1
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Xu Z, Shimokawa S. Local restrictions, population movement, and spillovers during the pandemic: Evidence from Japan's restaurant restriction. HEALTH ECONOMICS 2024; 33:2105-2122. [PMID: 38859659 DOI: 10.1002/hec.4864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 12/13/2023] [Accepted: 05/13/2024] [Indexed: 06/12/2024]
Abstract
We investigate how a local restaurant restriction aimed at containing the COVID-19 pandemic influenced population movement and COVID-19 prevalence within and outside the restricted districts. Using data on restaurant location and hourly population at the 500-m-mesh level and on COVID-19 prevalence at both prefecture and municipality level in Japan, we employ a triple-difference approach and a difference-in-differences approach with fixed effects. While the policy decreased population movement to restaurant areas in the restricted districts, it caused spillovers of increasing population movement to restaurant areas in the neighboring nonrestricted districts. Consequently, COVID-19 prevalence worsened in the neighboring nonrestricted districts but improved in the restricted districts. Our findings suggest that imposing such local restrictions in the context of the pandemic may contain the pandemic only in the restricted districts while sacrificing economic activities within these districts and public health in neighboring nonrestricted districts.
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Affiliation(s)
- Zihan Xu
- Graduate School of Economics, Waseda University, Tokyo, Japan
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2
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Gunlu A. Examining the mediating role of e-health literacy in the relationship between COVID-19 awareness and dispositional hope and the experiences of those who survived the disease. JOURNAL OF COMMUNITY PSYCHOLOGY 2024; 52:877-894. [PMID: 38995702 DOI: 10.1002/jcop.23134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 06/26/2024] [Accepted: 07/02/2024] [Indexed: 07/14/2024]
Abstract
The aim of this study was to examine the mediating effect of e-health literacy levels on the relationship between individuals' awareness of COVID-19 and dispositional hope during the COVID-19 pandemic. The research was conducted with a mixed-methods design. Quantitative data were collected for the study online using Google Forms and qualitative data were collected online with an interview technique. In this framework, the qualitative data were obtained from a total of 15 people who had been diagnosed with COVID-19. These participants were selected using the snowball sampling method. A personal information form, e-Health Literacy Scale, Coronavirus Awareness Scale, Dispositional Hope Scale, and semistructured interview form were utilized in the course of the research. As a result of, it was determined that there were significant relationships between coronavirus awareness and both e-health literacy and dispositional hope, as well as between e-health literacy and dispositional hope. The measurement model was found to have good fit values. Testing the structural equation model, it was determined that e-health literacy had a full mediating role between coronavirus awareness and dispositional hope. In addition, this study showed that people who had COVID-19 had increased awareness of COVID-19 after contracting the disease.
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Affiliation(s)
- Aykut Gunlu
- Department of Child Care and Youth Services, Pamukkale University, Denizli, Turkey
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3
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Lipsitch M, Bassett MT, Brownstein JS, Elliott P, Eyre D, Grabowski MK, Hay JA, Johansson MA, Kissler SM, Larremore DB, Layden JE, Lessler J, Lynfield R, MacCannell D, Madoff LC, Metcalf CJE, Meyers LA, Ofori SK, Quinn C, Bento AI, Reich NG, Riley S, Rosenfeld R, Samore MH, Sampath R, Slayton RB, Swerdlow DL, Truelove S, Varma JK, Grad YH. Infectious disease surveillance needs for the United States: lessons from Covid-19. Front Public Health 2024; 12:1408193. [PMID: 39076420 PMCID: PMC11285106 DOI: 10.3389/fpubh.2024.1408193] [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: 03/27/2024] [Accepted: 06/18/2024] [Indexed: 07/31/2024] Open
Abstract
The COVID-19 pandemic has highlighted the need to upgrade systems for infectious disease surveillance and forecasting and modeling of the spread of infection, both of which inform evidence-based public health guidance and policies. Here, we discuss requirements for an effective surveillance system to support decision making during a pandemic, drawing on the lessons of COVID-19 in the U.S., while looking to jurisdictions in the U.S. and beyond to learn lessons about the value of specific data types. In this report, we define the range of decisions for which surveillance data are required, the data elements needed to inform these decisions and to calibrate inputs and outputs of transmission-dynamic models, and the types of data needed to inform decisions by state, territorial, local, and tribal health authorities. We define actions needed to ensure that such data will be available and consider the contribution of such efforts to improving health equity.
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Affiliation(s)
- Marc Lipsitch
- Center for Forecasting and Outbreak Analytics, US Centers for Disease Control and Prevention, Atlanta, GA, United States
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, United States
| | - Mary T. Bassett
- François-Xavier Bagnoud Center for Health and Human Rights, Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA, United States
| | - John S. Brownstein
- Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States
| | - Paul Elliott
- Department of Epidemiology and Public Health Medicine, Imperial College London, London, United Kingdom
| | - David Eyre
- Big Data Institute, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - M. Kate Grabowski
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - James A. Hay
- Big Data Institute, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Michael A. Johansson
- Division of Vector-Borne Diseases, US Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Stephen M. Kissler
- Department of Computer Science, University of Colorado Boulder, Boulder, CO, United States
| | - Daniel B. Larremore
- Department of Computer Science, University of Colorado Boulder, Boulder, CO, United States
- BioFrontiers Institute, University of Colorado Boulder, Boulder, CO, United States
| | - Jennifer E. Layden
- Office of Public Health Data, Surveillance, and Technology, US Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Justin Lessler
- Department of Epidemiology, UNC Gillings School of Public Health, Chapel Hill, NC, United States
| | - Ruth Lynfield
- Minnesota Department of Health, Minneapolis, MN, United States
| | - Duncan MacCannell
- US Centers for Disease Control and Prevention, Office of Advanced Molecular Detection, Atlanta, GA, United States
| | | | - C. Jessica E. Metcalf
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, United States
| | - Lauren A. Meyers
- Department of Integrative Biology, University of Texas at Austin, Austin, TX, United States
| | - Sylvia K. Ofori
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, United States
| | - Celia Quinn
- Division of Disease Control, New York City Department of Health and Mental Hygiene, New York City, NY, United States
| | - Ana I. Bento
- Department of Public and Ecosystem Health, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States
| | - Nicholas G. Reich
- Departments of Biostatistics and Epidemiology, University of Massachusetts Amherst, Amherst, MA, United States
| | - Steven Riley
- United Kingdom Health Security Agency, London, United Kingdom
| | - Roni Rosenfeld
- Departments of Computer Science and Computational Biology, Carnegie Melon University, Pittsburgh, PA, United States
| | - Matthew H. Samore
- Division of Epidemiology, Department of Medicine, University of Utah, Salt Lake City, UT, United States
| | | | - Rachel B. Slayton
- Division of Healthcare Quality Promotion, US Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - David L. Swerdlow
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, United States
| | - Shaun Truelove
- Department of Epidemiology, UNC Gillings School of Public Health, Chapel Hill, NC, United States
| | - Jay K. Varma
- SIGA Technologies, New York City, NY, United States
| | - Yonatan H. Grad
- Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, MA, United States
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Hasanuzzaman G, Buchwald T, Schunk C, Egbers C, Schröder A, Hampel U. DATIV-Remote Enhancement of Smart Aerosol Measurement System Using Raspberry Pi-Based Distributed Sensors. SENSORS (BASEL, SWITZERLAND) 2024; 24:4314. [PMID: 39001092 PMCID: PMC11244025 DOI: 10.3390/s24134314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 06/08/2024] [Accepted: 06/15/2024] [Indexed: 07/16/2024]
Abstract
Enclosed public spaces are hotspots for airborne disease transmission. To measure and maintain indoor air quality in terms of airborne transmission, an open source, low cost and distributed array of particulate matter sensors was developed and named Dynamic Aerosol Transport for Indoor Ventilation, or DATIV, system. This system can use multiple particulate matter sensors (PMSs) simultaneously and can be remotely controlled using a Raspberry Pi-based operating system. The data acquisition system can be easily operated using the GUI within any common browser installed on a remote device such as a PC or smartphone with a corresponding IP address. The software architecture and validation measurements are presented together with possible future developments.
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Affiliation(s)
- Gazi Hasanuzzaman
- Department of Aerodynamics and Fluid Mechanics, Brandenburg University of Technology Cottbus-Senftenberg (BTU C-S), 03046 Cottbus, Germany
| | - Tom Buchwald
- Chair of Image Based Measurement Techniques, Brandenburg University of Technology Cottbus-Senftenberg (BTU C-S), 03046 Cottbus, Germany
| | - Christoph Schunk
- Institute of Fluid Dynamics, Helmholtz-Zentrum Dresden-Rossendorf (HZDR), 01328 Dresden, Germany
| | - Christoph Egbers
- Department of Aerodynamics and Fluid Mechanics, Brandenburg University of Technology Cottbus-Senftenberg (BTU C-S), 03046 Cottbus, Germany
| | - Andreas Schröder
- Chair of Image Based Measurement Techniques, Brandenburg University of Technology Cottbus-Senftenberg (BTU C-S), 03046 Cottbus, Germany
- Department of Experimental Methods, Institute of Aerodynamics and Flow Technology, German Aerospace Center (DLR), 37073 Göttingen, Germany
| | - Uwe Hampel
- Institute of Fluid Dynamics, Helmholtz-Zentrum Dresden-Rossendorf (HZDR), 01328 Dresden, Germany
- Chair of Imaging Techniques in Energy and Process Engineering, Dresden University of Technology (TUD), 01069 Dresden, Germany
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5
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Wu Y, Namilae S, Srinivasan A, Mubayi A, Scotch M. Parametric analysis of SARS-CoV-2 dose-response models in transportation scenarios. PLoS One 2024; 19:e0301996. [PMID: 38865326 PMCID: PMC11168674 DOI: 10.1371/journal.pone.0301996] [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: 09/29/2023] [Accepted: 03/26/2024] [Indexed: 06/14/2024] Open
Abstract
Transportation systems involve high-density crowds of geographically diverse people with variations in susceptibility; therefore, they play a large role in the spread of infectious diseases like SARS-CoV-2. Dose-response models are widely used to model the relationship between the trigger of a disease and the level of exposure in transmission scenarios. In this study, we quantified and bounded viral exposure-related parameters using empirical data from five transportation-related events of SARS-CoV-2 transmission. Dose-response models were then applied to parametrically analyze the infection spread in generic transportation systems, including a single-aisle airplane, bus, and railway coach, and then examined the mitigating efficiency of masks by performing a sensitivity analysis of the related factors. We found that dose level significantly affected the number of secondary infections. In general, we observed that mask usage reduced infection rates at all dose levels and that high-quality masks equivalent to FFP2/N95 masks are effective for all dose levels. In comparison, we found that lower-quality masks exhibit limited mitigation efficiency, especially in the presence of high dosage. The sensitivity analysis indicated that a reduction in the infection distance threshold is a critical factor in mask usage.
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Affiliation(s)
- Yuxuan Wu
- Embry-Riddle Aeronautical University, Daytona Beach, Florida, United States of America
| | - Sirish Namilae
- Embry-Riddle Aeronautical University, Daytona Beach, Florida, United States of America
| | - Ashok Srinivasan
- University of West Florida, Pensacola, Florida, United States of America
| | - Anuj Mubayi
- QVIA, Durham, North Carolina, United States of America
| | - Mathew Scotch
- Arizona State University, Tempe, Arizona, United States of America
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6
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Mizukoshi A, Okumura J, Azuma K. A COVID-19 cluster analysis in an office: Assessing the long-range aerosol and fomite transmissions with infection control measures. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2024; 44:1396-1412. [PMID: 37936539 DOI: 10.1111/risa.14249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 08/01/2023] [Accepted: 10/04/2023] [Indexed: 11/09/2023]
Abstract
Simulated exposure to severe acute respiratory syndrome coronavirus 2 in the environment was demonstrated based on the actual coronavirus disease 2019 cluster occurrence in an office, with a projected risk considering the likely transmission pathways via aerosols and fomites. A total of 35/85 occupants were infected, with the attack rate in the first stage as 0.30. It was inferred that the aerosol transmission at long-range produced the cluster at virus concentration in the saliva of the infected cases on the basis of the simulation, more than 108 PFU mL-1. Additionally, all wearing masks effectiveness was estimated to be 61%-81% and 88%-95% reduction in risk for long-range aerosol transmission in the normal and fit state of the masks, respectively, and a 99.8% or above decline in risk of fomite transmission. The ventilation effectiveness for long-range aerosol transmission was also calculated to be 12%-29% and 36%-66% reductions with increases from one air change per hour (ACH) to two ACH and six ACH, respectively. Furthermore, the virus concentration reduction in the saliva to 1/3 corresponded to the risk reduction for long-range aerosol transmission by 60%-64% and 40%-51% with and without masks, respectively.
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Affiliation(s)
- Atsushi Mizukoshi
- Department of Environmental Medicine and Behavioral Science, Kindai University Faculty of Medicine, Osakasayama, Osaka, Japan
| | - Jiro Okumura
- Department of Environmental Medicine and Behavioral Science, Kindai University Faculty of Medicine, Osakasayama, Osaka, Japan
| | - Kenichi Azuma
- Department of Environmental Medicine and Behavioral Science, Kindai University Faculty of Medicine, Osakasayama, Osaka, Japan
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7
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Ishigaki Y, Yokogawa S. Monitoring the ventilation of living spaces to assess the risk of airborne transmission of infection using a novel Pocket CO2 Logger to track carbon dioxide concentrations in Tokyo. PLoS One 2024; 19:e0303790. [PMID: 38781170 PMCID: PMC11115307 DOI: 10.1371/journal.pone.0303790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 04/30/2024] [Indexed: 05/25/2024] Open
Abstract
We employed carbon dioxide (CO2) concentration monitoring using mobile devices to identify location-specific risks for airborne infection transmission. We lent a newly developed, portable Pocket CO2 Logger to 10 participants, to be carried at all times, for an average of 8 days. The participants recorded their location at any given time as cinema, gym, hall, home, hospital, other indoors, other outgoings, pub, restaurant, university, store, transportation, or workplace. Generalized linear mixed model was used for statistical analysis, with the objective variable set to the logarithm of CO2 concentration. Analysis was performed by assigning participant identification as the random effect and location as the fixed effect. The data were collected per participant (seven males, four females), resulting in a total of 12,253 records. Statistical analysis identified three relatively poorly ventilated locations (median values > 1,000 ppm) that contributed significantly (p < 0.0001) to CO2 concentrations: homes (1,316 ppm), halls (1,173 ppm), and gyms (1005ppm). In contrast, two locations were identified to contribute significantly (p < 0.0001) to CO2 concentrations but had relatively low average values (<1,000 ppm): workplaces (705 ppm) and stores (620 ppm). The Pocket CO2 Logger can be used to visualize airborne infectious transmission risk by location to help guide recommendation regarding infectious disease policies, such as restrictions on human flow and ventilation measures and guidelines. In the future, large-scale surveys are expected to utilize the global positioning system, Wi-Fi, or Bluetooth of an individual's smartphone to improve ease and accuracy.
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Affiliation(s)
- Yo Ishigaki
- Research Center for Realizing Sustainable Societies, The University of Electro-Communications, Chofu, Tokyo, Japan
| | - Shinji Yokogawa
- Info-Powered Energy System Research Center (iPERC), The University of Electro-Communications, Chofu, Tokyo, Japan
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8
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Luo Q, Liu W, Liao J, Gu Z, Fan X, Luo Z, Zhang X, Hang J, Ou C. COVID-19 transmission and control in land public transport: A literature review. FUNDAMENTAL RESEARCH 2024; 4:417-429. [PMID: 38933205 PMCID: PMC11197583 DOI: 10.1016/j.fmre.2023.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 10/18/2023] [Accepted: 10/20/2023] [Indexed: 06/28/2024] Open
Abstract
Land public transport is an important link within and between cities, and how to control the transmission of COVID-19 in land public transport is a critical issue in our daily lives. However, there are still many inconsistent opinions and views about the spread of SARS-CoV-2 in land public transport, which limits our ability to implement effective interventions. The purpose of this review is to overview the literature on transmission characteristics and routes of the epidemic in land public transport, as well as to investigate factors affecting its spread and provide feasible measures to mitigate the infection risk of passengers. We obtained 898 papers by searching the Web of Science, Pubmed, and WHO global COVID database by keywords, and finally selected 45 papers that can address the purpose of this review. Land public transport is a high outbreak area for COVID-19 due to characteristics like crowding, inadequate ventilation, long exposure time, and environmental closure. Different from surface touch transmission and drop spray transmission, aerosol inhalation transmission can occur not only in short distances but also in long distances. Insufficient ventilation is the most important factor influencing long-distance aerosol transmission. Other transmission factors (e.g., interpersonal distance, relative orientation, and ambient conditions) should be noticed as well, which have been summarized in this paper. To address various influencing factors, it is essential to suggest practical and efficient preventive measures. Among these, increased ventilation, particularly the fresh air (i.e., natural ventilation), has proven to effectively reduce indoor infection risk. Many preventive measures are also effective, such as enlarging social distance, avoiding face-to-face orientation, setting up physical partitions, disinfection, avoiding talking, and so on. As research on the epidemic has intensified, people have broken down many perceived barriers, but more comprehensive studies on monitoring systems and prevention measures in land public transport are still needed.
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Affiliation(s)
- Qiqi Luo
- School of Atmospheric Sciences, Sun Yat-sen University, and Southern Marine Science and Engineering Guangdong Laboratory, Zhuhai 519082, China
- Key Laboratory of Urban Meteorology, China Meteorological Administration, Beijing 100089, China
- China Meteorological Administration Xiong'an Atmospheric Boundary Layer Key Laboratory, Xiong'an 070001, China
- Key Laboratory of Tropical Atmosphere-Ocean System (Sun Yat-sen University), Ministry of Education, Zhuhai 519000, China
| | - Wenbing Liu
- School of Atmospheric Sciences, Sun Yat-sen University, and Southern Marine Science and Engineering Guangdong Laboratory, Zhuhai 519082, China
| | - Jiayuan Liao
- School of Atmospheric Sciences, Sun Yat-sen University, and Southern Marine Science and Engineering Guangdong Laboratory, Zhuhai 519082, China
| | - Zhongli Gu
- Guangdong Fans-tech Agro Co., Ltd, Yunfu 527300, China
| | - Xiaodan Fan
- School of Atmospheric Sciences, Sun Yat-sen University, and Southern Marine Science and Engineering Guangdong Laboratory, Zhuhai 519082, China
| | - Zhiwen Luo
- Welsh School of Architecture, Cardiff University, Cardiff CF10 3XQ, United Kingdom
| | - Xuelin Zhang
- School of Atmospheric Sciences, Sun Yat-sen University, and Southern Marine Science and Engineering Guangdong Laboratory, Zhuhai 519082, China
| | - Jian Hang
- School of Atmospheric Sciences, Sun Yat-sen University, and Southern Marine Science and Engineering Guangdong Laboratory, Zhuhai 519082, China
- Key Laboratory of Urban Meteorology, China Meteorological Administration, Beijing 100089, China
- China Meteorological Administration Xiong'an Atmospheric Boundary Layer Key Laboratory, Xiong'an 070001, China
- Key Laboratory of Tropical Atmosphere-Ocean System (Sun Yat-sen University), Ministry of Education, Zhuhai 519000, China
| | - Cuiyun Ou
- School of Atmospheric Sciences, Sun Yat-sen University, and Southern Marine Science and Engineering Guangdong Laboratory, Zhuhai 519082, China
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9
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Packer S, Patrzylas P, Smith I, Chen C, Wensley A, Nsonwu O, Dack K, Turner C, Anderson C, Kwiatkowska R, Oliver I, Edeghere O, Fraser G, Hughes G. COVID-19 cluster surveillance using exposure data collected from routine contact tracing: The genomic validation of a novel informatics-based approach to outbreak detection in England. PLOS DIGITAL HEALTH 2024; 3:e0000485. [PMID: 38662648 PMCID: PMC11045073 DOI: 10.1371/journal.pdig.0000485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 03/13/2024] [Indexed: 04/28/2024]
Abstract
Contact tracing was used globally to prevent onwards transmission of COVID-19. Tracing contacts alone is unlikely to be sufficient in controlling community transmission, due to the pre-symptomatic, overdispersed and airborne nature of COVID-19 transmission. We describe and demonstrate the validity of a national enhanced contact tracing programme for COVID-19 cluster surveillance in England. Data on cases occurring between October 2020 and September 2021 were extracted from the national contact tracing system. Exposure clusters were identified algorithmically by matching ≥2 cases attending the same event, identified by matching postcode and event category within a 7-day rolling window. Genetic validity was defined as exposure clusters with ≥2 cases from different households with identical viral sequences. Exposure clusters were fuzzy matched to the national incident management system (HPZone) by postcode and setting description. Multivariable logistic regression modelling was used to determine cluster characteristics associated with genetic validity. Over a quarter of a million (269,470) exposure clusters were identified. Of the eligible clusters, 25% (3,306/13,008) were genetically valid. 81% (2684/3306) of these were not recorded on HPZone and were identified on average of one day earlier than incidents recorded on HPZone. Multivariable analysis demonstrated that exposure clusters occurring in workplaces (aOR = 5·10, 95% CI 4·23-6·17) and education (aOR = 3·72, 95% CI 3·08-4·49) settings were those most strongly associated with genetic validity. Cluster surveillance using enhanced contact tracing in England was a timely, comprehensive and systematic approach to the detection of transmission events occurring in community settings. Cluster surveillance can provide intelligence to stakeholders to support the assessment and management of clusters of COVID-19 at a local, regional, and national level. Future systems should include predictive modelling and network analysis to support risk assessment of exposure clusters to improve the effectiveness of enhanced contract tracing for outbreak detection.
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Affiliation(s)
- Simon Packer
- United Kingdom Health Security Agency, London, United Kingdom
| | - Piotr Patrzylas
- United Kingdom Health Security Agency, London, United Kingdom
| | - Iona Smith
- United Kingdom Health Security Agency, London, United Kingdom
| | - Cong Chen
- United Kingdom Health Security Agency, London, United Kingdom
| | - Adrian Wensley
- United Kingdom Health Security Agency, London, United Kingdom
| | | | - Kyle Dack
- United Kingdom Health Security Agency, London, United Kingdom
| | - Charlie Turner
- United Kingdom Health Security Agency, London, United Kingdom
| | | | | | - Isabel Oliver
- United Kingdom Health Security Agency, London, United Kingdom
| | - Obaghe Edeghere
- United Kingdom Health Security Agency, London, United Kingdom
| | - Graham Fraser
- United Kingdom Health Security Agency, London, United Kingdom
| | - Gareth Hughes
- United Kingdom Health Security Agency, London, United Kingdom
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10
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Atamer Balkan B, Chang Y, Sparnaaij M, Wouda B, Boschma D, Liu Y, Yuan Y, Daamen W, de Jong MCM, Teberg C, Schachtschneider K, Sikkema RS, van Veen L, Duives D, ten Bosch QA. The multi-dimensional challenges of controlling respiratory virus transmission in indoor spaces: Insights from the linkage of a microscopic pedestrian simulation and SARS-CoV-2 transmission model. PLoS Comput Biol 2024; 20:e1011956. [PMID: 38547311 PMCID: PMC11003685 DOI: 10.1371/journal.pcbi.1011956] [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: 07/17/2023] [Revised: 04/09/2024] [Accepted: 02/29/2024] [Indexed: 04/11/2024] Open
Abstract
SARS-CoV-2 transmission in indoor spaces, where most infection events occur, depends on the types and duration of human interactions, among others. Understanding how these human behaviours interface with virus characteristics to drive pathogen transmission and dictate the outcomes of non-pharmaceutical interventions is important for the informed and safe use of indoor spaces. To better understand these complex interactions, we developed the Pedestrian Dynamics-Virus Spread model (PeDViS), an individual-based model that combines pedestrian behaviour models with virus spread models incorporating direct and indirect transmission routes. We explored the relationships between virus exposure and the duration, distance, respiratory behaviour, and environment in which interactions between infected and uninfected individuals took place and compared this to benchmark 'at risk' interactions (1.5 metres for 15 minutes). When considering aerosol transmission, individuals adhering to distancing measures may be at risk due to the buildup of airborne virus in the environment when infected individuals spend prolonged time indoors. In our restaurant case, guests seated at tables near infected individuals were at limited risk of infection but could, particularly in poorly ventilated places, experience risks that surpass that of benchmark interactions. Combining interventions that target different transmission routes can aid in accumulating impact, for instance by combining ventilation with face masks. The impact of such combined interventions depends on the relative importance of transmission routes, which is hard to disentangle and highly context dependent. This uncertainty should be considered when assessing transmission risks upon different types of human interactions in indoor spaces. We illustrated the multi-dimensionality of indoor SARS-CoV-2 transmission that emerges from the interplay of human behaviour and the spread of respiratory viruses. A modelling strategy that incorporates this in risk assessments can help inform policy makers and citizens on the safe use of indoor spaces with varying inter-human interactions.
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Affiliation(s)
- Büsra Atamer Balkan
- Quantitative Veterinary Epidemiology, Wageningen University & Research, Wageningen, The Netherlands
| | - You Chang
- Quantitative Veterinary Epidemiology, Wageningen University & Research, Wageningen, The Netherlands
| | - Martijn Sparnaaij
- Department of Transport & Planning, Delft University of Technology, Delft, The Netherlands
| | - Berend Wouda
- Gamelab, Delft University of Technology, Delft, The Netherlands
| | - Doris Boschma
- Gamelab, Delft University of Technology, Delft, The Netherlands
| | - Yangfan Liu
- Quantitative Veterinary Epidemiology, Wageningen University & Research, Wageningen, The Netherlands
| | - Yufei Yuan
- Department of Transport & Planning, Delft University of Technology, Delft, The Netherlands
| | - Winnie Daamen
- Department of Transport & Planning, Delft University of Technology, Delft, The Netherlands
| | - Mart C. M. de Jong
- Quantitative Veterinary Epidemiology, Wageningen University & Research, Wageningen, The Netherlands
| | - Colin Teberg
- Steady State Scientific Computing, Chicago, Illinois, United States of America
| | | | | | - Linda van Veen
- Gamelab, Delft University of Technology, Delft, The Netherlands
| | - Dorine Duives
- Department of Transport & Planning, Delft University of Technology, Delft, The Netherlands
| | - Quirine A. ten Bosch
- Quantitative Veterinary Epidemiology, Wageningen University & Research, Wageningen, The Netherlands
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11
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Bayly H, Stoddard M, Van Egeren D, Murray EJ, Raifman J, Chakravarty A, White LF. Looking under the lamp-post: quantifying the performance of contact tracing in the United States during the SARS-CoV-2 pandemic. BMC Public Health 2024; 24:595. [PMID: 38395830 PMCID: PMC10893709 DOI: 10.1186/s12889-024-18012-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 02/06/2024] [Indexed: 02/25/2024] Open
Abstract
Contact tracing forms a crucial part of the public-health toolbox in mitigating and understanding emergent pathogens and nascent disease outbreaks. Contact tracing in the United States was conducted during the pre-Omicron phase of the ongoing COVID-19 pandemic. This tracing relied on voluntary reporting and responses, often using rapid antigen tests due to lack of accessibility to PCR tests. These limitations, combined with SARS-CoV-2's propensity for asymptomatic transmission, raise the question "how reliable was contact tracing for COVID-19 in the United States"? We answered this question using a Markov model to examine the efficiency with which transmission could be detected based on the design and response rates of contact tracing studies in the United States. Our results suggest that contact tracing protocols in the U.S. are unlikely to have identified more than 1.65% (95% uncertainty interval: 1.62-1.68%) of transmission events with PCR testing and 1.00% (95% uncertainty interval 0.98-1.02%) with rapid antigen testing. When considering a more robust contact tracing scenario, based on compliance rates in East Asia with PCR testing, this increases to 62.7% (95% uncertainty interval: 62.6-62.8%). We did not assume presence of asymptomatic transmission or superspreading, making our estimates upper bounds on the actual percentages traced. These findings highlight the limitations in interpretability for studies of SARS-CoV-2 disease spread based on U.S. contact tracing and underscore the vulnerability of the population to future disease outbreaks, for SARS-CoV-2 and other pathogens.
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Affiliation(s)
- Henry Bayly
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | | | | | - Eleanor J Murray
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Julia Raifman
- Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA, USA
| | | | - Laura F White
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA.
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Li X, Yan Y, Fang X, Tu J. Numerical studies of indoor particulate and gaseous micropollutant transport and its impact on human health in densely-occupied spaces. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 342:123031. [PMID: 38036091 DOI: 10.1016/j.envpol.2023.123031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 08/22/2023] [Accepted: 11/21/2023] [Indexed: 12/02/2023]
Abstract
Micropollutants (MPs) have increasingly become a matter of concern owing to potential health risks associated with human inhalation exposure, particularly in densely-occupied indoor environments. This study employed numerical simulations in a traditional built indoor workspace and a public transport cabin to elucidate the transport dynamics and health impacts of particulate and gaseous type of indoor MPs on varying groups of occupants. The risk of infection from pathogen-bearing MPs was evaluated in the workspace using the integrated Eulerian-Lagrangian and modified Wells-Riley model. In the cabin environment, the health impact of inhaled TVOC within the human nasal system was assessed via the integrated nasal-involved manikin model and cancer/non-cancer risk model. The results demonstrated that when ventilation layout was in favour of restricting particulate MPs spread, considerably high health risks (up to 17.22% infection possibility) were generally found in near-fields of emission source (< 2.25 m). Conversely, if the ventilated flow interacts robustly with emission source, every occupant has a minimum 5% infection risk. Incorporating the nasal cavity in the human model offers a nuanced understanding of gaseous MP distributions post-inhalation. Notably, the olfactory and sinus regions displayed heightened vulnerability to TVOC exposure, with a 62.5%-108% concentration increase compared to other nasal areas. Cancer risk assessment plausibly explained the rising occurrence of brain and central nervous system cancer for aircrew members. Non-cancer risk was found acceptable. This study was expected to advance the understanding of environmental pollution and the health risks tied to indoor MPs in densely-populated environments.
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Affiliation(s)
- Xueren Li
- School of Engineering, RMIT Unversity, PO Box 71, Bundoora, VIC, 3083, Australia
| | - Yihuan Yan
- School of Mechanical and Automotive Engineering, Shanghai University of Engineering Science, Shanghai, 201620, China.
| | - Xiang Fang
- School of Mechanical and Automotive Engineering, Shanghai University of Engineering Science, Shanghai, 201620, China
| | - Jiyuan Tu
- School of Engineering, RMIT Unversity, PO Box 71, Bundoora, VIC, 3083, Australia
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13
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Rakover A, Galmiche S, Charmet T, Chény O, Omar F, David C, Martin S, Mailles A, Fontanet A. Source of SARS-CoV-2 infection: results from a series of 584,846 cases in France from October 2020 to August 2022. BMC Public Health 2024; 24:325. [PMID: 38287286 PMCID: PMC10826227 DOI: 10.1186/s12889-024-17772-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 01/15/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND We aimed to study the source of infection for recently SARS-CoV-2-infected individuals from October 2020 to August 2022 in France. METHODS Participants from the nationwide ComCor case-control study who reported recent SARS-CoV-2 infection were asked to document the source and circumstances of their infection through an online questionnaire. Multivariable logistic regression was used to identify the factors associated with not identifying any source of infection. RESULTS Among 584,846 adults with a recent SARS-CoV-2 infection in France, 46.9% identified the source of infection and an additional 22.6% suspected an event during which they might have become infected. Known and suspected sources of infection were household members (30.8%), extended family (15.6%), work colleagues (15.0%), friends (11.0%), and possibly multiple/other sources (27.6%). When the source of infection was known, was not a household member, and involved a unique contact (n = 69,788), characteristics associated with transmission events were indoors settings (91.6%), prolonged (> 15 min) encounters (50.5%), symptomatic source case (64.9%), and neither the source of infection nor the participant wearing a mask (82.2%). Male gender, older age, lower education, living alone, using public transportation, attending places of public recreation (bars, restaurants, nightclubs), public gatherings, and cultural events, and practicing indoor sports were all independently associated with not knowing the source of infection. CONCLUSION Two-thirds of infections were attributed to interactions with close relatives, friends, or work colleagues. Extra-household indoor encounters without masks were commonly reported and represented avoidable circumstances of infection. TRIAL REGISTRATION ClinicalTrials.gov registration number: NCT04607941.
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Affiliation(s)
- Arthur Rakover
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Université Paris Cité, 25 Rue du Docteur Roux, 75015, Paris, France.
| | - Simon Galmiche
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Université Paris Cité, 25 Rue du Docteur Roux, 75015, Paris, France
- Sorbonne Université, Ecole Doctorale Pierre Louis de Santé Publique, Paris, France
| | - Tiffany Charmet
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Université Paris Cité, 25 Rue du Docteur Roux, 75015, Paris, France
| | - Olivia Chény
- Institut Pasteur, Université Paris Cité, Centre for Translational Research, Paris, France
| | | | | | - Sophie Martin
- Caisse Nationale de L'Assurance Maladie, Paris, France
| | | | - Arnaud Fontanet
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Université Paris Cité, 25 Rue du Docteur Roux, 75015, Paris, France
- Conservatoire National Des Arts Et Métiers, Unité PACRI, Paris, France
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14
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Huang W, Gao CX, Luo D, Wang Y, Zheng X, Liu C, Wang Y, Li Y, Qian H. Risk evaluation of venue types and human behaviors of COVID-19 outbreaks in public indoor environments: A systematic review and meta-analysis. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 341:122970. [PMID: 37979645 DOI: 10.1016/j.envpol.2023.122970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 10/03/2023] [Accepted: 11/14/2023] [Indexed: 11/20/2023]
Abstract
Despite increasing vaccination rates, the incidence of breakthrough infections with COVID-19 has increased due to the continued emergence of new variants of the SARS-CoV-2 coronavirus. Therefore, Non-pharmaceutical interventions remain the most effective measures for coping with the ever-changing pandemic. The lifting of compulsory interventions has made individuals primary responsibility for their own health, which highlights the importance of increasing awareness of the infection risk from the environment in which they live and their individual behaviors. We systematically searched PubMed, Web of Science, ScienceDirect, and Scopus on April 17, 2023, for all studies reporting COVID-19 outbreaks in public indoor venues. The study outcome was the attack rate. A total of 42 studies, which included cross-sectional studies, cohort studies, and case studies, reporting data on 1951 confirmed cases in 64 COVID-19 outbreaks satisfied the meta-analysis and were included in the review. A random-effect model was used in the meta-analysis, and subgroup analyses were conducted to investigate factors affecting attack rates. We found a strong level of evidence (p < 0.01) supporting a higher pooled attack rate in recreation-related venues (0.44, 95% CI: 0.30 to 0.60) than in work-related venues (0.21, 95% CI: 0.16 to 0.27). Compared to those outbreaks without that, outbreaks with high-intensity exercise, vocalization, contact behavior, or close body proximity had a higher attack rate of 0.51, 0.55, 0.33, and 0.39, respectively. Further studies suggest that different attack rates across different types of settings may be the result of heterogeneity in exposed people's behaviors. There were significant heterogeneities that may limit the interpretation of connections between influencing factors and outbreak outcomes. The identification of key behaviors that may contribute to transmission risk, and their correlation with venue type, has important implications for the development of future public health interventions and individual prevention strategies for respiratory infectious diseases such as COVID-19.
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Affiliation(s)
- Weiwei Huang
- School of Energy and Environment, Southeast University, Nanjing, China
| | - Caroline X Gao
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3052, Australia; Orygen, Parkville, VIC 3052, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Danting Luo
- School of Energy and Environment, Southeast University, Nanjing, China; Department of Mechanical Engineering, The University of Hong Kong, Pokfulam Road, Hong Kong, China
| | - Yong Wang
- School of Energy and Environment, Southeast University, Nanjing, China
| | - Xiaohong Zheng
- School of Energy and Environment, Southeast University, Nanjing, China
| | - Cong Liu
- School of Energy and Environment, Southeast University, Nanjing, China
| | - Ying Wang
- Hubei Engineering Center for Infectious Disease Prevention, Control and Treatment, Wuhan, China; Department of Infection Management, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Yuguo Li
- Department of Mechanical Engineering, The University of Hong Kong, Pokfulam Road, Hong Kong, China; School of Public Health, The University of Hong Kong, Pokfulam Road, Hong Kong, China
| | - Hua Qian
- School of Energy and Environment, Southeast University, Nanjing, China; Hubei Engineering Center for Infectious Disease Prevention, Control and Treatment, Wuhan, China.
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15
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Mongin D, Bürgisser N, Courvoisier DS. Time trends and modifiable factors of COVID-19 contact tracing coverage, Geneva, Switzerland, June 2020 to February 2022. Euro Surveill 2024; 29:2300228. [PMID: 38240059 PMCID: PMC10797663 DOI: 10.2807/1560-7917.es.2024.29.3.2300228] [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: 04/27/2023] [Accepted: 09/19/2023] [Indexed: 01/22/2024] Open
Abstract
BackgroundContact tracing was one of the central non-pharmaceutical interventions implemented worldwide to control the spread of SARS-CoV-2, but its effectiveness depends on its ability to detect contacts.AimEvaluate the proportion of secondary infections captured by the contact tracing system in Geneva.MethodsWe analysed 166,892 concomitant infections occurring at the same given address from June 2020 until February 2022 using an extensive operational database of SARS-CoV-2 tests in Geneva. We used permutation to compare the total number of secondary infections occurring at the same address with that reported through manual contact tracing.ResultsContact tracing captured on average 41% of secondary infections, varying from 23% during epidemic peaks to 60% during low epidemic activity. People living in wealthy neighbourhoods were less likely to report contacts (odds ratio (OR): 1.6). People living in apartment buildings were also less likely to report contacts than those living in a house (OR: 1.1-3.1) depending on the SARS-CoV-2 variant, the building size and the presence of shops. This under-reporting of contacts in apartment buildings decreased during periods of mandatory wearing of face masks and restrictions on private gatherings.ConclusionContact tracing alone did not detect sufficient secondary infections to reduce the spread of SARS-CoV-2. Campaigns targeting specific populations, such as those in wealthy areas or apartment buildings, could enhance coverage. Additionally, measures like wearing face masks, improving ventilation and implementing restrictions on gatherings should also be considered to reduce infections resulting from interactions that may not be perceived as high risk.
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Affiliation(s)
- Denis Mongin
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Nils Bürgisser
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
- General internal medicine division, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland
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16
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Chai D, El Mossadeq L, Raymond M, Courtier-Orgogozo V. Recommended distances for physical distancing during COVID-19 pandemics reveal cultural connections between countries. PLoS One 2023; 18:e0289998. [PMID: 38100502 PMCID: PMC10723704 DOI: 10.1371/journal.pone.0289998] [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: 07/29/2023] [Accepted: 11/22/2023] [Indexed: 12/17/2023] Open
Abstract
During COVID-19 pandemic several public health measures were implemented by diverse countries to reduce the risk of COVID-19, including social distancing. Here we collected the minimal distance recommended by each country for physical distancing at the onset of the pandemic and aimed to examine whether it had an impact on the outbreak dynamics and how this specific value was chosen. Despite an absence of data on SARS-CoV-2 viral transmission at the beginning of the pandemic, we found that most countries recommended physical distancing with a precise minimal distance, between one meter/three feet and two meters/six feet. 45% of the countries advised one meter/three feet and 49% advised a higher minimal distance. The recommended minimal distance did not show a clear correlation with reproduction rate nor with the number of new cases per million, suggesting that the overall COVID-19 dynamics in each country depended on multiple interacting factors. Interestingly, the recommended minimal distance correlated with several cultural parameters: it was higher in countries with larger interpersonal distance between two interacting individuals in non-epidemic conditions, and it correlated with civil law systems, and with currency. This suggests that countries which share common conceptions such as civil law systems and currency unions tend to adopt the same public health measures.
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Affiliation(s)
- Dongwoo Chai
- Institut Jacques Monod, Université Paris Cité, CNRS, Paris, France
| | | | - Michel Raymond
- ISEM, University Montpellier, CNRS, EPHE, IRD, Montpellier, France
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17
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Parrón I, Carol M, Bes N, Izquierdo C, Godoy P, Barrabeig I, Sala MR, Minguell S, Ferras J, Rius C, Martínez AI, Domínguez À. The impact of COVID-19 pandemic on the incidence of acute gastroenteritis outbreaks in Catalonia (Spain). Epidemiol Infect 2023; 152:e10. [PMID: 38073577 PMCID: PMC10804134 DOI: 10.1017/s0950268823001851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 10/29/2023] [Accepted: 11/16/2023] [Indexed: 01/19/2024] Open
Abstract
We carried out a retrospective study of acute gastroenteritis (AGE) outbreaks reported between 1 January 2015 and 31 December 2021 in Catalonia (Spain) to compare the incidence from 2015 to 2019 with that observed from 2020 to 2021. We observed a higher incidence rate of outbreaks during the prepandemic period (16.89 outbreaks/1,000,000 person-years) than during the pandemic period (6.96 outbreaks/1,000,000 person-years) (rate ratio (RR) 0.41; 95% confidence interval (CI) 0.34 to 0.51). According to the aetiology of the outbreak, those of viral aetiology decreased from 7.82 to 3.38 outbreaks/1,000,000 person-years (RR 2.31; 95% CI 1.72 to 3.12), and those of bacterial aetiology decreased from 5.01 to 2.78 outbreaks/1,000,000 person-years (RR 1.80; 95% CI 1.29 to 2.52). There was a great reduction in AGE outbreaks in Catalonia. This reduction may have been due to the effect of the nonpharmaceutical measures applied to reduce the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), but the collapse of the healthcare system and epidemiological surveillance services may also have had a strong influence.
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Affiliation(s)
- Ignasi Parrón
- Agència de Salut Pública de Catalunya, Barcelona, Spain
- Facultat de Medicina, Universitat de Barcelona, Barcelona, Spain
| | - Mònica Carol
- Agència de Salut Pública de Catalunya, Barcelona, Spain
| | - Núria Bes
- Agència de Salut Pública de Catalunya, Barcelona, Spain
| | | | - Pere Godoy
- Facultat de Medicina, Universitat de Lleida, Spain
- Grup d’Epidemiologia Aplicada, Institut de Recerca Biomédica (IRBLleida), Lleida, Spain
- CIBER de Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
| | - Irene Barrabeig
- Agència de Salut Pública de Catalunya, Barcelona, Spain
- CIBER de Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
| | - M. Rosa Sala
- Agència de Salut Pública de Catalunya, Barcelona, Spain
- CIBER de Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
| | | | | | - Cristina Rius
- CIBER de Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
- Agència de Salut Pública de Barcelona, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | | | - Àngela Domínguez
- Facultat de Medicina, Universitat de Barcelona, Barcelona, Spain
- CIBER de Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
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18
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Qiu G, Zhang X, deMello AJ, Yao M, Cao J, Wang J. On-site airborne pathogen detection for infection risk mitigation. Chem Soc Rev 2023; 52:8531-8579. [PMID: 37882143 PMCID: PMC10712221 DOI: 10.1039/d3cs00417a] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Indexed: 10/27/2023]
Abstract
Human-infecting pathogens that transmit through the air pose a significant threat to public health. As a prominent instance, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that caused the COVID-19 pandemic has affected the world in an unprecedented manner over the past few years. Despite the dissipating pandemic gloom, the lessons we have learned in dealing with pathogen-laden aerosols should be thoroughly reviewed because the airborne transmission risk may have been grossly underestimated. From a bioanalytical chemistry perspective, on-site airborne pathogen detection can be an effective non-pharmaceutic intervention (NPI) strategy, with on-site airborne pathogen detection and early-stage infection risk evaluation reducing the spread of disease and enabling life-saving decisions to be made. In light of this, we summarize the recent advances in highly efficient pathogen-laden aerosol sampling approaches, bioanalytical sensing technologies, and the prospects for airborne pathogen exposure measurement and evidence-based transmission interventions. We also discuss open challenges facing general bioaerosols detection, such as handling complex aerosol samples, improving sensitivity for airborne pathogen quantification, and establishing a risk assessment system with high spatiotemporal resolution for mitigating airborne transmission risks. This review provides a multidisciplinary outlook for future opportunities to improve the on-site airborne pathogen detection techniques, thereby enhancing the preparedness for more on-site bioaerosols measurement scenarios, such as monitoring high-risk pathogens on airplanes, weaponized pathogen aerosols, influenza variants at the workplace, and pollutant correlated with sick building syndromes.
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Affiliation(s)
- Guangyu Qiu
- Institute of Medical Robotics, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China.
- Institute of Environmental Engineering, ETH Zürich, Zürich 8093, Switzerland
- Laboratory for Advanced Analytical Technologies, Empa, Swiss Federal Laboratories for Materials Science and Technology, Dübendorf 8600, Switzerland
| | - Xiaole Zhang
- Institute of Environmental Engineering, ETH Zürich, Zürich 8093, Switzerland
- Laboratory for Advanced Analytical Technologies, Empa, Swiss Federal Laboratories for Materials Science and Technology, Dübendorf 8600, Switzerland
| | - Andrew J deMello
- Institute for Chemical and Bioengineering, Department of Chemistry and Applied Biosciences, ETH Zürich, Vladimir-Prelog-Weg1, Zürich, Switzerland
| | - Maosheng Yao
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, College of Environmental Sciences and Engineering, Peking University, China
| | - Junji Cao
- Institute of Atmospheric Physics, Chinese Academy of Science, China
| | - Jing Wang
- Institute of Environmental Engineering, ETH Zürich, Zürich 8093, Switzerland
- Laboratory for Advanced Analytical Technologies, Empa, Swiss Federal Laboratories for Materials Science and Technology, Dübendorf 8600, Switzerland
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19
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COVID-19 transmission in U.S. transit buses: A scenario-based approach with agent-based simulation modeling (ABSM). COMMUNICATIONS IN TRANSPORTATION RESEARCH 2023; 3:100090. [PMCID: PMC9826987 DOI: 10.1016/j.commtr.2023.100090] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 12/28/2022] [Accepted: 12/29/2022] [Indexed: 06/28/2023]
Abstract
The transit bus environment is considered one of the primary sources of transmission of the COVID-19 (SARS-CoV-2) virus. Modeling disease transmission in public buses remains a challenge, especially with uncertainties in passenger boarding, alighting, and onboard movements. Although there are initial findings on the effectiveness of some of the mitigation policies (such as face-covering and ventilation), evidence is scarce on how these policies could affect the onboard transmission risk under a realistic bus setting considering different headways, boarding and alighting patterns, and seating capacity control. This study examines the specific policy regimes that transit agencies implemented during early phases of the COVID-19 pandemic in USA, in which it brings crucial insights on combating current and future epidemics. We use an agent-based simulation model (ABSM) based on standard design characteristics for urban buses in USA and two different service frequency settings (10-min and 20-min headways). We find that wearing face-coverings (surgical masks) significantly reduces onboard transmission rates, from no mitigation rates of 85% in higher-frequency buses and 75% in lower-frequency buses to 12.5%. The most effective prevention outcome is the combination of KN-95 masks, open window policies, and half-capacity seating control during higher-frequency bus services, with an outcome of nearly 0% onboard infection rate. Our results advance understanding of COVID-19 risks in the urban bus environment and contribute to effective mitigation policy design, which is crucial to ensuring passenger safety. The findings of this study provide important policy implications for operational adjustment and safety protocols as transit agencies seek to plan for future emergencies.
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Arienzo A, Gallo V, Tomassetti F, Pitaro N, Pitaro M, Antonini G. A narrative review of alternative transmission routes of COVID 19: what we know so far. Pathog Glob Health 2023; 117:681-695. [PMID: 37350182 PMCID: PMC10614718 DOI: 10.1080/20477724.2023.2228048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023] Open
Abstract
The Coronavirus disease 19 (COVID-19) pandemics, caused by severe acute respiratory syndrome coronaviruses, SARS-CoV-2, represent an unprecedented public health challenge. Beside person-to-person contagion via airborne droplets and aerosol, which is the main SARS-CoV-2's route of transmission, alternative modes, including transmission via fomites, food and food packaging, have been investigated for their potential impact on SARS-CoV-2 diffusion. In this context, several studies have demonstrated the persistence of SARS-CoV-2 RNA and, in some cases, of infectious particles on exposed fomites, food and water samples, confirming their possible role as sources of contamination and transmission. Indeed, fomite-to-human transmission has been demonstrated in a few cases where person-to-person transmission had been excluded. In addition, recent studies supported the possibility of acquiring COVID-19 through the fecal-oro route; the occurrence of COVID-19 gastrointestinal infections, in the absence of respiratory symptoms, also opens the intriguing possibility that these cases could be directly related to the ingestion of contaminated food and water. Overall, most of the studies considered these alternative routes of transmission of low epidemiological relevance; however, it should be considered that they could play an important role, or even be prevalent, in settings characterized by different environmental and socio-economic conditions. In this review, we discuss the most recent findings regarding SARS-CoV-2 alternative transmission routes, with the aim to disclose what is known about their impact on COVID-19 spread and to stimulate research in this field, which could potentially have a great impact, especially in low-resource contexts.
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Affiliation(s)
| | | | | | | | - Michele Pitaro
- National Institute of Biostructures and Biosystems (INBB), Rome, Italy
| | - Giovanni Antonini
- National Institute of Biostructures and Biosystems (INBB), Rome, Italy
- Department of Science, Roma Tre University, Rome, Italy
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21
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Ashmore P, Sherwood E. An overview of COVID-19 global epidemiology and discussion of potential drivers of variable global pandemic impacts. J Antimicrob Chemother 2023; 78:ii2-ii11. [PMID: 37995358 PMCID: PMC10666997 DOI: 10.1093/jac/dkad311] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2023] Open
Abstract
With a WHO-estimated excess mortality burden of 14.9 million over the course of 2020 and 2021, the COVID-19 pandemic has had a major human impact so far. It has also affected a range of disciplines, systems and practices from mathematical modelling to behavioural sciences, pharmaceutical development to health system management. This article explores these developments and, to set the scene, this paper summarizes the global epidemiology of COVID-19 from January 2020 to June 2021 and considers some potential drivers of variation.
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Affiliation(s)
- Polly Ashmore
- Health Education England, Stewart House, 32 Russell Square, London WC1B 5DN, UK
| | - Emma Sherwood
- Health Education England, Stewart House, 32 Russell Square, London WC1B 5DN, UK
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22
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Greentree DH, Wilson BM, Donskey CJ. Carbon Dioxide Monitoring Demonstrates Variations in the Quality of Ventilation on Public Transportation Buses and University Student Shuttle Vans and Identifies Effective Interventions. Pathog Immun 2023; 8:148-160. [PMID: 38035133 PMCID: PMC10686372 DOI: 10.20411/pai.v8i1.619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 10/13/2023] [Indexed: 12/02/2023] Open
Abstract
Background There is a risk for transmission of severe acute respiratory syndrome 2 (SARS-CoV-2) and other respiratory viruses in motor vehicles, particularly if ventilation is inadequate. Methods We used carbon dioxide monitoring to examine the quality of ventilation in several public transportation buses and in university student shuttle vans in the Cleveland metro area during peak and non-peak travel times. Carbon dioxide levels above 800 parts per million (ppm) were considered an indicator of suboptimal ventilation for the number of people present. In the shuttle vans, we evaluated the impact of an intervention to improve ventilation. Results In large articulated buses with 2 ventilation systems, carbon dioxide concentrations never exceeded 800 ppm, whereas in standard buses with 1 ventilation system concentrations rose above 800 ppm during peak travel times and on some trips during non-peak travel times. In shuttle vans, the ventilation system was not turned on during routine operation, and carbon dioxide levels rose above 800 ppm on all trips during peak and non-peak travel times. In the shuttle vans, an intervention involving operation of the existing ventilation system resulted in a significant reduction in carbon dioxide levels (mean concentration, 1,042 no intervention versus 785 with intervention; P < 0.001). Conclusions Our findings demonstrate substantial variability in the quality of ventilation in public transportation buses and university shuttle vans. There is a need for efforts to assess and optimize ventilation in motor vehicles used for public transportation to reduce the risk for aerosol-mediated transmission of respiratory viruses. Carbon dioxide monitoring may provide a useful tool to assess and improve ventilation.
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Affiliation(s)
- David Henry Greentree
- Department of Biology, College of Arts and Sciences, Case Western Reserve University, Cleveland, Ohio
- College of Medicine, The Ohio State University, Columbus, Ohio
| | - Brigid M. Wilson
- Geriatric Research, Education and Clinical Center, Louis Stokes Veterans Affairs Medical Center, Cleveland, Ohio
- School of Medicine, Case Western Reserve University, Cleveland, Ohio
| | - Curtis J. Donskey
- Geriatric Research, Education and Clinical Center, Louis Stokes Veterans Affairs Medical Center, Cleveland, Ohio
- School of Medicine, Case Western Reserve University, Cleveland, Ohio
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Donskey CJ. High technology and low technology measures to reduce risk of SARS-CoV-2 transmission. Am J Infect Control 2023; 51:A126-A133. [PMID: 37890942 DOI: 10.1016/j.ajic.2023.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 03/09/2023] [Indexed: 10/29/2023]
Abstract
During the coronavirus disease 2019 (COVID-19) pandemic, a variety of low technology and high technology measures have been proposed to reduce the risk for transmission. Identifying those measures likely to be useful in reducing viral transmission without undue expense or potential for adverse effects has been a challenge for infection control programs. The challenge has been compounded by the lack of tools that can be used to assess the risk for viral transmission in different settings. This review discusses practical tools that can be used to assess ventilation and airflow and evaluates some of the low technology and high technology measures that have been proposed as control measures for COVID-19. Some typical questions posed to infection control programs during the pandemic are presented to illustrate real-world application of the concepts being discussed.
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Affiliation(s)
- Curtis J Donskey
- Geriatric Research, Education and Clinical Center, Louis Stokes Cleveland VA Medical Center, Cleveland, OH; Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH.
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Khan-White T, Whiston B, Cooper M. What does the biography of Duncan Forbes MBE (1873-1941), Medical Officer of Health for Brighton (1908-1938), reveal about managing pandemics? JOURNAL OF MEDICAL BIOGRAPHY 2023; 31:221-230. [PMID: 34213993 DOI: 10.1177/09677720211021575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Coronavirus disease 2019 (COVID-19) and the national lockdowns of 2020/2021 illustrate how modern public health systems are founded on empirical evidence and contemporary understanding of disease transmission. Duncan Forbes was one of the earliest sanitarians in Britain to propose and implement a new understanding of infectious disease control. Starting his early career in Manchester and Cambridge, his eventual tenure as Brighton's longest-serving medical officer of health (MOH) left an indelible mark by challenging the entrenched tradition of terminal disinfection and by devising his "Brighton methods" for the care of tubercular patients. Forbes led Brighton's public health responses during World War I and the 1918/1919 "Spanish" influenza pandemic. Forbes also strove to improve health and housing in Brighton. His views on limiting access to contraception on the grounds of eugenics are also significant. Analysis of Forbes' work then allowed a discussion of both his legacy and of the applicability of his experiences to our own in tackling COVID-19. Forbes undeniably had a great influence in shaping modern public health practice in Britain and his challenges as MOH bear many similarities, as well as stark differences, to today's experience of COVID-19.
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Affiliation(s)
- Thomas Khan-White
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, UK
| | - Benjamin Whiston
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, UK
| | - Max Cooper
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, UK
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25
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Weber DJ, Rutala WA, Sickbert-Bennett E. Emerging infectious diseases, focus on infection prevention, environmental survival and germicide susceptibility: SARS-CoV-2, Mpox, and Candida auris. Am J Infect Control 2023; 51:A22-A34. [PMID: 37890950 DOI: 10.1016/j.ajic.2023.02.006] [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: 02/14/2023] [Accepted: 02/15/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND New and emerging infectious diseases continue to represent a public health threat. Emerging infectious disease threats include pathogens increasing in range (eg, Mpox), zoonotic microbes jumping species lines to cause sustained infections in humans via person-to-person transmission (SARS-CoV-2) and multidrug-resistant pathogens (eg, Candida auris). MATERIALS AND METHODS We searched the published English literature and reviewed the selected articles on SARS-CoV-2, Mpox, and Candida auris with a focus on environmental survival, contamination of the patient's hospital environment, susceptibility of the pathogen to antiseptics and disinfectants and infection prevention recommendations. RESULTS All three pathogens (ie, SARS-CoV-2, Mpox, and Candida auris) can survive on surfaces for minutes to hours and for Mpox and C auris for days. Currently available antiseptics (eg, 70%-90% alcohol hand hygiene products) are active against SARS-CoV-2, Mpox and C auris. The U.S Environmental Protection Agency provides separate lists of surface disinfectants active against SARS-CoV-2, Mpox, and C auris. DISCUSSION The risk of environment-to-patient transmission of SARS-CoV-2, Mpox and Candida auris, is very low, low-moderate and high, respectively. In the absence of appropriate patient isolation and use of personal protection equipment, the risk of patient-to-health care provider transmission of SARS-CoV-2, Mpox, and C auris is high, moderate and low, respectively. CONCLUSIONS Appropriate patient isolation, use of personal protective equipment by health care personnel, hand hygiene, and surface disinfection can protect patients and health care personnel from acquiring SARS-CoV-2, Mpox, and C auris from infected patients.
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Affiliation(s)
- David J Weber
- Division of Infectious Diseases, School of Medicine, University of North Carolina, Chapel Hill, NC; Department of Infection Prevention, UNC Medical Center, Chapel Hill, NC; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC.
| | - William A Rutala
- Division of Infectious Diseases, School of Medicine, University of North Carolina, Chapel Hill, NC
| | - Emily Sickbert-Bennett
- Division of Infectious Diseases, School of Medicine, University of North Carolina, Chapel Hill, NC; Department of Infection Prevention, UNC Medical Center, Chapel Hill, NC; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
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Asai T, Kurosaki E, Kimachi K, Nakayama M, Koido M, Hong S. Peak risk of SARS-CoV-2 infection within 5 s of face-to-face encounters: an observational/retrospective study. Sci Rep 2023; 13:17520. [PMID: 37845540 PMCID: PMC10579401 DOI: 10.1038/s41598-023-44967-x] [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: 09/14/2023] [Accepted: 10/13/2023] [Indexed: 10/18/2023] Open
Abstract
The link between aerosol dynamics and viral exposure risk is not fully understood, particularly during movement and face-to-face interactions. To investigate this, we employed Particle Trace Velocimetry with a laser sheet and a high-speed camera to measure microparticles from a human mannequin's mouth. The average peak time in the non-ventilated condition (expiratory volume, 30 L; passing speed, 5 km/h) was 1.33 s (standard deviation = 0.32 s), while that in the ventilated condition was 1.38 s (standard deviation = 0.35 s). Our results showed that the peak of viral exposure risk was within 5 s during face-to-face encounters under both ventilated and non-ventilated conditions. Moreover, the risk of viral exposure greatly decreased in ventilated conditions compared to non-ventilated conditions. Based on these findings, considering a risk mitigation strategy for the duration of 5 s during face-to-face encounters is expected to significantly reduce the risk of virus exposure in airborne transmission.
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Affiliation(s)
- Takeshi Asai
- Faculty of Health and Sports Sciences, University of Tsukuba, Tennodai 1-1-1, Tsukuba, 305-8574, Japan.
- Faculty of Physical Education, International Pacific University, Okayama, Japan.
| | - Erina Kurosaki
- Faculty of Health and Sports Sciences, University of Tsukuba, Tennodai 1-1-1, Tsukuba, 305-8574, Japan
| | - Kaoru Kimachi
- Faculty of Health and Sports Sciences, University of Tsukuba, Tennodai 1-1-1, Tsukuba, 305-8574, Japan
| | - Masao Nakayama
- Faculty of Health and Sports Sciences, University of Tsukuba, Tennodai 1-1-1, Tsukuba, 305-8574, Japan
| | - Masaaki Koido
- Faculty of Health and Sports Sciences, University of Tsukuba, Tennodai 1-1-1, Tsukuba, 305-8574, Japan
| | - Sungchan Hong
- Faculty of Health and Sports Sciences, University of Tsukuba, Tennodai 1-1-1, Tsukuba, 305-8574, Japan
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Madhusudanan A, Iddon C, Cevik M, Naismith JH, Fitzgerald S. Non-pharmaceutical interventions for COVID-19: a systematic review on environmental control measures. PHILOSOPHICAL TRANSACTIONS. SERIES A, MATHEMATICAL, PHYSICAL, AND ENGINEERING SCIENCES 2023; 381:20230130. [PMID: 37611631 PMCID: PMC10446906 DOI: 10.1098/rsta.2023.0130] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 06/06/2023] [Indexed: 08/25/2023]
Abstract
The purpose of this review was to identify the effectiveness of environmental control (EC) non-pharmaceutical interventions (NPIs) in reducing transmission of SARS-CoV-2 through conducting a systematic review. EC NPIs considered in this review are room ventilation, air filtration/cleaning, room occupancy, surface disinfection, barrier devices, [Formula: see text] monitoring and one-way-systems. Systematic searches of databases from Web of Science, Medline, EMBASE, preprint servers MedRxiv and BioRxiv were conducted in order to identify studies reported between 1 January 2020 and 1 December 2022. All articles reporting on the effectiveness of ventilation, air filtration/cleaning, room occupancy, surface disinfection, barrier devices, [Formula: see text] monitoring and one-way systems in reducing transmission of SARS-CoV-2 were retrieved and screened. In total, 13 971 articles were identified for screening. The initial title and abstract screening identified 1328 articles for full text review. Overall, 19 references provided evidence for the effectiveness of NPIs: 12 reported on ventilation, 4 on air cleaning devices, 5 on surface disinfection, 6 on room occupancy and 1 on screens/barriers. No studies were found that considered the effectiveness of [Formula: see text] monitoring or the implementation of one-way systems. Many of these studies were assessed to have critical risk of bias in at least one domain, largely due to confounding factors that could have affected the measured outcomes. As a result, there is low confidence in the findings. Evidence suggests that EC NPIs of ventilation, air cleaning devices and reduction in room-occupancy may have a role in reducing transmission in certain settings. However, the evidence was usually of low or very low quality and certainty, and hence the level of confidence ascribed to this conclusion is low. Based on the evidence found, it was not possible to draw any specific conclusions regarding the effectiveness of surface disinfection and the use of barrier devices. From these results, we further conclude that community agreed standards for well-designed epidemiological studies with low risk of bias are needed. Implementation of such standards would enable more confident assessment in the future of the effectiveness of EC NPIs in reducing transmission of SARS-CoV-2 and other pathogens in real-world settings. This article is part of the theme issue 'The effectiveness of non-pharmaceutical interventions on the COVID-19 pandemic: the evidence'.
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Affiliation(s)
| | - Christopher Iddon
- Department of Civil, Environmental and Geomatic Engineering, University College London, WC1E 6BT, London, UK
| | - Muge Cevik
- Department of Infection and Global Health, School of Medicine, University of St Andrews, KY16 9TF, St Andrews, UK
| | | | - Shaun Fitzgerald
- Department of Engineering, University of Cambridge, CB2 1PZ, Cambridge, UK
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28
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Lou J, Borjigin S, Tang C, Saadat Y, Hu M, Niemeier DA. Facility design and worker justice: COVID-19 transmission in meatpacking plants. Am J Ind Med 2023; 66:713-727. [PMID: 37329208 DOI: 10.1002/ajim.23510] [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: 02/11/2023] [Revised: 06/02/2023] [Accepted: 06/05/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Meatpacking plants were major sources of COVID-19 outbreaks, posing unprecedented risks to employees, family members, and local communities. The effect on food availability during outbreaks was immediate and staggering: within 2 months, the price of beef increased by almost 7% with documented evidence of significant meat shortages. Meatpacking plant designs, in general, optimize on production; this design approach constrains the ability to enhance worker respiratory protection without reducing output. METHODS Using agent-based modeling, we simulate the spread of COVID-19 within a typical meatpacking plant design under varying levels of mitigation measures, including combinations of social distancing and masking interventions. RESULTS Simulations show an average infection rate of close to 99% with no mitigation, 99% with the policies that US companies ultimately adopted, 81% infected with the combination of surgical masks and distancing policies, and 71% infected with N95 masks and distancing. Estimated infection rates were high, reflecting the duration and exertion of the processing activities and lack of fresh airflow in an enclosed space. CONCLUSION Our results are consistent with anecdotal findings in a recent congressional report, and are much higher than US industry has reported. Our results suggest current processing plant designs made rapid transmission of the virus during the pandemic's early days almost inevitable, and implemented worker protections during COVID-19 did not significantly affect the spread of the virus. We argue current federal policies and regulations are insufficient to ensure the health and safety of workers, creating a justice issue, and jeopardizing food availability in a future pandemic.
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Affiliation(s)
- Jiehong Lou
- School of Public Policy, Center for Global Sustainability, University of Maryland, College Park, Maryland, USA
| | - Sachraa Borjigin
- Department of Civil and Environmental Engineering, University of Maryland, College Park, Maryland, USA
| | - Connie Tang
- Department of Civil and Environmental Engineering, University of Maryland, College Park, Maryland, USA
| | - Yalda Saadat
- Department of Civil and Environmental Engineering, University of Maryland, College Park, Maryland, USA
| | - Ming Hu
- School of Architecture, Planning and Preservation, University of Maryland, College Park, Maryland, USA
| | - Deb A Niemeier
- Department of Civil and Environmental Engineering, University of Maryland, College Park, Maryland, USA
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29
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Saulnier A, Wendling JM, Hermant B, Lepelletier D. SARS-CoV-2 transmission modes: Why and how contamination occurs around shared meals and drinks? Food Microbiol 2023; 114:104297. [PMID: 37290873 DOI: 10.1016/j.fm.2023.104297] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 04/24/2023] [Accepted: 04/24/2023] [Indexed: 06/10/2023]
Abstract
In spite of prevention measures enacted all over the world to control the COVID-19 pandemic outbreak, including mask wearing, social distancing, hand hygiene, vaccination, and other precautions, the SARS-CoV-2 virus continues to spread globally at an unabated rate of about 1 million cases per day. The specificities of superspreading events as well as evidence of human-to-human, human-to-animal and animal-to-human transmission, indoors or outdoors, raise questions about a possibly neglected viral transmission route. In addition to inhaled aerosols, which are already recognized as key contributors to transmission, the oral route represents a strong candidate, in particular when meals and drinks are shared. In this review, we intend to discuss that significant quantities of virus dispersed by large droplets during discussions at festive gatherings could explain group contamination either directly or indirectly after deposition on surfaces, food, drinks, cutlery, and several other soiled vectors. We suggest that hand hygiene and sanitary practices around objects brought to the mouth and food also need to be taken into account in order to curb transmission.
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Affiliation(s)
| | | | - Benoit Hermant
- Risk and Capability Assessment Unit, Public Health Agency of Canada, Ottawa, ON, Canada
| | - Didier Lepelletier
- Hospital Hygiene Department, Nantes University Hospital, F-44000, Nantes, France; Nantes University, IICiMEd 1155 Lab, IRS 2 Institute, F-44093, Nantes, France.
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30
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Schijven JF, van Veen T, Delmaar C, Kos J, Vermeulen L, Roosien R, Verhoeven F, Schipper M, Peerlings B, Duizer E, Derei J, Lammen W, Bartels O, van der Ven H, Maas R, de Roda Husman AM. Quantitative Microbial Risk Assessment of Contracting COVID-19 Derived from Measured and Simulated Aerosol Particle Transmission in Aircraft Cabins. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:87011. [PMID: 37589660 PMCID: PMC10434022 DOI: 10.1289/ehp11495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 07/13/2023] [Accepted: 07/13/2023] [Indexed: 08/18/2023]
Abstract
BACKGROUND SARS-CoV-2 can be effectively transmitted between individuals located in close proximity to each other for extended durations. Aircraft provide such conditions. Although high attack rates during flights were reported, little was known about the risk levels of aerosol transmission of SARS-CoV-2 in aircraft cabins. OBJECTIVES The major objective was to estimate the risk of contracting COVID-19 from transmission of aerosol particles in aircraft cabins. METHODS In two single-aisle and one twin-aisle aircraft, dispersion of generated aerosol particles over a seven-row economy class cabin section was measured under cruise and taxi conditions and simulated with a computational fluid dynamic model under cruise conditions. Using the aerosol particle dispersion data, a quantitative microbial risk assessment was conducted for scenarios with an asymptomatic infectious person expelling aerosol particles by breathing and speaking. Effects of flight conditions were evaluated using generalized additive mixed models. RESULTS Aerosol particle concentration decreased with increasing distance from the infectious person, and this decrease varied with direction. On a typical flight with an average shedder, estimated mean risk of contracting COVID-19 ranged from 1.3 × 10 - 3 to 9.0 × 10 - 2 . Risk increased to 7.7 × 10 - 2 with a super shedder (< 3 % of cases) on a long flight. Risks increased with increasing flight duration: 2-23 cruise flights of typical duration and 2-10 flights of longer duration resulted in at least 1 case of COVID-19 due to onboard aerosol transmission by one average shedder, and in the case of one super shedder, at least 1 case in 1-3 flights of typical duration cruise and 1 flight of longer duration. DISCUSSION Our findings indicate that the risk of contracting COVID-19 by aerosol transmission in an aircraft cabin is low, but it will not be zero. Testing before boarding may help reduce the chance of a (super)shedder boarding an aircraft and mask use further reduces aerosol transmission in the aircraft cabin. https://doi.org/10.1289/EHP11495.
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Affiliation(s)
- Jack F. Schijven
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
- Department of Earth Sciences, Utrecht University, Utrecht, the Netherlands
| | - Theo van Veen
- Royal Netherlands Aerospace Centre, Amsterdam, the Netherlands
| | - Christiaan Delmaar
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Johan Kos
- Royal Netherlands Aerospace Centre, Amsterdam, the Netherlands
| | - Lucie Vermeulen
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Rui Roosien
- Royal Netherlands Aerospace Centre, Amsterdam, the Netherlands
| | | | - Maarten Schipper
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Bram Peerlings
- Royal Netherlands Aerospace Centre, Amsterdam, the Netherlands
| | - Erwin Duizer
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Jonathan Derei
- Royal Netherlands Aerospace Centre, Amsterdam, the Netherlands
| | - Wim Lammen
- Royal Netherlands Aerospace Centre, Amsterdam, the Netherlands
| | - Onno Bartels
- Royal Netherlands Aerospace Centre, Amsterdam, the Netherlands
| | | | - Robert Maas
- Royal Netherlands Aerospace Centre, Amsterdam, the Netherlands
| | - Ana Maria de Roda Husman
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
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Ilgaz A, Saltan M. The impacts of Covid-19 pandemic on the sustainable mobility of university members in Turkey. CITIES (LONDON, ENGLAND) 2023; 141:104449. [PMID: 38620104 PMCID: PMC10291291 DOI: 10.1016/j.cities.2023.104449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 06/14/2023] [Accepted: 06/18/2023] [Indexed: 04/17/2024]
Abstract
The global Covid-19 pandemic had a devastating impact on our lives. The pandemic led to sudden and momentous changes in mobility styles and travel habits. Many users started preferring to travel via private vehicles, which is contrary to sustainability policies. Strict measures were implemented against the Covid-19 pandemic in Turkey during this process, as was the case all over the world. Taking into consideration these realities, the aim of the present study was to examine the impacts of the Covid-19 pandemic on the travel modes (public transportation, walking, and bicycle), anxiety and stress perceptions, and working conditions of individuals. A survey was conducted to measure the impacts of the pandemic and the measures taken. The sample of this study consists of people who regularly attended Suleyman Demirel University in Isparta and Akdeniz University in Antalya, Turkey, before the pandemic. An online survey was conducted for the case study during the May-June 2021 semester, and the survey was representative of the study population with a total of 556 participants. The travel time for both different university students decreased during the pandemic period. The percentage of those traveling to the university with their own cars increased to 77 % in AU and 66.8 % in SDU. The use of public transportation dropped to 6.1 % in AU and 11.8 % in SDU. 56.97 % of AU participants and 51.15 % of SDU participants reported that their walking habits decreased. It was reported that 52.73 % of the respondents in AU and 55.75 % of the respondents in SDU did not change their bicycle usage frequency. 64.24 % of AU and 74.42 % of SDU reported that their anxiety levels increased during the pandemic period. And for each of these analyses, there was no statistical difference between the two different university students.
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Affiliation(s)
- Arzu Ilgaz
- Akdeniz University, Building Works and Technical Head of Department, 07058 Antalya, Turkey
| | - Mehmet Saltan
- Suleyman Demirel University, Civil engineering faculty, Isparta, Turkey
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Bayly H, Stoddard M, Egeren DV, Murray EJ, Raifman J, Chakravarty A, White LF. Looking under the lamp-post: quantifying the performance of contact tracing in the United States during the SARS-CoV-2 pandemic. RESEARCH SQUARE 2023:rs.3.rs-2953875. [PMID: 37333276 PMCID: PMC10274953 DOI: 10.21203/rs.3.rs-2953875/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
Contact tracing forms a crucial part of the public-health toolbox in mitigating and understanding emergent pathogens and nascent disease outbreaks. Contact tracing in the United States was conducted during the pre-Omicron phase of the ongoing COVID-19 pandemic. This tracing relied on voluntary reporting and responses, often using rapid antigen tests (with a high false negative rate) due to lack of accessibility to PCR tests. These limitations, combined with SARS-CoV-2's propensity for asymptomatic transmission, raise the question "how reliable was contact tracing for COVID-19 in the United States"? We answered this question using a Markov model to examine the efficiency with which transmission could be detected based on the design and response rates of contact tracing studies in the United States. Our results suggest that contact tracing protocols in the U.S. are unlikely to have identified more than 1.65% (95% uncertainty interval: 1.62%-1.68%) of transmission events with PCR testing and 0.88% (95% uncertainty interval 0.86%-0.89%) with rapid antigen testing. When considering an optimal scenario, based on compliance rates in East Asia with PCR testing, this increases to 62.7% (95% uncertainty interval: 62.6%-62.8%). These findings highlight the limitations in interpretability for studies of SARS-CoV-2 disease spread based on U.S. contact tracing and underscore the vulnerability of the population to future disease outbreaks, for SARS-CoV-2 and other pathogens.
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Hirokawa K, Hirota J, Kawaguchi D, Masaki Y, Onita C. Investigating the epidemiological and economic effects of a third-party certification policy for restaurants with COVID-19 prevention measures. Sci Rep 2023; 13:7655. [PMID: 37169796 PMCID: PMC10173234 DOI: 10.1038/s41598-023-34498-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 05/03/2023] [Indexed: 05/13/2023] Open
Abstract
This study investigates the effects of a third-party certification policy for restaurants (including bars) that comply with indoor infection-prevention measures on COVID-19 cases and economic activities. We focus on the case of Yamanashi Prefecture in Japan, which introduced a third-party certification policy that accredits facilities, predominantly restaurants, that comply with the designated guidelines. We employ a difference-in-differences design for each of our epidemiological and economic analyses. The estimation results show that, from July 2020 to April 2021, the certification policy reduced the total number of new infection cases by approximately 45.3% (848 cases), while increasing total sales and the number of customers per restaurant by approximately 12.8% (3.21 million Japanese yen or $30,000) and 30.3% (2909 customers), respectively, compared to the non-intervention scenarios. The results suggest that a third-party certification policy can be an effective policy to mitigate the trade-off between economic activities and infection prevention during a pandemic, especially when effective vaccines are not widely available.
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Affiliation(s)
- Kazuya Hirokawa
- Graduate School of Public Policy, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8656, Japan
| | - Jumpei Hirota
- Graduate School of Public Policy, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8656, Japan
| | - Daiji Kawaguchi
- Graduate School of Public Policy, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8656, Japan.
- RIETI, Tokyo, Japan.
- IZA, Bonn, Germany.
| | - Yusuke Masaki
- Graduate School of Public Policy, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8656, Japan
| | - Chiaki Onita
- Graduate School of Public Policy, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8656, Japan
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Park S, Song D. CO 2 concentration as an indicator of indoor ventilation performance to control airborne transmission of SARS-CoV-2. J Infect Public Health 2023; 16:1037-1044. [PMID: 37196366 DOI: 10.1016/j.jiph.2023.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 05/02/2023] [Accepted: 05/08/2023] [Indexed: 05/19/2023] Open
Abstract
BACKGROUND The Wells-Riley equation has been extensively used to quantify the infection risk of airborne transmission indoors. This equation is difficult to apply to actual conditions because it requires measurement of the outdoor air supply rate, which vary with time and are difficult to quantify. The method of determining the fraction of inhaled air that has been exhaled previously by someone in a building using a CO2 concentration measurement can solve the limitations of the existing method. Using this method, the indoor CO2 concentration threshold can be determined to keep the risk of infection below certain conditions. METHODS Based on the calculation of the rebreathed fraction, an appropriate mean indoor CO2 concentration and required air exchange rate to control SARS-CoV-2 airborne transmission was calculated. The number of indoor occupants, ventilation rate, and the deposition and inactivation rates of the virus-laden aerosols were considered. The application of the proposed indoor CO2 concentration-based infection rate control was investigated through case studies in school classrooms and restaurants. RESULTS In a typical school classroom environment with 20-25 occupants and an exposure time of 6-8 h, the average indoor CO2 concentration should be kept below 700 ppm to control the risk of airborne infection indoors. The ASHRAE recommended ventilation rate is sufficient when wearing a mask in classrooms. For a typical restaurant with 50-100 occupants and an exposure time of 2-3 h, the average indoor CO2 concentration should be kept below about 900 ppm. Residence time in the restaurant had a significant effect on the acceptable CO2 concentration. CONCLUSION Given the conditions of the occupancy environment, it is possible to determine an indoor CO2 concentration threshold, and keeping the CO2 concentration lower than a certain threshold could help reduce the risk of COVID-19 infection.
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Affiliation(s)
- Sowoo Park
- Graduate School, Sungkyunkwan University, Suwon 16419, South Korea
| | - Doosam Song
- School of Civil, Architectural Eng., and Landscape Architecture, Sungkyunkwan University, Suwon 16419, South Korea.
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Abubakar-Waziri H, Kalaiarasan G, Wawman R, Hobbs F, Adcock I, Dilliway C, Fang F, Pain C, Porter A, Bhavsar PK, Ransome E, Savolainen V, Kumar P, Chung KF. SARS-CoV2 in public spaces in West London, UK during COVID-19 pandemic. BMJ Open Respir Res 2023; 10:10/1/e001574. [PMID: 37202121 DOI: 10.1136/bmjresp-2022-001574] [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: 12/02/2022] [Accepted: 04/28/2023] [Indexed: 05/20/2023] Open
Abstract
BACKGROUND Spread of SARS-CoV2 by aerosol is considered an important mode of transmission over distances >2 m, particularly indoors. OBJECTIVES We determined whether SARS-CoV2 could be detected in the air of enclosed/semi-enclosed public spaces. METHODS AND ANALYSIS Between March 2021 and December 2021 during the easing of COVID-19 pandemic restrictions after a period of lockdown, we used total suspended and size-segregated particulate matter (PM) samplers for the detection of SARS-CoV2 in hospitals wards and waiting areas, on public transport, in a university campus and in a primary school in West London. RESULTS We collected 207 samples, of which 20 (9.7%) were positive for SARS-CoV2 using quantitative PCR. Positive samples were collected from hospital patient waiting areas, from hospital wards treating patients with COVID-19 using stationary samplers and from train carriages in London underground using personal samplers. Mean virus concentrations varied between 429 500 copies/m3 in the hospital emergency waiting area and the more frequent 164 000 copies/m3 found in other areas. There were more frequent positive samples from PM samplers in the PM2.5 fractions compared with PM10 and PM1. Culture on Vero cells of all collected samples gave negative results. CONCLUSION During a period of partial opening during the COVID-19 pandemic in London, we detected SARS-CoV2 RNA in the air of hospital waiting areas and wards and of London Underground train carriage. More research is needed to determine the transmission potential of SARS-CoV2 detected in the air.
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Affiliation(s)
| | - Gopinath Kalaiarasan
- Department of Civil and Environmental Engineering, Global Centre for Clean Air Research, Surrey, UK
| | - Rebecca Wawman
- Airway Disease, National Heart & Lung Institute, Imperial College London, London, UK
| | - Faye Hobbs
- Airway Disease, National Heart & Lung Institute, Imperial College London, London, UK
| | - Ian Adcock
- Airway Disease, National Heart & Lung Institute, Imperial College London, London, UK
| | - Claire Dilliway
- Airway Disease, National Heart & Lung Institute, Imperial College London, London, UK
| | - Fangxin Fang
- Airway Disease, National Heart & Lung Institute, Imperial College London, London, UK
| | - Christopher Pain
- Airway Disease, National Heart & Lung Institute, Imperial College London, London, UK
| | - Alexandra Porter
- Airway Disease, National Heart & Lung Institute, Imperial College London, London, UK
| | - Pankaj K Bhavsar
- Airway Disease, National Heart & Lung Institute, Imperial College London, London, UK
| | - Emma Ransome
- Airway Disease, National Heart & Lung Institute, Imperial College London, London, UK
| | - Vincent Savolainen
- Airway Disease, National Heart & Lung Institute, Imperial College London, London, UK
| | - Prashant Kumar
- Department of Civil and Environmental Engineering, Global Centre for Clean Air Research, Surrey, UK
| | - Kian Fan Chung
- Airway Disease, National Heart & Lung Institute, Imperial College London, London, UK
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Na H, Kim H, Kim T. Dispersion of droplets due to the use of air purifiers during summer: Focus on the spread of COVID-19. BUILDING AND ENVIRONMENT 2023; 234:110136. [PMID: 36852256 PMCID: PMC9946730 DOI: 10.1016/j.buildenv.2023.110136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 02/14/2023] [Accepted: 02/19/2023] [Indexed: 06/18/2023]
Abstract
Coronavirus disease (COVID-19), which emerged in 2019, has induced worldwide chaos. The main cause of COVID-19 mass infection indoors is the spread of virus-containing droplets via indoor airflow, which is affected by air conditioners and purifiers. Here, ten experimental cases were established to analyze how use of air purifiers affects the spread of virus-containing droplets. The experiments were conducted in a school classroom with an air conditioner in summer. In the droplet dispersion experiment, paraffin oil was used as the droplet substance. Two main scenarios were simulated: (1) an infected student was seated in the back of the classroom; and (2) the teacher, standing in the front of the classroom, was infected. The results were expressed using two parameters: peak concentration and loss rate, which reflect the degree of direct and indirect infection (airborne infection), respectively. The air purifier induced a peak concentration decrease of 42% or an increase of 278%, depending on its location in the classroom. Conversely, when the air purifier was operated in the high mode (flow rate = 500 CMH; cubic meters per hour), the loss rate showed that the amount of droplet nuclei only decreased by 39% and the droplet amount decreased by 22%. Thus, the airborne infection degree can be significantly reduced. Finally, the use of air purifiers in the summer may be helpful in preventing group infections by reducing the loss rate and peak concentration if the air purifier is placed in a strategic location, according to the airflow of the corresponding room.
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Affiliation(s)
- Hooseung Na
- Architectural Engineering, Yonsei University, Seoul, South Korea
| | - Hyungkeun Kim
- R&D Institute. Risk Assessment PJT, LX Hausys, Seoul, South Korea
| | - Taeyeon Kim
- Architectural Engineering, Yonsei University, Seoul, South Korea
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Tsang TW, Mui KW, Wong LT, Law KY, Shek KW. A Novel IoT-Enabled Wireless Sensor Grid for Spatial and Temporal Evaluation of Tracer Gas Dispersion. SENSORS (BASEL, SWITZERLAND) 2023; 23:3920. [PMID: 37112265 PMCID: PMC10145748 DOI: 10.3390/s23083920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 04/07/2023] [Accepted: 04/11/2023] [Indexed: 06/19/2023]
Abstract
Current IoT applications in indoor air focus mainly on general monitoring. This study proposed a novel IoT application to evaluate airflow patterns and ventilation performance using tracer gas. The tracer gas is a surrogate for small-size particles and bioaerosols and is used in dispersion and ventilation studies. Prevalent commercial tracer-gas-measuring instruments, although highly accurate, are relatively expensive, have a long sampling cycle, and are limited in the number of sampling points. To enhance the spatial and temporal understanding of tracer gas dispersion under the influence of ventilation, a novel application of an IoT-enabled, wireless R134a sensing network using commercially available small sensors was proposed. The system has a detection range of 5-100 ppm and a sampling cycle of 10 s. Using Wi-Fi communication, the measurement data are transmitted to and stored in a cloud database for remote, real-time analysis. The novel system provides a quick response, detailed spatial and temporal profiles of the tracer gas level, and a comparable air change rate analysis. With multiple units deployed as a wireless sensing network, the system can be applied as an affordable alternative to traditional tracer gas systems to identify the dispersion pathway of the tracer gas and the general airflow direction.
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Affiliation(s)
- Tsz-Wun Tsang
- Department of Building Environment and Energy Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Kwok-Wai Mui
- Department of Building Environment and Energy Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Ling-Tim Wong
- Department of Building Environment and Energy Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Kwok-Yung Law
- Department of Mechanical Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Ka-Wing Shek
- Department of Building Environment and Energy Engineering, The Hong Kong Polytechnic University, Hong Kong, China
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38
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Susswein Z, Rest EC, Bansal S. Disentangling the rhythms of human activity in the built environment for airborne transmission risk: An analysis of large-scale mobility data. eLife 2023; 12:e80466. [PMID: 37014055 PMCID: PMC10118388 DOI: 10.7554/elife.80466] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 03/20/2023] [Indexed: 04/05/2023] Open
Abstract
Background Since the outset of the COVID-19 pandemic, substantial public attention has focused on the role of seasonality in impacting transmission. Misconceptions have relied on seasonal mediation of respiratory diseases driven solely by environmental variables. However, seasonality is expected to be driven by host social behavior, particularly in highly susceptible populations. A key gap in understanding the role of social behavior in respiratory disease seasonality is our incomplete understanding of the seasonality of indoor human activity. Methods We leverage a novel data stream on human mobility to characterize activity in indoor versus outdoor environments in the United States. We use an observational mobile app-based location dataset encompassing over 5 million locations nationally. We classify locations as primarily indoor (e.g. stores, offices) or outdoor (e.g. playgrounds, farmers markets), disentangling location-specific visits into indoor and outdoor, to arrive at a fine-scale measure of indoor to outdoor human activity across time and space. Results We find the proportion of indoor to outdoor activity during a baseline year is seasonal, peaking in winter months. The measure displays a latitudinal gradient with stronger seasonality at northern latitudes and an additional summer peak in southern latitudes. We statistically fit this baseline indoor-outdoor activity measure to inform the incorporation of this complex empirical pattern into infectious disease dynamic models. However, we find that the disruption of the COVID-19 pandemic caused these patterns to shift significantly from baseline and the empirical patterns are necessary to predict spatiotemporal heterogeneity in disease dynamics. Conclusions Our work empirically characterizes, for the first time, the seasonality of human social behavior at a large scale with a high spatiotemporal resolutio and provides a parsimonious parameterization of seasonal behavior that can be included in infectious disease dynamics models. We provide critical evidence and methods necessary to inform the public health of seasonal and pandemic respiratory pathogens and improve our understanding of the relationship between the physical environment and infection risk in the context of global change. Funding Research reported in this publication was supported by the National Institute of General Medical Sciences of the National Institutes of Health under award number R01GM123007.
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Affiliation(s)
- Zachary Susswein
- Department of Biology, Georgetown UniversityWashington, DCUnited States
| | - Eva C Rest
- Department of Biology, Georgetown UniversityWashington, DCUnited States
| | - Shweta Bansal
- Department of Biology, Georgetown UniversityWashington, DCUnited States
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Metellus P, Jegede O, Brown C, Qureshi D, Nkemjika S. A Review of the Mental Health Sequelae of the SARS-CoV-2 (COVID-19): Preparedness Perspective. Cureus 2023; 15:e37643. [PMID: 37200645 PMCID: PMC10187944 DOI: 10.7759/cureus.37643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2023] [Indexed: 05/20/2023] Open
Abstract
Despite the three significant epidemics that have rattled the world in the last two decades, many questions remain unanswered! The concept of unwanted psychological distress remains looming after any epidemic or pandemic. The public health burden of the COVID-19 pandemic still resonates with different aspects of life with predicted mental health sequelae. This review will focus on the role of natural disasters and past infectious epidemic-related mental health complications. Additionally, the study provides recommendations and policy suggestions for mitigating COVID-19-related mental health prevalence.
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Affiliation(s)
| | | | - Colvette Brown
- Environmental Health, Newton County Health Department, Covington, USA
- Population Health Sciences, Georgia State University School of Public Health, Atlanta, USA
| | | | - Stanley Nkemjika
- Population Health Sciences, Georgia State University School of Public Health, Atlanta, USA
- Psychiatry and Behavioral Sciences, Interfaith Medical Center, Brooklyn, USA
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40
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Chang Y, Ai Z, Ye J, Ma G. A cost-effectiveness assessment of the operational parameters of central HVAC systems during pandemics. BUILDING SIMULATION 2023; 16:667-682. [PMID: 37101942 PMCID: PMC10040913 DOI: 10.1007/s12273-023-1000-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 01/19/2023] [Accepted: 02/05/2023] [Indexed: 06/19/2023]
Abstract
The present study develops a cost-effectiveness assessment model to analyze the performance of major operational parameters of central HVAC systems in terms of airborne transmission risk, energy consumption, and medical and social cost. A typical multi-zone building model with a central HVAC system is built numerically, and the effect of outdoor air (OA) ratio (from 30% to 100%) and filtration level (MERV 13, MERV 16, and HEPA) are assessed under the conditions of five climate zones in China. Compared with the baseline case with 30% OA and MERV 13 filtration, the airborne transmission risk in zones without infector is negligibly reduced with the increase in OA ratio and the upgrade of filtration level, owing to their slight modification on the equivalent ventilation rate of virus-free air. However, depending on climate zone, a 10% increase in OA ratio results in 12.5%-78.6% and 0.1%-8.6% increase in heating and cooling energy consumption, respectively, while an upgrade of filtration level to MERV 16 and HEPA results in an increase of 0.08%-0.2% and 1.4%-2.6%, respectively. Overall, when compared to the use of 100% OA ratio and HEPA filtration, the application of 30% or 40% OA ratio and MERV 13 filtration would save annually an energy and facility related cost of $29.4 billion in China, though giving an increase of approximately $0.1 billion on medical and social cost from the increased number of confirmed cases. This study provides basic method and information for the formulation of cost-effective operational strategies of HVAC systems coping with the airborne transmission, especially in resource-limited regions.
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Affiliation(s)
- Yufan Chang
- Department of Building Environment and Energy, College of Civil Engineering, Hunan University, Changsha, Hunan, China
- National Center for International Research Collaboration in Building Safety and Environment, Hunan University, Changsha, Hunan, China
| | - Zhengtao Ai
- Department of Building Environment and Energy, College of Civil Engineering, Hunan University, Changsha, Hunan, China
- National Center for International Research Collaboration in Building Safety and Environment, Hunan University, Changsha, Hunan, China
| | - Jinjun Ye
- Department of Building Environment and Energy, College of Civil Engineering, Hunan University, Changsha, Hunan, China
- National Center for International Research Collaboration in Building Safety and Environment, Hunan University, Changsha, Hunan, China
| | - Guochuan Ma
- China Southwest Architectural Design and Research Institute, Chengdu, Sichuan, China
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Jiang Z, Deng Z, Wang X, Dong B. PANDEMIC: Occupancy driven predictive ventilation control to minimize energy consumption and infection risk. APPLIED ENERGY 2023; 334:120676. [PMID: 36714219 PMCID: PMC9867897 DOI: 10.1016/j.apenergy.2023.120676] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 01/06/2023] [Accepted: 01/08/2023] [Indexed: 05/31/2023]
Abstract
During the SARS-CoV-2 (COVID-19) pandemic, governments around the world have formulated policies requiring ventilation systems to operate at a higher outdoor fresh air flow rate for a sufficient time, which has led to a sharp increase in building energy consumption. Therefore, it is necessary to identify an energy-efficient ventilation strategy to reduce the risk of infection. In this study, we developed an occupant-number-based model predictive control (OBMPC) algorithm for building ventilation systems. First, we collected the occupancy and Heating, ventilation, and air conditioning system (HVAC) data from March to July 2021. Then, four different models (Auto regression moving average-based multilayer perceptron (ARMA_MLP), Recurrent neural networks (RNN), Long short-term memory networks (LSTM), and Nonhomogeneous Markov with change points detection (NH_Markov)) were used to predict the number of room occupants from 15 min to 24 h ahead with an interval output. We found that each model could predict the number of occupants with 85 % accuracy using a one-person offset. The accuracy of 15 min of the ahead prediction could reach 95 % with a one-person offset, but none of them could track abrupt changes. The occupancy prediction results were used to calculate the ventilation demand using the Wells-Riley equation, and the upper bound can maintain an infection risk lower than 2 % for 93 % of the day. This OBMPC model could reduce the coil load by 52.44 % and shift the peak load by 3 h up to 5 kW compared with 24 × 7 h full outdoor air (OA) system when people wear masks in the space. The occupancy prediction uncertainty could cause a 9 % to 26 % difference in demand ventilation, a 0.3 °C to 2.4 °C difference in zone temperature, a 28.5 % to 44.5 % difference in outdoor airflow rate, and a 10.7 % to 28.2 % difference in coil load.
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Affiliation(s)
- Zixin Jiang
- Department of Mechanical & Aerospace Engineering, Syracuse University, Syracuse, NY 13244, United States
- Built Environment Science and Technology (BEST) Lab, Syracuse University, Syracuse, NY 13244, United States
| | - Zhipeng Deng
- Department of Mechanical & Aerospace Engineering, Syracuse University, Syracuse, NY 13244, United States
- Built Environment Science and Technology (BEST) Lab, Syracuse University, Syracuse, NY 13244, United States
| | - Xuezheng Wang
- Department of Mechanical & Aerospace Engineering, Syracuse University, Syracuse, NY 13244, United States
- Built Environment Science and Technology (BEST) Lab, Syracuse University, Syracuse, NY 13244, United States
| | - Bing Dong
- Department of Mechanical & Aerospace Engineering, Syracuse University, Syracuse, NY 13244, United States
- Built Environment Science and Technology (BEST) Lab, Syracuse University, Syracuse, NY 13244, United States
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Shimizu A, Kitazume S. Nosocomial transmission of SARS-CoV-2 from infected children to uninfected caregivers: A retrospective cohort study in a Japanese tertiary children's hospital. J Infect Chemother 2023; 29:281-283. [PMID: 36470374 PMCID: PMC9719842 DOI: 10.1016/j.jiac.2022.11.013] [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: 10/05/2022] [Revised: 11/24/2022] [Accepted: 11/29/2022] [Indexed: 12/09/2022]
Abstract
BACKGROUND The transmission rate of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is unclear when caregivers accompany pediatric COVID-19 patients in the same isolation room in a hospital setting. AIM We investigated SARS-CoV-2 transmission from infected children to caregivers at our hospital. METHODS This retrospective cohort study included 34 discordant pairs of patients admitted between September 2020 and April 2022. FINDINGS The median ages of the children and caregivers were 3.7 years (interquartile range [IQR]: 1.6-8.1) and 33.1 years (IQR: 28.3-43.4), respectively. Of the 34 caregivers, 31 were mothers, two were fathers, and one was a relative. Sixteen caregivers received at least two doses of the mRNA vaccine. The mean duration of the hospital stays was 7.7 ± 4.1 days (range: 3-19). Two unvaccinated caregivers developed COVID-19 after admission; the onset was within 48 h after admission. It is likely that they had been infected in their household prior to admission, since the incubation period for COVID-19 is usually >2 days. CONCLUSIONS Nosocomial SARS-CoV-2 transmission from infected children to caregivers was not confirmed in this study. The combination of negative-pressure rooms, vaccinations, and infection-control bundles appears to be effective at preventing SARS-CoV-2 transmission. It is acceptable to allow caregivers to accompany pediatric COVID-19 patients in a hospital ward if they can comply with basic infection control measures.
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Affiliation(s)
- Akihiko Shimizu
- Department of Infectious Diseases, Gunma Children's Medical Center, Shibukawa, Japan.
| | - Sachiko Kitazume
- Department of Nursing, Gunma Children's Medical Center, Shibukawa, Japan
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Sayahi T, Workman AD, Kelly KE, Ardon-Dryer K, Presto AA, Bleier BS. Aerosol Generation During Nasal Airway Instrumentation. Otolaryngol Head Neck Surg 2023; 168:506-513. [PMID: 35503253 DOI: 10.1177/01945998221099028] [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: 06/11/2021] [Accepted: 04/18/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Airborne aerosol transmission, an established mechanism of SARS-CoV-2 spread, has been successfully mitigated in the health care setting through the adoption of universal masking. Upper airway endoscopy, however, requires direct access to the face, thereby potentially exposing the clinic environment to infectious particles. This study quantifies aerosol production during rigid nasal endoscopy (RNE) and RNE with debridement (RNED) as compared with intubation, a posited gold standard aerosol-generating procedure. STUDY DESIGN Prospective cross-sectional study. SETTING Subspecialty single-center clinic and surgical study. METHOD Three aerosol detectors (NANOSCAN-3910, OPS-3330, and APS-3321) with a particle size sensitivity of 10 to 20,000 nm were utilized to detect particulate production during the clinical care of 209 patients undergoing RNE/RNED and 25 patients undergoing intubation. RESULTS RNE and RNED produced statistically significant particles over baseline in 29.3% and 51.0% of subjects (P = .003-.049 and .002-.047, respectively). Intubation produced statistically significant particles in 31.2% (P = .001-.015). The mean ± SD particle diameter in all tests was 69.9 ± 10.5 nm with 99.7% <300 nm. There were no statistical differences in particle production among RNE, RNED, and intubation. The presence of concomitant cough, sneeze, or prolonged speech similarly did not significantly affect particle production during any procedure. CONCLUSIONS Instrumentation of nasal airway produces airborne aerosols to a similar degree of those seen during intubation, independent of reactive patient behaviors such as cough or sneeze. These data suggest that an improved understanding is necessary of both the definition of an aerosol-generating procedure and the functional consequences of procedural aerosol generation in clinical settings.
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Affiliation(s)
- Tofigh Sayahi
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
- Department of Mechanical Engineering, Carnegie Mellon University, Pittsburgh, Pennsylvania, USA
| | - Alan D Workman
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Kerry E Kelly
- Department of Chemical Engineering, University of Utah, Salt Lake City, Utah, USA
| | - Karin Ardon-Dryer
- Department of Geosciences, Texas Tech University, Lubbock, Texas, USA
| | - Albert A Presto
- Department of Mechanical Engineering, Carnegie Mellon University, Pittsburgh, Pennsylvania, USA
| | - Benjamin S Bleier
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
- Consultant for Inquis Medical, Inc, Redwood City, California, USA
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Agarwal AK, Sequeira A, Oza-Gajera BP, Ramani K, Packer J, Litchfield T, Nations ML, Lerma EV. Lessons learnt and future directions in managing dialysis access during the COVID 19 pandemic: Patient and provider experience in the United States. J Vasc Access 2023; 24:213-221. [PMID: 34162276 PMCID: PMC10018246 DOI: 10.1177/11297298211027014] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND The COVID 19 pandemic adversely impacted delivery of preventive, routine, urgent, and essential care worldwide. Dialysis access care was particularly affected due to the lack of specific guidelines regarding procedures for its creation and maintenance. Early guidance by Centers for Medicare and Medicaid was inadvertently interpreted as guidance to stop dialysis access procedures. Prompt action by professional societies was needed to furnish detailed guidance to establish essential nature of these procedures. METHODS The American Society of Diagnostic and Interventional Nephrology (ASDIN) issued a joint statement with Vascular Access Society of the Americas (VASA) - "Maintaining Lifelines for ESKD Patients" to clearly establish the role of vascular access as a lifeline for ESKD (End Stage Kidney Disease) patients and the importance and urgency of its timely management. ASDIN also conducted a survey in mid-2020, that was administered to the ASDIN database as well as shared with the general public via the organization's social media platforms. The respondents reported their experiences in the care of dialysis access, practice patterns and the utility of the ASDIN-VASA statement during the COVID 19 pandemic. RESULTS Of the 2030 individual surveys sent, 581 were opened and 53 (9.1%) responses were received from different parts of the country and from different practice settings. ASDIN COVID 19 triage document was frequently utilized and 83% of respondents found the document valuable. The survey also revealed multiple obstacles, including logistical and financial issues that led to significant disruption of services. CONCLUSIONS The care of dialysis access was significantly affected in the United States during the COVID 19 pandemic due to multiple reasons. ASDIN actions provided valuable specific guidance regarding and explored barriers to dialysis access care. We describe those results and discuss strategies to prevent COVID 19 transmission with innovative strategies of providing access care. Individualized decision making is of essence when considering dialysis access procedures.
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Affiliation(s)
- Anil K Agarwal
- University of California San Francisco, Fresno, California, USA
| | | | | | | | - Jeffrey Packer
- University of Arizona College of Medicine, Phoenix, AZ, USA
| | | | - Mary Lea Nations
- American Society of Diagnostic and Interventional Nephrology, Clinton, MS, USA
| | - Edgar V Lerma
- University of Illinois at Chicago/Advocate Christ Medical Center, Oak Lawn, IL, USA
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Berger S, Mattern M, Niessner J. Face mask performance related to potentially infectious aerosol particles, breathing mode and facial leakage. Int J Hyg Environ Health 2023; 248:114103. [PMID: 36525701 PMCID: PMC9748312 DOI: 10.1016/j.ijheh.2022.114103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 11/24/2022] [Accepted: 12/08/2022] [Indexed: 12/15/2022]
Abstract
During the COVID 19 pandemic, wearing certified Respiratory Protective Devices (RPDs) provided important means of protection against direct and indirect infections caused by virus-laden aerosols. Assessing the RPD performance associated with infection prevention in standardised certification tests, however, faces drawbacks, such as the representativeness of the test aerosols used, the protection of third parties during exhalation or the effect of facial leaks. To address these drawbacks, we designed a novel test bench to measure RPD performance, namely the number based total efficiency, size-segregated fractional filtration efficiency and net pressure loss, for 11 types of certified surgical masks and Filtering Face Pieces dependent on breathing mode and facial fit. To be representative for the context of potentially infectious particles, we use a test aerosol based on artificial saliva that is in its size distribution similar to exhaled aerosols. In inhalation mode excluding facial leaks, all investigated samples deposit by count more than 85% of artificial saliva particles, which suggests a high efficiency of certified RPD filter media related to these particles. In exhalation mode most RPDs tend to have similar efficiencies but lower pressure losses. This deviation tends to be significant primarily for the RPDs with thin filter layers like surgical masks or Filtering Face Pieces containing nanofibers and may depend on the RPDs shape. Both the filtration efficiency and pressure loss are strongly inter-dependent and significantly lower when RPDs are naturally fitted including facial leaks, leading to a wide efficiency range of approximately 30-85%. The results indicate a much greater influence of the facial fit than the filter material itself. Furthermore, RPDs tend be more effective in self-protection than in third-party protection, which is inversely correlated to pressure loss. Comparing different types of RPDs, the pressure loss partially differs at similar filtration efficiencies, which points out the influence of the material and the filter area on pressure loss.
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Affiliation(s)
- Simon Berger
- Institute of Flow in Additively Manufactured Porous Media (ISAPS), Heilbronn University of Applied Sciences, Max-Planck-Str. 39, 74081, Heilbronn, Germany.
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Brainard J, Jones NR, Harrison FC, Hammer CC, Lake IR. Super-spreaders of novel coronaviruses that cause SARS, MERS and COVID-19: A systematic review. Ann Epidemiol 2023:S1047-2797(23)00058-3. [PMID: 37001627 DOI: 10.1016/j.annepidem.2023.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 01/12/2023] [Accepted: 03/26/2023] [Indexed: 03/31/2023]
Abstract
PURPOSE Most index cases with novel coronavirus infections transmit disease to just one or two other individuals, but some individuals "super-spread"-they infect many secondary cases. Understanding common factors that super-spreaders may share could inform outbreak models, and be used to guide contact tracing during outbreaks. METHODS We searched in MEDLINE, Scopus, and preprints to identify studies about people documented as transmitting pathogens that cause SARS, MERS, or COVID-19 to at least nine other people. We extracted data to describe them by age, sex, location, occupation, activities, symptom severity, any underlying conditions, disease outcome and undertook quality assessment for outbreaks published by June 2021. RESULTS The most typical super-spreader was a male age 40+. Most SARS or MERS super-spreaders were very symptomatic, the super-spreading occurred in hospital settings and frequently the individual died. In contrast, COVID-19 super-spreaders often had very mild disease and most COVID-19 super-spreading happened in community settings. CONCLUSIONS SARS and MERS super-spreaders were often symptomatic, middle- or older-age adults who had a high mortality rate. In contrast, COVID-19 super-spreaders tended to have mild disease and were any adult age. More outbreak reports should be published with anonymized but useful demographic information to improve understanding of super-spreading, super-spreaders, and the settings in which super-spreading happens.
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Martínez-Baz I, Miqueleiz A, Egüés N, Casado I, Burgui C, Echeverría A, Navascués A, Fernández-Huerta M, García Cenoz M, Trobajo-Sanmartín C, Guevara M, Ezpeleta C, Castilla J. Effect of COVID-19 vaccination on the SARS-CoV-2 transmission among social and household close contacts: A cohort study. J Infect Public Health 2023; 16:410-417. [PMID: 36724697 PMCID: PMC9876028 DOI: 10.1016/j.jiph.2023.01.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 01/18/2023] [Accepted: 01/23/2023] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND COVID-19 vaccination was expected to reduce SARS-CoV-2 transmission, but the relevance of this effect remains unclear. We aimed to estimate the effectiveness of COVID-19 vaccination of the index cases and their close contacts in reducing the probability of SARS-CoV-2 transmission. METHODS Transmission of SARS-CoV-2 infection was evaluated in two cohorts of adult close contacts of COVID-19 confirmed cases (social and household settings) by COVID-19 vaccination status of the index case and the close contact, from April to November 2021 in Navarre, Spain. The effects of vaccination of the index case and the close contact were estimated as (1-adjusted relative risk) × 100%. RESULTS Among 19,631 social contacts, 3257 (17%) were confirmed with SARS-CoV-2. COVID-19 vaccination of the index case reduced infectiousness by 44% (95% CI, 27-57%), vaccination of the close contact reduced susceptibility by 69% (95% CI, 65-73%), and vaccination of both reduced transmissibility by 74% (95% CI, 70-78%) in social settings, suggesting some synergy of effects. Among 20,708 household contacts, 6269 (30%) were infected, and vaccine effectiveness estimates were 13% (95% CI, -5% to 28%), 61% (95% CI, 58-64%), and 52% (95% CI, 47-56%), respectively. These estimates were lower in older people and had not relevant differences between the Alpha (April-June) and Delta (July-November) variant periods. CONCLUSIONS COVID-19 vaccination reduces infectiousness and susceptibility; however, these effects are insufficient for complete control of SARS-CoV-2 transmission, especially in older people and household setting. Relaxation of preventive behaviors after vaccination may counteract part of the vaccine effect on transmission.
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Affiliation(s)
- Iván Martínez-Baz
- Instituto de Salud Pública de Navarra, Leyre 15, 31003 Pamplona, Spain,CIBER Epidemiología y Salud Pública, Pamplona, Spain,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Ana Miqueleiz
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain,Clinical Microbiology Department, Hospital Universitario de Navarra, Irunlarrea, 31008 Pamplona, Spain
| | - Nerea Egüés
- Instituto de Salud Pública de Navarra, Leyre 15, 31003 Pamplona, Spain,CIBER Epidemiología y Salud Pública, Pamplona, Spain,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Itziar Casado
- Instituto de Salud Pública de Navarra, Leyre 15, 31003 Pamplona, Spain,CIBER Epidemiología y Salud Pública, Pamplona, Spain,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Cristina Burgui
- Instituto de Salud Pública de Navarra, Leyre 15, 31003 Pamplona, Spain,CIBER Epidemiología y Salud Pública, Pamplona, Spain,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | | | - Ana Navascués
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain,Clinical Microbiology Department, Hospital Universitario de Navarra, Irunlarrea, 31008 Pamplona, Spain
| | - Miguel Fernández-Huerta
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain,Clinical Microbiology Department, Hospital Universitario de Navarra, Irunlarrea, 31008 Pamplona, Spain
| | - Manuel García Cenoz
- Instituto de Salud Pública de Navarra, Leyre 15, 31003 Pamplona, Spain,CIBER Epidemiología y Salud Pública, Pamplona, Spain,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Camino Trobajo-Sanmartín
- Instituto de Salud Pública de Navarra, Leyre 15, 31003 Pamplona, Spain,CIBER Epidemiología y Salud Pública, Pamplona, Spain,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Marcela Guevara
- Instituto de Salud Pública de Navarra, Leyre 15, 31003 Pamplona, Spain,CIBER Epidemiología y Salud Pública, Pamplona, Spain,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Carmen Ezpeleta
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain,Clinical Microbiology Department, Hospital Universitario de Navarra, Irunlarrea, 31008 Pamplona, Spain
| | - Jesús Castilla
- Instituto de Salud Pública de Navarra, Leyre 15, 31003 Pamplona, Spain; CIBER Epidemiología y Salud Pública, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.
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Norvihoho LK, Yin J, Zhou ZF, Han J, Chen B, Fan LH, Lichtfouse E. Mechanisms controlling the transport and evaporation of human exhaled respiratory droplets containing the severe acute respiratory syndrome coronavirus: a review. ENVIRONMENTAL CHEMISTRY LETTERS 2023; 21:1701-1727. [PMID: 36846189 PMCID: PMC9944801 DOI: 10.1007/s10311-023-01579-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 02/13/2023] [Indexed: 05/24/2023]
Abstract
Transmission of the coronavirus disease 2019 is still ongoing despite mass vaccination, lockdowns, and other drastic measures to control the pandemic. This is due partly to our lack of understanding on the multiphase flow mechanics that control droplet transport and viral transmission dynamics. Various models of droplet evaporation have been reported, yet there is still limited knowledge about the influence of physicochemical parameters on the transport of respiratory droplets carrying the severe acute respiratory syndrome coronavirus 2. Here we review the effects of initial droplet size, environmental conditions, virus mutation, and non-volatile components on droplet evaporation and dispersion, and on virus stability. We present experimental and computational methods to analyze droplet transport, and factors controlling transport and evaporation. Methods include thermal manikins, flow techniques, aerosol-generating techniques, nucleic acid-based assays, antibody-based assays, polymerase chain reaction, loop-mediated isothermal amplification, field-effect transistor-based assay, and discrete and gas-phase modeling. Controlling factors include environmental conditions, turbulence, ventilation, ambient temperature, relative humidity, droplet size distribution, non-volatile components, evaporation and mutation. Current results show that medium-sized droplets, e.g., 50 µm, are sensitive to relative humidity. Medium-sized droplets experience delayed evaporation at high relative humidity, and increase airborne lifetime and travel distance. By contrast, at low relative humidity, medium-sized droplets quickly shrink to droplet nuclei and follow the cough jet. Virus inactivation within a few hours generally occurs at temperatures above 40 °C, and the presence of viral particles in aerosols impedes droplet evaporation.
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Affiliation(s)
- Leslie Kojo Norvihoho
- State Key Laboratory of Multiphase Flow in Power Engineering, Xi’an Jiaotong University, Xi’an, 710049 Shaanxi People’s Republic of China
| | - Jing Yin
- State Key Laboratory of Multiphase Flow in Power Engineering, Xi’an Jiaotong University, Xi’an, 710049 Shaanxi People’s Republic of China
| | - Zhi-Fu Zhou
- State Key Laboratory of Multiphase Flow in Power Engineering, Xi’an Jiaotong University, Xi’an, 710049 Shaanxi People’s Republic of China
| | - Jie Han
- School of Human Settlements and Civil Engineering, Xi’an Jiaotong University, Xi’an, 710049 Shaanxi People’s Republic of China
| | - Bin Chen
- State Key Laboratory of Multiphase Flow in Power Engineering, Xi’an Jiaotong University, Xi’an, 710049 Shaanxi People’s Republic of China
| | - Li-Hong Fan
- The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, 710061 Shaanxi People’s Republic of China
| | - Eric Lichtfouse
- State Key Laboratory of Multiphase Flow in Power Engineering, Xi’an Jiaotong University, Xi’an, 710049 Shaanxi People’s Republic of China
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Yan Y, Li X, Fang X, Tao Y, Tu J. A spatiotemporal assessment of occupants' infection risks in a multi-occupants space using modified Wells-Riley model. BUILDING AND ENVIRONMENT 2023; 230:110007. [PMID: 36691649 PMCID: PMC9850653 DOI: 10.1016/j.buildenv.2023.110007] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 01/08/2023] [Accepted: 01/10/2023] [Indexed: 06/09/2023]
Abstract
Escalating demands of assessing airborne disease infection risks had been awakened from ongoing pandemics. An inhalation index linked to biomedical characteristics of pathogens (e.g. TCID 50 for coronavirus delta variant) was proposed to quantify human uptake dose. A modified Wells-Riley risk-assessment framework was then developed with enhanced capability of integrating biological and spatiotemporal features of infectious pathogens into assessment. The instantaneous transport characteristics of pathogens were traced by Eulerian-Lagrangian method. Droplets released via speaking and coughing in a conference room with three ventilation strategies were studied to assess occupants' infection risks using this framework. Outcomes revealed that speaking droplets could travel with less distance (0.5 m) than coughing droplets (1 m) due to the frequent interaction between speaking flow and thermal plume. Quantified analysis of inhalation index revealed a higher inhalation possibility of droplets with nuclei size smaller than 5 μ m , and this cut-off size was found sensitive to ventilation. With only 60-second exposure, occupants in the near-field of host started to have considerable infection risks (approximately 20%). This risk was found minimising over distance exponentially. This modified framework demonstrated the systematic analysis of airborne transmission, from quantifying particle inhalation possibility, targeting specific disease's TCID 50 , to ultimate evaluation of infection risks.
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Affiliation(s)
- Yihuan Yan
- School of Air Transportation/Flying, Shanghai University of Engineering Science, Shanghai 201620, China
| | - Xueren Li
- School of Air Transportation/Flying, Shanghai University of Engineering Science, Shanghai 201620, China
- School of Engineering, RMIT University, PO Box 71, Bundoora, VIC 3083, Australia
| | - Xiang Fang
- School of Engineering, RMIT University, PO Box 71, Bundoora, VIC 3083, Australia
| | - Yao Tao
- School of Engineering, RMIT University, PO Box 71, Bundoora, VIC 3083, Australia
| | - Jiyuan Tu
- School of Engineering, RMIT University, PO Box 71, Bundoora, VIC 3083, Australia
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50
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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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