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Carnicer-Pont D, Fu M, Castellano Y, Tigova O, Driezen P, Quah ACK, Kaai SC, Soriano JB, Vardavas CI, Fong GT, Fernández E. Incidence and Determinants of COVID-19 Among People Who Smoke (2018-2021): Findings From the ITC EUREST-PLUS Spain Surveys. Arch Bronconeumol 2024:S0300-2896(24)00223-0. [PMID: 38944617 DOI: 10.1016/j.arbres.2024.05.037] [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: 03/07/2024] [Revised: 05/21/2024] [Accepted: 05/29/2024] [Indexed: 07/01/2024]
Abstract
OBJECTIVE To estimate the cumulative incidence of COVID-19 and its determinants among a nationally representative sample of adults from Spain who smoke. METHODS This is a prospective cohort study that uses data from two waves (Wave 2 in 2018 and Wave 3 in 2021) of the ITC EUREST-PLUS Spain Survey. At baseline (Wave 1 in 2016), all respondents were adults (aged ≥18) who smoked. In total, 1008 respondents participated in Wave 2, and 570 out of 888 eligible participants were followed up in Wave 3 (64.2%). We estimated the cumulative incidence and the relative risk of COVID-19 (RR) and 95% confidence intervals (CI) during follow-up using self-reported information on sociodemographic, smoking-related and health-related characteristics and identified associated factors using multivariable Poisson models with robust variance adjusted for the independent variables. RESULTS The overall cumulative incidence of self-reported COVID-19 was 5.9% (95% CI: 3.9-8.0%), with no significant differences between males (6.3%; 95% CI: 3.6-9.0%) and females (5.6%; 95% CI: 3.2-8.0%). After adjusting for age, sex, and educational level, COVID-19 incidence was positively associated with moderate nicotine dependence (RR: 2.37; 95% CI: 1.04-5.40) and negatively associated with having a partner who smoked (RR: 0.12; 95% CI: 0.03-0.42), and having friends but not a partner who smoked (RR: 0.28; 95% CI: 0.14-0.56). CONCLUSION The correlates of having had COVID-19 among people who smoke should be considered when tailoring information and targeted non-pharmacological preventive measures.
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Affiliation(s)
- Dolors Carnicer-Pont
- Tobacco Control Unit, Catalan Institute of Oncology - WHO Collaborating Centre for Tobacco Control, L'Hospitalet de Llobregat, Spain; Tobacco Control Research Group, Bellvitge Biomedical Research Institute, L'Hospitalet de Llobregat, Spain; Centre for Biomedical Research in Respiratory Diseases, Institute of Health Carlos III, Madrid, Spain
| | - Marcela Fu
- Tobacco Control Unit, Catalan Institute of Oncology - WHO Collaborating Centre for Tobacco Control, L'Hospitalet de Llobregat, Spain; Tobacco Control Research Group, Bellvitge Biomedical Research Institute, L'Hospitalet de Llobregat, Spain; Centre for Biomedical Research in Respiratory Diseases, Institute of Health Carlos III, Madrid, Spain; Department of Public Health, Mental Health, and Maternal and Child Health Nursing, School of Nursing, University of Barcelona, Barcelona, Spain.
| | - Yolanda Castellano
- Tobacco Control Unit, Catalan Institute of Oncology - WHO Collaborating Centre for Tobacco Control, L'Hospitalet de Llobregat, Spain; Tobacco Control Research Group, Bellvitge Biomedical Research Institute, L'Hospitalet de Llobregat, Spain; Centre for Biomedical Research in Respiratory Diseases, Institute of Health Carlos III, Madrid, Spain
| | - Olena Tigova
- Tobacco Control Unit, Catalan Institute of Oncology - WHO Collaborating Centre for Tobacco Control, L'Hospitalet de Llobregat, Spain; Tobacco Control Research Group, Bellvitge Biomedical Research Institute, L'Hospitalet de Llobregat, Spain; Centre for Biomedical Research in Respiratory Diseases, Institute of Health Carlos III, Madrid, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Pete Driezen
- Department of Psychology, University of Waterloo, Waterloo, Canada; School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Anne C K Quah
- Department of Psychology, University of Waterloo, Waterloo, Canada
| | - Susan C Kaai
- Department of Psychology, University of Waterloo, Waterloo, Canada; School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Joan B Soriano
- Centre for Biomedical Research in Respiratory Diseases, Institute of Health Carlos III, Madrid, Spain; Pneumology Department, Hospital Universitario de la Princesa, Madrid, Spain
| | - Constantine I Vardavas
- School of Medicine, University of Crete, Heraklion, Greece; European Network for Smoking and Tobacco Prevention, Brussels, Belgium; Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Harvard University, Boston, MA, United States
| | - Geoffrey T Fong
- Department of Psychology, University of Waterloo, Waterloo, Canada; School of Public Health Sciences, University of Waterloo, Waterloo, Canada; Ontario Institute for Cancer Research, Toronto, Canada
| | - Esteve Fernández
- Tobacco Control Unit, Catalan Institute of Oncology - WHO Collaborating Centre for Tobacco Control, L'Hospitalet de Llobregat, Spain; Tobacco Control Research Group, Bellvitge Biomedical Research Institute, L'Hospitalet de Llobregat, Spain; Centre for Biomedical Research in Respiratory Diseases, Institute of Health Carlos III, Madrid, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
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Kadelka S, Bouman JA, Ashcroft P, Regoes RR. Correcting for Antibody Waning in Cumulative Incidence Estimation From Sequential Serosurveys. Am J Epidemiol 2024; 193:777-786. [PMID: 38012125 PMCID: PMC11074712 DOI: 10.1093/aje/kwad226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 08/31/2023] [Accepted: 11/14/2023] [Indexed: 11/29/2023] Open
Abstract
Serosurveys are a widely used tool to estimate the cumulative incidence-the fraction of a population that has been infected by a given pathogen. These surveys rely on serological assays that measure the level of pathogen-specific antibodies. Because antibody levels are waning, the fraction of previously infected individuals that have seroreverted increases with time past infection. To avoid underestimating the true cumulative incidence, it is therefore essential to correct for waning antibody levels. We present an empirically supported approach for seroreversion correction in cumulative incidence estimation when sequential serosurveys are conducted in the context of a newly emerging infectious disease. The correction is based on the observed dynamics of antibody titers in seropositive cases and validated using several in silico test scenarios. Furthermore, through this approach we revise a previous cumulative incidence estimate relying on the assumption of an exponentially declining probability of seroreversion over time, of severe acute respiratory syndrome coronavirus 2, of 76% in Manaus, Brazil, by October 2020 to 47.6% (95% confidence region: 43.5-53.5). This estimate has implications, for example, for the proximity to herd immunity in Manaus in late 2020.
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Affiliation(s)
- Sarah Kadelka
- Correspondence to Dr. Sarah Kadelka, ETH Zürich, Institut für Integrative Biologie, CHN K 12.2, Universitätstrasse 16, 8092 Zürich, Switzerland (e-mail: ); or Prof. Dr. Roland R. Regoes, ETH Zürich, Institut für Integrative Biologie, CHN K 12.2, Universitätstrasse 16, 8092 Zürich, Switzerland (e-mail: )
| | | | | | - Roland R Regoes
- Correspondence to Dr. Sarah Kadelka, ETH Zürich, Institut für Integrative Biologie, CHN K 12.2, Universitätstrasse 16, 8092 Zürich, Switzerland (e-mail: ); or Prof. Dr. Roland R. Regoes, ETH Zürich, Institut für Integrative Biologie, CHN K 12.2, Universitätstrasse 16, 8092 Zürich, Switzerland (e-mail: )
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Littlecott H, Krishnaratne S, Burns J, Rehfuess E, Sell K, Klinger C, Strahwald B, Movsisyan A, Metzendorf MI, Schoenweger P, Voss S, Coenen M, Müller-Eberstein R, Pfadenhauer LM. Measures implemented in the school setting to contain the COVID-19 pandemic. Cochrane Database Syst Rev 2024; 5:CD015029. [PMID: 38695826 PMCID: PMC11064884 DOI: 10.1002/14651858.cd015029.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/04/2024]
Abstract
BACKGROUND More than 767 million coronavirus 2019 (COVID-19) cases and 6.9 million deaths with COVID-19 have been recorded as of August 2023. Several public health and social measures were implemented in schools to contain the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and prevent onward transmission. We built upon methods from a previous Cochrane review to capture current empirical evidence relating to the effectiveness of school measures to limit SARS-CoV-2 transmission. OBJECTIVES To provide an updated assessment of the evidence on the effectiveness of measures implemented in the school setting to keep schools open safely during the COVID-19 pandemic. SEARCH METHODS We searched the Cochrane COVID-19 Study Register, Educational Resources Information Center, World Health Organization (WHO) COVID-19 Global literature on coronavirus disease database, and the US Department of Veterans Affairs Evidence Synthesis Program COVID-19 Evidence Reviews on 18 February 2022. SELECTION CRITERIA Eligible studies focused on measures implemented in the school setting to contain the COVID-19 pandemic, among students (aged 4 to 18 years) or individuals relating to the school, or both. We categorized studies that reported quantitative measures of intervention effectiveness, and studies that assessed the performance of surveillance measures as either 'main' or 'supporting' studies based on design and approach to handling key confounders. We were interested in transmission-related outcomes and intended or unintended consequences. DATA COLLECTION AND ANALYSIS Two review authors screened titles, abstracts and full texts. We extracted minimal data for supporting studies. For main studies, one review author extracted comprehensive data and assessed risk of bias, which a second author checked. We narratively synthesized findings for each intervention-comparator-outcome category (body of evidence). Two review authors assessed certainty of evidence. MAIN RESULTS The 15 main studies consisted of measures to reduce contacts (4 studies), make contacts safer (7 studies), surveillance and response measures (6 studies; 1 assessed transmission outcomes, 5 assessed performance of surveillance measures), and multicomponent measures (1 study). These main studies assessed outcomes in the school population (12), general population (2), and adults living with a school-attending child (1). Settings included K-12 (kindergarten to grade 12; 9 studies), secondary (3 studies), and K-8 (kindergarten to grade 8; 1 study) schools. Two studies did not clearly report settings. Studies measured transmission-related outcomes (10), performance of surveillance measures (5), and intended and unintended consequences (4). The 15 main studies were based in the WHO Regions of the Americas (12), and the WHO European Region (3). Comparators were more versus less intense measures, single versus multicomponent measures, and measures versus no measures. We organized results into relevant bodies of evidence, or groups of studies relating to the same 'intervention-comparator-outcome' categories. Across all bodies of evidence, certainty of evidence ratings limit our confidence in findings. Where we describe an effect as 'beneficial', the direction of the point estimate of the effect favours the intervention; a 'harmful' effect does not favour the intervention and 'null' shows no effect either way. Measures to reduce contact (4 studies) We grouped studies into 21 bodies of evidence: moderate- (10 bodies), low- (3 bodies), or very low-certainty evidence (8 bodies). The evidence was very low to moderate certainty for beneficial effects of remote versus in-person or hybrid teaching on transmission in the general population. For students and staff, mostly harmful effects were observed when more students participated in remote teaching. Moderate-certainty evidence showed that in the general population there was probably no effect on deaths and a beneficial effect on hospitalizations for remote versus in-person teaching, but no effect for remote versus hybrid teaching. The effects of hybrid teaching, a combination of in-person and remote teaching, were mixed. Very low-certainty evidence showed that there may have been a harmful effect on risk of infection among adults living with a school student for closing playgrounds and cafeterias, a null effect for keeping the same teacher, and a beneficial effect for cancelling extracurricular activities, keeping the same students together and restricting entry for parents and caregivers. Measures to make contact safer (7 studies) We grouped studies into eight bodies of evidence: moderate- (5 bodies), and low-certainty evidence (3 bodies). Low-certainty evidence showed that there may have been a beneficial effect of mask mandates on transmission-related outcomes. Moderate-certainty evidence showed full mandates were probably more beneficial than partial or no mandates. Evidence of a beneficial effect of physical distancing on risk of infection among staff and students was mixed. Moderate-certainty evidence showed that ventilation measures probably reduce cases among staff and students. One study (very low-certainty evidence) found that there may be a beneficial effect of not sharing supplies and increasing desk space on risk of infection for adults living with a school student, but showed there may be a harmful effect of desk shields. Surveillance and response measures (6 studies) We grouped studies into seven bodies of evidence: moderate- (3 bodies), low- (1 body), and very low-certainty evidence (3 bodies). Daily testing strategies to replace or reduce quarantine probably helped to reduce missed school days and decrease the proportion of asymptomatic school contacts testing positive (moderate-certainty evidence). For studies that assessed the performance of surveillance measures, the proportion of cases detected by rapid antigen detection testing ranged from 28.6% to 95.8%, positive predictive value ranged from 24.0% to 100.0% (very low-certainty evidence). There was probably no onward transmission from contacts of a positive case (moderate-certainty evidence) and replacing or shortening quarantine with testing may have reduced missed school days (low-certainty evidence). Multicomponent measures (1 study) Combining multiple measures may have led to a reduction in risk of infection among adults living with a student (very low-certainty evidence). AUTHORS' CONCLUSIONS A range of measures can have a beneficial effect on transmission-related outcomes, healthcare utilization and school attendance. We rated the current findings at a higher level of certainty than the original review. Further high-quality research into school measures to control SARS-CoV-2 in a wider variety of contexts is needed to develop a more evidence-based understanding of how to keep schools open safely during COVID-19 or a similar public health emergency.
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Affiliation(s)
- Hannah Littlecott
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Shari Krishnaratne
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Jacob Burns
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Eva Rehfuess
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Kerstin Sell
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Carmen Klinger
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Brigitte Strahwald
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Ani Movsisyan
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Maria-Inti Metzendorf
- Institute of General Practice, Medical Faculty of the Heinrich-Heine University, Düsseldorf, Germany
| | - Petra Schoenweger
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Stephan Voss
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Michaela Coenen
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Roxana Müller-Eberstein
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Lisa M Pfadenhauer
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
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Ferous S, Siafakas N, Boufidou F, Patrinos GP, Tsakris A, Anastassopoulou C. Investigating ABO Blood Groups and Secretor Status in Relation to SARS-CoV-2 Infection and COVID-19 Severity. J Pers Med 2024; 14:346. [PMID: 38672973 PMCID: PMC11051264 DOI: 10.3390/jpm14040346] [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: 02/20/2024] [Revised: 03/22/2024] [Accepted: 03/25/2024] [Indexed: 04/28/2024] Open
Abstract
The ABO blood groups, Lewis antigens, and secretor systems are important components of transfusion medicine. These interconnected systems have been also shown to be associated with differing susceptibility to bacterial and viral infections, likely as the result of selection over the course of evolution and the constant tug of war between humans and infectious microbes. This comprehensive narrative review aimed to explore the literature and to present the current state of knowledge on reported associations of the ABO, Lewis, and secretor blood groups with SARS-CoV-2 infection and COVID-19 severity. Our main finding was that the A blood group may be associated with increased susceptibility to SARS-CoV-2 infection, and possibly also with increased disease severity and overall mortality. The proposed pathophysiological pathways explaining this potential association include antibody-mediated mechanisms and increased thrombotic risk amongst blood group A individuals, in addition to altered inflammatory cytokine expression profiles. Preliminary evidence does not support the association between ABO blood groups and COVID-19 vaccine response, or the risk of developing long COVID. Even though the emergency state of the pandemic is over, further research is needed especially in this area since tens of millions of people worldwide suffer from lingering COVID-19 symptoms.
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Affiliation(s)
- Stefanos Ferous
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias Street, 11527 Athens, Greece; (S.F.); (A.T.)
| | - Nikolaos Siafakas
- Department of Clinical Microbiology, Attikon General Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece;
| | - Fotini Boufidou
- Neurochemistry and Biological Markers Unit, 1st Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece;
| | - George P. Patrinos
- Laboratory of Pharmacogenomics and Individualized Therapy, Department of Pharmacy, School of Health Sciences, University of Patras, 26504 Patras, Greece;
- Zayed Center for Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
- Department of Genetics and Genomics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
| | - Athanasios Tsakris
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias Street, 11527 Athens, Greece; (S.F.); (A.T.)
| | - Cleo Anastassopoulou
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias Street, 11527 Athens, Greece; (S.F.); (A.T.)
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Faucher B, Sabbatini CE, Czuppon P, Kraemer MUG, Lemey P, Colizza V, Blanquart F, Boëlle PY, Poletto C. Drivers and impact of the early silent invasion of SARS-CoV-2 Alpha. Nat Commun 2024; 15:2152. [PMID: 38461311 PMCID: PMC10925057 DOI: 10.1038/s41467-024-46345-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 02/22/2024] [Indexed: 03/11/2024] Open
Abstract
SARS-CoV-2 variants of concern (VOCs) circulated cryptically before being identified as a threat, delaying interventions. Here we studied the drivers of such silent spread and its epidemic impact to inform future response planning. We focused on Alpha spread out of the UK. We integrated spatio-temporal records of international mobility, local epidemic growth and genomic surveillance into a Bayesian framework to reconstruct the first three months after Alpha emergence. We found that silent circulation lasted from days to months and decreased with the logarithm of sequencing coverage. Social restrictions in some countries likely delayed the establishment of local transmission, mitigating the negative consequences of late detection. Revisiting the initial spread of Alpha supports local mitigation at the destination in case of emerging events.
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Affiliation(s)
- Benjamin Faucher
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), F75012, Paris, France
| | - Chiara E Sabbatini
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), F75012, Paris, France
| | - Peter Czuppon
- Institute for Evolution and Biodiversity, University of Münster, Münster, 48149, Germany
| | - Moritz U G Kraemer
- Department of Biology, University of Oxford, Oxford, UK
- Pandemic Sciences Institute, University of Oxford, Oxford, UK
| | - Philippe Lemey
- Department of Microbiology, Immunology and Transplantation, Rega Institute, Laboratory for Clinical and Epidemiological Virology, KU Leuven, Leuven, Belgium
| | - Vittoria Colizza
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), F75012, Paris, France
- Department of Biology, Georgetown University, Washington, DC, USA
| | - François Blanquart
- Center for Interdisciplinary Research in Biology, CNRS, Collège de France, PSL Research University, Paris, 75005, France
| | - Pierre-Yves Boëlle
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), F75012, Paris, France
| | - Chiara Poletto
- Department of Molecular Medicine, University of Padova, 35121, Padova, Italy.
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Vaughan A, Duffell E, Freidl GS, Lemos DS, Nardone A, Valenciano M, Subissi L, Bergeri I, K Broberg E, Penttinen P, Pebody R, Keramarou M. Systematic review of seroprevalence of SARS-CoV-2 antibodies and appraisal of evidence, prior to the widespread introduction of vaccine programmes in the WHO European Region, January-December 2020. BMJ Open 2023; 13:e064240. [PMID: 37931969 PMCID: PMC10632881 DOI: 10.1136/bmjopen-2022-064240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 09/04/2023] [Indexed: 11/08/2023] Open
Abstract
OBJECTIVES Systematic review of SARS-CoV-2 seroprevalence studies undertaken in the WHO European Region to measure pre-existing and cumulative seropositivity prior to the roll out of vaccination programmes. DESIGN A systematic review of the literature. DATA SOURCES We searched MEDLINE, EMBASE and the preprint servers MedRxiv and BioRxiv in the WHO 'COVID-19 Global literature on coronavirus disease' database using a predefined search strategy. Articles were supplemented with unpublished WHO-supported Unity-aligned seroprevalence studies and other studies reported directly to WHO Regional Office for Europe and European Centre for Disease Prevention and Control. ELIGIBILITY CRITERIA Studies published before the widespread implementation of COVID-19 vaccination programmes in January 2021 among the general population and blood donors, at national and regional levels. DATA EXTRACTION AND SYNTHESIS At least two independent researchers extracted the eligible studies; a third researcher resolved any disagreements. Study risk of bias was assessed using a quality scoring system based on sample size, sampling and testing methodologies. RESULTS In total, 111 studies from 26 countries published or conducted between 1 January 2020 and 31 December 2020 across the WHO European Region were included. A significant heterogeneity in implementation was noted across the studies, with a paucity of studies from the east of the Region. Sixty-four (58%) studies were assessed to be of medium to high risk of bias. Overall, SARS-CoV-2 seropositivity prior to widespread community circulation was very low. National seroprevalence estimates after circulation started ranged from 0% to 51.3% (median 2.2% (IQR 0.7-5.2%); n=124), while subnational estimates ranged from 0% to 52% (median 5.8% (IQR 2.3%-12%); n=101), with the highest estimates in areas following widespread local transmission. CONCLUSIONS The low levels of SARS-CoV-2 antibody in most populations prior to the start of vaccine programmes underlines the critical importance of targeted vaccination of priority groups at risk of severe disease, while maintaining reduced levels of transmission to minimise population morbidity and mortality.
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Affiliation(s)
- Aisling Vaughan
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Erika Duffell
- European Centre for Disease Prevention and Control, Solna, Sweden
| | - Gudrun S Freidl
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Diogo Simão Lemos
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | | | | | | | | | - Eeva K Broberg
- European Centre for Disease Prevention and Control, Solna, Sweden
| | - Pasi Penttinen
- European Centre for Disease Prevention and Control, Solna, Sweden
| | - Richard Pebody
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Maria Keramarou
- European Centre for Disease Prevention and Control, Solna, Sweden
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7
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Luong NDM, Guillier L, Federighi M, Guillois Y, Kooh P, Maillard AL, Pivette M, Boué G, Martin-Latil S, Chaix E, Duret S. An agent-based model to simulate SARS-CoV-2 contamination of surfaces and meat cuts in processing plants. Int J Food Microbiol 2023; 404:110321. [PMID: 37499271 DOI: 10.1016/j.ijfoodmicro.2023.110321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 05/24/2023] [Accepted: 07/10/2023] [Indexed: 07/29/2023]
Abstract
At the beginning of the COVID-19 pandemic, several contamination clusters were reported in food-processing plants in France and several countries worldwide. Therefore, a need arose to better understand viral transmission in such occupational environments from multiple perspectives: the protection of workers in hotspots of viral circulation; the prevention of supply disruption due to the closure of plants; and the prevention of cluster expansion due to exports of food products contaminated by the virus to other locations. This paper outlines a simulation-based approach (using agent-based models) to study the effects of measures taken to prevent the contamination of workers, surfaces, and food products. The model includes user-defined parameters to integrate characteristics relating to SARS-CoV-2 (variant of concern to be considered, symptom onset…), food-processing plants (dimensions, ventilation…), and other sociodemographic transmission factors based on laboratory experiments as well as industrial and epidemiological investigations. Simulations were performed for a typical meat-processing plant in different scenarios for illustration purposes. The results suggested that increasing the mask-wearing ratio led to great reductions in the probability of observing clusters of more than 25 infections. In the case of clusters, masks being worn by all workers limited the presence of contamination (defined as levels of at least 5 log10 viral RNA copies) on meat cuts at less than 0.05 % and maintained the production capacity of the plant at optimal levels. Increasing the average distance between two workers from less than 1 m to more than 2 m decreased the cluster-occurrence probability by up to 15 % as well as contamination of food products during cluster situations. The developed approach can open up several perspectives in terms of potential communication-support tools for the agri-food sector and further reuses or adaptations for other hazards and occupational environments.
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Affiliation(s)
| | | | - Michel Federighi
- UMR INRAE 1014 SECALIM, Oniris, Nantes, Cedex 03, France; ENVA, 94701 Maisons-Alfort, France; Laboratory for Food Safety, ANSES, University of Paris-EST, Maisons-Alfort, France.
| | - Yvonnick Guillois
- Santé Publique France, Direction des régions, Bretagne, Saint-Maurice, France.
| | - Pauline Kooh
- Risk Assessment Department, ANSES, Maisons-Alfort, France.
| | - Anne-Laure Maillard
- Santé Publique France, Direction des régions, Bretagne, Saint-Maurice, France.
| | - Mathilde Pivette
- Santé Publique France, Direction des régions, Bretagne, Saint-Maurice, France.
| | - Géraldine Boué
- UMR INRAE 1014 SECALIM, Oniris, Nantes, Cedex 03, France.
| | - Sandra Martin-Latil
- Laboratory for Food Safety, ANSES, University of Paris-EST, Maisons-Alfort, France.
| | - Estelle Chaix
- Risk Assessment Department, ANSES, Maisons-Alfort, France.
| | - Steven Duret
- Université Paris-Saclay, INRAE, FRISE, Antony, France.
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Severo M, Meireles P, Ribeiro AI, Morais V, Barros H. Measuring the clustering effect of the SARS-CoV-2 transmission in a school population: a cross-sectional study in a high incidence region. Sci Rep 2023; 13:16300. [PMID: 37770455 PMCID: PMC10539502 DOI: 10.1038/s41598-023-42470-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 09/11/2023] [Indexed: 09/30/2023] Open
Abstract
Since the beginning of the pandemic, there has been a great deal of controversy regarding the role of schools in the spread of SARS-CoV-2 infection, and the relative contribution of students, teachers, and others. To quantify the clustering effect of SARS-CoV-2 infection within classes and schools considering the seroprevalence of specific antibodies among students and school staff (teachers and non-teachers) evaluated in schools located in the Northern region of Portugal. 1517 individuals (1307 students and 210 school staff) from 4 public and 2 private schools, comprising daycare to secondary levels, were evaluated. A rapid point-of-care test for SARS-CoV-2 specific IgM and IgG antibodies was performed and a questionnaire was completed providing sociodemographic and clinical information. We calculated the seroprevalence of IgM and IgG antibodies and estimated the Median Odds Ratio (OR) and 95% confidence interval (CI) to assess the clustering effect, using a multilevel (school and class) logistic regression. SARS-CoV-2 seroprevalence (IgM or IgG) was 21.8% and 23.8% (p = 0.575) in students and school staff, respectively. A total of 84 (8.6%) students and 35 (16.7%) school staff reported a previous molecular diagnosis. Among students, those who reported high-risk contacts only at school (OR = 1.13; 95% CI 0.72-1.78) had a seroprevalence similar to those without high-risk contacts; however, seroprevalence was significantly higher among those who only reported a high-risk contact outside the school (OR = 6.56; 95% CI 3.68-11.72), or in both places (OR = 7.83; 95% CI 5.14-11.93). Similar associations were found for school staff. The median OR was 1.00 (95% CI 1.00, 1.38) at the school-level and 1.78 (95% CI 1.40, 2.06) at the class-level. SARS-CoV-2 seroprevalence was similar between students and staff, without a clustering effect observed at the school level, and only a moderate clustering effect documented within classes. These results indicate that the mitigation measures in the school environment can prevent the spread of class outbreaks to the remaining school community.
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Affiliation(s)
- Milton Severo
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, nº 135, 4050-600, Porto, Portugal.
- Laboratório Para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Rua das Taipas 135, 4050-600, Porto, Portugal.
- Instituto de Ciências Biomédicas- Abel Salazar, Universidade do Porto, Rua de Jorge Viterbo Ferreira, 228, 4050-313, Porto, Portugal.
| | - Paula Meireles
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, nº 135, 4050-600, Porto, Portugal
- Laboratório Para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Rua das Taipas 135, 4050-600, Porto, Portugal
| | - Ana Isabel Ribeiro
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, nº 135, 4050-600, Porto, Portugal
- Laboratório Para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Rua das Taipas 135, 4050-600, Porto, Portugal
- Faculdade de Medicina, Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
| | - Vítor Morais
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, nº 135, 4050-600, Porto, Portugal
| | - Henrique Barros
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, nº 135, 4050-600, Porto, Portugal
- Laboratório Para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Rua das Taipas 135, 4050-600, Porto, Portugal
- Faculdade de Medicina, Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
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Laroche E, Fournier PS, Ouedraogo NC. Prediction of compliance with preventive measures among teachers in the context of the COVID-19 pandemic. TECHNOLOGICAL FORECASTING AND SOCIAL CHANGE 2023; 192:122564. [PMID: 37065093 PMCID: PMC10080279 DOI: 10.1016/j.techfore.2023.122564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 02/10/2023] [Accepted: 02/16/2023] [Indexed: 05/21/2023]
Abstract
The objective of this study is to examine, in primary and high schools, teachers' compliance with preventive infection control measures (in the context of the COVID-19 pandemic). Inspired by the technology acceptance model (TAM) and occupational health and safety (OHS) literature on personal protective equipment (PPE) use, we propose a model of compliance with preventive measures among teachers. Data were collected following an observational, cross-sectional design. The data for the study were collected via a questionnaire survey of teachers working in the province of Quebec, Canada. To study the impact of the explanatory variables on the dependent variable, we developed a multiple linear regression model. This model was estimated to assess the preventive measures as a whole (six items). Results show that having tested positive for a COVID test in the last year, judging that the situation does not require the use of the mask or the protective glasses, training received on preventive measures, factors related to comfort and use of protective eyewear, as well as age influence teacher compliance with COVID-19 preventive measures.
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Affiliation(s)
- Elena Laroche
- Faculty of Administrative Sciences, Laval University, Pavillon Palasis-Prince (local 0523), 2325 rue de la Terrasse, Québec G1V 0A6, Canada
| | - Pierre-Sébastien Fournier
- Faculty of Administrative Sciences, Laval University, Pavillon Palasis-Prince (local 0523), 2325 rue de la Terrasse, Québec G1V 0A6, Canada
| | - Nafissatou Cynthia Ouedraogo
- Faculty of Administrative Sciences, Laval University, Pavillon Palasis-Prince (local 0523), 2325 rue de la Terrasse, Québec G1V 0A6, Canada
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De Thoisy A, Woudenberg T, Pelleau S, Donnadieu F, Garcia L, Pinaud L, Tondeur L, Meola A, Arowas L, Clement N, Backovic M, Ungeheuer MN, Fontanet A, White M. Seroepidemiology of the Seasonal Human Coronaviruses NL63, 229E, OC43 and HKU1 in France. Open Forum Infect Dis 2023; 10:ofad340. [PMID: 37496603 PMCID: PMC10368309 DOI: 10.1093/ofid/ofad340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 06/30/2023] [Indexed: 07/28/2023] Open
Abstract
Background The seasonal human coronaviruses (HCoV) NL63, 229E, OC43, and HKU1 are globally endemic, yet the majority of HCoV infections remain undiagnosed. Methods In a cross-sectional study, 2389 serum samples were collected from children and adults in France in 2020. In a longitudinal cohort study, 2520 samples were collected from 898 French individuals followed up between 2020 and 2021. Antibodies to HCoVs were measured using a bead-based multiplex assay. Results The rate of waning of anti-HCoV spike immunoglobulin G antibodies was estimated as 0.22-0.47 year-1 for children, and 0.13-0.27 year-1 for adults. Seroreversion was estimated as 0.31-1.37 year-1 in children and 0.19-0.72 year-1 in adults. The estimated seroconversion rate in children was consistent with 20%-39% of children being infected every year with each HCoV. Conclusions The high force of infection in children indicates that HCoVs may be responsible for a substantial proportion of fever episodes experienced by children.
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Affiliation(s)
- Alix De Thoisy
- Infectious Disease Epidemiology and Analytics G5 Unit, Department of Global Health, Institut Pasteur, Université Paris Cité, Paris, France
| | - Tom Woudenberg
- Infectious Disease Epidemiology and Analytics G5 Unit, Department of Global Health, Institut Pasteur, Université Paris Cité, Paris, France
| | - Stéphane Pelleau
- Correspondence: Michael White, PhD, Infectious Disease Epidemiology and Analytics G5 Unit, Department of Global Health, Institut Pasteur, Rue du Docteur Roux, Paris 75015, France (); Stéphane Pelleau, PhD, Infectious Disease Epidemiology and Analytics G5 Unit, Department of Global Health, Institut Pasteur, Rue du Docteur Roux, Paris 75015, France ()
| | - Françoise Donnadieu
- Infectious Disease Epidemiology and Analytics G5 Unit, Department of Global Health, Institut Pasteur, Université Paris Cité, Paris, France
| | - Laura Garcia
- Infectious Disease Epidemiology and Analytics G5 Unit, Department of Global Health, Institut Pasteur, Université Paris Cité, Paris, France
| | - Laurie Pinaud
- Epidemiology of Emerging Diseases Unit, Department of Global Health, Institut Pasteur, Université Paris Cité, Paris, France
| | - Laura Tondeur
- Epidemiology of Emerging Diseases Unit, Department of Global Health, Institut Pasteur, Université Paris Cité, Paris, France
| | - Annalisa Meola
- Structural Virology Unit, Department of Virology and CNRS UMR 3569, Institut Pasteur, Université Paris Cité, Paris, France
| | - Laurence Arowas
- Investigation Clinique et Accès aux Ressources Biologiques (ICAReB), Center for Translational Research, Institut Pasteur, Paris, France
| | - Nathalie Clement
- Coordination Clinique du CRT, Center for Translational Research, Institut Pasteur, Paris, France
| | - Marija Backovic
- Structural Virology Unit, Department of Virology and CNRS UMR 3569, Institut Pasteur, Université Paris Cité, Paris, France
| | - Marie-Noëlle Ungeheuer
- Investigation Clinique et Accès aux Ressources Biologiques (ICAReB), Center for Translational Research, Institut Pasteur, Paris, France
| | - Arnaud Fontanet
- Epidemiology of Emerging Diseases Unit, Department of Global Health, Institut Pasteur, Université Paris Cité, Paris, France
- PACRI Unit, Conservatoire National des Arts et Métiers, Paris, France
| | - Michael White
- Correspondence: Michael White, PhD, Infectious Disease Epidemiology and Analytics G5 Unit, Department of Global Health, Institut Pasteur, Rue du Docteur Roux, Paris 75015, France (); Stéphane Pelleau, PhD, Infectious Disease Epidemiology and Analytics G5 Unit, Department of Global Health, Institut Pasteur, Rue du Docteur Roux, Paris 75015, France ()
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11
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Woudenberg T, Pinaud L, Garcia L, Tondeur L, Pelleau S, De Thoisy A, Donnadieu F, Backovic M, Attia M, Hozé N, Duru C, Koffi AD, Castelain S, Ungeheuer MN, Fernandes Pellerin S, Planas D, Bruel T, Cauchemez S, Schwartz O, Fontanet A, White M. Estimated protection against COVID-19 based on predicted neutralisation titres from multiple antibody measurements in a longitudinal cohort, France, April 2020 to November 2021. Euro Surveill 2023; 28:2200681. [PMID: 37347417 PMCID: PMC10288827 DOI: 10.2807/1560-7917.es.2023.28.25.2200681] [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: 08/22/2022] [Accepted: 03/28/2023] [Indexed: 06/23/2023] Open
Abstract
BackgroundThe risk of SARS-CoV-2 (re-)infection remains present given waning of vaccine-induced and infection-acquired immunity, and ongoing circulation of new variants.AimTo develop a method that predicts virus neutralisation and disease protection based on variant-specific antibody measurements to SARS-CoV-2 antigens.MethodsTo correlate antibody and neutralisation titres, we collected 304 serum samples from individuals with either vaccine-induced or infection-acquired SARS-CoV-2 immunity. Using the association between antibody and neutralisation titres, we developed a prediction model for SARS-CoV-2-specific neutralisation titres. From predicted neutralising titres, we inferred protection estimates to symptomatic and severe COVID-19 using previously described relationships between neutralisation titres and protection estimates. We estimated population immunity in a French longitudinal cohort of 905 individuals followed from April 2020 to November 2021.ResultsWe demonstrated a strong correlation between anti-SARS-CoV-2 antibodies measured using a low cost high-throughput assay and antibody response capacity to neutralise live virus. Participants with a single vaccination or immunity caused by infection were especially vulnerable to symptomatic or severe COVID-19. While the median reduced risk of COVID-19 from Delta variant infection in participants with three vaccinations was 96% (IQR: 94-98), median reduced risk among participants with infection-acquired immunity was only 42% (IQR: 22-66).ConclusionOur results are consistent with data from vaccine effectiveness studies, indicating the robustness of our approach. Our multiplex serological assay can be readily adapted to study new variants and provides a framework for development of an assay that would include protection estimates.
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Affiliation(s)
- Tom Woudenberg
- Infectious Disease Epidemiology and Analytics G5 Unit, Department of Global Health, Institut Pasteur, Université Paris-Cité, Paris, France
| | - Laurie Pinaud
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Université Paris-Cité, Paris, France
| | - Laura Garcia
- Infectious Disease Epidemiology and Analytics G5 Unit, Department of Global Health, Institut Pasteur, Université Paris-Cité, Paris, France
| | - Laura Tondeur
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Université Paris-Cité, Paris, France
| | - Stéphane Pelleau
- Infectious Disease Epidemiology and Analytics G5 Unit, Department of Global Health, Institut Pasteur, Université Paris-Cité, Paris, France
| | - Alix De Thoisy
- Infectious Disease Epidemiology and Analytics G5 Unit, Department of Global Health, Institut Pasteur, Université Paris-Cité, Paris, France
| | - Françoise Donnadieu
- Infectious Disease Epidemiology and Analytics G5 Unit, Department of Global Health, Institut Pasteur, Université Paris-Cité, Paris, France
| | - Marija Backovic
- Structural Virology Unit, Department of Virology and CNRS UMR 3569, Institut Pasteur, Université Paris-Cité, Paris, France
| | - Mikaël Attia
- Molecular Genetics of RNA Viruses, Department of Virology, Institut Pasteur, Université Paris-Cité, CNRS UMR 3569, Paris, France
| | - Nathanael Hozé
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, Université Paris-Cité, UMR2000, CNRS, Paris, France
| | - Cécile Duru
- Hôpital de Crépy-en-Valois, Crépy-en-Valois, France
| | | | | | - Marie-Noelle Ungeheuer
- Clinical Investigation and Access to Research Bioresources (ICAReB) platform, Center for Translational Science, Institut Pasteur, Paris, France
| | | | - Delphine Planas
- Virus and Immunity Unit, Department of Virology, Institut Pasteur, Université Paris-Cité, Paris, France
| | - Timothée Bruel
- Virus and Immunity Unit, Department of Virology, Institut Pasteur, Université Paris-Cité, Paris, France
| | - Simon Cauchemez
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, Université Paris-Cité, UMR2000, CNRS, Paris, France
| | - Olivier Schwartz
- Virus and Immunity Unit, Department of Virology, Institut Pasteur, Université Paris-Cité, Paris, France
| | - Arnaud Fontanet
- PACRI Unit, Conservatoire National des Arts et Métiers, Paris, France
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Université Paris-Cité, Paris, France
| | - Michael White
- Infectious Disease Epidemiology and Analytics G5 Unit, Department of Global Health, Institut Pasteur, Université Paris-Cité, Paris, France
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12
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Moschovis PP, Lombay J, Rooney J, Schenkel SR, Singh D, Rezaei SJ, Salo N, Gong A, Yonker LM, Shah J, Hayden D, Hibberd PL, Demokritou P, Kinane TB. The effect of activity and face masks on exhaled particles in children. Pediatr Investig 2023; 7:75-85. [PMID: 37324601 PMCID: PMC10262878 DOI: 10.1002/ped4.12376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 01/29/2023] [Indexed: 06/17/2023] Open
Abstract
Importance Despite the high burden of respiratory infections among children, the production of exhaled particles during common activities and the efficacy of face masks in children have not been sufficiently studied. Objective To determine the effect of type of activity and mask usage on exhaled particle production in children. Methods Healthy children were asked to perform activities that ranged in intensity (breathing quietly, speaking, singing, coughing, and sneezing) while wearing no mask, a cloth mask, or a surgical mask. The concentration and size of exhaled particles were assessed during each activity. Results Twenty-three children were enrolled in the study. Average exhaled particle concentration increased by intensity of activity, with the lowest particle concentration during tidal breathing (1.285 particles/cm3 [95% CI 0.943, 1.627]) and highest particle concentration during sneezing (5.183 particles/cm3 [95% CI 1.911, 8.455]). High-intensity activities were associated with an increase primarily in the respirable size (≤ 5 µm) particle fraction. Surgical and cloth masks were associated with lower average particle concentration compared to no mask (P = 0.026 for sneezing). Surgical masks outperformed cloth masks across all activities, especially within the respirable size fraction. In a multivariable linear regression model, we observed significant effect modification of activity by age and by mask type. Interpretation Similar to adults, children produce exhaled particles that vary in size and concentration across a range of activities. Production of respirable size fraction particles (≤ 5 µm), the dominant mode of transmission of many respiratory viruses, increases significantly with coughing and sneezing and is most effectively reduced by wearing surgical face masks.
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Affiliation(s)
- Peter P. Moschovis
- Department of PediatricsMassachusetts General Hospital and Harvard Medical SchoolBostonMassachusettsUSA
| | - Jesiel Lombay
- Department of PediatricsMassachusetts General Hospital and Harvard Medical SchoolBostonMassachusettsUSA
| | - Jennifer Rooney
- Department of PediatricsMassachusetts General Hospital and Harvard Medical SchoolBostonMassachusettsUSA
| | - Sara R. Schenkel
- Department of PediatricsMassachusetts General Hospital and Harvard Medical SchoolBostonMassachusettsUSA
| | - Dilpreet Singh
- Department of Environmental HealthHarvard T. H. Chan School of Public HealthBostonMassachusettsUSA
- Department of Mechanical and Aerospace EngineeringRutgers University School of Public HealthNew BrunswickNew JerseyUSA
| | - Shawheen J. Rezaei
- Department of PediatricsMassachusetts General Hospital and Harvard Medical SchoolBostonMassachusettsUSA
| | - Nora Salo
- Department of PediatricsMassachusetts General Hospital and Harvard Medical SchoolBostonMassachusettsUSA
| | - Amanda Gong
- David Geffen School of Medicinethe University of California Los AngelesLos AngelesCaliforniaUSA
| | - Lael M. Yonker
- Department of PediatricsMassachusetts General Hospital and Harvard Medical SchoolBostonMassachusettsUSA
| | - Jhill Shah
- Department of PediatricsMassachusetts General Hospital and Harvard Medical SchoolBostonMassachusettsUSA
| | - Douglas Hayden
- Department of PediatricsMassachusetts General Hospital and Harvard Medical SchoolBostonMassachusettsUSA
| | - Patricia L. Hibberd
- Department of Global HealthBoston University School of Public HealthBostonMassachusettsUSA
| | - Philip Demokritou
- Department of Environmental HealthHarvard T. H. Chan School of Public HealthBostonMassachusettsUSA
- Department of Mechanical and Aerospace EngineeringRutgers University School of Public HealthNew BrunswickNew JerseyUSA
| | - T. Bernard Kinane
- Department of PediatricsMassachusetts General Hospital and Harvard Medical SchoolBostonMassachusettsUSA
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Campigotto A, Chris A, Orkin J, Lau L, Marshall C, Bitnun A, Buchan SA, MacDonald L, Thampi N, McCready J, Juni P, Parekh RS, Science M. Utility of SARS-CoV-2 Genomic Sequencing for Understanding Transmission and School Outbreaks. Pediatr Infect Dis J 2023; 42:324-331. [PMID: 36795555 PMCID: PMC9990487 DOI: 10.1097/inf.0000000000003834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/17/2022] [Indexed: 02/17/2023]
Abstract
OBJECTIVE An understanding of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) transmission in schools is important. It is often difficult, using epidemiological information alone, to determine whether cases associated with schools represent multiple introductions from the community or transmission within the school. We describe the use of whole genome sequencing (WGS) in multiple schools to investigate outbreaks of SARS-CoV-2 in the pre-Omicron period. STUDY DESIGN School outbreaks were identified for sequencing by local public health units based on multiple cases without known epidemiological links. Cases of SARS-CoV-2 from students and staff from 4 school outbreaks in Ontario underwent WGS and phylogenetic analysis. The epidemiological clinical cohort data and genomic cluster data are described to help further characterize these outbreaks. RESULTS A total of 132 positive SARS-CoV-2 cases among students and staff from 4 school outbreaks were identified with 65 (49%) of cases able to be sequenced with high-quality genomic data. The 4 school outbreaks consisted of 53, 37, 21 and 21 positive cases; within each outbreak there were between 8 and 28 different clinical cohorts identified. Among the sequenced cases, between 3 and 7 genetic clusters, defined as different strains, were identified in each outbreak. We found genetically different viruses within several clinical cohorts. CONCLUSIONS WGS, together with public health investigation, is a useful tool to investigate SARS-CoV-2 transmission within schools. Its early use has the potential to better understand when transmission may have occurred, can aid in evaluating how well mitigation interventions are working and has the potential to reduce unnecessary school closures when multiple genetic clusters are identified.
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Affiliation(s)
- Aaron Campigotto
- From the Division of Microbiology, Department of Paediatric Laboratory Medicine, The Hospital for Sick Children
- Department of Laboratory Medicine and Pathobiology, University of Toronto
| | | | | | - Lynette Lau
- Division of Genome Diagnostics, Department of Paediatric Laboratory Medicine
| | - Christian Marshall
- Department of Laboratory Medicine and Pathobiology, University of Toronto
- Division of Genome Diagnostics, Department of Paediatric Laboratory Medicine
| | - Ari Bitnun
- Department of Paediatrics
- Division of Infectious Diseases, The Hospital for Sick Children
| | - Sarah A Buchan
- Public Health Ontario
- Dalla Lana School of Public Health, University of Toronto
| | | | - Nisha Thampi
- Department of Paediatrics, Children’s Hospital of Eastern Ontario
| | - Janine McCready
- Division of Infectious Diseases, Department of Medicine, Michael Garron Hospital
| | - Peter Juni
- St. Michael’s Hospital, Applied Health Research Centre, Li Ka Shing Knowledge Institute, University of Toronto
| | - Rulan S Parekh
- Department of Medicine, Women’s College Hospital, Toronto, ON, Canada
| | - Michelle Science
- Division of Infectious Diseases, The Hospital for Sick Children
- Public Health Ontario
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Cuschieri L, Deguara M, Bartolo D, Calleja N, Gauci C. A descriptive study of COVID-19 cases in primary and secondary schools in the Maltese islands: a nationwide experience. Eur J Public Health 2023; 33:209-214. [PMID: 36773316 PMCID: PMC10066482 DOI: 10.1093/eurpub/ckad017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023] Open
Abstract
BACKGROUND As part of the measures to contain the initial cases of Coronavirus Disease (COVID-19) in 2020, all educational facilities were closed in March 2020 and remained so for the remainder of that scholastic year. When they reopened in October 2020, most educational facilities on the Maltese islands did so with various mitigation measures in place. METHODS A Schools Contact Tracing Team (SCTT) dedicated to the management of COVID-19 cases within schools was set up and networks established between the Ministries responsible for Health and Education to facilitate timely communication and, consequently, effective contact tracing. All cases pertaining to educational facilities, be they students, teaching or non-teaching staff were assessed and managed by this Team. RESULTS Between October 2020 and June 2021, the SCTT assessed 2603 COVID-19 cases within educational facilities in Malta. The highest rate of cases overall was observed in teaching staff (56.53/1000). In 72.45% of cases, no contacts were identified as high risk and thus nobody was placed in quarantine. In 3.07% of school cases >21 high-risk contacts were placed in mandatory quarantine together with their household members. Only 11% of the cases were epi-linked to another positive case within school. CONCLUSIONS The strong collaboration between the health and education authorities combined with strict measures observed in schools ensured that schools remained open throughout most of this pandemic. This study describes the processes by which contact tracing for COVID-19 cases in Maltese schools was carried out and analyses the data collected throughout the scholastic year 2020-21.
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Affiliation(s)
- Liliana Cuschieri
- Infectious Disease Prevention and Control Unit, Health Promotion and Disease Prevention Directorate, Pietà, Malta
| | - Michelle Deguara
- Health Promotion Unit, Health Promotion and Disease Prevention Directorate, Pietà, Malta
| | - Dale Bartolo
- Public Health Laboratory, Environmental Health Directorate, Valletta, Malta
| | - Neville Calleja
- Directorate for Health Information and Research, Pietà, Malta
| | - Charmaine Gauci
- Superintendence of Public Health, St. Luke's Hospital, Pietà, Malta
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15
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Ueda M, Hayashi K, Nishiura H. Identifying High-Risk Events for COVID-19 Transmission: Estimating the Risk of Clustering Using Nationwide Data. Viruses 2023; 15:v15020456. [PMID: 36851670 PMCID: PMC9967753 DOI: 10.3390/v15020456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 02/02/2023] [Accepted: 02/04/2023] [Indexed: 02/10/2023] Open
Abstract
The transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is known to be overdispersed, meaning that only a fraction of infected cases contributes to super-spreading. While cluster interventions are an effective measure for controlling pandemics due to the viruses' overdispersed nature, a quantitative assessment of the risk of clustering has yet to be sufficiently presented. Using systematically collected cluster surveillance data for coronavirus disease 2019 (COVID-19) from June 2020 to June 2021 in Japan, we estimated the activity-dependent risk of clustering in 23 establishment types. The analysis indicated that elderly care facilities, welfare facilities for people with disabilities, and hospitals had the highest risk of clustering, with 4.65 (95% confidence interval [CI]: 4.43-4.87), 2.99 (2.59-3.46), and 2.00 (1.88-2.12) cluster reports per million event users, respectively. Risks in educational settings were higher overall among older age groups, potentially being affected by activities with close and uncontrollable contact during extracurricular hours. In dining settings, drinking and singing increased the risk by 10- to 70-fold compared with regular eating settings. The comprehensive analysis of the COVID-19 cluster records provides an additional scientific basis for the design of customized interventions.
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Colosi E, Bassignana G, Barrat A, Lina B, Vanhems P, Bielicki J, Colizza V. Minimising school disruption under high incidence conditions due to the Omicron variant in France, Switzerland, Italy, in January 2022. Euro Surveill 2023; 28:2200192. [PMID: 36729116 PMCID: PMC9896604 DOI: 10.2807/1560-7917.es.2023.28.5.2200192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 11/21/2022] [Indexed: 02/03/2023] Open
Abstract
BackgroundAs record cases of Omicron variant were registered in Europe in early 2022, schools remained a vulnerable setting undergoing large disruption.AimThrough mathematical modelling, we compared school protocols of reactive screening, regular screening, and reactive class closure implemented in France, in Baselland (Switzerland), and in Italy, respectively, and assessed them in terms of case prevention, testing resource demand, and schooldays lost.MethodsWe used a stochastic agent-based model of SARS-CoV-2 transmission in schools accounting for within- and across-class contacts from empirical contact data. We parameterised it to the Omicron BA.1 variant to reproduce the French Omicron wave in January 2022. We simulated the three protocols to assess their costs and effectiveness for varying peak incidence rates in the range experienced by European countries.ResultsWe estimated that at the high incidence rates registered in France during the Omicron BA.1 wave in January 2022, the reactive screening protocol applied in France required higher test resources compared with the weekly screening applied in Baselland (0.50 vs 0.45 tests per student-week), but achieved considerably lower control (8% vs 21% reduction of peak incidence). The reactive class closure implemented in Italy was predicted to be very costly, leading to > 20% student-days lost.ConclusionsAt high incidence conditions, reactive screening protocols generate a large and unplanned demand in testing resources, for marginal control of school transmissions. Comparable or lower resources could be more efficiently used through weekly screening. Our findings can help define incidence levels triggering school protocols and optimise their cost-effectiveness.
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Affiliation(s)
- Elisabetta Colosi
- Sorbonne Université, INSERM, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
| | - Giulia Bassignana
- Sorbonne Université, INSERM, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
| | - Alain Barrat
- Aix Marseille Univ, Université de Toulon, CNRS, CPT, Turing Center for Living Systems, Marseille, France
| | - Bruno Lina
- Centre International de Recherche en Infectiologie (CIRI), Virpath Laboratory, INSERM U1111, CNRS-UMR 5308, École Normale Supérieure de Lyon, Université Claude Bernard Lyon, Lyon University, Lyon, France
- National Reference Center for Respiratory Viruses, Department of Virology, Infective Agents Institute, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France
| | - Philippe Vanhems
- Centre International de Recherche en Infectiologie (CIRI), Public Health, Epidemiology and Evolutionary Ecology of Infectious Diseases (PHE3ID) - Inserm - U1111 - UCBL Lyon 1 - CNRS -UMR5308 - ENS de Lyon, Lyon, France
- Service d'Hygiène, Épidémiologie, Infectiovigilance et Prévention, Hospices Civils de Lyon, Lyon, France
| | - Julia Bielicki
- Paediatric Infectious Diseases, University of Basel Children's Hospital, Basel, Switzerland
| | - Vittoria Colizza
- Sorbonne Université, INSERM, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
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17
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Van Egeren D, Stoddard M, Malakar A, Ghosh D, Acharya A, Mainuddin S, Majumdar B, Luo D, Nolan RP, Joseph-McCarthy D, White LF, Hochberg NS, Basu S, Chakravarty A. No magic bullet: Limiting in-school transmission in the face of variable SARS-CoV-2 viral loads. Front Public Health 2022; 10:941773. [PMID: 36530725 PMCID: PMC9751474 DOI: 10.3389/fpubh.2022.941773] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 11/04/2022] [Indexed: 12/05/2022] Open
Abstract
In the face of a long-running pandemic, understanding the drivers of ongoing SARS-CoV-2 transmission is crucial for the rational management of COVID-19 disease burden. Keeping schools open has emerged as a vital societal imperative during the pandemic, but in-school transmission of SARS-CoV-2 can contribute to further prolonging the pandemic. In this context, the role of schools in driving SARS-CoV-2 transmission acquires critical importance. Here we model in-school transmission from first principles to investigate the effectiveness of layered mitigation strategies on limiting in-school spread. We examined the effect of masks and air quality (ventilation, filtration and ionizers) on steady-state viral load in classrooms, as well as on the number of particles inhaled by an uninfected person. The effectiveness of these measures in limiting viral transmission was assessed for variants with different levels of mean viral load (ancestral, Delta, Omicron). Our results suggest that a layered mitigation strategy can be used effectively to limit in-school transmission, with certain limitations. First, poorly designed strategies (insufficient ventilation, no masks, staying open under high levels of community transmission) will permit in-school spread even if some level of mitigation is present. Second, for viral variants that are sufficiently contagious, it may be difficult to construct any set of interventions capable of blocking transmission once an infected individual is present, underscoring the importance of other measures. Our findings provide practical recommendations; in particular, the use of a layered mitigation strategy that is designed to limit transmission, with other measures such as frequent surveillance testing and smaller class sizes (such as by offering remote schooling options to those who prefer it) as needed.
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Affiliation(s)
- Debra Van Egeren
- Department of Medicine, Weill Cornell Medicine, New York, NY, United States
- New York Genome Center, New York, NY, United States
| | | | - Abir Malakar
- Department of Mechanical Engineering, South Dakota State University, Brookings, SD, United States
- Department of Civil Engineering, Jadavpur University, Kolkata, India
| | - Debayan Ghosh
- Department of Civil Engineering, Jadavpur University, Kolkata, India
| | - Antu Acharya
- Department of Civil Engineering, Jadavpur University, Kolkata, India
| | - Sk Mainuddin
- Department of Civil Engineering, Jadavpur University, Kolkata, India
| | - Biswajit Majumdar
- Department of Civil Engineering, Jadavpur University, Kolkata, India
| | - Deborah Luo
- Amity Regional High School, Woodbridge, CT, United States
| | | | | | - Laura F. White
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, United States
| | - Natasha S. Hochberg
- Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, MA, United States
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, United States
| | - Saikat Basu
- Department of Mechanical Engineering, South Dakota State University, Brookings, SD, United States
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18
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Rodríguez D, Urbieta IR, Velasco Á, Campano-Laborda MÁ, Jiménez E. Assessment of indoor air quality and risk of COVID-19 infection in Spanish secondary school and university classrooms. BUILDING AND ENVIRONMENT 2022; 226:109717. [PMID: 36313012 PMCID: PMC9595429 DOI: 10.1016/j.buildenv.2022.109717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 10/14/2022] [Accepted: 10/15/2022] [Indexed: 06/16/2023]
Abstract
Despite the risk of transmission of SARS-CoV-2, Spanish educational centers were reopened after six months of lockdown. Ventilation was mostly adopted as a preventive measure to reduce the transmission risk of the virus. However, it could also affect indoor air quality (IAQ). Therefore, here we evaluate the ventilation conditions, COVID-19 risk, and IAQ in secondary school and university classrooms in Toledo (central Spain) from November 2020 to June 2021. Ventilation was examined by monitoring outdoor and indoor CO2 levels. CO2, occupancy and hygrothermal parameters, allowed estimating the relative transmission risk of SARS-CoV-2 (Alpha and Omicron BA.1), H r, under different scenarios, using the web app COVID Risk airborne . Additionally, the effect of ventilation on IAQ was evaluated by measuring indoor/outdoor (I/O) concentration ratios of O3, NO2, and suspended particulate matter (PM). University classrooms, particularly the mechanically ventilated one, presented better ventilation conditions than the secondary school classrooms, as well as better thermal comfort conditions. The estimated H r for COVID-19 ranged from intermediate (with surgical masks) to high (no masks, teacher infected). IAQ was generally good in all classrooms, particularly at the university ones, with I/O below unity, implying an outdoor origin of gaseous pollutants, while the source of PM was heterogeneous. Consequently, controlled mechanical ventilation systems are essential in educational spaces, as well as wearing well-fitting FFP2-N95 masks indoors is also highly recommended to minimize the transmission risk of COVID-19 and other airborne infectious diseases.
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Affiliation(s)
- Diana Rodríguez
- Departamento de Química Física, Facultad de Ciencias Ambientales y Bioquímica, Universidad de Castilla-La Mancha (UCLM), Avenida Carlos III s/n, 45071, Toledo, Spain
| | - Itziar R Urbieta
- Departamento de Ciencias Ambientales, Facultad de Ciencias Ambientales y Bioquímica, UCLM, Avenida Carlos III s/n, 45071, Toledo, Spain
| | - Ángel Velasco
- Departamento de Ciencias Ambientales, Facultad de Ciencias Ambientales y Bioquímica, UCLM, Avenida Carlos III s/n, 45071, Toledo, Spain
| | - Miguel Ángel Campano-Laborda
- Instituto Universitario de Arquitectura y Ciencias de la Construcción, Escuela Técnica Superior de Arquitectura, Universidad de Sevilla, 41012, Sevilla, Spain
| | - Elena Jiménez
- Departamento de Química Física, Facultad de Ciencias y Tecnologías Químicas, UCLM, Avda. Camilo José Cela 1B, 13071, Ciudad Real, Spain
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19
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López-Muñoz I, Torrella A, Pérez-Quílez O, Castillo-Zuza A, Martró E, Bordoy AE, Saludes V, Blanco I, Soldevila L, Estrada O, Valerio L, Roure S, Vallès X. SARS-CoV-2 Secondary Attack Rates in Vaccinated and Unvaccinated Household Contacts during Replacement of Delta with Omicron Variant, Spain. Emerg Infect Dis 2022; 28:1999-2008. [PMID: 36037811 PMCID: PMC9514368 DOI: 10.3201/eid2810.220494] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
We performed a prospective, cross-sectional study of household contacts of symptomatic index case-patients with SARS-CoV-2 infection during the shift from Delta- to Omicron-dominant variants in Spain. We included 466 household contacts from 227 index cases. The secondary attack rate was 58.2% (95% CI 49.1%-62.6%) during the Delta-dominant period and 80.9% (95% CI 75.0%-86.9%) during the Omicron-dominant period. During the Delta-dominant period, unvaccinated contacts had higher probability of infection than vaccinated contacts (odds ratio 5.42, 95% CI 1.6-18.6), but this effect disappeared at ≈20 weeks after vaccination. Contacts showed a higher relative risk of infection (9.16, 95% CI 3.4-25.0) in the Omicron-dominant than Delta-dominant period when vaccinated within the previous 20 weeks. Our data suggest vaccine evasion might be a cause of rapid spread of the Omicron variant. We recommend a focus on developing vaccines with long-lasting protection against severe disease, rather than only against infectivity.
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20
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Endo (遠藤彰) A, Uchida (内田満夫) M, Liu (刘扬) Y, Atkins KE, Kucharski AJ, Funk S. Simulating respiratory disease transmission within and between classrooms to assess pandemic management strategies at schools. Proc Natl Acad Sci U S A 2022; 119:e2203019119. [PMID: 36074818 PMCID: PMC9478679 DOI: 10.1073/pnas.2203019119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 07/19/2022] [Indexed: 11/30/2022] Open
Abstract
The global spread of coronavirus disease 2019 (COVID-19) has emphasized the need for evidence-based strategies for the safe operation of schools during pandemics that balance infection risk with the society's responsibility of allowing children to attend school. Due to limited empirical data, existing analyses assessing school-based interventions in pandemic situations often impose strong assumptions, for example, on the relationship between class size and transmission risk, which could bias the estimated effect of interventions, such as split classes and staggered attendance. To fill this gap in school outbreak studies, we parameterized an individual-based model that accounts for heterogeneous contact rates within and between classes and grades to a multischool outbreak data of influenza. We then simulated school outbreaks of respiratory infectious diseases of ongoing threat (i.e., COVID-19) and potential threat (i.e., pandemic influenza) under a variety of interventions (changing class structures, symptom screening, regular testing, cohorting, and responsive class closures). Our results suggest that interventions changing class structures (e.g., reduced class sizes) may not be effective in reducing the risk of major school outbreaks upon introduction of a case and that other precautionary measures (e.g., screening and isolation) need to be employed. Class-level closures in response to detection of a case were also suggested to be effective in reducing the size of an outbreak.
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Affiliation(s)
- Akira Endo (遠藤彰)
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London WC1E 7HT, United Kingdom
- The Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London WC1E 7HT, United Kingdom
- The Alan Turing Institute, London NW1 2DB, United Kingdom
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki 852-8523, Japan
- Japan Society for the Promotion of Science, Tokyo 102-0083, Japan
| | - CMMID COVID-19 Working Group
- The Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London WC1E 7HT, United Kingdom
| | | | - Yang Liu (刘扬)
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London WC1E 7HT, United Kingdom
- The Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London WC1E 7HT, United Kingdom
| | - Katherine E. Atkins
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London WC1E 7HT, United Kingdom
- The Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London WC1E 7HT, United Kingdom
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh EH16 4UX, United Kingdom
| | - Adam J. Kucharski
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London WC1E 7HT, United Kingdom
- The Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London WC1E 7HT, United Kingdom
| | - Sebastian Funk
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London WC1E 7HT, United Kingdom
- The Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London WC1E 7HT, United Kingdom
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21
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Cyrille TM, Serge SM, Brice TMJ, Alain TNP, Grace N, Joseph F, Achta H, Gisèle N, Julius N, Marcel T, Melissa S, Lucy N, Ronald P, Claire OAM, Walter PYE, Alain EMG, Richard N, Sara E. Clinical presentation of COVID-19 at the time of testing and factors associated with pre-symptomatic cases in Cameroon. IJID REGIONS 2022; 4:33-41. [PMID: 35720960 PMCID: PMC9148624 DOI: 10.1016/j.ijregi.2022.05.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 05/25/2022] [Accepted: 05/26/2022] [Indexed: 05/29/2023]
Abstract
Objectives To describe the clinical features at time of testing and explore factors associated with SARS-CoV-2 infection and pre-symptomatic cases in Cameroon. Methods Data was collected on people in Cameroon who participated in COVID-19 testing by real-time reverse transcriptase-polymerase chain reaction between 1 March and 5 October 2020. After descriptive analysis, multivariate logistic regression was used to identify factors associated with SARS-CoV-2 infection and pre-symptomatic cases. Results Of 85 206 test participants, 14 863 (17.4%) were infected with SARS-CoV-2. The median age for cases was 38.4 years (interquartile range 29.6-49.4); 6.1% were aged <19 years, and 6.3% were ≥65 years. Of these cases, 46.5% had at least one symptom/sign with a median time from illness onset to testing of 6 days (interquartile range 3-9). Cough (64.2%), headache (46.5%), fatigue/malaise (46.0%), shortness of breath (30.6%) and myalgia/arthralgia (25.6%) were the most commonly observed symptoms/signs. Pre-symptomatic SARS-CoV-2 infection was associated with age <50 years, being male and absence of comorbidities. Conclusion This study provides a comprehensive summary of the early clinical profile of SARS-CoV-2 infection during the first wave of COVID-19 in Cameroon, which was dominated by pre-symptomatic illness. These findings would be helpful for SARS-CoV-2 surveillance and control at a regional level.
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Affiliation(s)
| | | | | | | | - Ngondi Grace
- Virology Laboratory, Laquintinie Hospital, Douala, Cameroon
| | - Fokam Joseph
- Chantal BIYA International Reference Centre for research on HIV/AIDS prevention and management, Yaoundé, Cameroon
| | - Hamadou Achta
- Epidemiology and Public Health Service, Pasteur Centre in Cameroon, Yaoundé, Cameroon
| | | | | | - Tongo Marcel
- Emerging and Reemerging Diseases Research Centre, IMPM, Yaoundé, Cameroon
| | - Sander Melissa
- Tuberculosis Reference Laboratory Bamenda, Bamenda, Cameroon
| | - Ndip Lucy
- Laboratory of Emerging Infectious Diseases, University of Buea, Buea, Cameroon
| | - Perraut Ronald
- Pasteur Centre in Cameroon, Annex of Garoua, Garoua, Cameroon
| | | | | | - Etoundi Mballa Georges Alain
- Public Health Emergency Operations Coordination Centre, Yaoundé, Cameroon
- Department for the Control of Disease, Epidemics, and Pandemics, Ministry of Public Health, Yaoundé, Cameroon
| | - Njouom Richard
- Virology Service, Pasteur Centre in Cameroon, Yaoundé, Cameroon
| | - Eyangoh Sara
- Public Health Emergency Operations Coordination Centre, Yaoundé, Cameroon
- Scientific Department, Pasteur Centre in Cameroon, Yaoundé
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22
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Nenna R, Zeric H, Petrarca L, Mancino E, Midulla F. Weighing policymaking: A narrative review of school closures as COVID-19 pandemic-mitigation strategies. Pediatr Pulmonol 2022; 57:1982-1989. [PMID: 34894111 DOI: 10.1002/ppul.25787] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 11/30/2021] [Accepted: 12/07/2021] [Indexed: 12/23/2022]
Abstract
INTRODUCTION In the era of data-driven decision-making, unacceptable haziness, and inconsistency surrounds the yearlong scientific and public debate on the school closure policy in the coronavirus disease-2019 (COVID-19) pandemic mitigation efforts. AIM The present literature review stems out of the need for a clear scaffold collecting in one place all current evidence, as well as helping to organize incoming future evidence, concerning both the role of schools in driving the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) community spread and the cost-effectiveness of school closure in containing such spread. METHODS References for this review were initially identified through searches of PubMed, Scopus, and Cochrane Library for articles published from March 2020 to March 2021 by the use of key terms "Schools," "COVID-19," "pandemic," "clusters," "outbreak," and "seroprevalence," selecting all articles from 2020 to 2021 with full-text availability. A further search was undertaken by screening citations of articles found in the original search and through Google Scholar and ResearchGate. RESULTS Overall, evidence shows that opening schools and keeping them open in the context of the SARS-CoV-2 pandemic is possible, although behaviorally challenging and unfeasible if educational facilities or testing services are inadequate. Contrary to other respiratory viruses, children are not chief targets of SARS-CoV-2 infection, transmission, and disease. It also appears that the second wave of the SARS-CoV-2 virus spread in the WHO European region has been unrelated to school re-opening. CONCLUSIONS A fact-based understanding of what is currently known on such a consequential policy is required to provide a basis of evidence for advocacy of either school closure or school opening at times of high-intensity community transmission of SARS-CoV-2.
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Affiliation(s)
- Raffaella Nenna
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Hana Zeric
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Laura Petrarca
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Enrica Mancino
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Fabio Midulla
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
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23
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Keeling MJ, Dyson L, Guyver-Fletcher G, Holmes A, Semple MG, Tildesley MJ, Hill EM. Fitting to the UK COVID-19 outbreak, short-term forecasts and estimating the reproductive number. Stat Methods Med Res 2022; 31:1716-1737. [PMID: 35037796 PMCID: PMC9465059 DOI: 10.1177/09622802211070257] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The COVID-19 pandemic has brought to the fore the need for policy makers to receive timely and ongoing scientific guidance in response to this recently emerged human infectious disease. Fitting mathematical models of infectious disease transmission to the available epidemiological data provide a key statistical tool for understanding the many quantities of interest that are not explicit in the underlying epidemiological data streams. Of these, the effective reproduction number, [Formula: see text], has taken on special significance in terms of the general understanding of whether the epidemic is under control ([Formula: see text]). Unfortunately, none of the epidemiological data streams are designed for modelling, hence assimilating information from multiple (often changing) sources of data is a major challenge that is particularly stark in novel disease outbreaks. Here, focusing on the dynamics of the first wave (March-June 2020), we present in some detail the inference scheme employed for calibrating the Warwick COVID-19 model to the available public health data streams, which span hospitalisations, critical care occupancy, mortality and serological testing. We then perform computational simulations, making use of the acquired parameter posterior distributions, to assess how the accuracy of short-term predictions varied over the time course of the outbreak. To conclude, we compare how refinements to data streams and model structure impact estimates of epidemiological measures, including the estimated growth rate and daily incidence.
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Affiliation(s)
- Matt J Keeling
- The Zeeman Institute for Systems Biology & Infectious Disease Epidemiology Research, School of Life Sciences and Mathematics Institute, 2707University of Warwick, UK
- Joint Universities Pandemic and Epidemiological Research, https://maths.org/juniper/
| | - Louise Dyson
- The Zeeman Institute for Systems Biology & Infectious Disease Epidemiology Research, School of Life Sciences and Mathematics Institute, 2707University of Warwick, UK
- Joint Universities Pandemic and Epidemiological Research, https://maths.org/juniper/
| | - Glen Guyver-Fletcher
- The Zeeman Institute for Systems Biology & Infectious Disease Epidemiology Research, School of Life Sciences and Mathematics Institute, 2707University of Warwick, UK
- Midlands Integrative Biosciences Training Partnership, School of Life Sciences, 2707University of Warwick, UK
| | - Alex Holmes
- The Zeeman Institute for Systems Biology & Infectious Disease Epidemiology Research, School of Life Sciences and Mathematics Institute, 2707University of Warwick, UK
- Mathematics for Real World Systems Centre for Doctoral Training, Mathematics Institute, 2707University of Warwick, UK
| | - Malcolm G Semple
- NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, Institute of Infection, Veterinary and Ecological Sciences, Faculty of Health and Life Sciences, 4591University of Liverpool, UK
- Respiratory Medicine, Alder Hey Children's Hospital, Institute in The Park, 4591University of Liverpool, Alder Hey Children's Hospital, Liverpool, UK
| | - Michael J Tildesley
- The Zeeman Institute for Systems Biology & Infectious Disease Epidemiology Research, School of Life Sciences and Mathematics Institute, 2707University of Warwick, UK
- Joint Universities Pandemic and Epidemiological Research, https://maths.org/juniper/
| | - Edward M Hill
- The Zeeman Institute for Systems Biology & Infectious Disease Epidemiology Research, School of Life Sciences and Mathematics Institute, 2707University of Warwick, UK
- Joint Universities Pandemic and Epidemiological Research, https://maths.org/juniper/
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24
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Muller J, Tran Ba Loc P, Binder Foucard F, Borde A, Bruandet A, Le Bourhis-Zaimi M, Lenne X, Ouattara É, Séguret F, Gilleron V, Tezenas du Montcel S. Major interregional differences in France of COVID-19 hospitalization and mortality from January to June 2020. Rev Epidemiol Sante Publique 2022; 70:265-276. [PMID: 36207228 PMCID: PMC9468311 DOI: 10.1016/j.respe.2022.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 08/24/2022] [Accepted: 08/31/2022] [Indexed: 10/26/2022] Open
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25
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Lorthe E, Bellon M, Michielin G, Berthelot J, Zaballa ME, Pennacchio F, Bekliz M, Laubscher F, Arefi F, Perez-Saez J, Azman AS, L’Huillier AG, Posfay-Barbe KM, Kaiser L, Guessous I, Maerkl SJ, Eckerle I, Stringhini S. Epidemiological, virological and serological investigation of a SARS-CoV-2 outbreak (Alpha variant) in a primary school: A prospective longitudinal study. PLoS One 2022; 17:e0272663. [PMID: 35976947 PMCID: PMC9385020 DOI: 10.1371/journal.pone.0272663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 07/24/2022] [Indexed: 11/19/2022] Open
Abstract
Objectives To report a prospective epidemiological, virological and serological investigation of a SARS-CoV-2 outbreak in a primary school. Methods As part of a longitudinal, prospective, school-based surveillance study, this investigation involved repeated testing of 73 pupils, 9 teachers, 13 non-teaching staff and 26 household members of participants who tested positive, with rapid antigen tests and/or RT-PCR (Day 0–2 and Day 5–7), serologies on dried capillary blood samples (Day 0–2 and Day 30), contact tracing interviews and SARS-CoV-2 whole genome sequencing. Results We identified 20 children (aged 4 to 6 years from 4 school classes), 2 teachers and a total of 4 household members who were infected by the Alpha variant during this outbreak. Infection attack rates were between 11.8 and 62.0% among pupils from the 4 school classes, 22.2% among teachers and 0% among non-teaching staff. Secondary attack rate among household members was 15.4%. Symptoms were reported by 63% of infected children, 100% of teachers and 50% of household members. All analysed sequences but one showed 100% identity. Serological tests detected 8 seroconversions unidentified by SARS-CoV-2 virological tests. Conclusions This study confirmed child-to-child and child-to-adult SARS-CoV-2 transmission and introduction into households. Effective measures to limit transmission in schools have the potential to reduce the overall community circulation.
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Affiliation(s)
- Elsa Lorthe
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
- * E-mail:
| | - Mathilde Bellon
- Department of Microbiology and Molecular Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Center for Emerging Viral Diseases, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Grégoire Michielin
- Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Julie Berthelot
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - María-Eugenia Zaballa
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Francesco Pennacchio
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Meriem Bekliz
- Department of Microbiology and Molecular Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Florian Laubscher
- Laboratory of Virology, Department of Diagnostics, Geneva University Hospitals, Geneva, Switzerland
| | - Fatemeh Arefi
- Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Javier Perez-Saez
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Andrew S. Azman
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Arnaud G. L’Huillier
- Laboratory of Virology, Department of Diagnostics, Geneva University Hospitals, Geneva, Switzerland
- Department of Pediatrics, Gynecology & Obstetrics, Pediatric Infectious Disease Unit, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Klara M. Posfay-Barbe
- Department of Pediatrics, Gynecology & Obstetrics, Pediatric Infectious Disease Unit, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Laurent Kaiser
- Center for Emerging Viral Diseases, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
- Division of Infectious Diseases, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Idris Guessous
- Division of Primary Care, Geneva University Hospitals, Geneva, Switzerland
- Department of Health and Community Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Sebastian J. Maerkl
- Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Isabella Eckerle
- Department of Microbiology and Molecular Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Center for Emerging Viral Diseases, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
- Laboratory of Virology, Department of Diagnostics, Geneva University Hospitals, Geneva, Switzerland
- Division of Infectious Diseases, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Silvia Stringhini
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
- Department of Health and Community Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- University Center for General Medicine and Public Health, University of Lausanne, Lausanne, Switzerland
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26
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Dasgupta S. School in the time of Covid. New Bioeth 2022; 40:120-144. [PMID: 35857276 PMCID: PMC9537117 DOI: 10.1007/s40592-022-00161-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 06/11/2022] [Accepted: 06/15/2022] [Indexed: 11/30/2022]
Abstract
This article argues that extended school closures during the Covid-19 pandemic were a moral catastrophe. It focuses on closures in the United States of America and discusses their effect on the pandemic (or lack thereof), their harmful effects on children, and other morally relevant factors. It concludes by discussing how these closures came to pass and suggests that the root cause was structural, not individual: the relevant decision-makers were working in an institutional setting that stacked the deck heavily in favor of extended closures.
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Affiliation(s)
- Shamik Dasgupta
- University of California, 310 Moses Hall, 94720, Berkeley, CA, USA.
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Bilinski A, Ciaranello A, Fitzpatrick MC, Giardina J, Shah M, Salomon JA, Kendall EA. Estimated Transmission Outcomes and Costs of SARS-CoV-2 Diagnostic Testing, Screening, and Surveillance Strategies Among a Simulated Population of Primary School Students. JAMA Pediatr 2022; 176:679-689. [PMID: 35442396 PMCID: PMC9021988 DOI: 10.1001/jamapediatrics.2022.1326] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
IMPORTANCE In addition to illness, the COVID-19 pandemic has led to historic educational disruptions. In March 2021, the federal government allocated $10 billion for COVID-19 testing in US schools. OBJECTIVE Costs and benefits of COVID-19 testing strategies were evaluated in the context of full-time, in-person kindergarten through eighth grade (K-8) education at different community incidence levels. DESIGN, SETTING, AND PARTICIPANTS An updated version of a previously published agent-based network model was used to simulate transmission in elementary and middle school communities in the United States. Assuming dominance of the delta SARS-CoV-2 variant, the model simulated an elementary school (638 students in grades K-5, 60 staff) and middle school (460 students grades 6-8, 51 staff). EXPOSURES Multiple strategies for testing students and faculty/staff, including expanded diagnostic testing (test to stay) designed to avoid symptom-based isolation and contact quarantine, screening (routinely testing asymptomatic individuals to identify infections and contain transmission), and surveillance (testing a random sample of students to identify undetected transmission and trigger additional investigation or interventions). MAIN OUTCOMES AND MEASURES Projections included 30-day cumulative incidence of SARS-CoV-2 infection, proportion of cases detected, proportion of planned and unplanned days out of school, cost of testing programs, and childcare costs associated with different strategies. For screening policies, the cost per SARS-CoV-2 infection averted in students and staff was estimated, and for surveillance, the probability of correctly or falsely triggering an outbreak response was estimated at different incidence and attack rates. RESULTS Compared with quarantine policies, test-to-stay policies are associated with similar model-projected transmission, with a mean of less than 0.25 student days per month of quarantine or isolation. Weekly universal screening is associated with approximately 50% less in-school transmission at one-seventh to one-half the societal cost of hybrid or remote schooling. The cost per infection averted in students and staff by weekly screening is lowest for schools with less vaccination, fewer other mitigation measures, and higher levels of community transmission. In settings where local student incidence is unknown or rapidly changing, surveillance testing may detect moderate to large in-school outbreaks with fewer resources compared with schoolwide screening. CONCLUSIONS AND RELEVANCE In this modeling study of a simulated population of primary school students and simulated transmission of COVID-19, test-to-stay policies and/or screening tests facilitated consistent in-person school attendance with low transmission risk across a range of community incidence. Surveillance was a useful reduced-cost option for detecting outbreaks and identifying school environments that would benefit from increased mitigation.
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Affiliation(s)
- Alyssa Bilinski
- Department of Health Services, Policy, and Practice, Brown School of Public Health, Providence, Rhode Island,Department of Biostatistics, Brown School of Public Health, Providence, Rhode Island
| | - Andrea Ciaranello
- Medical Practice Evaluation Center, Division of Infectious Disease, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Meagan C. Fitzpatrick
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore
| | - John Giardina
- Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Maunank Shah
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Joshua A. Salomon
- Center for Health Policy, Center for Primary Care and Outcomes Research, Stanford University School of Medicine, Stanford, California
| | - Emily A. Kendall
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Diederichs M, van Ewijk R, Isphording IE, Pestel N. Schools under mandatory testing can mitigate the spread of SARS-CoV-2. Proc Natl Acad Sci U S A 2022; 119:e2201724119. [PMID: 35733261 PMCID: PMC9245666 DOI: 10.1073/pnas.2201724119] [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: 02/02/2022] [Accepted: 04/01/2022] [Indexed: 12/24/2022] Open
Abstract
We use event study models based on staggered summer vacations in Germany to estimate the effect of school reopenings after the summer of 2021 on the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Estimations are based on daily counts of confirmed coronavirus infections across all 401 German counties. A central antipandemic measure in German schools included mandatory rapid testing multiple times per week. Our results are consistent with mandatory testing contributing to the containment of the viral spread. We find a short-term increase in infection rates right after summer breaks, indicating the uncovering of otherwise undetected (asymptomatic) cases through the testing. After a period of about 2 wk after school reopenings, the growth of case numbers is smaller in states that reopened schools compared with the control group of states still in summer break. The results show a similar pattern for older age groups as well, arguably as a result of detected clusters through the school testing. This means that under certain conditions, open schools can play a role in containing the spread of the virus. Our results suggest that closing schools as a means to reduce infections may have unintended consequences by giving up surveillance and should be considered only as a last resort.
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Affiliation(s)
- Marc Diederichs
- Department of Economics, Johannes Gutenberg-University Mainz, 55128 Mainz, Germany
| | - Reyn van Ewijk
- Department of Economics, Johannes Gutenberg-University Mainz, 55128 Mainz, Germany
| | - Ingo E. Isphording
- Institute of Labor Economics, 53113 Bonn, Germany
- CESifo, 81679 Munich, Germany
| | - Nico Pestel
- Institute of Labor Economics, 53113 Bonn, Germany
- CESifo, 81679 Munich, Germany
- Research Centre for Education and the Labour Market, Maastricht University, 6211 LM Maastricht, the Netherlands
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29
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Labro G, Tubach F, Belin L, Dubost JL, Osman D, Muller G, Quenot JP, Da Silva D, Zarka J, Turpin M, Mayaux J, Lamer C, Doyen D, Chevrel G, Plantefeve G, Demeret S, Piton G, Manzon C, Ochin E, Gaillard R, Dautzenberg B, Baldacini M, Lebbah S, Miyara M, Pineton de Chambrun M, Amoura Z, Combes A. Nicotine patches in patients on mechanical ventilation for severe COVID-19: a randomized, double-blind, placebo-controlled, multicentre trial. Intensive Care Med 2022; 48:876-887. [PMID: 35676335 PMCID: PMC9177407 DOI: 10.1007/s00134-022-06721-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 04/27/2022] [Indexed: 01/08/2023]
Abstract
Purpose Epidemiologic studies have documented lower rates of active smokers compared to former or non-smokers in symptomatic patients affected by coronavirus disease 2019 (COVID-19). We assessed the efficacy and safety of nicotine administered by a transdermal patch in critically ill patients with COVID-19 pneumonia. Methods In this multicentre, double-blind, placebo-controlled trial conducted in 18 intensive care units in France, we randomly assigned adult patients (non-smokers, non-vapers or who had quit smoking/vaping for at least 12 months) with proven COVID-19 pneumonia receiving invasive mechanical ventilation for up to 72 h to receive transdermal patches containing either nicotine at a daily dose of 14 mg or placebo until 48 h following successful weaning from mechanical ventilation or for a maximum of 30 days, followed by 3-week dose tapering by 3.5 mg per week. Randomization was stratified by centre, non- or former smoker status and Sequential Organ Function Assessment score (< or ≥ 7). The primary outcome was day-28 mortality. Main prespecified secondary outcomes included 60-day mortality, time to successful extubation, days alive and free from mechanical ventilation, renal replacement therapy, vasopressor support or organ failure at day 28. Results Between November 6th 2020, and April 2nd 2021, 220 patients were randomized from 18 active recruiting centers. After excluding 2 patients who withdrew consent, 218 patients (152 [70%] men) were included in the analysis: 106 patients to the nicotine group and 112 to the placebo group. Day-28 mortality did not differ between the two groups (30 [28%] of 106 patients in the nicotine group vs 31 [28%] of 112 patients in the placebo group; odds ratio 1.03 [95% confidence interval, CI 0.57–1.87]; p = 0.46). The median number of day-28 ventilator-free days was 0 (IQR 0–14) in the nicotine group and 0 (0–13) in the placebo group (with a difference estimate between the medians of 0 [95% CI -3–7]). Adverse events likely related to nicotine were rare (3%) and similar between the two groups. Conclusion In patients having developed severe COVID-19 pneumonia requiring invasive mechanical ventilation, transdermal nicotine did not significantly reduce day-28 mortality. There is no indication to use nicotine in this situation. Supplementary Information The online version contains supplementary material available at 10.1007/s00134-022-06721-1.
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Affiliation(s)
- Guylaine Labro
- Service de Médecine Intensive-Réanimation Groupement Hospitalier Régional Mulhouse Et Sud Alsace, Hôpital Emile Muller, 68100, Mulhouse, France
| | - Florence Tubach
- Département de Santé Publique, Unité de Recherche Clinique PSL-CFX, INSERM, Institut Pierre Louis d'Epidémiologie Et de Santé Publique, AP-HP, Hôpital Pitié Salpêtrière, Sorbonne Université, CIC-1901, 75013, Paris, France
| | - Lisa Belin
- Département de Santé Publique, Unité de Recherche Clinique PSL-CFX, INSERM, Institut Pierre Louis d'Epidémiologie Et de Santé Publique, AP-HP, Hôpital Pitié Salpêtrière, Sorbonne Université, CIC-1901, 75013, Paris, France
| | - Jean-Louis Dubost
- Centre Hospitalier René Dubos, 6, avenue de l'Ile de, 95303, Cergy-Pontoise, France
| | - David Osman
- CHU Bicêtre, 78 Rue du Général Leclerc, 94270, Le Kremlin-Bicêtre, France
| | - Grégoire Muller
- Service de Médecine Intensive Réanimation, Centre Hospitalier Régional d'Orléans, Orléans, France
| | - Jean-Pierre Quenot
- Department of Intensive Care, Burgundy University Hospital, Dijon, France.,Lipness Team, INSERM Research Center LNC-UMR1231 and LabEx LipSTIC, University of Burgundy, Dijon, France.,INSERM CIC 1432, Clinical Epidemiology, University of Burgundy, Dijon, France
| | - Daniel Da Silva
- Service de Médecine Intensive Réanimation du Centre, Hospitalier de Saint-Denis, Saint-Denis, France
| | - Jonathan Zarka
- Service de Réanimation Polyvalente, Grand Hôpital de L'Est Francilien, site de Marne-La-Vallée, Jossigny, France
| | - Matthieu Turpin
- Assistance Publique - Hôpitaux de Paris, Service de Médecine Intensive RéanimationHôpital Tenon, Sorbonne Université, Paris, France
| | - Julien Mayaux
- Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Service de Médecine Intensive Et Réanimation (Département R3S), AP-HP, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale Et Clinique, Sorbonne Université, Paris, France
| | - Christian Lamer
- Service de RéanimationInstitut Mutualiste Montsouris, 42 Bd Jourdan, 75014, Paris, France
| | - Denis Doyen
- Médecine Intensive RéanimationHôpital L'Archet 1, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Guillaume Chevrel
- Service de Réanimation; Centre Hospitalier Sud Francilien (CHSF), 40 Avenue Serge Dassault, Corbeil-Essonne, France
| | - Gaétan Plantefeve
- Service de Médecine Intensive-Réanimation, Centre Hospitalier Victor Dupouy, 95107, Argenteuil, France
| | - Sophie Demeret
- Médecine Intensive Réanimation À Orientation Neurologique - Site Pitié Salpêtrière - Sorbonne Université, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Gaël Piton
- Service de Réanimation Médicale, CHRU de Besançon, Boulevard Fleming, Besançon, France
| | - Cyril Manzon
- Service de Réanimation, Médipole Lyon Villeurbanne. Service de Réanimation, 158 rue Léon Blum, 69100, Villeurbanne, France
| | - Evelina Ochin
- Service de Médecine Intensive-Réanimation Hôpital Simone Veil, Eaubonne, France
| | - Raphael Gaillard
- Department of Psychiatry, Service Hospitalo-Universitaire, GHU Paris Psychiatrie & Neurosciences, 75014, Paris, France.,Université de Paris, 75006, Paris, France
| | - Bertrand Dautzenberg
- Sorbonne Université APHP (La Pitié-Salpêtrière), 75013, Paris, France.,Tabacologue Institut Arthur Vernes, Paris, France
| | - Mathieu Baldacini
- Service de Médecine Intensive-Réanimation Groupement Hospitalier Régional Mulhouse Et Sud Alsace, Hôpital Emile Muller, 68100, Mulhouse, France
| | - Said Lebbah
- Département de Santé Publique, Unité de Recherche Clinique PSL-CFX, INSERM, Institut Pierre Louis d'Epidémiologie Et de Santé Publique, AP-HP, Hôpital Pitié Salpêtrière, Sorbonne Université, CIC-1901, 75013, Paris, France
| | - Makoto Miyara
- Service de Médecine Interne 2, Institut E3M, CRMR Lupus. SAPL Et Autres Maladies Auto-Immunes, Hôpital Pitié Salpêtrière Et Université Paris 6, Paris, France
| | - Marc Pineton de Chambrun
- Service de Médecine Intensive-Réanimation, Institut de Cardiologie, APHP Hôpital Pitié-Salpêtrière, 75013, Paris, France.,INSERM, UMRS_1166-ICAN, Institute of Cardiometabolism and Nutrition, Sorbonne Université, 47, Boulevard de l'Hôpital, 75013, Paris, France
| | - Zahir Amoura
- Department of Psychiatry, Service Hospitalo-Universitaire, GHU Paris Psychiatrie & Neurosciences, 75014, Paris, France
| | - Alain Combes
- Service de Médecine Intensive-Réanimation, Institut de Cardiologie, APHP Hôpital Pitié-Salpêtrière, 75013, Paris, France. .,INSERM, UMRS_1166-ICAN, Institute of Cardiometabolism and Nutrition, Sorbonne Université, 47, Boulevard de l'Hôpital, 75013, Paris, France.
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Scotto G, Fazio V, Lo Muzio E, Lo Muzio L, Spirito F. SARS-CoV-2 Infection and Taste Alteration: An Overview. Life (Basel) 2022; 12:690. [PMID: 35629357 PMCID: PMC9147711 DOI: 10.3390/life12050690] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/28/2022] [Accepted: 05/04/2022] [Indexed: 02/07/2023] Open
Abstract
Since the worldwide spread of SARS-CoV-2 infection, the management of COVID-19 has been a challenge for healthcare professionals. Although the respiratory system has primarily been affected with symptoms ranging from mild pneumonia to acute respiratory distress syndrome, other organs or systems have also been targets of the virus. The mouth represents an important route of entry for SARS-CoV-2. Cells in the oral epithelium, taste buds, and minor and major salivary glands express cellular entry factors for the virus, such as ACE2, TMPRSS2 and Furin. This leads to symptoms such as deterioration of taste, salivary dysfunction, mucosal ulcers, before systemic manifestation of the disease. In this review we report and discuss the prevalence and socio-demographics of taste disturbances in COVID-19 patients, analysing the current international data. Importantly, we also take stock of the various hypothesized pathogenetic mechanisms and their impact on the reported symptoms. The literature indicated that COVID-19 patients frequently present with gustatory dysfunction, whose prevalence varies by country, age and sex. Furthermore, this dysfunction also has a variable duration in relation to the severity of the disease. The pathogenetic action is intricately linked to viral action which can be expressed in several ways. However, in many cases these are only hypotheses that need further confirmation.
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Affiliation(s)
- Gaetano Scotto
- Infectious Diseases Unit, University Hospital “OORR” Foggia, 71122 Foggia, Italy;
| | - Vincenzina Fazio
- Department of Prevention, Hygiene and Public Health Unit, University Hospital “OORR” Foggia, 71122 Foggia, Italy;
| | - Eleonora Lo Muzio
- Department of Dental Sciences, University of Ferrara, 44121 Ferrara, Italy;
| | - Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy;
| | - Francesca Spirito
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy;
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31
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Auerswald H, Eng C, Lay S, In S, Eng S, Vo HTM, Sith C, Cheng S, Delvallez G, Mich V, Meng N, Sovann L, Sidonn K, Vanhomwegen J, Cantaert T, Dussart P, Duong V, Karlsson EA. Rapid Generation of In-House Serological Assays Is Comparable to Commercial Kits Critical for Early Response to Pandemics: A Case With SARS-CoV-2. Front Med (Lausanne) 2022; 9:864972. [PMID: 35602487 PMCID: PMC9121123 DOI: 10.3389/fmed.2022.864972] [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: 01/29/2022] [Accepted: 04/13/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Accurate and sensitive measurement of antibodies is critical to assess the prevalence of infection, especially asymptomatic infection, and to analyze the immune response to vaccination during outbreaks and pandemics. A broad variety of commercial and in-house serological assays are available to cater to different laboratory requirements; however direct comparison is necessary to understand utility. Materials and Methods We investigate the performance of six serological methods against SARS-CoV-2 to determine the antibody profile of 250 serum samples, including 234 RT-PCR-confirmed SARS-CoV-2 cases, the majority with asymptomatic presentation (87.2%) at 1-51 days post laboratory diagnosis. First, we compare to the performance of two in-house antibody assays: (i) an in-house IgG ELISA, utilizing UV-inactivated virus, and (ii) a live-virus neutralization assay (PRNT) using the same Cambodian isolate as the ELISA. In-house assays are then compared to standardized commercial anti-SARS-CoV-2 electrochemiluminescence immunoassays (Elecsys ECLIAs, Roche Diagnostics; targeting anti-N and anti-S antibodies) along with a flow cytometry based assay (FACS) that measures IgM and IgG against spike (S) protein and a multiplex microsphere-based immunoassay (MIA) determining the antibodies against various spike and nucleoprotein (N) antigens of SARS-CoV-2 and other coronaviruses (SARS-CoV-1, MERS-CoV, hCoVs 229E, NL63, HKU1). Results Overall, specificity of assays was 100%, except for the anti-S IgM flow cytometry based assay (96.2%), and the in-house IgG ELISA (94.2%). Sensitivity ranged from 97.3% for the anti-S ECLIA down to 76.3% for the anti-S IgG flow cytometry based assay. PRNT and in-house IgG ELISA performed similarly well when compared to the commercial ECLIA: sensitivity of ELISA and PRNT was 94.7 and 91.1%, respectively, compared to S- and N-targeting ECLIA with 97.3 and 96.8%, respectively. The MIA revealed cross-reactivity of antibodies from SARS-CoV-2-infected patients to the nucleocapsid of SARS-CoV-1, and the spike S1 domain of HKU1. Conclusion In-house serological assays, especially ELISA and PRNT, perform similarly to commercial assays, a critical factor in pandemic response. Selection of suitable immunoassays should be made based on available resources and diagnostic needs.
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Affiliation(s)
- Heidi Auerswald
- Virology Unit, Institut Pasteur du Cambodge, Pasteur Network, Phnom Penh, Cambodia
| | - Chanreaksmey Eng
- Virology Unit, Institut Pasteur du Cambodge, Pasteur Network, Phnom Penh, Cambodia
| | - Sokchea Lay
- Immunology Unit, Institut Pasteur du Cambodge, Pasteur Network, Phnom Penh, Cambodia
| | - Saraden In
- Virology Unit, Institut Pasteur du Cambodge, Pasteur Network, Phnom Penh, Cambodia
| | - Sokchea Eng
- Medical Biology Laboratory, Institut Pasteur du Cambodge, Pasteur Network, Phnom Penh, Cambodia
| | - Hoa Thi My Vo
- Immunology Unit, Institut Pasteur du Cambodge, Pasteur Network, Phnom Penh, Cambodia
| | - Charya Sith
- Medical Biology Laboratory, Institut Pasteur du Cambodge, Pasteur Network, Phnom Penh, Cambodia
| | - Sokleaph Cheng
- Medical Biology Laboratory, Institut Pasteur du Cambodge, Pasteur Network, Phnom Penh, Cambodia
| | - Gauthier Delvallez
- Medical Biology Laboratory, Institut Pasteur du Cambodge, Pasteur Network, Phnom Penh, Cambodia
| | - Vann Mich
- Khmer–Soviet Friendship Hospital, Ministry of Health, Phnom Penh, Cambodia
| | - Ngy Meng
- Khmer–Soviet Friendship Hospital, Ministry of Health, Phnom Penh, Cambodia
| | - Ly Sovann
- Communicable Disease Control Department, Ministry of Health, Phnom Penh, Cambodia
| | - Kraing Sidonn
- Communicable Disease Control Department, Ministry of Health, Phnom Penh, Cambodia
| | | | - Tineke Cantaert
- Immunology Unit, Institut Pasteur du Cambodge, Pasteur Network, Phnom Penh, Cambodia
| | - Philippe Dussart
- Institut Pasteur de Madagascar, Pasteur Network, Antananarivo, Madagascar
| | - Veasna Duong
- Virology Unit, Institut Pasteur du Cambodge, Pasteur Network, Phnom Penh, Cambodia
| | - Erik A. Karlsson
- Virology Unit, Institut Pasteur du Cambodge, Pasteur Network, Phnom Penh, Cambodia
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32
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SARS-CoV-2 Circulation in the School Setting: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095384. [PMID: 35564779 PMCID: PMC9099553 DOI: 10.3390/ijerph19095384] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 04/20/2022] [Accepted: 04/26/2022] [Indexed: 02/01/2023]
Abstract
The contribution of children to viral spread in schools is still debated. We conducted a systematic review and meta-analysis of studies to investigate SARS-CoV-2 transmission in the school setting. Literature searches on 15 May 2021 yielded a total of 1088 publications, including screening, contact tracing, and seroprevalence studies. MOOSE guidelines were followed, and data were analyzed using random-effects models. From screening studies involving more than 120,000 subjects, we estimated 0.31% (95% confidence interval (CI) 0.05–0.81) SARS-CoV-2 point prevalence in schools. Contact tracing studies, involving a total of 112,622 contacts of children and adults, showed that onward viral transmission was limited (2.54%, 95% CI 0.76–5.31). Young index cases were found to be 74% significantly less likely than adults to favor viral spread (odds ratio (OR) 0.26, 95% CI 0.11–0.63) and less susceptible to infection (OR 0.60; 95% CI 0.25–1.47). Lastly, from seroprevalence studies, with a total of 17,879 subjects involved, we estimated that children were 43% significantly less likely than adults to test positive for antibodies (OR 0.57, 95% CI 0.49–0.68). These findings may not applied to the Omicron phase, we further planned a randomized controlled trial to verify these results.
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33
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Viner R, Waddington C, Mytton O, Booy R, Cruz J, Ward J, Ladhani S, Panovska-Griffiths J, Bonell C, Melendez-Torres GJ. Transmission of SARS-CoV-2 by children and young people in households and schools: A meta-analysis of population-based and contact-tracing studies. J Infect 2022; 84:361-382. [PMID: 34953911 PMCID: PMC8694793 DOI: 10.1016/j.jinf.2021.12.026] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 12/18/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND The role of children and young people (CYP) in transmission of SARS-CoV-2 in household and educational settings remains unclear. We undertook a systematic review and meta-analysis of contact-tracing and population-based studies at low risk of bias. METHODS We searched 4 electronic databases on 28 July 2021 for contact-tracing studies and population-based studies informative about transmission of SARS-CoV-2 from 0 to 19 year olds in household or educational settings. We excluded studies at high risk of bias, including from under-ascertainment of asymptomatic infections. We undertook multilevel random effects meta-analyses of secondary attack rates (SAR: contact-tracing studies) and school infection prevalence, and used meta-regression to examine the impact of community SARS-CoV-2 incidence on school infection prevalence. FINDINGS 4529 abstracts were reviewed, resulting in 37 included studies (16 contact-tracing; 19 population studies; 2 mixed studies). The pooled relative transmissibility of CYP compared with adults was 0.92 (0.68, 1.26) in adjusted household studies. The pooled SAR from CYP was lower (p = 0.002) in school studies 0.7% (0.2, 2.7) than household studies (7.6% (3.6, 15.9) . There was no difference in SAR from CYP to child or adult contacts. School population studies showed some evidence of clustering in classes within schools. School infection prevalence was associated with contemporary community 14-day incidence (OR 1.003 (1.001, 1.004), p<0.001). INTERPRETATION We found no difference in transmission of SARS-CoV-2 from CYP compared with adults within household settings. SAR were markedly lower in school compared with household settings, suggesting that household transmission is more important than school transmission in this pandemic. School infection prevalence was associated with community infection incidence, supporting hypotheses that school infections broadly reflect community infections. These findings are important for guiding policy decisions on shielding, vaccination school and operations during the pandemic.
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Affiliation(s)
- Russell Viner
- Population, Policy and Practice, UCL Great Ormond St. Institute of Child Health, London, United Kingdom.
| | | | | | | | - Joana Cruz
- Population, Policy and Practice, UCL Great Ormond St. Institute of Child Health, London, United Kingdom
| | - Joseph Ward
- Population, Policy and Practice, UCL Great Ormond St. Institute of Child Health, London, United Kingdom
| | | | | | - Chris Bonell
- London School of Hygiene and Tropical Medicine, United Kingdom
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Giardina J, Bilinski A, Fitzpatrick MC, Kendall EA, Linas BP, Salomon J, Ciaranello AL. Model-Estimated Association Between Simulated US Elementary School-Related SARS-CoV-2 Transmission, Mitigation Interventions, and Vaccine Coverage Across Local Incidence Levels. JAMA Netw Open 2022; 5:e2147827. [PMID: 35157056 PMCID: PMC8845023 DOI: 10.1001/jamanetworkopen.2021.47827] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 12/17/2021] [Indexed: 12/20/2022] Open
Abstract
Importance With recent surges in COVID-19 incidence and vaccine authorization for children aged 5 to 11 years, elementary schools face decisions about requirements for masking and other mitigation measures. These decisions require explicit determination of community objectives (eg, acceptable risk level for in-school SARS-CoV-2 transmission) and quantitative estimates of the consequences of changing mitigation measures. Objective To estimate the association between adding or removing in-school mitigation measures (eg, masks) and COVID-19 outcomes within an elementary school community at varying student vaccination and local incidence rates. Design, Setting, and Participants This decision analytic model used an agent-based model to simulate SARS-CoV-2 transmission within a school community, with a simulated population of students, teachers and staff, and their household members (ie, immediate school community). Transmission was evaluated for a range of observed local COVID-19 incidence (0-50 cases per 100 000 residents per day, assuming 33% of all infections detected). The population used in the model reflected the mean size of a US elementary school, including 638 students and 60 educators and staff members in 6 grades with 5 classes per grade. Exposures Variant infectiousness (representing wild-type virus, Alpha variant, and Delta variant), mitigation effectiveness (0%-100% reduction in the in-school secondary attack rate, representing increasingly intensive combinations of mitigations including masking and ventilation), and student vaccination levels were varied. Main Outcomes and Measures The main outcomes were (1) probability of at least 1 in-school transmission per month and (2) mean increase in total infections per month among the immediate school community associated with a reduction in mitigation; multiple decision thresholds were estimated for objectives associated with each outcome. Sensitivity analyses on adult vaccination uptake, vaccination effectiveness, and testing approaches (for selected scenarios) were conducted. Results With student vaccination coverage of 70% or less and moderate assumptions about mitigation effectiveness (eg, masking), mitigation could only be reduced when local case incidence was 14 or fewer cases per 100 000 residents per day to keep the mean additional cases associated with reducing mitigation to 5 or fewer cases per month. To keep the probability of any in-school transmission to less than 50% per month, the local case incidence would have to be 4 or fewer cases per 100 000 residents per day. Conclusions and Relevance In this study, in-school mitigation measures (eg, masks) and student vaccinations were associated with substantial reductions in transmissions and infections, but the level of reduction varied across local incidence. These findings underscore the potential role for responsive plans that deploy mitigation strategies based on local COVID-19 incidence, vaccine uptake, and explicit consideration of community objectives.
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Affiliation(s)
- John Giardina
- Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Alyssa Bilinski
- Department of Health Services, Policy, and Practice, Department of Biostatistics, Brown School of Public Health, Providence, Rhode Island
| | - Meagan C. Fitzpatrick
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore
| | - Emily A. Kendall
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Benjamin P. Linas
- Boston University Schools of Medicine and Public Health, Boston Medical Center, Boston, Massachusetts
| | - Joshua Salomon
- Center for Health Policy and Center for Primary Care and Outcomes Research, Stanford University School of Medicine, Stanford, California
| | - Andrea L. Ciaranello
- Division of Infectious Disease and Medical Practice Evaluation Center, Massachusetts General Hospital, Boston
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Kale P, Patel N, Gupta E, Bajpai M. SARS-Coronavirus-2 seroprevalence in asymptomatic healthy blood donors: Indicator of community spread. Transfus Apher Sci 2022; 61:103293. [PMID: 34686444 PMCID: PMC8516133 DOI: 10.1016/j.transci.2021.103293] [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: 07/21/2021] [Revised: 10/08/2021] [Accepted: 10/11/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND The Corona virus disease 2019 (COVID-19) pandemic caused by SARS -Corona virus-2 (SARS-CoV-2) has been a major concern the world over. Serological surveillance is an important tool to assess the spread of infection in the community. This study attempted to assess the prevalence of antibodies to SARS-CoV-2 among blood donors in Delhi, India during the pre-vaccination period. METHODS Seroprevalence of SARS-CoV2-2 IgG antibodies were determined in blood donors reporting to the Department of Transfusion medicine at a tertiary care hepatobiliary center, in India from September to October 2020. The SARS-CoV-2 IgG antibodies against spike subunit 1 protein were measured using the enhanced chemiluminescence method. RESULTS A total of 1066 blood donors were screened. The overall seropositivity for SARS-CoV-2 IgG antibodies was 27.57 % (294/1066). The highest seropositivity was seen in the age group 26-35 years, 46.6 % (137/492), followed by 18-25 years, 28.2 % (83/260), 36-45 years, 19.4 % (57/244), and more than 45 years, 5.8 % (17/70). The seropositivity in the donors who had donated blood previously was 26.1 % (189/723). There was no statistically significant difference amongst seroprevalence in the blood groups, AB blood group (32.6 %, 95 % CI 23.02-43.3), group B (27.2 %, 95 % CI 22.8-32.09 %), group A (27.1 %, 95 % CI 21.8-32.9 %), and group O (27.02 %, 95 % CI 22.3-32.1 %) (p 0.539). CONCLUSIONS There was significantly higher seropositivity for SARS-CoV-2 antibodies in the voluntary healthy blood donors indicating community spread and large number of asymptomatic cases in Delhi. Higher seroprevalence in younger adults indicated increased exposure to the virus and lack of COVID appropriate behaviour.
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Affiliation(s)
- Pratibha Kale
- Clinical Microbiology, Institute of Liver and Biliary Sciences, India
| | - Niharika Patel
- Clinical Microbiology, Institute of Liver and Biliary Sciences, India
| | - Ekta Gupta
- Clinical Virology, Institute of Liver and Biliary Sciences, India
| | - Meenu Bajpai
- Transfusion Medicine, Institute of Liver and Biliary Sciences, India.
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Miyara M, Tubach F, Pourcher V, Morélot-Panzini C, Pernet J, Haroche J, Lebbah S, Morawiec E, Gorochov G, Caumes E, Hausfater P, Combes A, Similowski T, Amoura Z. Lower Rate of Daily Smokers With Symptomatic COVID-19: A Monocentric Self-Report of Smoking Habit Study. Front Med (Lausanne) 2022; 8:668995. [PMID: 35071251 PMCID: PMC8766759 DOI: 10.3389/fmed.2021.668995] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 11/04/2021] [Indexed: 01/08/2023] Open
Abstract
Background: Identification of prognostic factors in COVID-19 remains a global challenge. The role of smoking is still controversial. Methods: PCR-positive in- and outpatients with symptomatic COVID-19 from a large French University hospital were systematically interviewed for their smoking status, use of e-cigarette, and nicotinic substitutes. The rates of daily smokers in in- and outpatients were compared using the same smoking habit questionnaire to those in the 2019 French general population, after standardisation for sex and age. Results: The inpatient group was composed of 340 patients, median age of 66 years: 203 men (59.7%) and 137 women (40.3%), median age of both 66 years, with a rate of 4.1% daily smokers (CI 95% [2.3-6.9]) (5.4% of men and 2.2% of women). The outpatient group was composed of 139 patients, median age of 44 years: 62 men (44.6%, median age of 43 years) and 77 women (55.4%, median age of 44 years). The daily smoker rate was 6.1% (CI 95% [2.7-11.6], 5.1% of men and 6.8% of women). Amongst inpatients, daily smokers represented 2.2 and 3.4% of the 45 dead patients and of the 29 patients transferred to ICU, respectively. The rate of daily smokers was significantly lower in patients with symptomatic COVID-19, as compared to that in the French general population after standardisation by age and sex, with standardised incidence ratios (SIRs) of 0.24 [0.12-0.48] for outpatients and 0.24 [0.14-0.40] for inpatients. Conclusions: Daily smoker rate in patients with symptomatic COVID-19 is lower as compared to the French general population.
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Affiliation(s)
- Makoto Miyara
- Sorbonne Université, Inserm UMR-S 1135, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), Groupe Hospitalier Universitaire APHP.Sorbonne-université, site Pitié-Salpêtrière, Département d'immunologie, Paris, France
| | - Florence Tubach
- Sorbonne Université, Inserm UMR-S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Groupe Hospitalier Universitaire APHP.Sorbonne-Université, site Pitié-Salpêtrière, Département de Santé Publique, Unité de Recherche Clinique Pitié, CIC-1422, Paris, France
| | - Valérie Pourcher
- Sorbonne Université, Inserm UMR-S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Groupe Hospitalier Universitaire APHP.Sorbonne-Université, site Pitié-Salpêtrière, Service des maladies infectieuses et tropicales, Paris, France
| | - Capucine Morélot-Panzini
- Sorbonne Université, Inserm, UMRS-1158, APHP, Groupe Hospitalier Universitaire APHP- Sorbonne Université, site Pitié-Salpêtrière, Service de Pneumologie et Réanimation Médicale (Département R3S), Paris, France
| | - Julie Pernet
- Sorbonne Université, GRC-14 BIOSFAST, UMR Inserm 1166, IHU ICAN, Service d'accueil des Urgences, Groupe Hospitalier Universitaire APHP.Sorbonne-université, site Pitié-Salpêtrière, Paris, France
| | - Julien Haroche
- Sorbonne Université, Inserm UMR-S 1135, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), Groupe Hospitalier Universitaire APHP.Sorbonne-université, site Pitié-Salpêtrière, service de médecine interne 2, Paris, France
| | - Said Lebbah
- Sorbonne Université, Inserm UMR-S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Groupe Hospitalier Universitaire APHP.Sorbonne-Université, site Pitié-Salpêtrière, Département de Santé Publique, Unité de Recherche Clinique Pitié, CIC-1422, Paris, France
| | - Elise Morawiec
- APHP, Groupe Hospitalier Universitaire APHP.Sorbonne Université, site Pitié-Salpêtrière, Service de Pneumologie et Réanimation Médicale (Département R3S), Paris, France
| | - Guy Gorochov
- Sorbonne Université, Inserm UMR-S 1135, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), Groupe Hospitalier Universitaire APHP.Sorbonne-université, site Pitié-Salpêtrière, Département d'immunologie, Paris, France
| | - Eric Caumes
- Sorbonne Université, Inserm UMR-S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Groupe Hospitalier Universitaire APHP.Sorbonne-Université, site Pitié-Salpêtrière, Service des maladies infectieuses et tropicales, Paris, France
| | - Pierre Hausfater
- Sorbonne Université, GRC-14 BIOSFAST, UMR Inserm 1166, IHU ICAN, Service d'accueil des Urgences, Groupe Hospitalier Universitaire APHP.Sorbonne-université, site Pitié-Salpêtrière, Paris, France
| | - Alain Combes
- Sorbonne Université, Inserm, UMRS_1166-ICAN, Institute of Cardiometabolism and Nutrition, APHP. Sorbonne-université, Service de médecine intensive-réanimation, Institut de Cardiologie, site Pitié-Salpêtrière, Paris, France
| | - Thomas Similowski
- Sorbonne Université, Inserm, UMRS-1158, APHP, Groupe Hospitalier Universitaire APHP- Sorbonne Université, site Pitié-Salpêtrière, Service de Pneumologie et Réanimation Médicale (Département R3S), Paris, France
| | - Zahir Amoura
- Sorbonne Université, Inserm UMR-S 1135, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), Groupe Hospitalier Universitaire APHP.Sorbonne-université, site Pitié-Salpêtrière, service de médecine interne 2, Paris, France
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Lordan R, Prior S, Hennessy E, Naik A, Ghosh S, Paschos GK, Skarke C, Barekat K, Hollingsworth T, Juska S, Mazaleuskaya LL, Teegarden S, Glascock AL, Anderson S, Meng H, Tang SY, Weljie A, Bottalico L, Ricciotti E, Cherfane P, Mrcela A, Grant G, Poole K, Mayer N, Waring M, Adang L, Becker J, Fries S, FitzGerald GA, Grosser T. Considerations for the Safe Operation of Schools During the Coronavirus Pandemic. Front Public Health 2021; 9:751451. [PMID: 34976917 PMCID: PMC8716382 DOI: 10.3389/fpubh.2021.751451] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 11/18/2021] [Indexed: 12/25/2022] Open
Abstract
During the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, providing safe in-person schooling has been a dynamic process balancing evolving community disease burden, scientific information, and local regulatory requirements with the mandate for education. Considerations include the health risks of SARS-CoV-2 infection and its post-acute sequelae, the impact of remote learning or periods of quarantine on education and well-being of children, and the contribution of schools to viral circulation in the community. The risk for infections that may occur within schools is related to the incidence of SARS-CoV-2 infections within the local community. Thus, persistent suppression of viral circulation in the community through effective public health measures including vaccination is critical to in-person schooling. Evidence suggests that the likelihood of transmission of SARS-CoV-2 within schools can be minimized if mitigation strategies are rationally combined. This article reviews evidence-based approaches and practices for the continual operation of in-person schooling.
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Affiliation(s)
- Ronan Lordan
- Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Samantha Prior
- Faculty of Science & Engineering, University of Limerick, Limerick, Ireland
| | - Elizabeth Hennessy
- Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Amruta Naik
- Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | - Soumita Ghosh
- Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Georgios K. Paschos
- Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Carsten Skarke
- Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Kayla Barekat
- Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Taylor Hollingsworth
- Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Sydney Juska
- Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Liudmila L. Mazaleuskaya
- Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Sarah Teegarden
- Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Abigail L. Glascock
- Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
- Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Sean Anderson
- Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Hu Meng
- Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Soon-Yew Tang
- Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Aalim Weljie
- Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
- Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Lisa Bottalico
- Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
- Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Emanuela Ricciotti
- Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
- Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Perla Cherfane
- Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Antonijo Mrcela
- Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Gregory Grant
- Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Kristen Poole
- Department of English, University of Delaware, Newark, DE, United States
| | - Natalie Mayer
- Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Michael Waring
- Department of Civil, Architectural and Environmental Engineering, Drexel University, Philadelphia, PA, United States
| | - Laura Adang
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | - Julie Becker
- Division of Public Health, University of the Sciences, Philadelphia, PA, United States
| | - Susanne Fries
- Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Garret A. FitzGerald
- Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
- Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Tilo Grosser
- Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
- Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
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Heudorf U, Gottschalk R, Walczok A, Tinnemann P, Steul K. [Children in the COVID-19 pandemic and the public health service (ÖGD) : Data and reflections from Frankfurt am Main, Germany]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2021; 64:1559-1569. [PMID: 34705052 PMCID: PMC8548699 DOI: 10.1007/s00103-021-03445-3] [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: 05/31/2021] [Accepted: 09/30/2021] [Indexed: 12/03/2022]
Abstract
BACKGROUND The measures taken to combat the COVID-19 pandemic have severely restricted the opportunities for the development of children. This paper will discuss the reporting data of children and the public health department's activities against the background of the restrictions of school and leisure time offers as well as sports and club activities. MATERIALS AND METHODS Reporting data from Frankfurt am Main, Hesse, were obtained using a SURVStat query for the calendar weeks 10/2020-28/2021 and from SURVNet (until 30 June 2021). Contact persons (CP) of SARS-CoV‑2 positive persons from schools and daycare centers were screened for SARS-CoV‑2 by PCR test. These results and those of rapid antigen testing, which has been mandatory for schoolchildren since April 2021, are presented. RESULTS Until Easter break, the age-related seven-day incidence values per 100,000 for children 14 years of age and younger were lower than the overall incidence; it was only higher after rapid antigen-testing was mandatory for schoolchildren. Most children with SARS-CoV‑2 had no or mild symptoms; hospitalization was rarely required and no deaths occurred. Contact tracing in schools and daycare centers found no positive contacts in most cases and rarely more than two. Larger outbreaks did not occur. CONCLUSION SARS-CoV‑2 infections in children appear to be less frequent and much less severe than in adults. Hygiene rules and contact management have proven themselves effective during times with high incidences in the local population without mandatory rapid antigen testing - and even with a high proportion of variants of concern (alpha and delta variants) in Germany. Against this background, further restriction of school and daycare operations appears neither necessary nor appropriate.
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Affiliation(s)
- Ursel Heudorf
- Gesundheitsamt Frankfurt am Main, Breite Gasse 28, 60313, Frankfurt, Deutschland
| | - René Gottschalk
- Gesundheitsamt Frankfurt am Main, Breite Gasse 28, 60313, Frankfurt, Deutschland
| | - Antoni Walczok
- Gesundheitsamt Frankfurt am Main, Breite Gasse 28, 60313, Frankfurt, Deutschland
| | - Peter Tinnemann
- Gesundheitsamt Frankfurt am Main, Breite Gasse 28, 60313, Frankfurt, Deutschland
| | - Katrin Steul
- Gesundheitsamt Frankfurt am Main, Breite Gasse 28, 60313, Frankfurt, Deutschland.
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Monel B, Planas D, Grzelak L, Smith N, Robillard N, Staropoli I, Goncalves P, Porrot F, Guivel-Benhassine F, Guinet ND, Rodary J, Puech J, Euzen V, Bélec L, Orvoen G, Nunes L, Moulin V, Fourgeaud J, Wack M, Imbeaud S, Campagne P, Duffy D, Santo JPD, Bruel T, Péré H, Veyer D, Schwartz O. Release of infectious virus and cytokines in nasopharyngeal swabs from individuals infected with non-alpha or alpha SARS-CoV-2 variants: an observational retrospective study. EBioMedicine 2021; 73:103637. [PMID: 34678613 PMCID: PMC8526063 DOI: 10.1016/j.ebiom.2021.103637] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 10/06/2021] [Accepted: 10/06/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The dynamics of SARS-CoV-2 alpha variant shedding and immune responses at the nasal mucosa remain poorly characterised. METHODS We measured infectious viral release, antibodies and cytokines in 426 PCR+ nasopharyngeal swabs from individuals harboring non-alpha or alpha variants. FINDINGS With both lineages, viral titers were variable, ranging from 0 to >106 infectious units. Rapid antigenic diagnostic tests were positive in 94% of samples with infectious virus. 68 % of individuals carried infectious virus within two days after onset of symptoms. This proportion decreased overtime. Viable virus was detected up to 14 days. Samples containing anti-spike IgG or IgA did not generally harbor infectious virus. Ct values were slightly but not significantly lower with alpha. This variant was characterized by a fast decrease of infectivity overtime and a marked release of 13 cytokines (including IFN-b, IP-10 and IL-10). INTERPRETATION The alpha variant displays modified viral decay and cytokine profiles at the nasopharyngeal mucosae during symptomatic infection. FUNDING This retrospective study has been funded by Institut Pasteur, ANRS, Vaccine Research Institute, Labex IBEID, ANR/FRM and IDISCOVR, Fondation pour la Recherche Médicale.
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Affiliation(s)
- Blandine Monel
- Virus & Immunity Unit, Department of Virology, Institut Pasteur, Paris, France; CNRS UMR 3569, Paris, France
| | - Delphine Planas
- Virus & Immunity Unit, Department of Virology, Institut Pasteur, Paris, France; CNRS UMR 3569, Paris, France; Vaccine Research Institute, Creteil, France
| | - Ludivine Grzelak
- Virus & Immunity Unit, Department of Virology, Institut Pasteur, Paris, France; CNRS UMR 3569, Paris, France; Université de Paris, Sorbonne Paris Cité, Paris, France
| | - Nikaïa Smith
- Translational Immunology Lab, Department of Immunology, Inserm U1223, Institut Pasteur, Paris
| | - Nicolas Robillard
- Hôpital Européen Georges Pompidou, Laboratoire de Virologie, Service de Microbiologie, Paris, France
| | - Isabelle Staropoli
- Virus & Immunity Unit, Department of Virology, Institut Pasteur, Paris, France; CNRS UMR 3569, Paris, France
| | - Pedro Goncalves
- Innate Immunity Unit, Department of Immunology, Department of Immunology, Inserm U1223, Institut Pasteur, Paris; Inserm U1223, Paris, France
| | - Françoise Porrot
- Virus & Immunity Unit, Department of Virology, Institut Pasteur, Paris, France; CNRS UMR 3569, Paris, France
| | - Florence Guivel-Benhassine
- Virus & Immunity Unit, Department of Virology, Institut Pasteur, Paris, France; CNRS UMR 3569, Paris, France
| | | | - Julien Rodary
- Hôpital Européen Georges Pompidou, Laboratoire de Virologie, Service de Microbiologie, Paris, France
| | - Julien Puech
- Hôpital Européen Georges Pompidou, Laboratoire de Virologie, Service de Microbiologie, Paris, France
| | - Victor Euzen
- Hôpital Européen Georges Pompidou, Laboratoire de Virologie, Service de Microbiologie, Paris, France
| | - Laurent Bélec
- Hôpital Européen Georges Pompidou, Laboratoire de Virologie, Service de Microbiologie, Paris, France; Hôpital européen Georges Pompidou INSERM U970, PARCC, Faculté de Médecine, Université de Paris, Paris, France
| | - Galdric Orvoen
- Hôpital Vaugirard, Service de gériatrie, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Léa Nunes
- Hôpital Corentin Celton, Service de gériatrie, Assistance Publique-Hôpitaux de Paris, Issy-les-Moulineaux, France
| | - Véronique Moulin
- Hôpital Corentin Celton, Service de gériatrie, Assistance Publique-Hôpitaux de Paris, Issy-les-Moulineaux, France
| | - Jacques Fourgeaud
- Université de Paris, EHU 7328 PACT, Institut Imagine, Paris, France; Virology Department, AP-HP, Necker Enfants Malades Hospital, Paris, France
| | - Maxime Wack
- Hôpital Européen Georges Pompidou, Département d'Informatique Médicale, Biostatistiques et Santé Publique
| | - Sandrine Imbeaud
- INSERM, Functional Genomics of Solid Tumors (FunGeST), Centre de Recherche des Cordeliers, Université de Paris and Sorbonne Université, Paris, France
| | | | - Darragh Duffy
- Translational Immunology Lab, Department of Immunology, Inserm U1223, Institut Pasteur, Paris
| | - James P Di Santo
- Innate Immunity Unit, Department of Immunology, Department of Immunology, Inserm U1223, Institut Pasteur, Paris; Inserm U1223, Paris, France
| | - Timothée Bruel
- Virus & Immunity Unit, Department of Virology, Institut Pasteur, Paris, France; CNRS UMR 3569, Paris, France; Vaccine Research Institute, Creteil, France
| | - Hélène Péré
- INSERM, Functional Genomics of Solid Tumors (FunGeST), Centre de Recherche des Cordeliers, Université de Paris and Sorbonne Université, Paris, France
| | - David Veyer
- Hôpital Européen Georges Pompidou, Laboratoire de Virologie, Service de Microbiologie, Paris, France; INSERM, Functional Genomics of Solid Tumors (FunGeST), Centre de Recherche des Cordeliers, Université de Paris and Sorbonne Université, Paris, France
| | - Olivier Schwartz
- Virus & Immunity Unit, Department of Virology, Institut Pasteur, Paris, France; CNRS UMR 3569, Paris, France; Vaccine Research Institute, Creteil, France.
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Rando HM, MacLean AL, Lee AJ, Lordan R, Ray S, Bansal V, Skelly AN, Sell E, Dziak JJ, Shinholster L, D’Agostino McGowan L, Ben Guebila M, Wellhausen N, Knyazev S, Boca SM, Capone S, Qi Y, Park Y, Mai D, Sun Y, Boerckel JD, Brueffer C, Byrd JB, Kamil JP, Wang J, Velazquez R, Szeto GL, Barton JP, Goel RR, Mangul S, Lubiana T, Gitter A, Greene CS. Pathogenesis, Symptomatology, and Transmission of SARS-CoV-2 through Analysis of Viral Genomics and Structure. mSystems 2021; 6:e0009521. [PMID: 34698547 PMCID: PMC8547481 DOI: 10.1128/msystems.00095-21] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2021] [Indexed: 02/06/2023] Open
Abstract
The novel coronavirus SARS-CoV-2, which emerged in late 2019, has since spread around the world and infected hundreds of millions of people with coronavirus disease 2019 (COVID-19). While this viral species was unknown prior to January 2020, its similarity to other coronaviruses that infect humans has allowed for rapid insight into the mechanisms that it uses to infect human hosts, as well as the ways in which the human immune system can respond. Here, we contextualize SARS-CoV-2 among other coronaviruses and identify what is known and what can be inferred about its behavior once inside a human host. Because the genomic content of coronaviruses, which specifies the virus's structure, is highly conserved, early genomic analysis provided a significant head start in predicting viral pathogenesis and in understanding potential differences among variants. The pathogenesis of the virus offers insights into symptomatology, transmission, and individual susceptibility. Additionally, prior research into interactions between the human immune system and coronaviruses has identified how these viruses can evade the immune system's protective mechanisms. We also explore systems-level research into the regulatory and proteomic effects of SARS-CoV-2 infection and the immune response. Understanding the structure and behavior of the virus serves to contextualize the many facets of the COVID-19 pandemic and can influence efforts to control the virus and treat the disease. IMPORTANCE COVID-19 involves a number of organ systems and can present with a wide range of symptoms. From how the virus infects cells to how it spreads between people, the available research suggests that these patterns are very similar to those seen in the closely related viruses SARS-CoV-1 and possibly Middle East respiratory syndrome-related CoV (MERS-CoV). Understanding the pathogenesis of the SARS-CoV-2 virus also contextualizes how the different biological systems affected by COVID-19 connect. Exploring the structure, phylogeny, and pathogenesis of the virus therefore helps to guide interpretation of the broader impacts of the virus on the human body and on human populations. For this reason, an in-depth exploration of viral mechanisms is critical to a robust understanding of SARS-CoV-2 and, potentially, future emergent human CoVs (HCoVs).
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Affiliation(s)
- Halie M. Rando
- Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Biochemistry and Molecular Genetics, University of Colorado School of Medicine, Aurora, Colorado, USA
- Center for Health AI, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Adam L. MacLean
- Department of Quantitative and Computational Biology, University of Southern California, Los Angeles, California, USA
| | - Alexandra J. Lee
- Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Ronan Lordan
- Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Sandipan Ray
- Department of Biotechnology, Indian Institute of Technology Hyderabad, Sangareddy, Telangana, India
| | - Vikas Bansal
- Biomedical Data Science and Machine Learning Group, German Center for Neurodegenerative Diseases, Tübingen, Germany
| | - Ashwin N. Skelly
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Institute for Immunology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Elizabeth Sell
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - John J. Dziak
- Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, Pennsylvania, USA
| | | | - Lucy D’Agostino McGowan
- Department of Mathematics and Statistics, Wake Forest University, Winston-Salem, North Carolina, USA
| | - Marouen Ben Guebila
- Department of Biostatistics, Harvard School of Public Health, Boston, Massachusetts, USA
| | - Nils Wellhausen
- Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | - Simina M. Boca
- Innovation Center for Biomedical Informatics, Georgetown University Medical Center, Washington, DC, USA
| | - Stephen Capone
- St. George’s University School of Medicine, St. George’s, Grenada
| | - Yanjun Qi
- Department of Computer Science, University of Virginia, Charlottesville, Virginia, USA
| | - YoSon Park
- Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - David Mai
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Yuchen Sun
- Department of Computer Science, University of Virginia, Charlottesville, Virginia, USA
| | - Joel D. Boerckel
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | - James Brian Byrd
- University of Michigan School of Medicine, Ann Arbor, Michigan, USA
| | - Jeremy P. Kamil
- Department of Microbiology and Immunology, Louisiana State University Health Sciences Center Shreveport, Shreveport, Louisiana, USA
| | - Jinhui Wang
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | | | - John P. Barton
- Department of Physics and Astronomy, University of California-Riverside, Riverside, California, USA
| | - Rishi Raj Goel
- Institute for Immunology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Serghei Mangul
- Department of Clinical Pharmacy, School of Pharmacy, University of Southern California, Los Angeles, California, USA
| | - Tiago Lubiana
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | - COVID-19 Review Consortium
- Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Biochemistry and Molecular Genetics, University of Colorado School of Medicine, Aurora, Colorado, USA
- Center for Health AI, University of Colorado School of Medicine, Aurora, Colorado, USA
- Department of Quantitative and Computational Biology, University of Southern California, Los Angeles, California, USA
- Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Biotechnology, Indian Institute of Technology Hyderabad, Sangareddy, Telangana, India
- Biomedical Data Science and Machine Learning Group, German Center for Neurodegenerative Diseases, Tübingen, Germany
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Institute for Immunology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, Pennsylvania, USA
- Mercer University, Macon, Georgia, USA
- Department of Mathematics and Statistics, Wake Forest University, Winston-Salem, North Carolina, USA
- Department of Biostatistics, Harvard School of Public Health, Boston, Massachusetts, USA
- Georgia State University, Atlanta, Georgia, USA
- Innovation Center for Biomedical Informatics, Georgetown University Medical Center, Washington, DC, USA
- St. George’s University School of Medicine, St. George’s, Grenada
- Department of Computer Science, University of Virginia, Charlottesville, Virginia, USA
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Clinical Sciences, Lund University, Lund, Sweden
- University of Michigan School of Medicine, Ann Arbor, Michigan, USA
- Department of Microbiology and Immunology, Louisiana State University Health Sciences Center Shreveport, Shreveport, Louisiana, USA
- Azimuth1, McLean, Virginia, USA
- Allen Institute for Immunology, Seattle, Washington, USA
- Department of Physics and Astronomy, University of California-Riverside, Riverside, California, USA
- Department of Clinical Pharmacy, School of Pharmacy, University of Southern California, Los Angeles, California, USA
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Morgridge Institute for Research, Madison, Wisconsin, USA
- Childhood Cancer Data Lab, Alex’s Lemonade Stand Foundation, Philadelphia, Pennsylvania, USA
| | - Anthony Gitter
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Morgridge Institute for Research, Madison, Wisconsin, USA
| | - Casey S. Greene
- Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Biochemistry and Molecular Genetics, University of Colorado School of Medicine, Aurora, Colorado, USA
- Center for Health AI, University of Colorado School of Medicine, Aurora, Colorado, USA
- Childhood Cancer Data Lab, Alex’s Lemonade Stand Foundation, Philadelphia, Pennsylvania, USA
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Zimmermann R, Sarma N, Thieme-Thörel D, Alpers K, Artelt T, Azouagh K, Bremer V, Broistedt P, Eckmanns T, Feltgen N, Huska M, Kröger S, Puls A, Scheithauer S, Mayr E, Rexroth U. COVID-19 Outbreaks in Settings With Precarious Housing Conditions in Germany: Challenges and Lessons Learned. Front Public Health 2021; 9:708694. [PMID: 34621717 PMCID: PMC8490676 DOI: 10.3389/fpubh.2021.708694] [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: 05/20/2021] [Accepted: 08/24/2021] [Indexed: 11/13/2022] Open
Abstract
Two COVID-19 outbreaks occurred in residential buildings with overcrowded housing conditions in the city of Göttingen in Germany during May and June 2020, when COVID-19 infection incidences were low across the rest of the country, with a national incidence of 2.6/100,000 population. The outbreaks increased the local incidence in the city of Göttingen to 123.5/100,000 in June 2020. Many of the affected residents were living in precarious conditions and experienced language barriers. The outbreaks were characterized by high case numbers and attack rates among the residents, many asymptomatic cases, a comparatively young population, and substantial outbreak control measures implemented by local authorities. We analyzed national and local surveillance data, calculated age-, and gender-specific attack rates and performed whole genome sequencing analysis to describe the outbreak and characteristics of the infected population. The authorities' infection control measures included voluntary and compulsory testing of all residents and mass quarantine. Public health measures, such as the general closure of schools and a public space as well as the prohibition of team sports at local level, were also implemented in the district to limit the outbreaks locally. The outbreaks were under control by the end of June 2020. We describe the measures to contain the outbreaks, the challenges experienced and lessons learned. We discuss how public health measures can be planned and implemented through consideration of the needs and vulnerabilities of affected populations. In order to avoid coercive measures, barrier-free communication, with language translation when needed, and consideration of socio-economic circumstances of affected populations are crucial for controlling infectious disease transmission in an outbreak effectively and in a timely way.
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Affiliation(s)
- Ruth Zimmermann
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Navina Sarma
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | | | - Katharina Alpers
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Tanja Artelt
- Infection Control and Infectious Diseases, University Medical Center Göttingen, Göttingen, Germany
| | | | - Viviane Bremer
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | | | - Tim Eckmanns
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Nicolas Feltgen
- Department of Ophthalmology, University Medical Center Göttingen, Göttingen, Germany
| | - Matthew Huska
- Department of Methodology and Research Infrastructure, Robert Koch Institute, Berlin, Germany
| | - Stefan Kröger
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | | | - Simone Scheithauer
- Infection Control and Infectious Diseases, University Medical Center Göttingen, Göttingen, Germany
| | - Eckart Mayr
- Local Public Health Authority, Göttingen, Germany
| | - Ute Rexroth
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
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42
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Sharma M, Mindermann S, Rogers-Smith C, Leech G, Snodin B, Ahuja J, Sandbrink JB, Monrad JT, Altman G, Dhaliwal G, Finnveden L, Norman AJ, Oehm SB, Sandkühler JF, Aitchison L, Gavenčiak T, Mellan T, Kulveit J, Chindelevitch L, Flaxman S, Gal Y, Mishra S, Bhatt S, Brauner JM. Understanding the effectiveness of government interventions against the resurgence of COVID-19 in Europe. Nat Commun 2021; 12:5820. [PMID: 34611158 PMCID: PMC8492703 DOI: 10.1038/s41467-021-26013-4] [Citation(s) in RCA: 96] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 08/23/2021] [Indexed: 12/24/2022] Open
Abstract
European governments use non-pharmaceutical interventions (NPIs) to control resurging waves of COVID-19. However, they only have outdated estimates for how effective individual NPIs were in the first wave. We estimate the effectiveness of 17 NPIs in Europe's second wave from subnational case and death data by introducing a flexible hierarchical Bayesian transmission model and collecting the largest dataset of NPI implementation dates across Europe. Business closures, educational institution closures, and gathering bans reduced transmission, but reduced it less than they did in the first wave. This difference is likely due to organisational safety measures and individual protective behaviours-such as distancing-which made various areas of public life safer and thereby reduced the effect of closing them. Specifically, we find smaller effects for closing educational institutions, suggesting that stringent safety measures made schools safer compared to the first wave. Second-wave estimates outperform previous estimates at predicting transmission in Europe's third wave.
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Affiliation(s)
- Mrinank Sharma
- Department of Statistics, University of Oxford, Oxford, UK.
- Department of Engineering Science, University of Oxford, Oxford, UK.
- Future of Humanity Institute, University of Oxford, Oxford, UK.
| | - Sören Mindermann
- Oxford Applied and Theoretical Machine Learning (OATML) Group, Department of Computer Science, University of Oxford, Oxford, UK.
| | - Charlie Rogers-Smith
- OATML Group (work done while at OATML as an external collaborator), Department of Computer Science, University of Oxford, Oxford, UK
| | - Gavin Leech
- Department of Computer Science, University of Bristol, Bristol, UK
| | - Benedict Snodin
- Future of Humanity Institute, University of Oxford, Oxford, UK
| | - Janvi Ahuja
- Future of Humanity Institute, University of Oxford, Oxford, UK
- Medical Sciences Division, University of Oxford, Oxford, UK
| | - Jonas B Sandbrink
- Future of Humanity Institute, University of Oxford, Oxford, UK
- Medical Sciences Division, University of Oxford, Oxford, UK
| | - Joshua Teperowski Monrad
- Future of Humanity Institute, University of Oxford, Oxford, UK
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
- Department of Health Policy, London School of Economics and Political Science, London, UK
| | - George Altman
- Manchester University NHS Foundation Trust, Manchester, UK
| | - Gurpreet Dhaliwal
- The Francis Crick Institute, London, UK
- School of Life Sciences, University of Warwick, Coventry, UK
| | - Lukas Finnveden
- Future of Humanity Institute, University of Oxford, Oxford, UK
| | - Alexander John Norman
- Mathematical, Physical and Life Sciences (MPLS) Doctoral Training Centre, University of Oxford, Oxford, UK
| | - Sebastian B Oehm
- Medical Research Council Laboratory of Molecular Biology, Cambridge, UK
- University of Cambridge, Cambridge, UK
| | | | | | | | - Thomas Mellan
- Medical Research Council (MRC) Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, UK
| | - Jan Kulveit
- Future of Humanity Institute, University of Oxford, Oxford, UK
| | - Leonid Chindelevitch
- Medical Research Council (MRC) Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, UK
| | - Seth Flaxman
- Department of Mathematics, Imperial College London, London, UK
| | - Yarin Gal
- Oxford Applied and Theoretical Machine Learning (OATML) Group, Department of Computer Science, University of Oxford, Oxford, UK
| | - Swapnil Mishra
- Medical Research Council (MRC) Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, UK.
- Abdul Latif Jameel Institute for Disease and Emergency Analytics (J-IDEA), School of Public Health, Imperial College London, London, UK.
| | - Samir Bhatt
- Medical Research Council (MRC) Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, UK.
- Abdul Latif Jameel Institute for Disease and Emergency Analytics (J-IDEA), School of Public Health, Imperial College London, London, UK.
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Jan Markus Brauner
- Future of Humanity Institute, University of Oxford, Oxford, UK.
- Oxford Applied and Theoretical Machine Learning (OATML) Group, Department of Computer Science, University of Oxford, Oxford, UK.
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43
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Neumann M, Aigner A, Rossow E, Schwarz D, Marschallek M, Steinmann J, Stücker R, Koenigs I, Stock P. Low SARS-CoV-2 seroprevalence but high perception of risk among healthcare workers at children's hospital before second pandemic wave in Germany. World J Pediatr 2021; 17:484-494. [PMID: 34415560 PMCID: PMC8378295 DOI: 10.1007/s12519-021-00447-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 07/15/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND Healthcare workers are considered a particularly high-risk group during the coronavirus disease 2019 (COVID-19) pandemic. Healthcare workers in paediatrics are a unique subgroup: they come into frequent contact with children, who often experience few or no symptoms when infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and, therefore, may transmit the disease to unprotected staff. In Germany, no studies exist evaluating the risk of COVID-19 to healthcare workers in paediatric institutions. METHODS We tested the staff at a large children's hospital in Germany for immunoglobulin (Ig) G antibodies against the nucleocapsid protein of SARS-CoV-2 in a period between the first and second epidemic wave in Germany. We used a questionnaire to assess each individual's exposure risk and his/her own perception of having already been infected with SARS-CoV-2. RESULTS We recruited 619 participants from all sectors, clinical and non-clinical, constituting 70% of the entire staff. The seroprevalence of SARS-CoV-2 antibodies was 0.325% (95% confidence interval 0.039-1.168). Self-perceived risk of a previous SARS-CoV-2 infection decreased with age (odds ratio, 0.81; 95% confidence interval, 0.70-0.93). Having experienced symptoms more than doubled the odds of a high self-perceived risk (odds ratio, 2.18; 95% confidence interval, 1.59-3.00). There was no significant difference in self-perceived risk between men and women. CONCLUSIONS Seroprevalence was low among healthcare workers at a large children's hospital in Germany before the second epidemic wave, and it was far from a level that confers herd immunity. Self-perceived risk of infection is often overestimated.
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Affiliation(s)
- Marietta Neumann
- Department of Paediatrics, Altona Children's Hospital, Universität Hamburg, Altonaer Kinderkrankenhaus, Bleickenallee 38, 22763, Hamburg, Germany.
| | - Annette Aigner
- Corporate Member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Institute of Biometry and Clinical Epidemiology Berlin, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Eileen Rossow
- Department of Neonatology and Paediatric Intensive Care Medicine, Altona Children's Hospital, Hamburg, Germany
| | - David Schwarz
- Department of Paediatric Surgery, Altona Children's Hospital, Hamburg, Germany
- Department of Paediatric Surgery, University Medical Centre Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Maria Marschallek
- Department of Paediatrics, Altona Children's Hospital, Universität Hamburg, Altonaer Kinderkrankenhaus, Bleickenallee 38, 22763, Hamburg, Germany
| | - Jörg Steinmann
- Labor Dr. Fenner and Colleagues, Hamburg, Germany
- Department of Paediatrics, Altona Children's Hospital, Hamburg, Germany
| | - Ralf Stücker
- Department of Paediatric Orthopaedics, Altona Children's Hospital, Hamburg, Germany
| | - Ingo Koenigs
- Department of Paediatric Surgery, Altona Children's Hospital, Hamburg, Germany
- Department of Paediatric Surgery, University Medical Centre Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Philippe Stock
- Department of Paediatrics, Altona Children's Hospital, Universität Hamburg, Altonaer Kinderkrankenhaus, Bleickenallee 38, 22763, Hamburg, Germany
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Blankenberger J, Haile SR, Puhan MA, Berger C, Radtke T, Kriemler S, Ulyte A. Prediction of Past SARS-CoV-2 Infections: A Prospective Cohort Study Among Swiss Schoolchildren. Front Pediatr 2021; 9:710785. [PMID: 34485200 PMCID: PMC8415623 DOI: 10.3389/fped.2021.710785] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 07/20/2021] [Indexed: 12/24/2022] Open
Abstract
Objective: To assess the predictive value of symptoms, sociodemographic characteristics, and SARS-CoV-2 exposure in household, school, and community setting for SARS-CoV-2 seropositivity in Swiss schoolchildren at two time points in 2020. Design: Serological testing of children in primary and secondary schools (aged 6-13 and 12-16 years, respectively) took place in June-July (T1) and October-November (T2) 2020, as part of the longitudinal, school-based study Ciao Corona in the canton of Zurich, Switzerland. Information on sociodemographic characteristics and clinical history was collected with questionnaires to parents; information on school-level SARS-CoV-2 infections was collected with questionnaires to school principals. Community-level cumulative incidence was obtained from official statistics. We used logistic regression to identify individual predictors of seropositivity and assessed the predictive performance of symptom- and exposure-based prediction models. Results: A total of 2,496 children (74 seropositive) at T1 and 2,152 children (109 seropositive) at T2 were included. Except for anosmia (odds ratio 15.4, 95% confidence interval [3.4-70.7]) and headache (2.0 [1.03-3.9]) at T2, none of the individual symptoms were significantly predictive of seropositivity at either time point. Of all the exposure variables, a reported SARS-CoV-2 case in the household was the strongest predictor for seropositivity at T1 (12.4 [5.8-26.7]) and T2 (10.8 [4.5-25.8]). At both time points, area under the receiver operating characteristic curve was greater for exposure-based (T1, 0.69; T2, 0.64) than symptom-based prediction models (T1, 0.59; T2, 0.57). Conclusions: In children, retrospective identification of past SARS-CoV-2 infections based on symptoms is imprecise. SARS-CoV-2 seropositivity is better predicted by factors of SARS-CoV-2 exposure, especially reported SARS-CoV-2 cases in the household. Predicting SARS-CoV-2 seropositivity in children in general is challenging, as few reliable predictors could be identified. For an accurate retrospective identification of SARS-CoV-2 infections in children, serological tests are likely indispensable. Trial registration number: NCT04448717.
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Affiliation(s)
- Jacob Blankenberger
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Sarah R. Haile
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Milo A. Puhan
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Christoph Berger
- Division of Infectious Diseases and Hospital Epidemiology, University Children Hospital Zurich, Zurich, Switzerland
| | - Thomas Radtke
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Susi Kriemler
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Agne Ulyte
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
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45
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Woudenberg T, Pelleau S, Anna F, Attia M, Donnadieu F, Gravet A, Lohmann C, Seraphin H, Guiheneuf R, Delamare C, Stefic K, Marlet J, Brochot E, Castelain S, Augereau O, Sibilia J, Dubos F, Meddour D, Guen CGL, Coste-Burel M, Imbert-Marcille BM, Chauvire-Drouard A, Schweitzer C, Gatin A, Lomazzi S, Joulié A, Haas H, Cantais A, Bertholon F, Chinazzo-Vigouroux MF, Abdallah MS, Arowas L, Charneau P, Hoen B, Demeret C, Werf SVD, Fontanet A, White M. Humoral immunity to SARS-CoV-2 and seasonal coronaviruses in children and adults in north-eastern France. EBioMedicine 2021; 70:103495. [PMID: 34304047 PMCID: PMC8299153 DOI: 10.1016/j.ebiom.2021.103495] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 06/25/2021] [Accepted: 07/05/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Children are underrepresented in the COVID-19 pandemic and often experience milder disease than adolescents and adults. Reduced severity is possibly due to recent and more frequent seasonal human coronaviruses (HCoV) infections. We assessed the seroprevalence of SARS-CoV-2 and seasonal HCoV specific antibodies in a large cohort in north-eastern France. METHODS In this cross-sectional seroprevalence study, serum samples were collected from children and adults requiring hospital admission for non-COVID-19 between February and August 2020. Antibody responses to SARS-CoV-2 and seasonal HCoV (229E, HKU1, NL63, OC43) were assessed using a bead-based multiplex assay, Luciferase-Linked ImmunoSorbent Assay, and a pseudotype neutralisation assay. FINDINGS In 2,408 individuals, seroprevalence of SARS-CoV-2-specific antibodies was 7-8% with three different immunoassays. Antibody levels to seasonal HCoV increased substantially up to the age of 10. Antibody responses in SARS-CoV-2 seropositive individuals were lowest in adults 18-30 years. In SARS-CoV-2 seronegative individuals, we observed cross-reactivity between antibodies to the four HCoV and SARS-CoV-2 Spike. In contrast to other antibodies to SARS-CoV-2, specific antibodies to sub-unit 2 of Spike (S2) in seronegative samples were highest in children. Upon infection with SARS-CoV-2, antibody levels to Spike of betacoronavirus OC43 increased across the whole age spectrum. No SARS-CoV-2 seropositive individuals with low levels of antibodies to seasonal HCoV were observed. INTERPRETATION Our findings underline significant cross-reactivity between antibodies to SARS-CoV-2 and seasonal HCoV, but provide no significant evidence for cross-protective immunity to SARS-CoV-2 infection due to a recent seasonal HCoV infection. In particular, across all age groups we did not observe SARS-CoV-2 infected individuals with low levels of antibodies to seasonal HCoV. FUNDING This work was supported by the « URGENCE COVID-19 » fundraising campaign of Institut Pasteur, by the French Government's Investissement d'Avenir program, Laboratoire d'Excellence Integrative Biology of Emerging Infectious Diseases (Grant No. ANR-10-LABX-62-IBEID), and by the REACTing (Research & Action Emerging Infectious Diseases), and by the RECOVER project funded by the European Union's Horizon 2020 research and innovation programme under grant agreement No. 101003589, and by a grant from LabEx IBEID (ANR-10-LABX-62-IBEID).
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Affiliation(s)
- Tom Woudenberg
- Infectious Disease Epidemiology and Analytics Unit, Department of Global Health, Institut Pasteur, Paris, France; Malaria: Parasites and Hosts Unit, Department of Parasites and Insect Vectors, Institut Pasteur, Paris, France.
| | - Stéphane Pelleau
- Infectious Disease Epidemiology and Analytics Unit, Department of Global Health, Institut Pasteur, Paris, France; Malaria: Parasites and Hosts Unit, Department of Parasites and Insect Vectors, Institut Pasteur, Paris, France
| | - François Anna
- Molecular Virology and Vaccinoloy Unit, Department of Virology, Institut Pasteur, Paris, France
| | - Mikael Attia
- Molecular Genetics of RNA Viruses, Department of Virology, Institut Pasteur, CNRS UMR 3569, Paris, France
| | - Françoise Donnadieu
- Infectious Disease Epidemiology and Analytics Unit, Department of Global Health, Institut Pasteur, Paris, France; Malaria: Parasites and Hosts Unit, Department of Parasites and Insect Vectors, Institut Pasteur, Paris, France
| | - Alain Gravet
- Laboratoire de Microbiologie, Groupement Hospitalier Régional de Mulhouse et Sud-Alsace, Mulhouse, France
| | - Caroline Lohmann
- Laboratoire de Microbiologie, Groupement Hospitalier Régional de Mulhouse et Sud-Alsace, Mulhouse, France
| | - Hélène Seraphin
- Centre Hospitalier Simone Veil de Beauvais, Beauvais, France
| | | | | | - Karl Stefic
- Service de Bactériologie-Virologie, Hôpital Bretonneau, CHRU de Tours, Tours, France
| | - Julien Marlet
- Service de Bactériologie-Virologie, Hôpital Bretonneau, CHRU de Tours, Tours, France
| | - Etienne Brochot
- Service de Virologie, CHU Amiens Picardie, UR 4294 AGIR UPJV, Amiens, France
| | - Sandrine Castelain
- Service de Virologie, CHU Amiens Picardie, UR 4294 AGIR UPJV, Amiens, France
| | - Olivier Augereau
- Service de Microbiologie, Hôpitaux Civils de Colmar, Colmar, France
| | - Jean Sibilia
- Laboratoire de Virologie, CHU de Strasbourg, Strasbourg, France
| | - François Dubos
- Univ. Lille, CHU Lille, Urgences pédiatriques et maladies infectieuses, Lille, France
| | - Damia Meddour
- Univ. Lille, CHU Lille, Urgences pédiatriques et maladies infectieuses, Lille, France
| | - Christèle Gras-Le Guen
- Urgences Pédiatrique et Pédiatrie Générale Hopital Mère Enfant CHU de Nantes, Nantes, France
| | | | | | | | - Cyril Schweitzer
- Hôpital d'Enfants, CHRU de Nancy, Vandoeuvre-Les-Nancy, France; EA 3450, DevAH, Université de Lorraine, Vandoeuvre Lès Nancy, France
| | - Amélie Gatin
- Pediatric Emergency Unit, Hôpital d'enfants, CHRU Nancy
| | | | - Aline Joulié
- Urgences pédiatriques et pédiatrie générale, hôpitaux pédiatriques CHU Lenval, Nice
| | - Hervé Haas
- Urgences pédiatriques et pédiatrie générale, hôpitaux pédiatriques CHU Lenval, Nice
| | - Aymeric Cantais
- Pediatric Emergency Department, Hospital University of St Etienne, France
| | | | | | | | - Laurence Arowas
- Investigation Clinique et Accès aux Ressources Biologiques (ICAReB), Center for Translational Research, Institut Pasteur, Paris, France
| | - Pierre Charneau
- Molecular Virology and Vaccinoloy Unit, Department of Virology, Institut Pasteur, Paris, France
| | - Bruno Hoen
- Direction de la recherche médicale, Institut Pasteur, Paris, France
| | - Caroline Demeret
- Molecular Genetics of RNA Viruses, Department of Virology, Institut Pasteur, CNRS UMR 3569, Paris, France
| | - Sylvie Van Der Werf
- Molecular Genetics of RNA Viruses, Department of Virology, Institut Pasteur, CNRS UMR 3569, Paris, France; National Reference Center for Respiratory Viruses, Institut Pasteur, Paris, France
| | - Arnaud Fontanet
- Emerging Diseases Epidemiology Unit, Department of Global Health, Institut Pasteur, Paris, France; PACRI Unit, Conservatoire National des Arts et Métiers, Paris, France.
| | - Michael White
- Infectious Disease Epidemiology and Analytics Unit, Department of Global Health, Institut Pasteur, Paris, France; Malaria: Parasites and Hosts Unit, Department of Parasites and Insect Vectors, Institut Pasteur, Paris, France.
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Keeling MJ, Dyson L, Guyver-Fletcher G, Holmes A, Semple MG, Tildesley MJ, Hill EM. Fitting to the UK COVID-19 outbreak, short-term forecasts and estimating the reproductive number. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021:2020.08.04.20163782. [PMID: 32817970 PMCID: PMC7430615 DOI: 10.1101/2020.08.04.20163782] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
The COVID-19 pandemic has brought to the fore the need for policy makers to receive timely and ongoing scientific guidance in response to this recently emerged human infectious disease. Fitting mathematical models of infectious disease transmission to the available epidemiological data provides a key statistical tool for understanding the many quantities of interest that are not explicit in the underlying epidemiological data streams. Of these, the effective reproduction number, R, has taken on special significance in terms of the general understanding of whether the epidemic is under control (R < 1). Unfortunately, none of the epidemiological data streams are designed for modelling, hence assimilating information from multiple (often changing) sources of data is a major challenge that is particularly stark in novel disease outbreaks. Here, focusing on the dynamics of the first-wave (March-June 2020), we present in some detail the inference scheme employed for calibrating the Warwick COVID-19 model to the available public health data streams, which span hospitalisations, critical care occupancy, mortality and serological testing. We then perform computational simulations, making use of the acquired parameter posterior distributions, to assess how the accuracy of short-term predictions varied over the timecourse of the outbreak. To conclude, we compare how refinements to data streams and model structure impact estimates of epidemiological measures, including the estimated growth rate and daily incidence.
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Affiliation(s)
- Matt J. Keeling
- The Zeeman Institute for Systems Biology & Infectious Disease Epidemiology Research, School of Life Sciences and Mathematics Institute, University of Warwick, Coventry, CV4 7AL, United Kingdom
- Joint UNIversities Pandemic and Epidemiological Research, https://maths.org/juniper/
| | - Louise Dyson
- The Zeeman Institute for Systems Biology & Infectious Disease Epidemiology Research, School of Life Sciences and Mathematics Institute, University of Warwick, Coventry, CV4 7AL, United Kingdom
- Joint UNIversities Pandemic and Epidemiological Research, https://maths.org/juniper/
| | - Glen Guyver-Fletcher
- The Zeeman Institute for Systems Biology & Infectious Disease Epidemiology Research, School of Life Sciences and Mathematics Institute, University of Warwick, Coventry, CV4 7AL, United Kingdom
- Midlands Integrative Biosciences Training Partnership, School of Life Sciences, University of Warwick, Coventry, CV4 7AL, United Kingdom
| | - Alex Holmes
- The Zeeman Institute for Systems Biology & Infectious Disease Epidemiology Research, School of Life Sciences and Mathematics Institute, University of Warwick, Coventry, CV4 7AL, United Kingdom
- Mathematics for Real World Systems Centre for Doctoral Training, Mathematics Institute, University of Warwick, Coventry, CV4 7AL, United Kingdom
| | - Malcolm G Semple
- NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, Institute of Infection, Veterinary and Ecological Sciences, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, United Kingdom
- Respiratory Medicine, Alder Hey Children’s Hospital, Institute in The Park, University of Liverpool, Alder Hey Children’s Hospital, Liverpool L12 2AP, United Kingdom
| | | | - Michael J. Tildesley
- The Zeeman Institute for Systems Biology & Infectious Disease Epidemiology Research, School of Life Sciences and Mathematics Institute, University of Warwick, Coventry, CV4 7AL, United Kingdom
- Joint UNIversities Pandemic and Epidemiological Research, https://maths.org/juniper/
| | - Edward M. Hill
- The Zeeman Institute for Systems Biology & Infectious Disease Epidemiology Research, School of Life Sciences and Mathematics Institute, University of Warwick, Coventry, CV4 7AL, United Kingdom
- Joint UNIversities Pandemic and Epidemiological Research, https://maths.org/juniper/
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47
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Jones TC, Biele G, Mühlemann B, Veith T, Schneider J, Beheim-Schwarzbach J, Bleicker T, Tesch J, Schmidt ML, Sander LE, Kurth F, Menzel P, Schwarzer R, Zuchowski M, Hofmann J, Krumbholz A, Stein A, Edelmann A, Corman VM, Drosten C. Estimating infectiousness throughout SARS-CoV-2 infection course. Science 2021; 373:eabi5273. [PMID: 34035154 PMCID: PMC9267347 DOI: 10.1126/science.abi5273] [Citation(s) in RCA: 297] [Impact Index Per Article: 99.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 05/21/2021] [Indexed: 12/20/2022]
Abstract
Two elementary parameters for quantifying viral infection and shedding are viral load and whether samples yield a replicating virus isolate in cell culture. We examined 25,381 cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Germany, including 6110 from test centers attended by presymptomatic, asymptomatic, and mildly symptomatic (PAMS) subjects, 9519 who were hospitalized, and 1533 B.1.1.7 lineage infections. The viral load of the youngest subjects was lower than that of the older subjects by 0.5 (or fewer) log10 units, and they displayed an estimated ~78% of the peak cell culture replication probability; in part this was due to smaller swab sizes and unlikely to be clinically relevant. Viral loads above 109 copies per swab were found in 8% of subjects, one-third of whom were PAMS, with a mean age of 37.6 years. We estimate 4.3 days from onset of shedding to peak viral load (108.1 RNA copies per swab) and peak cell culture isolation probability (0.75). B.1.1.7 subjects had mean log10 viral load 1.05 higher than that of non-B.1.1.7 subjects, and the estimated cell culture replication probability of B.1.1.7 subjects was higher by a factor of 2.6.
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Affiliation(s)
- Terry C Jones
- Institute of Virology, Charité--Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany
- German Centre for Infection Research (DZIF), partner site Charité, 10117 Berlin, Germany
- Centre for Pathogen Evolution, Department of Zoology, University of Cambridge, Cambridge CB2 3EJ, U.K
| | - Guido Biele
- Norwegian Institute of Public Health, 0473 Oslo, Norway
- University of Oslo, 0315 Oslo, Norway
| | - Barbara Mühlemann
- Institute of Virology, Charité--Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany
- German Centre for Infection Research (DZIF), partner site Charité, 10117 Berlin, Germany
| | - Talitha Veith
- Institute of Virology, Charité--Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany
- German Centre for Infection Research (DZIF), partner site Charité, 10117 Berlin, Germany
| | - Julia Schneider
- Institute of Virology, Charité--Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany
- German Centre for Infection Research (DZIF), partner site Charité, 10117 Berlin, Germany
| | - Jörn Beheim-Schwarzbach
- Institute of Virology, Charité--Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany
| | - Tobias Bleicker
- Institute of Virology, Charité--Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany
| | - Julia Tesch
- Institute of Virology, Charité--Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany
| | - Marie Luisa Schmidt
- Institute of Virology, Charité--Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany
| | - Leif Erik Sander
- Department of Infectious Diseases and Respiratory Medicine, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Florian Kurth
- Department of Infectious Diseases and Respiratory Medicine, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine, and Department of Medicine I, University Medical Centre Hamburg-Eppendorf, 20359 Hamburg, Germany
| | - Peter Menzel
- Labor Berlin-Charité Vivantes GmbH, Sylter Straße 2, 13353 Berlin, Germany
| | - Rolf Schwarzer
- Labor Berlin-Charité Vivantes GmbH, Sylter Straße 2, 13353 Berlin, Germany
| | - Marta Zuchowski
- Labor Berlin-Charité Vivantes GmbH, Sylter Straße 2, 13353 Berlin, Germany
| | - Jörg Hofmann
- Labor Berlin-Charité Vivantes GmbH, Sylter Straße 2, 13353 Berlin, Germany
| | - Andi Krumbholz
- Institute for Infection Medicine, Christian-Albrechts-Universität zu Kiel and University Medical Center Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany
- Labor Dr. Krause und Kollegen MVZ GmbH, 24106 Kiel, Germany
| | - Angela Stein
- Labor Berlin-Charité Vivantes GmbH, Sylter Straße 2, 13353 Berlin, Germany
| | - Anke Edelmann
- Labor Berlin-Charité Vivantes GmbH, Sylter Straße 2, 13353 Berlin, Germany
| | - Victor Max Corman
- Institute of Virology, Charité--Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany
- German Centre for Infection Research (DZIF), partner site Charité, 10117 Berlin, Germany
| | - Christian Drosten
- Institute of Virology, Charité--Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany.
- German Centre for Infection Research (DZIF), partner site Charité, 10117 Berlin, Germany
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COVID-19 in schools: Mitigating classroom clusters in the context of variable transmission. PLoS Comput Biol 2021; 17:e1009120. [PMID: 34237051 PMCID: PMC8266060 DOI: 10.1371/journal.pcbi.1009120] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 05/27/2021] [Indexed: 12/20/2022] Open
Abstract
Widespread school closures occurred during the COVID-19 pandemic. Because closures are costly and damaging, many jurisdictions have since reopened schools with control measures in place. Early evidence indicated that schools were low risk and children were unlikely to be very infectious, but it is becoming clear that children and youth can acquire and transmit COVID-19 in school settings and that transmission clusters and outbreaks can be large. We describe the contrasting literature on school transmission, and argue that the apparent discrepancy can be reconciled by heterogeneity, or “overdispersion” in transmission, with many exposures yielding little to no risk of onward transmission, but some unfortunate exposures causing sizeable onward transmission. In addition, respiratory viral loads are as high in children and youth as in adults, pre- and asymptomatic transmission occur, and the possibility of aerosol transmission has been established. We use a stochastic individual-based model to find the implications of these combined observations for cluster sizes and control measures. We consider both individual and environment/activity contributions to the transmission rate, as both are known to contribute to variability in transmission. We find that even small heterogeneities in these contributions result in highly variable transmission cluster sizes in the classroom setting, with clusters ranging from 1 to 20 individuals in a class of 25. None of the mitigation protocols we modeled, initiated by a positive test in a symptomatic individual, are able to prevent large transmission clusters unless the transmission rate is low (in which case large clusters do not occur in any case). Among the measures we modeled, only rapid universal monitoring (for example by regular, onsite, pooled testing) accomplished this prevention. We suggest approaches and the rationale for mitigating these larger clusters, even if they are expected to be rare. During the COVID-19 pandemic many jurisdictions closed schools in order to limit transmission of SARS-CoV-2. Because school closures are costly and damaging to students, schools were later reopened despite the risk of contact among students contributing to increased prevalence of the virus. Early data showed schools being mostly a low risk setting, but occasionally large outbreaks were observed. We argue that this heterogenous behaviour can be explained by variability in the rate of transmission, both at the level of the individual student and at the level of the classroom. We created a mathematical model of transmission in the classroom to explore the consequences of this variability for cluster size and control measures, considering what happens when a single infectious individual attends a classroom of susceptible students. We used the model to study different interventions with the aim of reducing the size of infection clusters, in situations where such clusters would be large. We found that interventions based on acting after symptomatic students receive a positive test, as is standard practice in many jurisdictions, are ineffective at preventing most infections, and instead found that only frequent screening of the entire class was able to reduce the size of clusters substantially.
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49
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Galmiche S, Bruel T, Madec Y, Tondeur L, Grzelak L, Staropoli I, Cailleau I, Ungeheuer MN, Renaudat C, Fernandes Pellerin S, Hoen B, Schwartz O, Fontanet A. Characteristics Associated with Olfactory and Taste Disorders in COVID-19. Neuroepidemiology 2021; 55:381-386. [PMID: 34198303 PMCID: PMC8339025 DOI: 10.1159/000517066] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 05/04/2021] [Indexed: 12/20/2022] Open
Abstract
Introduction Olfactory and taste disorders (OTDs) have been reported in COVID-19 caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the mechanisms of which remain unclear. We conducted a detailed analysis of OTDs as part of 2 seroepidemiological investigations of COVID-19 outbreaks. Methods Two retrospective cohort studies were conducted in a high school and primary schools of Northern France following a COVID-19 epidemic in February-March 2020. Students, their relatives, and school staff were included. Anti-SARS-CoV-2 antibodies were identified using a flow-cytometry-based assay detecting anti-S IgG. Results Among 2,004 participants (median [IQR] age: 31 [11–43] years), 303 (15.2%) tested positive for SARS-CoV-2 antibodies. OTDs were present in 91 (30.0%) and 92 (30.3%) of them, respectively, and had 85.1 and 78.0% positive predictive values for SARS-CoV-2 infection, respectively. In seropositive participants, OTDs were independently associated with an age above 18 years, female gender, fatigue, and headache. Conclusion This study confirms the higher frequency of OTDs in females than males and adults than children. Their high predictive value for the diagnosis of COVID-19 suggests that they should be systematically searched for in patients with respiratory symptoms, fever, or headache. The association of OTDs with headache, not previously reported, suggests that they share a common mechanism, which deserves further investigation.
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Affiliation(s)
- Simon Galmiche
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Paris, France,
| | - Timothée Bruel
- Virus and Immunity Unit, Department of Virology, Institut Pasteur, Paris, France
| | - Yoann Madec
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Paris, France
| | - Laura Tondeur
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Paris, France
| | - Ludivine Grzelak
- Virus and Immunity Unit, Department of Virology, Institut Pasteur, Paris, France.,UMR 3569, Centre National de la Recherche Scientifique (CNRS), Paris, France.,Université de Paris, Sorbonne Paris Cité, Paris, France
| | - Isabelle Staropoli
- Virus and Immunity Unit, Department of Virology, Institut Pasteur, Paris, France
| | | | - Marie-Noëlle Ungeheuer
- ICAReB platform (Clinical Investigation & Access to Research Bioresources) of the Center for Translational Sciences, Institut Pasteur, Paris, France
| | - Charlotte Renaudat
- ICAReB platform (Clinical Investigation & Access to Research Bioresources) of the Center for Translational Sciences, Institut Pasteur, Paris, France
| | | | - Bruno Hoen
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Paris, France.,Direction de la recherche médicale, Institut Pasteur, Paris, France
| | - Olivier Schwartz
- Virus and Immunity Unit, Department of Virology, Institut Pasteur, Paris, France.,UMR 3569, Centre National de la Recherche Scientifique (CNRS), Paris, France.,Université de Paris, Sorbonne Paris Cité, Paris, France.,Vaccine Research Institute, Créteil, France
| | - Arnaud Fontanet
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Paris, France.,PACRI Unit, Conservatoire National des Arts et Métiers, Paris, France
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50
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Roxhed N, Bendes A, Dale M, Mattsson C, Hanke L, Dodig-Crnković T, Christian M, Meineke B, Elsässer S, Andréll J, Havervall S, Thålin C, Eklund C, Dillner J, Beck O, Thomas CE, McInerney G, Hong MG, Murrell B, Fredolini C, Schwenk JM. Multianalyte serology in home-sampled blood enables an unbiased assessment of the immune response against SARS-CoV-2. Nat Commun 2021; 12:3695. [PMID: 34140485 PMCID: PMC8211676 DOI: 10.1038/s41467-021-23893-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 05/21/2021] [Indexed: 12/18/2022] Open
Abstract
Serological testing is essential to curb the consequences of the COVID-19 pandemic. However, most assays are still limited to single analytes and samples collected within healthcare. Thus, we establish a multianalyte and multiplexed approach to reliably profile IgG and IgM levels against several versions of SARS-CoV-2 proteins (S, RBD, N) in home-sampled dried blood spots (DBS). We analyse DBS collected during spring of 2020 from 878 random and undiagnosed individuals from the population in Stockholm, Sweden, and use classification approaches to estimate an accumulated seroprevalence of 12.5% (95% CI: 10.3%-14.7%). This includes 5.4% of the samples being IgG+IgM+ against several SARS-CoV-2 proteins, as well as 2.1% being IgG-IgM+ and 5.0% being IgG+IgM- for the virus' S protein. Subjects classified as IgG+ for several SARS-CoV-2 proteins report influenza-like symptoms more frequently than those being IgG+ for only the S protein (OR = 6.1; p < 0.001). Among all seropositive cases, 30% are asymptomatic. Our strategy enables an accurate individual-level and multiplexed assessment of antibodies in home-sampled blood, assisting our understanding about the undiagnosed seroprevalence and diversity of the immune response against the coronavirus.
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Affiliation(s)
- Niclas Roxhed
- Micro and Nanosystems, School of Electrical Engineering and Computer Science, KTH Royal Institute of Technology, Stockholm, Sweden.
- MedTechLabs, BioClinicum, Karolinska University Hospital, Solna, Sweden.
| | - Annika Bendes
- Science for Life Laboratory, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Solna, Sweden
| | - Matilda Dale
- Science for Life Laboratory, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Solna, Sweden
| | - Cecilia Mattsson
- Science for Life Laboratory, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Solna, Sweden
| | - Leo Hanke
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Solna, Sweden
| | - Tea Dodig-Crnković
- Science for Life Laboratory, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Solna, Sweden
| | - Murray Christian
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Solna, Sweden
| | - Birthe Meineke
- Science for Life Laboratory, Karolinska Institutet, Department of Medical Biochemistry and Biophysics, Division of Genome Biology, Solna, Sweden
- Ming Wai Lau Centre for Reparative Medicine, Stockholm node, Karolinska Institutet, Solna, Sweden
| | - Simon Elsässer
- Science for Life Laboratory, Karolinska Institutet, Department of Medical Biochemistry and Biophysics, Division of Genome Biology, Solna, Sweden
- Ming Wai Lau Centre for Reparative Medicine, Stockholm node, Karolinska Institutet, Solna, Sweden
| | - Juni Andréll
- Science for Life Laboratory, Department of Biochemistry and Biophysics, Stockholm University, Solna, Sweden
| | - Sebastian Havervall
- Division of Internal Medicine, Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Danderyd, Sweden
| | - Charlotte Thålin
- Division of Internal Medicine, Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Danderyd, Sweden
| | - Carina Eklund
- Karolinska University Laboratory, Karolinska University Hospital, Stockholm, Sweden
| | - Joakim Dillner
- Karolinska University Laboratory, Karolinska University Hospital, Stockholm, Sweden
| | - Olof Beck
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Cecilia E Thomas
- Science for Life Laboratory, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Solna, Sweden
| | - Gerald McInerney
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Solna, Sweden
| | - Mun-Gwan Hong
- Science for Life Laboratory, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Solna, Sweden
| | - Ben Murrell
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Solna, Sweden
| | - Claudia Fredolini
- Science for Life Laboratory, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Solna, Sweden
| | - Jochen M Schwenk
- Science for Life Laboratory, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Solna, Sweden.
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