028 Barcelona, Spain
| | - Cristina Fuentes
- Enteric Virus Laboratory, Dep. Genetics, Microbiology and Statistics, University of Barcelona, Avda. Diagonal 643, 08028 Barcelona, Spain
| | - Giorgio Buonanno
- Department of Civil and Mechanical Engineering, University of Cassino and Southern Lazio, Cassino, Italy; International Laboratory for Air Quality and Health, Queensland University of Technology, Brisbane, Australia
| | - Luca Stabile
- Department of Civil and Mechanical Engineering, University of Cassino and Southern Lazio, Cassino, Italy
| | - Lidia Morawska
- International Laboratory for Air Quality and Health, Queensland University of Technology, Brisbane, Australia
| | - Xavier Querol
- Institute of Environmental Assessment and Water Research (IDAEA), Spanish Research Council (CSIC), C/Jordi Girona 18-26, 08034 Barcelona, Spain
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123
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Abbas M, Robalo Nunes T, Martischang R, Zingg W, Iten A, Pittet D, Harbarth S. Nosocomial transmission and outbreaks of coronavirus disease 2019: the need to protect both patients and healthcare workers. Antimicrob Resist Infect Control 2021; 10:7. [PMID: 33407833 PMCID: PMC7787623 DOI: 10.1186/s13756-020-00875-7] [Citation(s) in RCA: 166] [Impact Index Per Article: 55.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 12/22/2020] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVES To compile current published reports on nosocomial outbreaks of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), evaluate the role of healthcare workers (HCWs) in transmission, and evaluate outbreak management practices. METHODS Narrative literature review. SHORT CONCLUSION The coronavirus disease 2019 (COVID-19) pandemic has placed a large burden on hospitals and healthcare providers worldwide, which increases the risk of nosocomial transmission and outbreaks to "non-COVID" patients or residents, who represent the highest-risk population in terms of mortality, as well as HCWs. To date, there are several reports on nosocomial outbreaks of SARS-CoV-2, and although the attack rate is variable, it can be as high as 60%, with high mortality. There is currently little evidence on transmission dynamics, particularly using genomic sequencing, and the role of HCWs in initiating or amplifying nosocomial outbreaks is not elucidated. There has been a paradigm shift in management practices of viral respiratory outbreaks, that includes widespread testing of patients (or residents) and HCWs, including asymptomatic individuals. These expanded testing criteria appear to be crucial in identifying and controlling outbreaks.
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Affiliation(s)
- Mohamed Abbas
- Infection Control Programme, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.
- Health Protection Research Unit, Imperial College London, London, UK.
| | - Tomás Robalo Nunes
- Infection Control Programme, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
- Infectious Diseases Service, Hospital Garcia de Orta, EPE, Almada, Portugal
| | - Romain Martischang
- Infection Control Programme, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Walter Zingg
- Infection Control Programme, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
- Infectious Diseases Service, Hospital Garcia de Orta, EPE, Almada, Portugal
- University of Geneva, Geneva, Switzerland
| | - Anne Iten
- Infection Control Programme, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Didier Pittet
- Infection Control Programme, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
- Infectious Diseases Service, Hospital Garcia de Orta, EPE, Almada, Portugal
- University of Geneva, Geneva, Switzerland
| | - Stephan Harbarth
- Infection Control Programme, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
- Infectious Diseases Service, Hospital Garcia de Orta, EPE, Almada, Portugal
- University of Geneva, Geneva, Switzerland
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124
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He R, Gao L, Trifonov M, Hong J. Aerosol generation from different wind instruments. JOURNAL OF AEROSOL SCIENCE 2021; 151:105669. [PMID: 32952210 PMCID: PMC7492159 DOI: 10.1016/j.jaerosci.2020.105669] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 09/07/2020] [Accepted: 09/07/2020] [Indexed: 05/21/2023]
Abstract
The potential airborne transmission of COVID-19 has raised significant concerns regarding the safety of musical activities involving wind instruments. However, currently, there is a lack of systematic study and quantitative information of the aerosol generation during these instruments, which is crucial for offering risk assessment and the corresponding mitigation strategies for the reopening of these activities. Collaborating with 15 musicians from the Minnesota Orchestra, we conduct a systematic study of the aerosol generation from a large variety of wind instruments under different music dynamic levels and articulation patterns. We find that the aerosol concentration from different brass and woodwinds exhibits two orders of magnitude variation. Accordingly, we categorize the instruments into low (tuba), intermediate (bassoon, piccolo, flute, bass clarinet, French horn, and clarinet) and high risk (trumpet, bass trombone, and oboe) levels based on a comparison of their aerosol generation with those from normal breathing and speaking. In addition, we observe that the aerosol generation can be affected by the changing dynamic level, articulation pattern, the normal respiratory behaviors of individuals, and even the usage of some special techniques during the instrument play. However, such effects vary substantially for different types of instrument, depending on specific breathing techniques as well as the tube structure and inlet design of the instrument. Overall, our findings can bring insights into the risk assessment of airborne decrease transmission and the corresponding mitigation strategies for various musical activities involving wind instrument plays, including orchestras, community and worship bands, music classes, etc.
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Affiliation(s)
- Ruichen He
- Department of Mechanical Engineering, University of Minnesota, Minneapolis, MN, 55414, USA
| | - Linyue Gao
- Saint Anthony Falls Laboratory, University of Minnesota, Minneapolis, MN, 55414, USA
| | - Maximilian Trifonov
- Department of Mechanical Engineering, University of Minnesota, Minneapolis, MN, 55414, USA
| | - Jiarong Hong
- Department of Mechanical Engineering, University of Minnesota, Minneapolis, MN, 55414, USA
- Saint Anthony Falls Laboratory, University of Minnesota, Minneapolis, MN, 55414, USA
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125
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Bartlett SL, Diel DG, Wang L, Zec S, Laverack M, Martins M, Caserta LC, Killian ML, Terio K, Olmstead C, Delaney MA, Stokol T, Ivančić M, Jenkins-Moore M, Ingerman K, Teegan T, McCann C, Thomas P, McAloose D, Sykes JM, Calle PP. SARS-COV-2 INFECTION AND LONGITUDINAL FECAL SCREENING IN MALAYAN TIGERS ( PANTHERA TIGRIS JACKSONI), AMUR TIGERS ( PANTHERA TIGRIS ALTAICA ), AND AFRICAN LIONS ( PANTHERA LEO KRUGERI) AT THE BRONX ZOO, NEW YORK, USA. J Zoo Wildl Med 2021; 51:733-744. [PMID: 33480553 DOI: 10.1638/2020-0171] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2020] [Indexed: 02/07/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) emerged as the cause of a global pandemic in 2019-2020. In March 2020, New York City became the epicenter in the United States for the pandemic. On 27 March 2020, a Malayan tiger (Panthera tigris jacksoni) at the Bronx Zoo in New York City developed a cough and wheezing with subsequent inappetence. Over the next week, an additional Malayan tiger and two Amur tigers (Panthera tigris altaica) in the same building and three lions (Panthera leo krugeri) in a separate building also became ill. The index case was anesthetized for diagnostic workup. Physical examination and bloodwork results were unremarkable. Thoracic radiography and ultrasonography revealed a bronchial pattern with peribronchial cuffing and mild lung consolidation with alveolar-interstitial syndrome, respectively. SARS-CoV-2 RNA was identified by real-time, reverse transcriptase PCR (rRT-PCR) on oropharyngeal and nasal swabs and tracheal wash fluid. Cytologic examination of tracheal wash fluid revealed necrosis, and viral RNA was detected in necrotic cells by in situ hybridization, confirming virus-associated tissue damage. SARS-CoV-2 was isolated from the tracheal wash fluid of the index case, as well as the feces from one Amur tiger and one lion. Fecal viral RNA shedding was confirmed in all seven clinical cases and an asymptomatic Amur tiger. Respiratory signs abated within 1-5 days for most animals, although they persisted intermittently for 16 days in the index case. Fecal RNA shedding persisted for as long as 35 days beyond cessation of respiratory signs. This case series describes the clinical presentation, diagnostic evaluation, and management of tigers and lions infected with SARS-CoV-2 and describes the duration of viral RNA fecal shedding in these cases. This report documents the first known natural transmission of SARS-CoV-2 from humans to nondomestic felids.
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Affiliation(s)
| | - Diego G Diel
- Department of Population Medicine and Diagnostic Sciences, Animal Health Diagnostic Center, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA
| | - Leyi Wang
- Veterinary Diagnostic Laboratory, College of Veterinary Medicine, University of Illinois, Urbana, IL 61802, USA
| | | | - Melissa Laverack
- Department of Population Medicine and Diagnostic Sciences, Animal Health Diagnostic Center, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA
| | - Mathias Martins
- Department of Population Medicine and Diagnostic Sciences, Animal Health Diagnostic Center, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA
| | - Leonardo Cardia Caserta
- Department of Population Medicine and Diagnostic Sciences, Animal Health Diagnostic Center, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA
| | - Mary Lea Killian
- National Veterinary Services Laboratories, Veterinary Services, United States Department of Agriculture, Ames, IA 50010, USA
| | - Karen Terio
- Zoological Pathology Program, College of Veterinary Medicine, University of Illinois, Brookfield, IL 60513, USA
| | - Colleen Olmstead
- Veterinary Diagnostic Laboratory, College of Veterinary Medicine, University of Illinois, Urbana, IL 61802, USA
| | - Martha A Delaney
- Zoological Pathology Program, College of Veterinary Medicine, University of Illinois, Brookfield, IL 60513, USA
| | - Tracy Stokol
- Department of Population Medicine and Diagnostic Sciences, Animal Health Diagnostic Center, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA
| | | | - Melinda Jenkins-Moore
- National Veterinary Services Laboratories, Veterinary Services, United States Department of Agriculture, Ames, IA 50010, USA
| | | | - Taryn Teegan
- Wildlife Conservation Society, Bronx, NY 10460, USA
| | | | | | | | - John M Sykes
- Wildlife Conservation Society, Bronx, NY 10460, USA
| | - Paul P Calle
- Wildlife Conservation Society, Bronx, NY 10460, USA
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126
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Pal M, Musib D, Roy M. Transition metal complexes as potential tools against SARS-CoV-2: an in silicoapproach. NEW J CHEM 2021. [DOI: 10.1039/d0nj04578k] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Screening of selected transition metal-based antiviral agents,in silico, predicted the potential inhibition of RNA-dependent RNA polymerase (RdRp) of SARS-CoV-2 which emerged as the potential drug candidate for COVID-19.
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Affiliation(s)
- Maynak Pal
- Department of Chemistry
- National Institute of Technology Manipur
- Imphal
- India
| | - Dulal Musib
- Department of Chemistry
- National Institute of Technology Manipur
- Imphal
- India
| | - Mithun Roy
- Department of Chemistry
- National Institute of Technology Manipur
- Imphal
- India
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127
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Zhang XS, Duchaine C. SARS-CoV-2 and Health Care Worker Protection in Low-Risk Settings: a Review of Modes of Transmission and a Novel Airborne Model Involving Inhalable Particles. Clin Microbiol Rev 2020; 34:e00184-20. [PMID: 33115724 PMCID: PMC7605309 DOI: 10.1128/cmr.00184-20] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Since the beginning of the COVID-19 pandemic, there has been intense debate over SARS-CoV-2's mode of transmission and appropriate personal protective equipment for health care workers in low-risk settings. The objective of this review is to identify and appraise the available evidence (clinical trials and laboratory studies on masks and respirators, epidemiological studies, and air sampling studies), clarify key concepts and necessary conditions for airborne transmission, and shed light on knowledge gaps in the field. We find that, except for aerosol-generating procedures, the overall data in support of airborne transmission-taken in its traditional definition (long-distance and respirable aerosols)-are weak, based predominantly on indirect and experimental rather than clinical or epidemiological evidence. Consequently, we propose a revised and broader definition of "airborne," going beyond the current droplet and aerosol dichotomy and involving short-range inhalable particles, supported by data targeting the nose as the main viral receptor site. This new model better explains clinical observations, especially in the context of close and prolonged contacts between health care workers and patients, and reconciles seemingly contradictory data in the SARS-CoV-2 literature. The model also carries important implications for personal protective equipment and environmental controls, such as ventilation, in health care settings. However, further studies, especially clinical trials, are needed to complete the picture.
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Affiliation(s)
- X Sophie Zhang
- Department of General Medicine, CIUSSS Centre-Sud-de-l'Île-de-Montréal, Montreal, Canada
- CHSLD Bruchési and CHSLD Jean De La Lande, Montreal, Canada
- GMF-U Faubourgs, Montreal, Canada
- Centre de Recherche et d'Aide aux Narcomanes, Montreal, Canada
| | - Caroline Duchaine
- Department of Biochemistry, Microbiology, and Bioinformatics, Université Laval, Quebec City, Canada
- Quebec Heart and Lung Institute-Université Laval (CRIUCPQ), Quebec City, Canada
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128
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Colbourn T, Waites W, Manheim D, Foster D, Sturniolo S, Sculpher M, Kerr CC, Colbourn G, Bowie C, Godfrey KM, Peto J, Burgess RA, McCoy D, Alwan NA, Yao G, Ouyang K, Roderick PJ, Pizzo E, Hill T, McGrath N, Orcutt M, Evans O, Cheetham NJ, Bonell C, Gomes M, Panovska-Griffiths J, Raine R. Modelling the health and economic impacts of different testing and tracing strategies for COVID-19 in the UK. F1000Res 2020. [DOI: 10.12688/f1000research.27980.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Background: Coronavirus disease 2019 (COVID-19) is resurgent in the UK and health and economic costs of the epidemic continue to rise. There is a need to understand the health and economic costs of different courses of action. Methods: We combine modelling, economic analysis and a user-friendly interface to contrast the impact and costs of different testing strategies: two levels of testing within the current test-trace-isolate (TTI) strategy (testing symptomatic people, tracing and isolating everyone) and a strategy where TTI is combined with universal testing (UT; i.e. additional population testing to identify asymptomatic cases). We also model effective coverage of face masks. Results: Increased testing is necessary to suppress the virus after lockdown. Partial reopening accompanied by scaled-up TTI (at 50% test and trace levels), full isolation and moderately effective coverage of masks (30% reduction in overall transmission) can reduce the current resurgence of the virus and protect the economy in the UK. Additional UT from December 2020 reduces the epidemic dramatically by Jan 2021 when combined with enhanced TTI (70% test-trace levels) and full isolation. UT could then be stopped; continued TTI would prevent rapid recurrence. This TTI+UT combination can suppress the virus further to save ~20,000 more lives and avoid ~£90bn economic losses, though costs ~£8bn more to deliver. We assume that all traced and lab-confirmed cases are isolated. The flexible interface we have developed allows exploration of additional scenarios, including different levels of reopening of society after the second lockdown in England as well as different levels of effective mask coverage. Conclusions: Our findings suggest that increased TTI is necessary to suppress the virus and protect the economy after the second lockdown in England. Additional UT from December 2020 reduces the epidemic dramatically by Jan 2021 and could then be stopped, as continued TTI would prevent rapid recurrence.
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129
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Swaminathan R, Mukundadura BP, Prasad S. Impact of enhanced personal protective equipment on the physical and mental well-being of healthcare workers during COVID-19. Postgrad Med J 2020; 98:231-233. [PMID: 33273107 DOI: 10.1136/postgradmedj-2020-139150] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND The COVID-19 pandemic has necessitated the use of enhanced personal protective equipment (PPE) in healthcare workers in patient-facing roles. We describe the impact on the physical and mental well-being of healthcare professionals who use enhanced PPE consistently. METHODS We conducted a single-centre, cross-sectional study among healthcare professionals who use enhanced PPE. A web-based questionnaire was disseminated to evaluate the effects on individuals' physical and mental well-being. Physical and mental impact was assessed through a visual analogue scale. RESULTS Prospective analysis of the views of 72 respondents is reported. 63.9% were women and 36.1% were men. Physical impact included exhaustion, headache, skin changes, breathlessness and a negative impact on vision. Communication difficulties, somnolence, negative impact on overall performance and difficulties in using surgical instrumentation were reported. CONCLUSION Our study demonstrates the undeniable negative impact on the front-line healthcare workers using enhanced PPE and lays the ground for larger multicentric assessments given for it to potentially be the norm for the foreseeable future.
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Affiliation(s)
| | | | - Shashi Prasad
- Ear, Nose and Throat, University Hospital Coventry, Coventry, UK
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130
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Suppan M, Catho G, Robalo Nunes T, Sauvan V, Perez M, Graf C, Pittet D, Harbarth S, Abbas M, Suppan L. A Serious Game Designed to Promote Safe Behaviors Among Health Care Workers During the COVID-19 Pandemic: Development of "Escape COVID-19". JMIR Serious Games 2020; 8:e24986. [PMID: 33242312 PMCID: PMC7717924 DOI: 10.2196/24986] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 11/12/2020] [Accepted: 11/26/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND As many countries fear and even experience the emergence of a second wave of COVID-19, reminding health care workers (HCWs) and other hospital employees of the critical role they play in preventing SARS-CoV-2 transmission is more important than ever. Building and strengthening the intrinsic motivation of HCWs to apply infection prevention and control (IPC) guidelines to avoid contaminating their colleagues, patients, friends, and relatives is a goal that must be energetically pursued. A high rate of nosocomial infections during the first COVID-19 wave was detected by IPC specialists and further cemented their belief in the need for an engaging intervention that could improve compliance with COVID-19 safe behaviors. OBJECTIVE Our aim was to develop a serious game that would promote IPC practices with a specific focus on COVID-19 among HCWs and other hospital employees. METHODS The first 3 stages of the SERES framework were used to develop this serious game. A brainswarming session between developers and IPC specialists was used to identify the target audience and acquisition objectives. Nicholson's RECIPE mnemonic (reflection, engagement, choice, information, play, exposition) for meaningful gamification was used to guide the general design. A common and simple terminology was used to suit the broad target audience. The game was tested on various platforms (smartphones, tablets, laptops, desktop computers) by different users during each development loop and before its final release. RESULTS The game was designed to target all hospital staff who could be in direct contact with patients within the Geneva University Hospitals. In total, 10 acquisition objectives were defined by IPC specialists and implemented into the game according to the principles of meaningful gamification. A simple storyboard was first created using Microsoft PowerPoint and was progressively refined through multiple iteration loops. Articulate Storyline was then used to create two successive versions of the actual game. In the final version, a unique graphic atmosphere was created with help from a professional graphic designer. Feedback mechanisms were used extensively throughout the game to strengthen key IPC messages. CONCLUSIONS The SERES framework was successfully used to create "Escape COVID-19," a serious game designed to promote safe IPC practices among HCWs and other hospital employees during the COVID-19 pandemic. This game can be obtained free of charge for research and educational purposes. A SCORM (shareable content object reference model) package is available to facilitate results and completion tracking on most current learning management systems.
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Affiliation(s)
- Mélanie Suppan
- Division of Anesthesiology, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Gaud Catho
- Infection Control Program, WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Tomás Robalo Nunes
- Infection Control Program, WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
- Infectious Diseases Department, Hospital Garcia de Orta, EPE, Almada, Portugal
| | - Valérie Sauvan
- Infection Control Program, WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Monique Perez
- Infection Control Program, WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Christophe Graf
- Department of Rehabilitation and Geriatrics, Geneva University Hospital, Geneva, Switzerland
| | - Didier Pittet
- Infection Control Program, WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Stephan Harbarth
- Infection Control Program, WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Mohamed Abbas
- Infection Control Program, WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Laurent Suppan
- Division of Emergency Medicine, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
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131
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Çobanoğlu HB, Eskiizmir G, Gökcan MK. Respiratory Protective Equipment for Healthcare Providers During Coronavirus Pandemic: "Nec Temere, Nec Timide". Turk Arch Otorhinolaryngol 2020; 58:268-273. [PMID: 33554202 DOI: 10.5152/tao.2020.5999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 12/03/2020] [Indexed: 11/22/2022] Open
Abstract
In otorhinolaryngology-head and neck surgery, there are several routine and surgical procedures applied to the upper airway that generate droplets and/or aerosols. Therefore, otorhinolaryngology-head and neck surgeons are at higher risk of being exposed to viral content. The COVID-19 pandemic has shaken the world with approximately 30 million affected cases and more than 900.000 deaths officially reported in more than 200 countries/regions from March 11th, 2020 to date (September 12th, 2020). All healthcare providers working at the frontlines of the fight against the COVID-19 are at risk of contracting the virus. In this review, we discuss the efficacy of the different types of respiratory protective equipment and remind about the surgery-based respiratory protection strategies in otorhinolaryngology and head and neck surgeries in the light of the latest literature.
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Affiliation(s)
- H Bengü Çobanoğlu
- Department of Otorhinolaryngology-Head and Neck Surgery, Karadeniz Technical University School of Medicine, Trabzon, Turkey
| | - Görkem Eskiizmir
- Department of Otolaryngology-Head and Neck Surgery, Celal Bayar University School of Medicine, Manisa, Turkey
| | - Mustafa Kürşat Gökcan
- Department of Otorhinolaryngology-Head and Neck Surgery, Ankara University School of Medicine, Ankara, Turkey
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132
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Wang MY, Zhao R, Gao LJ, Gao XF, Wang DP, Cao JM. SARS-CoV-2: Structure, Biology, and Structure-Based Therapeutics Development. Front Cell Infect Microbiol 2020; 10:587269. [PMID: 33324574 PMCID: PMC7723891 DOI: 10.3389/fcimb.2020.587269] [Citation(s) in RCA: 459] [Impact Index Per Article: 114.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 10/26/2020] [Indexed: 01/18/2023] Open
Abstract
The pandemic of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been posing great threats to the world in many aspects. Effective therapeutic and preventive approaches including drugs and vaccines are still unavailable although they are in development. Comprehensive understandings on the life logic of SARS-CoV-2 and the interaction of the virus with hosts are fundamentally important in the fight against SARS-CoV-2. In this review, we briefly summarized the current advances in SARS-CoV-2 research, including the epidemic situation and epidemiological characteristics of the caused disease COVID-19. We further discussed the biology of SARS-CoV-2, including the origin, evolution, and receptor recognition mechanism of SARS-CoV-2. And particularly, we introduced the protein structures of SARS-CoV-2 and structure-based therapeutics development including antibodies, antiviral compounds, and vaccines, and indicated the limitations and perspectives of SARS-CoV-2 research. We wish the information provided by this review may be helpful to the global battle against SARS-CoV-2 infection.
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Affiliation(s)
| | | | | | | | - De-Ping Wang
- Key Laboratory of Cellular Physiology at Shanxi Medical University, Ministry of Education, Key Laboratory of Cellular Physiology of Shanxi Province, and the Department of Physiology, Shanxi Medical University, Taiyuan, China
| | - Ji-Min Cao
- Key Laboratory of Cellular Physiology at Shanxi Medical University, Ministry of Education, Key Laboratory of Cellular Physiology of Shanxi Province, and the Department of Physiology, Shanxi Medical University, Taiyuan, China
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Suppan L, Stuby L, Gartner B, Larribau R, Iten A, Abbas M, Harbarth S, Suppan M. Impact of an e-learning module on personal protective equipment knowledge in student paramedics: a randomized controlled trial. Antimicrob Resist Infect Control 2020; 9:185. [PMID: 33168097 PMCID: PMC7652675 DOI: 10.1186/s13756-020-00849-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 10/29/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Prehospital professionals such as emergency physicians or paramedics must be able to choose and adequately don and doff personal protective equipment (PPE) in order to avoid COVID-19 infection. Our aim was to evaluate the impact of a gamified e-learning module on adequacy of PPE in student paramedics. METHODS This was a web-based, randomized 1:1, parallel-group, triple-blind controlled trial. Student paramedics from three Swiss schools were invited to participate. They were informed they would be presented with both an e-learning module and an abridged version of the current regional prehospital COVID-19 guidelines, albeit not in which order. After a set of 22 questions designed to assess baseline knowledge, the control group was shown the guidelines before answering a set of 14 post-intervention questions. The e-learning group was shown the gamified e-learning module right after the guidelines, and before answering post-intervention questions. The primary outcome was the difference in the percentage of adequate choices of PPE before and after the intervention. RESULTS The participation rate was of 71% (98/138). A total of 90 answer sets was analyzed. Adequate choice of PPE increased significantly both in the control (50% [33;83] vs 25% [25;50], P = .013) and in the e-learning group (67% [50;83] vs 25% [25;50], P = .001) following the intervention. Though the median of the difference was higher in the e-learning group, there was no statistically significant superiority over the control (33% [0;58] vs 17% [- 17;42], P = .087). The e-learning module was of greatest benefit in the subgroup of student paramedics who were actively working in an ambulance company (42% [8;58] vs 25% [- 17;42], P = 0.021). There was no significant effect in student paramedics who were not actively working in an ambulance service (0% [- 25;33] vs 17% [- 8;50], P = .584). CONCLUSIONS The use of a gamified e-learning module increases the rate of adequate choice of PPE only among student paramedics actively working in an ambulance service. In this subgroup, combining this teaching modality with other interventions might help spare PPE and efficiently protect against COVID-19 infection.
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Affiliation(s)
- Laurent Suppan
- Division of Emergency Medicine, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva 14, Switzerland.
| | | | - Birgit Gartner
- Division of Emergency Medicine, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva 14, Switzerland
| | - Robert Larribau
- Division of Emergency Medicine, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva 14, Switzerland
| | - Anne Iten
- Infection Control Program and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Mohamed Abbas
- Infection Control Program and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Stephan Harbarth
- Infection Control Program and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Mélanie Suppan
- Division of Anesthesiology, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
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Epidemiological Investigation and Prevention Control Analysis of the Longitudinal Distribution of COVID-19 in Henan Province, China. mSphere 2020; 5:5/5/e00867-20. [PMID: 33028688 PMCID: PMC7568649 DOI: 10.1128/msphere.00867-20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Epidemic prevention and control in China have entered a new stage of normalization. This article analyzes the epidemiological characteristics of COVID-19 in Henan Province and summarizes the effective disease prevention and control means and measures at the prefecture level; the normalized private data provide a theoretical reference for the formulation and conduct of future prevention and control work. At the same time, these epidemic prevention and control findings can also be used for reference in other countries and regions. The objective was to analyze the longitudinal distribution, epidemiological characteristics, and local prevention and control measures of coronavirus disease 2019 (COVID-19) in six cities in Henan Province, China, from 21 January 2020 to 17 June 2020: Xinyang City (including Gushi County), Nanyang City (including Dengzhou City), Zhumadian City (including Xincai County), Zhengzhou City (including Gongyi City), Puyang City, and Anyang City (including Hua County). Data were collected and analyzed through the COVID-19 information published on the official websites of the health commissions in the six selected cities of Henan Province. As of 17 June 2020, the cumulative incidence rate of COVID-19 in Henan Province was 1.33/100,000, the cumulative cure rate was 98.27%, the cumulative mortality rate was 1.73%, the age range of diagnosed cases was 5 days to 85 years old, and the male-to-female ratio was 1.09:1. The confirmed cases of COVID-19 in Henan Province were mainly imported cases from Hubei, accounting for 87.74% of all cases, of which the highest proportion was 70.50% in Zhumadian. The contact cases and local cases increased in a fluctuating manner over time. In this paper, epidemiological characteristics of COVID-19 in Henan Province were analyzed from the onset of the outbreak to the effective control within 60 days, and effective and distinctive prevention and control measures in various cities were summarized to provide a favorable useful reference for the further formulation and implementation of epidemic prevention and control and a valuable theoretical basis for effectively avoiding a second outbreak. IMPORTANCE Epidemic prevention and control in China have entered a new stage of normalization. This article analyzes the epidemiological characteristics of COVID-19 in Henan Province and summarizes the effective disease prevention and control means and measures at the prefecture level; the normalized private data provide a theoretical reference for the formulation and conduct of future prevention and control work. At the same time, these epidemic prevention and control findings can also be used for reference in other countries and regions.
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Rutkowski JL. AAID White Paper: Guidance for Implant Practices During the COVID-19 Pandemic. J ORAL IMPLANTOL 2020; 46:453. [PMID: 33257993 DOI: 10.1563/aaid-joi-d-20-editorial.4605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Rutkowski JL, Camm DP, El Chaar E. AAID White Paper: Management of the Dental Implant Patient During the COVID-19 Pandemic and Beyond. J ORAL IMPLANTOL 2020; 46:454-466. [PMID: 32882035 DOI: 10.1563/aaid-joi-d-20-00316] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The scientific community's understanding of how the SARS-CoV-2 virus is transmitted and how to best mitigate its spread is improving daily. To help protect patients from acquiring COVID-19 from a dental office nosocomial infection, many state or local governments have classified dental treatments as "nonessential" and have paused routine dental care. Dentists have been instructed to perform only procedures designated as emergencies. Unfortunately, there is not a good understanding of what a dental emergency is among governmental leaders. What a government agency may perceive as an elective procedure may be seen as "essential" by the dental clinician responsible for maintaining the oral health of the patient. Each dental specialty understands the effects delayed care has on a patient's oral and systemic health. Dentistry has made extensive progress in improving oral health through prevention of the dental emergency. The dental profession must work together to prevent the reversal of the progress dentistry and patients have made. This American Academy of Implant Dentistry (AAID) White Paper discusses what COVID-19 is and how it impacts dental treatments, presents guidelines for dentistry in general and for dental implant related treatments, specifically. Recommendations for implant dentistry include the following: (1) what constitutes a dental implant related emergency, (2) how patients should be screened and triaged, (3) what personal protective equipment is necessary, (4) how operatories should be equipped, (5) what equipment should be used, and (6) what, when, and how procedures can be performed. This paper is intended to provide guidance for the dental implant practice so patients and dental health care providers can be safe, and offices can remain open and viable during the pandemic.
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Affiliation(s)
- James L Rutkowski
- Editor-in-Chief, Journal of Oral Implantology; University of Buffalo School of Dental Medicine, Buffalo, NY
| | | | - Edgard El Chaar
- College of Dentistry, New York University, New York, NY; private practice, New York, NY
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Ortiz-Martínez Y, Cabeza-Ruiz LD, Vásquez-Lozano SH, Villamil-Gómez WE, Rodriguez-Morales AJ. Pericarditis in a young internal medicine resident with COVID-19 in Colombia. Travel Med Infect Dis 2020; 37:101863. [PMID: 32866659 PMCID: PMC7453264 DOI: 10.1016/j.tmaid.2020.101863] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 08/21/2020] [Indexed: 11/18/2022]
Affiliation(s)
- Yeimer Ortiz-Martínez
- Department of Internal Medicine, Universidad Industrial de Santander - Hospital Universitario de Santander. Bucaramanga, Colombia; Latin American Network of Coronavirus Disease 2019-COVID-19 Research (LANCOVID-19), Pereira, Risaralda, Colombia
| | - Luis Daniel Cabeza-Ruiz
- Department of Internal Medicine, Universidad Industrial de Santander - Hospital Universitario de Santander, Bucaramanga, Colombia
| | - Sergio Humberto Vásquez-Lozano
- Department of Internal Medicine, Universidad Industrial de Santander - Hospital Universitario de Santander, Bucaramanga, Colombia
| | - Wilmer E Villamil-Gómez
- Latin American Network of Coronavirus Disease 2019-COVID-19 Research (LANCOVID-19), Pereira, Risaralda, Colombia; Infectious Diseases and Infection Control Research Group, Hospital Universitario de Sincelejo, Sincelejo, Sucre, Colombia; Programa Del Doctorado de Medicina Tropical, SUE Caribe, Universidad Del Atlántico, Barranquilla, Colombia
| | - Alfonso J Rodriguez-Morales
- Latin American Network of Coronavirus Disease 2019-COVID-19 Research (LANCOVID-19), Pereira, Risaralda, Colombia; Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnologica de Pereira, Pereira, Risaralda, Colombia; Grupo de Investigación Biomedicina, Faculty of Medicine, Fundación Universitaria Autónoma de Las Américas, Pereira, Risaralda, Colombia; School of Medicine, Universidad Privada Franz Tamayo (UNIFRANZ), Cochabamba, Bolivia.
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