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Peng B, Wang Y, Xie Y, Dong X, Liu W, Li D, Chen H. An overview of influenza A virus detection methods: from state-of-the-art of laboratories to point-of-care strategies. ANALYTICAL METHODS : ADVANCING METHODS AND APPLICATIONS 2024; 16:4496-4515. [PMID: 38946516 DOI: 10.1039/d4ay00508b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/02/2024]
Abstract
Influenza A virus (IAV), a common respiratory infectious pathogen, poses a significant risk to personal health and public health safety due to rapid mutation and wide host range. To better prevent and treat IAV, comprehensive measures are needed for early and rapid screening and detection of IAV. Although traditional laboratory-based techniques are accurate, they are often time-consuming and not always feasible in emergency or resource-limited areas. In contrast, emerging point-of-care strategies provide faster results but may compromise sensitivity and specificity. Here, this review critically evaluates various detection methods for IAV from established laboratory-based procedures to innovative rapid diagnosis. By analyzing the recent research progress, we aim to address significant gaps in understanding the effectiveness, practicality, and applicability of these methods in different scenarios, which could provide information for healthcare strategies, guide public health response measures, and ultimately strengthen patient care in the face of the ongoing threat of IAV. Through a detailed comparison of diagnostic models, this review can provide a reliable reference for rapid, accurate and efficient detection of IAV, and to contribute to the diagnosis, treatment, prevention, and control of IAV.
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Affiliation(s)
- Bin Peng
- Guangzhou Huashang Vocational College, Guangzhou, 510000, China
| | - Yaqi Wang
- Guangzhou Institute for Food Inspection, Guangzhou, 510000, China
| | - Yueliang Xie
- Guangdong Agriculture Industry Business Polytechnic College, Guangzhou, 510000, China
| | - Xiangyan Dong
- State Key Laboratory of Chemical Oncogenomics, Institute of Biomedical and Health Engineering, Shenzhen International Graduate School, Tsinghua University, Shenzhen, 518055, China.
| | - Wen Liu
- Guangdong Agriculture Industry Business Polytechnic College, Guangzhou, 510000, China
| | - Dan Li
- College of Pharmacy, Jinzhou Medical University, Jinzhou, 121000, China
| | - Hui Chen
- State Key Laboratory of Chemical Oncogenomics, Institute of Biomedical and Health Engineering, Shenzhen International Graduate School, Tsinghua University, Shenzhen, 518055, China.
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Pennington ER, Griffin JS, McInroe EM, Steinhardt W, Chen H, Samet JM, Prince SE. Variation in the fitted filtration efficiency of disposable face masks by sex. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2024:10.1038/s41370-024-00697-4. [PMID: 38956275 DOI: 10.1038/s41370-024-00697-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 06/05/2024] [Accepted: 06/10/2024] [Indexed: 07/04/2024]
Abstract
BACKGROUND & OBJECTIVE Disposable face masks are a primary protective measure against the adverse health effects of exposure to infectious and toxic aerosols such as airborne viruses and particulate air pollutants. While the fit of high efficiency respirators is regulated in occupational settings, relatively little is known about the fitted filtration efficiencies of ear loop style face masks worn by the public. METHODS We measured the variation in fitted filtration efficiency (FFE) of four commonly worn disposable face masks, in a cohort of healthy adult participants (N = 100, 50% female, 50% male, average age = 32.3 ± 9.2 years, average BMI = 25.5 ± 3.4) using the U.S. Occupational Safety and Health Administration Quantitative Fit Test, for an N95 (respirator), KN95, surgical, and KF94 masks. The latter three ear loop style masks were additionally tested in a clip-modified condition, tightened using a plastic clip to centrally fasten loops in the back of the head. RESULTS The findings show that sex is a major determinant of the FFE of KN95, surgical, and KF94 masks. On average, males had an 11% higher FFE relative to females, at baseline testing. We show that a simple modification using an ear loop clip, results in improvements in the average FFE for females but provides comparatively minor changes for males. On average, females had a 20% increased FFE when a clip was worn behind the head, relative to a 6% increase for males. IMPACT The efficacy of a disposable face mask as protection against air contaminants depends on the efficiency of the mask materials and how well it fits the wearer. We report that the sex of the wearer is a major determinant of the baseline fitted filtration efficiency (FFE) of commonly available ear loop style face masks. In addition, we show that a simple fit modifier, an ear loop clip fastened behind the head, substantially improves baseline FFE for females but produces only minor changes for males. These findings have significant public health implications for the use of face masks as a protective intervention against inhalational exposure to airborne contaminants.
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Affiliation(s)
- Edward R Pennington
- Public Health and Integrated Toxicology Division, Center for Public Health and Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, NC, USA
- Oak Ridge Institute for Science Education, Oak Ridge, TN, USA
| | - Jacob S Griffin
- Oak Ridge Institute for Science Education, Oak Ridge, TN, USA
| | - E Melissa McInroe
- Public Health and Integrated Toxicology Division, Center for Public Health and Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, NC, USA
| | | | - Hao Chen
- Oak Ridge Institute for Science Education, Oak Ridge, TN, USA
- Department of Occupational and Environmental Health, School of Public Health, Guangxi Medical University, Guangxi, 530021, China
| | - James M Samet
- Public Health and Integrated Toxicology Division, Center for Public Health and Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, NC, USA
| | - Steven E Prince
- Public Health and Environmental Systems Division, Center for Public Health and Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, NC, USA.
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Sharma M, Sra H, Painter C, Pan-ngum W, Luangasanatip N, Chauhan A, Prinja S, Singh M. Cost-effectiveness analysis of surgical masks, N95 masks compared to wearing no mask for the prevention of COVID-19 among health care workers: Evidence from the public health care setting in India. PLoS One 2024; 19:e0299309. [PMID: 38768249 PMCID: PMC11104672 DOI: 10.1371/journal.pone.0299309] [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: 01/12/2023] [Accepted: 02/08/2024] [Indexed: 05/22/2024] Open
Abstract
BACKGROUND Nonpharmacological interventions, such as personal protective equipment for example, surgical masks and respirators, and maintenance of hand hygiene along with COVID-19 vaccines have been recommended to reduce viral transmission in the community and health care settings. There is evidence from the literature that surgical and N95 masks may reduce the initial degree of exposure to the virus. A limited research that has studied the cost-effective analysis of surgical masks and N95 masks among health care workers in the prevention of COVID-19 in India. The objective of this study was to estimate the cost-effectiveness of N95 and surgical mask compared to wearing no mask in public hospital settings for preventing COVID-19 infection among Health care workers (HCWs) from the health care provider's perspective. METHODS A deterministic baseline model, without any mask use, based on Eikenberry et al was used to form the foundation for parameter estimation and to estimate transmission rates among HCWs. Information on mask efficacy, including the overall filtering efficiency of a mask and clinical efficiency, in terms of either inward efficiency(ei) or outward efficiency(e0), was obtained from published literature. Hospitalized HCWs were assumed to be in one of the disease states i.e., mild, moderate, severe, or critical. A total of 10,000 HCWs was considered as representative of the size of a tertiary care institution HCW population. The utility values for the mild, moderate and severe model health states were sourced from the primary data collection on quality-of-life of HCWs COVID-19 survivors. The utility scores for mild, moderate, and severe COVID-19 conditions were 0.88, 0.738 and 0.58, respectively. The cost of treatment for mild sickness (6,500 INR per day), moderate sickness (10,000 INR per day), severe (require ICU facility without ventilation, 15,000 INR per day), and critical (require ICU facility with ventilation per day, 18,000 INR) per day as per government and private COVID-19 treatment costs and capping were considered. One way sensitivity analyses were performed to identify the model inputs which had the largest impact on model results. RESULTS The use of N95 masks compared to using no mask is cost-saving of $1,454,632 (INR 0.106 billion) per 10,000 HCWs in a year. The use of N95 masks compared to using surgical masks is cost-saving of $63,919 (INR 0.005 billion) per 10,000 HCWs in a year. the use of surgical masks compared to using no mask is cost-saving of $1,390,713 (INR 0.102 billion) per 10,000 HCWs in a year. The uncertainty analysis showed that considering fixed transmission rate (1.7), adoption of mask efficiency as 20%, 50% and 80% reduces the cumulative relative mortality to 41%, 79% and 94% respectively. On considering ei = e0 (99%) for N95 and surgical mask with ei = e0 (90%) the cumulative relative mortality was reduced by 97% and the use of N95 masks compared to using surgical masks is cost-saving of $24,361 (INR 0.002 billion) per 10,000 HCWs in a year. DISCUSSION Both considered interventions were dominant compared to no mask based on the model estimates. N95 masks were also dominant compared to surgical masks.
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Affiliation(s)
- Meenakshi Sharma
- Queens University, Belfast, United Kingdom
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Harnoor Sra
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Chris Painter
- Faculty of Tropical Medicine, Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand
- Health Intervention and Technology Assessment Program (HITAP), Ministry of Public Health, Nonthaburi, Thailand
- Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom
| | - Wirichada Pan-ngum
- Faculty of Tropical Medicine, Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand
| | - Nantasit Luangasanatip
- Faculty of Tropical Medicine, Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand
| | - Anil Chauhan
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Shankar Prinja
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Meenu Singh
- All India Institute of Medical Sciences, Rishikesh, India
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Paetkau T. Ladders and stairs: how the intervention ladder focuses blame on individuals and obscures systemic failings and interventions. JOURNAL OF MEDICAL ETHICS 2024:jme-2023-109563. [PMID: 38408850 DOI: 10.1136/jme-2023-109563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 02/10/2024] [Indexed: 02/28/2024]
Abstract
Introduced in 2007 by the Nuffield Council on Bioethics, the intervention ladder has become an influential tool in bioethics and public health policy for weighing the justification for interventions and for weighing considerations of intrusiveness and proportionality. However, while such considerations are critical, in its focus on these factors, the ladder overemphasises the role of personal responsibility and the importance of individual behaviour change in public health interventions. Through a study of vaccine hesitancy and vaccine mandates among healthcare workers, this paper investigates how the ladder obscures systemic factors such as the social determinants of health. In overlooking these factors, potentially effective interventions are left off the table and the intervention ladder serves to divert attention away from key issues in public health. This paper, therefore, proposes a replacement for the intervention ladder-the intervention stairway. By broadening the intervention ladder to include systemic factors, the stairway ensures relevant interventions are not neglected merely due to the framing of the issue. Moreover, it more accurately captures factors influencing individual health as well as allocations of responsibility for improving these factors.
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Affiliation(s)
- Tyler Paetkau
- Philosophy, McGill University, Montreal, Quebe, Canada
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5
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Tsukada K, Yasui Y, Miyata S, Fuyumuro J, Kikuchi T, Mizuno T, Nakayama S, Kawano H, Miyamoto W. Effectiveness of Virtual Reality Training in Teaching Personal Protective Equipment Skills: A Randomized Clinical Trial. JAMA Netw Open 2024; 7:e2355358. [PMID: 38353953 PMCID: PMC10867681 DOI: 10.1001/jamanetworkopen.2023.55358] [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: 09/11/2023] [Accepted: 12/12/2023] [Indexed: 02/16/2024] Open
Abstract
Importance Training on the proper use of personal protective equipment (PPE) is critical for infection prevention among health care workers. Traditional methods, such as face-to-face and video-based training, can strain resources and present challenges. Objective To determine the effectiveness of 360° virtual reality (VR) training for PPE donning and doffing compared with face-to-face and video training in enhancing the PPE use skills of prospective health care practitioners. Design, Setting, and Participants A blinded, prospective, and randomized noninferiority clinical trial was conducted from August to December 2021 at Teikyo University School of Medicine in Tokyo, Japan, with a mixed population of medical students. Participants were second- to fourth-year medicine, medical technology, or pharmacy students aged 20 years or older with no prior PPE training. Participants were randomized into 1 of 3 training groups (VR, face-to-face, or video) based on their enrollment order. An intention-to-treat analysis was conducted. Intervention A 30-minute lecture on PPE procedures was delivered to all participants before the training. After the lecture, the VR group trained with an immersive 360° VR tool, the face-to-face group trained with actual PPE, and the video group trained by watching video footage on a computer and a projector. After 3 days, a standardized practical skills test was administered. Main Outcomes and Measures The primary outcome was the mean score on a 20-point practical skills test, and the secondary outcome was the percentage of correct execution. Results A total of 91 participants were recruited and randomized into 3 groups: VR (n = 30), face-to-face (n = 30), and video (n = 31) training. After excluding 1 participant due to illness, 90 participants (mean [SD] age, 24.2 [3.15] years; 54 males [60.0%]) completed the assessment. The mean (SD) scores were 17.70 (2.10) points for the VR group, 17.57 (2.45) points for the face-to-face group, and 15.87 (2.90) points for the video group. The VR group demonstrated no significant difference in performance from the face-to-face group. However, the VR group had significantly higher effectiveness than the video group (17.70 vs 15.87 points; P = .02). Conclusions and Relevance Results of this trial indicate that VR training was as effective as face-to-face training in enhancing PPE donning and doffing skills and was superior to video training. The findings suggest that VR training is a viable resource-conserving training option. Trial Registration Japan Registry of Clinical Trials Identifier: jRCT103021029.
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Affiliation(s)
- Keisuke Tsukada
- Department of Orthopaedic Surgery, Teikyo University School of Medicine, Kaga Itabashi-ku, Tokyo, Japan
| | - Youichi Yasui
- Department of Orthopaedic Surgery, Teikyo University School of Medicine, Kaga Itabashi-ku, Tokyo, Japan
| | - Satoshi Miyata
- Teikyo University Graduate School of Public Health, Kaga Itabashi-ku, Tokyo, Japan
| | - Junko Fuyumuro
- Department of Infection Control, Teikyo University Hospital, Kaga Itabashi-ku, Tokyo, Japan
| | - Tomomi Kikuchi
- Department of Infection Control, Teikyo University Hospital, Kaga Itabashi-ku, Tokyo, Japan
| | | | - Satoshi Nakayama
- Department of Orthopaedic Surgery, Teikyo University School of Medicine, Kaga Itabashi-ku, Tokyo, Japan
| | - Hirotaka Kawano
- Department of Orthopaedic Surgery, Teikyo University School of Medicine, Kaga Itabashi-ku, Tokyo, Japan
| | - Wataru Miyamoto
- Department of Orthopaedic Surgery, Teikyo University School of Medicine, Kaga Itabashi-ku, Tokyo, Japan
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Wang RC, Degesys NF, Fahimi J, Jin C, Rosenthal E, Lazar AA, Yaffee AQ, Peterson S, Rothmann RE, Jones CMC, Tolia V, Shah MN, Raven MC. Incidence of Fit Test Failure During N95 Respirator Reuse and Extended Use. JAMA Netw Open 2024; 7:e2353631. [PMID: 38277142 DOI: 10.1001/jamanetworkopen.2023.53631] [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] [Indexed: 01/27/2024] Open
Abstract
Importance The COVID-19 pandemic resulted in a widespread acute shortage of N95 respirators, prompting the Centers for Disease Control and Prevention to develop guidelines for extended use and limited reuse of N95s for health care workers (HCWs). While HCWs followed these guidelines to conserve N95s, evidence from clinical settings regarding the safety of reuse and extended use is limited. Objective To measure the incidence of fit test failure during N95 reuse and compare the incidence between N95 types. Design, Setting, and Participants This prospective cohort study, conducted from April 2, 2021, to July 15, 2022, at 6 US emergency departments (EDs), included HCWs who practiced N95 reuse for more than half of their clinical shift. Those who were unwilling to wear an N95 for most of their shift, repeatedly failed baseline fit testing, were pregnant, or had facial hair or jewelry that interfered with the N95 face seal were excluded. Exposures Wearing the same N95 for more than half of each clinical shift and for up to 5 consecutive shifts. Participants chose an N95 model available at their institution; models were categorized into 3 types: dome (3M 1860R, 1860S, and 8210), trifold (3M 1870+ and 9205+), and duckbill (Halyard 46727, 46767, and 46827). Participants underwent 2 rounds of testing using a different mask of the same type for each round. Main Outcomes and Measures The primary outcome was Occupational Safety and Health Administration-approved qualitative fit test failure. Trained coordinators conducted fit tests after clinical shifts and recorded pass or fail based on participants tasting a bitter solution. Results A total of 412 HCWs and 824 N95s were fit tested at baseline; 21 N95s (2.5%) were withdrawn. Participants' median age was 34.5 years (IQR, 29.5-41.8 years); 252 (61.2%) were female, and 205 (49.8%) were physicians. The overall cumulative incidence of fit failure after 1 shift was 38.7% (95% CI, 35.4%-42.1%), which differed by N95 type: dome, 25.8% (95% CI, 21.2%-30.6%); duckbill, 28.3% (95% CI, 22.2%-34.7%); and trifold, 61.3% (95% CI, 55.3%-67.3%). The risk of fit failure was significantly higher for trifold than dome N95s (adjusted hazard ratio, 1.75; 95% CI, 1.46-2.10). Conclusions and Relevance In this cohort study of ED HCWs practicing N95 reuse, fit failure occurred in 38.7% of masks after 1 shift. Trifold N95s had higher incidence of fit failure compared with dome N95s. These results may inform pandemic preparedness, specifically policies related to N95 selection and reuse practices.
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Affiliation(s)
- Ralph C Wang
- Department of Emergency Medicine, University of California, San Francisco
| | - Nida F Degesys
- Department of Emergency Medicine, University of California, San Francisco
| | - Jahan Fahimi
- Department of Emergency Medicine, University of California, San Francisco
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco
| | - Chengshi Jin
- Department of Epidemiology & Biostatistics, University of California, San Francisco
| | - Efrat Rosenthal
- Department of Emergency Medicine, University of California, San Francisco
| | - Ann A Lazar
- Department of Epidemiology & Biostatistics, University of California, San Francisco
| | - Anna Q Yaffee
- Department of Emergency Medicine, Emory University, Atlanta, Georgia
| | - Susan Peterson
- Department of Emergency Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Richard E Rothmann
- Department of Emergency Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Courtney M C Jones
- Department of Emergency Medicine, University of Rochester Medical Center, Rochester, New York
| | - Vaishal Tolia
- Department of Emergency Medicine, University of California, San Diego
| | - Manish N Shah
- BerbeeWalsh Department of Emergency Medicine, University of Wisconsin, Madison
| | - Maria C Raven
- Department of Emergency Medicine, University of California, San Francisco
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco
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7
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Wu G, Ji Q, Shi Y. A systematic review and meta-analysis of the efficacy of N95 respirators and surgical masks for protection against COVID-19. Prev Med Rep 2023; 36:102414. [PMID: 37736310 PMCID: PMC10509348 DOI: 10.1016/j.pmedr.2023.102414] [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: 05/25/2023] [Revised: 07/15/2023] [Accepted: 09/11/2023] [Indexed: 09/23/2023] Open
Abstract
Former meta-analyses concluded that there was not sufficient evidence to determine the effect of surgical masks and N95 respirators. We collected randomized controlled trials (RCTs) and conducted a systematic review and meta-analysis to evaluate the efficacy of N95 respirators and surgical masks for protection against COVID-19. We retrieved relevant RCTs published between January 2019 and January 2023 by searching the PubMed, EMBASE, and Cochrane CENTRAL. Study quality was evaluated using the Cochrane Risk of Bias tool with the RevMan 5.4 software. Meta-analyses were conducted to calculate pooled estimates using the RevMan 5.4 software. A total of six RCTs were finally included. The findings revealed that wearing a mark made little difference in preventing COVID-19 [odds ratio (OR) = 0.10; 95% confidence interval (CI): 0.01-0.93; P = 0.04]. Subgroup analysis showed that the heterogeneity of data was I2 = 64% (OR = 0.32; 95% CI: 0.06-1.77; P = 0.19) for surgical mask use and I2 = 0% (OR = 0.03; 95 %CI: 0.01-0.15; P < 0.01) for N95 respirator use. The heterogeneity of data for medical staff was I2 = 0% (OR = 0.03; 95 %CI: 0.01-0.12; P < 0.01). Meta-analysis indicated a protective effect of N95 respirators against COVID-19, particularly for medical staff. The use of surgical masks is not associated with a lower risk of COVID-19. However, the subgroup using N95 respirators, particularly medical staff, showed a significant protective. These findings suggest that N95 respirators should be reserved for high-risk medical staff in the absence of sufficient resources during an epidemic. But the number of included studies was small, more studies in future analyses is required to reduce the risk of distribution bias.
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Affiliation(s)
- Gaohong Wu
- Department of Neonatology, Zhuhai Center for Maternal and Child Health Care, Zhuhai, China
- Department of Neonatology Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China Chongqing, China
| | - Qingyang Ji
- Department of Breast Surgery, Zhuhai Center for Maternal and Child Health Care, Zhuhai, China
| | - Yuan Shi
- Department of Neonatology Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China Chongqing, China
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Graham LA, Maldonado YA, Tompkins LS, Wald SH, Chawla A, Hawn MT. Asymptomatic SARS-CoV-2 Transmission From Community Contacts in Healthcare Workers. Ann Surg 2023; 278:e947-e948. [PMID: 32487801 PMCID: PMC7299117 DOI: 10.1097/sla.0000000000003968] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Laura A Graham
- Stanford University, School of Medicine, Stanford, California
- VA Palo Alto Healthcare System, Palo Alto, California
| | - Yvonne A Maldonado
- Stanford University, School of Medicine, Stanford, California
- Stanford Health Care and Lucile Packard Children's Hospital, Stanford, California
| | - Lucy S Tompkins
- Stanford University, School of Medicine, Stanford, California
| | - Samuel H Wald
- Stanford University, School of Medicine, Stanford, California
| | - Amanda Chawla
- Stanford Health Care and Lucile Packard Children's Hospital, Stanford, California
| | - Mary T Hawn
- Stanford University, School of Medicine, Stanford, California
- VA Palo Alto Healthcare System, Palo Alto, California
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9
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Chuang ST, Lin MH, Hsu H, Chi CM, Lee YR, Yen YH. Epidemic-Prevention Measures and Health Management in a Nursing Home during the Coronavirus Disease 2019 Pandemic. Healthcare (Basel) 2023; 11:2535. [PMID: 37761732 PMCID: PMC10531124 DOI: 10.3390/healthcare11182535] [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: 07/27/2023] [Revised: 09/06/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023] Open
Abstract
This study aimed to investigate the impact of epidemic prevention and isolation policies on residents' health and well-being and assess the effectiveness of implementing intervention measures to maintain their quality of life. This mixed-methods research study involved a retrospective record review of residents' daily life diaries and descriptive statistical analysis. Data were collected between March 2021 and June 2022, and epidemic-prevention measures were implemented using Taiwan's Centers for Disease Control guidelines. Three interventions were developed to address residents' health, social, and rehabilitation needs. Despite an overall infection rate of 10% at various times between 2021 and 2022, there were no reported outbreaks of nosocomial infections. The concept of reablement proved effective in helping residents maintain their independence and physical function, with a maintenance rate of 66.6%, thereby improving their quality of life. By implementing epidemic-prevention measures, we found that proper hand washing and the use of surgical masks were effective in controlling infections. Furthermore, the decline in physical function is a continuous and gradual process for older adults. Even under the restriction of social interaction, it is essential to incorporate rehabilitation plans into residents' daily activities and encourage their active participation, as this promotes improved physical function and enhances their overall quality of life.
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Affiliation(s)
- Shu-Ting Chuang
- Department of Nursing, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung City 427213, Taiwan;
- Department of Nursing, Tzu Chi University of Science and Technology, Hualien 970046, Taiwan
- Taichung Tzu Chi Nursing Home, Buddhist Tzu Chi Medical Foundation, Taichung City 427213, Taiwan; (C.-M.C.); (Y.-R.L.)
| | - Mei-Hui Lin
- Department of Accounting Information, Da-Yeh University, Changhua 515006, Taiwan;
| | - Honda Hsu
- Division of Plastic Surgery, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi City 622007, Taiwan;
- School of Medicine, Tzu Chi University, Hualien 970374, Taiwan
| | - Chia-Ming Chi
- Taichung Tzu Chi Nursing Home, Buddhist Tzu Chi Medical Foundation, Taichung City 427213, Taiwan; (C.-M.C.); (Y.-R.L.)
- Ph.D. Program in Healthcare Science, China Medical University, Taichung City 406040, Taiwan
| | - Yu-Ru Lee
- Taichung Tzu Chi Nursing Home, Buddhist Tzu Chi Medical Foundation, Taichung City 427213, Taiwan; (C.-M.C.); (Y.-R.L.)
| | - Ya-Hui Yen
- Department of Nursing, National Chi Nan University, Puli Township 545301, Taiwan
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10
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Landelle C, Birgand G, Price JR, Mutters NT, Morgan DJ, Lucet JC, Kerneis S, Zingg W. Considerations for de-escalating universal masking in healthcare centers. ANTIMICROBIAL STEWARDSHIP & HEALTHCARE EPIDEMIOLOGY : ASHE 2023; 3:e128. [PMID: 37592969 PMCID: PMC10428150 DOI: 10.1017/ash.2023.200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 05/10/2023] [Accepted: 05/10/2023] [Indexed: 08/19/2023]
Abstract
Three years after the beginning of the COVID-19 pandemic, better knowledge on the transmission of respiratory viral infections (RVI) including the contribution of asymptomatic infections encouraged most healthcare centers to implement universal masking. The evolution of the SARS-CoV-2 epidemiology and improved immunization of the population call for the infection and prevention control community to revisit the masking strategy in healthcare. In this narrative review, we consider factors for de-escalating universal masking in healthcare centers, addressing compliance with the mask policy, local epidemiology, the level of protection provided by medical face masks, the consequences of absenteeism and presenteeism, as well as logistics, costs, and ecological impact. Most current national and international guidelines for mask use are based on the level of community transmission of SARS-CoV-2. Actions are now required to refine future recommendations, such as establishing a list of the most relevant RVI to consider, implement reliable local RVI surveillance, and define thresholds for activating masking strategies. Considering the epidemiological context (measured via sentinel networks or wastewater analysis), and, if not available, considering a time period (winter season) may guide to three gradual levels of masking: (i) standard and transmission-based precautions and respiratory etiquette, (ii) systematic face mask wearing when in direct contact with patients, and (iii) universal masking. Cost-effectiveness analysis of the different strategies is warranted in the coming years. Masking is just one element to be considered along with other preventive measures such as staff and patient immunization, and efficient ventilation.
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Affiliation(s)
- Caroline Landelle
- University of Grenoble Alpes, CNRS, UMR 5525, Grenoble INP, CHU Grenoble Alpes, Infection Prevention and Control Unit, 38000 Grenoble, France
| | - Gabriel Birgand
- National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at Imperial College London, London, UK
- Regional Center for Infection Prevention and Control Pays de la Loire, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | | | - Nico T. Mutters
- Institute for Hygiene and Public Health, University Hospital Bonn, Bonn, Germany
| | - Daniel J. Morgan
- University of Maryland School of Medicine, Baltimore, MD, USA
- VA Maryland Healthcare System, Baltimore, MD, USA
| | - Jean-Christophe Lucet
- Infection Control Unit, Hôpital Bichat-Claude Bernard, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Solen Kerneis
- Infection Control Unit, Hôpital Bichat-Claude Bernard, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Walter Zingg
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital of Zurich, Zurich, Switzerland
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11
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Widyarman AS, Roeslan MO, Dewanto I. Pre-dental treatment screening in Indonesia during the COVID-19 pandemic: a questionnaire survey of dental practitioners. BMC Oral Health 2023; 23:311. [PMID: 37217988 DOI: 10.1186/s12903-023-03004-z] [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: 12/30/2021] [Accepted: 05/02/2023] [Indexed: 05/24/2023] Open
Abstract
BACKGROUND Dental practitioners have a high risk of contracting COVID-19 during the treatment of patients because of exposure to airborne droplets. However, the application of pre-procedure treatment screening in dental practices in Indonesia varied during the pandemic. The purpose of this study was to investigate the use of updated pre-procedure dental treatment protocols and procedures among dental practitioners in Indonesia. METHODS This study consisted of dentists registered as members of the Indonesian Dental Association who attended the Indonesian Dental Association webinar series in 2021. All the participants completed a questionnaire survey. The participants, who were from various regions in Indonesia, were granted password-protected access to a URL hosting the questionnaire. The questionnaire collected demographic information and contained questions on adherence to updated protocols and patient screening procedures, to which the respondents answered "Yes" or "No". For the analysis, the participants were divided into three groups based on the type of facility where they were employed: public (government) hospitals, private hospitals, or university hospitals (dental schools). A chi-square test was used to investigate the association between professional background and the implementation of updated protocols, including pre-procedure dental treatment screening. A value of P < 0.05 was considered statistically significant. RESULTS The age range of the participants was 20 - 60 years. The participants worked in facilities in 32 provinces in Indonesia. In total, there were 5,323 participants (males: n = 829; females: n = 4,494). In terms of professional backgrounds, 2,171, 2,867, and 285 participants were employed in government hospitals, private hospitals, and dental faculties, respectively. Among 5,232 participants who implemented updated COVID-19 prevention protocols, 5,053 (98%) participants performed pre-surgery procedures Among 151 participants who did not implement updated COVID-19 prevention protocols, 133 (88%) individuals carried out pre-rinse procedures. CONCLUSIONS Almost all the dental practitioners employed in government hospitals, private hospitals, and dental faculties in Indonesia performed pre-surgery patient screening procedures. There was an agreement between the dental professionals in all three settings on the need for COVID-19 pre-treatment screening procedures in dental practices during the COVID-19 pandemic.
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Affiliation(s)
- Armelia Sari Widyarman
- Department of Microbiology, Faculty of Dentistry, Universitas Trisakti, Kyai Tapa 260, Grogol, 11440, West Jakarta, Indonesia
| | - Moehamad Orliando Roeslan
- Department of Oral Biology, Faculty of Dentistry, Universitas Trisakti , Kyai Tapa 260, Grogol, 11440, West Jakarta, Indonesia.
| | - Iwan Dewanto
- Faculty of Medical and Health Science, School of Dentistry, University Muhammadiyah Yogyakarta, Bantul, 55183, Indonesia
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Tandjaoui-Lambiotte Y, Lomont A, Moenne-Locoz P, Seytre D, Zahar JR. Spread of viruses, which measures are the most apt to control COVID-19? Infect Dis Now 2023; 53:104637. [PMID: 36526247 PMCID: PMC9746078 DOI: 10.1016/j.idnow.2022.12.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 11/22/2022] [Accepted: 12/06/2022] [Indexed: 12/15/2022]
Abstract
The persistent debate about the modes of transmission of SARS-CoV2 and preventive measures has illustrated the limits of our knowledge regarding the measures to be implemented in the face of viral risk. Past and present (pandemic-related) scientific data underline the complexity of the phenomenon and its variability over time. Several factors contribute to the risk of transmission, starting with incidence in the general population (i.e., colonization pressure) and herd immunity. Other major factors include intensity of symptoms, interactions with the reservoir (proximity and duration of contact), the specific characteristics of the virus(es) involved, and a number of unpredictable elements (humidity, temperature, ventilation…). In this review, we will emphasize the difficulty of "standardizing" the situations that might explain the discrepancies found in the literature. We will show that the airborne route remains the main mode of transmission. Regarding preventive measures of prevention, while vaccination remains the cornerstone of the fight against viral outbreaks, we will remind the reader that wearing a mask is the main barrier measure and that the choice of type of mask depends on the risk situations. Finally, we believe that the recent pandemic should induce us in the future to modify our recommendations by adapting our measures in hospitals, not to the pathogen concerned, which is currently the case, but rather to the type of at-risk situation.
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Affiliation(s)
- Y Tandjaoui-Lambiotte
- Service de Pneumologie-Infectiologie, CH Saint Denis, 2 rue Dr. Delafontaine, 93200, France
| | - A Lomont
- Unité de Prévention du Risque Infectieux, Service de microbiologie clinique, GHU Paris Seine Saint-Denis, Université Sorbonne Paris Nord, France
| | - P Moenne-Locoz
- Unité de Prévention du Risque Infectieux, Service de microbiologie clinique, GHU Paris Seine Saint-Denis, Université Sorbonne Paris Nord, France
| | - D Seytre
- Unité de Prévention du Risque Infectieux, Service de microbiologie clinique, GHU Paris Seine Saint-Denis, Université Sorbonne Paris Nord, France
| | - J R Zahar
- Unité de Prévention du Risque Infectieux, Service de microbiologie clinique, GHU Paris Seine Saint-Denis, Université Sorbonne Paris Nord, France.
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McMichael TM, Duca LM, Lewis J, Riedo FX, Wilde N, McDonald M, Spitters C, Wechkin HA. Use of standard, contact, and droplet precautions with eye protection for the prevention of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) transmission among home healthcare personnel in hospice and home healthcare settings-King and Snohomish counties, Washington, February-October 2020. Infect Control Hosp Epidemiol 2023; 44:510-513. [PMID: 35264278 PMCID: PMC10503311 DOI: 10.1017/ice.2021.499] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Among EvergreenHealth Home Care Service professionals, no coronavirus disease 2019 (COVID-19) cases were reported when they were instructed to use standard, contact, and droplet precautions with eye protection while providing home health care to patients diagnosed with laboratory-confirmed severe acute respiratory coronavirus virus 2 (SARS-CoV-2). These precautions might provide some level of protection against coronavirus disease 2019 (COVID-19) among home healthcare personnel.
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Affiliation(s)
- Temet M. McMichael
- Public Health—Seattle and King County, Seattle, Washington
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lindsey M. Duca
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - James Lewis
- Public Health—Seattle and King County, Seattle, Washington
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14
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Jefferson T, Dooley L, Ferroni E, Al-Ansary LA, van Driel ML, Bawazeer GA, Jones MA, Hoffmann TC, Clark J, Beller EM, Glasziou PP, Conly JM. Physical interventions to interrupt or reduce the spread of respiratory viruses. Cochrane Database Syst Rev 2023; 1:CD006207. [PMID: 36715243 PMCID: PMC9885521 DOI: 10.1002/14651858.cd006207.pub6] [Citation(s) in RCA: 47] [Impact Index Per Article: 47.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Viral epidemics or pandemics of acute respiratory infections (ARIs) pose a global threat. Examples are influenza (H1N1) caused by the H1N1pdm09 virus in 2009, severe acute respiratory syndrome (SARS) in 2003, and coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 in 2019. Antiviral drugs and vaccines may be insufficient to prevent their spread. This is an update of a Cochrane Review last published in 2020. We include results from studies from the current COVID-19 pandemic. OBJECTIVES To assess the effectiveness of physical interventions to interrupt or reduce the spread of acute respiratory viruses. SEARCH METHODS We searched CENTRAL, PubMed, Embase, CINAHL, and two trials registers in October 2022, with backwards and forwards citation analysis on the new studies. SELECTION CRITERIA We included randomised controlled trials (RCTs) and cluster-RCTs investigating physical interventions (screening at entry ports, isolation, quarantine, physical distancing, personal protection, hand hygiene, face masks, glasses, and gargling) to prevent respiratory virus transmission. DATA COLLECTION AND ANALYSIS: We used standard Cochrane methodological procedures. MAIN RESULTS We included 11 new RCTs and cluster-RCTs (610,872 participants) in this update, bringing the total number of RCTs to 78. Six of the new trials were conducted during the COVID-19 pandemic; two from Mexico, and one each from Denmark, Bangladesh, England, and Norway. We identified four ongoing studies, of which one is completed, but unreported, evaluating masks concurrent with the COVID-19 pandemic. Many studies were conducted during non-epidemic influenza periods. Several were conducted during the 2009 H1N1 influenza pandemic, and others in epidemic influenza seasons up to 2016. Therefore, many studies were conducted in the context of lower respiratory viral circulation and transmission compared to COVID-19. The included studies were conducted in heterogeneous settings, ranging from suburban schools to hospital wards in high-income countries; crowded inner city settings in low-income countries; and an immigrant neighbourhood in a high-income country. Adherence with interventions was low in many studies. The risk of bias for the RCTs and cluster-RCTs was mostly high or unclear. Medical/surgical masks compared to no masks We included 12 trials (10 cluster-RCTs) comparing medical/surgical masks versus no masks to prevent the spread of viral respiratory illness (two trials with healthcare workers and 10 in the community). Wearing masks in the community probably makes little or no difference to the outcome of influenza-like illness (ILI)/COVID-19 like illness compared to not wearing masks (risk ratio (RR) 0.95, 95% confidence interval (CI) 0.84 to 1.09; 9 trials, 276,917 participants; moderate-certainty evidence. Wearing masks in the community probably makes little or no difference to the outcome of laboratory-confirmed influenza/SARS-CoV-2 compared to not wearing masks (RR 1.01, 95% CI 0.72 to 1.42; 6 trials, 13,919 participants; moderate-certainty evidence). Harms were rarely measured and poorly reported (very low-certainty evidence). N95/P2 respirators compared to medical/surgical masks We pooled trials comparing N95/P2 respirators with medical/surgical masks (four in healthcare settings and one in a household setting). We are very uncertain on the effects of N95/P2 respirators compared with medical/surgical masks on the outcome of clinical respiratory illness (RR 0.70, 95% CI 0.45 to 1.10; 3 trials, 7779 participants; very low-certainty evidence). N95/P2 respirators compared with medical/surgical masks may be effective for ILI (RR 0.82, 95% CI 0.66 to 1.03; 5 trials, 8407 participants; low-certainty evidence). Evidence is limited by imprecision and heterogeneity for these subjective outcomes. The use of a N95/P2 respirators compared to medical/surgical masks probably makes little or no difference for the objective and more precise outcome of laboratory-confirmed influenza infection (RR 1.10, 95% CI 0.90 to 1.34; 5 trials, 8407 participants; moderate-certainty evidence). Restricting pooling to healthcare workers made no difference to the overall findings. Harms were poorly measured and reported, but discomfort wearing medical/surgical masks or N95/P2 respirators was mentioned in several studies (very low-certainty evidence). One previously reported ongoing RCT has now been published and observed that medical/surgical masks were non-inferior to N95 respirators in a large study of 1009 healthcare workers in four countries providing direct care to COVID-19 patients. Hand hygiene compared to control Nineteen trials compared hand hygiene interventions with controls with sufficient data to include in meta-analyses. Settings included schools, childcare centres and homes. Comparing hand hygiene interventions with controls (i.e. no intervention), there was a 14% relative reduction in the number of people with ARIs in the hand hygiene group (RR 0.86, 95% CI 0.81 to 0.90; 9 trials, 52,105 participants; moderate-certainty evidence), suggesting a probable benefit. In absolute terms this benefit would result in a reduction from 380 events per 1000 people to 327 per 1000 people (95% CI 308 to 342). When considering the more strictly defined outcomes of ILI and laboratory-confirmed influenza, the estimates of effect for ILI (RR 0.94, 95% CI 0.81 to 1.09; 11 trials, 34,503 participants; low-certainty evidence), and laboratory-confirmed influenza (RR 0.91, 95% CI 0.63 to 1.30; 8 trials, 8332 participants; low-certainty evidence), suggest the intervention made little or no difference. We pooled 19 trials (71, 210 participants) for the composite outcome of ARI or ILI or influenza, with each study only contributing once and the most comprehensive outcome reported. Pooled data showed that hand hygiene may be beneficial with an 11% relative reduction of respiratory illness (RR 0.89, 95% CI 0.83 to 0.94; low-certainty evidence), but with high heterogeneity. In absolute terms this benefit would result in a reduction from 200 events per 1000 people to 178 per 1000 people (95% CI 166 to 188). Few trials measured and reported harms (very low-certainty evidence). We found no RCTs on gowns and gloves, face shields, or screening at entry ports. AUTHORS' CONCLUSIONS The high risk of bias in the trials, variation in outcome measurement, and relatively low adherence with the interventions during the studies hampers drawing firm conclusions. There were additional RCTs during the pandemic related to physical interventions but a relative paucity given the importance of the question of masking and its relative effectiveness and the concomitant measures of mask adherence which would be highly relevant to the measurement of effectiveness, especially in the elderly and in young children. There is uncertainty about the effects of face masks. The low to moderate certainty of evidence means our confidence in the effect estimate is limited, and that the true effect may be different from the observed estimate of the effect. The pooled results of RCTs did not show a clear reduction in respiratory viral infection with the use of medical/surgical masks. There were no clear differences between the use of medical/surgical masks compared with N95/P2 respirators in healthcare workers when used in routine care to reduce respiratory viral infection. Hand hygiene is likely to modestly reduce the burden of respiratory illness, and although this effect was also present when ILI and laboratory-confirmed influenza were analysed separately, it was not found to be a significant difference for the latter two outcomes. Harms associated with physical interventions were under-investigated. There is a need for large, well-designed RCTs addressing the effectiveness of many of these interventions in multiple settings and populations, as well as the impact of adherence on effectiveness, especially in those most at risk of ARIs.
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Affiliation(s)
- Tom Jefferson
- Department for Continuing Education, University of Oxford, Oxford OX1 2JA, UK
| | - Liz Dooley
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Australia
| | - Eliana Ferroni
- Epidemiological System of the Veneto Region, Regional Center for Epidemiology, Veneto Region, Padova, Italy
| | - Lubna A Al-Ansary
- Department of Family and Community Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mieke L van Driel
- General Practice Clinical Unit, Faculty of Medicine, The University of Queensland, Brisbane, Australia
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Ghada A Bawazeer
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Mark A Jones
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Australia
| | - Tammy C Hoffmann
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Australia
| | - Justin Clark
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Australia
| | - Elaine M Beller
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Australia
| | - Paul P Glasziou
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Australia
| | - John M Conly
- Cumming School of Medicine, University of Calgary, Room AGW5, SSB, Foothills Medical Centre, Calgary, Canada
- O'Brien Institute for Public Health and Synder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, Canada
- Calgary Zone, Alberta Health Services, Calgary, Canada
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15
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Ibrahim AFAH, Sheikhany AR. Economic and emotional impact of COVID-19 pandemic on phoniatricians’ practice in Egypt. THE EGYPTIAN JOURNAL OF OTOLARYNGOLOGY 2022. [PMCID: PMC8852922 DOI: 10.1186/s43163-022-00217-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Abstract
Background
COVID-19 is not only a health crisis; it has the potential to create devastating social, as well as economic crises. Health care practitioners are the category with the highest diffusion of the contagion. The aim was to determine the economic and emotional impact of the COVID-19 pandemic on phoniatricians in Egypt in an attempt to analyze this data to determine the magnitude of this effect and if it is age and/or location specific.
Subjects and methods
An online structured Google-free form survey composed of 49 questions was created and sent online to phoniatricians all over Egypt. The survey was divided into three sections about demographic, economical then emotional-related questions. The studied group was further subdivided into 2 groups according to age and location for comparison purposes.
Results
82.5% of phoniatricians confirmed that the pandemic had a lot of negative impact on their practice. About 37.5% reduced their practices to urgent procedures and the same percentage closed their practice. The expenses of 56.3% exceeded their income. 91.2% had negative feelings when thinking about the pandemic. The economic problems have affected 71.3% of the participants emotionally. The pandemic had comparable negative impact on the economic and emotional aspects of both age groups. However, the younger age group suffered more from getting infected, and they thought more about career shift and was the group that needed psychological support during the pandemic. Outside Cairo organizations succeeded in providing the personal protective equipment to the phoniatricians in comparison to Cairo.
Conclusion
COVID-19 had a negative effect on the economical and emotional aspects of Egyptian phoniatricians’ lives. The pandemic economic burden was related to quarantine period, heath problems and getting infected, family requirements, and purchasing the protective equipment. The emotional burden was related most to the pandemic hazards and financial effect on the clients and chance of losing job. Few effects were age- and location-specific.
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16
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Ratchatavech K, Techasatian L, Panombualert S, Uppala R. The Adverse and Advantage Effects of Wearing a Facemask in Thai Children: A Survey During the COVID-19 Pandemic. J Prim Care Community Health 2022; 13:21501319221131704. [PMID: 36300437 PMCID: PMC9614596 DOI: 10.1177/21501319221131704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND There is little information on facemask use during the COVID-19 pandemic in the pediatric population. This became the main purpose of the present study to investigate demographic data of facemask wearing in children, types, and length of facemask, as well as the benefits, drawbacks, and negative consequences of facemask wearing in this population. METHODS A cross-sectional study was conducted using a structured questionnaire sent via Google Forms. Caregivers for consecutive convenience were asked in the survey (parents of children under the age of 18). RESULTS A total number of 706 children were enrolled. There were 320 boys (45.33%), and 386 girls (54.67%). The children's ages range between 4 months and 18 years, with a median age of 9 years. A surgical mask (549, 77.76%) was the most frequent type of facemask in the study population, followed by a cloth mask (86, 12.18%). Facemasks have been shown to be beneficial in the pediatric population. When compared to a former time when facemasks were not used routinely, there were considerably fewer respiratory infections, reduced diarrhea symptoms, and a drop in hospital admissions. In 317 cases (44.9%), children were shown to have negative consequences from wearing facemasks. The most prevalent adverse effect observed in the study population was non-cutaneous (respiratory discomfort/breathing difficulty) which were found in 240 cases (33.99%). Double masking method (surgical + surgical) and wearing a facemask oversize revealed a higher risk in the presence of facemask adverse effects, whereas wearing a proper size facemask reduces the risk of adverse effects from facemask use in children (Adjusted OR [95% CI] = 0.55 [0.38-0.78], P .0003). CONCLUSIONS Wearing a proper-size facemask reduces the risk of adverse effects from facemask use in children. The future suggestion of an appropriate facemask size for a certain age will aid in the avoidance of facemask adverse effects in the pediatric population.
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Affiliation(s)
| | - Leelawadee Techasatian
- Khon Kaen University, Khon Kaen,
Thailand,Leelawadee Techasatian, Dermatology
Division, Pediatric Department, Faculty of Medicine, Khon Kaen University, Khon
Kaen 40000, Thailand.
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Electrospun-Based Membranes as a Key Tool to Prevent Respiratory Infections. Polymers (Basel) 2022; 14:polym14183787. [PMID: 36145931 PMCID: PMC9504510 DOI: 10.3390/polym14183787] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 08/31/2022] [Accepted: 09/06/2022] [Indexed: 11/24/2022] Open
Abstract
The use of electrospun meshes has been proposed as highly efficient protective equipment to prevent respiratory infections. Those infections can result from the activity of micro-organisms and other small dust particles, such as those resulting from air pollution, that impair the respiratory tract, induce cellular damage and compromise breathing capacity. Therefore, electrospun meshes can contribute to promoting air-breathing quality and controlling the spread of such epidemic-disrupting agents due to their intrinsic characteristics, namely, low pore size, and high porosity and surface area. In this review, the mechanisms behind the pathogenesis of several stressors of the respiratory system are covered as well as the strategies adopted to inhibit their action. The main goal is to discuss the performance of antimicrobial electrospun nanofibers by comparing the results already reported in the literature. Further, the main aspects of the certification of filtering systems are highlighted, and the expected technology developments in the industry are also discussed.
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18
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Rosa N, Jordão M, Costa J, Gaspar A, Martinho N, Gameiro Lopes A, Panão M, Gameiro da Silva M. Experimental and numerical evaluation of a new visor concept with aerodynamic sealing to protect medical professionals from contaminated droplets and aerosols. INDOOR AIR 2022; 32:e13114. [PMID: 36168222 PMCID: PMC9538746 DOI: 10.1111/ina.13114] [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: 04/04/2022] [Revised: 07/25/2022] [Accepted: 08/31/2022] [Indexed: 06/16/2023]
Abstract
The fast spreading of the SARS-CoV-2 virus led to a significant increase in the demand for personal protective equipment (PPE). Healthcare professionals, mainly dentists, work near the patients, increasing their risk of infection. This paper investigates the effectiveness of an air-curtain sealing effect in a newly designed visor developed to reduce the risk of contracting a respiratory infection. This PPE was developed by computational fluid dynamics (CFD) modeling. CFD results show that the aerodynamic sealing in this PPE device effectively protects the user's face by 43% from a contaminated environment. The experiments considered two different tests: one using a tracer gas (CO2 ) to simulate a gaseous contaminant inside and outside the PPE face shield and a second test using smoke to simulate aerosol transport and evaluate the PPE efficiency. The particle concentration within the aerodynamically sealed PPE was evaluated and compared with the protection efficiency of other PPE. Results show similar protection levels for particles in the 1-5 μm range between the prototype and a KN95 respirator. The combined use of this novel PPE with aerodynamic sealing and a physical mask (KN95 or surgical) produced protection efficiency values within the range of 57%-70% for particles greater than 0.5 μm. This study reveals the potential of using an air curtain combined with a face shield to reduce the risks from contaminated environments.
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Affiliation(s)
- Nuno Rosa
- Univ CoimbraADAI, Department of Mechanical EngineeringCoimbraPortugal
| | - Mário Jordão
- Univ CoimbraADAI, Department of Mechanical EngineeringCoimbraPortugal
| | - José Costa
- Univ CoimbraADAI, Department of Mechanical EngineeringCoimbraPortugal
| | - Adélio Gaspar
- Univ CoimbraADAI, Department of Mechanical EngineeringCoimbraPortugal
| | - Nuno Martinho
- Univ CoimbraADAI, Department of Mechanical EngineeringCoimbraPortugal
- Polytechnic Institute of Leiria, Department of Mechanical EngineeringLeiriaPortugal
| | | | - Miguel Panão
- Univ CoimbraADAI, Department of Mechanical EngineeringCoimbraPortugal
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19
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Effectiveness of Household Disinfection Techniques to Remove SARS-CoV-2 from Cloth Masks. Pathogens 2022; 11:pathogens11080916. [PMID: 36015037 PMCID: PMC9415727 DOI: 10.3390/pathogens11080916] [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: 07/07/2022] [Revised: 08/06/2022] [Accepted: 08/10/2022] [Indexed: 11/17/2022] Open
Abstract
To assess the efficacy of washing cloth masks, we simulated SARS-CoV-2 contamination in tricoline fabric and tested decontaminants to reduce viral particles. Viral suspensions using two variants (B.1.1.28 and P.1) were inoculated in these fabrics, and the inactivation kinetics were evaluated after washing with various household disinfection products (Soap powder, Lysoform®, Hypochlorite sodium and 70% Alcohol), rinse numbers, and exposure times. Afterward, the fabrics were washed in sterile water, and viral RNA was extracted and amplified using RT-qPCR. Finally, viral replication in cell cultures was examined. Our findings show that all biocidal treatments successfully disinfected the tissue tested. Some products showed less reduction in viral loads, such as soap powder (1.60 × 104, 1.04 × 103), soap powder and Lysoform® (1.60 × 104, 1.04 × 103), and alcohol 70% (1.02 × 103, 5.91 × 101), respectively. However, when sodium hypochlorite was used, this reduction was significantly increased (viral inactivation in 100% of the washes). After the first wash, the reduction in the number of viral particles was greater for the P.1 variant than for the B.1.1.28 variant (W = 51,759, p < 0.05). In conclusion, the role of sodium hypochlorite in cloth mask disinfection may also have implications for future health emergencies as well as recommendation by WHO.
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Use of an algorithm based on routine blood laboratory tests to exclude COVID-19 in a screening-setting of healthcare workers. PLoS One 2022; 17:e0270548. [PMID: 35763522 PMCID: PMC9239486 DOI: 10.1371/journal.pone.0270548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 06/13/2022] [Indexed: 11/19/2022] Open
Abstract
Background COVID-19 is an ongoing pandemic leading to exhaustion of the hospital care system. Our health care system has to deal with a high level of sick leave of health care workers (HCWs) with COVID-19 related complaints, in whom an infection with SARS-CoV-2 has to be ruled out before they can return back to work. The aim of the present study is to investigate if the recently described CoLab-algorithm can be used to exclude COVID-19 in a screening setting of HCWs. Methods In the period from January 2021 till March 2021, HCWs with COVID-19-related complaints were prospectively collected and included in this study. Next to the routinely performed SARS-CoV-2 RT-PCR, using a set of naso- and oropharyngeal swab samples, two blood tubes (one EDTA- and one heparin-tube) were drawn for analysing the 10 laboratory parameters required for running the CoLab-algorithm. Results In total, 726 HCWs with a complete CoLab-laboratory panel were included in this study. In this group, 684 HCWs were tested SARS-CoV-2 RT-PCR negative and 42 cases RT-PCR positive. ROC curve analysis showed an area under the curve (AUC) of 0.853 (95% CI: 0.801–0.904). At a safe cut-off value for excluding COVID-19 of -6.525, the sensitivity was 100% with a specificity of 34% (95% CI: 21 to 49%). No SARS-CoV-2 RT-PCR cases were missed with this cut-off and COVID-19 could be safely ruled out in more than one third of HCWs. Conclusion The CoLab-score is an easy and reliable algorithm that can be used for screening HCWs with COVID-19 related complaints. A major advantage of this approach is that the results of the score are available within 1 hour after collecting the samples. This results in a faster return to labour process of a large part of the COVID-19 negative HCWs (34%), next to a reduction in RT-PCR tests (reagents and labour costs) that can be saved.
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21
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Abstract
PURPOSE To evaluate the effect of wearing facemasks on dry eye symptoms and on the tear film while comparing surgical face masks to N95 particulate respirators. METHODS A prospective observational study was conducted at Ain Shams University Hospitals in the period from September 2020 to January 2021. Two hundred volunteers were recruited, and the daily number of hours spent by each participant wearing a facemask was recorded. Recruits were divided into two groups: 100 volunteers were allocated to Group A to use the surgical mask, and 100 participants to Group B to use the N95 particulate respirator. The tear film parameters were assessed at baseline by answering the Ocular Surface Disease Index (OSDI) questionnaire and performing tear break-up time (TBUT), corneal fluorescein staining, and Schirmer-I test Subjects then wore a facemask for 60 min and then the tear film parameters were reassessed by repeating TBUT, corneal staining and Schirmer-I test. RESULTS Facemask use for 60 min significantly worsened all tear film parameters in both groups (P-value <0.0001). The deterioration was significantly larger in Group A subjects (P < 0.0001). The daily number of hours spent wearing a facemask correlated strongly with the OSDI and corneal staining. There was a strong negative correlation between the daily number of hours spent wearing a facemask and Schirmer test, and a weak negative correlation with TBUT. CONCLUSIONS Wearing facemasks during the COVID-19 pandemic is a risk factor for worsening tear film parameters. This deterioration is significantly greater with surgical masks than with N95 particulate respirators and increases with the duration of facemask use.
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Affiliation(s)
- Hisham Samy Shalaby
- Department of Ophthalmology, Faculty of Medicine, Ain Shams University, Cairo, Egypt,Hisham Samy Shalaby, Department of Ophthalmology, Faculty of Medicine, Ain Shams University, Abbassia square, Cairo, Egypt.
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22
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Liu N, Ye M, Zhu Q, Chen D, Xu M, He J, Li Q, Li J. Adverse Reactions to Facemasks in Health-Care Workers: A Cross-Sectional Survey. Clin Cosmet Investig Dermatol 2022; 15:947-954. [PMID: 35642175 PMCID: PMC9148581 DOI: 10.2147/ccid.s365390] [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: 03/16/2022] [Accepted: 05/17/2022] [Indexed: 11/23/2022]
Abstract
Background Coronavirus disease 2019 (COVID-19) has developed into a worldwide pandemic, which presents several challenges for frontline health-care workers (HCWs). HCWs are highly prone to various skin diseases due to prolonged use of personal protective equipment (PPE). The most frequently used type of PPE is facemasks. To effectively control adverse skin reactions, there is an urgent need for a range of preventive practices. Methods This cross-sectional study was conducted at 12 hospitals in Zhejiang province, China. HCWs were invited to participate in the web survey. Data were extracted by two independent reviewers using a predesigned data collection form and analyzed with SPSS 20.0. Results A total of 1147 questionnaires were collected, and of these, 1090 (95.03%) were valid and returned. The incidence of chest tightness and shortness of breath and face eczema was significantly higher in HCWs wearing N95 facemasks (41.91%; 31.62%) than in the HCWs wearing medical facemasks (38.05%, P = 0.010; 21.91%, P = 0.012). The incidence of ear pain and indentation was significantly higher in HCWs wearing hang-facemasks (83.81%) than in HCWs wearing strains-facemasks (61.19%, P < 0.001). The incidence of ear pain and indentation was significantly higher in HCWs wearing undiscriminating size code facemasks (79.88%) than in the HCWs wearing discriminating size code facemasks (67.86%, P = 0.031). There was a significant reduction (P < 0.001) in the incidence of HCWs without adverse reactions (ADRs) with increasing time wearing facemasks. Conclusion Incidence of ADRs does not significantly increase with the durations of mask wear where wearing mask time exceeded 4 hours per day. The medical staff generally wore masks for more than 4 hours per day; therefore, we recommend taking 15 min of rest after 2 hours of mask-wearing. Results in this study support the conclusion that the type of strain-facemasks and discriminating size code facemasks has a lower incidence of ADRs than other type of medical facemasks.
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Affiliation(s)
- Ning Liu
- Outpatient Department, Zhejiang Rongjun Hospital, Jiaxing, Zhejiang Province, 314000, People's Republic of China
| | - Min Ye
- Nursing Department, Zhejiang Rongjun Hospital, Jiaxing, Zhejiang Province, 314000, People's Republic of China
| | - Qinya Zhu
- Nursing Department, Zhejiang Rongjun Hospital, Jiaxing, Zhejiang Province, 314000, People's Republic of China
| | - Dingchao Chen
- Medical Department, Zhejiang Rongjun Hospital, Jiaxing, Zhejiang Province, 314000, People's Republic of China
| | - Mingmin Xu
- Ultrasonic Department, Zhejiang Rongjun Hospital, Jiaxing, Zhejiang Province, 314000, People's Republic of China
| | - Jia He
- Department of Urology, Zhejiang Rongjun Hospital, Jiaxing, Zhejiang Province, 314000, People's Republic of China
| | - Qian Li
- Ultrasonic Department, Zhejiang Rongjun Hospital, Jiaxing, Zhejiang Province, 314000, People's Republic of China
| | - Jie Li
- The Health Administration Center, Zhejiang Rongjun Hospital, Jiaxing, Zhejiang Province, 314000, People's Republic of China
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23
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Hassa E, Alıç T. An Evaluation of the Effect of the Use of N95 Respirators by Surgical Teams on Early Surgical Site Infections in Orthopedic Cases. Cureus 2022; 14:e25138. [PMID: 35747035 PMCID: PMC9206446 DOI: 10.7759/cureus.25138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/19/2022] [Indexed: 11/13/2022] Open
Abstract
Background Surgical site infections (SSIs) are seen in the postoperative period in orthopedic and traumatology clinics. Just as in all surgical clinics, SSIs lead to patient dissatisfaction with the results, prolong the length of stay in the hospital, and increase treatment costs. SSIs are known to occur as a result of wound contamination through inoculation of microorganisms found mainly in the air or in the surgical area. Because of the coronavirus disease 2019 pandemic, N95 masks have been widely used in the operating rooms of our hospital by nurses, residents, and surgeons since March 2020. This study aims to evaluate the effect of N95 respirator use by the surgical team on SSIs determined in patients operated on in our clinic compared to surgical mask use. Methodology In this retrospective study, the use of N95 respirators by the surgical team was compared with the use of surgical masks to evaluate the effect on SSIs in patients operated on in our clinic. Two groups were formed of patients operated on by the surgical team wearing surgical masks between February 2019 and February 2020 and those operated on with the surgical team using N95 respirators between March 2020 and March 2021. Each patient was diagnosed with postoperative SSIs by two different surgeons in the same clinic and by an infection clinic specialist based on clinical and laboratory findings. Results A total of 1,486 patients were examined; 729 patients in February 2019-February 2020 period (Group 1) and 757 in March 2020-March 2021 period (Group 2). In total, 124 and 104 patients were excluded from the first and second groups, respectively, for various reasons, including revision surgery, open fractures, diabetes, smoking, peripheral vascular disease, or other comorbidities that could affect infection rates. SSIs were determined in 35 patients in Group 1 and 13 patients in Group 2. The SSI rates in the second period in both types of procedures (arthroplasty and trauma surgeries) were determined to be significantly lower. Conclusions Because of the use of intraoperative N95 respiratory masks by surgical teams in orthopedics and traumatology procedures, the number of SSIs decreased significantly compared to the use of surgical masks.
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24
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Kunstler B, Newton S, Hill H, Ferguson J, Hore P, Mitchell BG, Dempsey K, Stewardson AJ, Friedman D, Cole K, Sim MR, Ferguson B, Burns P, King N, McGloughlin S, Dicks M, McCarthy S, Tam B, Hazelton B, McGurgan C, McDonald S, Turner T. P2/N95 respirators & surgical masks to prevent SARS-CoV-2 infection: Effectiveness & adverse effects. Infect Dis Health 2022; 27:81-95. [PMID: 35151628 PMCID: PMC8769935 DOI: 10.1016/j.idh.2022.01.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 01/03/2022] [Accepted: 01/05/2022] [Indexed: 12/19/2022]
Abstract
BACKGROUND Millions of people have acquired and died from SARS-CoV-2 infection during the COVID-19 pandemic. Healthcare workers (HCWs) are required to wear personal protective equipment (PPE), including surgical masks and P2/N95 respirators, to prevent infection while treating patients. However, the comparative effectiveness of respirators and masks in preventing SARS-CoV-2 infection and the likelihood of experiencing adverse events (AEs) with wear are unclear. METHODS Searches were carried out in PubMed, Europe PMC and the Cochrane COVID-19 Study Register to 14 June 2021. A systematic review of comparative epidemiological studies examining SARS-CoV-2 infection or AE incidence in HCWs wearing P2/N95 (or equivalent) respirators and surgical masks was performed. Article screening, risk of bias assessment and data extraction were duplicated. Meta-analysis of extracted data was carried out in RevMan. RESULTS Twenty-one studies were included, with most having high risk of bias. There was no statistically significant difference in respirator or surgical mask effectiveness in preventing SARS-CoV-2 infection (OR 0.85, [95%CI 0.72, 1.01]). Healthcare workers experienced significantly more headaches (OR 2.62, [95%CI 1.18, 5.81]), respiratory distress (OR 4.21, [95%CI 1.46, 12.13]), facial irritation (OR 1.80, [95%CI 1.03, 3.14]) and pressure-related injuries (OR 4.39, [95%CI 2.37, 8.15]) when wearing respirators compared to surgical masks. CONCLUSION The existing epidemiological evidence does not enable definitive assessment of the effectiveness of respirators compared to surgical masks in preventing infection. Healthcare workers wearing respirators may be more likely to experience AEs. Effective mitigation strategies are important to ensure the uptake and correct use of respirators by HCWs.
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Affiliation(s)
- Breanne Kunstler
- BehaviourWorks Australia, Monash Sustainable Development Institute, Monash University, 8 Scenic Boulevard, Clayton, Melbourne, VIC, 3800, Australia.
| | - Skye Newton
- Adelaide Health Technology Assessment (AHTA), School of Public Health, University of Adelaide, Australia
| | - Hayley Hill
- Adelaide Health Technology Assessment (AHTA), School of Public Health, University of Adelaide, Australia
| | - John Ferguson
- Division of Medicine, John Hunter Hospital, Newcastle Regional Mail Centre, NSW, 2310, Australia
| | - Phillipa Hore
- Department of Anaesthesia and Acute Pain Medicine, St Vincent's Hospital, Victoria Parade, Fitzroy, VIC, 3065, Australia
| | - Brett G. Mitchell
- The University of Newcastle, School of Nursing and Midwifery, Level 9, 77a Holden St, Gosford Hospital, Gosford, NSW, Australia, 2250
| | - Kathy Dempsey
- The Clinical Excellence Commission, 1 Reserve Road, St Leonards, NSW, Australia, 2065
| | - Andrew J. Stewardson
- Department of Infectious Diseases, The Alfred and Central Clinical School, Monash University, 85 Commercial Rd, Melbourne, VIC, Australia, 3004
| | - Deborah Friedman
- Deputy Chief Health Officer, Victorian Department of Health Melbourne, VIC, Australia, 3004
| | - Kate Cole
- Cole Health Pty Ltd, Balmain, NSW, Australia, 2041
| | - Malcolm R. Sim
- Monash Centre for Occupational & Environmental Health (MonCOEH), School of Public Health & Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, 553 St Kilda Rd, Melbourne, VIC, Australia, 3004
| | - Bridget Ferguson
- Central Queensland University, School of Nursing, Midwifery and Social Sciences; 554-700 Yaamba Rd, Norman Gardens, QLD, 4701, Australia
| | - Penelope Burns
- Academic Unit of General Practice, ANU Medical School, The Australian National University, Building 4, Hospital Road, Garran, ACT, 2605, Australia
| | - Nicole King
- North Shore Private Hospital, 3 Westbourne St, St Leonard's, 2065, Australia
| | - Steven McGloughlin
- Alfred Health and School of Public Health and Preventive Medicine, Monash University, Level 4, 553 St Kilda Road, Melbourne, VIC, Australia, 3004
| | - Melanie Dicks
- Ernst & Young, 121 Marcus Clarke Street, Canberra, ACT, Australia, 2601
| | - Sally McCarthy
- Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Barry Tam
- Health Infrastructure NSW, 60 Day Road, Cheltenham, NSW, 2119, Australia
| | - Briony Hazelton
- PathWest Laboratory Medicine, QEII Medical Centre, Hospital Avenue, Nedlands, WA, Australia, 6009
| | - Cherylynn McGurgan
- Royal Melbourne Hospital Emergency Department, 300 Grattan Street, Parkville, VIC, Australia, 3050
| | - Steve McDonald
- Cochrane Australia, School of Public Health and Preventive Medicine, Monash University, Level 4, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Tari Turner
- Cochrane Australia, School of Public Health and Preventive Medicine, Monash University, Level 4, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
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25
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Ashour DM, Elkitkat RS, Gabr H, Yosef M, Singh Grewal D, Saleh MI. Challenges of personal protective equipment use among ophthalmologists during the COVID-19 pandemic: A multicenter international study. Eur J Ophthalmol 2022; 32:1398-1405. [PMID: 34180262 PMCID: PMC9111902 DOI: 10.1177/11206721211028037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 06/05/2021] [Indexed: 01/03/2023]
Abstract
PURPOSE To explore the possible challenges and difficulties of using Personal Protective Equipment (PPE) in ophthalmic practice during the Coronavirus disease 2019 (COVID-19) pandemic. METHODS This is a multicenter, international survey among practicing ophthalmologists across different countries. The survey was conducted from September 9th to October 24th, 2020. It included a total of 23 questions that navigated through the currently adopted recommendations in different clinical situations. The survey also assessed the convenience of using various PPE in ophthalmic practice and addressed the clarity of the examination field while using various PPE during clinical or surgical procedures. RESULTS One hundred and seventy-two ophthalmologists completed the survey (101 from Egypt, 50 from the USA, and 21 from four other countries). The analysis of the responses showed that most ophthalmologists use face masks without significant problems during their examinations, while face shields followed by protective goggles were the most inconvenient PPE in the current ophthalmic practice. Moreover, most of the participants (133, 77.3%) noticed an increase in their examination time when using PPE. Furthermore, a considerable percentage of the respondents (70, 40.7%) stopped using one or more of the PPE due to inconvenience or discomfort. CONCLUSIONS Due to the unique nature of the ophthalmic examination, certain PPE are not ophthalmologist-friendly. Innovative PPE should be tailored for prompt, more convenient, and clearer ophthalmological practice.
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Affiliation(s)
- Doaa Maamoun Ashour
- Department of Ophthalmology, Faculty of
Medicine, Ain Shams University, Cairo, Egypt
| | - Rania Serag Elkitkat
- Department of Ophthalmology, Faculty of
Medicine, Ain Shams University, Cairo, Egypt
- Watany Eye Hospital, Cairo, Egypt
- Watany Research and Development Center,
Cairo, Egypt
| | - Hesham Gabr
- Department of Ophthalmology, Faculty of
Medicine, Ain Shams University, Cairo, Egypt
- Department of Ophthalmology, Duke
University, Durham, NC, USA
| | - Mostafa Yosef
- Department of Community, Environmental
and Occupational Medicine, Ain Shams University, Cairo, Egypt
| | | | - Mohamed Ibrahim Saleh
- Department of Ophthalmology, Faculty of
Medicine, Ain Shams University, Cairo, Egypt
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26
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Chen Y, Wang Y, Quan N, Yang J, Wu Y. Associations Between Wearing Masks and Respiratory Viral Infections: A Meta-Analysis and Systematic Review. Front Public Health 2022; 10:874693. [PMID: 35570912 PMCID: PMC9092448 DOI: 10.3389/fpubh.2022.874693] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 03/30/2022] [Indexed: 11/13/2022] Open
Abstract
Background Respiratory viral infections (RVIs) are a major health concern, and some previous studies have shown that wearing masks was effective in preventing RVIs, while others failed to show such effect. Therefore, a systematic review and meta-analysis was conducted to investigate the effectiveness of wearing masks. Methods PubMed, ScienceDirect, Web of Science, the Cochrane Library, EMBASE, MEDLINE, China National Knowledge Infrastructure (CNKI), and Chinese Scientific Journal Database (VIP database) were searched for studies evaluating the effectiveness of wearing masks. The risk ratio (RR) was used to measure the effectiveness of wearing masks in preventing RVIs for randomized controlled trials (RCTs) and cohort studies, and the odds ratio (OR) was used for case-control studies. Forest plots were used to visually assess pooled estimates and corresponding 95% CIs. The I2 test was used to examine the heterogeneity, and subgroup analysis was used to explore the possible explanations for heterogeneity or compare the results between subgroups. Sensitivity analysis was conducted to assess robustness of the synthesized results. Begg's test and Egger's test were used to assess the publications bias. Results Thirty-one studies (13,329 participants) were eligible for meta-analyses. Overall, the results showed that wearing masks was effective in preventing RVIs. The sensitivity analysis showed that the results of those meta-analyses were robust and reliable. There was no significant publication bias in meta-analysis of case-control studies and most subgroup analyses. Conclusions Wearing masks might be effective in preventing RVIs. To reduce their RVI risk, people should wear masks when they go out in public. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42021296092.
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Affiliation(s)
- Yiming Chen
- Department of Epidemiology and Health Statistics, School of Public Health, Faculty of Medicine, Hangzhou Normal University, Hangzhou, China
| | - Yuelin Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Faculty of Medicine, Hangzhou Normal University, Hangzhou, China
| | - Ningbin Quan
- Department of Epidemiology and Health Statistics, School of Public Health, Faculty of Medicine, Hangzhou Normal University, Hangzhou, China
| | - Jun Yang
- Department of Nutrition and Toxicology, School of Public Health, Faculty of Medicine, Hangzhou Normal University, Hangzhou, China
- National Key Laboratory for the Diagnosis and Treatment for Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yinyin Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Faculty of Medicine, Hangzhou Normal University, Hangzhou, China
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27
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Aljaroudi ME, Alghamdi SK, Al Salman BA, Alabdulghani MJ. Liver and Gastrointestinal Involvement in Patients With COVID-19: A Retrospective Study. Cureus 2022; 14:e24580. [PMID: 35664387 PMCID: PMC9152160 DOI: 10.7759/cureus.24580] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2022] [Indexed: 12/12/2022] Open
Abstract
Background Coronavirus disease 2019 (COVID-19) classically presents as a respiratory illness with fever, dry cough, and dyspnea on exertion. Along with respiratory signs and symptoms, gastrointestinal (GI) manifestations and liver injury have been recognized during the progression of the disease. This study aimed to determine the prevalence of GI symptoms and hepatic injury during COVID-19 infections and their consequences on the outcome of the disease. Methodology We conducted a retrospective survey of 715 participants age 16 or older diagnosed with COVID-19 and reported GI and hepatic manifestations in the Dammam Medical Complex in Dammam, Eastern Province, Saudi Arabia, from March 1, 2020, to May 31, 2020. We recorded clinical manifestations, laboratory test results, patient demographics, comorbidities, and treatments. Results The mean age of the study population was 46 years (88% were male, 12% were female), and 80% were non-Saudi. While most patients recovered and were discharged (n=603, 84.62%), 100 (13.99%) died due to COVID-19. Type 2 diabetes was present in 182 patients (79%) discharged and 45 patients (21%) who died. Hypertension was present in 26 (67%) discharged and 158 patients (81%) who died. Cardiovascular disease was present in 26 patients (67%) discharged and 13 (33%) who died. Chronic kidney disease was found in 11 patients (61%) discharged and six (33%) who died. Diarrhea was present in 11% of patients, nausea in 8%, and vomiting in 9% of patients. Twenty percent of patients had at least one GI symptom. Only 10% of those who died had GI symptoms, while 88% of those discharged had GI symptoms. Serum levels of alanine aminotransferase, aspartate aminotransferase, total bilirubin, alkaline phosphatase, and γ-glutamyl transpeptidase were generally higher in the patients who died than in those who were discharged. Conclusions We noted an increase in at least one liver enzyme with no clinically significant acute liver injury or cases of acute liver failure as sequelae of COVID-19. However, the presence of injury at the time of admission resulted in a significantly higher mortality rate. Only a small number of patients infected with COVID-19 exhibited GI manifestations. The etiology of severe acute respiratory syndrome coronavirus 2-related GI involvement is due to multiple factors. It is not yet fully understood if GI manifestations are clinical signs of high viral loads or another physiological process. The clinical manifestation and laboratory test results indicate that COVID-19 impacts the hepatic system and GI tract, indicating that COVID-19 infection may risk liver and GI tract injury.
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Affiliation(s)
- Mahdi E Aljaroudi
- Gastroenterology and Hepatology, Dammam Medical Complex, Dammam, SAU
| | | | - Balqis A Al Salman
- Gastroenterology and Hepatology, King Fahad General Hospital Hofuf, Al Ahssa, SAU
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28
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Rashid TU, Sharmeen S, Biswas S. Effectiveness of N95 Masks against SARS-CoV-2: Performance Efficiency, Concerns, and Future Directions. ACS CHEMICAL HEALTH & SAFETY 2022; 29:135-164. [PMID: 37556270 PMCID: PMC8768005 DOI: 10.1021/acs.chas.1c00016] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Indexed: 12/24/2022]
Abstract
The coronavirus disease 2019 (COVID-19) epidemic, which is caused by novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has continued to spread around the world since December 2019. Healthcare workers and other medical first responders in particular need personal protective equipment to protect their respiratory system from airborne particulates, in addition to liquid splashes to the face. N95 respirator have become a critical component for reducing SARS-CoV-2 transmission and controlling the scale of the COVID-19 pandemic. However, a major dispute concerning the protective performance of N95 respirators has erupted, with a myriad of healthcare workers affected despite wearing N95 masks. This article reviews the most recent updates about the performance of N95 respirators in protecting against the SARS-CoV-2 virus in the present pandemic situation. A brief overview of the manufacturing methods, air filtration mechanisms, stability, and reusability of the mask is provided. A detailed performance evaluation of the mask is studied from an engineering point of view. This Review also reports on a comparative study about the protective performance of all commercially available surgical and respiratory masks used to combat the spread of COVID-19. With the aim of protecting healthcare providers more efficiently, we suggest some potential directions for the development of this respiratory mask that improve the performance efficiency of the mask.
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Affiliation(s)
- Taslim Ur Rashid
- Fiber and Polymer Science, Department of Textile
Engineering, Chemistry and Science, Wilson College of Textiles, North
Carolina State University, 1020 Main Campus Drive, Raleigh, North Carolina
27695, United States
- Department of Applied Chemistry and Chemical
Engineering, Faculty of Engineering and Technology, University of
Dhaka, Dhaka 1000, Bangladesh
| | - Sadia Sharmeen
- Department of Applied Chemistry and Chemical
Engineering, Faculty of Engineering and Technology, University of
Dhaka, Dhaka 1000, Bangladesh
- Chemistry Department, University of
Nebraska−Lincoln, Lincoln, Nebraska 68588, United
States
| | - Shanta Biswas
- Department of Applied Chemistry and Chemical
Engineering, Faculty of Engineering and Technology, University of
Dhaka, Dhaka 1000, Bangladesh
- Department of Chemistry, Louisiana State
University, Baton Rouge, Louisiana 70803, United
States
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29
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Effectiveness of face masks in blocking the transmission of SARS-CoV-2: A preliminary evaluation of masks used by SARS-CoV-2-infected individuals. PLoS One 2022; 17:e0264389. [PMID: 35196363 PMCID: PMC8865648 DOI: 10.1371/journal.pone.0264389] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 02/09/2022] [Indexed: 12/18/2022] Open
Abstract
In 2019, a novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is transmitted via the airborne route, caused a new pandemic namely, “coronavirus disease 2019” (COVID-19). Although the effectiveness of face masks to prevent the transmission of SARS-CoV-2 is debated, no study has evaluated the virus-blocking efficacy of masks used by patients. We aimed to evaluate this efficacy of masks used by SARS-CoV-2-infected individuals. Data, masks used, and nasopharyngeal swab samples were obtained from these patients. Forty-five paired samples of nasopharyngeal swabs and masks were obtained and processed; the majority of masks were woven. Viral RNAs were amplified using quantitative reverse‐transcription polymerase chain reaction and detected only on the inner parts of masks. Median viral load (VL) values of swabs and masks were 1.954x106 and 2,51x103, respectively. Statistically, there was a difference of approximately 1000 RNA copies/mL between swabs and masks and no significant difference in VL values among different types of masks. There were statistically significant differences in VL values between men and women and between symptomatic and asymptomatic patients. Our findings suggest the blocking of virus transmission by different types of masks and reinforce the use of masks by both infected and non-infected individuals.
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30
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Demchenko I, Blumberger DM, Flint AJ, Anderson M, Daskalakis ZJ, Foley K, Karkouti K, Kennedy SH, Ladha KS, Robertson J, Vaisman A, Koczerginski D, Parikh SV, Bhat V. Electroconvulsive Therapy in Canada During the First Wave of COVID-19: Results of the "What Happened" National Survey. J ECT 2022; 38:52-59. [PMID: 34519681 PMCID: PMC8875437 DOI: 10.1097/yct.0000000000000801] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 06/21/2021] [Indexed: 01/09/2023]
Abstract
OBJECTIVES The COVID-19 pandemic has disrupted the provision of essential and potentially life-saving procedural treatments such as electroconvulsive therapy (ECT). We surveyed ECT providers across Canada to understand how the first wave of the pandemic affected ECT delivery between mid-March 2020 and mid-May 2020. METHODS The survey was administered to ECT team members and decision makers at 107 Canadian health care centers with a focus on 5 domains: operations, decision-making, hospital resources, ECT procedure, and patient impact. Responses were obtained from 72 institutions, and collected answers were used to derive representative responses reflecting the situation at each ECT center. For specific domains, responses were split into 2 databases representing the perspective of psychiatrists (n = 67 centers) and anesthesiologists (n = 24 centers). RESULTS Provision of ECT decreased in 64% centers and was completely suspended in 27% of centers after the onset of the pandemic. Outpatient and maintenance ECT were more affected than inpatient and acute ECT. Programs reported a high level of collaboration between psychiatry and hospital leadership (59%) but a limited input from clinical ethicists (18%). Decisions were mostly made ad hoc leading to variability across institutions in adopted resource allocation, physical location of ECT delivery, and triaging frameworks. The majority of centers considered ECT to be aerosol-generating and incorporated changes to airway management. CONCLUSIONS Electroconvulsive therapy services in Canada were markedly disrupted by the COVID-19 pandemic. The variability in decision-making across centers warrants the development of a rational approach toward offering ECT in pandemic contexts.
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Affiliation(s)
- Ilya Demchenko
- From the Interventional Psychiatry Program, Mental Health and Addictions Service, St Michael's Hospital
| | - Daniel M. Blumberger
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health
- Department of Psychiatry, University of Toronto
- Institute of Medical Science, University of Toronto
| | - Alastair J. Flint
- Department of Psychiatry, University of Toronto
- Institute of Medical Science, University of Toronto
- Centre for Mental Health, University Health Network
| | - Melanie Anderson
- Library and Information Services, University Health Network, Toronto, Ontario, Canada
| | | | - Karen Foley
- Department of Anesthesia and Pain Management, University Health Network
- Department of Anesthesiology and Pain Medicine
| | - Keyvan Karkouti
- Department of Anesthesia and Pain Management, University Health Network
- Department of Anesthesiology and Pain Medicine
- Institute of Health Policy, Management, and Evaluation, University of Toronto
| | - Sidney H. Kennedy
- From the Interventional Psychiatry Program, Mental Health and Addictions Service, St Michael's Hospital
- Department of Psychiatry, University of Toronto
- Institute of Medical Science, University of Toronto
| | - Karim S. Ladha
- Department of Anesthesiology and Pain Medicine
- Institute of Health Policy, Management, and Evaluation, University of Toronto
- Department of Anesthesia
| | - Jamie Robertson
- Centre for Clinical Ethics, St Michael's Hospital
- Dalla Lana School of Public Health, University of Toronto
| | - Alon Vaisman
- Department of Infection Prevention and Control, University Health Network
| | - David Koczerginski
- Department of Psychiatry, North York General Hospital, Toronto, Ontario, Canada
| | - Sagar V. Parikh
- Department of Psychiatry, University of Michigan, Ann Arbor, MI
| | - Venkat Bhat
- From the Interventional Psychiatry Program, Mental Health and Addictions Service, St Michael's Hospital
- Department of Psychiatry, University of Toronto
- Institute of Medical Science, University of Toronto
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Everts RJ, Al Ghusaini S, Telfar-Barnard L, Barclay E, Tan S, Jekel S, Jennings L, Choi DH, Hilson D, Gibson B. Liquid-Immersion Reprocessing Effects on Filtration Efficiency of 'Single-Use' Commercial Medical Face Masks. Ann Work Expo Health 2022; 66:246-259. [PMID: 34564717 PMCID: PMC8500144 DOI: 10.1093/annweh/wxab079] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 08/08/2021] [Accepted: 09/01/2021] [Indexed: 11/28/2022] Open
Abstract
PURPOSE Medical masks have inferior filtration efficiency and fit to filtering facepiece respirators (FFRs) but are widely used in healthcare and the community. These masks are intended for disposal after use but in the event of mask shortage re-use after reprocessing may be an option. We investigated eight reprocessing methods that each involved washing or soaking in liquid, are likely to eliminate respiratory viruses, and are safe and available in most community and healthcare settings. METHODS Three brands of EN 14683 standards-compliant commercial medical mask were each reprocessed 10 times by one of eight methods. We measured filtration efficiency for poly-dispersed sodium chloride particles and pressure differential. RESULTS Compared with new medical masks, reprocessed masks had significantly reduced filtration efficiency. The reduction was mild-moderate (6.5-25.8%) after warm water wash, hot water soak or boiling water soak; and moderate-large (24.1-51.5%) after detergent, soap or laundry machine wash, or bleach soak. There were mixed and minor changes in pressure differential. Most reprocessed standards-compliant masks had better filtration efficiency than new non-standard commercial masks and then cotton and cotton-polyester mix fabric samples, even triple-layered fabrics. CONCLUSIONS High-quality commercial medical masks reprocessed 10 times by water immersion methods had better filtration efficiency than new non-standard masks and washable fabrics. These findings have particular relevance for community and low-resource healthcare settings.
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Affiliation(s)
- Richard J Everts
- Infectious Disease Service, Nelson Bays Primary Health, 281 Queen St, Richmond, Nelson, New Zealand
| | | | - Lucy Telfar-Barnard
- Department of Public Health, University of Otago, 23a Mein St, Newton, Wellington, New Zealand
| | - Ella Barclay
- University of Otago, 2 Riccarton Ave, Christchurch, New Zealand
| | - Shaun Tan
- Lanaco, 2–4 Sultan St, Ellerslie, Auckland, New Zealand
| | - Sonja Jekel
- Lanaco, 2–4 Sultan St, Ellerslie, Auckland, New Zealand
| | - Lance Jennings
- Department of Pathology and Biomedical Sciences, University of Otago, 2 Riccarton Ave, Christchurch, New Zealand
- Canterbury Health Laboratories, Hagley Ave, Christchurch, New Zealand
| | - Dong Hoon Choi
- Biomedical Engineering Department, Nelson Hospital, Tipahi St, Nelson, New Zealand
| | - Dougal Hilson
- University of Otago, 2 Riccarton Ave, Christchurch, New Zealand
| | - Barbara Gibson
- Infection Prevention and Control Service, Nelson Hospital, Tipahi St, Nelson, New Zealand
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Ayed IIA, Khalil R, Adam I, Al-Wutayd O. Face Mask Practice and Technique During the COVID-19 Pandemic: A Nonrepresentative Cross-Sectional Study in Sudan. Patient Prefer Adherence 2022; 16:1163-1176. [PMID: 35535254 PMCID: PMC9078352 DOI: 10.2147/ppa.s366099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 04/12/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The World Health Organization issued guidelines for face mask use in community settings during the current COVID-19 pandemic. However, data are limited on public compliance with those guidelines in Sudan. Therefore, this study assessed face mask-wearing practice and technique during the COVID-19 pandemic among residents of Sudan. METHODS A cross-sectional study was conducted from July to September 2021 among Sudanese aged ≥18 years. A web-based questionnaire was shared through different social media platforms. Personal characteristics, four knowledge-associated items, three attitude-associated items, one item concerning mask-wearing practice, and five items related to mask-wearing technique were determined. Univariate, bivariate, and multivariable analyses were performed using STATA v17. RESULTS The survey included 1059 participants (48% males, 52% females) from different regions of Sudan. The overall mean ± SD was 3 ± 0.73 for knowledge of COVID-19 transmission; 2.3 ± 0.71 for attitude toward wearing face masks; 0.38 ± 0.49 for the practice of wearing a face mask; and 4.17 ± 0.97 for face mask-wearing technique. Approximately one-third (38%) of participants always wore a face mask during the pandemic, with age, sex, education level, family income, face mask attitude, occupation, and history of COVID-19 infection affecting the practice. All steps of face mask-wearing technique were performed by 46% of participants (59% performed hand hygiene before putting on a mask and 86% after removing it; 98% covered mouth and nose; 90% adjusted masks at the nose bridge, and 84% tied masks securely), and associated with age, occupation, family income, history of COVID-19 infection, and face-mask attitude. CONCLUSION Although knowledge and attitude were relatively good, the practice of wearing a face mask and using proper techniques among participants were low. To ensure optimal face mask use and proper mask-wearing techniques, educational intervention and establishing governmental regulations are highly recommended.
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Affiliation(s)
- Itimad I A Ayed
- Department of Basic Medical Sciences, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Saudi Arabia
- Department of Pharmacology, Faculty of Medicine, International University of Africa, Khartoum, Sudan
| | - Rehana Khalil
- Department of Family and Community Medicine, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Saudi Arabia
| | - Ishag Adam
- Department of Obstetrics and Gynecology, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Kingdom of Saudi Arabia
| | - Osama Al-Wutayd
- Department of Family and Community Medicine, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Saudi Arabia
- Correspondence: Osama Al-Wutayd, Email
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de Araujo CM, Guariza-Filho O, Gonçalves FM, Basso IB, Schroder AGD, Cavalcante-Leão BL, Ravazzi GC, Zeigelboim BS, Stechman-Neto J, Santos RS. Front lines of the COVID-19 pandemic: what is the effectiveness of using personal protective equipment in health service environments?-a systematic review. Int Arch Occup Environ Health 2022; 95:7-24. [PMID: 34674034 PMCID: PMC8528650 DOI: 10.1007/s00420-021-01775-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 01/08/2021] [Indexed: 01/09/2023]
Abstract
PURPOSE This systematic review aimed to evaluate the effectiveness of the use of personal protective equipment (PPE) in closed environments, similar to waiting or exam rooms of healthcare facilities, in the face of exposure to a bioaerosol. METHODS Combinations of words were selected for six electronic databases and for the gray literature. To consider the eligibility of the studies to be included/excluded, the acronym "PECOS" was used: humans and/or experimental models that simulate aerosol (Population); aerosol exposure and the use of masks/respirators (exposition/intervention); controlled or not controlled (comparison); effectiveness of PPE and the receiver exposure (outcomes); and randomized clinical studies or not, observational or laboratory simulation studies (Studies design). RESULTS A total of 4820 references were retrieved by the search strategy. Thirty-five articles were selected for complete reading, of which 13 articles were included for qualitative synthesis. A surgical mask or N95 respirator reduced the risk of transmission, even over short distances. The use of masks, even those with less filtering power, when used by all individuals in the same environment is more effective in reducing risk than the use of respirators with high filtering power for only some of the individuals present. CONCLUSION The use of mask in closed environments is effective in reducing the risk of transmission and contagion of a contaminated bioaerosol, with greater effectiveness when these devices are used by the source and receiver, regardless of the equipment's filtering power. (PROSPERO 2020 CRD 42020183759).
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Affiliation(s)
| | - Odilon Guariza-Filho
- Department of Orthodontics, School of Health and Bioscience, Pontifícia Universidade Católica do Paraná, Street Imaculada Conceição, 1155, Prado Velho, Curitiba, Paraná 80215-901 Brazil
| | - Flavio Magno Gonçalves
- Postgraduate Program in Communication Disorders, Tuiuti University of Paraná, Curitiba, Brazil
| | - Isabela Bittencourt Basso
- Postgraduate Program in Dentistry, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná Brazil
| | | | | | - Glória Cortz Ravazzi
- Postgraduate Program in Communication Disorders, Tuiuti University of Paraná, Curitiba, Brazil
| | | | - José Stechman-Neto
- Postgraduate Program in Communication Disorders, Tuiuti University of Paraná, Curitiba, Brazil
| | - Rosane Sampaio Santos
- Postgraduate Program in Communication Disorders, Tuiuti University of Paraná, Curitiba, Brazil
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Life after COVID-19: Future directions? COVID-19 PANDEMIC 2022. [PMCID: PMC8175769 DOI: 10.1016/b978-0-323-82860-4.00001-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The humans’ vulnerability and fragility have been demonstrated during pandemics, and as a community, will need proper preparation. The coronavirus outbreak was first reported at the end of 2019 and declared a pandemic by the World Health Organization. Around the world, the response to the virus outbreak has been different. The detection, traceability, and the response for different countries have been delayed, causing the overwhelming of the health systems. However, some other nations exercised various strategies to contain the infection’s dissemination and recorded a low number of cases. The different measures taken, including contact tracing, lockdown, case detection, social distancing, and quarantine strategies, helped control the disease’s spreading. Only time will tell how well the world faced the outbreak. We also suggest the future directions that the global community should take to manage and mitigate the emergency.
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Almutairi A, Kalevaru CS. Lifestyle changes of attendees at primary health care centers during the COVID-19 pandemic in Qassim Province, Saudi Arabia. J Family Med Prim Care 2021; 10:3838-3844. [PMID: 34934689 PMCID: PMC8653433 DOI: 10.4103/jfmpc.jfmpc_930_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 07/14/2021] [Accepted: 07/30/2021] [Indexed: 11/05/2022] Open
Abstract
Background: The COVID-19 pandemic has affected many individuals in the past year through increased mortality, morbidity, and economic disturbances while also affecting individual lifestyles. Healthy lifestyle practices can reduce mortality and morbidity and improve quality of life. We aimed to identify daily lifestyle changes during the COVID-19 pandemic. To do so, we examined factors related to family, livelihood, and other associated changes. Methodology: A cross-sectional study was conducted among attendees visiting selected primary health care centers of Qassim province. The data was collected through direct interview method, and 365 individuals participated during the study period. Data was entered in SPSS version 21.0, and necessary statistical tests were applied. Results: Out of 365 individuals, 27.4% were male and 72.6% were female. There was a drastic decrease in the frequency of in-person shopping (74.2%) and a steep increase in online shopping (41.4%). The mean weight increase was 4.5 (SD = 3.09) kg. Telemedicine use was 43.6%. There was a statistically significant association found between male gender and fear about COVID-19 (P = 0.019). Conclusions: We noticed adverse lifestyle changes in the study population during the COVID-19 pandemic. Health promotional measures and lifestyle modifications are still required to combat COVID-19.
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Affiliation(s)
- Abdulaziz Almutairi
- Family Medicine Academy, Qassim Health Cluster, Qassim Province, Saudi Arabia
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de Sá-Caputo DDC, Coelho-Oliveira AC, Sonza A, Paineiras-Domingos LL, Taiar R, Das S, Bello AR, Bernardo-Filho M. Face Masks Use to Avoid Airborne Contamination during COVID-19 Pandemic and Related Conditions: A Systematic Review. IRANIAN JOURNAL OF PUBLIC HEALTH 2021; 50:2361-2373. [PMID: 36317023 PMCID: PMC9577161 DOI: 10.18502/ijph.v50i12.7920] [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: 07/09/2021] [Accepted: 09/10/2021] [Indexed: 06/16/2023]
Abstract
BACKGROUND The facemasks use has been discussed to prevent respiratory disease due airborne contamination. The aim of this study was to perform a systematic review about the face masks use to avoid airborne contamination during COVID-19 pandemic and related conditions, registered (PROSPERO-CRD42020198347) and performed according PRISMA. METHODS PubMed, Embase and Scopus databases were used to collect data. Observational studies, published in 2020, and English language, were included. Two reviewers independently identified records through database search and reference screening and disagreements were resolved by a third reviewer. Six studies were included. RESULTS The works investigated about the use of masks (different types) to prevent droplets dissemination with virus or bacterial suspension and decrease COVID-19 transmission routes, comfort, or temperature. The studies have moderate to critical risk of bias and the level of evidence is III-2. CONCLUSION It is recommended facemask use to prevent droplets from escaping airborne and infecting other people, although there are different percentages of protection and can be possible a discomfort related the use. Further clinical trials to the effectiveness of face mask to avoid airborne contamination during the COVID-19 pandemic and the factors interfering with their effectiveness should be conducted.
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Affiliation(s)
- Danúbia da Cunha de Sá-Caputo
- Laboratory of Mechanical Vibrations and Integrative Practices, Department of Biophysics and Biometrics, Roberto Alcântara Gomes Institute of Biology and Piquet Carneiro Polyclinic, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
- Postgraduate Program in Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
- Bezerra de Araújo College, Rio de Janeiro, RJ, Brazil
- Postgraduate Program in Clinical and Experimental Pathophysiology, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Ana Carolina Coelho-Oliveira
- Laboratory of Mechanical Vibrations and Integrative Practices, Department of Biophysics and Biometrics, Roberto Alcântara Gomes Institute of Biology and Piquet Carneiro Polyclinic, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
- Postgraduate Program in Clinical and Experimental Pathophysiology, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Anelise Sonza
- Department of Physiotherapy, Graduate Program in Physiotherapy, State University of Santa Catarina, Florianópolis, SC, Brazil and Graduate Program in Human Movement Sciences, State University of Santa Catarina, Florianópolis, SC, Brazil
| | - Laisa Liane Paineiras-Domingos
- Laboratory of Mechanical Vibrations and Integrative Practices, Department of Biophysics and Biometrics, Roberto Alcântara Gomes Institute of Biology and Piquet Carneiro Polyclinic, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
- Postgraduate Program in Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
- Department of Physiotherapy, Institute of Health Sciences, Federal University of Bahia, Salvador, BA, Brazil
| | - Redha Taiar
- Physical and Rehabilitation Medicine Department, Sebastopol Hospital, University of Reims Champagne-Ardenne, France
| | | | | | - Mario Bernardo-Filho
- Laboratory of Mechanical Vibrations and Integrative Practices, Department of Biophysics and Biometrics, Roberto Alcântara Gomes Institute of Biology and Piquet Carneiro Polyclinic, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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Kallon II, Swartz A, Colvin CJ, MacGregor H, Zwama G, Voce AS, Grant AD, Kielmann K. Organisational Culture and Mask-Wearing Practices for Tuberculosis Infection Prevention and Control among Health Care Workers in Primary Care Facilities in the Western Cape, South Africa: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182212133. [PMID: 34831888 PMCID: PMC8620186 DOI: 10.3390/ijerph182212133] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 11/09/2021] [Accepted: 11/15/2021] [Indexed: 11/25/2022]
Abstract
Background: Although many healthcare workers (HCWs) are aware of the protective role that mask-wearing has in reducing transmission of tuberculosis (TB) and other airborne diseases, studies on infection prevention and control (IPC) for TB in South Africa indicate that mask-wearing is often poorly implemented. Mask-wearing practices are influenced by aspects of the environment and organisational culture within which HCWs work. Methods: We draw on 23 interviews and four focus group discussions conducted with 44 HCWs in six primary care facilities in the Western Cape Province of South Africa. Three key dimensions of organisational culture were used to guide a thematic analysis of HCWs’ perceptions of masks and mask-wearing practices in the context of TB infection prevention and control. Results: First, HCW accounts address both the physical experience of wearing masks, as well as how mask-wearing is perceived in social interactions, reflecting visual manifestations of organisational culture in clinics. Second, HCWs expressed shared ways of thinking in their normalisation of TB as an inevitable risk that is inherent to their work and their localization of TB risk in specific areas of the clinic. Third, deeper assumptions about mask-wearing as an individual choice rather than a collective responsibility were embedded in power and accountability relationships among HCWs and clinic managers. These features of organisational culture are underpinned by broader systemic shortcomings, including limited availability of masks, poorly enforced protocols, and a general lack of role modelling around mask-wearing. HCW mask-wearing was thus shaped not only by individual knowledge and motivation but also by the embodied social dimensions of mask-wearing, the perceptions that TB risk was normal and localizable, and a shared underlying tendency to assume that mask-wearing, ultimately, was a matter of individual choice and responsibility. Conclusions: Organisational culture has an important, and under-researched, impact on HCW mask-wearing and other PPE and IPC practices. Consistent mask-wearing might become a more routine feature of IPC in health facilities if facility managers more actively promote engagement with TB-IPC guidelines and develop a sense of collective involvement and ownership of TB-IPC in facilities.
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Affiliation(s)
- Idriss I. Kallon
- Division of Social and Behavioural Sciences, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa; (I.I.K.); (A.S.)
- Centre for Evidence-Based Health Care, Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town 7505, South Africa
| | - Alison Swartz
- Division of Social and Behavioural Sciences, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa; (I.I.K.); (A.S.)
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI 02912, USA
| | - Christopher J. Colvin
- Division of Social and Behavioural Sciences, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa; (I.I.K.); (A.S.)
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI 02912, USA
- Department of Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, VA 22903, USA
- Correspondence:
| | - Hayley MacGregor
- Institute of Development Studies, University of Sussex, Brighton BN1 9RE, UK;
| | - Gimenne Zwama
- Institute of Global Health & Development, Queen Margaret University, Musselburgh EH21 6UU, UK; (G.Z.); (K.K.)
| | - Anna S. Voce
- School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban 4041, South Africa;
| | - Alison D. Grant
- TB Centre, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK;
- Africa Health Research Institute, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban 4001, South Africa
| | - Karina Kielmann
- Institute of Global Health & Development, Queen Margaret University, Musselburgh EH21 6UU, UK; (G.Z.); (K.K.)
- Department of Public Health, Institute of Tropical Medicine, 2000 Antwerp, Belgium
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Olry de Labry-Lima A, Bermúdez-Tamayo C, Martinez-Olmos J, Martin-Ruiz E. The use of masks to protect against respiratory infections: An umbrella review. ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA (ENGLISH ED.) 2021; 39:436-444. [PMID: 34446392 PMCID: PMC8382596 DOI: 10.1016/j.eimce.2021.08.002] [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: 05/04/2020] [Accepted: 07/15/2020] [Indexed: 01/05/2023]
Abstract
INTRODUCTION The global health emergency caused by the current COVID-19 pandemic is resulting in a huge challenge at all levels. The use of masks may reduce the spread of the infection by minimising the excretion of Flügge droplets. The objective of this study was to compile the evidence available on the use of masks in relation to respiratory infections. METHODOLOGY An umbrella review (review of systematic reviews) was conducted. Two reviewers independently carried out the screening process, data extraction and data analysis. Discrepancies were resolved with a third reviewer, and the assessment of the risk of bias of the studies was carried out using the AMSTAR 2 tool. The Rayyan QCRI program was used for the screening process. RESULTS A total of eight systematic reviews were included. The studies analysed the use of masks in the general population, in long-term care facilities, in hospitals and at mass gatherings, and compared the effectiveness thereof in preventing infection. The results of this review revealed that the use of masks is associated with a protective effect against respiratory infections in healthcare facilities, in long-term care facilities and at mass gatherings. CONCLUSIONS In light of the results, it seems reasonable to recommend the use of masks to the general population, but this use should be accompanied by a training programme to improve compliance, as not using them properly may increase the risk of infection.
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Affiliation(s)
- Antonio Olry de Labry-Lima
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain,Instituto de Investigación Biosanitaria ibs. Granada. Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain,CIBER en Epidemiología y Salud Pública (CIBERESP), Spain,Corresponding author
| | - Clara Bermúdez-Tamayo
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain,Instituto de Investigación Biosanitaria ibs. Granada. Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain,CIBER en Epidemiología y Salud Pública (CIBERESP), Spain
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Koklu M, Cinar I, Taspinar YS. CNN-based bi-directional and directional long-short term memory network for determination of face mask. Biomed Signal Process Control 2021; 71:103216. [PMID: 34697552 PMCID: PMC8527867 DOI: 10.1016/j.bspc.2021.103216] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 08/30/2021] [Accepted: 09/30/2021] [Indexed: 01/10/2023]
Abstract
Context The COVID-19 virus, exactly like in
numerous other diseases, can be contaminated from person to person by
inhalation. In order to prevent the spread of this virus, which led to a
pandemic around the world, a series of rules have been set by governments
that people must follow. The obligation to use face masks, especially in
public spaces, is one of these rules. Objective The aim of this study is to determine
whether people are wearing the face mask correctly by using deep learning
methods. Methods A dataset consisting of 2000 images
was created. In the dataset, images of a person from three different
angles were collected in four classes, which are “masked”, “non-masked”,
“masked but nose open”, and “masked but under the chin”. Using this data,
new models are proposed by transferring the learning through AlexNet and
VGG16, which are the Convolutional Neural network architectures.
Classification layers of these models were removed and, Long-Short Term
Memory and Bi-directional Long-Short Term Memory architectures were added
instead. Result and conclusions Although there are four different
classes to determine whether the face masks are used correctly, in the
six models proposed, high success rates have been achieved. Among all
models, the TrVGG16 + BiLSTM model has achieved the highest
classification accuracy with 95.67%. Significance The study has proven that it can take
advantage of the proposed models in conjunction with transfer learning to
ensure the proper and effective use of the face mask, considering the
benefit of society.
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Affiliation(s)
- Murat Koklu
- Department of Computer Engineering, Selcuk University, Konya, Turkey
| | - Ilkay Cinar
- Department of Computer Engineering, Selcuk University, Konya, Turkey
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De-Yñigo-Mojado B, Becerro-de-Bengoa-Vallejo R, Losa-Iglesias ME, Madera-García J, Rodríguez-Sanz D, Calvo-Lobo C, López-López D, Angulo-Carrere MT, San-Antolín M. Facial Hair Decreases Fit Factor of Masks and Respirators in Healthcare Providers. BIOLOGY 2021; 10:1031. [PMID: 34681128 PMCID: PMC8533569 DOI: 10.3390/biology10101031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/09/2021] [Accepted: 10/11/2021] [Indexed: 01/10/2023]
Abstract
In response to the current state of the COVID-19 pandemic, healthcare providers are using common surgical masks and filtering respirators in conjunction with the presence of facial hair, which could lead to a large number of particles passing into their respiratory system. The purpose of this study was to determine the fit factor effectiveness of filtering respirators and surgical masks in bearded versus non-bearded healthcare providers. A controlled randomized clinical trial (NCT04391010) was carried out, analyzing a sample of 63 healthcare providers. The fit factors of surgical masks and FFP3 filtering respirators for healthcare providers with (n = 32) and without (n = 31) facial hair were compared. Fit factors were measured during an exercises protocol in which healthcare providers wore surgical masks and FFP3 filtering respirators. Surgical mask fit factor comparisons did not show significant differences (p > 0.05) between healthcare providers with and without facial hair. In contrast, filtering respirator fit factor comparisons showed statistically significant differences (p < 0.01) between both groups, indicating that healthcare providers with facial hair showed lower fit factor scores, which implies a worse fit factor with respect to healthcare providers without facial hair. The fit factor effectiveness of filtering respirators was reduced in healthcare providers with facial hair. The authors of this paper encourage healthcare providers to trim their beards during filtering respirator use or wear full-mask filtering facepiece respirators, especially during the COVID-19 pandemic.
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Affiliation(s)
- Borja De-Yñigo-Mojado
- Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, 28040 Madrid, Spain; (B.D.-Y.-M.); (R.B.-d.-B.-V.); (D.R.-S.); (M.T.A.-C.)
| | - Ricardo Becerro-de-Bengoa-Vallejo
- Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, 28040 Madrid, Spain; (B.D.-Y.-M.); (R.B.-d.-B.-V.); (D.R.-S.); (M.T.A.-C.)
| | | | | | - David Rodríguez-Sanz
- Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, 28040 Madrid, Spain; (B.D.-Y.-M.); (R.B.-d.-B.-V.); (D.R.-S.); (M.T.A.-C.)
| | - Cesar Calvo-Lobo
- Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, 28040 Madrid, Spain; (B.D.-Y.-M.); (R.B.-d.-B.-V.); (D.R.-S.); (M.T.A.-C.)
| | - Daniel López-López
- Research, Health and Podiatry Group, Department of Health Sciences, Faculty of Nursing and Podiatry, Universidade da Coruña, 15403 Ferrol, Spain;
| | - María Teresa Angulo-Carrere
- Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, 28040 Madrid, Spain; (B.D.-Y.-M.); (R.B.-d.-B.-V.); (D.R.-S.); (M.T.A.-C.)
| | - Marta San-Antolín
- Department of Psychology, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain;
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Collins AP, Service BC, Gupta S, Mubarak N, Zeini IM, Osbahr DC, Romeo AA. N95 respirator and surgical mask effectiveness against respiratory viral illnesses in the healthcare setting: A systematic review and meta-analysis. J Am Coll Emerg Physicians Open 2021; 2:e12582. [PMID: 34746923 PMCID: PMC8552225 DOI: 10.1002/emp2.12582] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 06/30/2021] [Accepted: 08/06/2021] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE To examine the results, level of evidence, and methodologic quality of original studies regarding surgical mask effectiveness in minimizing viral respiratory illness transmission, and, in particular, the performance of the N95 respirator versus surgical mask. METHODS Meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines with use of PubMed, MEDLINE, and the Cochrane Library databases. RESULTS Eight studies (9164 participants) were included after screening 153 articles. Analyses showed statistically significant differences between N95 respirator versus surgical mask use to prevent influenza-like-illness (risk ratio [RR] = 0.81, 95% confidence interval [CI] = 0.68-0.94, P < 0.05), non-influenza respiratory viral infection (RR = 0.62, 95% CI = 0.52-0.74, P < 0.05), respiratory viral infection (RR = 0.73, 95% CI = 0.65-0.82, P < 0.05), severe acute respiratory syndrome coronavirus (SARS-CoV) 1 and 2 virus infection (RR = 0.17, 95% CI = 0.06-0.49, P < 0.05), and laboratory-confirmed respiratory viral infection (RR = 0.75, 95% CI = 0.66-0.84, P < 0.05). Analyses did not indicate statistically significant results against laboratory-confirmed influenza (RR = 0.87, CI = 0.74-1.03, P > 0.05). CONCLUSIONS N95 respirator use was associated with fewer viral infectious episodes for healthcare workers compared with surgical masks. The N95 respirator was most effective in reducing the risk of a viral infection in the hospital setting from the SARS-CoV 1 and 2 viruses compared to the other viruses included in this investigation. Methodologic quality, risk of biases, and small number of original studies indicate the necessity for further research to be performed, especially in front-line healthcare delivery settings.
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Affiliation(s)
| | | | - Sunny Gupta
- Department of OrthopedicsUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Naser Mubarak
- University of Central Florida College of MedicineOrlandoFloridaUSA
| | | | - Daryl C. Osbahr
- Orthopaedic Surgery, Rothman Orthopaedic Institute FloridaOrlandoFloridaUSA
| | - Anthony A. Romeo
- DuPage Medical Group Musculoskeletal InstituteChicagoIllinoisUSA
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Mergener K. The Future of Endoscopic Operations After the Coronavirus Pandemic. Gastrointest Endosc Clin N Am 2021; 31:773-785. [PMID: 34538415 PMCID: PMC8149204 DOI: 10.1016/j.giec.2021.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The unprecedented COVID-19 pandemic and its rapid global shutdowns have posed tremendous challenges for GI practices, including sudden delays in endoscopic procedures. As full reopening approaches, practices are wrestling with completely retooling their operations to ensure the resumption of high-quality, safe, and effective patient care. The pandemic's long-term effects on practice operations must be assessed: What will postpandemic GI care look like? Will some aspects of our work be changed forever, and if so, what are the practice management implications? This chapter surveys the pandemic's impact on US-based GI practices and discusses key "lessons learned" for future operations.
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Affiliation(s)
- Klaus Mergener
- Division of Gastroenterology, University of Washington, 1917 Warren Avenue North, Seattle, WA 98109, USA.
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Shaterian N, Abdi F, Atarodi Kashani Z, Shaterian N, Darvishmotevalli M. Facemask and Respirator in Reducing the Spread of Respiratory Viruses; a Systematic Review. ARCHIVES OF ACADEMIC EMERGENCY MEDICINE 2021; 9:e56. [PMID: 34580654 PMCID: PMC8464015 DOI: 10.22037/aaem.v9i1.1286] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Introduction Respiratory viruses spread fast, and some manners have been recommended for reducing the spread of these viruses, including the use of a facemask or respirator, maintaining hand hygiene, and perfoming social distancing. This systematic review aimed to assess the impact of facemasks and respirators on reducing the spread of respiratory viruses. Methods We conducted a systematic review using MeSH terms, and reported findings according to PRISMA. PubMed, Embase, Cochrane Library, Scopus, ProQuest, Web of Science(WoS), and Google Scholar were searched for articles published between 2009 and 2020. Two independent reviewers determined whether the studies met inclusion criteria. The risk of bias of studies was assessed using Newcastle-Ottawa (NOS) and Consolidated Standards of Reporting Trials (CONSORT). Results A total of 1505 articles were initially retrieved and 10 were finally included in our analysis (sample size: 3065). 96.8% of non-infected participants used facemask or respirator in contact with people infected with a respiratory virus, facemask and respirator have a significant effect on reducing the spread of respiratory viruses. Conclusion Evidence support that using a facemask or respirator can reduce the spread of all types of respiratory viruses; therefore, this result can be generalized to the present pandemic of a respiratory virus (SARS-COV-2) and it is recommended to use a facemask or respirator for reducing the spread of this respiratory virus.
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Affiliation(s)
- Negin Shaterian
- Student Research Committee, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Abdi
- School of Nursing and Midwifery, Alborz University of Medical Sciences, Karaj, Iran.,Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | | | - Negar Shaterian
- Student Research Committee, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Mohammad Darvishmotevalli
- Research Center for Health, Safety and Environment , Alborz University of Medical Sciences, Karaj, Iran
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Meisha DE. Comparison of Compliance with Infection Control Practices Among Dental Students in Saudi Arabia Before and During the COVID-19 Pandemic. Risk Manag Healthc Policy 2021; 14:3625-3633. [PMID: 34512050 PMCID: PMC8412817 DOI: 10.2147/rmhp.s318031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 08/19/2021] [Indexed: 12/16/2022] Open
Abstract
Background With the emergence of the COVID-19 pandemic, professional organizations issued new guidelines for infection control standards in dental clinics. The objective of this study was to compare dental students' compliance with those standards before the COVID-19 outbreak and during the pandemic. Methods This cross-sectional study entailed observing 622 dental students during their clinical sessions to assess compliance with the infection control protocol. The compliance checklist used was adopted from the Centers for Disease Control and Prevention Infection Control Checklist for Dental Settings. Observations took place during two consecutive years: once in 2019 before the COVID-19 outbreak and once in 2020 during the pandemic. Results The dental students audited in 2019 were 1.4 times more likely to violate infection control measures compared with those in 2020. The two most common violations in both audits were not wearing eye protection and not following hand hygiene recommendations immediately after they removed their gloves. During both audits, male students violated infection controls significantly less often than female students. Conclusion Dental students' adherence to infection control measures improved during the COVID-19 pandemic compared with before the COVID-19 pandemic. Compliance with personal protective equipment standards was higher than with hand hygiene practices. Our findings have important clinical implications in designing strategies to improve dental students' compliance with infection control standards, particularly hand hygiene practices.
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Affiliation(s)
- Dalia E Meisha
- Department of Dental Public Health, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
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Tran TQ, Mostafa EM, Tawfik GM, Soliman M, Mahabir S, Mahabir R, Dong V, Ravikulan R, Alhijazeen S, Farrag DA, Dumre SP, Huy NT, Hirayama K. Efficacy of face masks against respiratory infectious diseases: a systematic review and network analysis of randomized-controlled trials. J Breath Res 2021; 15. [PMID: 34407516 DOI: 10.1088/1752-7163/ac1ea5] [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: 02/11/2021] [Accepted: 08/18/2021] [Indexed: 11/12/2022]
Abstract
During the ongoing COVID-19 pandemic, face masks are among the most common and practical control measures used globally in reducing the risk of infection and disease transmission. Although several studies have investigated the efficacy of various face masks and respirators in preventing infection, the results have been inconsistent. Therefore, we performed a systematic review and network meta-analysis (NMA) of the randomized-controlled trials (RCTs) to assess the actual efficacy of face masks in preventing respiratory infections. We searched nine electronic databases up to July 2020 to find potential articles. We accepted trials reporting the protective efficacy of face masks against respiratory infections, of which the primary endpoint was the presence of respiratory infections. We used the ROB-2 Cochrane tool to grade the trial quality. We initially registered the protocol for this study in PROSPERO (CRD42020178516). Sixteen RCTs involving 17 048 individuals were included for NMA. Overall, evidence was weak, lacking statistical power due to the small number of participants, and there was substantial inconsistency in our findings. In comparison to those without face masks, participants with fit-tested N95 respirators were likely to have lesser infection risk (RR 0.67, 95% CI 0.38-1.19,P-score 0.80), followed by those with non-fit-tested N95 and non-fit-tested FFP2 respirators that shared the similar risk, (RR 0.73, 95% CI 0.12-4.36,P-score 0.63) and (RR 0.80, 95% CI 0.38-1.71,P-score 0.63), respectively. Next, participants who donned face masks with and without hand hygiene practices showed modest risk improvement alike (RR 0.89, 95% CI 0.67-1.17,P-score 0.55) and (RR 0.92, 95% CI 0.70-1.22,P-score 0.51). Otherwise, participants donning double-layered cloth masks were prone to infection (RR 4.80, 95% CI 1.42-16.27,P-score 0.01). Eleven out of 16 RCTs that underwent a pairwise meta-analysis revealed a substantially lower infection risk in those donning medical face masks (MFMs) than those without face masks (RR 0.83 95% CI 0.71-0.96). Given the body of evidence through a systematic review and meta-analyses, our findings supported the protective benefits of MFMs in reducing respiratory transmissions, and the universal mask-wearing should be applied-especially during the COVID-19 pandemic. More clinical data is required to conclude the efficiency of cloth masks; in the short term, users should not use cloth face masks in the outbreak hot spots and places where social distancing is impossible.
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Affiliation(s)
- Thach Quang Tran
- Department of Immunogenetics, Nagasaki University, Nagasaki, Japan
| | | | | | | | | | | | - Vinh Dong
- AU/UGA Medical Partnership, Athens, Georgia, United States of America
| | | | | | | | | | - Nguyen Tien Huy
- School of Tropical Medicine and Global Health (TMGH), Nagasaki University, Nagasaki 852-8523, Japan
| | - Kenji Hirayama
- School of Tropical Medicine and Global Health (TMGH), Nagasaki University, Nagasaki 852-8523, Japan
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Johansson B. Challenges and Controversies in COVID-19: Masking the General Population may Attenuate This Pandemic's Outbreak. Front Public Health 2021; 9:643991. [PMID: 34568248 PMCID: PMC8455895 DOI: 10.3389/fpubh.2021.643991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 06/22/2021] [Indexed: 11/13/2022] Open
Abstract
SARS-CoV-2, the virus that causes COVID-19, spreads i. a., by respiratory droplets. The use of masks in preventing spread is controversial; masks are considered useless by many, while being mandated in some locations. Here, the effect of masking the general population on a COVID-19-like epidemic is estimated by computer simulation using three separate types of software. The main questions are whether mask use by the general population can limit the spread of SARS-CoV-2 in a country and how to identify opportunities when mask use is cost-effective and safe. To address these questions, the protective effects of different types of masks, the side-effects of masks, and avenues for improvements of masks and masking are addressed. Main results: (i) Any type of mask, even simple home-made ones, may be of value, even if the protective effect of each mask (here dubbed "one mask-protection") is low. Strict adherence to mask use does not appear to be critical but increasing one mask-protection to >50% was found to be advantageous. (ii) Masks do seem to reduce the number of new cases even if introduced at a late stage in an epidemic, but early implementation helps reduce the cumulative and total number of cases. (iii) The simulations suggest that it might be possible to eliminate a COVID-19 outbreak by widespread mask use during a limited period. There is a brief discussion of why the reported effect size of masking varies widely, and is expected to do so, because of different filtration abilities of different masks, differences in compliance and fitting, other routes of transmission, pre-existing immunity, and because a system of interconnected, disease-prone individuals has non-linear properties. A software solution to visualize infection spread is presented. The results from these simulations are encouraging, but do not necessarily represent the real-life situation, so it is suggested that clinical trials of masks are now carried out while continuously monitoring effects and side-effects. As mask use is not without risks and costs, it is suggested that governments and scientists have an important role in advising the public about the sensible use of masks.
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Affiliation(s)
- Björn Johansson
- Theme Aging, Karolinska University Hospital, Stockholm, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Paediatric orthopaedic surgery during the SARS-CoV-2 pandemic. A safe and pragmatic approach to service provision. Surgeon 2021; 20:e338-e343. [PMID: 34600829 PMCID: PMC8418910 DOI: 10.1016/j.surge.2021.08.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 11/11/2020] [Accepted: 08/19/2021] [Indexed: 11/23/2022]
Abstract
The SARS-COV-2 pandemic has brought unparalleled challenges to healthcare provision. Being a newly discovered virus, there is a lack of previous experience and published evidence to guide healthcare providers on how to deliver services. We would like to share our approach to service delivery in a newly open children's hospital in the United Arab Emirates with a particular focus on paediatric orthopaedic services.
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Thatiparthi A, Liu J, Martin A, Wu JJ. Adverse Effects of COVID-19 and Face Masks: A Systematic Review. THE JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY 2021; 14:S39-S45. [PMID: 34980966 PMCID: PMC8562946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND Due to the public health risk associated with SARS-CoV-2 (COVID-19) infection, universal use of face masks has been recommended to protect against viral spread. Adverse facial reactions from the utilization of masks in the general public are poorly characterized in literature. OBJECTIVE We aimed to provide a systematic review of studies reporting adverse facial reactions associated with use of face masks during the COVID-19 pandemic. METHODS PubMed and Cochrane databases were searched using the following search terms: "masks" AND "skin reactions, facial dermatosis, rash, acne, atopic dermatitis, rosacea, OR seborrheic dermatitis." METHODS A total of 954 cases of dermatological adverse effects were reported. Over 17 different adverse facial reactions were found, including the top 10 in order: itch (370, 38.8%), indentation/ear pain (102, 10.7%), discomfort (90, 9.4%), erythema (72, 7.5%), dryness (62, 6.5%), rash (60, 6.3%), scarring (42, 4.4%), desquamation (22, 2.3%), pain (19, 2.0%), burning (19, 2.0%), and wheals (7, 0.7%). Face masks can increase acne (n=44), rosacea (n=14), and seborrheic dermatitis (n=9). LIMITATIONS Publication bias of articles, with limited studies available regarding this topic. CONCLUSION Wearing face masks to protect from COVID-19 can increase adverse facial dermatoses and exacerbate underlying dermatology conditions; however, several preventative measures may be taken.
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Affiliation(s)
- Akshitha Thatiparthi
- Ms. Thatiparthi is with the College of Osteopathic Medicine of the Pacific, Western University of Health Sciences in Pomona, California
- Mr. Liu is with the Keck School of Medicine, University of Southern California in Los Angeles, California
- Ms. Martin is with the School of Medicine, University of California in Riverside, California
- Dr. Wu is with the Dermatology Research and Education Foundation in Irvine, California
| | - Jeffrey Liu
- Ms. Thatiparthi is with the College of Osteopathic Medicine of the Pacific, Western University of Health Sciences in Pomona, California
- Mr. Liu is with the Keck School of Medicine, University of Southern California in Los Angeles, California
- Ms. Martin is with the School of Medicine, University of California in Riverside, California
- Dr. Wu is with the Dermatology Research and Education Foundation in Irvine, California
| | - Amylee Martin
- Ms. Thatiparthi is with the College of Osteopathic Medicine of the Pacific, Western University of Health Sciences in Pomona, California
- Mr. Liu is with the Keck School of Medicine, University of Southern California in Los Angeles, California
- Ms. Martin is with the School of Medicine, University of California in Riverside, California
- Dr. Wu is with the Dermatology Research and Education Foundation in Irvine, California
| | - Jashin J Wu
- Ms. Thatiparthi is with the College of Osteopathic Medicine of the Pacific, Western University of Health Sciences in Pomona, California
- Mr. Liu is with the Keck School of Medicine, University of Southern California in Los Angeles, California
- Ms. Martin is with the School of Medicine, University of California in Riverside, California
- Dr. Wu is with the Dermatology Research and Education Foundation in Irvine, California
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Li J, Qiu Y, Zhang Y, Gong X, He Y, Yue P, Zheng X, Liu L, Liao H, Zhou K, Hua Y, Li Y. Protective efficient comparisons among all kinds of respirators and masks for health-care workers against respiratory viruses: A PRISMA-compliant network meta-analysis. Medicine (Baltimore) 2021; 100:e27026. [PMID: 34449478 PMCID: PMC8389967 DOI: 10.1097/md.0000000000027026] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 07/06/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND There is no definite conclusion about comparison of better effectiveness between N95 respirators and medical masks in preventing health-care workers (HCWs) from respiratory infectious diseases, so that conflicting results and recommendations regarding the protective effects may cause difficulties for selection and compliance of respiratory personal protective equipment use for HCWs, especially facing with pandemics of corona virus disease 2019. METHODS We systematically searched MEDLINE, Embase, PubMed, China National Knowledge Infrastructure, Wanfang, medRxiv, and Google Scholar from initiation to November 10, 2020 for randomized controlled trials, case-control studies, cohort studies, and cross-sectional studies that reported protective effects of masks or respirators for HCWs against respiratory infectious diseases. We gathered data and pooled differences in protective effects according to different types of masks, pathogens, occupations, concurrent measures, and clinical settings. The study protocol is registered with PROSPERO (registration number: 42020173279). RESULTS We identified 4165 articles, reviewed the full text of 66 articles selected by abstracts. Six randomized clinical trials and 26 observational studies were included finally. By 2 separate conventional meta-analyses of randomized clinical trials of common respiratory viruses and observational studies of pandemic H1N1, pooled effects show no significant difference between N95 respirators and medical masks against common respiratory viruses for laboratory-confirmed respiratory virus infection (risk ratio 0.99, 95% confidence interval [CI] 0.86-1.13, I2 = 0.0%), clinical respiratory illness (risk ratio 0.89, 95% CI 0.45-1.09, I2 = 83.7%, P = .002), influenza-like illness (risk ratio 0.75, 95% CI 0.54-1.05, I2 = 0.0%), and pandemic H1N1 for laboratory-confirmed respiratory virus infection (odds ratio 0.92, 95% CI 0.49-1.70, I2 = 0.0%, P = .967). But by network meta-analysis, N95 respirators has a significantly stronger protection for HCWs from betacoronaviruses of severe acute respiratory syndrome, middle east respiratory syndrome, and corona virus disease 2019 (odds ratio 0.43, 95% CI 0.20-0.94). CONCLUSIONS Our results provide moderate and very-low quality evidence of no significant difference between N95 respirators and medical masks for common respiratory viruses and pandemic H1N1, respectively. And we found low quality evidence that N95 respirators had a stronger protective effectiveness for HCWs against betacoronaviruses causative diseases compared to medical masks. The evidence of comparison between N95 respirators and medical masks for corona virus disease 2019 is open to question and needs further study.
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Singh P, Pal K, Chakravraty A, Ikram S. Execution and viable applications of face shield "a safeguard" against viral infections of cross-protection studies: A comprehensive review. J Mol Struct 2021; 1238:130443. [PMID: 33867574 PMCID: PMC8035530 DOI: 10.1016/j.molstruc.2021.130443] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 03/27/2021] [Accepted: 04/05/2021] [Indexed: 12/16/2022]
Abstract
Face shield are the unmistakable plastic gatekeepers secures eyes and face, simpler to wear and a group of specialists state face shields may supplant masks as an increasingly agreeable and progressively successful obstacle to COVID-19. Face shields are useful in stopping respiratory droplets from speading from the wearer to others. The droplets, which come into contact with the shield, are quickly spread over a large area, both transversely and vertically, over the shield, but with a shrinking concentration of droplets, as opposed to face masks, which appear to slide under the nose of the wearer or, worse, collapse entirely off the shield. Hence, a face- shield can be considered as personal protective equipment (PPE), which is a first line of resistance, utilized by the clinicians and forefront health workers for protection against the infectious body fluid and aerosols. Face-shields are mainly fabricated using polycarbonate material, because of their excellent optical transparency in UVA-visible-IR spectrum and mechanical properties. The goal of this article is to provide researchers working in the same area, as well as health and industrial staff, with a detailed analysis of the usage of face shields against bioaerosols and the need for personal security. The reviews main focus on the background of the face shield, provide assistance in the selection, its design and structure, applications, advantages and disadvantages. Lastly, people's view about the usage of face shield as it becomes an essential part of human beings like an accomplice during this current pandemic situation.
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Affiliation(s)
- Preeti Singh
- Bio/Polymers Research Laboratory, Department of Chemistry, Jamia Millia Islamia, New Delhi, India
| | - Kaushik Pal
- Laboratório de Biopolímeros e-Sensores, Instituto de Macromoléculas, Universidade Federal do Rio de Janeiro (LABIOS/IMA/UFRJ), Rio de Janeiro 21941-901, Brazil
| | - Archana Chakravraty
- Bio/Polymers Research Laboratory, Department of Chemistry, Jamia Millia Islamia, New Delhi, India
| | - Saiqa Ikram
- Bio/Polymers Research Laboratory, Department of Chemistry, Jamia Millia Islamia, New Delhi, India
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