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Boom TT, de Hoog MLA, Westerhof I, Jaddoe V, Heuvelman VD, Fourie E, Sluiter-Post JGC, Badoux P, Euser S, Herpers B, Sanders EAM, Eggink D, Reusken C, Bont LJ, Wildenbeest JG, van Houten MA, Duijts L, Bruijning-Verhagen PCJL. Age-specific SARS-CoV-2 transmission differed from human rhinovirus in households during the early COVID-19 pandemic. J Infect 2024; 89:106218. [PMID: 38950866 DOI: 10.1016/j.jinf.2024.106218] [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: 03/21/2024] [Revised: 06/25/2024] [Accepted: 06/26/2024] [Indexed: 07/03/2024]
Abstract
OBJECTIVES Children are generally considered main drivers of transmission for respiratory viruses, but the emergence of SARS-CoV-2 challenged this paradigm. Human rhinovirus (RV) continued to co-circulate throughout the pandemic, allowing for direct comparison of age-specific infectivity and susceptibility within households between these viruses during a time of low SARS-CoV-2 population immunity. METHODS Households with children were prospectively monitored for ≥23 weeks between August 2020 and July 2021. Upon onset of respiratory symptoms in a household, an outbreak study was initiated, including questionnaires and repeated nasal self-sampling in all household members. Swabs were tested by PCR. Age-stratified within-household secondary attack rates (SARs) were compared between SARS-CoV-2 and RV. RESULTS A total of 307 households participated, including 582 children and 627 adults. Overall, SAR was lower for SARS-CoV-2 than for RV (aOR 0.55) and age distributions differed between both viruses (p < 0.001). Following household exposure, children were significantly less likely to become infected with SARS-CoV-2 compared to RV (aOR 0.16), whereas this was opposite in adults (aOR 1.71). CONCLUSION In households, age-specific susceptibility to SARS-CoV-2 and RV differs and drives differences in household transmission between these pathogens. This highlights the importance of characterizing age-specific transmission risks, particularly for emerging infections, to guide appropriate infection control interventions.
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Affiliation(s)
- Trisja T Boom
- Julius Centre for Health Sciences and Primary Care, Department of Epidemiology, University Medical Centre Utrecht, Utrecht, the Netherlands.
| | - Marieke L A de Hoog
- Julius Centre for Health Sciences and Primary Care, Department of Epidemiology, University Medical Centre Utrecht, Utrecht, the Netherlands.
| | - Ilse Westerhof
- Julius Centre for Health Sciences and Primary Care, Department of Epidemiology, University Medical Centre Utrecht, Utrecht, the Netherlands.
| | - Vincent Jaddoe
- Erasmus MC - Sophia Children's Hospital, Erasmus University Medical Center, Department of Pediatrics, Rotterdam, the Netherlands.
| | - Valerie D Heuvelman
- Erasmus MC - Sophia Children's Hospital, Erasmus University Medical Center, Department of Pediatrics, Rotterdam, the Netherlands.
| | - Elandri Fourie
- Spaarne Gasthuis Academy, Spaarne Gasthuis, Hoofddorp, the Netherlands.
| | | | - Paul Badoux
- Regional Public Health Laboratory Kennemerland, Haarlem, the Netherlands.
| | - Sjoerd Euser
- Regional Public Health Laboratory Kennemerland, Haarlem, the Netherlands.
| | - Bjorn Herpers
- Regional Public Health Laboratory Kennemerland, Haarlem, the Netherlands.
| | - Elisabeth A M Sanders
- Centre for Infectious Disease Control, WHO COVID-19 Reference Laboratory, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands; Department of Pediatric Infectious Diseases and Immunology, Wilhelmina Children's Hospital University Medical Center Utrecht, Utrecht, the Netherlands.
| | - Dirk Eggink
- Centre for Infectious Disease Control, WHO COVID-19 Reference Laboratory, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.
| | - Chantal Reusken
- Centre for Infectious Disease Control, WHO COVID-19 Reference Laboratory, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.
| | - Louis J Bont
- Department of Pediatric Infectious Diseases and Immunology, Wilhelmina Children's Hospital University Medical Center Utrecht, Utrecht, the Netherlands.
| | - Joanne G Wildenbeest
- Department of Pediatric Infectious Diseases and Immunology, Wilhelmina Children's Hospital University Medical Center Utrecht, Utrecht, the Netherlands.
| | - Marlies A van Houten
- Spaarne Gasthuis Academy, Spaarne Gasthuis, Hoofddorp, the Netherlands; Spaarne Gasthuis, Department of Pediatrics, Hoofddorp, Haarlem, the Netherlands.
| | - Liesbeth Duijts
- Erasmus MC - Sophia Children's Hospital, Erasmus University Medical Center, Department of Pediatrics, Rotterdam, the Netherlands.
| | - Patricia C J L Bruijning-Verhagen
- Julius Centre for Health Sciences and Primary Care, Department of Epidemiology, University Medical Centre Utrecht, Utrecht, the Netherlands.
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Smith P, Little F, Hermans S, Davies MA, Wood R, Orrell C, Pike C, Peters F, Dube A, Georgeu-Pepper D, Curran R, Fairall L, Bekker LG. A prospective randomised controlled trial investigating household SARS-CoV-2 transmission in a densely populated community in Cape Town, South Africa - the transmission of COVID-19 in crowded environments (TRACE) study. BMC Public Health 2024; 24:1924. [PMID: 39020307 PMCID: PMC11256445 DOI: 10.1186/s12889-024-19462-1] [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: 09/06/2023] [Accepted: 07/12/2024] [Indexed: 07/19/2024] Open
Abstract
BACKGROUND South Africa's first SARS-CoV-2 case was identified 5th March 2020 and national lockdown followed March 26th. Households are an important location for secondary SARS-CoV-2 infection. Physical distancing and sanitation - infection mitigation recommended by the World Health Organization (WHO) at the time - are difficult to implement in limited-resource settings because of overcrowded living conditions. METHODS This study (ClinicalTrials.gov NCT05119348) was conducted from August 2020 to September 2021 in two densely populated, low socioeconomic Cape Town community sub-districts. New COVID-19 index cases (ICs) identified at public clinics were randomised to an infection mitigation intervention (STOPCOV) delivered by lay community health workers (CHWs) or standard of care group. STOPCOV mitigation measures included one initial household assessment conducted by a CHW in which face masks, sanitiser, bleach and written information on managing and preventing spread were provided. This was followed by regular telephonic follow-up from CHWs. SARS-CoV-2 PCR and IgM/IgG serology was performed at baseline, weeks 1, 2, 3 and 4 of follow-up. RESULTS The study randomised 81 ICs with 245 HHCs. At baseline, no HHCs in the control and 7 (5%) in the intervention group had prevalent SARS-CoV-2. The secondary infection rate (SIR) based on SARS-CoV-2 PCR testing was 1.9% (n = 2) in control and 2.9% (n = 4) in intervention HHCs (p = 0.598). At baseline, SARS-CoV-2 antibodies were present in 15% (16/108) of control and 38% (52/137) of intervention participants. At study end incidence was 8.3% (9/108) and 8.03% (11/137) in the intervention and control groups respectively. Antibodies were present in 23% (25/108) of control HHCs over the course of the study vs. 46% (63/137) in the intervention arm. CHWs made twelve clinic and 47 food parcel referrals for individuals in intervention households in need. DISCUSSION Participants had significant exposure to SARS-CoV-2 infections prior to the study. In this setting, household transmission mitigation was ineffective. However, CHWs may have facilitated other important healthcare and social referrals.
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Affiliation(s)
- Philip Smith
- The Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa.
| | - Francesca Little
- Department of Statistical Sciences, University of Cape Town, Cape Town, South Africa
| | - Sabine Hermans
- Amsterdam UMC, Department of Global Health, University of Amsterdam, Amsterdam, The Netherlands
- Centre for Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam UMC, Amsterdam Institute for Immunology and Infectious Diseases, University of Amsterdam, Amsterdam Public Health - Global Health, Amsterdam, The Netherlands
| | - Mary-Ann Davies
- Center for Infectious Diseases Epidemiology and Research, University of Cape Town, Cape Town, South Africa
| | - Robin Wood
- The Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa
| | - Catherine Orrell
- The Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa
| | - Carey Pike
- The Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa
| | - Fatima Peters
- Western Cape Department of Health, Cape Town, South Africa
| | - Audry Dube
- Knowledge Translation Unit, University of Cape Town, Cape Town, South Africa
| | | | - Robyn Curran
- Knowledge Translation Unit, University of Cape Town, Cape Town, South Africa
| | - Lara Fairall
- Knowledge Translation Unit, University of Cape Town, Cape Town, South Africa
| | - Linda-Gail Bekker
- The Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa.
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González-Beltrán D, Donat M, Politi J, Ronda E, Barrio G, Belza MJ, Regidor E. Changes in all-cause and cause-specific mortality by occupational skill during COVID-19 epidemic in Spain. J Epidemiol Community Health 2024:jech-2024-222065. [PMID: 38977297 DOI: 10.1136/jech-2024-222065] [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: 02/15/2024] [Accepted: 06/25/2024] [Indexed: 07/10/2024]
Abstract
BACKGROUND There is little information on the differential impact of the COVID-19 pandemic on mortality by occupation. The objective was to examine changes in mortality during the COVID-19 period compared with the prepandemic period in different occupational groups in Spain. METHODS Average mortality in the entire period 2020-2021, and each of its semesters, was compared, respectively, with the average mortality in the entire period 2017-2019, and the corresponding semester (first or second) of this last period, across occupational skill levels. For this, age-standardised death rates and age-adjusted mortality rate ratios (MRRs) obtained through Poisson regression were used. Data were obtained from the National Institute of Statistics and the Labour Force Survey. RESULTS The excess all-cause mortality during the 2020-2021 pandemic period by the MRR was higher in low-skilled (1.18, 95% CI 1.16 to 1.20) and medium-skilled workers (1.14; 95% CI 1.13 to 1.15) than high-skilled workers (1.04; 95% CI 1.02 to 1.05). However, the greatest excess mortality was observed in low-skilled workers in 2020 and in medium-skilled workers in 2021. Focusing on causes of death other than COVID-19, low-skilled workers showed the highest MRR from cardiovascular diseases (1.31; 95% CI 1.26 to 1.36) and high-skilled workers the lowest (1.02; 95% CI 0.98 to 1.02). However, this pattern was reversed for mortality from external causes, with low-skilled workers showing the lowest MRR (1.04; 95% CI 0.97 to 1.09) and high-skilled workers the highest (1.08; 95% CI 1.03 to 1.13). CONCLUSION Globally, in Spain, during the 2020-2021 COVID-19 epidemic period, low-skilled workers experienced a greater excess all-cause mortality than other occupational groups, but this was not the case during the entire epidemic period or for all causes of death.
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Affiliation(s)
- Damián González-Beltrán
- National School of Public Health, Instituto de Salud Carlos III, Madrid, Comunidad de Madrid, Spain
| | - Marta Donat
- National School of Public Health, Instituto de Salud Carlos III, Madrid, Comunidad de Madrid, Spain
| | - Julieta Politi
- National School of Public Health, Instituto de Salud Carlos III, Madrid, Comunidad de Madrid, Spain
| | - Elena Ronda
- Preventive Medicine and Public Health Area, Universidad de Alicante, Alicante, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Gregorio Barrio
- National School of Public Health, Instituto de Salud Carlos III, Madrid, Comunidad de Madrid, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - María José Belza
- National School of Public Health, Instituto de Salud Carlos III, Madrid, Comunidad de Madrid, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Enrique Regidor
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
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Chan CP, Lee SS, Kwan TH, Wong SYS, Yeoh EK, Wong NS. Population Behavior Changes Underlying Phasic Shifts of SARS-CoV-2 Exposure Settings Across 3 Omicron Epidemic Waves in Hong Kong: Prospective Cohort Study. JMIR Public Health Surveill 2024; 10:e51498. [PMID: 38896447 PMCID: PMC11222765 DOI: 10.2196/51498] [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: 08/02/2023] [Revised: 10/26/2023] [Accepted: 05/05/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND Exposure risk was shown to have affected individual susceptibility and the epidemic spread of COVID-19. The dynamics of risk by and across exposure settings alongside the variations following the implementation of social distancing interventions are understudied. OBJECTIVE This study aims to examine the population's trajectory of exposure risk in different settings and its association with SARS-CoV-2 infection across 3 consecutive Omicron epidemic waves in Hong Kong. METHODS From March to June 2022, invitation letters were posted to 41,132 randomly selected residential addresses for the recruitment of households into a prospective population cohort. Through web-based monthly surveys coupled with email reminders, a representative from each enrolled household self-reported incidents of SARS-CoV-2 infections, COVID-19 vaccination uptake, their activity pattern in the workplace, and daily and social settings in the preceding month. As a proxy of their exposure risk, the reported activity trend in each setting was differentiated into trajectories based on latent class growth analyses. The associations of different trajectories of SARS-CoV-2 infection overall and by Omicron wave (wave 1: February-April; wave 2: May-September; wave 3: October-December) in 2022 were evaluated by using Cox proportional hazards models and Kaplan-Meier analysis. RESULTS In total, 33,501 monthly responses in the observation period of February-December 2022 were collected from 5321 individuals, with 41.7% (2221/5321) being male and a median age of 46 (IQR 34-57) years. Against an expanding COVID-19 vaccination coverage from 81.9% to 95.9% for 2 doses and 20% to 77.7% for 3 doses, the cumulative incidence of SARS-CoV-2 infection escalated from <0.2% to 25.3%, 32.4%, and 43.8% by the end of waves 1, 2, and 3, respectively. Throughout February-December 2022, 52.2% (647/1240) of participants had worked regularly on-site, 28.7% (356/1240) worked remotely, and 19.1% (237/1240) showed an assorted pattern. For daily and social settings, 4 and 5 trajectories were identified, respectively, with 11.5% (142/1240) and 14.6% (181/1240) of the participants gauged to have a high exposure risk. Compared to remote working, working regularly on-site (adjusted hazard ratio [aHR] 1.47, 95% CI 1.19-1.80) and living in a larger household (aHR 1.12, 95% CI 1.06-1.18) were associated with a higher risk of SARS-CoV-2 infection in wave 1. Those from the highest daily exposure risk trajectory (aHR 1.46, 95% CI 1.07-2.00) and the second highest social exposure risk trajectory (aHR 1.52, 95% CI 1.18-1.97) were also at an increased risk of infection in waves 2 and 3, respectively, relative to the lowest risk trajectory. CONCLUSIONS In an infection-naive population, SARS-CoV-2 transmission was predominantly initiated at the workplace, accelerated in the household, and perpetuated in the daily and social environments, as stringent restrictions were scaled down. These patterns highlight the phasic shift of exposure settings, which is important for informing the effective calibration of targeted social distancing measures as an alternative to lockdown.
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Affiliation(s)
- Chin Pok Chan
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Shui Shan Lee
- Stanley Ho Centre for Emerging Infectious Diseases, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
- S.H. Ho Research Centre for Infectious Diseases, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Tsz Ho Kwan
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
- Stanley Ho Centre for Emerging Infectious Diseases, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
- S.H. Ho Research Centre for Infectious Diseases, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Samuel Yeung Shan Wong
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Eng-Kiong Yeoh
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
- Centre for Health Systems and Policy Research, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Ngai Sze Wong
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
- Stanley Ho Centre for Emerging Infectious Diseases, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
- S.H. Ho Research Centre for Infectious Diseases, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
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Althaus T, Overton CE, Devaux I, House T, Lapouze A, Troel A, Vanzo B, Laroche M, Bordero A, Jorgensen P, Pebody R, Voiglio EJ. How effective is the BNT162b2 mRNA vaccine against SARS-CoV-2 transmission and infection? A national programme analysis in Monaco, July 2021 to September 2022. BMC Med 2024; 22:227. [PMID: 38840159 PMCID: PMC11155114 DOI: 10.1186/s12916-024-03444-6] [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] [Received: 12/11/2023] [Accepted: 05/24/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND We quantified SARS-CoV-2 dynamics in different community settings and the direct and indirect effect of the BNT162b2 mRNA vaccine in Monaco for different variants of concern (VOC). METHODS Between July 2021 and September 2022, we prospectively investigated 20,443 contacts from 6320 index cases using data from the Monaco COVID-19 Public Health Programme. We calculated secondary attack rates (SARs) in households (n = 13,877), schools (n = 2508) and occupational (n = 6499) settings. We used binomial regression with a complementary log-log link function to measure adjusted hazard ratios (aHR) and vaccine effectiveness (aVE) for index cases to infect contacts and contacts to be infected in households. RESULTS In households, the SAR was 55% (95% CI 54-57) and 50% (48-51) among unvaccinated and vaccinated contacts, respectively. The SAR was 32% (28-36) and 12% (10-13) in workplaces, and 7% (6-9) and 6% (3-10) in schools, among unvaccinated and vaccinated contacts respectively. In household, the aHR was lower in contacts than in index cases (aHR 0.68 [0.55-0.83] and 0.93 [0.74-1.1] for delta; aHR 0.73 [0.66-0.81] and 0.89 [0.80-0.99] for omicron BA.1&2, respectively). Vaccination had no significant effect on either direct or indirect aVE for omicron BA.4&5. The direct aVE in contacts was 32% (17, 45) and 27% (19, 34), and for index cases the indirect aVE was 7% (- 17, 26) and 11% (1, 20) for delta and omicron BA.1&2, respectively. The greatest aVE was in contacts with a previous SARS-CoV-2 infection and a single vaccine dose during the omicron BA.1&2 period (45% [27, 59]), while the lowest were found in contacts with either three vaccine doses (aVE - 24% [- 63, 6]) or one single dose and a previous SARS-CoV-2 infection (aVE - 36% [- 198, 38]) during the omicron BA.4&5 period. CONCLUSIONS Protection conferred by the BNT162b2 mRNA vaccine against transmission and infection was low for delta and omicron BA.1&2, regardless of the number of vaccine doses and previous SARS-CoV-2 infection. There was no significant vaccine effect for omicron BA.4&5. Health authorities carrying out vaccination campaigns should bear in mind that the current generation of COVID-19 vaccines may not represent an effective tool in protecting individuals from either transmitting or acquiring SARS-CoV-2 infection.
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Affiliation(s)
| | - Christopher E Overton
- Department of Mathematical Sciences, University of Liverpool, Liverpool, UK
- United Kingdom Health Security Agency, London, UK
| | - Isabelle Devaux
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Thomas House
- Department of Mathematics, University of Manchester, Manchester, UK
| | | | | | | | | | | | - Pernille Jorgensen
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Richard Pebody
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
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Williams C, Rauwolf P, Boulter M, Parkinson JA. Closing the Gap: How Psychological Distance Influences Willingness to Engage in Risky COVID Behavior. Behav Sci (Basel) 2024; 14:449. [PMID: 38920782 PMCID: PMC11201267 DOI: 10.3390/bs14060449] [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: 04/15/2024] [Revised: 05/22/2024] [Accepted: 05/24/2024] [Indexed: 06/27/2024] Open
Abstract
Pandemics, and other risk-related contexts, require dynamic changes in behavior as situations develop. Human behavior is influenced by both explicit (cognitive) and implicit (intuitive) factors. In this study, we used psychological distance as a lens to understand what influences our decision-making with regard to risk in the context of COVID-19. This study was based on the rationale that our relational needs are more concrete to us than the risk of the virus. First, we explored the impact of social-psychological distance on participants' risk perceptions and behavioral willingness. As hypothesized, we found that close social relationships of agents promoted willingness to engage in risky behavior. In the second phase, we tested an intervention designed to increase the concreteness of information about virus transmission as a mechanism to mitigate the bias of social influence. We found that the concreteness intervention resulted in significantly reduced willingness to engage in risky behavior. As such, communications aimed at changing the behavior of citizens during times of increased risk or danger should consider conceptually concrete messaging when communicating complex risk, and hence may provide a valuable tool in promoting health-related behavior.
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Affiliation(s)
- Ceridwen Williams
- Wales Centre for Behaviour Change, Department of Psychology, Bangor University, Bangor LL57 2AS, UK; (C.W.); (P.R.)
| | - Paul Rauwolf
- Wales Centre for Behaviour Change, Department of Psychology, Bangor University, Bangor LL57 2AS, UK; (C.W.); (P.R.)
| | - Matt Boulter
- School of Health and Life Sciences, University of the West of Scotland, Glasgow G72 0LH, UK;
| | - John A. Parkinson
- Wales Centre for Behaviour Change, Department of Psychology, Bangor University, Bangor LL57 2AS, UK; (C.W.); (P.R.)
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Guo Z, Zeng T, Lu Y, Sun S, Liang X, Ran J, Wu Y, Chong MKC, Wang K, Zhao S. Transmission risks of Omicron BA.5 following inactivated COVID-19 vaccines among children and adolescents in China. COMMUNICATIONS MEDICINE 2024; 4:92. [PMID: 38762678 PMCID: PMC11102477 DOI: 10.1038/s43856-024-00521-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 05/03/2024] [Indexed: 05/20/2024] Open
Abstract
BACKGROUND As SARS-CoV-2 Omicron variants circulating globally since 2022, assessing the transmission characteristics, and the protection of vaccines against emerging Omicron variants among children and adolescents are needed for guiding the control and vaccination policies. METHODS We conducted a retrospective cohort study for SARS-CoV-2 infections and close contacts aged <18 years from an outbreak seeded by Omicron BA.5 variants. The secondary attack rate (SAR) was calculated and the protective effects of two doses of inactivated vaccine (mainly Sinopharm /BBIBP-CorV) within a year versus one dose or two doses above a year after vaccination against the transmission and infection of Omicron BA.5 were estimated. RESULTS A total of 3442 all-age close contacts of 122 confirmed SARS-CoV-2 infections aged 0-17 years were included. The SAR was higher in the household setting and for individuals who received a one-dose inactivated vaccine or those who received a two-dose for more than one year, with estimates of 28.5% (95% credible interval [CrI]: 21.1, 37.7) and 55.3% (95% CrI: 24.4, 84.8), respectively. The second dose of inactivated vaccine conferred substantial protection against all infection and transmission of Omicron BA.5 variants within a year. CONCLUSIONS Our findings support the rollout of the second dose of inactivated vaccine for children and adolescents during the Omciron BA.5 predominant epidemic phase. Given the continuous emergence of SARS-CoV-2 variants, monitoring the transmission risk and corresponding vaccine effectiveness against SARS-CoV-2 variants among children and adolescents is important to inform control strategy.
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Affiliation(s)
- Zihao Guo
- JC School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China
| | - Ting Zeng
- School of Public Health, Xinjiang Medical University, Urumqi, China
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Department of Medical Engineering and Technology, Xinjiang Medical University, Urumqi, China
| | - Yaoqin Lu
- School of Public Health, Xinjiang Medical University, Urumqi, China
- Urumqi Center for Disease Control and Prevention, Urumqi, China
| | - Shengzhi Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, China
| | - Xiao Liang
- Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hong Kong, China
| | - Jinjun Ran
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yushan Wu
- JC School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China
- Centre for Health Systems and Policy Research, Chinese University of Hong Kong, Hong Kong, China
| | - Marc K C Chong
- JC School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China
- Centre for Health Systems and Policy Research, Chinese University of Hong Kong, Hong Kong, China
- Clinical Trials and Biostatistics Laboratory, CUHK Shenzhen Research Institute, Shenzhen, China
| | - Kai Wang
- School of Public Health, Xinjiang Medical University, Urumqi, China.
| | - Shi Zhao
- School of Public Health, Tianjin Medical University, Tianjin, China.
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin Medical University, Tianjin, China.
- MoE Key Laboratory of Prevention and Control of Major Diseases in the Population, Tianjin Medical University, Tianjin, China.
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Johannesen N, Tang-Andersen Martinello A, Meyer BB, Vestergaard ET, Andersen AL, Jensen TL. Substantial transmission of SARS-CoV-2 through casual contact in retail stores: Evidence from matched administrative microdata on card payments and testing. Proc Natl Acad Sci U S A 2024; 121:e2317589121. [PMID: 38630715 PMCID: PMC11047087 DOI: 10.1073/pnas.2317589121] [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: 10/10/2023] [Accepted: 03/21/2024] [Indexed: 04/19/2024] Open
Abstract
This paper presents quasiexperimental evidence of Covid-19 transmission through casual contact between customers in retail stores. For a large sample of individuals in Denmark, we match card payment data, indicating exactly where and when each individual made purchases, with Covid-19 test data, indicating when each individual was tested and whether the test was positive. The resulting dataset identifies more than 100,000 instances where an infected individual made a purchase in a store and, in each instance, allows us to track the infection dynamics of other individuals who made purchases in the same store around the same time. We estimate transmissions by comparing the infection rate of exposed customers, who made a purchase within 5 min of an infected individual, and nonexposed customers, who made a purchase in the same store 16 to 30 min before. We find that exposure to an infected individual in a store increases the infection rate by around 0.12 percentage points (P < 0.001) between day 3 and day 7 after exposure. The estimates imply that transmissions in stores contributed around 0.04 to the reproduction number for the average infected individual and significantly more in the period where Omicron was the dominant variant.
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Affiliation(s)
- Niels Johannesen
- Saïd Business School, Oxford University, OxfordOX1 1HP, United Kingdom
- Department of Economics, University of Copenhagen, CopenhagenK 1353, Denmark
- Center for Economic Behavior and Inequality, University of Copenhagen, CopenhagenK 1353, Denmark
| | | | | | | | - Asger Lau Andersen
- Department of Economics, University of Copenhagen, CopenhagenK 1353, Denmark
- Center for Economic Behavior and Inequality, University of Copenhagen, CopenhagenK 1353, Denmark
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Moniz M, Soares P, Nunes B, Leite A. Is a tiered restrictions system an effective intervention for COVID-19 control? Results from Portugal, November-December 2020. BMC Public Health 2024; 24:956. [PMID: 38575989 PMCID: PMC10993531 DOI: 10.1186/s12889-024-18369-1] [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: 08/24/2023] [Accepted: 03/15/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND In November 2020, similar to other European countries, Portugal implemented a tiered restrictions system to control the COVID-19 pandemic. We aimed to compare the COVID-19 growth rate across tiers to assess the effect of a tiered restrictions system in Portugal, using models with different times between tiers assessment. Our hypothesis was that being in a higher tier brings a faster deceleration in the growth rate than being in a lower tier. METHODS The national database of notified COVID-19 cases and publicly available data were used to analyse the effect of the tiered restrictions system on the COVID-19 incidence growth rate. The tiers were based on the European Centre for Disease Control risk classification: moderate, high, very and extremely high. We used a generalised mixed-effects regression model to estimate the growth rate ratio (GRR) for each tier, comparing the growth rates of higher tiers using moderate tier as reference. Three models were fitted using different times between tiers assessment, separated by 14 days. RESULTS We included 156 034 cases. Very high tier was the most frequent combination in all the three moments assessed (21.2%), and almost 50% of the municipalities never changed tier during the study period. Immediately after the tiers implementation, a reduction was identified in the municipalities in high tier (GRR high tier: 0.90 [95%CI: 0.79; 1.02]) and very high tier (GRR very high tier: 0.68 [95%CI: 0.61; 0.77]), however with some imprecision in the 95% confidence interval for the high tier. A reduction in very high tier growth rate was identified two weeks (GRR: 0.79 [95%CI: 0.71; 0.88]) and four weeks (GRR: 0.77 [95%CI: 0.74; 0.82]) after the implementation, compared to moderate tier. In high tier, a reduction was also identified in both times, although smaller. CONCLUSIONS We observed a reduction in the growth rate in very high tier after the tiered restriction system was implemented, but we also observed a lag between tiered restriction system implementation and the onset of consequent effects. This could suggest the importance of early implementation of stricter measures for pandemic control. Thus, studies analysing a broader period of time are needed.
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Affiliation(s)
- Marta Moniz
- Public Health Research Center, Comprehensive Health Research Center, NOVA National School of Public Health, NOVA University Lisbon, CHRC, Lisbon, Portugal.
| | - Patrícia Soares
- Public Health Research Center, Comprehensive Health Research Center, NOVA National School of Public Health, NOVA University Lisbon, CHRC, Lisbon, Portugal
- Centre for Vectors and Infectious Diseases Research, National Institute of Health Doutor Ricardo Jorge, Águas de Moura, Portugal
- Department of Epidemiology, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
| | - Baltazar Nunes
- Public Health Research Center, Comprehensive Health Research Center, NOVA National School of Public Health, NOVA University Lisbon, CHRC, Lisbon, Portugal
- Department of Epidemiology, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
| | - Andreia Leite
- Public Health Research Center, Comprehensive Health Research Center, NOVA National School of Public Health, NOVA University Lisbon, CHRC, Lisbon, Portugal
- Department of Epidemiology, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
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Aranega-Bou P, Pottage T, Fenwick A, D'Costa W, Brown NF, Yaxley N, King MF, Parker ST, Miller D, López-García M, Noakes CJ, Moore G, Bennett A. A 17-month longitudinal surface sampling study carried out on public transport vehicles operating in England during the COVID-19 pandemic identified low levels of SARS-CoV-2 RNA contamination. J Appl Microbiol 2024; 135:lxae095. [PMID: 38637309 DOI: 10.1093/jambio/lxae095] [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: 12/20/2023] [Revised: 03/28/2024] [Accepted: 04/17/2024] [Indexed: 04/20/2024]
Abstract
AIMS To monitor severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) RNA contamination in vehicles operating in England during the pandemic, to better understand transmission risk of SARS-CoV-2 on public transport. METHODS AND RESULTS We collected 1314 surface samples between December 2020 and April 2022 on trains and buses managed by five different transport operators. The presence of SARS-CoV-2 RNA was investigated through reverse transcription polymerase chain reaction (RT-PCR). SARS-CoV-2 RNA was found on 197 (15%) of the 1314 surfaces sampled, including seat head rests, handholds, and air extract grilles, but the levels of RNA recovered on those samples (median value of 23.4, interquartile range: 14.3-35.4, N gene copies per extraction) made the presence of infectious virus at the time of sampling extremely unlikely. However, detection rates varied over time with peaks broadly coinciding with times of high community transmission, when it was more likely that people infected with SARS-CoV-2 were travelling on public transport. CONCLUSION During the pandemic, and as in other public spaces, low levels of SARS-CoV-2 RNA were found on surfaces associated with public transport.
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Affiliation(s)
- Paz Aranega-Bou
- Biosafety, Air and Water Microbiology Group, UK Health Security Agency, Porton Down, SP4 0JG Salisbury, United Kingdom
| | - Thomas Pottage
- Biosafety, Air and Water Microbiology Group, UK Health Security Agency, Porton Down, SP4 0JG Salisbury, United Kingdom
| | - Abigail Fenwick
- Biosafety, Air and Water Microbiology Group, UK Health Security Agency, Porton Down, SP4 0JG Salisbury, United Kingdom
| | - Wilhemina D'Costa
- Biosafety, Air and Water Microbiology Group, UK Health Security Agency, Porton Down, SP4 0JG Salisbury, United Kingdom
| | - Natalie F Brown
- Biosafety, Air and Water Microbiology Group, UK Health Security Agency, Porton Down, SP4 0JG Salisbury, United Kingdom
| | - Nicola Yaxley
- Biosafety, Air and Water Microbiology Group, UK Health Security Agency, Porton Down, SP4 0JG Salisbury, United Kingdom
| | - Marco-Felipe King
- School of Civil Engineering, University of Leeds, Woodhouse Lane, LS29JT Leeds, United Kingdom
| | - Simon T Parker
- Defence Science and Technology Laboratory, Porton Down, SP4 0JG Salisbury, United Kingdom
| | - Daniel Miller
- Defence Science and Technology Laboratory, Porton Down, SP4 0JG Salisbury, United Kingdom
| | - Martín López-García
- School of Mathematics, University of Leeds, Woodhouse Lane, LS2 9JT Leeds , United Kingdom
| | - Catherine J Noakes
- School of Civil Engineering, University of Leeds, Woodhouse Lane, LS29JT Leeds, United Kingdom
| | - Ginny Moore
- Biosafety, Air and Water Microbiology Group, UK Health Security Agency, Porton Down, SP4 0JG Salisbury, United Kingdom
| | - Allan Bennett
- Biosafety, Air and Water Microbiology Group, UK Health Security Agency, Porton Down, SP4 0JG Salisbury, United Kingdom
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11
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Gohil VS, Shah VR, Shukla RP. Household secondary attack rate amongst the susceptible contacts of COVID-19 cases and its epidemiological profile: A retrospective study from central Gujarat, India. J Family Med Prim Care 2024; 13:1448-1453. [PMID: 38827718 PMCID: PMC11141985 DOI: 10.4103/jfmpc.jfmpc_1474_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 12/13/2023] [Accepted: 12/17/2023] [Indexed: 06/04/2024] Open
Abstract
Introduction Secondary attack rate (SAR) is a proportion of primary contacts developing the diseases within the incubation period upon exposure to a primary case among the total susceptible household contacts. The epidemiological profile and SAR will help in understanding the transmission dynamics of COVID-19 for further strengthening preventive and effective control measures. Objectives of the Study The study was conducted with the primary objective to estimate the household SAR of COVID-19 cases at Mahisagar District, Gujarat, and to study the epidemiological profile of primary and secondary cases of COVID-19. Methodology A retrospective study was conducted to estimate SAR among 245 confirmed cases of COVID-19 and 898 susceptible household contacts in Mahisagar district through telephonic interview and questionnaire by the Investigator team. Results The household SAR was calculated from the current study in Mahisagar district, Gujarat, and was 13.9%. Among primary cases, 74.7% males were affected, and among secondary cases, 52.8% females were affected. The SAR among elderly was 23.9%, and the SAR among children was 3.9%. 74.1% household contacts had developed disease among symptomatic contacts as compared to asymptomatic household contacts. Conclusion The household SAR in Mahisagar district, Gujarat, was found to be 13.9%. In primary cases, more males, and in secondary cases, more females were found to be affected. The household SAR was increased in elderly as compared to the younger age group. The SAR was more among the contacts of symptomatic cases than asymptomatic cases. Overall hospitalization in public hospitals was more than that in private hospitals.
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Affiliation(s)
- Vaidehi S. Gohil
- Community Medicine Department, Dr. M. K. Shah Medical College, Ahmedabad, Gujarat, India
| | - Venu R. Shah
- Community Medicine Department GCS Medical College, Ahmedabad, Gujarat, India
| | - Rujul P. Shukla
- Community Medicine Department, Ananya Medical College, Ahmedabad, Gujarat, India
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12
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Bullón-Vela V, Toledo D, Vera-Punzano N, Godoy P, García Cenoz M, Pardos-Plaza J, Castilla J, Domínguez A, Martínez-Baz I. [Level of knowledge, attitudes and the use of preventive measures among household contacts of COVID-19 cases after the acute phase of the pandemic]. An Sist Sanit Navar 2024; 47:e1070. [PMID: 38501156 PMCID: PMC11016338 DOI: 10.23938/assn.1070] [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: 11/10/2023] [Revised: 01/04/2024] [Accepted: 01/31/2024] [Indexed: 03/20/2024]
Abstract
BACKGROUND Assessment of the level of knowledge and attitudes regarding COVID-19 and preventive measures in household contacts of COVID-19 cases after the acute phase of the pandemic. METHODS Survey among household contacts of COVID-19 cases conducted in healthcare centers in Navarre (1) and Catalonia (8) between May 2022 and July 2023. The frequency of use of preventive measures and the knowledge and attitudes towards COVID-19 were assessed through 12 items. RESULTS 215 contacts participated who correctly used the preventive measures (>85%), except for facemasks (35.8%) and interpersonal distance (47%); >85% showed adequate knowledge (5/6 items) and >80% had a positive attitude (3/6 items). Moreover, 54.7% considered that COVID-19 negatively affected their life and 54.1% that it is better to develop immunity by getting infected than by vaccination. CONCLUSIONS Household contacts show a correct level of knowledge and positive attitude towards the disease and its preventive measures.
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Faucher B, Sabbatini CE, Czuppon P, Kraemer MUG, Lemey P, Colizza V, Blanquart F, Boëlle PY, Poletto C. Drivers and impact of the early silent invasion of SARS-CoV-2 Alpha. Nat Commun 2024; 15:2152. [PMID: 38461311 PMCID: PMC10925057 DOI: 10.1038/s41467-024-46345-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 02/22/2024] [Indexed: 03/11/2024] Open
Abstract
SARS-CoV-2 variants of concern (VOCs) circulated cryptically before being identified as a threat, delaying interventions. Here we studied the drivers of such silent spread and its epidemic impact to inform future response planning. We focused on Alpha spread out of the UK. We integrated spatio-temporal records of international mobility, local epidemic growth and genomic surveillance into a Bayesian framework to reconstruct the first three months after Alpha emergence. We found that silent circulation lasted from days to months and decreased with the logarithm of sequencing coverage. Social restrictions in some countries likely delayed the establishment of local transmission, mitigating the negative consequences of late detection. Revisiting the initial spread of Alpha supports local mitigation at the destination in case of emerging events.
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Affiliation(s)
- Benjamin Faucher
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), F75012, Paris, France
| | - Chiara E Sabbatini
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), F75012, Paris, France
| | - Peter Czuppon
- Institute for Evolution and Biodiversity, University of Münster, Münster, 48149, Germany
| | - Moritz U G Kraemer
- Department of Biology, University of Oxford, Oxford, UK
- Pandemic Sciences Institute, University of Oxford, Oxford, UK
| | - Philippe Lemey
- Department of Microbiology, Immunology and Transplantation, Rega Institute, Laboratory for Clinical and Epidemiological Virology, KU Leuven, Leuven, Belgium
| | - Vittoria Colizza
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), F75012, Paris, France
- Department of Biology, Georgetown University, Washington, DC, USA
| | - François Blanquart
- Center for Interdisciplinary Research in Biology, CNRS, Collège de France, PSL Research University, Paris, 75005, France
| | - Pierre-Yves Boëlle
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), F75012, Paris, France
| | - Chiara Poletto
- Department of Molecular Medicine, University of Padova, 35121, Padova, Italy.
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14
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Pulido J, Barrio G, Donat M, Politi J, Moreno A, Cea-Soriano L, Guerras JM, Huertas L, Mateo-Urdiales A, Ronda E, Martínez D, Lostao L, Belza MJ, Regidor E. Excess Mortality During 2020 in Spain: The Most Affected Population, Age, and Educational Group by the COVID-19 Pandemic. Disaster Med Public Health Prep 2024; 18:e27. [PMID: 38372080 DOI: 10.1017/dmp.2024.17] [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] [Indexed: 02/20/2024]
Abstract
OBJECTIVE The objective of this work was to study mortality increase in Spain during the first and second academic semesters of 2020, coinciding with the first 2 waves of the Covid-19 pandemic; by sex, age, and education. METHODS An observational study was carried out, using linked populations and deaths' data from 2017 to 2020. The mortality rates from all causes and leading causes other than Covid-19 during each semester of 2020, compared to the 2017-2019 averages for the same semester, was also estimated. Mortality rate ratios (MRR) and differences were used for comparison. RESULTS All-cause mortality rates increased in 2020 compared to pre-covid, except among working-age, (25-64 years) highly-educated women. Such increases were larger in lower-educated people between the working age range, in both 2020 semesters, but not at other ages. In the elderly, the MMR in the first semester in women and men were respectively, 1.14, and 1.25 among lower-educated people, and 1.28 and 1.23 among highly-educated people. In the second semester, the MMR were 1.12 in both sexes among lower-educated people and 1.13 in women and 1.16 in men among highly-educated people. CONCLUSION Lower-educated people within working age and highly-educated people at older ages showed the greatest increase in all-cause mortality in 2020, compared to the pre-pandemic period.
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Affiliation(s)
- José Pulido
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Gregorio Barrio
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- National School of Public Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Marta Donat
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- National School of Public Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Julieta Politi
- National School of Public Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Almudena Moreno
- Department of Sociology, Universidad Pública de Navarra, Spain
| | - Lucía Cea-Soriano
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - Juan Miguel Guerras
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- National School of Public Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Lidia Huertas
- Instituto Valenciano de Estadística, Valencia, Spain
- National Epidemiology Center, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Elena Ronda
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Preventive Medicine and Public Health Area, Universidad de Alicante, Alicante, Spain
| | - David Martínez
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - Lourdes Lostao
- Department of Sociology, Universidad Pública de Navarra, Spain
| | - María José Belza
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- National School of Public Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Enrique Regidor
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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Vyas N, Bennett A, Shaver N, Beck A, Zitiktye G, Whelan B, O’Regan R, Conway A, Skidmore B, Moher D, Little J. SARS-CoV-2 transmission risk for common group activities and settings: a living scoping review. Eur J Public Health 2024; 34:196-201. [PMID: 37995320 PMCID: PMC10843946 DOI: 10.1093/eurpub/ckad195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND While the modes of transmission of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) are well studied, the risk of transmission in various group settings or activities is less clear. This living scoping review aims to summarize the risk factors of coronavirus disease 2019 (COVID-19) spread in common group activities (e.g. social gatherings) or settings (e.g. schools, hospitals, shared workplaces) to understand the drivers of transmission and to inform a risk assessment profile tool for use of rapid antigen detection tests. METHODS We systematically searched electronic databases, MEDLINE and Embase, from January 2019 until February 2022. We included studies that evaluated the risk of SARS-CoV-2 transmission in activities and settings, deemed strategically important to government departments in Ireland, provided by the Department of Health (Ireland) Expert Advisory Group on Rapid Testing. RESULTS After screening 14 052 records, data from 139 studies were narratively synthesized. The risk was consistently reported as 'high' for large social events (e.g. weddings) and indoor sports, working in healthcare settings and shared workplaces, working/living in residential settings and travelling via public transportation. Most studies were from healthcare settings, with common risk factors including close contact with COVID-19 cases, working in high-risk departments and inappropriate use of personal protective equipment. For other settings and activities, lack of infection prevention and control practices reportedly contributed to infection transmission. CONCLUSION The heterogeneity across studies and lack of direct information on dominant variants, preventive measures, vaccination coverage necessitates further research on transmission risk within group activities to inform infection prevention and control measures.
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Affiliation(s)
- Niyati Vyas
- Knowledge Synthesis and Application Unit, School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Alexandria Bennett
- Knowledge Synthesis and Application Unit, School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Nicole Shaver
- Knowledge Synthesis and Application Unit, School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Andrew Beck
- Knowledge Synthesis and Application Unit, School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Gabriele Zitiktye
- Knowledge Synthesis and Application Unit, School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Barbara Whelan
- Evidence Synthesis Ireland & Cochrane Ireland, School of Nursing and Midwifery, University of Galway, Galway, Ireland
| | - Rhea O’Regan
- Evidence Synthesis Ireland & Cochrane Ireland, School of Nursing and Midwifery, University of Galway, Galway, Ireland
| | - Aileen Conway
- Evidence Synthesis Ireland & Cochrane Ireland, School of Nursing and Midwifery, University of Galway, Galway, Ireland
| | - Becky Skidmore
- Independent Information Specialist, Ottawa, Ontario, Canada
| | - David Moher
- Knowledge Synthesis and Application Unit, School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Julian Little
- Knowledge Synthesis and Application Unit, School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
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Rakover A, Galmiche S, Charmet T, Chény O, Omar F, David C, Martin S, Mailles A, Fontanet A. Source of SARS-CoV-2 infection: results from a series of 584,846 cases in France from October 2020 to August 2022. BMC Public Health 2024; 24:325. [PMID: 38287286 PMCID: PMC10826227 DOI: 10.1186/s12889-024-17772-y] [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: 10/03/2023] [Accepted: 01/15/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND We aimed to study the source of infection for recently SARS-CoV-2-infected individuals from October 2020 to August 2022 in France. METHODS Participants from the nationwide ComCor case-control study who reported recent SARS-CoV-2 infection were asked to document the source and circumstances of their infection through an online questionnaire. Multivariable logistic regression was used to identify the factors associated with not identifying any source of infection. RESULTS Among 584,846 adults with a recent SARS-CoV-2 infection in France, 46.9% identified the source of infection and an additional 22.6% suspected an event during which they might have become infected. Known and suspected sources of infection were household members (30.8%), extended family (15.6%), work colleagues (15.0%), friends (11.0%), and possibly multiple/other sources (27.6%). When the source of infection was known, was not a household member, and involved a unique contact (n = 69,788), characteristics associated with transmission events were indoors settings (91.6%), prolonged (> 15 min) encounters (50.5%), symptomatic source case (64.9%), and neither the source of infection nor the participant wearing a mask (82.2%). Male gender, older age, lower education, living alone, using public transportation, attending places of public recreation (bars, restaurants, nightclubs), public gatherings, and cultural events, and practicing indoor sports were all independently associated with not knowing the source of infection. CONCLUSION Two-thirds of infections were attributed to interactions with close relatives, friends, or work colleagues. Extra-household indoor encounters without masks were commonly reported and represented avoidable circumstances of infection. TRIAL REGISTRATION ClinicalTrials.gov registration number: NCT04607941.
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Affiliation(s)
- Arthur Rakover
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Université Paris Cité, 25 Rue du Docteur Roux, 75015, Paris, France.
| | - Simon Galmiche
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Université Paris Cité, 25 Rue du Docteur Roux, 75015, Paris, France
- Sorbonne Université, Ecole Doctorale Pierre Louis de Santé Publique, Paris, France
| | - Tiffany Charmet
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Université Paris Cité, 25 Rue du Docteur Roux, 75015, Paris, France
| | - Olivia Chény
- Institut Pasteur, Université Paris Cité, Centre for Translational Research, Paris, France
| | | | | | - Sophie Martin
- Caisse Nationale de L'Assurance Maladie, Paris, France
| | | | - Arnaud Fontanet
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Université Paris Cité, 25 Rue du Docteur Roux, 75015, Paris, France
- Conservatoire National Des Arts Et Métiers, Unité PACRI, Paris, France
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17
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Chung MK, Hart B, Santillana M, Patel CJ. Pediatric and Young Adult Household Transmission of the Initial Waves of SARS-CoV-2 in the United States: Administrative Claims Study. J Med Internet Res 2024; 26:e44249. [PMID: 37967280 PMCID: PMC10768807 DOI: 10.2196/44249] [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: 11/11/2022] [Revised: 07/18/2023] [Accepted: 10/29/2023] [Indexed: 11/17/2023] Open
Abstract
BACKGROUND The correlates responsible for the temporal changes of intrahousehold SARS-CoV-2 transmission in the United States have been understudied mainly due to a lack of available surveillance data. Specifically, early analyses of SARS-CoV-2 household secondary attack rates (SARs) were small in sample size and conducted cross-sectionally at single time points. From these limited data, it has been difficult to assess the role that different risk factors have had on intrahousehold disease transmission in different stages of the ongoing COVID-19 pandemic, particularly in children and youth. OBJECTIVE This study aimed to estimate the transmission dynamic and infectivity of SARS-CoV-2 among pediatric and young adult index cases (age 0 to 25 years) in the United States through the initial waves of the pandemic. METHODS Using administrative claims, we analyzed 19 million SARS-CoV-2 test records between January 2020 and February 2021. We identified 36,241 households with pediatric index cases and calculated household SARs utilizing complete case information. Using a retrospective cohort design, we estimated the household SARS-CoV-2 transmission between 4 index age groups (0 to 4 years, 5 to 11 years, 12 to 17 years, and 18 to 25 years) while adjusting for sex, family size, quarter of first SARS-CoV-2 positive record, and residential regions of the index cases. RESULTS After filtering all household records for greater than one member in a household and missing information, only 36,241 (0.85%) of 4,270,130 households with a pediatric case remained in the analysis. Index cases aged between 0 and 17 years were a minority of the total index cases (n=11,484, 11%). The overall SAR of SARS-CoV-2 was 23.04% (95% CI 21.88-24.19). As a comparison, the SAR for all ages (0 to 65+ years) was 32.4% (95% CI 32.1-32.8), higher than the SAR for the population between 0 and 25 years of age. The highest SAR of 38.3% was observed in April 2020 (95% CI 31.6-45), while the lowest SAR of 15.6% was observed in September 2020 (95% CI 13.9-17.3). It consistently decreased from 32% to 21.1% as the age of index groups increased. In a multiple logistic regression analysis, we found that the youngest pediatric age group (0 to 4 years) had 1.69 times (95% CI 1.42-2.00) the odds of SARS-CoV-2 transmission to any family members when compared with the oldest group (18 to 25 years). Family size was significantly associated with household viral transmission (odds ratio 2.66, 95% CI 2.58-2.74). CONCLUSIONS Using retrospective claims data, the pediatric index transmission of SARS-CoV-2 during the initial waves of the COVID-19 pandemic in the United States was associated with location and family characteristics. Pediatric SAR (0 to 25 years) was less than the SAR for all age other groups. Less than 1% (n=36,241) of all household data were retained in the retrospective study for complete case analysis, perhaps biasing our findings. We have provided measures of baseline household pediatric transmission for tracking and comparing the infectivity of later SARS-CoV-2 variants.
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Affiliation(s)
- Ming Kei Chung
- Department of Biomedical Informatics, Harvard Medical School, Harvard University, Boston, MA, United States
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
- Institute of Environment, Energy, and Sustainability, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Brian Hart
- Optum Labs, Eden Prairie, MN, United States
| | - Mauricio Santillana
- Machine Intelligence Group for the Betterment of Health and the Environment, Network Science Institute, Northeastern University, Boston, MA, United States
| | - Chirag J Patel
- Department of Biomedical Informatics, Harvard Medical School, Harvard University, Boston, MA, United States
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Zhu W, Yuan S, Mao S, Chen J, Zheng Y, Jiang X, Yu X, Jiang C, Fang Q, Wang W, Yuan Z, Yao Y. Relationship of close contact settings with transmission and infection during the SARS-CoV-2 Omicron BA.2 epidemic in Shanghai. BMJ Glob Health 2023; 8:e012289. [PMID: 38135296 DOI: 10.1136/bmjgh-2023-012289] [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: 03/13/2023] [Accepted: 10/07/2023] [Indexed: 12/24/2023] Open
Abstract
INTRODUCTION We analysed case-contact clusters during the Omicron BA.2 epidemic in Shanghai to assess the risk of infection of contacts in different settings and to evaluate the effect of demographic factors on the association of infectivity and susceptibility to the Omicron variant. METHODS Data on the settings and frequency of contact, demographic characteristics and comorbidities of index cases, contacts and secondary cases were analysed. Independent effect of multiple variables on the risk for transmission and infection was evaluated using generalised estimating equations. RESULTS From 1 March to 1 June 2022, we identified 450 770 close contacts of 90 885 index cases. The risk for infection was greater for contacts in farmers' markets (fixed locations where farmers gather to sell products, adjusted OR (aOR): 3.62; 95% CI 2.87 to 4.55) and households (aOR: 2.68; 95% CI 2.15 to 3.35). Children (0-4 years) and elderly adults (60 years and above) had higher risk for infection and transmission. During the course of the epidemic, the risk for infection and transmission in different age groups initially increased, and then decreased on about 21 April (17th day of citywide home quarantine). Compared with medical workers (reference, aOR: 1.00), unemployed contacts (aOR: 1.77; 95% CI 1.53 to 2.04) and preschoolers (aOR: 1.61; 95% CI 1.26 to 2.05) had the highest risk for infection; delivery workers (aOR: 1.90, 95% CI 1.51 to 2.40) and public service workers (aOR: 1.85; 95% CI 1.64 to 2.10) had the highest risk for transmission. Contacts who had comorbidities (aOR: 1.10; 95% CI 1.09 to 1.12) had a higher risk for infection, particularly those with lung diseases or immune deficiency. CONCLUSION Farmers' markets and households were the main setting for transmission of Omicron. Children, the elderly, delivery workers and public service workers had the highest risk for transmission and infection. These findings should be considered when implementing targeted interventions.
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Affiliation(s)
- Wenlong Zhu
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China
| | - Shiying Yuan
- Department of Infectious Disease Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Shenghua Mao
- Department of Infectious Disease Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Jian Chen
- Department of Infectious Disease Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Yaxu Zheng
- Department of Infectious Disease Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Xianjin Jiang
- Department of Infectious Disease Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Xiao Yu
- Department of Infectious Disease Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Chenyan Jiang
- Department of Infectious Disease Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Qiwen Fang
- Department of Infectious Disease Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Weibing Wang
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Zheng'an Yuan
- Department of Infectious Disease Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Ye Yao
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China
- Department of Biostatics, School of Public Health, Fudan University, Shanghai, China
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19
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Ramalho JP, Simões DG, Aguiar P. Impact of sociodemographic and economic determinants of health on COVID-19 infection: incidence variation between reference periods. Public Health 2023; 225:305-310. [PMID: 37963420 DOI: 10.1016/j.puhe.2023.10.023] [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: 07/04/2023] [Revised: 09/13/2023] [Accepted: 10/10/2023] [Indexed: 11/16/2023]
Abstract
OBJECTIVES The COVID-19 pandemic hit Portugal in March 2020, causing widespread disruption to various aspects of society. While extensive research has been conducted on the significance of socio-economic disparities in infection risk, this study aims to enhance our understanding of their evolving relationship over time by analysing four distinct periods in 2020. STUDY DESIGN AND METHODS This retrospective observational ecological study included individuals residing in the Primary Healthcare Cluster areas of Almada-Seixal and Western Lisbon and Oeiras, who tested positive for SARS-CoV-2 through a polymerase chain reaction (PCR) test between the 2nd of March and the 8th of November of 2020. Using incidence rates for each specific neighbourhood (n = 29) and period, we explored the relationship between neighbourhood-level socio-economic variables and the risk of infection using negative-binomial regression models. RESULTS In the analysed period, a total of 8562 confirmed COVID-19 cases were identified. Overall incidence rates for each period were sequentially 2.74, 5.03, 3.99 and 14.29 COVID-19 cases per 100,000 person-days. Housing overcrowding, illiteracy rate and place of birth were associated with increased risk of infection, while age, congregate living, and employment in the secondary sector exhibited the opposite association. No association was consistent across all time periods. CONCLUSIONS Our findings support the idea that the influence of socio-economic determinants of health is not immutable throughout time. In a pandemic context where information, knowledge, beliefs, and behaviours are ever-changing and evolving, a dynamic, inclusive, and adaptable approach to disease control can lead to a more equitable distribution of improved outcomes, benefiting all strata of society.
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Affiliation(s)
- J P Ramalho
- Public Health Unit of Primary Healthcare Cluster of Western Lisbon and Oeiras, Regional Health Administration of Lisbon and Tagus Valley, Lisbon, Portugal; National School of Public Health, NOVA University of Lisbon, Portugal.
| | - D G Simões
- National School of Public Health, NOVA University of Lisbon, Portugal; Public Health Unit of Primary Healthcare Cluster of Almada-Seixal, Regional Health Administration of Lisbon and Tagus Valley, Lisbon, Portugal
| | - P Aguiar
- National School of Public Health, NOVA University of Lisbon, Portugal; Public Health Research Centre (CISP/PHRC), NOVA University of Lisbon, Portugal; Comprehensive Health Research Centre (CHRC), NOVA University of Lisbon, Portugal
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20
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Donskey CJ. High technology and low technology measures to reduce risk of SARS-CoV-2 transmission. Am J Infect Control 2023; 51:A126-A133. [PMID: 37890942 DOI: 10.1016/j.ajic.2023.03.007] [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: 03/07/2023] [Accepted: 03/09/2023] [Indexed: 10/29/2023]
Abstract
During the coronavirus disease 2019 (COVID-19) pandemic, a variety of low technology and high technology measures have been proposed to reduce the risk for transmission. Identifying those measures likely to be useful in reducing viral transmission without undue expense or potential for adverse effects has been a challenge for infection control programs. The challenge has been compounded by the lack of tools that can be used to assess the risk for viral transmission in different settings. This review discusses practical tools that can be used to assess ventilation and airflow and evaluates some of the low technology and high technology measures that have been proposed as control measures for COVID-19. Some typical questions posed to infection control programs during the pandemic are presented to illustrate real-world application of the concepts being discussed.
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Affiliation(s)
- Curtis J Donskey
- Geriatric Research, Education and Clinical Center, Louis Stokes Cleveland VA Medical Center, Cleveland, OH; Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH.
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21
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Wilkinson B, Patel KS, Smith K, Walker R, Wang C, Greene AM, Smith G, Smith ER, Gurwith M, Chen RT. A Brighton Collaboration standardized template with key considerations for a benefit/risk assessment for the Novavax COVID-19 Vaccine (NVX-CoV2373), a recombinant spike protein vaccine with Matrix-M adjuvant to prevent disease caused by SARS-CoV-2 viruses. Vaccine 2023; 41:6762-6773. [PMID: 37739888 DOI: 10.1016/j.vaccine.2023.07.040] [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: 07/18/2023] [Accepted: 07/20/2023] [Indexed: 09/24/2023]
Abstract
Novavax, a global vaccine company, began evaluating NVX-CoV2373 in human studies in May 2020 and the pivotal placebo-controlled phase 3 studies started in November 2020; five clinical studies provided adult and adolescent clinical data for over 31,000 participants who were administered NVX-CoV2373. This extensive data has demonstrated a well-tolerated response to NVX-CoV2373 and high vaccine efficacy against mild, moderate, or severe COVID-19 using a two-dose series (Dunkle et al., 2022) [1], (Heath et al., 2021) [2], (Keech et al., 2020) [3], (Mallory et al., 2022) [4]. The most common adverse events seen after administration with NVX-CoV2373 were injection site tenderness, injection site pain, fatigue, myalgia, headache, malaise, arthralgia, nausea, or vomiting. In addition, immunogenicity against variants of interest (VOI) and variants of concern (VOC) was established with high titers of ACE2 receptor-inhibiting and neutralizing antibodies in these studies (EMA, 2022) [5], (FDA, 2023) [6]. Further studies on correlates of protection determined that titers of anti-Spike IgG and neutralizing antibodies correlated with efficacy against symptomatic COVID-19 established in clinical trials (p < 0.001 for recombinant protein vaccine and p = 0.005 for mRNA vaccines for IgG levels) (Fong et al., 2022) [7]. Administration of a booster dose of the recombinant protein vaccine approximately 6 months following the primary two-dose series resulted in substantial increases in humoral antibodies against both the prototype strain and all evaluated variants, similar to or higher than the antibody levels observed in phase 3 studies that were associated with high vaccine efficacy (Dunkle et al., 2022) [1], (Mallory et al., 2022) [4]. These findings, together with the well tolerated safety profile, support use of the recombinant protein vaccine as primary series and booster regimens.
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Affiliation(s)
| | | | | | | | | | | | | | - Emily R Smith
- Brighton Collaboration, a program of the Task Force for Global Health, Decatur, GA, USA.
| | - Marc Gurwith
- Brighton Collaboration, a program of the Task Force for Global Health, Decatur, GA, USA
| | - Robert T Chen
- Brighton Collaboration, a program of the Task Force for Global Health, Decatur, GA, USA
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22
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Zhang WW, Li CX, Cao SJ, Wang YY, Lu ZX, Sun JL, Jing MX. A network meta-analysis of risk factors of infection among close contacts of COVID-19. Heliyon 2023; 9:e20861. [PMID: 37860512 PMCID: PMC10582502 DOI: 10.1016/j.heliyon.2023.e20861] [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: 11/24/2022] [Revised: 10/06/2023] [Accepted: 10/09/2023] [Indexed: 10/21/2023] Open
Abstract
Objective We aimed to use network meta-analysis to compare the impact of infection risk factors of close contacts with COVID-19, identify the most influential factors and rank their subgroups. It can provide a theoretical basis for the rapid and accurate tracking and management of close contacts. Methods We searched nine databases from December 1, 2019 to August 2, 2023, which only took Chinese and English studies into consideration. Odd ratios (ORs) were calculated from traditional meta-estimated secondary attack rates (SARs) for different risk factors, and risk ranking of these risk factors was calculated by the surface under the cumulative ranking curve (SUCRA). Results 25 studies with 152647 participants identified. Among all risk factors, the SUCRA of type of contact was 69.6 % and ranked first. Among six types of contact, compared with transportation contact, medical contact, social contact and other, daily contact increased risk of infection by 12.11 (OR: 12.11, 95 % confidence interval (CI): 6.51-22.55), 7.76 (OR: 7.76, 95 % CI: 4.09-14.73), 4.65 (OR: 4.65, 95 % CI: 2.66-8.51) and 8.23 OR: 8.23, 95 % CI: 4.23-16.01) times, respectively. Overall, SUCRA ranks from highest to lowest as daily contact (94.7 %), contact with pollution subjects (78.4 %), social contact (60.8 %), medical contact (31.8 %), other (27.9 %), transportation contact (6.4 %). Conclusion The type of contact had the greatest impact on COVID-19 close contacts infection among the risk factors we included. Daily contact carried the greatest risk of infection among six types of contact, followed by contact with pollution subjects, social contact, other, medical contact and transportation contact. The results can provide scientific basis for rapid assess the risk of infection among close contacts based on fewer risk factors and pay attention to high-risk close contacts during management, thereby reducing tracking and management costs.
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Affiliation(s)
- Wei-wen Zhang
- Department of Preventive Medicine, School of Medicine, Shihezi University. Shihezi, 832003, PR China
- Key Laboratory for Prevention and Control of Emerging Infectious Diseases and Public Health Security, The Xinjiang Production and Construction Corps, PR China
| | - Chen-xi Li
- Oncological Department of Oral & Maxillofacial Surgery, The First Affiliated Hospital of Xinjiang Medical University, School/Hospital of Stomatology, Xinjiang Medical University, Stomatological Research Institute of Xinjiang Uygur Autonomous Region, Urumqi, 830054, PR China
| | - Shu-jing Cao
- Department of Preventive Medicine, School of Medicine, Shihezi University. Shihezi, 832003, PR China
- Key Laboratory for Prevention and Control of Emerging Infectious Diseases and Public Health Security, The Xinjiang Production and Construction Corps, PR China
| | - Yu-yuan Wang
- Department of Preventive Medicine, School of Medicine, Shihezi University. Shihezi, 832003, PR China
- Key Laboratory for Prevention and Control of Emerging Infectious Diseases and Public Health Security, The Xinjiang Production and Construction Corps, PR China
| | - Ze-xi Lu
- Department of Preventive Medicine, School of Medicine, Shihezi University. Shihezi, 832003, PR China
- Key Laboratory for Prevention and Control of Emerging Infectious Diseases and Public Health Security, The Xinjiang Production and Construction Corps, PR China
| | - Jia-lin Sun
- Department of Preventive Medicine, School of Medicine, Shihezi University. Shihezi, 832003, PR China
- Key Laboratory for Prevention and Control of Emerging Infectious Diseases and Public Health Security, The Xinjiang Production and Construction Corps, PR China
| | - Ming -xia Jing
- Department of Preventive Medicine, School of Medicine, Shihezi University. Shihezi, 832003, PR China
- Key Laboratory for Prevention and Control of Emerging Infectious Diseases and Public Health Security, The Xinjiang Production and Construction Corps, PR China
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23
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Galmiche S, Charmet T, Rakover A, Schaeffer L, Chény O, von Platen C, Omar F, David C, Mailles A, Carrat F, Fontanet A. Risk of SARS-CoV-2 Infection Among Households With Children in France, 2020-2022. JAMA Netw Open 2023; 6:e2334084. [PMID: 37713194 PMCID: PMC10504612 DOI: 10.1001/jamanetworkopen.2023.34084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 07/18/2023] [Indexed: 09/16/2023] Open
Abstract
Importance Understanding the contribution of children to SARS-CoV-2 circulation in households is critical for designing public health policies and mitigation strategies. Objective To identify temporal changes in the risk of SARS-CoV-2 infection in people living with children. Design, Setting, and Participants This case-control study included online questionnaire responses from French adults between October 2020 and October 2022. Eligible cases were adults with ongoing SARS-CoV-2 infection with an email address on record with the national health insurance system, which centralized all new diagnoses in France. Eligible controls were adults who had never tested positive for SARS-CoV-2 until February 2021, when eligibility was extended to all adults without ongoing SARS-CoV-2 infection. Exposure Transmission of SARS-CoV-2 from a child (aged under 18 years) within the household in the descriptive analysis, as reported by the participating case. Sharing household with a child (of any age or broken down by school level) in the case-control analysis. Main Outcome and Measures Ongoing SARS-CoV-2 infection diagnosed by reverse transcription-polymerase chain reaction or supervised rapid antigen test (ie, not self-tests). Results A total of 682 952 cases were included for the descriptive analysis (68.8% female, median [IQR] age, 44 [34-55] years). Among those, 45 108 (6.6%) identified a household child as the source case; this proportion peaked at 10.4% during the Omicron BA.1 wave (December 20, 2021, to April 8, 2022). For the case-control analysis, we matched 175 688 cases (with a 4:1 ratio) for demographic characteristics with 43 922 controls. In multivariable logistic regression analysis, household exposure to children was associated with an increased risk of infection mainly at the end of summer 2021 (receding Delta wave) and during winter 2022 (Omicron BA.1 wave). In subgroup analysis by school level of the child, living with children under the age of 6 was associated with increased odds of infection throughout the study period, peaking at an odds ratio (OR) 1.8 (95% CI, 1.6-2.1) for children looked after by professional in-home caregivers, 1.7 (95% CI, 1.5-1.7) for children in day care facilities, and 1.6 (95% CI, 1.4-1.8) for children in preschool. The ORs associated with household exposure to children aged 6 to 14 years increased during the Delta (August 14, 2021, to December 19, 2021) and Omicron BA.1 waves, reaching 1.6 (95% CI, 1.5-1.7) for primary school children and 1.4 (95% CI, 1.3-1.5) for middle school children. Exposure to older children aged 15 to 17 years was associated with a moderate risk until April 2021, with an OR of 1.2 (95% CI, 1.2-1.3) during curfew in early 2021 (December 4, 2020, to April 8, 2021). Conclusions and Relevance The presence of children, notably very young ones, was associated with an increased risk of SARS-CoV-2 infection in other household members, especially during the Delta and Omicron BA.1 waves. These results should help to guide policies targeting children and immunocompromised members of their household.
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Affiliation(s)
- Simon Galmiche
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Université Paris Cité, Paris, France
- Sorbonne Université, Ecole Doctorale Pierre Louis de Santé Publique, Paris, France
| | - Tiffany Charmet
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Université Paris Cité, Paris, France
| | - Arthur Rakover
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Université Paris Cité, Paris, France
| | - Laura Schaeffer
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Université Paris Cité, Paris, France
| | - Olivia Chény
- Center for Translational Research, Institut Pasteur, Université Paris Cité, Paris, France
| | - Cassandre von Platen
- Center for Translational Research, Institut Pasteur, Université Paris Cité, Paris, France
| | - Faïza Omar
- Department of Public Affairs—Public Statistics, Institut Ipsos, Paris, France
| | - Christophe David
- Department of Public Affairs—Public Statistics, Institut Ipsos, Paris, France
| | | | - Fabrice Carrat
- Sorbonne Université, Inserm, IPLESP, Hôpital Saint-Antoine, AP-HP, Paris, France
| | - Arnaud Fontanet
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Université Paris Cité, Paris, France
- Unité PACRI, Conservatoire National des Arts et Métiers, Paris, France
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24
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Babu TM, Feldstein LR, Saydah S, Acker Z, Boisvert CL, Briggs-Hagen M, Carone M, Casto A, Cox SN, Ehmen B, Englund JA, Fortmann SP, Frivold CJ, Groom H, Han PD, Kuntz JL, Lockwood T, Midgley CM, Mularski RA, Ogilvie T, Reich SL, Schmidt MA, Smith N, Starita L, Stone J, Vandermeer M, Weil AA, Wolf CR, Chu HY, Naleway AL. CASCADIA: a prospective community-based study protocol for assessing SARS-CoV-2 vaccine effectiveness in children and adults using a remote nasal swab collection and web-based survey design. BMJ Open 2023; 13:e071446. [PMID: 37451722 PMCID: PMC10350906 DOI: 10.1136/bmjopen-2022-071446] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 06/13/2023] [Indexed: 07/18/2023] Open
Abstract
INTRODUCTION Although SARS-CoV-2 vaccines were first approved under Emergency Use Authorization by the Food and Drug Administration in late 2020 for adults, authorisation for young children 6 months to <5 years of age did not occur until 2022. These authorisations were based on clinical trials, understanding real-world vaccine effectiveness (VE) in the setting of emerging variants is critical. The primary goal of this study is to evaluate SARS-CoV-2 VE against infection among children aged >6 months and adults aged <50 years. METHODS CASCADIA is a 4-year community-based prospective study of SARS-CoV-2 VE among 3500 adults and paediatric populations aged 6 months to 49 years in Oregon and Washington, USA. At enrolment and regular intervals, participants complete a sociodemographic questionnaire. Individuals provide a blood sample at enrolment and annually thereafter, with optional blood draws every 6 months and after infection and vaccination. Participants complete weekly self-collection of anterior nasal swabs and symptom questionnaires. Swabs are tested for SARS-CoV-2 and other respiratory pathogens by reverse transcription-PCR, with results of selected pathogens returned to participants; nasal swabs with SARS-CoV-2 detected will undergo whole genome sequencing. Participants who test positive for SARS-CoV-2 undergo serial swab collection every 3 days for 21 days. Serum samples are tested for SARS-CoV-2 antibody by binding and neutralisation assays. ANALYSIS The primary outcome is SARS-CoV-2 infection. Cox regression models will be used to estimate the incidence rate ratio associated with SARS-CoV-2 vaccination among the paediatric and adult population, controlling for demographic factors and other potential confounders. ETHICS AND DISSEMINATION All study materials including the protocol, consent forms, data collection instruments, participant communication and recruitment materials, were approved by the Kaiser Permanente Interregional Institutional Review Board, the IRB of record for the study. Results will be disseminated through peer-reviewed publications, presentations, participant newsletters and appropriate general news media.
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Affiliation(s)
- Tara M Babu
- Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, Washington, USA
| | - Leora R Feldstein
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Sharon Saydah
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Zachary Acker
- Brotman Baty Institute for Precision Medicine, University of Washington, Seattle, Washington, USA
| | | | - Melissa Briggs-Hagen
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Marco Carone
- Department of Biostatistics, University of Washington, Seattle, Washington, USA
| | - Amanda Casto
- Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, Washington, USA
| | - Sarah N Cox
- Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, Washington, USA
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Brenna Ehmen
- Brotman Baty Institute for Precision Medicine, University of Washington, Seattle, Washington, USA
| | - Janet A Englund
- Department of Pediatrics, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Stephen P Fortmann
- Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon, USA
| | - Collrane J Frivold
- Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, Washington, USA
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Holly Groom
- Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon, USA
| | - Peter D Han
- Brotman Baty Institute for Precision Medicine, University of Washington, Seattle, Washington, USA
| | - Jennifer L Kuntz
- Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon, USA
| | - Tina Lockwood
- Brotman Baty Institute for Precision Medicine, University of Washington, Seattle, Washington, USA
- Department of Pathology, University of Washington, Seattle, Washington, USA
| | - Claire M Midgley
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Richard A Mularski
- Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon, USA
| | - Tara Ogilvie
- Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, Washington, USA
| | - Sacha L Reich
- Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon, USA
| | - Mark A Schmidt
- Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon, USA
| | - Ning Smith
- Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon, USA
| | - Lea Starita
- Brotman Baty Institute for Precision Medicine, University of Washington, Seattle, Washington, USA
- Genome Sciences, University of Washington, Seattle, Washington, USA
| | - Jeremy Stone
- Brotman Baty Institute for Precision Medicine, University of Washington, Seattle, Washington, USA
| | - Meredith Vandermeer
- Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon, USA
| | - Ana A Weil
- Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, Washington, USA
| | - Caitlin R Wolf
- Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, Washington, USA
| | - Helen Y Chu
- Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, Washington, USA
| | - Allison L Naleway
- Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon, USA
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25
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Brown ER, O’Brien MP, Snow B, Isa F, Forleo-Neto E, Chan KC, Hou P, Cohen MS, Herman G, Barnabas RV. A Prospective Study of Key Correlates for Household Transmission of Severe Acute Respiratory Syndrome Coronavirus 2. Open Forum Infect Dis 2023; 10:ofad271. [PMID: 37416758 PMCID: PMC10319621 DOI: 10.1093/ofid/ofad271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 05/22/2023] [Indexed: 07/08/2023] Open
Abstract
Background Randomized controlled trials evaluated monoclonal antibodies for the treatment (Study 2067) and prevention (Study 2069) of coronavirus disease 2019 (COVID-19). Household contacts of the infected index case in Study 2067 were enrolled in Study 2069 and prospectively followed; these cohorts provided a unique opportunity to evaluate correlates of transmission, specifically viral load. Methods This post hoc analysis was designed to identify and evaluate correlates of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission, adjusting for potential confounding factors related to source SARS-CoV-2 viral load and risk of SARS-CoV-2 acquisition in this population. Correlates of transmission were evaluated in potential transmission pairs (any infected household member plus susceptible household contact). Results In total, 943 participants were included. In multivariable regression, 2 potential correlates were determined to have a statistically significant (P < .05) association with transmission risk. A 10-fold increase in viral load was associated with a 40% increase in odds of transmission; sharing a bedroom with the index participant was associated with a 199% increase in odds of transmission. Conclusions In this prospective, post hoc analysis that controlled for confounders, the 2 key correlates for transmission of SARS-CoV-2 within a household are sharing a bedroom and increased viral load, consistent with increased exposure to the infected individual.
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Affiliation(s)
- Elizabeth R Brown
- Vaccine and Infectious Disease and Public Health Services Divisions, Fred Hutchinson Cancer Center, Seattle, Washington, USA
- Department of Biostatistics, University of Washington, Seattle, Washington, USA
| | - Meagan P O’Brien
- Global Development, Regeneron Pharmaceuticals, Inc, Tarrytown, New York, USA
| | - Brian Snow
- Global Development, Regeneron Pharmaceuticals, Inc, Tarrytown, New York, USA
| | - Flonza Isa
- Global Development, Regeneron Pharmaceuticals, Inc, Tarrytown, New York, USA
| | - Eduardo Forleo-Neto
- Global Development, Regeneron Pharmaceuticals, Inc, Tarrytown, New York, USA
| | - Kuo-Chen Chan
- Global Development, Regeneron Pharmaceuticals, Inc, Tarrytown, New York, USA
| | - Peijie Hou
- Global Development, Regeneron Pharmaceuticals, Inc, Tarrytown, New York, USA
| | - Myron S Cohen
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Gary Herman
- Global Development, Regeneron Pharmaceuticals, Inc, Tarrytown, New York, USA
| | - Ruanne V Barnabas
- Division of Infectious Diseases, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Alleman TW, Rollier M, Vergeynst J, Baetens JM. A Stochastic Mobility-Driven Spatially Explicit SEIQRD covid-19 Model with VOCs, Seasonality, and Vaccines. APPLIED MATHEMATICAL MODELLING 2023; 123:S0307-904X(23)00281-0. [PMID: 38620163 PMCID: PMC10306418 DOI: 10.1016/j.apm.2023.06.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 06/12/2023] [Accepted: 06/20/2023] [Indexed: 04/17/2024]
Abstract
In this work, we extend our previously developed compartmental SEIQRD model for sars-cov-2 in Belgium. We introduce sars-cov-2 variants of concern, vaccines, and seasonality in our model, as their addition has proven necessary for modelling sars-cov-2 transmission dynamics during the 2020-2021 covid-19 pandemic in Belgium. The model is geographically stratified into eleven spatial patches (provinces), and a telecommunication dataset provided by Belgium's biggest operator is used to incorporate interprovincial mobility. We calibrate the model using the daily number of hospitalisations in each province and serological data. We find the model adequately describes these data, but the addition of interprovincial mobility was not necessary to obtain an accurate description of the 2020-2021 sars-cov-2 pandemic in Belgium. We further demonstrate how our model can be used to help policymakers decide on the optimal timing of the release of social restrictions.We find that adding spatial heterogeneity by geographically stratifying the model results in more uncertain model projections as compared to an equivalent nation-level model, which has both communicative advantages and disadvantages. We finally discuss the impact of imposing local mobility or social contact restrictions to contain an epidemic in a given province and find that lowering social contact is a more effective strategy than lowering mobility.
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Affiliation(s)
- Tijs W Alleman
- BIOSPACE, Department of Data Analysis and Mathematical Modelling, Ghent University, Coupure Links 653, Ghent, 9000, Belgium
- BIOMATH, Department of Data Analysis and Mathematical Modelling, Ghent University, Coupure Links 653, Ghent, 9000, Belgium
| | - Michiel Rollier
- BIOSPACE, Department of Data Analysis and Mathematical Modelling, Ghent University, Coupure Links 653, Ghent, 9000, Belgium
| | - Jenna Vergeynst
- BIOSPACE, Department of Data Analysis and Mathematical Modelling, Ghent University, Coupure Links 653, Ghent, 9000, Belgium
- BIOMATH, Department of Data Analysis and Mathematical Modelling, Ghent University, Coupure Links 653, Ghent, 9000, Belgium
| | - Jan M Baetens
- BIOSPACE, Department of Data Analysis and Mathematical Modelling, Ghent University, Coupure Links 653, Ghent, 9000, Belgium
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Galmiche S, Charmet T, Madec Y, Rakover A, Schaeffer L, Chény O, Omar F, Martin S, Mailles A, Carrat F, Fontanet A. Reduction of SARS-CoV-2 intra-household child-to-parent transmission associated with ventilation: results from a case-control study. BMC Public Health 2023; 23:1240. [PMID: 37365557 DOI: 10.1186/s12889-023-16144-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 06/18/2023] [Indexed: 06/28/2023] Open
Abstract
PURPOSE Our objective was to describe circumstances of SARS-CoV-2 household transmission and to identify factors associated with a lower risk of transmission in a nationwide case-control study in France. METHODS In a descriptive analysis, we analysed cases reporting transmission from someone in the household (source case). Index cases could invite a non-infected household member to participate as a related control. In such situations, we compared the exposures of the index case and related control to the source case by conditional logistic regression matched for household, restricted to households in which the source case was a child, and the index case and related control were the infected child's parents. RESULTS From October 27, 2020 to May 16, 2022, we included 104 373 cases for the descriptive analysis with a documented infection from another household member. The source case was mostly the index case's child (46.9%) or partner (45.7%). In total, 1026 index cases invited a related control to participate in the study. In the case-control analysis, we included 611 parental pairs of cases and controls exposed to the same infected child. COVID-19 vaccination with 3 + doses versus no vaccination (OR 0.1, 95%CI: 0.04-0.4), isolation from the source case (OR 0.6, 95%CI: 0.4-0.97) and the ventilation of indoor areas (OR 0.6, 95%CI: 0.4-0.9) were associated with lower risk of infection. CONCLUSION Household transmission was common during the SARS-CoV-2 pandemic in France. Mitigation strategies, including isolation and ventilation, decreased the risk of secondary transmission within the household. TRIAL REGISTRATION ClinicalTrials.gov registration number: NCT04607941.
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Affiliation(s)
- Simon Galmiche
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Université Paris Cité, 25 rue du Docteur Roux, Paris, 75015, France
- Sorbonne Université, Ecole Doctorale Pierre Louis de Santé Publique, Paris, France
| | - Tiffany Charmet
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Université Paris Cité, 25 rue du Docteur Roux, Paris, 75015, France
| | - Yoann Madec
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Université Paris Cité, 25 rue du Docteur Roux, Paris, 75015, France
| | - Arthur Rakover
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Université Paris Cité, 25 rue du Docteur Roux, Paris, 75015, France
| | - Laura Schaeffer
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Université Paris Cité, 25 rue du Docteur Roux, Paris, 75015, France
| | - Olivia Chény
- Institut Pasteur, Université Paris Cité, Centre for Translational Research, Paris, France
| | | | - Sophie Martin
- Caisse Nationale de L'Assurance Maladie, Paris, France
| | | | - Fabrice Carrat
- Sorbonne Université, Inserm, IPLESP, Hôpital Saint-Antoine, AP-HP, Paris, France
| | - Arnaud Fontanet
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Université Paris Cité, 25 rue du Docteur Roux, Paris, 75015, France.
- Conservatoire National Des Arts Et Métiers, Unité PACRI, Paris, France.
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28
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Bridgen JRE, Wei H, Whitfield C, Han Y, Hall I, Jewell CP, van Tongeren MJA, Read JM. Contact patterns of UK home delivery drivers and their use of protective measures during the COVID-19 pandemic: a cross-sectional study. Occup Environ Med 2023; 80:333-338. [PMID: 37055066 PMCID: PMC10314008 DOI: 10.1136/oemed-2022-108646] [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: 09/09/2022] [Accepted: 03/30/2023] [Indexed: 04/15/2023]
Abstract
OBJECTIVES To quantify contact patterns of UK home delivery drivers and identify protective measures adopted during the pandemic. METHODS We conducted a cross-sectional online survey to measure the interactions of 170 UK delivery drivers during a working shift between 7 December 2020 and 31 March 2021. RESULTS Delivery drivers had a mean number of 71.6 (95% CI 61.0 to 84.1) customer contacts per shift and 15.0 (95% CI 11.2 to 19.2) depot contacts per shift. Maintaining physical distancing with customers was more common than at delivery depots. Prolonged contact (more than 5 min) with customers was reported by 5.4% of drivers on their last shift. We found 3.0% of drivers had tested positive for SARS-CoV-2 since the start of the pandemic and 16.8% of drivers had self-isolated due to a suspected or confirmed case of COVID-19. In addition, 5.3% (95% CI 2.3% to 10.2%) of participants reported having worked while ill with COVID-19 symptoms, or with a member of their household having a suspected or confirmed case of COVID-19. CONCLUSION Delivery drivers had a large number of face-to-face customer and depot contacts per shift compared with other working adults during this time. However, transmission risk may be curtailed as contact with customers was of short duration. Most drivers were unable to maintain physical distance with customers and at depots at all times. Usage of protective items such as face masks and hand sanitiser was widespread.
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Affiliation(s)
- Jessica R E Bridgen
- Centre for Health Informatics, Computing and Statistics, Lancaster Medical School, Lancaster University, Lancaster, UK
| | - Hua Wei
- School of Health Sciences, University of Manchester, Manchester, UK
| | - Carl Whitfield
- Immunity and Respiratory Medicine, University of Manchester, Manchester, UK
| | - Yang Han
- Department of Mathematics, University of Manchester, Manchester, UK
| | - Ian Hall
- Department of Mathematics, University of Manchester, Manchester, UK
| | - Chris P Jewell
- Department of Mathematics and Statistics, Lancaster University, Lancaster, UK
| | | | - Jonathan M Read
- Centre for Health Informatics, Computing and Statistics, Lancaster Medical School, Lancaster University, Lancaster, UK
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29
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Islam F, Alvi Y, Ahmad M, Ahmed F, Rahman A, Singh FHD, Das AK, Dudeja M, Gupta E, Agarwalla R, Alam I, Roy S. Household transmission dynamics of COVID-19 among residents of Delhi, India: a prospective case-ascertained study. IJID REGIONS 2023; 7:22-30. [PMID: 36852156 PMCID: PMC9946776 DOI: 10.1016/j.ijregi.2023.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 02/13/2023] [Accepted: 02/14/2023] [Indexed: 02/25/2023]
Abstract
Objective The aim of this study was to observe the secondary infection rate and transmission dynamics of COVID-19 among household contacts, and their associations with various factors across four dimensions of interaction. Methods This was a case-ascertained study among unvaccinated household contacts of a laboratory-confirmed COVID-19 case in New Delhi between December 2020 and July 2021. For this study, 99 index cases and their 316 household contacts were interviewed and sampled (blood and oro-nasal swab) on days 1, 7, 14, and 28. Results The secondary infection rate among unvaccinated household contacts was 44.6% (95% confidence interval (CI) 39.1-50.1). The predictors of secondary infection among individual contact levels were: being female (odds ratio (OR) 2.13), increasing age (OR 1.01), symptoms at baseline (OR 3.39), and symptoms during follow-up (OR 3.18). Among index cases, age of the primary case (OR 1.03) and symptoms during follow-up (OR 6.29) were significantly associated with secondary infection. Among household-level and contact patterns, having more rooms (OR 4.44) and taking care of the index case (OR 2.02) were significantly associated with secondary infection. Conclusion A high secondary infection rate highlights the need to adopt strict measures and advocate COVID-19-appropriate behaviors. A targeted approach for higher-risk household contacts would efficiently limit infections among susceptible contacts.
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Affiliation(s)
- Farzana Islam
- Department of Community Medicine, Hamdard Institute of Medical Science and Research, New Delhi, India
| | - Yasir Alvi
- Department of Community Medicine, Hamdard Institute of Medical Science and Research, New Delhi, India
| | | | - Faheem Ahmed
- Department of Community Medicine, Hamdard Institute of Medical Science and Research, New Delhi, India.,Department of Public Health, King Khalid University, Abha, Kingdom of Saudi Arabia
| | | | - Farishta Hannah D Singh
- Department of Community Medicine, Hamdard Institute of Medical Science and Research, New Delhi, India
| | - Ayan Kumar Das
- Department of Microbiology, Hamdard Institute of Medical Science and Research, New Delhi, India
| | - Mridu Dudeja
- Department of Microbiology, Hamdard Institute of Medical Science and Research, New Delhi, India
| | - Ekta Gupta
- Scientist-E, National Institute of Cancer Prevention and Research, ICMR, Noida, India
| | - Rashmi Agarwalla
- Department of Community and Family Medicine, All India Institute of Medical Science, Guwahati, India
| | - Iqbal Alam
- Department of Physiology, Hamdard Institute of Medical Science and Research, New Delhi, India
| | - Sushovan Roy
- Department of Community Medicine, Hamdard Institute of Medical Science and Research, New Delhi, India
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30
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Fairbanks EL, Bolton KJ, Jia R, Figueredo GP, Knight H, Vedhara K. Influence of setting-dependent contacts and protective behaviours on asymptomatic SARS-CoV-2 infection amongst members of a UK university. Epidemics 2023; 43:100688. [PMID: 37270967 DOI: 10.1016/j.epidem.2023.100688] [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: 11/07/2021] [Revised: 03/26/2023] [Accepted: 05/12/2023] [Indexed: 06/06/2023] Open
Abstract
We survey 62 users of a university asymptomatic SARS-CoV-2 testing service on details of their activities, protective behaviours and contacts in the 7 days prior to receiving a positive or negative SARS-CoV-2 PCR test result in the period October 2020-March 2021. The resulting data set is novel in capturing very detailed social contact history linked to asymptomatic disease status during a period of significant restriction on social activities. We use this data to explore 3 questions: (i) Did participation in university activities enhance infection risk? (ii) How do contact definitions rank in their ability to explain test outcome during periods of social restrictions? (iii) Do patterns in the protective behaviours help explain discrepancies between the explanatory performance of different contact measures? We classify activities into settings and use Bayesian logistic regression to model test outcome, computing posterior model probabilities to compare the performance of models adopting different contact definitions. Associations between protective behaviours, participant characteristics and setting are explored at the level of individual activities using multiple correspondence analysis (MCA). We find that participation in air travel or non-university work activities was associated with a positive asymptomatic SARS-CoV-2 PCR test, in contrast to participation in research and teaching settings. Intriguingly, logistic regression models with binary measures of contact in a setting performed better than more traditional contact numbers or person contact hours (PCH). The MCA indicates that patterns of protective behaviours vary between setting, in a manner which may help explain the preference for any participation as a contact measure. We conclude that linked PCR testing and social contact data can in principle be used to test the utility of contact definitions, and the investigation of contact definitions in larger linked studies is warranted to ensure contact data can capture environmental and social factors influencing transmission risk.
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Affiliation(s)
- Emma L Fairbanks
- School of Veterinary Medicine and Science, University of Nottingham, United Kingdom; School of Mathematical Sciences, University of Nottingham, United Kingdom
| | - Kirsty J Bolton
- School of Mathematical Sciences, University of Nottingham, United Kingdom.
| | - Ru Jia
- School of Medicine, University of Nottingham, United Kingdom
| | | | - Holly Knight
- School of Medicine, University of Nottingham, United Kingdom
| | - Kavita Vedhara
- School of Medicine, University of Nottingham, United Kingdom
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31
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Vaux S, Gautier A, Soullier N, Levy-Bruhl D. SARS-CoV-2 testing, infection and places of contamination in France, a national cross-sectional study, December 2021. BMC Infect Dis 2023; 23:279. [PMID: 37138208 PMCID: PMC10155649 DOI: 10.1186/s12879-023-08257-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 04/15/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND This study aimed to describe the use of diagnostic testing for SARS-CoV-2 in France until December 2021, the characteristics of people infected, and places of contamination. METHODS Data were collected from the national 2021 Health Barometer cross-sectional study, which was conducted between February and December 2021 and included French-speaking individuals aged 18-85 years old selected through randomly generated landline and mobile phone numbers. Participants were interviewed about COVID-19-like symptoms in the previous 12 months, diagnostic testing for SARS-CoV-2, positive diagnosis for SARS-CoV-2, and the place(s) of contamination. Determinants of diagnostic testing and of infection were studied using univariate and multivariate Poisson regressions. RESULTS A total of 24,514 persons participated in the study. We estimated that 66.4% [65.0-67.7] of persons had been tested for SARS-CoV-2 the last time they experienced COVID-19-like symptoms, and that 9.8% [9.3-10.3] of the population in France - with or without symptoms - had been tested positive. Diagnostic testing was less frequent in men, unemployed persons, and people living alone; it was also less frequent during the first months of the pandemic. The estimated proportion of the population infected was higher in healthcare professionals (PRa: 1.5 [1.3-1.7]), those living in large cities ( > = 200 000 inhabitants, and Paris area) (1.4 [1.2-1.6]), and in households comprising > 3 persons (1.7 [1.5-2.0]). It was lower in retired persons (0.8 [0.6-0.97]) and those over 65 years old (0.6 [0.4-0.9]). Almost two-thirds (65.7%) of infected persons declared they knew where they were contaminated; 5.8% [4.5-7.4] reported being contaminated outdoors, 47.9% [44.8-51.0] in unventilated indoor environments, and 43.4% [40.3-46.6] in ventilated indoor environments. Specifically, 51.1% [48.0-54.2] declared they were contaminated at home or in a family of friend's house, 29.1% [26.4-31.9] at their workplace, 13.9% [11.9-16.1] in a healthcare structure, and 9.0% [7.4-10.8] in a public eating place (e.g., cafeteria, bar, restaurant). CONCLUSIONS To limit viral spread, preventive actions should preferentially target persons tested least frequently and those at a higher risk of infection. They should also target contamination in households, healthcare structures, and public eating places. Importantly, contamination is most frequent in places where prevention measures are most difficult to implement.
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Affiliation(s)
- Sophie Vaux
- Santé publique France, The National Public Health Agency, 12, rue du Val d'Osne, Saint Maurice, 94415, France.
| | - Arnaud Gautier
- Santé publique France, The National Public Health Agency, 12, rue du Val d'Osne, Saint Maurice, 94415, France
| | - Noemie Soullier
- Santé publique France, The National Public Health Agency, 12, rue du Val d'Osne, Saint Maurice, 94415, France
| | - Daniel Levy-Bruhl
- Santé publique France, The National Public Health Agency, 12, rue du Val d'Osne, Saint Maurice, 94415, France
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32
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Prosser A, Helfer B, Streiner DL. Estimating the risk reduction of isolation on COVID-19 nonhousehold transmission and severe/critical illness in nonimmune individuals: September to November 2021. J Eval Clin Pract 2023; 29:438-446. [PMID: 36755507 DOI: 10.1111/jep.13813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 01/12/2023] [Accepted: 01/16/2023] [Indexed: 02/10/2023]
Abstract
There is growing scientific interest in immunity mandates/passports (IMP) for viral diseases in light of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. IMP isolate those who remain nonimmune from various settings to reduce nonhousehold transmissions from the nonimmune and reduce severe/critical illness among the nonimmune. A major limitation in the scientific literature is that there are currently no methods to quantify how many nonimmune individuals need to be isolated to achieve these purported benefits. This paper develops a procedure for estimating the benefits of IMP using a novel variant of the number needed to treat which we call the number needed to isolate (NNI). We use data from the SARS-CoV-2 pandemic to demonstrate the properties and utility of the NNI and to inform the debate about IMP. We focus on data from the European Union, United Kingdom, United States, Canada, Australia, and Israel during the fall 2021 when the Delta (B.1.617.2) variant predominated.
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Affiliation(s)
- Aaron Prosser
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Bartosz Helfer
- Institute of Psychology, University of Wrocław, Wrocław, Poland.,Academic Excellence Incubator - Meta Research Centre, University of Wrocław, Wrocław, Poland
| | - David L Streiner
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
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33
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Tsang TK, Huang X, Wang C, Chen S, Yang B, Cauchemez S, Cowling BJ. The effect of variation of individual infectiousness on SARS-CoV-2 transmission in households. eLife 2023; 12:82611. [PMID: 36880191 PMCID: PMC9991055 DOI: 10.7554/elife.82611] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 02/20/2023] [Indexed: 02/25/2023] Open
Abstract
Quantifying variation of individual infectiousness is critical to inform disease control. Previous studies reported substantial heterogeneity in transmission of many infectious diseases including SARS-CoV-2. However, those results are difficult to interpret since the number of contacts is rarely considered in such approaches. Here, we analyze data from 17 SARS-CoV-2 household transmission studies conducted in periods dominated by ancestral strains, in which the number of contacts was known. By fitting individual-based household transmission models to these data, accounting for number of contacts and baseline transmission probabilities, the pooled estimate suggests that the 20% most infectious cases have 3.1-fold (95% confidence interval: 2.2- to 4.2-fold) higher infectiousness than average cases, which is consistent with the observed heterogeneity in viral shedding. Household data can inform the estimation of transmission heterogeneity, which is important for epidemic management.
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Affiliation(s)
- Tim K Tsang
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong KongHong KongChina
- Laboratory of Data Discovery for HealthHong KongChina
| | - Xiaotong Huang
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong KongHong KongChina
| | - Can Wang
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong KongHong KongChina
| | - Sijie Chen
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong KongHong KongChina
| | - Bingyi Yang
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong KongHong KongChina
| | - Simon Cauchemez
- Mathematical Modelling of Infectious Diseases Unit, Institut PasteurParisFrance
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34
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Martínez-Baz I, Miqueleiz A, Egüés N, Casado I, Burgui C, Echeverría A, Navascués A, Fernández-Huerta M, García Cenoz M, Trobajo-Sanmartín C, Guevara M, Ezpeleta C, Castilla J. Effect of COVID-19 vaccination on the SARS-CoV-2 transmission among social and household close contacts: A cohort study. J Infect Public Health 2023; 16:410-417. [PMID: 36724697 PMCID: PMC9876028 DOI: 10.1016/j.jiph.2023.01.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 01/18/2023] [Accepted: 01/23/2023] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND COVID-19 vaccination was expected to reduce SARS-CoV-2 transmission, but the relevance of this effect remains unclear. We aimed to estimate the effectiveness of COVID-19 vaccination of the index cases and their close contacts in reducing the probability of SARS-CoV-2 transmission. METHODS Transmission of SARS-CoV-2 infection was evaluated in two cohorts of adult close contacts of COVID-19 confirmed cases (social and household settings) by COVID-19 vaccination status of the index case and the close contact, from April to November 2021 in Navarre, Spain. The effects of vaccination of the index case and the close contact were estimated as (1-adjusted relative risk) × 100%. RESULTS Among 19,631 social contacts, 3257 (17%) were confirmed with SARS-CoV-2. COVID-19 vaccination of the index case reduced infectiousness by 44% (95% CI, 27-57%), vaccination of the close contact reduced susceptibility by 69% (95% CI, 65-73%), and vaccination of both reduced transmissibility by 74% (95% CI, 70-78%) in social settings, suggesting some synergy of effects. Among 20,708 household contacts, 6269 (30%) were infected, and vaccine effectiveness estimates were 13% (95% CI, -5% to 28%), 61% (95% CI, 58-64%), and 52% (95% CI, 47-56%), respectively. These estimates were lower in older people and had not relevant differences between the Alpha (April-June) and Delta (July-November) variant periods. CONCLUSIONS COVID-19 vaccination reduces infectiousness and susceptibility; however, these effects are insufficient for complete control of SARS-CoV-2 transmission, especially in older people and household setting. Relaxation of preventive behaviors after vaccination may counteract part of the vaccine effect on transmission.
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Affiliation(s)
- Iván Martínez-Baz
- Instituto de Salud Pública de Navarra, Leyre 15, 31003 Pamplona, Spain,CIBER Epidemiología y Salud Pública, Pamplona, Spain,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Ana Miqueleiz
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain,Clinical Microbiology Department, Hospital Universitario de Navarra, Irunlarrea, 31008 Pamplona, Spain
| | - Nerea Egüés
- Instituto de Salud Pública de Navarra, Leyre 15, 31003 Pamplona, Spain,CIBER Epidemiología y Salud Pública, Pamplona, Spain,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Itziar Casado
- Instituto de Salud Pública de Navarra, Leyre 15, 31003 Pamplona, Spain,CIBER Epidemiología y Salud Pública, Pamplona, Spain,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Cristina Burgui
- Instituto de Salud Pública de Navarra, Leyre 15, 31003 Pamplona, Spain,CIBER Epidemiología y Salud Pública, Pamplona, Spain,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | | | - Ana Navascués
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain,Clinical Microbiology Department, Hospital Universitario de Navarra, Irunlarrea, 31008 Pamplona, Spain
| | - Miguel Fernández-Huerta
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain,Clinical Microbiology Department, Hospital Universitario de Navarra, Irunlarrea, 31008 Pamplona, Spain
| | - Manuel García Cenoz
- Instituto de Salud Pública de Navarra, Leyre 15, 31003 Pamplona, Spain,CIBER Epidemiología y Salud Pública, Pamplona, Spain,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Camino Trobajo-Sanmartín
- Instituto de Salud Pública de Navarra, Leyre 15, 31003 Pamplona, Spain,CIBER Epidemiología y Salud Pública, Pamplona, Spain,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Marcela Guevara
- Instituto de Salud Pública de Navarra, Leyre 15, 31003 Pamplona, Spain,CIBER Epidemiología y Salud Pública, Pamplona, Spain,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Carmen Ezpeleta
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain,Clinical Microbiology Department, Hospital Universitario de Navarra, Irunlarrea, 31008 Pamplona, Spain
| | - Jesús Castilla
- Instituto de Salud Pública de Navarra, Leyre 15, 31003 Pamplona, Spain; CIBER Epidemiología y Salud Pública, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.
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35
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Jendrossek SN, Jurk LA, Remmers K, Cetin YE, Sunder W, Kriegel M, Gastmeier P. The Influence of Ventilation Measures on the Airborne Risk of Infection in Schools: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3746. [PMID: 36834438 PMCID: PMC9961295 DOI: 10.3390/ijerph20043746] [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: 01/27/2023] [Revised: 02/15/2023] [Accepted: 02/17/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVES To review the risk of airborne infections in schools and evaluate the effect of intervention measures reported in field studies. BACKGROUND Schools are part of a country's critical infrastructure. Good infection prevention measures are essential for reducing the risk of infection in schools as much as possible, since these are places where many individuals spend a great deal of time together every weekday in a small area where airborne pathogens can spread quickly. Appropriate ventilation can reduce the indoor concentration of airborne pathogens and reduce the risk of infection. METHODS A systematic search of the literature was conducted in the databases Embase, MEDLINE, and ScienceDirect using keywords such as school, classroom, ventilation, carbon dioxide (CO2) concentration, SARS-CoV-2, and airborne transmission. The primary endpoint of the studies selected was the risk of airborne infection or CO2 concentration as a surrogate parameter. Studies were grouped according to the study type. RESULTS We identified 30 studies that met the inclusion criteria, six of them intervention studies. When specific ventilation strategies were lacking in schools being investigated, CO2 concentrations were often above the recommended maximum values. Improving ventilation lowered the CO2 concentration, resulting in a lower risk of airborne infections. CONCLUSIONS The ventilation in many schools is not adequate to guarantee good indoor air quality. Ventilation is an important measure for reducing the risk of airborne infections in schools. The most important effect is to reduce the time of residence of pathogens in the classrooms.
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Affiliation(s)
- Sandra N. Jendrossek
- Institute of Hygiene and Environmental Medicine, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 12203 Berlin, Germany
| | - Lukas A. Jurk
- Institute of Industrial Building and Construction Design, Technical University Carolo Wilhelmina, 38106 Braunschweig, Germany
| | - Kirsten Remmers
- Institute of Industrial Building and Construction Design, Technical University Carolo Wilhelmina, 38106 Braunschweig, Germany
| | - Yunus E. Cetin
- Hermann-Rietschel-Institut, Technical University of Berlin, 10623 Berlin, Germany
| | - Wolfgang Sunder
- Institute of Industrial Building and Construction Design, Technical University Carolo Wilhelmina, 38106 Braunschweig, Germany
| | - Martin Kriegel
- Hermann-Rietschel-Institut, Technical University of Berlin, 10623 Berlin, Germany
| | - Petra Gastmeier
- Institute of Hygiene and Environmental Medicine, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 12203 Berlin, Germany
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Colosi E, Bassignana G, Barrat A, Lina B, Vanhems P, Bielicki J, Colizza V. Minimising school disruption under high incidence conditions due to the Omicron variant in France, Switzerland, Italy, in January 2022. Euro Surveill 2023; 28:2200192. [PMID: 36729116 PMCID: PMC9896604 DOI: 10.2807/1560-7917.es.2023.28.5.2200192] [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] [Indexed: 02/03/2023] Open
Abstract
BackgroundAs record cases of Omicron variant were registered in Europe in early 2022, schools remained a vulnerable setting undergoing large disruption.AimThrough mathematical modelling, we compared school protocols of reactive screening, regular screening, and reactive class closure implemented in France, in Baselland (Switzerland), and in Italy, respectively, and assessed them in terms of case prevention, testing resource demand, and schooldays lost.MethodsWe used a stochastic agent-based model of SARS-CoV-2 transmission in schools accounting for within- and across-class contacts from empirical contact data. We parameterised it to the Omicron BA.1 variant to reproduce the French Omicron wave in January 2022. We simulated the three protocols to assess their costs and effectiveness for varying peak incidence rates in the range experienced by European countries.ResultsWe estimated that at the high incidence rates registered in France during the Omicron BA.1 wave in January 2022, the reactive screening protocol applied in France required higher test resources compared with the weekly screening applied in Baselland (0.50 vs 0.45 tests per student-week), but achieved considerably lower control (8% vs 21% reduction of peak incidence). The reactive class closure implemented in Italy was predicted to be very costly, leading to > 20% student-days lost.ConclusionsAt high incidence conditions, reactive screening protocols generate a large and unplanned demand in testing resources, for marginal control of school transmissions. Comparable or lower resources could be more efficiently used through weekly screening. Our findings can help define incidence levels triggering school protocols and optimise their cost-effectiveness.
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Affiliation(s)
- Elisabetta Colosi
- Sorbonne Université, INSERM, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
| | - Giulia Bassignana
- Sorbonne Université, INSERM, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
| | - Alain Barrat
- Aix Marseille Univ, Université de Toulon, CNRS, CPT, Turing Center for Living Systems, Marseille, France
| | - Bruno Lina
- National Reference Center for Respiratory Viruses, Department of Virology, Infective Agents Institute, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France,Centre International de Recherche en Infectiologie (CIRI), Virpath Laboratory, INSERM U1111, CNRS—UMR 5308, École Normale Supérieure de Lyon, Université Claude Bernard Lyon, Lyon University, Lyon, France
| | - Philippe Vanhems
- Service d'Hygiène, Épidémiologie, Infectiovigilance et Prévention, Hospices Civils de Lyon, Lyon, France,Centre International de Recherche en Infectiologie (CIRI), Public Health, Epidemiology and Evolutionary Ecology of Infectious Diseases (PHE3ID) – Inserm - U1111 - UCBL Lyon 1 - CNRS –UMR5308 - ENS de Lyon, Lyon, France
| | - Julia Bielicki
- Paediatric Infectious Diseases, University of Basel Children's Hospital, Basel, Switzerland
| | - Vittoria Colizza
- Sorbonne Université, INSERM, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
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Briggs J, Takahashi S, Nayebare P, Cuu G, Rek J, Zedi M, Kizza T, Arinaitwe E, Nankabirwa JI, Kamya M, Jagannathan P, Jacobson K, Rosenthal PJ, Dorsey G, Greenhouse B, Ssewanyana I, Rodríguez-Barraquer I. Seroprevalence of Antibodies to SARS-CoV-2 in Rural Households in Eastern Uganda, 2020-2022. JAMA Netw Open 2023; 6:e2255978. [PMID: 36790811 PMCID: PMC9932849 DOI: 10.1001/jamanetworkopen.2022.55978] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 12/28/2022] [Indexed: 02/16/2023] Open
Abstract
Importance Estimating the true burden of SARS-CoV-2 infection has been difficult in sub-Saharan Africa owing to asymptomatic infections and inadequate testing capacity. Antibody responses from serologic surveys can provide an estimate of SARS-CoV-2 exposure at the population level. Objective To estimate SARS-CoV-2 seroprevalence, attack rates, and reinfection in eastern Uganda using serologic surveillance from 2020 to early 2022. Design, Setting, and Participants This cohort study was conducted in the Tororo and Busia districts of eastern Uganda. Plasma samples from participants in the Program for Resistance, Immunology, Surveillance, and Modeling of Malaria in Uganda Border Cohort were obtained at 4 sampling intervals: October to November 2020, March to April 2021, August to September 2021, and February to March 2022. Each participant contributed up to 4 time points for SARS-CoV-2 serology, with almost half of all participants contributing at all 4 time points, and almost 90% contributing at 3 or 4 time points. Information on SARS-CoV-2 vaccination status was collected from participants, with the earliest reported vaccinations in the cohort occurring in May 2021. Main Outcomes and Measures The main outcomes of this study were antibody responses to the SARS-CoV-2 spike protein as measured with a bead-based serologic assay. Individual-level outcomes were aggregated to population-level SARS-CoV-2 seroprevalence, attack rates, and boosting rates. Estimates were weighted by the local age distribution according to census data. Results A total of 1483 samples from 441 participants living in 76 households were tested. Of the 441 participants, 245 (55.6%) were female, and their mean (SD) age was 16.04 (16.04) years. By the end of the Delta wave and before widespread vaccination, adjusted SARS-CoV-2 seroprevalence was 67.7% (95% credible interval [CrI], 62.5%-72.6%) in the study population. During the subsequent Omicron wave, 84.8% (95% CrI, 67.9%-93.7%) of unvaccinated, previously seronegative individuals were infected for the first time, and 50.8% (95% CrI, 40.6%-59.7%) of unvaccinated, already seropositive individuals were likely reinfected, leading to an overall seropositivity of 96.0% (95% CrI, 93.4%-97.9%) in this population. These results suggest a lower probability of reinfection in individuals with higher preexisting antibody levels. There was evidence of household clustering of SARS-CoV-2 seroconversion. No significant associations were found between SARS-CoV-2 seroconversion and gender, household size, or recent Plasmodium falciparum malaria exposure. Conclusions and Relevance In this cohort study in a rural population in eastern Uganda, there was evidence of very high SARS-CoV-2 infection rates throughout the pandemic inconsistent with national level case data and high reinfection rates during the Omicron wave.
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Affiliation(s)
- Jessica Briggs
- Division of HIV, ID, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco
| | - Saki Takahashi
- Division of HIV, ID, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco
| | | | - Gloria Cuu
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | - John Rek
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | - Maato Zedi
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | - Timothy Kizza
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | | | - Joaniter I. Nankabirwa
- Infectious Diseases Research Collaboration, Kampala, Uganda
- Department of Medicine, Makerere University, Kampala, Uganda
| | - Moses Kamya
- Infectious Diseases Research Collaboration, Kampala, Uganda
- Department of Medicine, Makerere University, Kampala, Uganda
| | - Prasanna Jagannathan
- Department of Medicine, Stanford University, Stanford, California
- Department of Microbiology and Immunology, Stanford University, Stanford, California
| | - Karen Jacobson
- Department of Medicine, Stanford University, Stanford, California
| | - Philip J. Rosenthal
- Division of HIV, ID, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco
| | - Grant Dorsey
- Division of HIV, ID, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco
| | - Bryan Greenhouse
- Division of HIV, ID, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco
| | - Isaac Ssewanyana
- Infectious Diseases Research Collaboration, Kampala, Uganda
- Central Public Health Laboratories, Butabika, Uganda
| | - Isabel Rodríguez-Barraquer
- Division of HIV, ID, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco
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Fu S, He F, Wang R, Song W, Wang Q, Xia W, Qiu Z. Development of quantitative wastewater surveillance models facilitated the precise epidemic management of COVID-19. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 857:159357. [PMID: 36240917 PMCID: PMC9554229 DOI: 10.1016/j.scitotenv.2022.159357] [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: 06/10/2022] [Revised: 10/05/2022] [Accepted: 10/07/2022] [Indexed: 06/16/2023]
Abstract
Wastewater surveillance serves as a promising approach to elucidate the silent transmission of SARS-CoV-2 in communities. To understand the decay of the coronavirus in sewage pipes, the decay of the coronavirus traveling over 20 km distance of pipeline was analyzed. Based on the decay model, a WWTP and a community model were then proposed for predicting COVID-19 cases in Xi'an and Nanchang city during the COVID-19 outbreak in 2021 and 2022. The results suggested that Monte Carol simulations estimated 23.3, 50.1, 127.3 and 524.2 infected persons in the Yanta district of Xi'an city on December 14th, 18th, 22nd and 26th of 2021, respectively, which is largely consistent with the clinical reports. Next, we further conducted wastewater surveillance in two WWTPs that covered the whole metropolitan region in Nanchang to validate the robustness of the WWTP model from December 2021 to April 2022. SARS-CoV-2 signals were detected in two WWTPs from March 15th to April 5th. Predicted infection numbers were in agreement with the actual infection cases, which promoted precise epidemic control. Finally, community wastewater surveillance was conducted for 40 communities that were not 100 % covered by massive nucleic acid testing in Nanchang city, which accurately identified the SARS-CoV-2 carriers not detected by massive nucleic acid testing. In conclusion, accurate prediction of COVID-19 cases based on WWTP and community models promoted precise epidemic control. This work highlights the viability of wastewater surveillance for outbreak evaluation and identification of hidden cases, which provides an extraordinary example for implementing precise epidemic control of COVID-19.
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Affiliation(s)
- Songzhe Fu
- Key Laboratory of Environment Controlled Aquaculture (KLECA), Ministry of Education, Dalian Ocean University, Dalian 116023, China; Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education, Northwest University, Xi'an 710069, China.
| | - Fenglan He
- The Collaboration Unit for Field Epidemiology of State Key Laboratory for Infectious Disease Prevention and Control, Nanchang Center for Disease Control and Prevention, Nanchang 330038, China
| | - Rui Wang
- Key Laboratory of Environment Controlled Aquaculture (KLECA), Ministry of Education, Dalian Ocean University, Dalian 116023, China
| | - Wentao Song
- The Collaboration Unit for Field Epidemiology of State Key Laboratory for Infectious Disease Prevention and Control, Nanchang Center for Disease Control and Prevention, Nanchang 330038, China
| | - Qingyao Wang
- Key Laboratory of Environment Controlled Aquaculture (KLECA), Ministry of Education, Dalian Ocean University, Dalian 116023, China
| | - Wen Xia
- The Collaboration Unit for Field Epidemiology of State Key Laboratory for Infectious Disease Prevention and Control, Nanchang Center for Disease Control and Prevention, Nanchang 330038, China
| | - Zhiguang Qiu
- School of Environment and Energy, Shenzhen Graduate School, Peking University, Shenzhen 518055, China
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Shafie MH, Antony Dass M, Ahmad Shaberi HS, Zafarina Z. Screening and confirmation tests for SARS-CoV-2: benefits and drawbacks. BENI-SUEF UNIVERSITY JOURNAL OF BASIC AND APPLIED SCIENCES 2023; 12:6. [PMID: 36647397 PMCID: PMC9833029 DOI: 10.1186/s43088-023-00342-3] [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: 08/16/2022] [Accepted: 01/03/2023] [Indexed: 01/13/2023] Open
Abstract
Background Coronavirus disease 2019 is a pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection that emerged in late 2019 and has activated an ongoing international public health emergency. SARS-CoV-2 was discovered in Wuhan, China, in December 2019 and rapidly spread to other cities and countries. Currently, SARS-CoV-2 diagnostic tests have relied heavily on detecting viral genes, antigens, and human antibodies. Hence, this review discusses and analyses the existing screening and confirmation tests for SARS-CoV-2, including the real-time reverse transcriptase polymerase chain reaction (RT-PCR), lateral flow immunoassay (LFIA), and enzyme-linked immunosorbent assay (ELISA). Main body The illustrations of each testing were presented to provide the readers with an understanding of the scientific principles behind the testing methods. The comparison was made by highlighting the advantages and disadvantages of each testing. ELISA is ideal for performing the maximum population screening to determine immunological capacity, although its inability to provide reliable results on the status of the infection. Recently, LFIA has been approved as a quicker way of determining whether a patient is infected at the analysis time without using particular instruments and non-laboratory settings. RT-PCR is the gold-standard approach in terms of sensitivity and specificity. Conclusion However, the combination of LFIA or ELISA with RT-PCR is also proposed in this review to obtain an adequate level of sensitivity and specificity. Graphic Abstract
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Affiliation(s)
- Muhammad Hakimin Shafie
- grid.11875.3a0000 0001 2294 3534Analytical Biochemistry Research Centre (ABrC), Bangunan Inkubator Inovasi Universiti (I2U), Kampus Sains@usm, Universiti Sains Malaysia, Lebuh Bukit Jambul, 11900 Bayan Lepas, Penang Malaysia
| | - Marie Antony Dass
- grid.11875.3a0000 0001 2294 3534Analytical Biochemistry Research Centre (ABrC), Bangunan Inkubator Inovasi Universiti (I2U), Kampus Sains@usm, Universiti Sains Malaysia, Lebuh Bukit Jambul, 11900 Bayan Lepas, Penang Malaysia ,grid.1021.20000 0001 0526 7079School of Life and Environmental Sciences, Deakin University, Waurn Ponds, Geelong, 3216 Australia
| | - Hazlam Shamin Ahmad Shaberi
- grid.11875.3a0000 0001 2294 3534Analytical Biochemistry Research Centre (ABrC), Bangunan Inkubator Inovasi Universiti (I2U), Kampus Sains@usm, Universiti Sains Malaysia, Lebuh Bukit Jambul, 11900 Bayan Lepas, Penang Malaysia ,grid.7445.20000 0001 2113 8111Department of Life Sciences, Imperial College London, Exhibition Rd, London, SW7 2AZ UK
| | - Zainuddin Zafarina
- grid.11875.3a0000 0001 2294 3534Analytical Biochemistry Research Centre (ABrC), Bangunan Inkubator Inovasi Universiti (I2U), Kampus Sains@usm, Universiti Sains Malaysia, Lebuh Bukit Jambul, 11900 Bayan Lepas, Penang Malaysia
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Bayhan Gİ, Akça H, Akça Çağlar A, Kurt F, Akcan Yıldız L, Şenel S, Karacan CD. SARS-CoV-2 Transmission among Students after the Full Reopening of Schools. J PEDIAT INF DIS-GER 2022. [DOI: 10.1055/s-0042-1760193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Abstract
Objective Closing of schools within the scope of the pandemic measures and switching to online education have negatively affected the mental and physical health of children as well as their education. The effect of complete reopening of schools on the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is not fully known. In the 2021–2022 academic year, the Ministry of National Education of Türkiye has decided to continue face-to-face education at all levels and in all private and public schools, by following a series of measures. There are no studies on school transmission reported from Türkiye since then. This study aimed to assess the dynamics of coronavirus diseases 2019 (COVID-19) transmission in schools by evaluating the data of the school contact screening outpatient clinic of a tertiary children's hospital.
Methods According to the Ministry of National Education guidelines in Türkiye, all students in a class with two polymerase chain reaction (PCR)–confirmed COVID-19 cases are sent to their homes and have a SARS-CoV-2 PCR test on the fifth day. While the students with negative test results return to school, students who test positive continue to stay at home until the 10th day. The current study retrospectively analyzed the screening results of primary, middle, and high school students who presented at the school contact screening polyclinic during the first semester of the 2021–2022 academic season.
Discussion There were a total of 11,608 presentations to the school contact screening polyclinic, and 1,107 children tested positive with SARS-CoV-2 PCR (9.5%). The median weekly positivity rate was 9.7% in primary school, 9.4% in middle school, and 5.6% in high school. The weekly positivity rate increased from the 16th week at all school levels; the positivity rates ran in parallel before this time but significantly increased from the 16th week to the half-term break.
Conclusion The curve of the positivity rates in schools was similar to Türkiye's pandemic curve. In this respect, the low SARS-CoV-2 transmission in schools correlated with the low number of cases in the community.
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Affiliation(s)
- Gülsüm İclal Bayhan
- Department of Pediatric Infectious Disease, Medical Faculty of Yildirim Beyazit University, Children's Hospital of Ankara City Hospital, Türkiye
| | - Halise Akça
- Department of Pediatric Emergency Care, Medical Faculty of Yildirim Beyazit University, Children's Hospital of Ankara City Hospital, Türkiye
| | - Ayla Akça Çağlar
- Department of Pediatric Emergency Care, Children's Hospital of Ankara City Hospital, Türkiye
| | - Funda Kurt
- Department of Pediatric Emergency Care, Children's Hospital of Ankara City Hospital, Türkiye
| | - Leman Akcan Yıldız
- Department of Pediatric Emergency Care, Children's Hospital of Ankara City Hospital, Türkiye
| | - Saliha Şenel
- Department of Pediatric Emergency Care, Medical Faculty of Yildirim Beyazit University, Children's Hospital of Ankara City Hospital, Türkiye
| | - Can Demir Karacan
- Department of Pediatric Emergency Care, Medical Faculty of Yildirim Beyazit University, Children's Hospital of Ankara City Hospital, Türkiye
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Semi-automated contact tracing and management of contact precautions during the COVID-19 pandemic within a tertiary hospital. Infect Prev Pract 2022; 5:100266. [PMID: 36575771 PMCID: PMC9780020 DOI: 10.1016/j.infpip.2022.100266] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 12/09/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022] Open
Abstract
Background Evaluation of a spreadsheet-based COVID-19 contact-tracing tool (CTT) and determination of risk factors for SARS-CoV-2 transmission among hospital staff members. Design Observational descriptive study on the application and acceptance of the CTT. Retrospective case-control study for SARS-CoV-2 transmission risk factor determination and for evaluation of the CTT's risk stratification algorithm. Setting: Tertiary hospital in Germany. Participants 3514 contacts of hospital staff members to 322 SARS-CoV-2-positive cases. Methods A case-control study was performed to identify risk factors for SARS-CoV-2 transmission and for unprotected contacts among staff members. To evaluate strengths and weaknesses of the CTT performance statistics were analyzed and users completed a questionnaire measuring satisfaction and acceptance of the tool. Results In 2021, the CTT was used for the algorithm-based semi-automated management of 3514 in-hospital contacts. The tool determined the risk category of individual contacts and generated messages for the information of the local public health department, the in-hospital SARS-CoV-2 test center and all staff members who had contact to the index case. Staff members without regular contacts to patients had significantly (P<0.005) more unprotected contacts to other staff members (25.5% vs. 9.6%) and more SARS-CoV-2 transmissions per contact (4.9% vs. 0.6%) than staff members with frequent contacts to patients. The profession "nurse or medical technical service" was associated with significantly (P<0.005) more unprotected contacts between staff members (11.0% vs. 2.6%) compared to the profession "physician". Conclusions Digital tools can increase the efficiency of in-hospital contact tracing. The CTT enable a timely systematic analysis of risk factors among staff members.
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Leung MW, O’Donoghue M, Suen LKP. Personal and Household Hygiene Measures for Preventing Upper Respiratory Tract Infections among Children: A Cross-Sectional Survey of Parental Knowledge, Attitudes, and Practices. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:229. [PMID: 36612552 PMCID: PMC9819782 DOI: 10.3390/ijerph20010229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 12/17/2022] [Accepted: 12/19/2022] [Indexed: 06/17/2023]
Abstract
Personal and household hygiene measures are important for preventing upper respiratory tract infections (URTIs) and other infectious diseases, including coronavirus disease 2019 (COVID-19). An online survey recruited 414 eligible parents in Hong Kong to study their hygiene knowledge, attitudes, and practices (KAPs) regarding the prevention of URTIs among their children. The average knowledge score was high (10.2/12.0), but some misconceptions were identified. The majority of the participants agreed that good personal hygiene (93.5%) and good environmental hygiene (92.8%) can prevent URTIs. The average score for hand hygiene practices was high (3.78/4.00), but only 56.8% of the parents always performed hand hygiene before touching their mouths, noses, or eyes. In terms of environmental hygiene, only some household items were disinfected with disinfectants (door handles in 69.8% of the households, toilet seats in 60.4% of the households, the floor in 42.8% of the households, dining chairs in 24.2% of the households, and dining tables in 20.5% of the households). A higher knowledge score was associated with parents having tertiary educational levels or above, working as healthcare professionals, living in private residential flats or staff quarters, or having household incomes of HKD 70,000 or above. The results of multiple regression analyses also indicated that parents who were healthcare professionals and with higher household income had a better parental knowledge of hygiene measures after adjusting the attitude score. For hand hygiene, parents who achieved higher attitude scores obtained higher practice scores. Under the fifth wave of the COVID-19 epidemic, there were some misconceptions regarding hygiene among parents. Any health promotion program should target parents regarding taking proper personal and household hygienic measures, especially for those who had relatively lower socio-economic status and/or from a non-healthcare background. Motivating attitudes toward hand hygiene can lead to better practices.
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Affiliation(s)
- Man-Wai Leung
- Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong
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Wang C, Huang X, Lau EHY, Cowling BJ, Tsang TK. Association Between Population-Level Factors and Household Secondary Attack Rate of SARS-CoV-2: A Systematic Review and Meta-analysis. Open Forum Infect Dis 2022; 10:ofac676. [PMID: 36655186 PMCID: PMC9835764 DOI: 10.1093/ofid/ofac676] [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: 09/02/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022] Open
Abstract
Background Accurate estimation of household secondary attack rate (SAR) is crucial to understand the transmissibility of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The impact of population-level factors, such as transmission intensity in the community, on SAR estimates is rarely explored. Methods In this study, we included articles with original data to compute the household SAR. To determine the impact of transmission intensity in the community on household SAR estimates, we explored the association between SAR estimates and the incidence rate of cases by country during the study period. Results We identified 163 studies to extract data on SARs from 326 031 cases and 2 009 859 household contacts. The correlation between the incidence rate of cases during the study period and SAR estimates was 0.37 (95% CI, 0.24-0.49). We found that doubling the incidence rate of cases during the study period was associated with a 1.2% (95% CI, 0.5%-1.8%) higher household SAR. Conclusions Our findings suggest that the incidence rate of cases during the study period is associated with higher SAR. Ignoring this factor may overestimate SARs, especially for regions with high incidences, which further impacts control policies and epidemiological characterization of emerging variants.
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Affiliation(s)
- Can Wang
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Xiaotong Huang
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Eric H Y Lau
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China,Laboratory of Data Discovery for Health Limited, Hong Kong Science and Technology Park, New Territories, Hong Kong Special Administrative Region, China
| | - Benjamin J Cowling
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China,Laboratory of Data Discovery for Health Limited, Hong Kong Science and Technology Park, New Territories, Hong Kong Special Administrative Region, China
| | - Tim K Tsang
- Correspondence: Tim K. Tsang, PhD, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 7 Sassoon Road, Pokfulam, Hong Kong Special Administrative Region, China ()
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Ha W, Stiefel MA, Gries JR, Cadnum JL, Torres-Teran MM, Wilson BM, Donskey CJ. Evaluation of Interventions to Improve Ventilation in Households to Reduce Risk for Transmission of Severe Acute Respiratory Syndrome Coronavirus 2. Pathog Immun 2022; 7:120-130. [PMID: 36655199 PMCID: PMC9836208 DOI: 10.20411/pai.v7i2.553] [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] [Received: 10/11/2022] [Accepted: 11/19/2022] [Indexed: 12/14/2022] Open
Abstract
Background Inadequate ventilation may contribute to the high risk for household transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods We evaluated the effectiveness of several interventions recommended to improve ventilation in households. In 7 residential homes, carbon dioxide monitoring was conducted to assess ventilation in occupied open areas such as family rooms and in bedrooms and/or offices. Carbon dioxide levels above 800 parts per million (ppm) were considered an indicator of suboptimal ventilation for the number of people present. In 1 of the 7 homes, various interventions to improve ventilation or to filter air were assessed in a kitchen area by measuring clearance of aerosol particles produced using an aerosol-based spray system and carbon dioxide generated by cooking with a gas stove. Results Carbon dioxide levels rose above 800 ppm in bedrooms and offices with 2 occupants when windows and doors were closed and in open areas during gatherings of 5 to 10 people; carbon dioxide levels decreased when windows or doors were opened. Clearance of carbon dioxide and aerosol particles significantly increased with interventions including running fans, operating portable air cleaners, and opening windows, particularly when there was a noticeable breeze or when a window fan was used to blow contaminated air outside. Conclusion In households, several measures to improve ventilation or air filtration were effective in reducing carbon dioxide accumulation or enhancing clearance of carbon dioxide and aerosol particles. Studies are needed to determine if interventions to improve ventilation can reduce the risk for airborne transmission of SARS-CoV-2 in households.
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Affiliation(s)
- Wilson Ha
- John Carroll University, University Heights, Ohio
| | | | | | - Jennifer L. Cadnum
- Research Service, Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio
| | | | - Brigid M. Wilson
- Geriatric Research, Education, and Clinical Center, Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio
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Migliara G, Renzi E, Baccolini V, Cerri A, Donia P, Massimi A, Marzuillo C, De Vito C, Casini L, Polimeni A, Gaudio E, Villari P. Predictors of SARS-CoV-2 Infection in University Students: A Case-Control Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14376. [PMID: 36361257 PMCID: PMC9655450 DOI: 10.3390/ijerph192114376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 10/30/2022] [Accepted: 10/30/2022] [Indexed: 06/16/2023]
Abstract
Closure of Higher Education Institutions in the early phase of the SARS-CoV-2 pandemic was largely diffused. With their reopening, numerous preventive measures have been enacted, but limited evidence exists on students' behavior that could influence their infection risk. We conducted a case-control study at the Sapienza University of Rome to identify protective and risk factors for SARS-CoV-2 infection. Students attending the campus within 48 h of SARS-CoV-2 infection were considered cases. Controls were students who come in contact with a confirmed case within the campus. Demographic features and activities carried out before positivity or contact were investigated. Multivariable logistic regression models were built to identify factors associated with SARS-CoV-2 infection, estimating adjusted odds ratios (aOR) and 95% confidence intervals (95% CI). The analysis showed an increased risk of SARS-CoV-2 infection for attending the second year or above of university (aOR 17.7, 95% CI 2.21-142.82) and participating in private parties or ceremonies (aOR 15.9, 95% CI 2.30-109.67) while living outside the family (aOR 0.08, 95% CI 0.01-0.54) and attending practical activities or libraries on campus (aOR 0.29, 95% CI 0.08-0.97) reduced the risk. Data strongly suggests that it may be safe to participate in activities organized under strict infection prevention guidelines. Tailored prevention measures might reduce the risk of infection in university students.
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Affiliation(s)
- Giuseppe Migliara
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Erika Renzi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Valentina Baccolini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Ambrogio Cerri
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Pierluigi Donia
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Azzurra Massimi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Carolina Marzuillo
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Corrado De Vito
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Leandro Casini
- Special Office for Prevention, Protection and High Vigilance, Sapienza University of Rome, 00185 Rome, Italy
| | - Antonella Polimeni
- Department of Oral and Maxillofacial Science, Sapienza University of Rome, 00185 Rome, Italy
| | - Eugenio Gaudio
- Department of Anatomical, Histological, Forensic Medicine and Orthopedics Sciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Paolo Villari
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
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Marcato AJ, Black AJ, Walker CR, Morris D, Meagher N, Price DJ, McVernon J. Learnings from the Australian first few X household transmission project for COVID-19. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2022; 28:100573. [PMID: 36089928 PMCID: PMC9444248 DOI: 10.1016/j.lanwpc.2022.100573] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Background First Few "X" (FFX) studies provide a platform to collect the required epidemiological, clinical and virological data to help address emerging information needs about the COVID-19 pandemic. Methods We adapted the WHO FFX protocol for COVID-19 to understand severity and household transmission dynamics in the early stages of the pandemic in Australia. Implementation strategies were developed for participating sites; all household members were followed for 14 days from case identification. Household contacts completed symptom diaries and had multiple respiratory swabs taken irrespective of symptoms. We modelled the spread of COVID-19 within households using a susceptible-exposed-infectious-recovered-type model, and calculated the household secondary attack rate and key epidemiological parameters. Findings 96 households with 101 cases and 286 household contacts were recruited into the study between April-October 2020. Forty household contacts tested positive for SARS-CoV-2 in the study follow-up period. Our model estimated the household secondary attack rate to be 15% (95% CI 8-25%), which scaled up with increasing household size. Our findings suggest children were less infectious than their adult counterparts but were also more susceptible to infection. Interpretation Our study provides important baseline data characterising the transmission of early SARS-CoV-2 strains from children and adults in Australia, against which properties of variants of concern can be benchmarked. We encountered many challenges with respect to logistics, ethics, governance and data management. Continued efforts to invest in preparedness research will help to test, refine and further develop Australian FFX study protocols in advance of future outbreaks. Funding Australian Government Department of Health.
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Affiliation(s)
- Adrian J. Marcato
- Department of Infectious Diseases, The University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - Andrew J. Black
- School of Mathematical Sciences, The University of Adelaide, Adelaide, Australia
| | - Camelia R. Walker
- School of Mathematical Sciences, The University of Adelaide, Adelaide, Australia
- School of Mathematics & Statistics, The University of Melbourne, Melbourne, Australia
| | - Dylan Morris
- School of Mathematical Sciences, The University of Adelaide, Adelaide, Australia
| | - Niamh Meagher
- Department of Infectious Diseases, The University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
- Centre for Epidemiology & Biostatistics, Melbourne School of Population & Global Health, The University of Melbourne
| | - David J. Price
- Department of Infectious Diseases, The University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
- Centre for Epidemiology & Biostatistics, Melbourne School of Population & Global Health, The University of Melbourne
| | - Jodie McVernon
- Department of Infectious Diseases, The University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
- Centre for Epidemiology & Biostatistics, Melbourne School of Population & Global Health, The University of Melbourne
- Murdoch Children's Research Institute, Melbourne, Australia
| | - the Australian FFX Household Transmission Project Group
- Department of Infectious Diseases, The University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
- School of Mathematical Sciences, The University of Adelaide, Adelaide, Australia
- School of Mathematics & Statistics, The University of Melbourne, Melbourne, Australia
- Centre for Epidemiology & Biostatistics, Melbourne School of Population & Global Health, The University of Melbourne
- Murdoch Children's Research Institute, Melbourne, Australia
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Transmission of SARS-CoV-2 by children to contacts in schools and households: a prospective cohort and environmental sampling study in London. THE LANCET. MICROBE 2022; 3:e814-e823. [PMID: 36029775 PMCID: PMC9401977 DOI: 10.1016/s2666-5247(22)00124-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 04/20/2022] [Accepted: 04/29/2022] [Indexed: 01/14/2023]
Abstract
BACKGROUND Assessing transmission of SARS-CoV-2 by children in schools is of crucial importance to inform public health action. We assessed frequency of acquisition of SARS-CoV-2 by contacts of pupils with COVID-19 in schools and households, and quantified SARS-CoV-2 shedding into air and onto fomites in both settings. METHODS We did a prospective cohort and environmental sampling study in London, UK in eight schools. Schools reporting new cases of SARS-CoV-2 infection to local health protection teams were invited to take part if a child index case had been attending school in the 48 h before a positive SARS-CoV-2 PCR test. At the time of the study, PCR testing was available to symptomatic individuals only. Children aged 2-14 years (extended to <18 years in November, 2020) with a new nose or throat swab SARS-CoV-2 positive PCR from an accredited laboratory were included. Incidents involving exposure to at least one index pupil with COVID-19 were identified (the prevailing variants were original, α, and δ). Weekly PCR testing for SARS-CoV-2 was done on immediate classroom contacts (the so-called bubble), non-bubble school contacts, and household contacts of index pupils. Testing was supported by genome sequencing and on-surface and air samples from school and home environments. FINDINGS Between October, 2020, and July, 2021 from the eight schools included, secondary transmission of SARS-CoV-2 was not detected in 28 bubble contacts, representing ten bubble classes (participation rate 8·8% [IQR 4·6-15·3]). Across eight non-bubble classes, 3 (2%) of 62 pupils tested positive, but these were unrelated to the original index case (participation rate 22·5% [9·7-32·3]). All three were asymptomatic and tested positive in one setting on the same day. In contrast, secondary transmission to previously negative household contacts from infected index pupils was found in six (17%) of 35 household contacts rising to 13 (28%) of 47 household contacts when considering all potential infections in household contacts. Environmental contamination with SARS-CoV-2 was rare in schools: fomite SARS-CoV-2 was identified in four (2%) of 189 samples in bubble classrooms, two (2%) of 127 samples in non-bubble classrooms, and five (4%) of 130 samples in washrooms. This contrasted with fomites in households, where SARS-CoV-2 was identified in 60 (24%) of 248 bedroom samples, 66 (27%) of 241 communal room samples, and 21 (11%) 188 bathroom samples. Air sampling identified SARS-CoV-2 RNA in just one (2%) of 68 of school air samples, compared with 21 (25%) of 85 air samples taken in homes. INTERPRETATION There was no evidence of large-scale SARS-CoV-2 transmission in schools with precautions in place. Low levels of environmental contamination in schools are consistent with low transmission frequency and suggest adequate cleaning and ventilation in schools during the period of study. The high frequency of secondary transmission in households associated with evident viral shedding throughout the home suggests a need to improve advice to households with infection in children to prevent onward community spread. The data suggest that SARS-CoV-2 transmission from children in any setting is very likely to occur when precautions are reduced. FUNDING UK Research and Innovation and UK Department of Health and Social Care, National Institute for Health and Care Research.
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Setiawan KB, Hikmawati I, Wardani DPK, Juanita J. Differences in elderly stress levels before Covid-19 vaccination: History of exposure to Covid-19 reduces stress before vaccination. VACUNAS 2022; 24:135-140. [PMID: 36341005 PMCID: PMC9622388 DOI: 10.1016/j.vacun.2022.10.005] [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: 07/29/2022] [Accepted: 10/22/2022] [Indexed: 11/06/2022]
Abstract
Background The Covid-19 pandemic requires the government to take various prevention and countermeasures, one of which is the Covid-19 Vaccination program, however, the program experiences a high dropout at various doses and causes immunization stress related response (ISRR), especially in the elderly. The research aims to determine differences in the stress levels of the elderly before the covid-19 vaccination. Methods Descriptive study with the elderly population who will take vaccinations at the Bojong Purbalingga Health Center. Sampling used random sampling, the inclusion criteria were 45-79 years old, with a total sample of 90 respondents. Research instruments developed by research, relating to vaccination containing cognitive responses (such as difficulty concentrating), physiological responses (such as shortness of breath, dry lips) feelings of fear, anxiety, trust in vaccination. Data were analyzed descriptively with percentages and proportions. Results The results showed that the most moderate stress levels were middle age (22.2%), women 33.3% had higher stress levels than men (10%), the highest vaccination coverage was 26.7% at a distance of 1-2 KM. The level of stress is in the moderate category 33.3% in the elderly who have never been exposed to Covid-19 and 10% in the elderly who have been exposed. Non-family health workers, 36.7% higher than families of health workers (6.7%). Conclusion Stress levels before vaccination are higher in the elderly who have never been exposed to Covid-19, compared to those who have been exposed to Covid-19. The need for family assistance to prepare for vaccination in the elderly.
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Affiliation(s)
| | - Isna Hikmawati
- Epidemiology, Universitas Muhammadiyah Purwokerto, Indonesia,Corresponding author
| | | | - Juanita Juanita
- Civil Engineering, Universitas Muhammadiyah Purwokerto, Indonesia
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Nosocomial SARS-CoV-2 transmission in multi-bedded hospital cubicles over successive pandemic waves: Lower mortality but wider spread with Omicron despite enhanced infection-prevention measures. Infect Dis Health 2022; 28:81-87. [PMID: 37032572 PMCID: PMC9537248 DOI: 10.1016/j.idh.2022.09.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 09/14/2022] [Accepted: 09/27/2022] [Indexed: 11/06/2022]
Abstract
Background Increased transmissibility of severe-acute-respiratory-syndrome-coronavirus-2(SARS-CoV-2) variants, such as the Omicron-variant, presents an infection-control challenge. We contrasted nosocomial transmission amongst hospitalized inpatients across successive pandemic waves attributed to the Delta- and Omicron variants, over a 9-month period in which enhanced-infection-prevention-measures were constantly maintained. Methods Enhanced-infection-prevention-measures in-place at a large tertiary hospital included universal N95-usage, routine-rostered-testing (RRT) for all inpatient/healthcare-workers (HCWs), rapid-antigen-testing (RAT) for visitors, and outbreak-investigation coupled with enhanced-surveillance (daily-testing) of exposed patients. The study-period lasted from 21st June 2021–21st March 2022. Chi-square test and multivariate-logistic-regression was utilized to identify factors associated with onward transmission and 28d-mortality amongst inpatient cases of hospital-onset COVID-19. Results During the Delta-wave, hospital-onset cases formed 2.7% (47/1727) of all COVID-19 cases requiring hospitalisation; in contrast, hospital onset-cases formed a greater proportion (17.7%, 265/1483; odds-ratio, OR = 7.78, 95%CI = 5.65–10.70) during the Omicron-wave, despite universal N95-usage and other enhanced infection-prevention measures that remained unchanged. The odds of 28d-mortality were higher during the Delta-wave compared to the Omicron-wave (27.7%, 13/47, vs. 10.6%, 28/265, adjusted-odds-ratio, aOR = 2.78, 95%CI = 1.02–7.69). Onward-transmission occurred in 21.2% (66/312) of hospital-onset cases; being on enhanced-surveillance (daily-testing) was independently associated with lower odds of onward-transmission (aOR = 0.18, 95%CI = 0.09–0.38). Costs amounted to $USD7141 per-hospital-onset COVID-19 case. Conclusion A surge of hospital-onset COVID-19 cases was encountered during the Omicron-wave, despite continuation of enhanced infection-prevention measures; mortality amongst hospital-onset cases was reduced. The Omicron variant poses an infection-control challenge in contrast to Delta; surveillance is important especially in settings where infrastructural limitations make room-sharing unavoidable, despite the high risk of transmission.
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Household transmission of the Delta COVID-19 variant in Queensland, Australia: a case series. Epidemiol Infect 2022; 150:e173. [PMID: 36192365 PMCID: PMC9671917 DOI: 10.1017/s0950268822001546] [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] [Indexed: 12/14/2022] Open
Abstract
Household transmission plays a key role in the spread of COVID-19 through populations. In this paper, we report on the transmission of COVID-19 within households in a metropolitan area in Australia, examine the impact of various factors and highlight priority areas for future public health responses. We collected and reviewed retrospective case report data and follow-up interview responses from households with a positive case of the Delta COVID-19 variant in Queensland in 2021. The overall secondary attack rate (SAR) among household contacts was 29.6% and the mean incubation period for secondary cases was 4.3 days. SAR was higher where the index case was male (57.9% vs. 14.3%) or aged ≤12 years (38.7% vs. 17.4%) but similar for adult contacts that were double vaccinated (35.7%) and unvaccinated (33.3%). Most interview participants emphasised the importance of clear, consistent and compassionate health advice as a key priority for managing outbreaks in the home. The overall rate of household transmission was slightly higher than that reported in previous studies on the wild COVID-19 variant and secondary infections developed more rapidly. While vaccination did not appear to affect the risk of transmission to adult subjects, uptake in the sample was ultimately high.
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