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Plachouras D, Kacelnik O, Rodríguez-Baño J, Birgand G, Borg MA, Kristensen B, Kubele J, Lyytikäinen O, Presterl E, Reilly J, Voss A, Zingg W, Suetens C, Monnet DL. Revisiting the personal protective equipment components of transmission-based precautions for the prevention of COVID-19 and other respiratory virus infections in healthcare. Euro Surveill 2023; 28:2200718. [PMID: 37561052 PMCID: PMC10416576 DOI: 10.2807/1560-7917.es.2023.28.32.2200718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 05/10/2023] [Indexed: 08/11/2023] Open
Abstract
The COVID-19 pandemic highlighted some potential limitations of transmission-based precautions. The distinction between transmission through large droplets vs aerosols, which have been fundamental concepts guiding infection control measures, has been questioned, leading to considerable variation in expert recommendations on transmission-based precautions for COVID-19. Furthermore, the application of elements of contact precautions, such as the use of gloves and gowns, is based on low-quality and inconclusive evidence and may have unintended consequences, such as increased incidence of healthcare-associated infections and spread of multidrug-resistant organisms. These observations indicate a need for high-quality studies to address the knowledge gaps and a need to revisit the theoretical background regarding various modes of transmission and the definitions of terms related to transmission. Further, we should examine the implications these definitions have on the following components of transmission-based precautions: (i) respiratory protection, (ii) use of gloves and gowns for the prevention of respiratory virus infections, (iii) aerosol-generating procedures and (iv) universal masking in healthcare settings as a control measure especially during seasonal epidemics. Such a review would ensure that transmission-based precautions are consistent and rationally based on available evidence, which would facilitate decision-making, guidance development and training, as well as their application in practice.
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Affiliation(s)
| | | | - Jesús Rodríguez-Baño
- CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
- Infectious Diseases and Microbiology division, Hospital Universitario Virgen Macarena and Department of Medicine, University of Seville/CSIC, Biomedicine Institute of Seville, Seville, Spain
| | - Gabriel Birgand
- Health Protection Research Unit, Healthcare Associated Infection and Antimicrobial Resistance, Imperial College London, London, United Kingdom
- Regional Centre for Infection Prevention and Control, Region of Pays de la Loire, Nantes, France
| | - Michael A Borg
- Infection Control Department, Mater Dei Hospital, Msida, Malta
| | | | - Jan Kubele
- Clinical Microbiology and ATB centre, Na Homolce Hospital, Prague, Czechia
| | | | - Elisabeth Presterl
- Department for Hospital Epidemiology and Infection Control, Medical University of Vienna, Vienna, Austria
| | - Jacqui Reilly
- Research Centre for Health, Glasgow Caledonian University, Glasgow, United Kingdom
| | - Andreas Voss
- Department of Medical Microbiology and Infection Prevention, University Medical Centre Groningen, Groningen, the Netherlands
| | - Walter Zingg
- Charité Universitätsmedizin, Berlin, Germany
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland
| | - Carl Suetens
- European Centre for Disease Prevention and Control, Stockholm, Sweden
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Solanki R, Shankar A, Modi U, Patel S. New insights from nanotechnology in SARS-CoV-2 detection, treatment strategy, and prevention. MATERIALS TODAY. CHEMISTRY 2023; 29:101478. [PMID: 36950312 PMCID: PMC9981536 DOI: 10.1016/j.mtchem.2023.101478] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 02/13/2023] [Accepted: 02/25/2023] [Indexed: 05/14/2023]
Abstract
The recent outbreak of SARS-CoV-2 resulted into the deadly COVID-19 pandemic, which has made a profound impact on mankind and the world health care system. SARS-CoV-2 is mainly transmitted within the population via symptomatic carriers, enters the host cell via ACE2 and TMPSSR2 receptors and damages the organs. The standard diagnostic tests and treatment methods implemented lack required efficiency to beat SARS-CoV-2 in the race of its spreading. The most prominently used diagnostic test,reverse transcription-polymerase chain reaction (a nucleic acid-based method), has limitations including a prolonged time taken to reveal results, limited sensitivity, a high rate of false negative results, and lacking specificity due to a homology with other viruses. Furthermore, as part of the treatment, antiviral drugs such as remdesivir, favipiravir, lopinavir/ritonavir, chloroquine, daclatasvir, atazanavir, and many more have been tested clinically to check their potency for the treatment of SARS-CoV-2 but none of these antiviral drugs are the definitive cure or suitable prophylaxis. Thus, it is always required to combat SARS-CoV-2 spread and infection for a better and precise prognosis. This review answers the above mentioned challenges by employing nanomedicine for the development of improved detection, treatment, and prevention strategies for SARS-CoV-2. In this review, nanotechnology-based detection methods such as colorimetric assays, photothermal biosensors, molecularly imprinted nanoparticles sensors, electrochemical nanoimmunosensors, aptamer-based biosensors have been discussed. Furthermore, nanotechnology-based treatment strategies involving polymeric nanoparticles, metallic nanoparticles, lipid nanoparticles, and nanocarrier-based antiviral siRNA delivery have been depicted. Moreover, SARS-CoV-2 prevention strategies, which include the nanotechnology for upgrading personal protective equipment, facemasks, ocular protection gears, and nanopolymer-based disinfectants, have been also reviewed. This review will provide a one-site informative platform for researchers to explore the crucial role of nanomedicine in managing the COVID-19 curse more effectively.
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Affiliation(s)
- R Solanki
- School of Life Sciences, Central University of Gujarat, Sector-30, Gandhinagar, 382030, India
| | - A Shankar
- School of Life Sciences, Central University of Gujarat, Sector-30, Gandhinagar, 382030, India
| | - U Modi
- Biomaterials & Biomimetics Laboratory, School of Life Sciences, Central University of Gujarat, Sector-30, Gandhinagar, 382030, India
| | - S Patel
- School of Life Sciences, Central University of Gujarat, Sector-30, Gandhinagar, 382030, India
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3
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Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection remains asymptomatic in 33% to 90% of older adults depending on their immune status from prior infection, vaccination, and circulating strain. Older adults symptomatic with SARS-CoV-2 often both present atypically, such as with a blunted fever response, and develop more severe disease. Early and late reports showed that older adults have increased severity of coronavirus disease 2019 (COVID-19) with higher case fatality rates and higher intensive care needs compared with younger adults. Infection and vaccine-induced antibody response and long-term effects of COVID-19 also differ in older adults.
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4
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Chen W, Liu L, Hang J, Li Y. Predominance of inhalation route in short-range transmission of respiratory viruses: Investigation based on computational fluid dynamics. BUILDING SIMULATION 2022; 16:765-780. [PMID: 36575690 PMCID: PMC9782262 DOI: 10.1007/s12273-022-0968-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 11/19/2022] [Accepted: 11/25/2022] [Indexed: 05/28/2023]
Abstract
During the Coronavirus disease 2019 pandemic, short-range virus transmission has been observed to have a higher risk of causing infection than long-range virus transmission. However, the roles played by the inhalation and large droplet routes cannot be distinguished in practice. A recent analytical study revealed the predominance of short-range inhalation over the large droplet spray route as causes of respiratory infections. In the current study, short-range exposure was analyzed via computational fluid dynamics (CFD) simulations using a discrete phase model. Detailed facial membranes, including eyes, nostrils, and a mouth, were considered. In CFD simulations, there is no need for a spherical approximation of the human head for estimating deposition nor the "anisokinetic aerosol sampling" approximation for estimating inhalation in the analytical model. We considered two scenarios (with two spheres [Scenario 1] and two human manikins [Scenario 2]), source-target distances of 0.2 to 2 m, and droplet diameters of 3 to 1,500 µm. The overall CFD exposure results agree well with data previously obtained from a simple analytical model. The CFD results confirm the predominance of the short-range inhalation route beyond 0.2 m for expiratory droplets smaller than 50 µm during talking and coughing. A critical droplet size of 87.5 µm was found to differentiate droplet behaviors. The number of droplets deposited on the target head exceeded those exposed to facial membranes, which implies a risk of exposure through the immediate surface route over a short range. Electronic Supplementary Material ESM the Supplementary Materials are available in the online version of this article at 10.1007/s12273-022-0968-y.
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Affiliation(s)
- Wenzhao Chen
- Department of Mechanical Engineering, The University of Hong Kong, Pokfulam Road, Hong Kong, China
| | - Li Liu
- Department of Building Science, Tsinghua University, Beijing, 100084 China
| | - Jian Hang
- School of Atmospheric Sciences, Sun Yat-sen University, and Southern Marine Science and Engineering Guangdong Laboratory (Zhuhai), Zhuhai, 519082 China
| | - Yuguo Li
- Department of Mechanical Engineering, The University of Hong Kong, Pokfulam Road, Hong Kong, China
- Faculty of Architecture, The University of Hong Kong, Pokfulam Road, Hong Kong, China
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5
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Detection of Airborne Influenza A and SARS-CoV-2 Virus Shedding following Ocular Inoculation of Ferrets. J Virol 2022; 96:e0140322. [PMID: 36448801 PMCID: PMC9769371 DOI: 10.1128/jvi.01403-22] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Despite reports of confirmed human infection following ocular exposure with both influenza A virus (IAV) and SARS-CoV-2, the dynamics of virus spread throughout oculonasal tissues and the relative capacity of virus transmission following ocular inoculation remain poorly understood. Furthermore, the impact of exposure route on subsequent release of airborne viral particles into the air has not been examined previously. To assess this, ferrets were inoculated by the ocular route with A(H1N1)pdm09 and A(H7N9) IAVs and two SARS-CoV-2 (early pandemic Washington/1 and Delta variant) viruses. Virus replication was assessed in both respiratory and ocular specimens, and transmission was evaluated in direct contact or respiratory droplet settings. Viral RNA in aerosols shed by inoculated ferrets was quantified with a two-stage cyclone aerosol sampler (National Institute for Occupational Safety and Health [NIOSH]). All IAV and SARS-CoV-2 viruses mounted a productive and transmissible infection in ferrets following ocular inoculation, with peak viral titers and release of virus-laden aerosols from ferrets indistinguishable from those from ferrets inoculated by previously characterized intranasal inoculation methods. Viral RNA was detected in ferret conjunctival washes from all viruses examined, though infectious virus in this specimen was recovered only following IAV inoculation. Low-dose ocular-only aerosol exposure or inhalation aerosol exposure of ferrets to IAV similarly led to productive infection of ferrets and shedding of aerosolized virus. Viral evolution during infection was comparable between all inoculation routes examined. These data support that both IAV and SARS-CoV-2 can establish a high-titer mammalian infection following ocular exposure that is associated with rapid detection of virus-laden aerosols shed by inoculated animals. IMPORTANCE Documented human infection with influenza viruses and SARS-CoV-2 has been reported among individuals wearing respiratory protection in the absence of eye protection, highlighting the capacity of these respiratory tract-tropic viruses to exploit nonrespiratory routes of exposure to initiate productive infection. However, comprehensive evaluations of how ocular exposure may modulate virus pathogenicity and transmissibility in mammals relative to respiratory exposure are limited and have not investigated multiple virus families side by side. Using the ferret model, we show that ocular exposure with multiple strains of either coronaviruses or influenza A viruses leads to an infection that results in shedding of detectable aerosolized virus from inoculated animals, contributing toward onward transmission of both viruses to susceptible contacts. Collectively, these studies support that the ocular surface represents a susceptible mucosal surface that, if exposed to a sufficient quantity of either virus, permits establishment of an infection which is similarly transmissible as that following respiratory exposure.
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Fretheim A, Elgersma IH, Helleve A, Elstrøm P, Kacelnik O, Hemkens LG. Effect of Wearing Glasses on Risk of Infection With SARS-CoV-2 in the Community: A Randomized Clinical Trial. JAMA Netw Open 2022; 5:e2244495. [PMID: 36454571 PMCID: PMC9716386 DOI: 10.1001/jamanetworkopen.2022.44495] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 10/17/2022] [Indexed: 12/05/2022] Open
Abstract
Importance Observational studies have reported an association between the use of eye protection and reduced risk of infection with SARS-CoV-2 and other respiratory viruses, but, as with most infection control measures, no randomized clinical trials have been conducted. Objectives To evaluate the effectiveness of wearing glasses in public as protection against being infected with SARS-CoV-2 and other respiratory viruses. Design, Setting, and Participants A randomized clinical trial was conducted in Norway from February 2 to April 24, 2022; all adult members of the public who did not regularly wear glasses, had no symptoms of COVID-19, and did not have COVID-19 in the last 6 weeks were eligible. Intervention Wearing glasses (eg, sunglasses) when close to others in public spaces for 2 weeks. Main Outcomes and Measures The primary outcome was a positive COVID-19 test result reported to the Norwegian Surveillance System for Communicable Diseases. Secondary outcomes included a positive COVID-19 test result and respiratory infection based on self-report. All analyses adhered to the intention-to-treat principle. Results A total of 3717 adults (2439 women [65.6%]; mean [SD] age, 46.9 [15.1] years) were randomized. All were identified and followed up in the registries, and 3231 (86.9%) responded to the end of study questionnaire. The proportions with a reported positive COVID-19 test result in the national registry were 3.7% (68 of 1852) in the intervention group and 3.5% (65 of 1865) in the control group (absolute risk difference, 0.2%; 95% CI, -1.0% to 1.4%; relative risk, 1.10; 95% CI, 0.75-1.50). The proportions with a positive COVID-19 test result based on self-report were 9.6% (177 of 1852) in the intervention group and 11.5% (214 of 1865) in the control group (absolute risk difference, -1.9%; 95% CI, -3.9% to 0.1%; relative risk, 0.83; 95% CI, 0.69-1.00). The risk of respiratory infections based on self-reported symptoms was lower in the intervention group (30.8% [571 of 1852]) than in the control group (34.1% [636 of 1865]; absolute risk difference, -3.3%; 95% CI, -6.3% to -0.3%; relative risk, 0.90; 95% CI, 0.82-0.99). Conclusions and Relevance In this randomized clinical trial, wearing glasses in the community was not protective regarding the primary outcome of a reported positive COVID-19 test. However, results were limited by a small sample size and other issues. Glasses may be worth considering as one component in infection control, pending further studies. Trial Registration ClinicalTrials.gov Identifier: NCT05217797.
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Affiliation(s)
- Atle Fretheim
- Centre for Epidemic Interventions Research, Norwegian Institute of Public Health, Oslo, Norway
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Ingeborg Hess Elgersma
- Centre for Epidemic Interventions Research, Norwegian Institute of Public Health, Oslo, Norway
| | - Arnfinn Helleve
- Centre for Evaluation of Public Health Measures, Norwegian Institute of Public Health, Oslo, Norway
| | - Petter Elstrøm
- Centre for Epidemic Interventions Research, Norwegian Institute of Public Health, Oslo, Norway
- Division for Infection Control, Norwegian Institute of Public Health, Oslo, Norway
| | - Oliver Kacelnik
- Centre for Epidemic Interventions Research, Norwegian Institute of Public Health, Oslo, Norway
- Division for Infection Control, Norwegian Institute of Public Health, Oslo, Norway
| | - Lars G. Hemkens
- Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
- Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, California
- Meta-Research Innovation Center Berlin (METRIC-B), Berlin Institute of Health, Berlin, Germany
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7
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Abstract
The German Society of Pneumology initiated 2021 the AWMF S1 guideline Long COVID/Post-COVID. In a broad interdisciplinary approach, this S1 guideline was designed based on the current state of knowledge.The clinical recommendations describe current Long COVID/Post-COVID symptoms, diagnostic approaches, and therapies.In addition to the general and consensus introduction, a subject-specific approach was taken to summarize the current state of knowledge.The guideline has an explicit practical claim and will be developed and adapted by the author team based on the current increase in knowledge.
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8
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Kaushik J, Riyaz E, Chaitanya YVK, Nair R, Kumar A, Singh A, Parihar JKS, Srikant S, Shetty R. An insight into the altered ophthalmic dynamics during the COVID-19 pandemic. Indian J Ophthalmol 2022; 70:3643-3648. [PMID: 36190064 PMCID: PMC9789823 DOI: 10.4103/ijo.ijo_254_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Purpose The objective of this survey-based study was to examine the effects of personal protective measures taken at the level of instrument and surgeon during the pandemic on the optics in ophthalmology. Methods The study involved an online questionnaire of 24 questions which was distributed to ophthalmologists practicing in several hospitals, including residents and fellows undergoing training in ophthalmology in India. The responses were collected through an online data collection tool (Google forms). The participants could choose from multiple options provided to them in each question. Results A total of 285 participants out of 296 had used modified methods for examining and performing surgical procedures during the pandemic, while 78.7% (265) of the participants acknowledged having encountered difficulty in interpreting the ocular findings of patients while examining in personal protective equipment. Moreover, 58.7% (198) of our study respondents also reported that there was significant worsening of the quality of ophthalmological examination with pandemic-appropriate measures and 84.8% (286) of our study participants also felt that these measures have significantly added to the time of examination, hence increasing the risk of exposure to both patient and doctor. Conclusion The workplace study has highlighted the crucial aspects of optics in ophthalmology during the pandemic. The protective measures taken during the pandemic have significantly worsened the quality of ophthalmological examination and increased the time taken to perform outpatient department-based and surgical procedures in ophthalmology.
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Affiliation(s)
- Jaya Kaushik
- Department of Ophthalmology, Golden Jublee Block, Armed Forces Medical College, Pune, Maharashtra, India,Correspondence to: Dr. Jaya Kaushik, Department of Ophthalmology, Golden Jublee Block, Armed Forces Medical College, Pune, Maharashtra - 411 040, India. E-mail:
| | - Eram Riyaz
- Department of Ophthalmology, Golden Jublee Block, Armed Forces Medical College, Pune, Maharashtra, India
| | - YVK Chaitanya
- Department of Ophthalmology, Golden Jublee Block, Armed Forces Medical College, Pune, Maharashtra, India
| | - Renu Nair
- Department of Ophthalmology, Golden Jublee Block, Armed Forces Medical College, Pune, Maharashtra, India
| | - Ashok Kumar
- Department of Ophthalmology, Golden Jublee Block, Armed Forces Medical College, Pune, Maharashtra, India
| | - Ankita Singh
- Department of Ophthalmology, Golden Jublee Block, Armed Forces Medical College, Pune, Maharashtra, India
| | - JKS Parihar
- Department of Ophthalmology and Post Graduate Training and Education, Centre for Sight, New Delhi, India
| | - S Srikant
- Department of Ophthalmology, Golden Jublee Block, Armed Forces Medical College, Pune, Maharashtra, India
| | - Rakesh Shetty
- Department of Ophthalmology, Golden Jublee Block, Armed Forces Medical College, Pune, Maharashtra, India
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Gregersen R, Jacobsen RK, Laursen J, Mobech R, Ostrowski SR, Iversen K, Petersen J. Association of COVID-19 Infection With Wearing Glasses in a High-Prevalence Area in Denmark and Sweden. JAMA Ophthalmol 2022; 140:957-964. [PMID: 36006635 DOI: 10.1001/jamaophthalmol.2022.3234] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Observational studies have indicated that glasses might protect against contracting COVID-19 through reduced airborne and contact transmission. Objective To investigate the association between wearing one's own glasses with contracting COVID-19 when adjusting for relevant confounders. Design, Setting, and Participants This cohort study was conducted during the first wave of the COVID-19 pandemic (June to August 2020) in Denmark and Sweden, where personal protective equipment was not recommended for the general population at the time. Employees at Falck, an international rescue corps with different job functions (ambulance, health care, office, and field staff, firefighters, and roadside assistance) participated in the study. Exposures The main exposure was wearing glasses (also including contact lenses and reading glasses), which was assessed in a questionnaire. Persons wearing glasses were compared with those who did not wear glasses (ie, nonusers). To adjust for potential confounders, information on age, sex, job function, and number of workday contacts were included. Main Outcomes and Measures The outcome was COVID-19 infection before (positive polymerase chain reaction test) or during the study period (biweekly voluntary tests with a rapid test). The investigated hypothesis was formulated after collecting the data. Results A total of 1279 employees in Denmark and 841 in Sweden were included (839 [39.6%] female and 1281 [60.4%] male; 20.5% were aged <40 years; 57.0%, 40-60 years, and 22.5%, >60 years). Of these, 829 individuals (64.8%) in Denmark and 619 (73.6%) in Sweden wore glasses. Wearing glasses was inversely associated with COVID-19 infection in the Swedish cohort (odds ratio [OR], 0.61 [95% CI, 0.37-0.99]; P = .047; seroprevalence, 9.3%) but not in the Danish cohort (OR, 1.14 [95% CI, 0.53-2.45]; P = .73; seroprevalence, 2.4%). Adjusting for age, sex, job function, and number of workday contacts in Sweden, wearing glasses no longer was associated with COVID-19 infection (OR, 0.64 [95% CI, 0.37-1.11]; P = .11). When stratifying by job function, a large difference was observed among office staff (OR, 0.20 [95% CI, 0.06-0.70]; P = .01) but not ambulance staff (OR, 0.83 [95% CI, 0.41-1.67]; P = .60) nor health care staff (OR, 0.89 [95% CI, 0.35-2.30]; P = .81). Conclusions and Relevance While wearing one's glasses was inversely associated with COVID-19 in Sweden in an unadjusted analysis, an association no longer was identified when adjusting for confounders. These results provide inconclusive findings regarding whether wearing one's own glasses is associated with a decreased risk of COVID-19 infections.
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Affiliation(s)
- Rasmus Gregersen
- Department of Emergency Medicine, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark.,Center for Clinical Research and Prevention, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark.,Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Rikke Kart Jacobsen
- Center for Clinical Research and Prevention, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Jannie Laursen
- Department of Global Business Quality Management, Falck, Copenhagen, Denmark
| | - Regine Mobech
- Department of Global Business Quality Management, Falck, Copenhagen, Denmark
| | - Sisse Rye Ostrowski
- Department of Clinical Immunology, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Kasper Iversen
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Department of Emergency Medicine, Copenhagen University Hospital-Herlev and Gentofte, Herlev, Denmark.,Department of Cardiology, Copenhagen University Hospital-Herlev and Gentofte, Herlev, Denmark
| | - Janne Petersen
- Center for Clinical Research and Prevention, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark.,Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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10
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Pandey SK, Mohanta GC, Kumar V, Gupta K. Diagnostic Tools for Rapid Screening and Detection of SARS-CoV-2 Infection. Vaccines (Basel) 2022; 10:1200. [PMID: 36016088 PMCID: PMC9414050 DOI: 10.3390/vaccines10081200] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 07/19/2022] [Accepted: 07/25/2022] [Indexed: 12/11/2022] Open
Abstract
The novel coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has severely impacted human health and the health management system globally. The ongoing pandemic has required the development of more effective diagnostic strategies for restricting deadly disease. For appropriate disease management, accurate and rapid screening and isolation of the affected population is an efficient means of containment and the decimation of the disease. Therefore, considerable efforts are being directed toward the development of rapid and robust diagnostic techniques for respiratory infections, including SARS-CoV-2. In this article, we have summarized the origin, transmission, and various diagnostic techniques utilized for the detection of the SARS-CoV-2 virus. These higher-end techniques can also detect the virus copy number in asymptomatic samples. Furthermore, emerging rapid, cost-effective, and point-of-care diagnostic devices capable of large-scale population screening for COVID-19 are discussed. Finally, some breakthrough developments based on spectroscopic diagnosis that could revolutionize the field of rapid diagnosis are discussed.
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Affiliation(s)
- Satish Kumar Pandey
- Department of Biotechnology, School of Life Sciences, Mizoram University (Central University), Aizawl 796004, India
| | - Girish C. Mohanta
- Materials Science and Sensor Applications, CSIR-Central Scientific Instruments Organisation (CSIR-CSIO), Chandigarh 160030, India;
| | - Vinod Kumar
- Department of Dermatology, Venerology and Leprology, Post Graduate Institute of Medical Education & Research, Chandigarh 160012, India;
| | - Kuldeep Gupta
- Russel H. Morgan, Department of Radiology and Radiological Sciences, School of Medicine, Johns Hopkins University, Baltimore, MD 21287, USA
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11
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Li D, Xiong L, Pan G, Wang T, Li R, Zhu L, Tong Q, Yang Q, Peng Y, Zuo C, Wang C, Li X. Molecular Imaging on ACE2-dependent Transocular Infection of Coronavirus. J Med Virol 2022; 94:4878-4889. [PMID: 35754185 PMCID: PMC9349515 DOI: 10.1002/jmv.27958] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 06/15/2022] [Accepted: 06/21/2022] [Indexed: 11/17/2022]
Abstract
A transocular infection has been proved as one of the main approaches that severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) invades the body, and angiotensin‐converting enzyme 2 (ACE2) plays a key role in this procedure. Dynamic and quantitative details on virus distribution are lacking for virus prevention and drug design. In this study, a radiotraceable pseudovirus packed with an enhanced green fluorescent protein (EGFP) gene, 125I‐CoV, was prepared and inoculated in the unilateral eye of humanized ACE2 (hACE2) mice or ACE2‐knockout (ACE2‐KO) mice. Single‐photon emission computed tomography/computed tomography images were acquired at multiple time points to exhibit ACE2‐dependent procedures from invasion to clearance. Positron emission tomography (PET) and western blot were performed to quantify ACE2 expression and verify the factors affecting transocular infection. For the transocular infection of coronavirus (CoV), the renin–angiotensin–aldosterone system (RAAS), lungs, intestines, and genital glands were the main targeted organs. Due to the specific anchor to ACE2‐expressed host cells, virus concentrations in genital glands, liver, and lungs ranked the top three most and stabilized at 3.75 ± 0.55, 3.30 ± 0.25, and 2.10 ± 0.55% inoculated dose (ID)/mL at 48 h post treatment. Meanwhile, ACE2‐KO mice had already completed the in vivo clearance. In consideration of organ volumes, lungs (14.50 ± 3.75%ID) and liver (10.94 ± 0.71%ID) were the main in‐store reservoirs of CoV. However, the inoculated eye (5.52 ± 1.85%ID for hACE2, 5.24 ± 1.45%ID for ACE2‐KO, p > 0.05) and the adjacent brain exhibited ACE2‐independent virus infection at the end of 72 h observation, and absolute amount of virus played a key role in host cell infection. These observations on CoV infection were further manifested by infection‐driven intracellular EGFP expression. ACE2 PET revealed an infection‐related systematic upregulation of ACE2 expression in the organs involved in RAAS (e.g., brain, lung, heart, liver, and kidney) and the organ that was of own local renin–angiotensin system (e.g., eye). Transocular infection of CoV is ACE2‐dependent and constitutes the cause of disturbed ACE2 expression in the host. The brain, genital glands, and intestines were of the highest unit uptake, potentially accounting for the sequelae. Lungs and liver were of the highest absolute amount, closely related to the respiratory diffusion and in vivo duplication. ACE2 expression was upregulated in the short term after infection with CoV. These visual and quantitative results are helpful to fully understanding the transocular path of SARS‐CoV‐2 and other CoVs.
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Affiliation(s)
- Danni Li
- Department of Nuclear Medicine, Shanghai Changhai Hospital, Shanghai, 200433, China
| | - Liyan Xiong
- School of Medicine, Shanghai University, Shanghai, 200444, China
| | - Guixia Pan
- Department of Nuclear Medicine, Shanghai Changhai Hospital, Shanghai, 200433, China
| | - Tingfang Wang
- School of Medicine, Shanghai University, Shanghai, 200444, China
| | - Rou Li
- Department of Nuclear Medicine, Shanghai Changhai Hospital, Shanghai, 200433, China
| | - Lizhi Zhu
- Department of Nuclear Medicine, Shanghai Changhai Hospital, Shanghai, 200433, China
| | - Qianqian Tong
- Department of Nuclear Medicine, Shanghai Changhai Hospital, Shanghai, 200433, China
| | - Qinqin Yang
- Department of Nuclear Medicine, Shanghai Changhai Hospital, Shanghai, 200433, China
| | - Ye Peng
- Department of Nuclear Medicine, Shanghai Changhai Hospital, Shanghai, 200433, China
| | - Changjing Zuo
- Department of Nuclear Medicine, Shanghai Changhai Hospital, Shanghai, 200433, China
| | - Cong Wang
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, 200322, China
| | - Xiao Li
- Department of Nuclear Medicine, Shanghai Changhai Hospital, Shanghai, 200433, China.,Shanghai Institute of Applied Physics, Chinese Academy of Sciences, Shanghai, 201800, China
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12
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Temmesfeld MJ, Gorzkowska-Sobas AA, Hedlund K, Øyen MØ, Kanten L, Grant P, Jakobsen RB. Surgical helmets can be converted into efficient disinfectable powered air-purifying respirators. Am J Infect Control 2022; 50:624-630. [PMID: 34958857 DOI: 10.1016/j.ajic.2021.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 12/11/2021] [Accepted: 12/13/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND Filtering facepiece respirators often fail to provide sufficient protection due to a poor fit. Powered air-purifying respirators (PAPRs) are not designed for healthcare personnel, and are challenging to disinfect. Surgical helmets (SH) are available in many United States hospitals but do not provide respiratory protection. Several modifications to SH have been suggested, but none are sufficiently compliant with safety and efficiency standards. The purpose of this investigation was the development of a filter adaptor, which converts SHs into efficient, safe, and disinfectable PAPRs. METHODS Four critical features were investigated close to regulatory requirements: total inward leakage of particles, CO2 concentrations, intra-helmet differential pressure, and automated disinfection. RESULTS The average total inward leakage in the 2 independent tests were 0.005% and 0.01%. CO2 concentrations were lower than in the original SH. The modification generates a positive differential pressure. The filter's performance was not compromised after 50 cycles in a sterilization machine. DISCUSSION The modified SH provides several hundred times better protection than FFP-3 masks. CONCLUSIONS Surgical helmets can be modified into safe, efficient, and disinfectable PAPRs, suitable for HCP and the operating room in particular. They can play a role in the preparedness for upcoming events requiring efficient respiratory protection.
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Affiliation(s)
- Max Joachim Temmesfeld
- Institute of Health and Society, University of Oslo, Oslo, Norway; Department of Orthopedics, Akershus University Hospital, Lørenskog, Norway.
| | | | | | | | - Lars Kanten
- Department of Sterile Supplies, Akershus University Hospital, Lørenskog, Norway
| | - Peter Grant
- Department of Orthopaedics, Institute of Clinical Sciences Sahlgrenska Academy, University of Gothenburg, Gotehnburg, Sweden; Lovisenberg Diaconal Hospital, Nydalen, Oslo, Norway
| | - Rune B Jakobsen
- Institute of Health and Society, University of Oslo, Oslo, Norway; Department of Orthopedics, Akershus University Hospital, Lørenskog, Norway
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13
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Ung L, Chodosh J. COVID-19 and the eye: alternative facts The 2022 Bowman Club, David L. Easty lecture. BMJ Open Ophthalmol 2022; 7:bmjophth-2022-001042. [PMID: 35675203 PMCID: PMC9114314 DOI: 10.1136/bmjophth-2022-001042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 04/18/2022] [Indexed: 01/08/2023] Open
Abstract
In addition to catastrophic loss of life, and dramatic and unwanted alterations to the daily lives of those left behind, the COVID-19 pandemic has fostered the publication and dissemination of an unprecedented quantity of peer-reviewed medical and scientific publications on a single subject. In particular, the ophthalmic literature is now replete with clinical and laboratory studies on putative eye involvement by SARS-CoV-2, the aetiologic agent of COVID-19. In this review, we critically appraise the published literature on COVID-19, and suggest that the quality of scientific peer review and editorial decision-making also suffered during the COVID-19 pandemic.
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Affiliation(s)
- Lawson Ung
- Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard University T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - James Chodosh
- Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA
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14
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Ozkan J, Willcox M, Coroneo M. A comparative analysis of the cephalic microbiome: The ocular, aural, nasal/nasopharyngeal, oral and facial dermal niches. Exp Eye Res 2022; 220:109130. [DOI: 10.1016/j.exer.2022.109130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 05/08/2022] [Accepted: 05/22/2022] [Indexed: 12/12/2022]
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15
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Golob-Schwarzl N, Woltsche N, Armento A, Wolf P, Horwath-Winter J, Wedrich A, Patra V, Merle DA. SARS-CoV-2 spike protein functionally interacts with primary human conjunctival epithelial cells to induce a pro-inflammatory response. Eye (Lond) 2022; 36:2353-2355. [PMID: 35428870 PMCID: PMC9012050 DOI: 10.1038/s41433-022-02066-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 03/26/2022] [Accepted: 04/04/2022] [Indexed: 11/09/2022] Open
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16
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Agossou O, Atchadé MN, Djibril AM. Modeling the effects of preventive measures and vaccination on the COVID-19 spread in Benin Republic with optimal control. RESULTS IN PHYSICS 2021; 31:104969. [PMID: 34804781 PMCID: PMC8592642 DOI: 10.1016/j.rinp.2021.104969] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/29/2021] [Accepted: 11/01/2021] [Indexed: 05/12/2023]
Abstract
Coronavirus disease (COVID-19) onset in December 2019 is a contagious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Since, the spread of the virus and mortality due to COVID-19 have continued to increase daily leading to a pandemic. In absence of approved medicine and vaccines, many countries imposed policies such as social distancing, mask wearing, hand washing, airport screening, quarantine and others. But rapidly, they were confronted with the high economic and social cost resulting from those policies. Many vaccines have been proposed but their efficiency is still controversial. Now, governments and scholars search for how manage with preventives measures policies and vaccination campaigns to stop the COVID-19 spread. This work studied the effects of these different strategies as time-dependent interventions using mathematical modeling and optimal control approach to ascertain their contribution in the dynamic transmission of COVID-19. The model was proven to have an invariant region and was well-posed. The basic reproduction number was computed with and without respect of preventives measures. The optimal control analysis was carried out using the Pontryagin's maximum principle to figure out the optimal strategy necessary to curtail the disease. The findings revealed that the optimal implementation of preventive measures reduce highly the number of infected individuals but zero infection was not achieved in the population. That was obtained with the optimal implementation of vaccination campaigns which reduce the number of infected individuals. But the optimal and combined implementation of the two interventions performed better with less costs than the two singular implementations.
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Affiliation(s)
- Onésime Agossou
- National Higher School of Mathematics Genius and Modelization, National University of Sciences, Technologies, Engineering and Mathematics, Abomey, Republic of Benin
| | - Mintodê Nicodème Atchadé
- National Higher School of Mathematics Genius and Modelization, National University of Sciences, Technologies, Engineering and Mathematics, Abomey, Republic of Benin
- Université d'Abomey-Calavi/ International Chair in Mathematical Physics and Applications (ICMPA : UNESCO-Chair), 072 BP 50 Cotonou, Republic of Benin
- Saint-Petersburg State University of Economics, Department of Statistics and Econometrics, Russian Federation
| | - Aliou Moussa Djibril
- National Higher School of Mathematics Genius and Modelization, National University of Sciences, Technologies, Engineering and Mathematics, Abomey, Republic of Benin
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17
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The effect of eye protection on SARS-CoV-2 transmission: a systematic review. Antimicrob Resist Infect Control 2021; 10:156. [PMID: 34736533 PMCID: PMC8567128 DOI: 10.1186/s13756-021-01025-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 10/12/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND The effect of eye protection to prevent SARS-CoV-2 infection in the real-world remains uncertain. We aimed to synthesize all available research on the potential impact of eye protection on transmission of SARS-CoV-2. METHODS We searched PROSPERO, PubMed, Embase, The Cochrane Library for clinical trials and comparative observational studies in CENTRAL, and Europe PMC for pre-prints. We included studies that reported sufficient data to estimate the effect of any form of eye protection including face shields and variants, goggles, and glasses, on subsequent confirmed infection with SARS-CoV-2. RESULTS We screened 898 articles and included 6 reports of 5 observational studies from 4 countries (USA, India, Columbia, and United Kingdom) that tested face shields, goggles, and wraparound eyewear on 7567 healthcare workers. The three before-and-after and one retrospective cohort studies showed statistically significant and substantial reductions in SARS-CoV-2 infections favouring eye protection with odds ratios ranging from 0.04 to 0.6, corresponding to relative risk reductions of 96% to 40%. These reductions were not explained by changes in the community rates. However, the one case-control study reported odds ratio favouring no eye protection (OR 1.7, 95% CI 0.99, 3.0). The high heterogeneity between studies precluded any meaningful meta-analysis. None of the studies adjusted for potential confounders such as other protective behaviours, thus increasing the risk of bias, and decreasing the certainty of evidence to very low. CONCLUSIONS Current studies suggest that eye protection may play a role in prevention of SARS-CoV-2 infection in healthcare workers. However, robust comparative trials are needed to clearly determine effectiveness of eye protections and wearability issues in both healthcare and general populations.
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18
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Pashankar DS, Follo M, Zhao AM, Saeri M, Khokhar B. Letter to the Editor: Implementation of Patient Screening in Ambulatory Settings During the COVID-19 Pandemic. J Ambul Care Manage 2021; 44:331-335. [PMID: 34120123 PMCID: PMC8386390 DOI: 10.1097/jac.0000000000000387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Dinesh S. Pashankar
- Ambulatory Operations, Yale Medicine, Yale University School of Medicine, New Haven, Connecticut
| | - Marie Follo
- Ambulatory Operations, Yale Medicine, Yale University School of Medicine, New Haven, Connecticut
| | - Anna M. Zhao
- Ambulatory Operations, Yale Medicine, Yale University School of Medicine, New Haven, Connecticut
| | - Maryam Saeri
- Ambulatory Operations, Yale Medicine, Yale University School of Medicine, New Haven, Connecticut
| | - Babar Khokhar
- Ambulatory Operations, Yale Medicine, Yale University School of Medicine, New Haven, Connecticut
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19
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Lee BU. Why Does the SARS-CoV-2 Delta VOC Spread So Rapidly? Universal Conditions for the Rapid Spread of Respiratory Viruses, Minimum Viral Loads for Viral Aerosol Generation, Effects of Vaccination on Viral Aerosol Generation, and Viral Aerosol Clouds. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9804. [PMID: 34574724 PMCID: PMC8470664 DOI: 10.3390/ijerph18189804] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 09/15/2021] [Accepted: 09/16/2021] [Indexed: 12/16/2022]
Abstract
This study analyzes the reasons the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Delta variant of concern (VOC) spreads so rapidly. Novel topics such as universal conditions for the rapid spread of respiratory viruses, minimum viral loads for viral aerosol generation, effects of vaccination on viral aerosol generation, and viral aerosol clouds were studied. The analyses were based on experimental results and analytic model studies. Four universal conditions, namely asymptomatic host, high viral load, stability of viruses in air, and binding affinity of viruses to human cells, need to be satisfied for the rapid spread of respiratory viruses. SARS-CoV-2 and its variants such as the Alpha VOC and Delta VOC satisfy the four fundamental conditions. In addition, there is an original principle of aerosol generation of respiratory viruses. Assuming that the aerosol-droplet cutoff particle diameter for distinguishing potential aerosols from earthbound respiratory particles is 100 μm, the minimum viral load required in respiratory fluids to generate viral aerosols is ~106 copies mL-1, which is within the range of the reported viral loads in the Alpha VOC cases and the Delta VOC cases. The daily average viral loads of the Delta VOC in hosts have been reported to be between ~109 copies mL-1 and ~1010 copies mL-1 during the four days after symptom onset in 1848 cases of the Delta VOC infection. Owing to the high viral load, the SARS-CoV-2 Delta VOC has the potential to effectively spread through aerosols. COVID-19 vaccination can decrease aerosol transmission of the SARS-CoV-2 Alpha VOC by reducing the viral load. The viral load can explain the conundrum of viral aerosol spreading. The SARS-CoV-2 Delta VOC aerosol clouds have been assumed to be formed in restricted environments, resulting in a massive numbers of infected people in a very short period with a high spreading speed. Strong control methods against bioaerosols should be considered in this SARS-CoV-2 Delta VOC pandemic. Large-scale environmental monitoring campaigns of SARS-CoV-2 Delta VOC aerosols in public places in many countries are necessary, and these activities could contribute to controlling the coronavirus disease pandemic.
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Affiliation(s)
- Byung Uk Lee
- Aerosol and Bioengineering Laboratory, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul 05029, Korea
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20
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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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