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Lee SY, Ham JH, Park HK, Jang DH, Jang WM. Association Between Risk Perceptions of COVID-19, Political Ideology, and Mask-Wearing Behavior After the Outbreak: A Cross-Sectional Survey in South Korea. Risk Manag Healthc Policy 2024; 17:1659-1668. [PMID: 38915789 PMCID: PMC11195682 DOI: 10.2147/rmhp.s463739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Accepted: 06/11/2024] [Indexed: 06/26/2024] Open
Abstract
Purpose After the declaration by the World Health Organization signaling the conclusion of the COVID-19 pandemic, most countries lifted mandatory mask-wearing regulations. This study aimed to investigate factors such as risk perception and political ideology associated with continued adherence to mask-wearing among specific populations, particularly when it is no longer deemed necessary. Methods We conducted a cross-sectional study including a sample of 1001 respondents stratified by sex, age (≥ 18 years), and region from January 31 to February 2, 2023, after the mandatory mask regulation was lifted in South Korea. Multivariate logistic regression models were applied to estimate the relationships between risk perceptions, political ideology, and mask-wearing maintenance, adjusting for factors such as sex, age, occupation, and trust in the government. Results Our results indicated significant associations between age, self-reported household economic status, political ideology, affective risk perception, and perceived effectiveness of the government's COVID-related measures with indoor mask-wearing. Specifically, liberals were more likely to keep mask-wearing indoors than conservatives (adjusted odds ratio [aOR]: 2.19; 95% confidence interval [CI]: 1.33-3.59); and those who perceived a greater affective risk of COVID-19 (aOR: 2.47; 95% CI: 1.96-3.10), along with those who perceived the government's countermeasures as inadequate, were more inclined to maintain the habit of wearing masks indoors (aOR: 1.90; 95% CI: 1.19-3.03). Conclusion Our study highlighted the multifaceted factors influencing mask-wearing behavior in the post-COVID-19 era. Even after adjusting for various confounding factors, such as age, sex, and trust in the government, an association remained between affective risk perception, political ideology, and mask-wearing behavior. However, further research for psychological mechanisms is needed to foster a culture of preventive behaviors proportional to the risk of infection.
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Affiliation(s)
- Seung Yeon Lee
- Department of Administration, Seoul National University Hospital, Seoul, South Korea
- Office of External Affairs, Seoul Metropolitan Government-Seoul National University Boramae Medical Centre, Seoul, South Korea
| | - Ji Hye Ham
- Seoul Public Health Research Institute, Seoul Medical Center, Seoul, South Korea
| | - Hyun-Kyung Park
- Health Insurance Research Institute, National Health Insurance Service, Wonju, South Korea
| | - Deok Hyun Jang
- Research Analytics & Communications, Gallup Korea, Seoul, South Korea
| | - Won Mo Jang
- Department of Public Health and Community Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Centre, Seoul, South Korea
- Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, South Korea
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Cui C, Timbrook TT, Polacek C, Heins Z, Rosenthal NA. Disease burden and high-risk populations for complications in patients with acute respiratory infections: a scoping review. Front Med (Lausanne) 2024; 11:1325236. [PMID: 38818396 PMCID: PMC11138209 DOI: 10.3389/fmed.2024.1325236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 04/24/2024] [Indexed: 06/01/2024] Open
Abstract
Background Acute respiratory infections (ARIs) represent a significant public health concern in the U.S. This study aimed to describe the disease burden of ARIs and identify U.S. populations at high risk of developing complications. Methods This scoping review searched PubMed and EBSCO databases to analyze U.S. studies from 2013 to 2022, focusing on disease burden, complications, and high-risk populations associated with ARIs. Results The study included 60 studies and showed that ARI is associated with a significant disease burden and healthcare resource utilization (HRU). In 2019, respiratory infection and tuberculosis caused 339,703 cases per 100,000 people, with most cases being upper respiratory infections and most deaths being lower respiratory infections. ARI is responsible for millions of outpatient visits, especially for influenza and pneumococcal pneumonia, and indirect costs of billions of dollars. ARI is caused by multiple pathogens and poses a significant burden on hospitalizations and outpatient visits. Risk factors for HRU associated with ARI include age, chronic conditions, and socioeconomic factors. Conclusion The review underscores the substantial disease burden of ARIs and the influence of age, chronic conditions, and socioeconomic status on developing complications. It highlights the necessity for targeted strategies for high-risk populations and effective pathogen detection to prevent severe complications and reduce HRU.
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Affiliation(s)
- Chendi Cui
- PINC, AI Applied Sciences, Premier Inc., Charlotte, NC, United States
| | - Tristan T. Timbrook
- Global Medical Affairs, bioMérieux, Inc., Salt Lake City, UT, United States
- University of Utah College of Pharmacy, Salt Lake City, UT, United States
| | - Cate Polacek
- PINC, AI Applied Sciences, Premier Inc., Charlotte, NC, United States
| | - Zoe Heins
- Global Medical Affairs, bioMérieux, Inc., Salt Lake City, UT, United States
| | - Ning A. Rosenthal
- PINC, AI Applied Sciences, Premier Inc., Charlotte, NC, United States
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Sandlund J, Duriseti R, Ladhani SN, Stuart K, Noble J, Høeg TB. Child mask mandates for COVID-19: a systematic review. Arch Dis Child 2024; 109:e2. [PMID: 38050026 PMCID: PMC10894839 DOI: 10.1136/archdischild-2023-326215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 11/03/2023] [Indexed: 12/06/2023]
Abstract
BACKGROUND Mask mandates for children during the COVID-19 pandemic varied in different locations. A risk-benefit analysis of this intervention has not yet been performed. In this study, we performed a systematic review to assess research on the effectiveness of mask wearing in children. METHODS We performed database searches up to February 2023. The studies were screened by title and abstract, and included studies were further screened as full-text references. A risk-of-bias analysis was performed by two independent reviewers and adjudicated by a third reviewer. RESULTS We screened 597 studies and included 22 in the final analysis. There were no randomised controlled trials in children assessing the benefits of mask wearing to reduce SARS-CoV-2 infection or transmission. The six observational studies reporting an association between child masking and lower infection rate or antibody seropositivity had critical (n=5) or serious (n=1) risk of bias; all six were potentially confounded by important differences between masked and unmasked groups and two were shown to have non-significant results when reanalysed. Sixteen other observational studies found no association between mask wearing and infection or transmission. CONCLUSIONS Real-world effectiveness of child mask mandates against SARS-CoV-2 transmission or infection has not been demonstrated with high-quality evidence. The current body of scientific data does not support masking children for protection against COVID-19.
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Affiliation(s)
- Johanna Sandlund
- Board-Certified Clinical Microbiologist and Independent Scholar, Alameda, California, USA
| | - Ram Duriseti
- Stanford University School of Medicine, Stanford, California, USA
| | - Shamez N Ladhani
- Immunisation Department, UK Health Security Agency, London, UK
- Centre for Neonatal and Paediatric Infection, St. George's University of London, London, UK
| | - Kelly Stuart
- SmallTalk Pediatric Therapy, San Diego, California, USA
| | - Jeanne Noble
- Emergency Medicine, University of California San Francisco, San Francisco, California, USA
| | - Tracy Beth Høeg
- Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
- Clinical Research, University of Southern Denmark, Odense, Denmark
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Modjo R, Lestari F, Tanjung H, Kadir A, Putra RS, Rahmadani M, Chaeruman AS, Lestari F, Sutanto J. COVID-19 infection prevention and control for hospital workers in Indonesia. Front Public Health 2024; 11:1276898. [PMID: 38259732 PMCID: PMC10800904 DOI: 10.3389/fpubh.2023.1276898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 12/12/2023] [Indexed: 01/24/2024] Open
Abstract
Introduction The outbreak of SARS-CoV-2 in 2019 led to a global pandemic, posing unprecedented challenges to healthcare systems, particularly in hospitals. Purpose This study explores the intricacies of strategies employed for preventing and controlling COVID-19 in Indonesian hospitals, with a particular focus on the protocols, challenges, and solutions faced by healthcare professionals. Methods Using a cross-sectional analysis, we examined 27 hospitals and uncovered disparities in their preparedness levels. During our investigation, we observed the robust implementation of infection prevention measures, which encompassed stringent protocols, adequate ventilation, and proper use of personal protective equipment. However, shortcomings were identified in areas such as surveillance, mental health support, and patient management. Discussion This study underscores the importance of addressing these gaps, suggesting tailored interventions, and continuous training for healthcare staff. Effective leadership, positive team dynamics, and adherence to comprehensive policies emerge as pivotal factors. Hospitals should strengthen weak areas, ensure the ethical execution of emergency protocols, and integrate technology for tracking and improving standard operating procedures. By enhancing the knowledge and skills of healthcare workers and maintaining strong management practices, hospitals can optimize their efforts in COVID-19 prevention and control, thereby safeguarding the wellbeing of professionals, patients, and communities.
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Affiliation(s)
- Robiana Modjo
- Occupational Health and Safety Department, Faculty of Public Health, Universitas Indonesia, Depok, West Java, Indonesia
- Indonesia Occupational Health Experts Association, Jakarta, Indonesia
| | - Fatma Lestari
- Occupational Health and Safety Department, Faculty of Public Health, Universitas Indonesia, Depok, West Java, Indonesia
- Disaster Risk Reduction Center, Universitas Indonesia, Depok, West Java, Indonesia
| | - Hendra Tanjung
- Occupational Health and Safety Department, Faculty of Public Health, Universitas Indonesia, Depok, West Java, Indonesia
- Indonesia Occupational Health Experts Association, Jakarta, Indonesia
| | - Abdul Kadir
- Occupational Health and Safety Department, Faculty of Public Health, Universitas Indonesia, Depok, West Java, Indonesia
| | | | - Meilisa Rahmadani
- Indonesia Occupational Health Experts Association, Jakarta, Indonesia
- Universitas Indonesia Hospital, Depok, West Java, Indonesia
| | | | - Fetrina Lestari
- Indonesia Occupational Health Experts Association, Jakarta, Indonesia
| | - Juliana Sutanto
- Department of Human Centred Computing, Monash University, Melbourne, VIC, Australia
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Clifford Astbury C, Lee KM, Mcleod R, Aguiar R, Atique A, Balolong M, Clarke J, Demeshko A, Labonté R, Ruckert A, Sibal P, Togño KC, Viens AM, Wiktorowicz M, Yambayamba MK, Yau A, Penney TL. Policies to prevent zoonotic spillover: a systematic scoping review of evaluative evidence. Global Health 2023; 19:82. [PMID: 37940941 PMCID: PMC10634115 DOI: 10.1186/s12992-023-00986-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 11/01/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Emerging infectious diseases of zoonotic origin present a critical threat to global population health. As accelerating globalisation makes epidemics and pandemics more difficult to contain, there is a need for effective preventive interventions that reduce the risk of zoonotic spillover events. Public policies can play a key role in preventing spillover events. The aim of this review is to identify and describe evaluations of public policies that target the determinants of zoonotic spillover. Our approach is informed by a One Health perspective, acknowledging the inter-connectedness of human, animal and environmental health. METHODS In this systematic scoping review, we searched Medline, SCOPUS, Web of Science and Global Health in May 2021 using search terms combining animal health and the animal-human interface, public policy, prevention and zoonoses. We screened titles and abstracts, extracted data and reported our process in line with PRISMA-ScR guidelines. We also searched relevant organisations' websites for evaluations published in the grey literature. All evaluations of public policies aiming to prevent zoonotic spillover events were eligible for inclusion. We summarised key data from each study, mapping policies along the spillover pathway. RESULTS Our review found 95 publications evaluating 111 policies. We identified 27 unique policy options including habitat protection; trade regulations; border control and quarantine procedures; farm and market biosecurity measures; public information campaigns; and vaccination programmes, as well as multi-component programmes. These were implemented by many sectors, highlighting the cross-sectoral nature of zoonotic spillover prevention. Reports emphasised the importance of surveillance data in both guiding prevention efforts and enabling policy evaluation, as well as the importance of industry and private sector actors in implementing many of these policies. Thoughtful engagement with stakeholders ranging from subsistence hunters and farmers to industrial animal agriculture operations is key for policy success in this area. CONCLUSION This review outlines the state of the evaluative evidence around policies to prevent zoonotic spillover in order to guide policy decision-making and focus research efforts. Since we found that most of the existing policy evaluations target 'downstream' determinants, additional research could focus on evaluating policies targeting 'upstream' determinants of zoonotic spillover, such as land use change, and policies impacting infection intensity and pathogen shedding in animal populations, such as those targeting animal welfare.
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Affiliation(s)
- Chloe Clifford Astbury
- School of Global Health, York University, Toronto, ON, Canada
- Dahdaleh Institute for Global Health Research, York University, Toronto, ON, Canada
- Global Strategy Lab, York University, Toronto, ON, Canada
| | - Kirsten M Lee
- School of Global Health, York University, Toronto, ON, Canada
- Dahdaleh Institute for Global Health Research, York University, Toronto, ON, Canada
| | - Ryan Mcleod
- School of Global Health, York University, Toronto, ON, Canada
| | - Raphael Aguiar
- Dahdaleh Institute for Global Health Research, York University, Toronto, ON, Canada
| | - Asma Atique
- School of Global Health, York University, Toronto, ON, Canada
| | - Marilen Balolong
- Applied Microbiology for Health and Environment Research Group, College of Arts and Sciences, University of the Philippines Manila, Manila, Philippines
| | - Janielle Clarke
- School of Global Health, York University, Toronto, ON, Canada
| | | | - Ronald Labonté
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Arne Ruckert
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Priyanka Sibal
- School of Health Policy and Management, York University, Toronto, ON, Canada
| | - Kathleen Chelsea Togño
- Applied Microbiology for Health and Environment Research Group, College of Arts and Sciences, University of the Philippines Manila, Manila, Philippines
| | - A M Viens
- School of Global Health, York University, Toronto, ON, Canada
- Global Strategy Lab, York University, Toronto, ON, Canada
| | - Mary Wiktorowicz
- School of Global Health, York University, Toronto, ON, Canada
- Dahdaleh Institute for Global Health Research, York University, Toronto, ON, Canada
| | - Marc K Yambayamba
- School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Amy Yau
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Tarra L Penney
- School of Global Health, York University, Toronto, ON, Canada.
- Dahdaleh Institute for Global Health Research, York University, Toronto, ON, Canada.
- Global Strategy Lab, York University, Toronto, ON, Canada.
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Al Lawati T, Al Lawati ZT, Al Bahrani B, Al Awaidy S. COVID-19 Among Omani Pilgrim Returnees From the Ashura Mass Gathering. Cureus 2023; 15:e36003. [PMID: 37051000 PMCID: PMC10085350 DOI: 10.7759/cureus.36003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2023] [Indexed: 03/13/2023] Open
Abstract
Background The annual Ashura pilgrimage is a mass Islamic gathering during which millions of worshippers converge in the city of Karbala in Iraq. We report on the incidence of the coronavirus disease 2019 (COVID-19) in Omani pilgrims returning from Karbala in the month of Muharram (August) 2021 during the COVID-19 pandemic. Methodology This is a retrospective study using an electronic, self-completed, and Arab-language survey, composed of 17 questions, that was distributed to all pilgrims returning from Karbala. Participation was voluntary, and consent with confidentiality was obtained. Data on the demographics including sex, COVID-19 vaccination record, type of vaccine, duration of stay, compliance with wearing a face mask, using hand sanitization, and polymerase chain reaction (PCR) results for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus before the departure from Oman, upon the return to Oman, and on the eighth post-quarantine day were collected. The responses were collected from the period between August 28, 2021, and September 25, 2022. Statistical association and analysis were performed using the Statistical Package for Social Sciences (SPSS) software (IBM SPSS Statistics, Armonk, NY). Results Out of 250 pilgrims, 139 responded to the survey. Fifty-two participants (37.4%) were males, and 87 (63.6%) were females. None of the pilgrims had positive SARS-CoV-2 PCR results before their departure from Oman. Only four pilgrims (2.9%) were detected positive on PCR by the end of a compulsory quarantine on the eighth day after arrival to Oman. No hospital admissions were recorded. The vast majority of the pilgrims were vaccinated with two doses of COVID-19 vaccination, while some few pilgrims were not vaccinated at all. Most of the pilgrims were also compliant with mask wearing, and just over half the pilgrims were compliant with hand sanitization. No significant statistical association was found between contracting SARS-CoV-2 virus infection and taking SARS-CoV-2 vaccination, the number of vaccination doses, having had COVID-19 before, wearing a mask, or compliance with hand sanitization. Conclusion The incidence of COVID-19 cases among pilgrims returning from Iraq during the COVID-19 pandemic was low. No significant difference was noted between pilgrims vaccinated and compliant with the protective measures and those who were not vaccinated or compliant. Herd immunity could be a possible explanation for the low incidence of COVID-19 infection. Larger studies are needed to investigate the incidence of COVID-19 in Ashura pilgrims.
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Jefferson T, Dooley L, Ferroni E, Al-Ansary LA, van Driel ML, Bawazeer GA, Jones MA, Hoffmann TC, Clark J, Beller EM, Glasziou PP, Conly JM. Physical interventions to interrupt or reduce the spread of respiratory viruses. Cochrane Database Syst Rev 2023; 1:CD006207. [PMID: 36715243 PMCID: PMC9885521 DOI: 10.1002/14651858.cd006207.pub6] [Citation(s) in RCA: 47] [Impact Index Per Article: 47.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Viral epidemics or pandemics of acute respiratory infections (ARIs) pose a global threat. Examples are influenza (H1N1) caused by the H1N1pdm09 virus in 2009, severe acute respiratory syndrome (SARS) in 2003, and coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 in 2019. Antiviral drugs and vaccines may be insufficient to prevent their spread. This is an update of a Cochrane Review last published in 2020. We include results from studies from the current COVID-19 pandemic. OBJECTIVES To assess the effectiveness of physical interventions to interrupt or reduce the spread of acute respiratory viruses. SEARCH METHODS We searched CENTRAL, PubMed, Embase, CINAHL, and two trials registers in October 2022, with backwards and forwards citation analysis on the new studies. SELECTION CRITERIA We included randomised controlled trials (RCTs) and cluster-RCTs investigating physical interventions (screening at entry ports, isolation, quarantine, physical distancing, personal protection, hand hygiene, face masks, glasses, and gargling) to prevent respiratory virus transmission. DATA COLLECTION AND ANALYSIS: We used standard Cochrane methodological procedures. MAIN RESULTS We included 11 new RCTs and cluster-RCTs (610,872 participants) in this update, bringing the total number of RCTs to 78. Six of the new trials were conducted during the COVID-19 pandemic; two from Mexico, and one each from Denmark, Bangladesh, England, and Norway. We identified four ongoing studies, of which one is completed, but unreported, evaluating masks concurrent with the COVID-19 pandemic. Many studies were conducted during non-epidemic influenza periods. Several were conducted during the 2009 H1N1 influenza pandemic, and others in epidemic influenza seasons up to 2016. Therefore, many studies were conducted in the context of lower respiratory viral circulation and transmission compared to COVID-19. The included studies were conducted in heterogeneous settings, ranging from suburban schools to hospital wards in high-income countries; crowded inner city settings in low-income countries; and an immigrant neighbourhood in a high-income country. Adherence with interventions was low in many studies. The risk of bias for the RCTs and cluster-RCTs was mostly high or unclear. Medical/surgical masks compared to no masks We included 12 trials (10 cluster-RCTs) comparing medical/surgical masks versus no masks to prevent the spread of viral respiratory illness (two trials with healthcare workers and 10 in the community). Wearing masks in the community probably makes little or no difference to the outcome of influenza-like illness (ILI)/COVID-19 like illness compared to not wearing masks (risk ratio (RR) 0.95, 95% confidence interval (CI) 0.84 to 1.09; 9 trials, 276,917 participants; moderate-certainty evidence. Wearing masks in the community probably makes little or no difference to the outcome of laboratory-confirmed influenza/SARS-CoV-2 compared to not wearing masks (RR 1.01, 95% CI 0.72 to 1.42; 6 trials, 13,919 participants; moderate-certainty evidence). Harms were rarely measured and poorly reported (very low-certainty evidence). N95/P2 respirators compared to medical/surgical masks We pooled trials comparing N95/P2 respirators with medical/surgical masks (four in healthcare settings and one in a household setting). We are very uncertain on the effects of N95/P2 respirators compared with medical/surgical masks on the outcome of clinical respiratory illness (RR 0.70, 95% CI 0.45 to 1.10; 3 trials, 7779 participants; very low-certainty evidence). N95/P2 respirators compared with medical/surgical masks may be effective for ILI (RR 0.82, 95% CI 0.66 to 1.03; 5 trials, 8407 participants; low-certainty evidence). Evidence is limited by imprecision and heterogeneity for these subjective outcomes. The use of a N95/P2 respirators compared to medical/surgical masks probably makes little or no difference for the objective and more precise outcome of laboratory-confirmed influenza infection (RR 1.10, 95% CI 0.90 to 1.34; 5 trials, 8407 participants; moderate-certainty evidence). Restricting pooling to healthcare workers made no difference to the overall findings. Harms were poorly measured and reported, but discomfort wearing medical/surgical masks or N95/P2 respirators was mentioned in several studies (very low-certainty evidence). One previously reported ongoing RCT has now been published and observed that medical/surgical masks were non-inferior to N95 respirators in a large study of 1009 healthcare workers in four countries providing direct care to COVID-19 patients. Hand hygiene compared to control Nineteen trials compared hand hygiene interventions with controls with sufficient data to include in meta-analyses. Settings included schools, childcare centres and homes. Comparing hand hygiene interventions with controls (i.e. no intervention), there was a 14% relative reduction in the number of people with ARIs in the hand hygiene group (RR 0.86, 95% CI 0.81 to 0.90; 9 trials, 52,105 participants; moderate-certainty evidence), suggesting a probable benefit. In absolute terms this benefit would result in a reduction from 380 events per 1000 people to 327 per 1000 people (95% CI 308 to 342). When considering the more strictly defined outcomes of ILI and laboratory-confirmed influenza, the estimates of effect for ILI (RR 0.94, 95% CI 0.81 to 1.09; 11 trials, 34,503 participants; low-certainty evidence), and laboratory-confirmed influenza (RR 0.91, 95% CI 0.63 to 1.30; 8 trials, 8332 participants; low-certainty evidence), suggest the intervention made little or no difference. We pooled 19 trials (71, 210 participants) for the composite outcome of ARI or ILI or influenza, with each study only contributing once and the most comprehensive outcome reported. Pooled data showed that hand hygiene may be beneficial with an 11% relative reduction of respiratory illness (RR 0.89, 95% CI 0.83 to 0.94; low-certainty evidence), but with high heterogeneity. In absolute terms this benefit would result in a reduction from 200 events per 1000 people to 178 per 1000 people (95% CI 166 to 188). Few trials measured and reported harms (very low-certainty evidence). We found no RCTs on gowns and gloves, face shields, or screening at entry ports. AUTHORS' CONCLUSIONS The high risk of bias in the trials, variation in outcome measurement, and relatively low adherence with the interventions during the studies hampers drawing firm conclusions. There were additional RCTs during the pandemic related to physical interventions but a relative paucity given the importance of the question of masking and its relative effectiveness and the concomitant measures of mask adherence which would be highly relevant to the measurement of effectiveness, especially in the elderly and in young children. There is uncertainty about the effects of face masks. The low to moderate certainty of evidence means our confidence in the effect estimate is limited, and that the true effect may be different from the observed estimate of the effect. The pooled results of RCTs did not show a clear reduction in respiratory viral infection with the use of medical/surgical masks. There were no clear differences between the use of medical/surgical masks compared with N95/P2 respirators in healthcare workers when used in routine care to reduce respiratory viral infection. Hand hygiene is likely to modestly reduce the burden of respiratory illness, and although this effect was also present when ILI and laboratory-confirmed influenza were analysed separately, it was not found to be a significant difference for the latter two outcomes. Harms associated with physical interventions were under-investigated. There is a need for large, well-designed RCTs addressing the effectiveness of many of these interventions in multiple settings and populations, as well as the impact of adherence on effectiveness, especially in those most at risk of ARIs.
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Affiliation(s)
- Tom Jefferson
- Department for Continuing Education, University of Oxford, Oxford OX1 2JA, UK
| | - Liz Dooley
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Australia
| | - Eliana Ferroni
- Epidemiological System of the Veneto Region, Regional Center for Epidemiology, Veneto Region, Padova, Italy
| | - Lubna A Al-Ansary
- Department of Family and Community Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mieke L van Driel
- General Practice Clinical Unit, Faculty of Medicine, The University of Queensland, Brisbane, Australia
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Ghada A Bawazeer
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Mark A Jones
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Australia
| | - Tammy C Hoffmann
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Australia
| | - Justin Clark
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Australia
| | - Elaine M Beller
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Australia
| | - Paul P Glasziou
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Australia
| | - John M Conly
- Cumming School of Medicine, University of Calgary, Room AGW5, SSB, Foothills Medical Centre, Calgary, Canada
- O'Brien Institute for Public Health and Synder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, Canada
- Calgary Zone, Alberta Health Services, Calgary, Canada
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Park K, Sung H, Kim MN. Reemergence of Parainfluenza Virus Type 3 and Respiratory Syncytial Virus Infections During the COVID-19 Pandemic. Ann Lab Med 2023; 43:114-116. [PMID: 36045068 PMCID: PMC9467829 DOI: 10.3343/alm.2023.43.1.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 05/09/2022] [Accepted: 07/28/2022] [Indexed: 12/31/2022] Open
Affiliation(s)
- Kuenyoul Park
- Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Heungsup Sung
- Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea,Corresponding author: Heungsup Sung, M.D., Ph.D. Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea Tel: +82-2-3010-4499, Fax: +82-2-478-0884, E-mail:
| | - Mi-Na Kim
- Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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9
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Wang S, Song J, Zhang H. The effectiveness of social distancing in reducing transmission during influenza epidemics: A systematic review. Public Health Nurs 2023; 40:208-217. [PMID: 36372954 DOI: 10.1111/phn.13146] [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: 05/06/2022] [Revised: 10/10/2022] [Accepted: 10/16/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Social distance practices are crucial for outpatient clinics during disease outbreaks and are an effective preventive measure for reducing influenza transmission during such pandemics in people with poor health. METHODS This study applies an evidence-based practice (EBP) approach to confirm the effectiveness of social distancing in healthy individuals during an influenza pandemic and employs the induced ordered weighted averaging model to confirm the effectiveness of EBP. The study design, validity, reliability, results, and generalizability focused on discussing three systematic reviews and two cohort studies via the Critical Appraisal Skills Programme (CASP). First, by introducing the patient, intervention, comparison, outcome (PICO) question; second, by establishing the five steps of EBP; third, by utilizing the CASP checklist for the appraisal; and finally, by presenting a conclusion. RESULTS According to the hierarchy of evidence, preferred reporting items for systematic reviews and meta-analyses retrieved five articles for addressing the PICO question. All the evidence demonstrates that social distancing is valuable during influenza pandemics among non-infected individuals. Precise, timely, and robust social distancing implementation can reduce the spread of infection, delay the epidemic peak, and ease the pressure on healthcare resources. Gatekeepers are responsible for guiding individuals through the implementation process for reducing influenza transmission, particularly in densely populated areas. CONCLUSIONS Social distance is crucial for outpatient clinics during an epidemic and effectively reduces the spread of infection, delay epidemic peaks, and eases pressure on healthcare resources.
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Affiliation(s)
- Sisi Wang
- Department of Dermatology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Henan University, Zhengzhou, Henan, China
| | - Jinghui Song
- Department of Dermatology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Henan University, Zhengzhou, Henan, China
| | - Hongmei Zhang
- Department of Nursing, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Henan University, Zhengzhou, Henan, China
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10
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Al-Jwadi RF, Mills EHA, Torp-Pedersen C, Andersen MP, Jørgensen IM. Consequences of COVID-19-related lockdowns and reopenings on emergency hospitalizations in pediatric patients in Denmark during 2020-2021. Eur J Pediatr 2023; 182:285-293. [PMID: 36331619 PMCID: PMC9638206 DOI: 10.1007/s00431-022-04682-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 10/18/2022] [Accepted: 10/26/2022] [Indexed: 11/06/2022]
Abstract
UNLABELLED There is a considerable burden of children being hospitalized due to infectious diseases worldwide. The COVID-19 pandemic provided a unique opportunity to examine effects of worldwide efforts to control spread of infection. We aimed to investigate overall age-specific hospitalizations due to viral and bacterial infections and diseases triggered by respiratory tract infections during and after lockdown. This nationwide register-based observational study included children from 29 days to 17 years old hospitalized in all Danish pediatric emergency departments during the years 2015-2021. Main outcomes were ICD-10 diagnoses for infectious diseases and infection triggered illnesses. Fluctuations in hospitalization events were explored using figures with weekly events per 100,000. Total events followed a predictable pattern during 2015-2019. In 2020-2021, there was a drop in hospital encounters after lockdowns and surge after reopenings. In 2021, there was a surge of hospital encounters in the late summer due to respiratory syncytial virus infections and asthmatic bronchitis mostly in infants from 29 days to 2 years. For the infectious diseases, there was a dramatic decrease in events after lockdowns and immediate increase in cases that followed the same pattern of previous years after reopenings. Bacterial infections, like urinary tract infections, sepsis, and meningitis followed a steady pattern throughout all calendar-years. CONCLUSIONS Nationwide efforts to minimize infectious disease spread like lockdowns have a preventative and period lasting effect but reopenings/reunions result in surges of infectious diseases. This might be due to children not getting immunized steadily thereby increasing the pool of possible hosts for potential viral infections. WHAT IS KNOWN • There is a seasonal fluctuation in viral/respiratory infections in children with higher infection rates in the winter and lower rates in the summer. • RSV infection is a major source of concern. WHAT IS NEW • Major lockdowns and reopenings disrupt the seasonal fluctuations which can result in high surges in infections that increases the burden of children emergency departments and the risk of serious complications.
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Affiliation(s)
- Rada Faris Al-Jwadi
- Department of Pediatric and Adolescent Medicine, Nordsjællands Hospital, Hillerød, Denmark.
| | | | | | | | - Inger Merete Jørgensen
- Department of Pediatric and Adolescent Medicine, Nordsjællands Hospital, Hillerød, Denmark ,Department of Clinical Medicine, Faculty of Health and Medical Science, University of Copenhagen, København, Denmark
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11
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Seong BH, Hong CY. Decision-Making in Virtual Reality Sports Games Explained via the Lens of Extended Planned Behavior Theory. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:592. [PMID: 36612910 PMCID: PMC9819123 DOI: 10.3390/ijerph20010592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 12/26/2022] [Accepted: 12/27/2022] [Indexed: 06/17/2023]
Abstract
This study aims to determine whether the effect of interactivity on participation in virtual sports has risen because of the COVID-19 pandemic and if there is a difference in decision-making. The significance of social factors may be highlighted even more as a rationale for using virtual reality (VR) sports apps throughout the prolonged COVID-19 epidemic. A model was built based on the literature to describe the intention to participate in VR sports, and eight associated hypotheses were established. A sample of 301 submissions from a user poll on Korea's cycling information sharing website was used for our analysis. SPSS 23.0 (IBM, Armonk, NY, USA) and AMOS 18.0 (IBM, Armonk, NY, USA) were used to validate Hypotheses 1-8 using a multigroup structural equation model (SEM) analysis and multigroup analysis. Although some hypotheses were not validated, the impact of perceived interaction presented as an extra variable altered based on the group participating before and after the COVID-19 epidemic, and the study's goal was achieved. Given that information technology has evolved by overcoming physical space and socio-cultural constraints to create a society that connects people, the importance of online interaction, such as networking and competition between users, will be emphasized in the VR sports field in the future.
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Affiliation(s)
- Bo-Hyun Seong
- Chungbuk Research Institute, Cheongju-si 28517, Republic of Korea
| | - Chang-Yu Hong
- Division of Global and Interdisciplinary Studies, Pukyong National University, Busan 48513, Republic of Korea
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12
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Clifford Astbury C, Lee KM, Aguiar R, Atique A, Balolong M, Clarke J, Labonte R, Ruckert A, Togño KC, Viens AM, Wiktorowicz M, Yau A, Penney TL. Policies to prevent zoonotic spillover: protocol for a systematic scoping review of evaluative evidence. BMJ Open 2022; 12:e058437. [PMID: 36379648 PMCID: PMC9668000 DOI: 10.1136/bmjopen-2021-058437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION The increasing incidence of pathogen transmission from animals to humans (zoonotic spillover events) has been attributed to behavioural practices and ecological and socioeconomic change. As these events sometimes involve pathogens with epidemic or pandemic potential, they pose a serious threat to population health. Public policies may play a key role in preventing these events. The aim of this review is to identify evaluations of public policies that target the determinants of zoonotic spillover, examining approaches taken to evaluation, choice of outcomes measures and evidence of effectiveness. Our approach to identifying and analysing this literature will be informed by a One Health lens, acknowledging the interconnectedness of human, animal and environmental health. METHODS AND ANALYSIS A systematic scoping review methodology will be used. To identify articles, we will search Medline, SCOPUS, Web of Science and Global Health in May 2021 using search terms combining animal health and the animal-human interface, public policy, prevention and zoonoses. We will screen titles and abstracts and extract data according to published guidelines for scoping reviews. All evaluations of public policies aiming to prevent zoonotic spillover events will be eligible for inclusion. We will summarise key data from each study, mapping policies along the spillover pathway and outlining the range of policies, approaches to evaluation and outcome measures. Review findings will provide a useful reference for researchers and practitioners, outlining the state of the evaluative evidence around policies to prevent zoonotic spillover. ETHICS AND DISSEMINATION Formal ethical approval is not required, because the study does not involve primary data collection. The findings of this study will be disseminated through a peer-reviewed publication, presentations and summaries for key stakeholders.
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Affiliation(s)
- Chloe Clifford Astbury
- School of Global Health, York University, Toronto, Ontario, Canada
- Dahdaleh Institute for Global Health Research, York University, Toronto, Ontario, Canada
| | - Kirsten M Lee
- School of Global Health, York University, Toronto, Ontario, Canada
- Dahdaleh Institute for Global Health Research, York University, Toronto, Ontario, Canada
| | - Raphael Aguiar
- Dahdaleh Institute for Global Health Research, York University, Toronto, Ontario, Canada
| | - Asma Atique
- School of Global Health, York University, Toronto, Ontario, Canada
| | | | - Janielle Clarke
- School of Global Health, York University, Toronto, Ontario, Canada
| | | | | | | | - A M Viens
- School of Global Health, York University, Toronto, Ontario, Canada
| | - M Wiktorowicz
- School of Global Health, York University, Toronto, Ontario, Canada
- Dahdaleh Institute for Global Health Research, York University, Toronto, Ontario, Canada
| | - Amy Yau
- London School of Hygiene & Tropical Medicine, London, UK
| | - Tarra L Penney
- School of Global Health, York University, Toronto, Ontario, Canada
- Dahdaleh Institute for Global Health Research, York University, Toronto, Ontario, Canada
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13
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Barbato L, Bernardelli F, Braga G, Clementini M, Di Gioia C, Littarru C, Oreglia F, Raspini M, Brambilla E, Iavicoli I, Pinchi V, Landi L, Sforza NM, Cavalcanti R, Crea A, Cairo F. Surface disinfection and protective masks for SARS-CoV-2 and other respiratory viruses: A review by SIdP COVID-19 task force. Oral Dis 2022; 28 Suppl 2:2317-2325. [PMID: 32946152 PMCID: PMC7646272 DOI: 10.1111/odi.13646] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 09/04/2020] [Accepted: 09/06/2020] [Indexed: 01/04/2023]
Abstract
OBJECTIVES Primary focused question for this systematic review (SR) was "Which is the evidence about surfaces decontamination and protection masks for SARS-Cov-2 in dental practice?" Secondary question was "Which is the evidence about surfaces decontamination and protection masks against airborne pathogens and directly transmitted viral pathogens causing respiratory infections?" MATERIALS AND METHODS PRISMA guidelines were used. Studies on surface decontamination and protective masks for SARS-CoV-2 in dental practice were considered. Studies on other respiratory viruses were considered for the secondary question. RESULTS No studies are available for SARS-CoV-2. Four studies on surface disinfection against respiratory viruses were included. Ethanol 70% and sodium hypochlorite 0,5% seem to be effective in reducing infectivity by > 3log TCID. Four RCTs compared different types of masks on HCW. The single studies reported no difference for laboratory-diagnosed influenza, laboratory-diagnosed respiratory infection, and influenza-like illness. A meta-analysis was not considered appropriate. CONCLUSIONS There is lack of evidence on the efficacy of surface disinfection and protective masks to reduce the spread of SARS-CoV-2 or other respiratory viruses in dentistry. However, the consistent use of respirator and routine surface disinfection is strongly suggested. There is urgent need of data on the efficacy of specific protection protocols for dental HCW against viral infections.
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Affiliation(s)
- Luigi Barbato
- Research Unit in Periodontology and Periodontal MedicineDepartment of Department of Experimental and Clinical MedicineUniversity of FlorenceFlorenceItaly
| | | | | | - Marco Clementini
- Department of PeriodontologyUniversità Vita‐Salute San RaffaeleMilanoItaly
| | | | | | | | | | - Eugenio Brambilla
- Department of BiomedicalSurgical and Dental SciencesUniversity of MilanMilanItaly
| | - Ivo Iavicoli
- Section of Occupational MedicineDepartment of Public HealthUniversity of Naples Federico IINaplesItaly
| | - Vilma Pinchi
- Department of Health SciencesSection of Medical Forensic SciencesUniversity of FlorenceFlorenceItaly
| | - Luca Landi
- Private PracticeRomeItaly
- SIdPFlorenceItaly
| | | | | | | | - Francesco Cairo
- SIdPFlorenceItaly
- Research Unit in Periodontology and Periodontal MedicineDepartment of Experimental and Clinical MedicineUniversity of FlorenceFlorenceItaly
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14
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Shobako N. Lessons from the health policies for children during the pandemic in Japan. Front Public Health 2022; 10:1015955. [PMID: 36339184 PMCID: PMC9628751 DOI: 10.3389/fpubh.2022.1015955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 09/21/2022] [Indexed: 01/28/2023] Open
Abstract
It is everyone's desire to seek the sound growth of children through food education and there is a critical need for fostering an environment for this purpose. Health policies are important for this support. To the present, the Japanese society has been greatly disrupted by COVID-19 pandemic. "Stay at home", "mokusyoku (silent eating)", and mask wearing were encouraged in nationwide campaigns as public health measures to combat COVID-19. There are some papers reporting negative effects of "stay at home" and lockdowns such as weight gain, decrease in physical activities and change in eating habits. In Japan, while benefits and advantages of food education during mealtime were previously well studied, the "mokusyoku" rule may directly run counter to this food education. Moreover, there are several reports showing that nutrients might contribute to prevention of infectious diseases. Japanese children were also encouraged to wear masks all day long. The results of the clinical research, especially randomized control trials, show limited protective effect of masks. On the other hand, negative outcomes of the masks were reported in various scenes. This review focuses on these topics and arousing reconsideration for a better environment for children.
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15
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Hyams C, Challen R, Begier E, Southern J, King J, Morley A, Szasz-Benczur Z, Gonzalez MG, Kinney J, Campling J, Gray S, Oliver J, Hubler R, Valluri S, Vyse A, McLaughlin JM, Ellsbury G, Maskell NA, Gessner BD, Danon L, Finn A. Incidence of community acquired lower respiratory tract disease in Bristol, UK during the COVID-19 pandemic: A prospective cohort study. THE LANCET REGIONAL HEALTH. EUROPE 2022; 21:100473. [PMID: 35965672 PMCID: PMC9359590 DOI: 10.1016/j.lanepe.2022.100473] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Background The emergence of COVID-19 and public health measures implemented to reduce SARS-CoV-2 infections have both affected acute lower respiratory tract disease (aLRTD) epidemiology and incidence trends. The severity of COVID-19 and non-SARS-CoV-2 aLRTD during this period have not been compared in detail. Methods We conducted a prospective cohort study of adults age ≥18 years admitted to either of two acute care hospitals in Bristol, UK, from August 2020 to November 2021. Patients were included if they presented with signs or symptoms of aLRTD (e.g., cough, pleurisy), or a clinical or radiological aLRTD diagnosis. Findings 12,557 adult aLRTD hospitalisations occurred: 10,087 were associated with infection (pneumonia or non-pneumonic lower respiratory tract infection [NP-LRTI]), 2161 with no infective cause, with 306 providing a minimal surveillance dataset. Confirmed SARS-CoV-2 infection accounted for 32% (3178/10,087) of respiratory infections. Annual incidences of overall, COVID-19, and non- SARS-CoV-2 pneumonia were 714.1, 264.2, and 449.9, and NP-LRTI were 346.2, 43.8, and 302.4 per 100,000 adults, respectively. Weekly incidence trends in COVID-19 aLRTD showed large surges (median 6.5 [IQR 0.7-10.2] admissions per 100,000 adults per week), while other infective aLRTD events were more stable (median 14.3 [IQR 12.8-16.4] admissions per 100,000 adults per week) as were non-infective aLRTD events (median 4.4 [IQR 3.5-5.5] admissions per 100,000 adults per week). Interpretation While COVID-19 disease was a large component of total aLRTD during this pandemic period, non- SARS-CoV-2 infection still caused the majority of respiratory infection hospitalisations. COVID-19 disease showed significant temporal fluctuations in frequency, which were less apparent in non-SARS-CoV-2 infection. Despite public health interventions to reduce respiratory infection, disease incidence remains high. Funding AvonCAP is an investigator-led project funded under a collaborative agreement by Pfizer.
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Affiliation(s)
- Catherine Hyams
- Bristol Vaccine Centre, Population Health Sciences, University of Bristol, UK
- Academic Respiratory Unit, University of Bristol, UK
| | | | - Elizabeth Begier
- Global Medical Development Scientific and Clinical Affairs, Pfizer Vaccines, Ireland
| | - Jo Southern
- Vaccines Medical Affairs, Pfizer Ltd, Tadworth KT20 7NS, UK
| | - Jade King
- Clinical Research and Imaging Centre, UHBW NHS Trust, Bristol, UK
| | - Anna Morley
- Academic Respiratory Unit, University of Bristol, UK
| | | | | | - Jane Kinney
- Bristol Vaccine Centre, Population Health Sciences, University of Bristol, UK
| | - James Campling
- Vaccines Medical Affairs, Pfizer Ltd, Tadworth KT20 7NS, UK
| | - Sharon Gray
- Vaccines Medical Development, Scientific and Clinical Affairs, Pfizer Inc, Collegeville, PA, USA
| | | | - Robin Hubler
- Vaccines Medical Development, Scientific and Clinical Affairs, Pfizer Inc, Collegeville, PA, USA
| | - Srinivas Valluri
- Vaccines Medical Development, Scientific and Clinical Affairs, Pfizer Inc, Collegeville, PA, USA
| | - Andrew Vyse
- Vaccines Medical Affairs, Pfizer Ltd, Tadworth KT20 7NS, UK
| | - John M. McLaughlin
- Vaccines Medical Development, Scientific and Clinical Affairs, Pfizer Inc, Collegeville, PA, USA
| | | | | | - Bradford D. Gessner
- Vaccines Medical Development, Scientific and Clinical Affairs, Pfizer Inc, Collegeville, PA, USA
| | - Leon Danon
- Engineering Mathematics, University of Bristol, UK
| | - Adam Finn
- Bristol Vaccine Centre, Population Health Sciences, University of Bristol, UK
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16
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Hyams C, Challen R, Begier E, Southern J, King J, Morley A, Szasz-Benczur Z, Gonzalez MG, Kinney J, Campling J, Gray S, Oliver J, Hubler R, Valluri S, Vyse A, McLaughlin JM, Ellsbury G, Maskell NA, Gessner BD, Danon L, Finn A. Incidence of community acquired lower respiratory tract disease in Bristol, UK during the COVID-19 pandemic: A prospective cohort study. THE LANCET REGIONAL HEALTH. EUROPE 2022; 21:100473. [PMID: 35965672 DOI: 10.2139/ssrn.4087373] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
BACKGROUND The emergence of COVID-19 and public health measures implemented to reduce SARS-CoV-2 infections have both affected acute lower respiratory tract disease (aLRTD) epidemiology and incidence trends. The severity of COVID-19 and non-SARS-CoV-2 aLRTD during this period have not been compared in detail. METHODS We conducted a prospective cohort study of adults age ≥18 years admitted to either of two acute care hospitals in Bristol, UK, from August 2020 to November 2021. Patients were included if they presented with signs or symptoms of aLRTD (e.g., cough, pleurisy), or a clinical or radiological aLRTD diagnosis. FINDINGS 12,557 adult aLRTD hospitalisations occurred: 10,087 were associated with infection (pneumonia or non-pneumonic lower respiratory tract infection [NP-LRTI]), 2161 with no infective cause, with 306 providing a minimal surveillance dataset. Confirmed SARS-CoV-2 infection accounted for 32% (3178/10,087) of respiratory infections. Annual incidences of overall, COVID-19, and non- SARS-CoV-2 pneumonia were 714.1, 264.2, and 449.9, and NP-LRTI were 346.2, 43.8, and 302.4 per 100,000 adults, respectively. Weekly incidence trends in COVID-19 aLRTD showed large surges (median 6.5 [IQR 0.7-10.2] admissions per 100,000 adults per week), while other infective aLRTD events were more stable (median 14.3 [IQR 12.8-16.4] admissions per 100,000 adults per week) as were non-infective aLRTD events (median 4.4 [IQR 3.5-5.5] admissions per 100,000 adults per week). INTERPRETATION While COVID-19 disease was a large component of total aLRTD during this pandemic period, non- SARS-CoV-2 infection still caused the majority of respiratory infection hospitalisations. COVID-19 disease showed significant temporal fluctuations in frequency, which were less apparent in non-SARS-CoV-2 infection. Despite public health interventions to reduce respiratory infection, disease incidence remains high. FUNDING AvonCAP is an investigator-led project funded under a collaborative agreement by Pfizer.
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Affiliation(s)
- Catherine Hyams
- Bristol Vaccine Centre, Population Health Sciences, University of Bristol, UK
- Academic Respiratory Unit, University of Bristol, UK
| | | | - Elizabeth Begier
- Global Medical Development Scientific and Clinical Affairs, Pfizer Vaccines, Ireland
| | - Jo Southern
- Vaccines Medical Affairs, Pfizer Ltd, Tadworth KT20 7NS, UK
| | - Jade King
- Clinical Research and Imaging Centre, UHBW NHS Trust, Bristol, UK
| | - Anna Morley
- Academic Respiratory Unit, University of Bristol, UK
| | | | | | - Jane Kinney
- Bristol Vaccine Centre, Population Health Sciences, University of Bristol, UK
| | - James Campling
- Vaccines Medical Affairs, Pfizer Ltd, Tadworth KT20 7NS, UK
| | - Sharon Gray
- Vaccines Medical Development, Scientific and Clinical Affairs, Pfizer Inc, Collegeville, PA, USA
| | | | - Robin Hubler
- Vaccines Medical Development, Scientific and Clinical Affairs, Pfizer Inc, Collegeville, PA, USA
| | - Srinivas Valluri
- Vaccines Medical Development, Scientific and Clinical Affairs, Pfizer Inc, Collegeville, PA, USA
| | - Andrew Vyse
- Vaccines Medical Affairs, Pfizer Ltd, Tadworth KT20 7NS, UK
| | - John M McLaughlin
- Vaccines Medical Development, Scientific and Clinical Affairs, Pfizer Inc, Collegeville, PA, USA
| | | | | | - Bradford D Gessner
- Vaccines Medical Development, Scientific and Clinical Affairs, Pfizer Inc, Collegeville, PA, USA
| | - Leon Danon
- Engineering Mathematics, University of Bristol, UK
| | - Adam Finn
- Bristol Vaccine Centre, Population Health Sciences, University of Bristol, UK
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17
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Effect of New Surfactants on Biological Properties of Liquid Soaps. Molecules 2022; 27:molecules27175425. [PMID: 36080193 PMCID: PMC9458098 DOI: 10.3390/molecules27175425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 08/18/2022] [Accepted: 08/19/2022] [Indexed: 11/16/2022] Open
Abstract
Liquid soaps are the basic cosmetics used to clean the skin of the hands. Frequent hand washing prevents viral contamination but may damage the skin’s hydro-lipid layer, leading to various types of irritation. Therefore, four liquid soap formulas were developed with three amphoteric surfactants: Cocamidopropyl Betaine (LS II), CocamidopropylHydroxysultaine (LS III), and newly synthesized Evening PrimroseaamidopropylSulfobetaine (LS IV). We evaluated the skin irritating potential (zein number, bovine albumin test) and cytotoxicity (AlamarBlue™, Cell viability, and Cell cycle assays) on HaCaT cell line. We observed lower values of the zein number and bovine albumin tests after adding soaps with surfactants (the highest differences in LS IV) compared to the base soap (LS I). However, LS I and LS II did not differ in cytotoxic assays. Therefore, adding LS III and LS IV seems potentially more dangerous to the cells. However, it should be noted that cells were continuously exposed to liquid soaps for more than 24 h, so its cytotoxic effects after dermal use in humans may be unnoticeable. Concluding, results suggest that the newly synthesized LS IV should improve the safety of liquid hand washing soaps.
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18
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Wang Q, Luo N, Lei M, Zhong L, Li C, Hao P. Facial Irritant Contact Dermatitis Caused by Pyraclostrobin. Clin Cosmet Investig Dermatol 2022; 15:1643-1647. [PMID: 35996399 PMCID: PMC9392485 DOI: 10.2147/ccid.s373075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 08/12/2022] [Indexed: 01/19/2023]
Abstract
Contact dermatitis and facial contact dermatitis caused by pesticides are not uncommon in China. However, clinically, due to the wide variety of pesticides, they mainly appear in the form of case reports. We reported a 70-year-old male patient developed facial irritant contact dermatitis (ICD) due to pyraclostrobin which was sprayed on his face. Initially, he felt facial burning and tingling, and localized erythematous-edematous and scaly rash appeared on his face as well as front hairline scalp. During the outpatient visit, the main symptoms were a facial burning sensation, itching, and tingling. The patient’s facial lesions improved after treatment. To better protect the skin of agricultural workers, preventive measures should be undertaken, such as personal protective equipment, gas masks, protective clothing and goggles, which are indispensable for manual pesticide spraying. Pyraclostrobin diluted according to the instructions is a potential source of ICD. Agricultural workers should undertake preventive measures during manual pesticide spraying. Safety education and publicity are particularly important. We need dermatologists to spread knowledge and agricultural workers to develop the right protective habits.
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Affiliation(s)
- Qiuyue Wang
- School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, People's Republic of China.,Department of Dermatology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, People's Republic of China
| | - Nana Luo
- School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, People's Republic of China.,Department of Dermatology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, People's Republic of China
| | - Min Lei
- School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, People's Republic of China.,Department of Dermatology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, People's Republic of China
| | - Lingyuan Zhong
- School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, People's Republic of China.,Department of Dermatology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, People's Republic of China
| | - Chunxiao Li
- Department of Dermatology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, People's Republic of China
| | - Pingsheng Hao
- Department of Dermatology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, People's Republic of China
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19
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Khashaba E, El-Gilany AH, Shalaby H, El-Kurdy R. Personal protective equipment used by obstetricians and obstetric nurses during the COVID-19 pandemic in Mansoura, Egypt. F1000Res 2022; 11:413. [PMID: 35903420 PMCID: PMC9274016 DOI: 10.12688/f1000research.110835.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/30/2022] [Indexed: 11/20/2022] Open
Abstract
Background: This study was done to describe the pattern of personal protective equipment (PPE) use, associated factors, and adverse events among obstetricians and obstetric nurses in obstetrics & gynecology departments. Methods: A cross sectional study was conducted in Obstetrics & Gynecology departments in three hospitals (physician & nurses n=252) using an online Google form including demographic and occupational health data, type of available personal protective equipment during usual care, CS and emergency labor, infection control measures and hazards of full PPE use. Results Full PPE use was 37.7% during CS and 34.9% during emergency labor. The significant predictors of wearing full PPE during CS were daily work hours > 8 hours and receiving formal training about PPE use. During CS & emergency labor most of HCws used sterile gloves and sterile fluid resistant gowns and surgical mask.to less extent used face shields or tight fitting googles and one tenth (11.8%) only used N95. The most common health effects of full PPE use was sense of heat (79.5%)
. Conclusion: During the COVID-19 pandemic more vigorous respiratory (N95 mask) and eye protection is required during aerosol-generating procedures. Formal training is an evident predictor for full PPE use.
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Affiliation(s)
- Eman Khashaba
- Assistant professor of Occupational Health and Industrial Medicine,Public health & Community medicine, Faculty of Medicine,Mansoura University, Mansoura, 35516, Egypt
| | - Abdel-Hady El-Gilany
- Professor of Public Health & Preventive Medicine,, Faculty of Medicine, Mansoura University, Mansoura, 35516, Egypt
| | - Hend Shalaby
- Professor of Obstetrics & Gynecology, Faculty of Medicine, Mansoura University, Mansoura, 35516, Egypt
| | - Rania El-Kurdy
- Lecturer of Woman’s Health & Midwifery Nursing, Faculty of Nursing,Mansoura University, Mansoura, 35516, Egypt
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20
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Juneau CE, Pueyo T, Bell M, Gee G, Collazzo P, Potvin L. Lessons from past pandemics: a systematic review of evidence-based, cost-effective interventions to suppress COVID-19. Syst Rev 2022; 11:90. [PMID: 35550674 PMCID: PMC9096744 DOI: 10.1186/s13643-022-01958-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 04/11/2022] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND In an unparalleled global response, during the COVID-19 pandemic, 90 countries asked 3.9 billion people to stay home. Yet other countries avoided lockdowns and focused on other strategies, like contact tracing. How effective and cost-effective are these strategies? We aimed to provide a comprehensive summary of the evidence on past pandemic controls, with a focus on cost-effectiveness. METHODS Following PRISMA guidelines, MEDLINE (1946 to April week 2, 2020) and EMBASE (1974 to April 17, 2020) were searched using a range of terms related to pandemic control. Articles reporting on the effectiveness or cost-effectiveness of at least one intervention were included. RESULTS We found 1653 papers; 62 were included. The effectiveness of hand-washing and face masks was supported by randomized trials. These measures were highly cost-effective. For other interventions, only observational and modelling studies were found. They suggested that (1) the most cost-effective interventions are swift contact tracing and case isolation, surveillance networks, protective equipment for healthcare workers, and early vaccination (when available); (2) home quarantines and stockpiling antivirals are less cost-effective; (3) social distancing measures like workplace and school closures are effective but costly, making them the least cost-effective options; (4) combinations are more cost-effective than single interventions; and (5) interventions are more cost-effective when adopted early. For 2009 H1N1 influenza, contact tracing was estimated to be 4363 times more cost-effective than school closure ($2260 vs. $9,860,000 per death prevented). CONCLUSIONS AND CONTRIBUTIONS For COVID-19, a cautious interpretation suggests that (1) workplace and school closures are effective but costly, especially when adopted late, and (2) scaling up as early as possible a combination of interventions that includes hand-washing, face masks, ample protective equipment for healthcare workers, and swift contact tracing and case isolation is likely to be the most cost-effective strategy.
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Affiliation(s)
- Carl-Etienne Juneau
- Direction Régionale de Santé Publique, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, QC, Canada
| | | | - Matt Bell
- COVID-19 Work Group, Washington, D.C., USA
| | | | - Pablo Collazzo
- Danube University, Dr. Karl Dorrek Straße 30, 3500, Krems, Austria.
| | - Louise Potvin
- École de Santé Publique, Université de Montréal, C.P. 6128, Succursale Centre-ville, Montréal, QC, H3C 3J7, Canada
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Awoyemi T, Adenipekun A, Chima-Kalu R, Adedayo O, Obarombi J, Bello O, Bello O, Adamu D. COVID-19 in Africa: An Explorative Cross-Sectional Analysis of Twenty-One African Countries From January to June 2020. Cureus 2022; 14:e24767. [PMID: 35686270 PMCID: PMC9170426 DOI: 10.7759/cureus.24767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2022] [Indexed: 11/26/2022] Open
Abstract
Introduction: Africa has surprisingly recorded better gains in containing the coronavirus spread than countries with the better health indices, such as the USA and UK. The low rate of coronavirus disease 2019 (COVID-19) cases and death in Africa represents a puzzle with different biological and social theories such as low COVID-19 testing capacity, substantial young population, few old people, favourable climate, genetic admixture, infectious disease antibodies, and sound community health care systems proposed. We aimed to understand the COVID-19 preventive measures in a group of twenty-one systematically selected African countries that may explain the low burden of COVID-19 in Africa. Methods: Data (COVID-19, health, socioeconomic, and demographics indices) of twenty-one systemically selected African countries were retrieved from the various official country and multilateral organization sources such as Worldbank, and the United nations development Programme (UNDP). The extracted data were analyzed in three large groups: international travel restrictions, physical and social distancing, and movement restrictions (lockdown measures; curfews, partial or/and national lockdowns). Data cleaning, analysis (including Pearson correlation), and visualization were done with Microsoft Excel and Graph Pad Prism version 9 (https://www.graphpad.com/). Result: Southern Africa had the greatest number of cases and deaths within the period studied compared to East Africa, which was the least COVID-19 affected sub-region (in terms of COVID-19 cases and deaths). We observed that coronary artery disease death rate was highly correlated with COVID-19 death density (number of COVID-19 deaths/total population) and similarly observed a correlation between the number of cases and deaths and number of in-country arrivals, pandemic preparedness (health security index), COVID-19 containment, and health index (not correlated with deaths). Finally, we noted that the most effective preventive strategy was the 'use of a face mask'. Conclusion: Africa had fewer COVID-19 cases and COVID-19 related deaths. Our data shows that the rapidity and stringency of COVID-19 preventive measures and government policies, and the low level of tourism in Africa compared to other countries (i.e., low COVID-19 seeding rate) may have been contributory to these favorable statistics. We hope these findings impact how the preparedness for pandemics can be enhanced to decrease the burden of preventable deaths and morbidity.
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22
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Sharma MK, Adhikari R. Effect of School Water, Sanitation, and Hygiene on Health Status Among Basic Level Students' in Nepal. ENVIRONMENTAL HEALTH INSIGHTS 2022; 16:11786302221095030. [PMID: 35495174 PMCID: PMC9044779 DOI: 10.1177/11786302221095030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 03/30/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Access to drinking Water, Sanitation, and Hygiene (WASH) at schools are the basic determinants of a child's right to healthy and quality education. In Nepal, most of the schools had limited WASH facilities, including separate sanitation facilities for girls. The limited WASH facilities, unsafe drinking water, poor sanitation, and hygiene practices result in irresponsible behaviors that directly impede on students' health. This study examines the association between WASH services and health status of basic level students', ranging sixth to eighth grades. In Nepal, basic level education consists up to eighth standards from grade 1. METHODS The study applies causal-comparative research design within 2 groups; 1 having improved WASH and another without improved WASH services at the schools in Dhanusha and Chitwan districts of Nepal. Each group consists 2 schools, so altogether 4 schools were included in this study. Total 768, equal 384 respondents were selected from each improved and without improved WASH facilities. The study was conducted in between January and March 2021 at a single-phase time. The sample size was calculated using the standard statistical formula for the infinite population. The study applied quantitative research method, including 3 sorts of analysis; univariate, bivariate, and the multivariate. The univariate was applied to analyze the frequency and percentages of the respondents. Bivariate analysis was made applying chi2 test in order to show the association between 2 variables, whereas the multivariate logistic regression was performed through multilevel modeling to show the effects of school WASH facilities on students' health status. RESULTS Out of 768 students', 384 (50%) were from improved and 384 (50%) were from unimproved WASH facilities at schools. More than two third (64%) of respondents from the unimproved and higher than two fifth (41%) from the improved schools got sickness (P <.001). Further, three fifth (59%) of respondents aged 15 to 19 and higher than half (51%) of respondents ages of 10 to 14 years got sickness (P <.05). Most (57%) of the female respondents had sickness compared to males (47%), (P <.05). More than two-thirds (67%) of respondents from Dalit and nearly two-thirds (62%) of respondents from Brahmin/Chhetri-Terai more often found being sick in unimproved schools compared to other castes (55%), Janajati (43%), and Brahmin/Chhetri-Hill (39%) (P <.001). The school WASH services has significant effect (cOR = 0.388, CI; 290-0.519, P <.001) on students health status, even adjusting other socio-covariates (aOR = .442, CI; 0.302-0.646, P <.001). The female respondents were more likely to fall sick (aOR = 678, CI; 0.502-0.915, P <.01) compared to the male respondents keeping all other variables constant in the model. CONCLUSION The study recommends to extend WASH awareness program to school families, particularly to the students as there is an evident need to increase preventive as well as the therapeutic efficacy of the potential infections.
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Affiliation(s)
- Mohan Kumar Sharma
- Tribhuvan University Graduate School of
Education (GSE), Kathmandu, Nepal
- Center for Research on Education Health
and Social Science (CREHSS), Kathmandu, Nepal
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23
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Methodology and experiences of rapid advice guideline development for children with COVID-19: responding to the COVID-19 outbreak quickly and efficiently. BMC Med Res Methodol 2022; 22:89. [PMID: 35369859 PMCID: PMC8977048 DOI: 10.1186/s12874-022-01545-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 02/14/2022] [Indexed: 11/26/2022] Open
Abstract
Background Rapid Advice Guidelines (RAG) provide decision makers with guidance to respond to public health emergencies by developing evidence-based recommendations in a short period of time with a scientific and standardized approach. However, the experience from the development process of a RAG has so far not been systematically summarized. Therefore, our working group will take the experience of the development of the RAG for children with COVID-19 as an example to systematically explore the methodology, advantages, and challenges in the development of the RAG. We shall propose suggestions and reflections for future research, in order to provide a more detailed reference for future development of RAGs. Result The development of the RAG by a group of 67 researchers from 11 countries took 50 days from the official commencement of the work (January 28, 2020) to submission (March 17, 2020). A total of 21 meetings were held with a total duration of 48 h (average 2.3 h per meeting) and an average of 16.5 participants attending. Only two of the ten recommendations were fully supported by direct evidence for COVID-19, three recommendations were supported by indirect evidence only, and the proportion of COVID-19 studies among the body of evidence in the remaining five recommendations ranged between 10 and 83%. Six of the ten recommendations used COVID-19 preprints as evidence support, and up to 50% of the studies with direct evidence on COVID-19 were preprints. Conclusions In order to respond to public health emergencies, the development of RAG also requires a clear and transparent formulation process, usually using a large amount of indirect and non-peer-reviewed evidence to support the formation of recommendations. Strict following of the WHO RAG handbook does not only enhance the transparency and clarity of the guideline, but also can speed up the guideline development process, thereby saving time and labor costs. Supplementary Information The online version contains supplementary material available at 10.1186/s12874-022-01545-5.
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24
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Ioannidis JPA, Cripps S, Tanner MA. Forecasting for COVID-19 has failed. INTERNATIONAL JOURNAL OF FORECASTING 2022; 38:423-438. [PMID: 32863495 PMCID: PMC7447267 DOI: 10.1016/j.ijforecast.2020.08.004] [Citation(s) in RCA: 124] [Impact Index Per Article: 62.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Epidemic forecasting has a dubious track-record, and its failures became more prominent with COVID-19. Poor data input, wrong modeling assumptions, high sensitivity of estimates, lack of incorporation of epidemiological features, poor past evidence on effects of available interventions, lack of transparency, errors, lack of determinacy, consideration of only one or a few dimensions of the problem at hand, lack of expertise in crucial disciplines, groupthink and bandwagon effects, and selective reporting are some of the causes of these failures. Nevertheless, epidemic forecasting is unlikely to be abandoned. Some (but not all) of these problems can be fixed. Careful modeling of predictive distributions rather than focusing on point estimates, considering multiple dimensions of impact, and continuously reappraising models based on their validated performance may help. If extreme values are considered, extremes should be considered for the consequences of multiple dimensions of impact so as to continuously calibrate predictive insights and decision-making. When major decisions (e.g. draconian lockdowns) are based on forecasts, the harms (in terms of health, economy, and society at large) and the asymmetry of risks need to be approached in a holistic fashion, considering the totality of the evidence.
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Affiliation(s)
- John P A Ioannidis
- Stanford Prevention Research Center, Department of Medicine, and Departments of Epidemiology and Population Health, of Biomedical Data Science, and of Statistics, Stanford University, and Meta-Research Innovation Center at Stanford (METRICS), Stanford, CA, USA
| | - Sally Cripps
- School of Mathematics and Statistics, The University of Sydney and Data Analytics for Resources and Environments (DARE) Australian Research Council, Sydney, Australia
| | - Martin A Tanner
- Department of Statistics, Northwestern University, Evanston, IL, USA
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Sengupta K, Srivastava PR. HRNET: AI-on-Edge for Mask Detection and Social Distancing Calculation. SN COMPUTER SCIENCE 2022; 3:157. [PMID: 35194579 PMCID: PMC8830974 DOI: 10.1007/s42979-022-01023-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 01/04/2022] [Indexed: 11/24/2022]
Abstract
The purpose of the paper is to provide innovative emerging technology framework for community to combat epidemic situations. The paper proposes a unique outbreak response system framework based on artificial intelligence and edge computing for citizen centric services to help track and trace people eluding safety policies like mask detection and social distancing measure in public or workplace setup. The framework further provides implementation guideline in industrial setup as well for governance and contact tracing tasks. The adoption will thus lead in smart city planning and development focusing on citizen health systems contributing to improved quality of life. The conceptual framework presented is validated through quantitative data analysis via secondary data collection from researcher's public websites, GitHub repositories and renowned journals and further benchmarking were conducted for experimental results in Microsoft Azure cloud environment. The study includes selective AI models for benchmark analysis and were assessed on performance and accuracy in edge computing environment for large-scale societal setup. Overall YOLO model outperforms in object detection task and is faster enough for mask detection and HRNetV2 outperform semantic segmentation problem applied to solve social distancing task in AI-Edge inferencing environmental setup. The paper proposes new Edge-AI algorithm for building technology-oriented solutions for detecting mask in human movement and social distance. The paper enriches the technological advancement in artificial intelligence and edge computing applied to problems in society and healthcare systems. The framework further equips government agency, system providers to design and construct technology-oriented models in community setup to increase the quality of life using emerging technologies into smart urban environments.
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Affiliation(s)
| | - Praveen Ranjan Srivastava
- Indian Institute of Management, Management, City Southern Bypass, Sunaria, Rohtak, Haryana 124010 India
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26
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Summan A, Nandi A. Timing of non-pharmaceutical interventions to mitigate COVID-19 transmission and their effects on mobility: a cross-country analysis. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2022; 23:105-117. [PMID: 34304325 PMCID: PMC8310614 DOI: 10.1007/s10198-021-01355-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 07/13/2021] [Indexed: 05/03/2023]
Abstract
In the early stages of a pandemic, non-pharmaceutical interventions (NPIs) that encourage physical distancing and reduce contact can decrease and delay disease transmission. Although NPIs have been implemented globally during the COVID-19 pandemic, their intensity and timing have varied widely. This paper analyzed the country-level determinants and effects of NPIs during the early stages of the pandemic (January 1st to April 29th, 2020). We examined countries that had implemented NPIs within 30 or 45 days since first case detection, as well as countries in which 30 or 45 days had passed since first case detection. The health and socioeconomic factors associated with delay in implementation of three NPIs-national school closure, national lockdown, and global travel ban-were analyzed using fractional logit and probit models, and beta regression models. The probability of implementation of national school closure, national lockdown, and strict national lockdown by a country was analyzed using a probit model. The effects of these three interventions on mobility changes were analyzed with propensity score matching methods using Google's social mobility reports. Countries with larger populations and better health preparedness measures had greater delays in implementation. Countries with greater population density, higher income, more democratic political systems, and later arrival of first cases were more likely to implement NPIs within 30 or 45 days of first case detection. Implementation of lockdowns significantly reduced physical mobility. Mobility was further reduced when lockdowns were enforced with curfews or fines, or when they were more strictly defined. National school closures did not significantly change mobility.
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Affiliation(s)
- Amit Summan
- Center for Disease Dynamics, Economics and Policy, 5636 Connecticut Ave NW, PO Box 42735, Washington, DC 20015 USA
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27
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Wang Q, Shi N, Huang J, Yang L, Cui T, Ai J, Ji H, Xu K, Ahmad T, Bao C, Jin H. Cost-Effectiveness of Public Health Measures to Control COVID-19 in China: A Microsimulation Modeling Study. Front Public Health 2022; 9:726690. [PMID: 35059369 PMCID: PMC8763804 DOI: 10.3389/fpubh.2021.726690] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 12/03/2021] [Indexed: 11/13/2022] Open
Abstract
This study aimed to assess the cost-effectiveness of various public health measures in dealing with coronavirus disease 2019 (COVID-19) in China. A stochastic agent-based model was used to simulate the progress of the COVID-19 outbreak in scenario I (imported one case) and scenario II (imported four cases) with a series of public health measures. The main outcomes included the avoided infections and incremental cost-effectiveness ratios (ICERs). Sensitivity analyses were performed to assess uncertainty. The results indicated that isolation-and-quarantine averted the COVID-19 outbreak at the lowest ICERs. The joint strategy of personal protection and isolation-and-quarantine averted one more case than only isolation-and-quarantine with additional costs. The effectiveness of isolation-and-quarantine decreased with lowering quarantine probability and increasing delay time. The strategy that included community containment would be cost-effective when the number of imported cases was >65, or the delay time of the quarantine was more than 5 days, or the quarantine probability was below 25%, based on current assumptions. In conclusion, isolation-and-quarantine was the most cost-effective intervention. However, personal protection combined with isolation-and-quarantine was the optimal strategy for averting more cases. The community containment could be more cost-effective as the efficiency of isolation-and-quarantine drops and the imported cases increases.
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Affiliation(s)
- Qiang Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Naiyang Shi
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Jinxin Huang
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Liuqing Yang
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Tingting Cui
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Jing Ai
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Hong Ji
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Ke Xu
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Tauseef Ahmad
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| | - Changjun Bao
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Hui Jin
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
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Yang S, Cheng Y, Liu T, Huang S, Yin L, Pu Y, Liang G. Impact of waste of COVID-19 protective equipment on the environment, animals and human health: a review. ENVIRONMENTAL CHEMISTRY LETTERS 2022; 20:2951-2970. [PMID: 35791338 PMCID: PMC9247942 DOI: 10.1007/s10311-022-01462-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 05/10/2022] [Indexed: 05/06/2023]
Abstract
During the Corona Virus Disease 2019 (COVID-19) pandemic, protective equipment, such as masks, gloves and shields, has become mandatory to prevent person-to-person transmission of coronavirus. However, the excessive use and abandoned protective equipment is aggravating the world's growing plastic problem. Moreover, above protective equipment can eventually break down into microplastics and enter the environment. Here we review the threat of protective equipment associated plastic and microplastic wastes to environments, animals and human health, and reveal the protective equipment associated microplastic cycle. The major points are the following:1) COVID-19 protective equipment is the emerging source of plastic and microplastic wastes in the environment. 2) protective equipment associated plastic and microplastic wastes are polluting aquatic, terrestrial, and atmospheric environments. 3) Discarded protective equipment can harm animals by entrapment, entanglement and ingestion, and derived microplastics can also cause adverse implications on animals and human health. 4) We also provide several recommendations and future research priority for the sustainable environment. Therefore, much importance should be attached to potential protective equipment associated plastic and microplastic pollution to protect the environment, animals and humans.
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Affiliation(s)
- Sheng Yang
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Yanping Cheng
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Tong Liu
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Shaoping Huang
- Department of Histology and Embryology, Medical School, Southeast University, Nanjing, China
| | - Lihong Yin
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Yuepu Pu
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Geyu Liang
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
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Greenhalgh T. Miasmas, mental models and preventive public health: some philosophical reflections on science in the COVID-19 pandemic. Interface Focus 2021; 11:20210017. [PMID: 34956591 PMCID: PMC8504883 DOI: 10.1098/rsfs.2021.0017] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2021] [Indexed: 12/12/2022] Open
Abstract
When the history of the COVID-19 pandemic is written, it is likely to show that the mental models held by scientists sometimes facilitated their thinking, thereby leading to lives saved, and at other times constrained their thinking, thereby leading to lives lost. This paper explores some competing mental models of how infectious diseases spread and shows how these models influenced the scientific process and the kinds of facts that were generated, legitimized and used to support policy. A central theme in the paper is the relative weight given by dominant scientific voices to probabilistic arguments based on experimental measurements versus mechanistic arguments based on theory. Two examples are explored: the cholera epidemic in nineteenth century London-in which the story of John Snow and the Broad Street pump is retold-and the unfolding of the COVID-19 pandemic in 2020 and early 2021-in which the evidence-based medicine movement and its hierarchy of evidence features prominently. In each case, it is shown that prevailing mental models-which were assumed by some to transcend theory but were actually heavily theory-laden-powerfully shaped both science and policy, with fatal consequences for some.
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Affiliation(s)
- Trisha Greenhalgh
- Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK
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30
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Trends in non-pharmaceutical intervention (NPI) related community practice for the prevention of COVID-19 in Addis Ababa, Ethiopia. PLoS One 2021; 16:e0259229. [PMID: 34813617 PMCID: PMC8610281 DOI: 10.1371/journal.pone.0259229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 10/18/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has affected Ethiopia since March 13, 2020, when the first case was detected in Addis Ababa. Since then, the incidence of cases has continued to increase day by day. As a result, the health sector has recommended universal preventive measures to be practiced by the public. However, studies on adherence to these preventive measures are limited. OBJECTIVE To monitor the status of preventive practices of the population related to hand washing, physical distancing, and respiratory hygiene practices at selected sites within the city of Addis Ababa. METHODS Weekly cross-sectional non-participatory observations were done during the period of April-June, 2020. Data was collected using the Open Data Kit (ODK) tool in ten public sites involving eight public facilities targeted for individual observations. Ten individuals were randomly observed at each facility over two days a week at peak hours of public services. WHO operational definitions of the preventive behaviors were adopted for this study. Observations were conducted anonymously at gates or entrances of public facilities and places. RESULTS A total of 12,056 individual observations with 53% males and 82% in an estimated age range of 18-50 years age group were involved in this study. There was an increase in the practice of respiratory hygiene from 14% in week one to 77% in week 10, while those of hand hygiene and physical distancing changed little over the weeks from their baseline of 24% and 34%, respectively. Overall, respiratory hygiene demonstrated an increased rate of 6% per week, while hand hygiene and physical distancing had less than a 1% change per week, Females and the estimated age group of 18-50 years had practice changes in respiratory hygiene with no difference in hand hygiene and physical distancing practices. Respiratory hygiene took about six weeks to reach a level of 77% from its baseline of 24%, making an increment of about 9% per week. CONCLUSION The public practice of respiratory hygiene improved threefold whereas hand hygiene and physical distancing revealed no change. Regularly sustained public mobilization and mass education are required to sustain the achievements gained in respiratory hygiene and further hand hygiene and physical distancing.
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Rabbani MG, Akter O, Hasan MZ, Samad N, Mahmood SS, Joarder T. COVID-19 Knowledge, Attitudes, and Practices Among People in Bangladesh: Telephone-Based Cross-sectional Survey. JMIR Form Res 2021; 5:e28344. [PMID: 34519660 PMCID: PMC8575001 DOI: 10.2196/28344] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/04/2021] [Accepted: 04/22/2021] [Indexed: 11/16/2022] Open
Abstract
Background The world has been grappling with the COVID-19 pandemic, a dire public health crisis, since December 2019. Preventive and control measures have been adopted to reduce the spread of COVID-19. To date, the public’s knowledge, attitudes, and practices regarding COVID-19 across Bangladesh have been poorly understood. Therefore, it is important to assess people’s knowledge, attitudes, and practices (KAP) toward the disease and suggest appropriate strategies to combat COVID-19 effectively. Objective This study aimed to assess the KAP of Bangladeshi people toward COVID-19 and to identify their determinants. Methods We conducted a country-wide cross-sectional telephonic survey from May 7 to 29, 2020. A purposive sampling method was applied, and adult Bangladeshi citizens who have mobile phones were approached to participate in the survey. Interviews were conducted based on verbal consent. Multiple logistic regression analyses and several tests were performed to identify the factors associated with KAP related to COVID-19. Results A total of 492 of 576 Bangladeshi adults aged 18 years and above completed the interview, with a response rate of 85.4% (492/576). Of the 492 participants, 321 (65.2%) were male, and 304 (61.8%) lived in a rural area. Mean scores for knowledge, attitudes, and practices were 10.56 (SD 2.86), 1.24 (SD 0.83), and 3.17 (SD 1.5), respectively. Among the 492 respondents, 273 (55.5%) had poor knowledge, and 251 (49%) expressed a negative attitude; 192 out of 359 respondents (53.5%) had poor practices toward COVID-19. Mean scores of knowledge, attitudes, and practices differed significantly across various demographic and socioeconomic groups. Rural residents had lower mean scores of knowledge (mean 9.8, SD 3.1, P<.001) and adherence to appropriate practice measures (mean 4, SD 1.4, P<.001) compared to their urban counterparts. Positive and statistically strong correlations between knowledge and attitudes (r=0.21, P<.001), knowledge and practices (r=0.45, P<.001), and attitudes and practices (r=0.27, P<.001) were observed. Television (53.7%) was identified as the major source of knowledge regarding COVID-19. Almost three-quarters of the respondents (359/492, 73%) went outside the home during the lockdown period. Furthermore, the study found that good knowledge (odds ratio [OR] 3.13, 95% CI 2.03-4.83, and adjusted OR 2.33, 95% CI 1.16-4.68) and a positive attitude (OR 2.43, 95% CI 1.59-3.72, and adjusted OR 3.87, 95% CI 1.95-7.68) are significantly associated with better practice of COVID-19 health measures. Conclusions Evidence-informed and context-specific risk communication and community engagement, and a social and behavior change communication strategy against COVID-19 should be developed in Bangladesh based on the findings of this study, targeting different socioeconomic groups.
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Affiliation(s)
| | - Orin Akter
- Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Md Zahid Hasan
- Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Nandeeta Samad
- Department of Public Health, North South University, Dhaka, Bangladesh
| | - Shehrin Shaila Mahmood
- Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
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Trmčić A, Demmings E, Kniel K, Wiedmann M, Alcaine S. Food Safety and Employee Health Implications of COVID-19: A Review. J Food Prot 2021; 84:1973-1989. [PMID: 34265068 PMCID: PMC9906301 DOI: 10.4315/jfp-21-201] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 07/14/2021] [Indexed: 11/11/2022]
Abstract
The COVID-19 pandemic has greatly impacted the U.S. food supply and consumer behavior. Food production and processing are being disrupted as illnesses, proactive quarantines, and government-mandated movement restrictions cause labor shortages. In this environment, the food industry has been required to adopt new, additional practices to minimize the risk of COVID-19 cases and outbreaks among its workforce. Successfully overcoming these challenges requires a comprehensive approach that addresses COVID-19 transmission both within and outside the facility. Possible interventions include strategies (i) to vaccinate employees, (ii) to assure that employees practice social distancing, (iii) to assure that employees wear face coverings, (iv) to screen employees for COVID-19, (v) to assure that employees practice frequent hand washing and avoid touching their faces, (vi) to clean frequently touched surfaces, and (vii) to assure proper ventilation. Compliance with these control strategies must be verified, and an overall COVID-19 control culture must be established to implement an effective program. Despite some public misperceptions about the health risk of severe acute respiratory syndrome coronavirus 2 on foods or food packaging, both the virus biology and epidemiological data clearly support a negligible risk of COVID-19 transmission through food and food packing. However, COVID-19 pandemic-related supply chain and workforce disruptions and the shift in resources to protect food industry employees from COVID-19 may increase the actual food safety risks. The goal of this review was to describe the COVID-19 mitigation practices adopted by the food industry and the potential impact of these practices and COVID-19-related disruptions on the industry's food safety mission. A review of these impacts is necessary to ensure that the food industry is prepared to maintain a safe and nutritious food supply in the face of future global disruptions.
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Affiliation(s)
- Aljoša Trmčić
- Department of Food Science, Cornell University, Ithaca, New York 14850
| | | | - Kalmia Kniel
- Department of Animal and Food Sciences, University of Delaware, Newark, Delaware 19716, USA
| | - Martin Wiedmann
- Department of Food Science, Cornell University, Ithaca, New York 14850
| | - Sam Alcaine
- Department of Food Science, Cornell University, Ithaca, New York 14850,Author for correspondence. Tel: 607-255-9183; Fax: 607-254-4868
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Seing I, Thórný Stefánsdóttir N, Wassar Kirk J, Andersen O, Tjørnhøj-Thomsen T, Kallemose T, Vedung E, Vrangbæk K, Nilsen P. Social Distancing Policies in the Coronavirus Battle: A Comparison of Denmark and Sweden. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10990. [PMID: 34682734 PMCID: PMC8536108 DOI: 10.3390/ijerph182010990] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 10/13/2021] [Accepted: 10/14/2021] [Indexed: 11/17/2022]
Abstract
Social distancing measures have been a key component in government strategies to mitigate COVID-19 globally. Based on official documents, this study aimed to identify, compare and analyse public social distancing policy measures adopted in Denmark and Sweden regarding the coronavirus from 1 March 2020 until 1 October 2020. A key difference was the greater emphasis on laws and executive orders (sticks) in Denmark, which allowed the country to adopt many stricter policy measures than Sweden, which relied mostly on general guidelines and recommendations (sermons). The main policy adopters in Denmark were the government and the Danish Parliament, whereas the Public Health Agency issued most policies in Sweden, reflecting a difference in political governance and administrative structure in the two countries. During the study period, Sweden had noticeably higher rates of COVID-19 deaths and hospitalizations per 100,000 population than Denmark, yet it is difficult to determine the impact or relative effectiveness of sermons and sticks, particularly with regard to broader and longer-term health, economic and societal effects.
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Affiliation(s)
- Ida Seing
- Department of Behavioral Science and Learning, Linköping University, SE 581 83 Linköping, Sweden
| | - Nina Thórný Stefánsdóttir
- Department of Clinical Research, Copenhagen University Hospital—Amager and Hvidovre, DK-2650 Hvidovre, Denmark; (N.T.S.); (J.W.K.); (O.A.); (T.K.)
| | - Jeanette Wassar Kirk
- Department of Clinical Research, Copenhagen University Hospital—Amager and Hvidovre, DK-2650 Hvidovre, Denmark; (N.T.S.); (J.W.K.); (O.A.); (T.K.)
- Department of Public Health, Nursing, Aarhus University, DK-8000 Aarhus, Denmark
| | - Ove Andersen
- Department of Clinical Research, Copenhagen University Hospital—Amager and Hvidovre, DK-2650 Hvidovre, Denmark; (N.T.S.); (J.W.K.); (O.A.); (T.K.)
- Department of Clinical Medicine, University of Copenhagen, DK-2200 Copenhagen, Denmark
| | - Tine Tjørnhøj-Thomsen
- National Institute of Public Health, University of Southern Denmark, DK-1455 Copenhagen, Denmark;
| | - Thomas Kallemose
- Department of Clinical Research, Copenhagen University Hospital—Amager and Hvidovre, DK-2650 Hvidovre, Denmark; (N.T.S.); (J.W.K.); (O.A.); (T.K.)
| | - Evert Vedung
- Institute for Housing and Urban Research (IBF), Uppsala University, SE 751 20 Uppsala, Sweden;
- Department of Government, Uppsala University, SE 751 20 Uppsala, Sweden
| | - Karsten Vrangbæk
- Department of Public Health, University of Copenhagen, DK-1353 Copenhagen, Denmark;
- Department of Political Science, University of Copenhagen, DK-1353 Copenhagen, Denmark
| | - Per Nilsen
- Department of Health, Medicine and Caring Sciences, Linköping University, SE 581 83 Linköping, Sweden;
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Amuakwa-Mensah F, Klege RA, Adom PK, Köhlin G. COVID-19 and handwashing: Implications for water use in Sub-Saharan Africa. WATER RESOURCES AND ECONOMICS 2021; 36:100189. [PMID: 34745865 PMCID: PMC8563594 DOI: 10.1016/j.wre.2021.100189] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 09/27/2021] [Accepted: 10/28/2021] [Indexed: 05/21/2023]
Abstract
Because the main modes of transmission of the COVID-19 virus are respiration and contact, WHO recommends frequent washing of hands with soap under running water for at least 20 s. This article investigates how the level of concern about COVID-19 affects the likelihood of washing hands frequently in sub-Saharan Africa. We discuss the implication of the findings for water-scarce environment. The study makes use of a unique survey dataset from 12 sub-Saharan African countries collected in April 2020 (first round) and May 2020 (second round) and employs an extended ordered probit model with endogenous covariate. The results show that the level of concern about the spread of the virus increases the likelihood of washing hands with soap under running water for a minimum of 20 s at least five times a day. The increase in the probability of handwashing due to concern about COVID-19, ranges from 3% for Benin to 6.3% for South Africa. The results also show heterogeneous effects across gender- and age-groups, locality and various water sources. However, in Africa, the sustainability of the handwashing protocol could be threatened by the severe water scarcity that exists in the region. To sustain frequent handwashing, sub-Saharan Africa needs an effective strategy for water management and supply.
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Affiliation(s)
- Franklin Amuakwa-Mensah
- Environment for Development, University of Gothenburg, Box 645, SE 405 30, Göteborg, Sweden
- Department of Business Administration, Technology and Social Sciences, Luleå University of Technology, 971 87, Luleå, Sweden
| | - Rebecca Afua Klege
- School of Economics, University of Cape Town, Private Bag, Rondebosch, 7701, Cape Town, South Africa
- Henry J Austin Health Center, 321 N. Warren Street, Trenton, 08618, New Jersey, USA
| | - Philip Kofi Adom
- Department of Development Policy School of Public Service, Governance Ghana Institute of Management and Public Administration GIMPA, Ghana
| | - Gunnar Köhlin
- Environment for Development, University of Gothenburg, Box 645, SE 405 30, Göteborg, Sweden
- School of Economics, University of Cape Town, Private Bag, Rondebosch, 7701, Cape Town, South Africa
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A cross-sectional study of COVID-19-related bullying in a sample of Lebanese adults: scale validation, correlates, and mediating effect of fear and anxiety. BMC Psychol 2021; 9:137. [PMID: 34496963 PMCID: PMC8425023 DOI: 10.1186/s40359-021-00643-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 08/18/2021] [Indexed: 11/30/2022] Open
Abstract
Background The COVID-19 pandemic has led to prolonged exposure to stress and anxiety, raising concerns about a large spectrum of psychological side effects. The primary objective of the study was to validate the COVID-19 Bullying Scale (CBS-11). The second objective was to explore factors associated with COVID-19-related bullying and evaluate the mediating effect of fear and anxiety between knowledge and COVID-19-related bullying.
Methods A cross-sectional online survey conducted between December 20, 2020, and January 5, 2021, recruited 405 Lebanese adults using a snowball sampling technique. The CBS-11, an 11-item tool specifically created for this study, was used to measure bullying behaviors towards COVID-19 patients. Results All items of the CBS-11 converged over a 1-factor solution with an eigenvalue over 1, accounting for a variance of 75.16%. The scale has a high Cronbach’s alpha (.974), indicating excellent reliability. A positive correlation was found between the COVID-19 bullying scale and fear, anxiety, and stigma discrimination. The logistic regression showed that higher fear of COVID-19 (ORa = 1.04), a positive attitude toward COVID-19 preventive measures and hygiene recommendations (ORa = 1.18), higher stigma discrimination scores (ORa = 1.09), and having a health professional family member (ORa = 2.42) were significantly associated with bullying. Conclusion Our main findings showed that the CBS-11 could be an efficient tool to measure bullying behaviors toward COVID-19 patients. Stigma discrimination and fear from COVID-19 were associated with higher bullying attitudes. Future prospective studies are needed to understand better the factors related to bullying among adults during a pandemic, such as COVID-19. Supplementary Information The online version contains supplementary material available at 10.1186/s40359-021-00643-1.
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Yeom M, Stewart F, Stewart A. The impact of social distancing on community case count in the United States: Testing the efficacy of protection motivation theory during early stages of the COVID-19 pandemic. RISK, HAZARDS & CRISIS IN PUBLIC POLICY 2021; 12:303-327. [PMID: 34909111 PMCID: PMC8661797 DOI: 10.1002/rhc3.12232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 02/18/2021] [Accepted: 06/02/2021] [Indexed: 06/14/2023]
Abstract
Centuries of practice and an array of public health literature support social distancing (SD), or self-quarantine, as a valuable nonpharmaceutical intervention. To convince individuals to engage in behaviors that limit infection, public health professionals communicate risk and hazard based on application of protection motivation theory (PMT). The COVID-19 pandemic presents an opportunity to explore the efficacy of PMT in the context of a novel coronavirus with unique public health implications. We test an integrative conceptual model of social distancing compliance in U.S. counties and examine the mediating impact of SD on community spread of infection. We find that PMT does impact individual behavior, observing that the proportion of vulnerable populations affects social distancing compliance. However, actions to protect individual health are made within the context of economic concerns and priorities. While results indicate that PMT influences behavior, the expected relationship between that behavior and spread of disease in the community is not found. We do not repudiate SD or the value of PMT, but we suggest that these results may indicate that communication of risk in the context of COVID-19 may need community, as well as individual, framing.
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Affiliation(s)
- Minkyu Yeom
- Department of Urban Studies, Levin College of Urban AffairsCleveland State UniversityClevelandOhioUSA
| | - Fran Stewart
- John Glenn College of Public Affairs and the Ohio Manufacturing InstituteThe Ohio State UniversityColumbusOhioUSA
| | - Alice Stewart
- Department of Management, Willie A. Deese College of Business and EconomicsNorth Carolina A&T State UniversityGreensboroNorth CarolinaUSA
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Hoffmann T, Bakhit M, Krzyzaniak N, Del Mar C, Scott AM, Glasziou P. Soap versus sanitiser for preventing the transmission of acute respiratory infections in the community: a systematic review with meta-analysis and dose-response analysis. BMJ Open 2021; 11:e046175. [PMID: 34408031 PMCID: PMC8375726 DOI: 10.1136/bmjopen-2020-046175] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE To compare the effectiveness of hand hygiene using alcohol-based hand sanitiser to soap and water for preventing the transmission of acute respiratory infections (ARIs) and to assess the relationship between the dose of hand hygiene and the number of ARI, influenza-like illness (ILI) or influenza events. DESIGN Systematic review and meta-analysis. DATA SOURCES Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Embase, Cumulative Index of Nursing and Allied Health Literature (CINAHL) and trial registries were searched in April 2020. INCLUSION CRITERIA We included randomised controlled trials that compared a community-based hand hygiene intervention (soap and water, or sanitiser) with a control, or trials that compared sanitiser with soap and water, and measured outcomes of ARI, ILI or laboratory-confirmed influenza or related consequences. DATA EXTRACTION AND ANALYSIS Two review authors independently screened the titles and abstracts for inclusion and extracted data. RESULTS Eighteen trials were included. When meta-analysed, three trials of soap and water versus control found a non-significant increase in ARI events (risk ratio (RR) 1.23, 95% CI 0.78 to 1.93); six trials of sanitiser versus control found a significant reduction in ARI events (RR 0.80, 95% CI 0.71 to 0.89). When hand hygiene dose was plotted against ARI relative risk, no clear dose-response relationship was observable. Four trials were head-to-head comparisons of sanitiser and soap and water but too heterogeneous to pool: two found a significantly greater reduction in the sanitiser group compared with the soap group and two found no significant difference between the intervention arms. CONCLUSIONS Adequately performed hand hygiene, with either soap or sanitiser, reduces the risk of ARI virus transmission; however, direct and indirect evidence suggest sanitiser might be more effective in practice.
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Affiliation(s)
- Tammy Hoffmann
- Institute for Evidence-Based Healthcare, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Mina Bakhit
- Institute for Evidence-Based Healthcare, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Natalia Krzyzaniak
- Institute for Evidence-Based Healthcare, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Chris Del Mar
- Institute for Evidence-Based Healthcare, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Anna Mae Scott
- Institute for Evidence-Based Healthcare, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Paul Glasziou
- Institute for Evidence-Based Healthcare, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
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Probst LF, Guerrero ATG, Cardoso AIDQ, Grande AJ, Croda MG, Venturini J, Fonseca MCDC, Paniago AMM, Barreto JOM, de Oliveira SMDVL. Mask decontamination methods (model N95) for respiratory protection: a rapid review. Syst Rev 2021; 10:219. [PMID: 34364396 PMCID: PMC8349237 DOI: 10.1186/s13643-021-01742-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 06/13/2021] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND N95 respiratory protection masks are used by healthcare professionals to prevent contamination from infectious microorganisms transmitted by droplets or aerosols. METHODS We conducted a rapid review of the literature analyzing the effectiveness of decontamination methods for mask reuse. The database searches were carried out up to September 2020. The systematic review was conducted in a way which simplified the stages of a complete systematic review, due to the worldwide necessity for reliable fast evidences on this matter. RESULTS A total of 563 articles were retrieved of which 48 laboratory-based studies were selected. Fifteen decontamination methods were included in the studies. A total of 19 laboratory studies used hydrogen peroxide, 21 studies used ultraviolet germicidal irradiation, 4 studies used ethylene oxide, 11 studies used dry heat, 9 studies used moist heat, 5 studies used ethanol, two studies used isopropanol solution, 11 studies used microwave oven, 10 studies used sodium hypochlorite, 7 studies used autoclave, 3 studies used an electric rice cooker, 1 study used cleaning wipes, 1 study used bar soap, 1 study used water, 1 study used multi-purpose high-level disinfection cabinet, and another 1 study used chlorine dioxide. Five methods that are promising are as follows: hydrogen peroxide vapor, ultraviolet irradiation, dry heat, wet heat/pasteurization, and microwave ovens. CONCLUSIONS We have presented the best available evidence on mask decontamination; nevertheless, its applicability is limited due to few studies on the topic and the lack of studies on real environments.
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Affiliation(s)
- Livia Fernandes Probst
- Piracicaba Dental School, State University of Campinas, Piracicaba, Brazil
- Health Technology Assessment Unit, Hospital Alemão Oswaldo Cruz, São Paulo, Brazil
| | - Ana Tereza Gomes Guerrero
- Institute of Technology in Immunobiologicals: Bio-Manguinhos. Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | | | - Antonio Jose Grande
- Faculty of Medicine , State University of Mato Grosso do Sul, Campo Grande, Brazil
| | | | - James Venturini
- Federal University of Mato Grosso do Sul , Campo Grande, Brazil
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Alqahtani JS, Oyelade T, Aldhahir AM, Mendes RG, Alghamdi SM, Miravitlles M, Mandal S, Hurst JR. Reduction in hospitalised COPD exacerbations during COVID-19: A systematic review and meta-analysis. PLoS One 2021; 16:e0255659. [PMID: 34343205 PMCID: PMC8330941 DOI: 10.1371/journal.pone.0255659] [Citation(s) in RCA: 81] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 07/21/2021] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Reports have suggested a reduction in exacerbations of chronic obstructive pulmonary disease (COPD) during the coronavirus disease 2019 (COVID-19) pandemic, particularly hospital admissions for severe exacerbations. However, the magnitude of this reduction varies between studies. METHOD Electronic databases were searched from January 2020 to May 2021. Two independent reviewers screened titles and abstracts and, when necessary, full text to determine if studies met inclusion criteria. A modified version of the Newcastle-Ottawa Scale was used to assess study quality. A narrative summary of eligible studies was synthesised, and meta-analysis was conducted using a random effect model to pool the rate ratio and 95% confidence intervals (95% CI) for hospital admissions. Exacerbation reduction was compared against the COVID-19 Containment and Health Index. RESULTS A total of 13 of 745 studies met the inclusion criteria and were included in this review, with data from nine countries. Nine studies could be included in the meta-analysis. The pooled rate ratio of hospital admissions for COPD exacerbations during the pandemic period was 0.50 (95% CI 0.44-0.57). Findings on the rate of community-treated exacerbations were inconclusive. Three studies reported a significant decrease in the incidence of respiratory viral infections compared with the pre-pandemic period. There was not a significant relationship between exacerbation reduction and the COVID-19 Containment and Health Index (rho = 0.20, p = 0.53). CONCLUSION There was a 50% reduction in admissions for COPD exacerbations during the COVID-19 pandemic period compared to pre-pandemic times, likely associated with a reduction in respiratory viral infections that trigger exacerbations. Future guidelines should consider including recommendations on respiratory virus infection control measures to reduce the burden of COPD exacerbations beyond the pandemic period.
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Affiliation(s)
- Jaber S. Alqahtani
- UCL Respiratory, University College London, London, United Kingdom
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia
| | - Tope Oyelade
- UCL Division of Medicine, London, United Kingdom
| | - Abdulelah M. Aldhahir
- Respiratory Care Department, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | - Renata Gonçalves Mendes
- Department of Physical Therapy, Cardiopulmonary Physiotherapy Laboratory, Federal University of São Carlos, São Paulo, Brazil
| | - Saeed M. Alghamdi
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
- Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Marc Miravitlles
- Pneumology Department, Hospital Universitari Vall d´Hebron/Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Hospital Campus; CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain
| | - Swapna Mandal
- UCL Respiratory, University College London, London, United Kingdom
- Royal Free London NHS Foundation Trust, London, United Kingdom
| | - John R. Hurst
- UCL Respiratory, University College London, London, United Kingdom
- Royal Free London NHS Foundation Trust, London, United Kingdom
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Escandón K, Rasmussen AL, Bogoch II, Murray EJ, Escandón K, Popescu SV, Kindrachuk J. COVID-19 false dichotomies and a comprehensive review of the evidence regarding public health, COVID-19 symptomatology, SARS-CoV-2 transmission, mask wearing, and reinfection. BMC Infect Dis 2021; 21:710. [PMID: 34315427 PMCID: PMC8314268 DOI: 10.1186/s12879-021-06357-4] [Citation(s) in RCA: 81] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 06/24/2021] [Indexed: 02/07/2023] Open
Abstract
Scientists across disciplines, policymakers, and journalists have voiced frustration at the unprecedented polarization and misinformation around coronavirus disease 2019 (COVID-19) pandemic. Several false dichotomies have been used to polarize debates while oversimplifying complex issues. In this comprehensive narrative review, we deconstruct six common COVID-19 false dichotomies, address the evidence on these topics, identify insights relevant to effective pandemic responses, and highlight knowledge gaps and uncertainties. The topics of this review are: 1) Health and lives vs. economy and livelihoods, 2) Indefinite lockdown vs. unlimited reopening, 3) Symptomatic vs. asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, 4) Droplet vs. aerosol transmission of SARS-CoV-2, 5) Masks for all vs. no masking, and 6) SARS-CoV-2 reinfection vs. no reinfection. We discuss the importance of multidisciplinary integration (health, social, and physical sciences), multilayered approaches to reducing risk ("Emmentaler cheese model"), harm reduction, smart masking, relaxation of interventions, and context-sensitive policymaking for COVID-19 response plans. We also address the challenges in understanding the broad clinical presentation of COVID-19, SARS-CoV-2 transmission, and SARS-CoV-2 reinfection. These key issues of science and public health policy have been presented as false dichotomies during the pandemic. However, they are hardly binary, simple, or uniform, and therefore should not be framed as polar extremes. We urge a nuanced understanding of the science and caution against black-or-white messaging, all-or-nothing guidance, and one-size-fits-all approaches. There is a need for meaningful public health communication and science-informed policies that recognize shades of gray, uncertainties, local context, and social determinants of health.
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Affiliation(s)
- Kevin Escandón
- School of Medicine, Universidad del Valle, Cali, Colombia.
| | - Angela L Rasmussen
- Vaccine and Infectious Disease Organization, University of Saskatchewan, Saskatoon, Canada
- Georgetown Center for Global Health Science and Security, Georgetown University, Washington, DC, USA
| | - Isaac I Bogoch
- Division of Infectious Diseases, University of Toronto, Toronto General Hospital, Toronto, Canada
| | - Eleanor J Murray
- Department of Epidemiology, Boston University School of Public Health, Boston, USA
| | - Karina Escandón
- Department of Anthropology, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Saskia V Popescu
- Georgetown Center for Global Health Science and Security, Georgetown University, Washington, DC, USA
- Schar School of Policy and Government, George Mason University, Fairfax, VA, USA
| | - Jason Kindrachuk
- Vaccine and Infectious Disease Organization, University of Saskatchewan, Saskatoon, Canada
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Canada
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Fietsam AC, Deters JR, Workman CD, Rudroff T. Personal Protective Equipment Alters Leg Muscle Fatigability Independent of Transcranial Direct Current Stimulation: A Comparison with Pre-COVID-19 Pandemic Results. Brain Sci 2021; 11:brainsci11080962. [PMID: 34439581 PMCID: PMC8392507 DOI: 10.3390/brainsci11080962] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 07/02/2021] [Accepted: 07/19/2021] [Indexed: 01/12/2023] Open
Abstract
In response to the COVID-19 pandemic, the use of personal protective equipment (PPE; e.g., face mask) has increased. Mandating subjects to wear PPE during vigorous exercise might affect the fatigue outcomes of transcranial direct current stimulation (tDCS) studies. The purpose of this study was to investigate whether the use of PPE affected the performance of a tDCS-influenced fatigue task in healthy adults. A total of 16 young and healthy subjects were recruited and wore PPE during an isokinetic fatigue task in conjunction with sham, 2 mA, and 4 mA tDCS conditions. Subjects were matched to subjects who did not wear PPE during our previous pre-pandemic study in which right knee extensor fatigability increased under these same conditions. The results show that right knee extensor fatigability, derived from torque and work (FI-T and FI-W, respectively), was higher in the PPE study compared to the No PPE study in the sham condition. Additionally, there were no differences in knee extensor fatigability or muscle activity between sham, 2 mA, and 4 mA tDCS in the present study, which contrasts with our previous results. Thus, PPE worn by subjects and researchers might have a detrimental effect on fatigue outcomes in tDCS studies irrespective of the stimulation intervention.
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Affiliation(s)
- Alexandra C. Fietsam
- Department of Health and Human Physiology, University of Iowa, Iowa City, IA 52242, USA; (A.C.F.); (J.R.D.); (C.D.W.)
| | - Justin R. Deters
- Department of Health and Human Physiology, University of Iowa, Iowa City, IA 52242, USA; (A.C.F.); (J.R.D.); (C.D.W.)
| | - Craig D. Workman
- Department of Health and Human Physiology, University of Iowa, Iowa City, IA 52242, USA; (A.C.F.); (J.R.D.); (C.D.W.)
| | - Thorsten Rudroff
- Department of Health and Human Physiology, University of Iowa, Iowa City, IA 52242, USA; (A.C.F.); (J.R.D.); (C.D.W.)
- Department of Neurology, University of Iowa Health Clinics, Iowa City, IA 52242, USA
- Correspondence: ; Tel.: +1-319-467-0363
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42
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Gopal V, Nilsson-Payant BE, French H, Siegers JY, Yung WS, Hardwick M, te Velthuis AJW. Zinc-Embedded Polyamide Fabrics Inactivate SARS-CoV-2 and Influenza A Virus. ACS APPLIED MATERIALS & INTERFACES 2021; 13:30317-30325. [PMID: 34180223 PMCID: PMC8262172 DOI: 10.1021/acsami.1c04412] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 06/17/2021] [Indexed: 05/18/2023]
Abstract
Influenza A viruses (IAV) and SARS-CoV-2 can spread via liquid droplets and aerosols. Face masks and other personal protective equipment (PPE) can act as barriers that prevent the spread of these viruses. However, IAV and SARS-CoV-2 are stable for hours on various materials, which makes frequent and correct disposal of these PPE important. Metal ions embedded into PPE may inactivate respiratory viruses, but confounding factors such as adsorption of viruses make measuring and optimizing the inactivation characteristics difficult. Here, we used polyamide 6.6 (PA66) fibers containing embedded zinc ions and systematically investigated if these fibers can adsorb and inactivate SARS-CoV-2 and IAV H1N1 when woven into a fabric. We found that our PA66-based fabric decreased the IAV H1N1 and SARS-CoV-2 titer by approximately 100-fold. Moreover, we found that the zinc content and the virus inactivating property of the fabric remained stable over 50 standardized washes. Overall, these results provide insights into the development of reusable PPE that offer protection against RNA virus spread.
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Affiliation(s)
- Vikram Gopal
- Ascend
Performance Materials, 1010 Travis Street, Suite 900, Houston, Texas 77002, United States
| | - Benjamin E. Nilsson-Payant
- Department
of Microbiology, Icahn School of Medicine
at Mount Sinai, New York, New York 10029, United States
| | - Hollie French
- Division
of Virology, Department of Pathology, Addenbrooke’s Hospital, University of Cambridge, Hills Road, Cambridge CB2 2QQ, U.K.
| | - Jurre Y. Siegers
- Department
of Viroscience, Erasmus University Medical
Centre, Rotterdam 3015 GD, the Netherlands
| | - Wai-shing Yung
- Ascend
Performance Materials, 1010 Travis Street, Suite 900, Houston, Texas 77002, United States
| | - Matthew Hardwick
- ResInnova
Laboratories, 8807 Colesville
Rd, 3rd Floor, Silver Spring, Maryland 20910, United
States
| | - Aartjan J. W. te Velthuis
- Division
of Virology, Department of Pathology, Addenbrooke’s Hospital, University of Cambridge, Hills Road, Cambridge CB2 2QQ, U.K.
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43
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Tan HMJ, Tan MS, Chang ZY, Tan KT, Ee GLA, Ng CCD, Hwang YKW, Koh YLE, Low YPS, Tan NC. The impact of COVID-19 pandemic on the health-seeking behaviour of an Asian population with acute respiratory infections in a densely populated community. BMC Public Health 2021; 21:1196. [PMID: 34158019 PMCID: PMC8219514 DOI: 10.1186/s12889-021-11200-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 05/31/2021] [Indexed: 12/02/2022] Open
Abstract
Background The COVID-19 pandemic led to the implementation of various non-pharmaceutical interventions (NPI) as the Singapore government escalated containment efforts from DORSCON Orange to Circuit Breaker. NPI include mandatory mask wearing, hand hygiene, social distancing, and closure of schools and workplaces. Considering the similar mode of transmission of COVID-19 and other pathogens related to acute respiratory infections (ARI), the effects of NPI could possibly lead to decreased ARI attendances in the community. This study aims to determine the year-on-year and weekly changes of ARI attendances across a cluster of polyclinics following the implementation of NPI. Methods The effect of the nation-wide measures on the health-seeking behaviour of the study population was examined over three periods: (1) 9 weeks prior to the start of Circuit Breaker (DORSCON Orange period), (2) 8 weeks during the Circuit Breaker, and (3) 9 weeks after easing of Circuit Breaker. Data on ARI attendances for the corresponding periods in 2019 were also extracted for comparison and to assess the seasonal variations of ARI. The average weekly workday ARI attendances were compared with those of the preceding week using Wilcoxon signed rank test. Results ARI attendances dropped steadily throughout the study period and were 50–80% lower than in 2019 since Circuit Breaker. They remained low even after Circuit Breaker ended. Positivity rate for influenza-like illnesses samples in the community was 0.0% from the last week of Circuit Breaker to end of study period. Conclusions NPI and public education measures during DORSCON Orange and Circuit Breaker periods appear to be associated with the health-seeking behaviour of the public. Changing levels of perceived susceptibility, severity, benefits and barriers, and widespread visual cues based on the Health Belief Model may account for this change. Understanding the impact of NPI and shifts in the public’s health-seeking behaviour will be relevant and helpful in the planning of future pandemic responses.
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Affiliation(s)
- Hwee Mian Jane Tan
- SingHealth Polyclinics, 167 Jalan Bukit Merah Connection One (Tower 5), #15-10, Singapore, 150167, Singapore. .,SingHealth Duke-NUS Family Medicine Academic Clinical Program, Singapore, Singapore.
| | - Mui Suan Tan
- SingHealth Polyclinics, 167 Jalan Bukit Merah Connection One (Tower 5), #15-10, Singapore, 150167, Singapore.,SingHealth Duke-NUS Family Medicine Academic Clinical Program, Singapore, Singapore
| | - Zi Ying Chang
- SingHealth Polyclinics, 167 Jalan Bukit Merah Connection One (Tower 5), #15-10, Singapore, 150167, Singapore.,SingHealth Duke-NUS Family Medicine Academic Clinical Program, Singapore, Singapore
| | - Kee Tung Tan
- SingHealth Polyclinics, 167 Jalan Bukit Merah Connection One (Tower 5), #15-10, Singapore, 150167, Singapore.,SingHealth Duke-NUS Family Medicine Academic Clinical Program, Singapore, Singapore
| | - Guan Liang Adrian Ee
- SingHealth Polyclinics, 167 Jalan Bukit Merah Connection One (Tower 5), #15-10, Singapore, 150167, Singapore.,SingHealth Duke-NUS Family Medicine Academic Clinical Program, Singapore, Singapore
| | - Chee Chin David Ng
- SingHealth Polyclinics, 167 Jalan Bukit Merah Connection One (Tower 5), #15-10, Singapore, 150167, Singapore.,SingHealth Duke-NUS Family Medicine Academic Clinical Program, Singapore, Singapore
| | - Ying Khee William Hwang
- National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 169610, Singapore.,SingHealth Duke-NUS Family Oncology Academic Clinical Program, Singapore, Singapore
| | - Yi Ling Eileen Koh
- SingHealth Polyclinics, 167 Jalan Bukit Merah Connection One (Tower 5), #15-10, Singapore, 150167, Singapore
| | - Yan Ping Sarah Low
- SingHealth Polyclinics, 167 Jalan Bukit Merah Connection One (Tower 5), #15-10, Singapore, 150167, Singapore
| | - Ngiap Chuan Tan
- SingHealth Polyclinics, 167 Jalan Bukit Merah Connection One (Tower 5), #15-10, Singapore, 150167, Singapore.,SingHealth Duke-NUS Family Medicine Academic Clinical Program, Singapore, Singapore
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44
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Cappa CD, Asadi S, Barreda S, Wexler AS, Bouvier NM, Ristenpart WD. Expiratory aerosol particle escape from surgical masks due to imperfect sealing. Sci Rep 2021; 11:12110. [PMID: 34103573 PMCID: PMC8187651 DOI: 10.1038/s41598-021-91487-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 05/27/2021] [Indexed: 01/20/2023] Open
Abstract
Wearing surgical masks or other similar face coverings can reduce the emission of expiratory particles produced via breathing, talking, coughing, or sneezing. Although it is well established that some fraction of the expiratory airflow leaks around the edges of the mask, it is unclear how these leakage airflows affect the overall efficiency with which masks block emission of expiratory aerosol particles. Here, we show experimentally that the aerosol particle concentrations in the leakage airflows around a surgical mask are reduced compared to no mask wearing, with the magnitude of reduction dependent on the direction of escape (out the top, the sides, or the bottom). Because the actual leakage flowrate in each direction is difficult to measure, we use a Monte Carlo approach to estimate flow-corrected particle emission rates for particles having diameters in the range 0.5-20 μm. in all orientations. From these, we derive a flow-weighted overall number-based particle removal efficiency for the mask. The overall mask efficiency, accounting both for air that passes through the mask and for leakage flows, is reduced compared to the through-mask filtration efficiency, from 93 to 70% for talking, but from only 94-90% for coughing. These results demonstrate that leakage flows due to imperfect sealing do decrease mask efficiencies for reducing emission of expiratory particles, but even with such leakage surgical masks provide substantial control.
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Affiliation(s)
- Christopher D Cappa
- Department of Civil and Environmental Engineering, University of California Davis, 1 Shields Ave., Davis, CA, 95616, USA.
| | - Sima Asadi
- Department of Chemical Engineering, University of California Davis, 1 Shields Ave., Davis, CA, 95616, USA
- Department of Chemical Engineering, Massachusetts Institute of Technology, 77 Massachusetts Av., Cambridge, MA, 02139, USA
| | - Santiago Barreda
- Department of Linguistics, University of California Davis, 1 Shields Ave., Davis, CA, 95616, USA
| | - Anthony S Wexler
- Department of Chemical Engineering, University of California Davis, 1 Shields Ave., Davis, CA, 95616, USA
- Department of Mechanical and Aerospace Engineering, University of California Davis, 1 Shields Ave., Davis, CA, 95616, USA
- Air Quality Research Center, University of California Davis, 1 Shields Ave., Davis, CA, 95616, USA
- Department of Land, Air and Water Resources, University of California Davis, 1 Shields Ave., Davis, CA, 95616, USA
| | - Nicole M Bouvier
- Department of Medicine, Division of Infectious Diseases, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY, 10029, USA
- Department Microbiology, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY, 10029, USA
| | - William D Ristenpart
- Department of Chemical Engineering, University of California Davis, 1 Shields Ave., Davis, CA, 95616, USA
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45
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Guellich A, Tella E, Ariane M, Grodner C, Nguyen-Chi HN, Mahé E. The face mask-touching behavior during the COVID-19 pandemic: Observational study of public transportation users in the greater Paris region: The French-mask-touch study. JOURNAL OF TRANSPORT & HEALTH 2021; 21:101078. [PMID: 33968608 PMCID: PMC8092492 DOI: 10.1016/j.jth.2021.101078] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 04/26/2021] [Accepted: 04/26/2021] [Indexed: 05/18/2023]
Abstract
BACKGROUND To limit the spread of the new coronavirus disease 2019 (COVID-19), the World Health Organization recommends the use of face mask as a part of the pandemic control strategy. It has published also "best practices" in which it advises to avoid touching the mask while wearing it. This might be challenging. The purpose of this study was to investigate the frequency of mask-touching behavior in public transportation. METHODS Observational study using data collected in real life. This survey was conducted in subways and local trains of the greater Paris region, France, between May 4th and 25th, 2020. Public Transportation users were covertly observed. Demographic characteristics, type of mask and the main activity were collected by the investigator. The duration of observation, the frequency of touching face mask, hair and the uncovered area of the face were also recorded. Frequency of mask-touching per hour was determined. RESULTS One hundred eighty two persons were observed. The median of estimated age [1st and 3rd interquartile] was 35 [30;45] years and 87 (48%) were women. One hundred forty three (79%) were wearing surgical mask. The median time of observation was 8 [4;12] minutes. During this period, 87 (48%) persons touched their mask 15 [7.5;30] times per hour of whom only two (8%) have used hydroalcoholic solution to disinfect their hands. CONCLUSIONS Mask touching is frequent and is rarely followed by hand disinfection. Actions regarding mask use should be taken to improve compliance.
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Affiliation(s)
- Aziz Guellich
- Dermatology Department, Hôpital Victor Dupouy Argenteuil, Argenteuil, France
- Primary Care Department, Université Paris-Est Créteil (UPEC), School of Medicine, Créteil, France
| | - Emilie Tella
- Dermatology Department, Hôpital Victor Dupouy Argenteuil, Argenteuil, France
| | - Molka Ariane
- Dermatology Department, Hôpital Victor Dupouy Argenteuil, Argenteuil, France
| | - Camille Grodner
- Dermatology Department, Hôpital Victor Dupouy Argenteuil, Argenteuil, France
| | - Hoai-Nam Nguyen-Chi
- Dermatology Department, Hôpital Victor Dupouy Argenteuil, Argenteuil, France
| | - Emmanuel Mahé
- Dermatology Department, Hôpital Victor Dupouy Argenteuil, Argenteuil, France
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46
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Moschovis PP, Yonker LM, Shah J, Singh D, Demokritou P, Kinane TB. Aerosol transmission of SARS-CoV-2 by children and adults during the COVID-19 pandemic. Pediatr Pulmonol 2021; 56:1389-1394. [PMID: 33624927 PMCID: PMC8014227 DOI: 10.1002/ppul.25330] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 01/13/2021] [Accepted: 02/09/2021] [Indexed: 12/23/2022]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can be transmitted via respiratory droplets, aerosols, and to a lesser extent, fomites. Defining the factors driving infectivity and transmission is critical for infection control and containment of this pandemic. We outline the major methods of transmission of SARS-CoV-2, focusing on aerosol transmission. We review principles of aerosol science and discuss their implications for mitigating the spread of SARS-CoV-2 among children and adults.
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Affiliation(s)
- Peter P Moschovis
- Division of Pediatric Pulmonary Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Lael M Yonker
- Division of Pediatric Pulmonary Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Jhill Shah
- Division of Pediatric Pulmonary Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Dilpreet Singh
- Center for Nanotechnology and Nanotoxicology, Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Philip Demokritou
- Center for Nanotechnology and Nanotoxicology, Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - T Bernard Kinane
- Division of Pediatric Pulmonary Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
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47
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BOCCALINI SARA, PARIANI ELENA, CALABRÒ GIOVANNAELISA, DE WAURE CHIARA, PANATTO DONATELLA, AMICIZIA DANIELA, LAI PIEROLUIGI, RIZZO CATERINA, AMODIO EMANUELE, VITALE FRANCESCO, CASUCCIO ALESSANDRA, DI PIETRO MARIALUISA, GALLI CRISTINA, BUBBA LAURA, PELLEGRINELLI LAURA, VILLANI LEONARDO, D’AMBROSIO FLORIANA, CAMINITI MARTA, LORENZINI ELISA, FIORETTI PAOLA, MICALE ROSANNATINDARA, FRUMENTO DAVIDE, CANTOVA ELISA, PARENTE FLAVIO, TRENTO GIACOMO, SOTTILE SARA, PUGLIESE ANDREA, BIAMONTE MASSIMILIANOALBERTO, GIORGETTI DUCCIO, MENICACCI MARCO, D’ANNA ANTONIO, AMMOSCATO CLAUDIA, LA GATTA EMANUELE, BECHINI ANGELA, BONANNI PAOLO. [Health Technology Assessment (HTA) of the introduction of influenza vaccination for Italian children with Fluenz Tetra ®]. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2021; 62:E1-E118. [PMID: 34909481 PMCID: PMC8639053 DOI: 10.15167/2421-4248/jpmh2021.62.2s1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- SARA BOCCALINI
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze, Firenze, Italia
- Autore corrispondente: Sara Boccalini, Dipartimento di Scienze della Salute, Università degli Studi di Firenze, 50134 Firenze, Italia - Tel.: 055-2751084 - E-mail:
| | - ELENA PARIANI
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano, Italia
- Centro Interuniversitario per la Ricerca sull'Influenza e le altre Infezioni Trasmissibili CIRI-IT, Italia
| | - GIOVANNA ELISA CALABRÒ
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
- VIHTALI (Value In Health Technology and Academy for Leadership & Innovation), spin off dell’Università Cattolica del Sacro Cuore, Roma, Italia
| | - CHIARA DE WAURE
- Dipartimento di Medicina e Chirurgia, Università degli Studi di Perugia, Perugia, Italia
| | - DONATELLA PANATTO
- Centro Interuniversitario per la Ricerca sull'Influenza e le altre Infezioni Trasmissibili CIRI-IT, Italia
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genova, Italia
| | - DANIELA AMICIZIA
- Centro Interuniversitario per la Ricerca sull'Influenza e le altre Infezioni Trasmissibili CIRI-IT, Italia
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genova, Italia
| | - PIERO LUIGI LAI
- Centro Interuniversitario per la Ricerca sull'Influenza e le altre Infezioni Trasmissibili CIRI-IT, Italia
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genova, Italia
| | - CATERINA RIZZO
- Area Funzionale Percorsi Clinici ed Epidemiologia, Ospedale Pediatrico Bambino Gesù, IRCCS, Roma, Italia
| | - EMANUELE AMODIO
- Dipartimento Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza “G. D'Alessandro”, Università degli Studi di Palermo, Palermo, Italia
| | - FRANCESCO VITALE
- Dipartimento Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza “G. D'Alessandro”, Università degli Studi di Palermo, Palermo, Italia
| | - ALESSANDRA CASUCCIO
- Dipartimento Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza “G. D'Alessandro”, Università degli Studi di Palermo, Palermo, Italia
| | - MARIA LUISA DI PIETRO
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
| | - CRISTINA GALLI
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano, Italia
| | - LAURA BUBBA
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano, Italia
| | - LAURA PELLEGRINELLI
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano, Italia
| | - LEONARDO VILLANI
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
| | - FLORIANA D’AMBROSIO
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
| | - MARTA CAMINITI
- Dipartimento di Medicina e Chirurgia, Università degli Studi di Perugia, Perugia, Italia
| | - ELISA LORENZINI
- Dipartimento di Medicina e Chirurgia, Università degli Studi di Perugia, Perugia, Italia
| | - PAOLA FIORETTI
- Dipartimento di Medicina e Chirurgia, Università degli Studi di Perugia, Perugia, Italia
| | | | - DAVIDE FRUMENTO
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genova, Italia
| | - ELISA CANTOVA
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genova, Italia
| | - FLAVIO PARENTE
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genova, Italia
| | - GIACOMO TRENTO
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genova, Italia
| | - SARA SOTTILE
- Università degli Studi di Trento, Trento, Italia
| | | | | | - DUCCIO GIORGETTI
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze, Firenze, Italia
| | - MARCO MENICACCI
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze, Firenze, Italia
| | - ANTONIO D’ANNA
- Dipartimento Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza “G. D'Alessandro”, Università degli Studi di Palermo, Palermo, Italia
| | - CLAUDIA AMMOSCATO
- Dipartimento Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza “G. D'Alessandro”, Università degli Studi di Palermo, Palermo, Italia
| | - EMANUELE LA GATTA
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
| | - ANGELA BECHINI
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze, Firenze, Italia
| | - PAOLO BONANNI
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze, Firenze, Italia
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48
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Collignon P. COVID-19 and future pandemics: is isolation and social distancing the new norm? Intern Med J 2021; 51:647-653. [PMID: 33960091 PMCID: PMC8206944 DOI: 10.1111/imj.15287] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 03/01/2021] [Accepted: 03/01/2021] [Indexed: 01/07/2023]
Abstract
The coronavirus, named SARS‐CoV‐2, is the cause of COVID‐19. This virus spreads readily from person to person and predominantly to and from the respiratory route and through droplets. There are many different interventions that can be and are used to decrease successfully the risk and spread of COVID‐19. Most of the principles underpinning these interventions relate to isolation and social distancing. These will need to be continued, at least in part, until safe and very effective vaccines become widely available and are delivered extensively and successfully globally. This new norm is isolation, plus social and physical distancing, and this new norm will likely be with us for some time to come. It will also be with us in any future pandemics, whether caused by bacteria or viruses, but especially when the causative pathogen spreads predominantly through the respiratory route. However, lockdowns and restrictions also cause many adverse but unintended economic, social and health consequences. Therefore, what is put into place needs to be proportionate to levels of risk of disease as well as spread, and which will vary in different localities and with time.
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Affiliation(s)
- Peter Collignon
- Microbiology and Infectious Disease, Canberra Hospital, Canberra, Australian Capital Territory, Australia.,Medical School, Australian National University, Canberra, Australian Capital Territory, Australia
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49
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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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Li Y, Wei Z, Zhang J, Li R, Li H, Cao L, Hou L, Zhang W, Chen N, Guo K, Li X, Yang K. Wearing masks to reduce the spread of respiratory viruses: a systematic evidence mapping. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:811. [PMID: 34268424 PMCID: PMC8246209 DOI: 10.21037/atm-20-6745] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Accepted: 02/28/2021] [Indexed: 01/08/2023]
Abstract
Since the outbreak of coronavirus disease in 2019, the controversy over the effectiveness, safety, and enforceability of masks used by the public has been prominent. This study aims to identify, describe, and organize the currently available high-quality design evidence concerning mask use during the spread of respiratory viruses and find evidence gaps. Databases including PubMed, Cochrane Library, Web of Science, EMBASE, WHO International Clinical Trials Registry Platform (ICTRP), clinical trial registry, gray literature database, and reference lists of articles were searched for relevant randomized controlled trials (RCTs) and systematic reviews (SRs) in April 2020. The quality of the studies was assessed using the risk of bias tool recommended by the Cochrane Handbook Version 5.1.0 and the Assessment of Multiple Systematic Reviews (AMSTAR 2) tool. A bubble plot was designed to display information in four dimensions. Finally, twenty-one RCTs and nine SRs met our inclusion criteria. Most studies were of “Low quality” and focused on healthcare workers. Six RCTs reported adverse effects, with one implying that the cloth masks reuse may increase the infection risk. When comparing masks with usual practice, over 70% RCTs and also SRs showed that masks were “beneficial” or “probably beneficial”; however, when comparing N95 respirators with medical masks, 75% of SRs showed “no effect”, whereas 50% of RCTs showed “beneficial effect”. Overall, the current evidence provided by high-quality designs may be insufficient to deal with a second impact of the pandemic. Masks may be effective in interrupting or reducing the spread of respiratory viruses; however, the effect of an N95 respirator or cloth masks versus medical masks is unclear. Additional high-quality studies determining the impact of prolonged mask use on vulnerable populations (such as children and pregnant women), the possible adverse effects (such as skin allergies and shortness of breath) and optimal settings and exposure circumstances for populations to use masks are needed.
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Affiliation(s)
- Yanfei Li
- Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, Lanzhou, China.,Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou University, Lanzhou, China.,WHO Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou University, Lanzhou, China.,Chinese GRADE Center, Lanzhou University, Lanzhou, China
| | - Zhipeng Wei
- Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, Lanzhou, China.,Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou University, Lanzhou, China.,WHO Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou University, Lanzhou, China.,Chinese GRADE Center, Lanzhou University, Lanzhou, China.,Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Jingyun Zhang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Rui Li
- Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, Lanzhou, China.,Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou University, Lanzhou, China.,WHO Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou University, Lanzhou, China.,Chinese GRADE Center, Lanzhou University, Lanzhou, China
| | - Huijuan Li
- Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, Lanzhou, China.,Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou University, Lanzhou, China.,WHO Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou University, Lanzhou, China.,Chinese GRADE Center, Lanzhou University, Lanzhou, China
| | - Liujiao Cao
- Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, Lanzhou, China.,Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou University, Lanzhou, China.,WHO Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou University, Lanzhou, China.,Chinese GRADE Center, Lanzhou University, Lanzhou, China
| | - Liangying Hou
- Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, Lanzhou, China.,Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou University, Lanzhou, China.,WHO Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou University, Lanzhou, China.,Chinese GRADE Center, Lanzhou University, Lanzhou, China
| | - Weiyi Zhang
- Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, Lanzhou, China.,Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou University, Lanzhou, China.,WHO Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou University, Lanzhou, China.,Chinese GRADE Center, Lanzhou University, Lanzhou, China
| | - Nan Chen
- Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, Lanzhou, China.,Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou University, Lanzhou, China.,WHO Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou University, Lanzhou, China.,Chinese GRADE Center, Lanzhou University, Lanzhou, China
| | - Kangle Guo
- Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, Lanzhou, China.,Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou University, Lanzhou, China.,WHO Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou University, Lanzhou, China.,Chinese GRADE Center, Lanzhou University, Lanzhou, China
| | - Xiuxia Li
- Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, Lanzhou, China.,Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou University, Lanzhou, China.,WHO Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou University, Lanzhou, China.,Chinese GRADE Center, Lanzhou University, Lanzhou, China
| | - Kehu Yang
- Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, Lanzhou, China.,Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou University, Lanzhou, China.,WHO Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou University, Lanzhou, China.,Chinese GRADE Center, Lanzhou University, Lanzhou, China.,Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
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