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Liu R, Li J, Wen Y, Li H, Zhang P, Sheng B, Feng DD. DDE: Deep Dynamic Epidemiological Modeling for Infectious Illness Development Forecasting in Multi-level Geographic Entities. JOURNAL OF HEALTHCARE INFORMATICS RESEARCH 2024; 8:478-505. [PMID: 39131102 PMCID: PMC11310392 DOI: 10.1007/s41666-024-00167-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 04/27/2024] [Accepted: 05/13/2024] [Indexed: 08/13/2024]
Abstract
Understanding and addressing the dynamics of infectious diseases, such as coronavirus disease 2019, are essential for effectively managing the current situation and developing intervention strategies. Epidemiologists commonly use mathematical models, known as epidemiological equations (EE), to simulate disease spread. However, accurately estimating the parameters of these models can be challenging due to factors like variations in social distancing policies and intervention strategies. In this study, we propose a novel method called deep dynamic epidemiological modeling (DDE) to address these challenges. The DDE method combines the strengths of EE with the capabilities of deep neural networks to improve the accuracy of fitting real-world data. In DDE, we apply neural ordinary differential equations to solve variant-specific equations, ensuring a more precise fit for disease progression in different geographic regions. In the experiment, we tested the performance of the DDE method and other state-of-the-art methods using real-world data from five diverse geographic entities: the USA, Colombia, South Africa, Wuhan in China, and Piedmont in Italy. Compared to the state-of-the-art method, DDE significantly improved accuracy, with an average fitting Pearson coefficient exceeding 0.97 across the five geographic entities. In summary, the DDE method enhances the accuracy of parameter fitting in epidemiological models and provides a foundation for constructing simpler models adaptable to different geographic areas.
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Affiliation(s)
- Ruhan Liu
- Furong Laboratory, Central South University, Changsha, 410012 Hunan China
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, 410008 Hunan China
- Hunan Key Laboratory of Skin Cancer and Psoriasis, Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Changsha, 410008 Hunan China
| | - Jiajia Li
- School of Chemistry and Chemical Engineering and National Center for Translational Medicine, Shanghai Jiao Tong University, Shanghai, 200240 Shanghai China
| | - Yang Wen
- College of Electronics and Information Engineering, Shenzhen University, Shenzhen, 518060 Guangdong China
| | - Huating Li
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, 200233 Shanghai China
| | - Ping Zhang
- Department of Computer Science and Engineering, The Ohio State University, Columbus, 43210 OH USA
- Department of Biomedical Informatics, The Ohio State University, Columbus, 43210 OH USA
| | - Bin Sheng
- Department of Computer Science and Engineering, Shanghai Jiao Tong University, Shanghai, 200240 Shanghai China
| | - David Dagan Feng
- School of Computer Science, The University of Sydney, Sydney, 410008 New South Wales Australia
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He Y, Martinez L, Ge Y, Feng Y, Chen Y, Tan J, Westbrook A, Li C, Cheng W, Ling F, Cheng H, Wu S, Zhong W, Handel A, Huang H, Sun J, Shen Y. Social Mixing and Network Characteristics of COVID-19 Patients Before and After Widespread Interventions: A Population-based Study. Epidemiol Infect 2023; 151:1-38. [PMID: 37577939 PMCID: PMC10540215 DOI: 10.1017/s0950268823001292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 06/28/2023] [Accepted: 07/31/2023] [Indexed: 08/15/2023] Open
Abstract
SARS-CoV-2 rapidly spreads among humans via social networks, with social mixing and network characteristics potentially facilitating transmission. However, limited data on topological structural features has hindered in-depth studies. Existing research is based on snapshot analyses, preventing temporal investigations of network changes. Comparing network characteristics over time offers additional insights into transmission dynamics. We examined confirmed COVID-19 patients from an eastern Chinese province, analyzing social mixing and network characteristics using transmission network topology before and after widespread interventions. Between the two time periods, the percentage of singleton networks increased from 38.9 to 62.8 ; the average shortest path length decreased from 1.53 to 1.14 ; the average betweenness reduced from 0.65 to 0.11 ; the average cluster size dropped from 4.05 to 2.72 ; and the out-degree had a slight but nonsignificant decline from 0.75 to 0.63 Results show that nonpharmaceutical interventions effectively disrupted transmission networks, preventing further disease spread. Additionally, we found that the networks’ dynamic structure provided more information than solely examining infection curves after applying descriptive and agent-based modeling approaches. In summary, we investigated social mixing and network characteristics of COVID-19 patients during different pandemic stages, revealing transmission network heterogeneities.
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Affiliation(s)
- Yuncong He
- School of Mathematics, Sun Yat-sen University, Guangzhou, China
| | - Leonardo Martinez
- Department of Epidemiology, School of Public Health, Boston University, Boston, USA
| | - Yang Ge
- School of Health Professions, University of Southern Mississippi, Hattiesburg, USA
| | - Yan Feng
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Yewen Chen
- Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, USA
| | - Jianbin Tan
- School of Mathematics, Sun Yat-sen University, Guangzhou, China
| | - Adrianna Westbrook
- Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, USA
| | - Changwei Li
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, USA
| | - Wei Cheng
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Feng Ling
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Huimin Cheng
- Department of Statistics, University of Georgia, Athens, USA
| | - Shushan Wu
- Department of Statistics, University of Georgia, Athens, USA
| | - Wenxuan Zhong
- Department of Statistics, University of Georgia, Athens, USA
| | - Andreas Handel
- Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, USA
| | - Hui Huang
- Center for Applied Statistics and School of Statistics, Renmin University of China, Beijing, China
| | - Jimin Sun
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Ye Shen
- Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, USA
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Wegehaupt O, Endo A, Vassall A. Superspreading, overdispersion and their implications in the SARS-CoV-2 (COVID-19) pandemic: a systematic review and meta-analysis of the literature. BMC Public Health 2023; 23:1003. [PMID: 37254143 DOI: 10.1186/s12889-023-15915-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 05/17/2023] [Indexed: 06/01/2023] Open
Abstract
BACKGROUND A recurrent feature of infectious diseases is the observation that different individuals show different levels of secondary transmission. This inter-individual variation in transmission potential is often quantified by the dispersion parameter k. Low values of k indicate a high degree of variability and a greater probability of superspreading events. Understanding k for COVID-19 across contexts can assist policy makers prepare for future pandemics. METHODS A literature search following a systematic approach was carried out in PubMed, Embase, Web of Science, Cochrane Library, medRxiv, bioRxiv and arXiv to identify publications containing epidemiological findings on superspreading in COVID-19. Study characteristics, epidemiological data, including estimates for k and R0, and public health recommendations were extracted from relevant records. RESULTS The literature search yielded 28 peer-reviewed studies. The mean k estimates ranged from 0.04 to 2.97. Among the 28 studies, 93% reported mean k estimates lower than one, which is considered as marked heterogeneity in inter-individual transmission potential. Recommended control measures were specifically aimed at preventing superspreading events. The combination of forward and backward contact tracing, timely confirmation of cases, rapid case isolation, vaccination and preventive measures were suggested as important components to suppress superspreading. CONCLUSIONS Superspreading events were a major feature in the pandemic of SARS-CoV-2. On the one hand, this made outbreaks potentially more explosive but on the other hand also more responsive to public health interventions. Going forward, understanding k is critical for tailoring public health measures to high-risk groups and settings where superspreading events occur.
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Affiliation(s)
- Oliver Wegehaupt
- Institute for Immunodeficiency, Center for Chronic Immunodeficiency (CCI), Medical Center, Faculty of Medicine, University of Freiburg, Breisacherstr. 115, Freiburg, 79106, Germany.
- Clinic of Pediatric Hematology, Oncology and Stem Cell Transplantation, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK.
| | - Akira Endo
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
- The Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Anna Vassall
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
- Department of Global Health, The Academic Medical Center (AMC), The University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
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Parvin R. The Nexus Between COVID-19 Factors and Air Pollution. ENVIRONMENTAL HEALTH INSIGHTS 2023; 17:11786302231164288. [PMID: 37065166 PMCID: PMC10099915 DOI: 10.1177/11786302231164288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 03/01/2023] [Indexed: 06/19/2023]
Abstract
Background and Objective There have been significant effects of the current coronavirus-19 (COVID-19) infection outbreak on many facets of everyday life, particularly the environment. Despite the fact that a number of studies have already been published on the topic, an analysis of those studies' findings on COVID-19's effects on environmental pollution is still lacking. The goal of the research is to look into greenhouse gas emissions and air pollution in Bangladesh when COVID-19 is under rigorous lockdown. The specific drivers of the asymmetric relationship between air pollution and COVID-19 are being investigated. Methods The nonlinear relationship between carbon dioxide ( C O 2 ) emissions, fine particulate matter ( P M 2 . 5 ) , and COVID-19, as well as its precise components, are also being investigated. To examine the asymmetric link between COVID-19 factors on C O 2 emissions and P M 2 . 5 , we employed the nonlinear autoregressive distributed lag (NARDL) model. Daily positive cases and daily confirmed death by COVID-19 are considered the factors of COVID-19, with lockdown as a dummy variable. Results The bound test confirmed the existence of long-run and short-run relationships between variables. Bangladesh's strict lockdown, enforced in reaction to a surge of COVID-19 cases, reduced air pollution and dangerous gas emissions, mainly C O 2 , according to the dynamic multipliers graph.
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Affiliation(s)
- Rehana Parvin
- Department of Statistics, International University
of Business Agriculture and Technology, Dhaka, Bangladesh
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5
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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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Fuente D, Hervás D, Rebollo M, Conejero JA, Oliver N. COVID-19 outbreaks analysis in the Valencian Region of Spain in the prelude of the third wave. Front Public Health 2022; 10:1010124. [PMID: 36466513 PMCID: PMC9713945 DOI: 10.3389/fpubh.2022.1010124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 11/02/2022] [Indexed: 11/19/2022] Open
Abstract
Introduction The COVID-19 pandemic has led to unprecedented social and mobility restrictions on a global scale. Since its start in the spring of 2020, numerous scientific papers have been published on the characteristics of the virus, and the healthcare, economic and social consequences of the pandemic. However, in-depth analyses of the evolution of single coronavirus outbreaks have been rarely reported. Methods In this paper, we analyze the main properties of all the tracked COVID-19 outbreaks in the Valencian Region between September and December of 2020. Our analysis includes the evaluation of the origin, dynamic evolution, duration, and spatial distribution of the outbreaks. Results We find that the duration of the outbreaks follows a power-law distribution: most outbreaks are controlled within 2 weeks of their onset, and only a few last more than 2 months. We do not identify any significant differences in the outbreak properties with respect to the geographical location across the entire region. Finally, we also determine the cluster size distribution of each infection origin through a Bayesian statistical model. Discussion We hope that our work will assist in optimizing and planning the resource assignment for future pandemic tracking efforts.
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Affiliation(s)
- David Fuente
- Instituto Universitario de Aplicaciones de las Tecnologías de la Información y de las Comunicaciones Avanzadas, Universitat Politècnica de València, València, Spain
| | - David Hervás
- Departamento de Estadística e Investigación Operativa Aplicadas y Calidad, Universitat Politècnica de València, València, Spain
| | - Miguel Rebollo
- Valencia Research Institute on Artificial Intelligence, Universitat Politècnica de València, València, Spain
| | - J. Alberto Conejero
- Instituto Universitario de Matemática Pura y Aplicada, Universitat Politècnica de València, València, Spain
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Du Z, Wang C, Liu C, Bai Y, Pei S, Adam DC, Wang L, Wu P, Lau EHY, Cowling BJ. Systematic review and meta-analyses of superspreading of SARS-CoV-2 infections. Transbound Emerg Dis 2022; 69:e3007-e3014. [PMID: 35799321 PMCID: PMC9349569 DOI: 10.1111/tbed.14655] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 07/03/2022] [Accepted: 07/04/2022] [Indexed: 11/29/2022]
Abstract
Superspreading, or overdispersion in transmission, is a feature of SARS-CoV-2 transmission which results in surging epidemics and large clusters of infection. The dispersion parameter is a statistical parameter used to characterize and quantify heterogeneity. In the context of measuring transmissibility, it is analogous to measures of superspreading potential among populations by assuming that collective offspring distribution follows a negative-binomial distribution. We conducted a systematic review and meta-analysis on globally reported dispersion parameters of SARS-CoV-2 infection. All searches were carried out on 10 September 2021 in PubMed for articles published from 1 January 2020 to 10 September 2021. Multiple estimates of the dispersion parameter have been published for 17 studies, which could be related to where and when the data were obtained, in 8 countries (e.g. China, the United States, India, Indonesia, Israel, Japan, New Zealand and Singapore). High heterogeneity was reported among the included studies. The mean estimates of dispersion parameters range from 0.06 to 2.97 over eight countries, the pooled estimate was 0.55 (95% CI: 0.30, 0.79), with changing means over countries and decreasing slightly with the increasing reproduction number. The expected proportion of cases accounting for 80% of all transmissions is 19% (95% CrI: 7, 34) globally. The study location and method were found to be important drivers for diversity in estimates of dispersion parameters. While under high potential of superspreading, larger outbreaks could still occur with the import of the COVID-19 virus by traveling even when an epidemic seems to be under control.
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Affiliation(s)
- Zhanwei Du
- Li Ka Shing Faculty of MedicineWHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong KongHong Kong Special Administrative RegionChina
- Laboratory of Data Discovery for HealthHong Kong Science and Technology ParkHong Kong Special Administrative RegionChina
| | - Chunyu Wang
- Li Ka Shing Faculty of MedicineWHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong KongHong Kong Special Administrative RegionChina
- Laboratory of Data Discovery for HealthHong Kong Science and Technology ParkHong Kong Special Administrative RegionChina
| | - Caifen Liu
- Li Ka Shing Faculty of MedicineWHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong KongHong Kong Special Administrative RegionChina
- Laboratory of Data Discovery for HealthHong Kong Science and Technology ParkHong Kong Special Administrative RegionChina
| | - Yuan Bai
- Li Ka Shing Faculty of MedicineWHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong KongHong Kong Special Administrative RegionChina
- Laboratory of Data Discovery for HealthHong Kong Science and Technology ParkHong Kong Special Administrative RegionChina
| | - Sen Pei
- Department of Environmental Health Sciences, Mailman School of Public HealthColumbia UniversityNew YorkNew York
| | - Dillon C. Adam
- Li Ka Shing Faculty of MedicineWHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong KongHong Kong Special Administrative RegionChina
| | - Lin Wang
- Department of GeneticsUniversity of CambridgeCambridgeUK
| | - Peng Wu
- Li Ka Shing Faculty of MedicineWHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong KongHong Kong Special Administrative RegionChina
- Laboratory of Data Discovery for HealthHong Kong Science and Technology ParkHong Kong Special Administrative RegionChina
| | - Eric H. Y. Lau
- Li Ka Shing Faculty of MedicineWHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong KongHong Kong Special Administrative RegionChina
- Laboratory of Data Discovery for HealthHong Kong Science and Technology ParkHong Kong Special Administrative RegionChina
| | - Benjamin J. Cowling
- Li Ka Shing Faculty of MedicineWHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong KongHong Kong Special Administrative RegionChina
- Laboratory of Data Discovery for HealthHong Kong Science and Technology ParkHong Kong Special Administrative RegionChina
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Lee H, Han C, Jung J, Lee S. Analysis of Superspreading Potential from Transmission Clusters of COVID-19 in South Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182412893. [PMID: 34948504 PMCID: PMC8701974 DOI: 10.3390/ijerph182412893] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/28/2021] [Accepted: 12/02/2021] [Indexed: 12/23/2022]
Abstract
The COVID-19 pandemic has been spreading worldwide with more than 246 million confirmed cases and 5 million deaths across more than 200 countries as of October 2021. There have been multiple disease clusters, and transmission in South Korea continues. We aim to analyze COVID-19 clusters in Seoul from 4 March to 4 December 2020. A branching process model is employed to investigate the strength and heterogeneity of cluster-induced transmissions. We estimate the cluster-specific effective reproduction number Reff and the dispersion parameter κ using a maximum likelihood method. We also compute Rm as the mean secondary daily cases during the infection period with a cluster size m. As a result, a total of 61 clusters with 3088 cases are elucidated. The clusters are categorized into six groups, including religious groups, convalescent homes, and hospitals. The values of Reff and κ of all clusters are estimated to be 2.26 (95% CI: 2.02-2.53) and 0.20 (95% CI: 0.14-0.28), respectively. This indicates strong evidence for the occurrence of superspreading events in Seoul. The religious groups cluster has the largest value of Reff among all clusters, followed by workplaces, schools, and convalescent home clusters. Our results allow us to infer the presence or absence of superspreading events and to understand the cluster-specific characteristics of COVID-19 outbreaks. Therefore, more effective suppression strategies can be implemented to halt the ongoing or future cluster transmissions caused by small and sporadic clusters as well as large superspreading events.
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Affiliation(s)
- Hyojung Lee
- Department of Statistics, Kyungpook National University, Daegu 41566, Korea;
| | - Changyong Han
- Department of Applied Mathematics, Kyung Hee University, Yongin 17104, Korea;
| | - Jooyi Jung
- Department of Biostatistics, Korea University, Seoul 02841, Korea;
| | - Sunmi Lee
- Department of Applied Mathematics, Kyung Hee University, Yongin 17104, Korea;
- Correspondence:
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Barani S, Jahan N, Karuppiah M, Chaudhuri S, Raju M, Ponnaiah M, Rajaraman S, Vaidhyalingam V, Ganeshkumar P, Kumar Cp G, Muthappan S, Murugesan J, Srinivasan M, Krishnan U, John Varghese A. Epidemiology of hospital-based COVID- 19 cluster in a tertiary care cancer hospital, Chennai, India 2020. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2021; 12:100889. [PMID: 34754984 PMCID: PMC8566092 DOI: 10.1016/j.cegh.2021.100889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 10/05/2021] [Accepted: 10/26/2021] [Indexed: 10/29/2022] Open
Abstract
Objectives To identify risk factors associated with Coronavirus disease 2019 (COVID-19) in a Tertiary care cancer hospital-based cluster and recommend control measures. Methods We conducted tracing and confirmation among hospital and community contacts. We telephonically interviewed and abstracted information from hospital records and registers. We described the cluster by time, place and person. We conducted unmatched case-control study to compare risk factors and computed Odds Ratio (OR) and 95% confidence interval. Results We confirmed COVID-19 in 21 of 1478 tested (1.4%). Secondary attack (%) of COVID-19 among 824 contacts was higher among in-patients of block A (18), household contacts (3.4), housekeeping staff (3.3) and nurses (1.7). The cluster started on April 22 with two successive peaks five days apart and lasted until May 8. Being male, patients aged >33 years [OR = 30·7; 95% CI = 3·6 to 264], having hypertension [OR = 4·3; 95% CI = 1·1 to 16·7] or diabetes [OR = 3·8; 95% CI = 1·0 to 14·1] were associated with COVID-19. Mask compliance was poor (20%) among hospital workers. Discussion We recommended screening of all patients for diabetes and hypertension and isolation/testing of anyone with influenza-like illness for preventing COVID-19 clusters in hospital settings.
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Affiliation(s)
- Suganya Barani
- Hospital Cluster Investigation Team: ICMR-National Institute of Epidemiology, Chennai, India
| | - Nuzrath Jahan
- Hospital Cluster Investigation Team: ICMR-National Institute of Epidemiology, Chennai, India
| | - Mathan Karuppiah
- Hospital Cluster Investigation Team: ICMR-National Institute of Epidemiology, Chennai, India
| | - Sirshendu Chaudhuri
- Hospital Cluster Investigation Team: ICMR-National Institute of Epidemiology, Chennai, India
| | - Mohankumar Raju
- Hospital Cluster Investigation Team: ICMR-National Institute of Epidemiology, Chennai, India
| | - Manickam Ponnaiah
- Hospital Cluster Investigation Team: ICMR-National Institute of Epidemiology, Chennai, India
| | | | | | - Parasuraman Ganeshkumar
- Hospital Cluster Investigation Team: ICMR-National Institute of Epidemiology, Chennai, India
| | - Girish Kumar Cp
- Hospital Cluster Investigation Team: ICMR-National Institute of Epidemiology, Chennai, India
| | - Sendhilkumar Muthappan
- Hospital Cluster Investigation Team: ICMR-National Institute of Epidemiology, Chennai, India
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Wang J, Chen X, Guo Z, Zhao S, Huang Z, Zhuang Z, Wong ELY, Zee BCY, Chong MKC, Wang MH, Yeoh EK. Superspreading and heterogeneity in transmission of SARS, MERS, and COVID-19: A systematic review. Comput Struct Biotechnol J 2021; 19:5039-5046. [PMID: 34484618 PMCID: PMC8409018 DOI: 10.1016/j.csbj.2021.08.045] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 08/28/2021] [Accepted: 08/28/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and coronavirus disease 2019 (COVID-19) have caused substantial public health burdens and global health threats. Understanding the superspreading potentials of these viruses are important for characterizing transmission patterns and informing strategic decision-making in disease control. This systematic review aimed to summarize the existing evidence on superspreading features and to compare the heterogeneity in transmission within and among various betacoronavirus epidemics of SARS, MERS and COVID-19. METHODS PubMed, MEDLINE, and Embase databases were extensively searched for original studies on the transmission heterogeneity of SARS, MERS, and COVID-19 published in English between January 1, 2003, and February 10, 2021. After screening the articles, we extracted data pertaining to the estimated dispersion parameter (k) which has been a commonly-used measurement for superspreading potential. FINDINGS We included a total of 60 estimates of transmission heterogeneity from 26 studies on outbreaks in 22 regions. The majority (90%) of the k estimates were small, with values less than 1, indicating an over-dispersed transmission pattern. The point estimates of k for SARS and MERS ranged from 0.12 to 0.20 and from 0.06 to 2.94, respectively. Among 45 estimates of individual-level transmission heterogeneity for COVID-19 from 17 articles, 91% were derived from Asian regions. The point estimates of k for COVID-19 ranged between 0.1 and 5.0. CONCLUSIONS We detected a substantial over-dispersed transmission pattern in all three coronaviruses, while the k estimates varied by differences in study design and public health capacity. Our findings suggested that even with a reduced R value, the epidemic still has a high resurgence potential due to transmission heterogeneity.
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Affiliation(s)
- Jingxuan Wang
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Xiao Chen
- School of Public Health, Zhejiang University, Hangzhou, China
| | - Zihao Guo
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Shi Zhao
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
- Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China
| | - Ziyue Huang
- Mianyang Maternal and Child Health Care Hospital, Mianyang, China
| | - Zian Zhuang
- Department of Biostatistics, University of California Los Angeles Fielding School of Public Health, Los Angeles, CA, USA
| | - Eliza Lai-yi Wong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
- Centre for Health Systems and Policy Research, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Benny Chung-Ying Zee
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
- Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China
| | - Marc Ka Chun Chong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
- Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China
| | - Maggie Haitian Wang
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
- Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China
| | - Eng Kiong Yeoh
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
- Centre for Health Systems and Policy Research, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
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Shultz JM, Berg RC, Kossin JP, Burkle F, Maggioni A, Pinilla Escobar VA, Castillo MN, Espinel Z, Galea S. Convergence of climate-driven hurricanes and COVID-19: The impact of 2020 hurricanes Eta and Iota on Nicaragua. THE JOURNAL OF CLIMATE CHANGE AND HEALTH 2021; 3:100019. [PMID: 34235501 PMCID: PMC8146267 DOI: 10.1016/j.joclim.2021.100019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 05/23/2021] [Indexed: 06/13/2023]
Abstract
The 2020 Atlantic hurricane season was notable for a record-setting 30 named storms while, contemporaneously, the COVID-19 pandemic was circumnavigating the globe. The active spread of COVID-19 complicated disaster preparedness and response actions to safeguard coastal and island populations from hurricane hazards. Major hurricanes Eta and Iota, the most powerful storms of the 2020 Atlantic season, made November landfalls just two weeks apart, both coming ashore along the Miskito Coast in Nicaragua's North Caribbean Coast Autonomous Region. Eta and Iota bore the hallmarks of climate-driven storms, including rapid intensification, high peak wind speeds, and decelerating forward motion prior to landfall. Hurricane warning systems, combined with timely evacuation and sheltering procedures, minimized loss of life during hurricane impact. Yet these protective actions potentially elevated risks for COVID-19 transmission for citizens sharing congregate shelters during the storms and for survivors who were displaced post-impact due to severe damage to their homes and communities. International border closures and travel restrictions that were in force to slow the spread of COVID-19 diminished the scope, timeliness, and effectiveness of the humanitarian response for survivors of Eta and Iota. Taken together, the extreme impacts from hurricanes Eta and Iota, compounded by the ubiquitous threat of COVID-19 transmission, and the impediments to international humanitarian response associated with movement restrictions during the pandemic, acted to exacerbate harms to population health for the citizens of Nicaragua.
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Affiliation(s)
- James M Shultz
- Center for Disaster & Extreme Event Preparedness (DEEP Center), Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Ryan C Berg
- Senior Fellow, Americas Program, Center for Strategic and International Studies (CSIS), Washington, DC 20036, USA
| | - James P Kossin
- Climate Science and Services Division, NOAA's National Centers for Environmental Information (NCEI), Madison, WI 53706, USA. Current affiliation: The Climate Service, Durham, NC 27701, USA
| | - Frederick Burkle
- Harvard Humanitarian Initiative, Harvard University & T.H. Chan School of Public Health, Senior International Public Policy Scholar, Woodrow Wilson International Center for Scholars, USA
| | - Alessandra Maggioni
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Victoria A Pinilla Escobar
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Melissa Nicole Castillo
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Zelde Espinel
- Sylvester Comprehensive Cancer Center, Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Sandro Galea
- Robert A Knox Professor, School of Public Health, Boston University, 715 Albany Street - Talbot 301, Boston, MA 02118, USA
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12
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Keshta AS, Mallah SI, Al Zubaidi K, Ghorab OK, Keshta MS, Alarabi D, Abousaleh MA, Salman MT, Taha OE, Zeidan AA, Elsaid MF, Tang P. COVID-19 versus SARS: A comparative review. J Infect Public Health 2021; 14:967-977. [PMID: 34130121 PMCID: PMC8064890 DOI: 10.1016/j.jiph.2021.04.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 04/11/2021] [Accepted: 04/15/2021] [Indexed: 12/15/2022] Open
Abstract
The two genetically similar severe acute respiratory syndrome coronaviruses, SARS-CoV-1 and SARS-CoV-2, have each been responsible for global epidemics of vastly different scales. Although both viruses arose from similar origins, they quickly diverged due to differences in their transmission dynamics and spectrum of clinical presentations. The potential involvement of multiple organs systems, including the respiratory, cardiac, gastrointestinal and neurological, during infection necessitates a comprehensive understanding of the clinical pathogenesis of each virus. The management of COVID-19, initially modelled after SARS and other respiratory illnesses, has continued to evolve as we accumulate more knowledge and experience during the pandemic, as well as develop new therapeutics and vaccines. The impact of these two coronaviruses has been profound for our health care and public health systems, and we hope that the lessons learned will not only bring the current pandemic under control, but also prevent and reduce the impact of future pandemics.
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Affiliation(s)
- Ahmed S Keshta
- School of Medicine, Royal College of Surgeons in Ireland - Bahrain, Busaiteen, Kingdom of Bahrain
| | - Saad I Mallah
- School of Medicine, Royal College of Surgeons in Ireland - Bahrain, Busaiteen, Kingdom of Bahrain
| | - Khaled Al Zubaidi
- Division of Paediatric Infectious Diseases, Hamad Medical Corporation, Doha, Qatar
| | - Omar K Ghorab
- School of Medicine, Royal College of Surgeons in Ireland - Bahrain, Busaiteen, Kingdom of Bahrain
| | - Mohamed S Keshta
- School of Medicine, Royal College of Surgeons in Ireland - Bahrain, Busaiteen, Kingdom of Bahrain
| | - Dalal Alarabi
- School of Medicine, Royal College of Surgeons in Ireland - Bahrain, Busaiteen, Kingdom of Bahrain
| | - Mohammad A Abousaleh
- School of Medicine, Royal College of Surgeons in Ireland - Bahrain, Busaiteen, Kingdom of Bahrain
| | - Mustafa Thaer Salman
- School of Medicine, Royal College of Surgeons in Ireland - Bahrain, Busaiteen, Kingdom of Bahrain
| | - Omer E Taha
- School of Medicine, Royal College of Surgeons in Ireland - Bahrain, Busaiteen, Kingdom of Bahrain
| | - Anas A Zeidan
- School of Medicine, Royal College of Surgeons in Ireland - Bahrain, Busaiteen, Kingdom of Bahrain
| | - Mahmoud F Elsaid
- Division of Pediatric Neurology, Hamad Medical Corporation, Doha, Qatar; Division of Neurology, Sidra Medicine, Doha, Qatar; Department of Pediatrics, Weill Cornell Medicine - Qatar, Doha, Qatar
| | - Patrick Tang
- Department of Pathology, Sidra Medicine, Doha, Qatar; Department of Pathology and Laboratory Medicine, Weill Cornell Medicine - Qatar, Doha, Qatar.
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13
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Kwok KO, Huang Y, Tsoi MTF, Tang A, Wong SYS, Wei WI, Hui DSC. Epidemiology, clinical spectrum, viral kinetics and impact of COVID-19 in the Asia-Pacific region. Respirology 2021; 26:322-333. [PMID: 33690946 PMCID: PMC8207122 DOI: 10.1111/resp.14026] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 02/08/2021] [Indexed: 01/08/2023]
Abstract
COVID-19 has hit the world by surprise, causing substantial mortality and morbidity since 2020. This narrative review aims to provide an overview of the epidemiology, induced impact, viral kinetics and clinical spectrum of COVID-19 in the Asia-Pacific Region, focusing on regions previously exposed to outbreaks of coronavirus. COVID-19 progressed differently by regions, with some (such as China and Taiwan) featured by one to two epidemic waves and some (such as Hong Kong and South Korea) featured by multiple waves. There has been no consensus on the estimates of important epidemiological time intervals or proportions, such that using them for making inferences should be done with caution. Viral loads of patients with COVID-19 peak in the first week of illness around days 2 to 4 and hence there is very high transmission potential causing community outbreaks. Various strategies such as government-guided and suppress-and-lift strategies, trigger-based/suppression approaches and alert systems have been employed to guide the adoption and easing of control measures. Asymptomatic and pre-symptomatic transmission is a hallmark of COVID-19. Identification and isolation of symptomatic patients alone is not effective in controlling the ongoing outbreaks. However, early, prompt and coordinated enactment predisposed regions to successful disease containment. Mass COVID-19 vaccinations are likely to be the light at the end of the tunnel. There is a need to review what we have learnt in this pandemic and examine how to transfer and improve existing knowledge for ongoing and future epidemics.
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Affiliation(s)
- Kin On Kwok
- JC School of Public Health and Primary CareThe Chinese University of Hong KongHong Kong Special Administrative RegionChina
- Stanley Ho Centre for Emerging Infectious DiseasesThe Chinese University of Hong KongHong Kong Special Administrative RegionChina
- Shenzhen Research Institute of the Chinese University of Hong KongShenzhenChina
| | - Ying Huang
- JC School of Public Health and Primary CareThe Chinese University of Hong KongHong Kong Special Administrative RegionChina
| | - Margaret Ting Fong Tsoi
- JC School of Public Health and Primary CareThe Chinese University of Hong KongHong Kong Special Administrative RegionChina
| | - Arthur Tang
- Department of SoftwareSungkyunkwan UniversitySeoulRepublic of Korea
| | - Samuel Yeung Shan Wong
- JC School of Public Health and Primary CareThe Chinese University of Hong KongHong Kong Special Administrative RegionChina
| | - Wan In Wei
- JC School of Public Health and Primary CareThe Chinese University of Hong KongHong Kong Special Administrative RegionChina
| | - David Shu Cheong Hui
- Stanley Ho Centre for Emerging Infectious DiseasesThe Chinese University of Hong KongHong Kong Special Administrative RegionChina
- Department of Medicine and TherapeuticsThe Chinese University of Hong KongHong Kong Special Administrative RegionChina
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14
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Loo BPY, Tsoi KH, Wong PPY, Lai PC. Identification of superspreading environment under COVID-19 through human mobility data. Sci Rep 2021; 11:4699. [PMID: 33633273 PMCID: PMC7907097 DOI: 10.1038/s41598-021-84089-w] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 02/09/2021] [Indexed: 01/13/2023] Open
Abstract
COVID-19 reaffirms the vital role of superspreaders in a pandemic. We propose to broaden the research on superspreaders through integrating human mobility data and geographical factors to identify superspreading environment. Six types of popular public facilities were selected: bars, shopping centres, karaoke/cinemas, mega shopping malls, public libraries, and sports centres. A historical dataset on mobility was used to calculate the generalized activity space and space-time prism of individuals during a pre-pandemic period. Analysis of geographic interconnections of public facilities yielded locations by different classes of potential spatial risk. These risk surfaces were weighed and integrated into a "risk map of superspreading environment" (SE-risk map) at the city level. Overall, the proposed method can estimate empirical hot spots of superspreading environment with statistical accuracy. The SE-risk map of Hong Kong can pre-identify areas that overlap with the actual disease clusters of bar-related transmission. Our study presents first-of-its-kind research that combines data on facility location and human mobility to identify superspreading environment. The resultant SE-risk map steers the investigation away from pure human focus to include geographic environment, thereby enabling more differentiated non-pharmaceutical interventions and exit strategies to target some places more than others when complete city lockdown is not practicable.
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Affiliation(s)
- Becky P Y Loo
- Department of Geography, The University of Hong Kong, Pokfulam Road, Pok Fu Lam, Hong Kong
- Institute of Transport Studies, The University of Hong Kong, Pok Fu Lam, Hong Kong
- Urban and Transport Research Laboratory, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Ka Ho Tsoi
- Department of Geography, The University of Hong Kong, Pokfulam Road, Pok Fu Lam, Hong Kong
- Urban and Transport Research Laboratory, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Paulina P Y Wong
- Science Unit, Lingnan University of Hong Kong, Pok Fu Lam, Hong Kong
- Centre for Social Policy and Social Change, Lingnan University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Poh Chin Lai
- Department of Geography, The University of Hong Kong, Pokfulam Road, Pok Fu Lam, Hong Kong.
- Institute of Transport Studies, The University of Hong Kong, Pok Fu Lam, Hong Kong.
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15
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Günther T, Czech‐Sioli M, Indenbirken D, Robitaille A, Tenhaken P, Exner M, Ottinger M, Fischer N, Grundhoff A, Brinkmann MM. SARS-CoV-2 outbreak investigation in a German meat processing plant. EMBO Mol Med 2020; 12:e13296. [PMID: 33012091 PMCID: PMC7646008 DOI: 10.15252/emmm.202013296] [Citation(s) in RCA: 103] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 09/23/2020] [Accepted: 09/25/2020] [Indexed: 01/09/2023] Open
Abstract
We describe a multifactorial investigation of a SARS-CoV-2 outbreak in a large meat processing complex in Germany. Infection event timing, spatial, climate and ventilation conditions in the processing plant, sharing of living quarters and transport, and viral genome sequences were analyzed. Our results suggest that a single index case transmitted SARS-CoV-2 to co-workers over distances of more than 8 m, within a confined work area in which air is constantly recirculated and cooled. Viral genome sequencing shows that all cases share a set of mutations representing a novel sub-branch in the SARS-CoV-2 C20 clade. We identified the same set of mutations in samples collected in the time period between this initial infection cluster and a subsequent outbreak within the same factory, with the largest number of confirmed SARS-CoV-2 cases in a German meat processing facility reported so far. Our results indicate climate conditions, fresh air exchange rates, and airflow as factors that can promote efficient spread of SARS-CoV-2 via long distances and provide insights into possible requirements for pandemic mitigation strategies in industrial workplace settings.
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Affiliation(s)
- Thomas Günther
- Heinrich Pette InstituteLeibniz Institute for Experimental VirologyHamburgGermany
| | - Manja Czech‐Sioli
- Institute for Medical Microbiology, Virology and HygieneUniversity Medical Center Hamburg‐EppendorfHamburgGermany
| | - Daniela Indenbirken
- Heinrich Pette InstituteLeibniz Institute for Experimental VirologyHamburgGermany
| | - Alexis Robitaille
- Heinrich Pette InstituteLeibniz Institute for Experimental VirologyHamburgGermany
| | | | - Martin Exner
- Institute of Hygiene and Public HealthUniversity of BonnBonnGermany
| | | | - Nicole Fischer
- Institute for Medical Microbiology, Virology and HygieneUniversity Medical Center Hamburg‐EppendorfHamburgGermany
| | - Adam Grundhoff
- Heinrich Pette InstituteLeibniz Institute for Experimental VirologyHamburgGermany
| | - Melanie M Brinkmann
- Viral Immune Modulation Research GroupHelmholtz Centre for Infection ResearchBraunschweigGermany
- Institute of GeneticsTechnische Universität BraunschweigBraunschweigGermany
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16
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Günther T, Czech-Sioli M, Indenbirken D, Robitaille A, Tenhaken P, Exner M, Ottinger M, Fischer N, Grundhoff A, Brinkmann MM. SARS-CoV-2 outbreak investigation in a German meat processing plant. EMBO Mol Med 2020. [PMID: 33012091 DOI: 10.2139/ssrn.3654517] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023] Open
Abstract
We describe a multifactorial investigation of a SARS-CoV-2 outbreak in a large meat processing complex in Germany. Infection event timing, spatial, climate and ventilation conditions in the processing plant, sharing of living quarters and transport, and viral genome sequences were analyzed. Our results suggest that a single index case transmitted SARS-CoV-2 to co-workers over distances of more than 8 m, within a confined work area in which air is constantly recirculated and cooled. Viral genome sequencing shows that all cases share a set of mutations representing a novel sub-branch in the SARS-CoV-2 C20 clade. We identified the same set of mutations in samples collected in the time period between this initial infection cluster and a subsequent outbreak within the same factory, with the largest number of confirmed SARS-CoV-2 cases in a German meat processing facility reported so far. Our results indicate climate conditions, fresh air exchange rates, and airflow as factors that can promote efficient spread of SARS-CoV-2 via long distances and provide insights into possible requirements for pandemic mitigation strategies in industrial workplace settings.
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Affiliation(s)
- Thomas Günther
- Heinrich Pette Institute, Leibniz Institute for Experimental Virology, Hamburg, Germany
| | - Manja Czech-Sioli
- Institute for Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Daniela Indenbirken
- Heinrich Pette Institute, Leibniz Institute for Experimental Virology, Hamburg, Germany
| | - Alexis Robitaille
- Heinrich Pette Institute, Leibniz Institute for Experimental Virology, Hamburg, Germany
| | | | - Martin Exner
- Institute of Hygiene and Public Health, University of Bonn, Bonn, Germany
| | | | - Nicole Fischer
- Institute for Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Adam Grundhoff
- Heinrich Pette Institute, Leibniz Institute for Experimental Virology, Hamburg, Germany
| | - Melanie M Brinkmann
- Viral Immune Modulation Research Group, Helmholtz Centre for Infection Research, Braunschweig, Germany
- Institute of Genetics, Technische Universität Braunschweig, Braunschweig, Germany
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17
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Lidström AK, Sund F, Albinsson B, Lindbäck J, Westman G. Work at inpatient care units is associated with an increased risk of SARS-CoV-2 infection; a cross-sectional study of 8679 healthcare workers in Sweden. Ups J Med Sci 2020; 125:305-310. [PMID: 32684119 PMCID: PMC7594729 DOI: 10.1080/03009734.2020.1793039] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND During the Covid-19 pandemic, the protection of healthcare workers has been in focus throughout the world, but the availability and quality of personal protective equipment has at times and in some settings been suboptimal. MATERIALS AND METHODS A total of 8679 healthcare workers and healthcare support staff in the county of Uppsala, north of Stockholm, were included in this cross-sectional study. All subjects were analysed for IgG anti-SARS-CoV-2, and predictors for positive serostatus were analysed in a logistic regression model including demographic parameters and self-reported employment characteristics. RESULTS Overall, 577 (6.6%) were classified as seropositive, with no statistically significant differences between healthcare workers and support staff. Among healthcare workers, age (OR 0.987 per year, 95% CI 0.980-0.995), time to sampling (OR 1.019 per day, 95% CI 1.004-1.035), and employment at an outpatient care unit (OR 0.620, 95% CI 0.487-0.788) were statistically significantly associated with risk of infection. Covid-19 specific units were not at particular risk, compared to other units with comparable characteristics and staff demography. CONCLUSION Our findings indicate that SARS-CoV-2 transmission is related to inpatient healthcare work, and illustrate the need for a high standard of basic hygiene routines in all inpatient care settings.
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Affiliation(s)
- Anna-Karin Lidström
- Department of Medical Sciences, Section of Infectious Diseases, Uppsala University, Uppsala, Sweden
| | - Fredrik Sund
- Department of Medical Sciences, Section of Infectious Diseases, Uppsala University, Uppsala, Sweden
| | - Bo Albinsson
- Laboratory of Clinical Microbiology, Uppsala University Hospital, Uppsala, Sweden
| | - Johan Lindbäck
- Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden
| | - Gabriel Westman
- Department of Medical Sciences, Section of Infectious Diseases, Uppsala University, Uppsala, Sweden
- CONTACT Gabriel Westman Department of Medical Sciences, Uppsala University, Uppsala, 751 85, Sweden
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18
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Wong NS, Lee SS, Kwan TH, Yeoh EK. Settings of virus exposure and their implications in the propagation of transmission networks in a COVID-19 outbreak. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2020; 4:100052. [PMID: 34013218 PMCID: PMC7649091 DOI: 10.1016/j.lanwpc.2020.100052] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 10/15/2020] [Accepted: 10/27/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Transmission dynamics of SARS-CoV-2 varied by the settings of virus exposure. Understanding the inter-relationship between exposure setting and transmission networks would provide a basis for informing public health control strategies. METHODS Surveillance and clinical data from the first wave of COVID-19 outbreaks in Hong Kong were accessed. Twelve exposure setting types were differentiated - household, neighbourhood, eateries, entertainment, parties, shopping, personalised service, workplace, education, worship, healthcare, transport. Clustering was investigated followed by reconstructing the transmission cascades of clustered cases using social networking approach. Linked and unlinked cases were compared in statistical analyses. FINDINGS Between 23 January and 19 June 2020, 1128 cases were reported. Among 324 cases related to local transmission, 123 clusters comprising two or more epidemiologically linked cases were identified. Linked cases had lower Ct value (p < 0·001) than unlinked cases. Households accounted for 63% of all clusters with half as primary setting, while entertainment accounted for the highest number of primary setting transmission cases. There were altogether 19 cascades involving >1 exposure setting, with a median reproduction number of 3(IQR: 2-4), versus 1(IQR:1-2) for cascades involving a single setting (n = 36 cascades). The longest cascade featured a bar (entertainment) as primary setting, with propagation through 30 non-primary exposure settings from seven setting types, reflecting, propensity for widespread dispersion and difficulty in containment. INTERPRETATION There was marked heterogeneity in the characteristics of SARS-CoV-2 transmission cascades which differed by exposure setting. Network epidemiological analyses of transmission cascades can be applied as a risk assessment tool in decision-making for calibrating social distancing measures. FUNDING Health and Medical Research Fund.
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Affiliation(s)
- Ngai Sze Wong
- Stanley Ho Centre for Emerging Infectious Diseases, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Shui Shan Lee
- Stanley Ho Centre for Emerging Infectious Diseases, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Tsz Ho Kwan
- Stanley Ho Centre for Emerging Infectious Diseases, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Eng-Kiong Yeoh
- Centre for Health Systems and Policy Research, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, China
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, China
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19
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Shultz JM, Kossin JP, Ali A, Borowy V, Fugate C, Espinel Z, Galea S. Superimposed threats to population health from tropical cyclones in the prevaccine era of COVID-19. Lancet Planet Health 2020; 4:e506-e508. [PMID: 33159875 DOI: 10.1016/s2542-5196(20)30250-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 09/25/2020] [Indexed: 05/05/2023]
Affiliation(s)
- James M Shultz
- Center for Disaster and Extreme Event Preparedness, Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL 33136, USA.
| | - James P Kossin
- NOAA's National Centers for Environmental Information, Center for Weather and Climate, Madison, WI, USA
| | - Aleeza Ali
- Herbert Wertheim College of Medicine, Miami, FL, USA
| | - Veronica Borowy
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | | | - Zelde Espinel
- Sylvester Comprehensive Cancer Center, Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Sandro Galea
- School of Public Health, Boston University, Boston, MA, USA
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20
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Kyriakopoulos AM, Papaefthymiou A, Georgilas N, Doulberis M, Kountouras J. The Potential Role of Super Spread Events in SARS-COV-2 Pandemic; a Narrative Review. ARCHIVES OF ACADEMIC EMERGENCY MEDICINE 2020; 8:e74. [PMID: 33134970 PMCID: PMC7587986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Coronaviruses, members of Coronaviridae family, cause extensive epidemics of vast diseases like severe acute respiratory syndrome (SARS) and Coronavirus Disease-19 (COVID-19) in animals and humans. Super spread events (SSEs) potentiate early outbreak of the disease and its constant spread in later stages. Viral recombination events within species and across hosts lead to natural selection based on advanced infectivity and resistance. In this review, the importance of containment of SSEs was investigated with emphasis on stopping COVID-19 spread and its socio-economic consequences. A comprehensive search was conducted among literature available in multiple electronic sources to find articles that addressed the "potential role of SSEs on severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) pandemic" and were published before 20th of August 2020. Overall, ninety-eight articles were found eligible and reviewed. Specific screening strategies within potential super spreading host groups can also help to efficiently manage severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) epidemics, in contrast to the partially effective general restriction measures. The effect of SSEs on previous SARS epidemics has been documented in detail. However, the respective potential impact of SSEs on SARS-COV-2 outbreak is composed and presented in the current review, thereby implying the warranted effort required for effective SSE preventive strategies, which may lead to overt global community health benefits. This is crucial for SARS-COV-2 pandemic containment as the vaccine(s) development process will take considerable time to safely establish its potential usefulness for future clinical usage.
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Affiliation(s)
- Anthony M. Kyriakopoulos
- Department of Research and Development, Nasco AD Biotechnology Laboratory, Piraeus 18536, Greece. ,Corresponding author: Anthony M. Kyriakopoulos; Department of Research and Development, Nasco AD Biotechnology Laboratory, 11 Sachtouri Str, Piraeus 18536, Greece. , Fax : 00309210818032
| | - Apostolis Papaefthymiou
- Department of Gastroenterology, University Hospital of Larisa, Larisa 41110, Greece.,Department of Internal Medicine, Second Medical Clinic, Ippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, 54642 Macedonia, Greece
| | - Nikolaos Georgilas
- Department of Nephrology, Agios Pavlos Hospital of Thessaloniki, Thessaloniki 55134, Macedonia, Greece
| | - Michael Doulberis
- Department of Internal Medicine, Second Medical Clinic, Ippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, 54642 Macedonia, Greece.,Division of Gastroenterology and Hepatology, University Medical Department Kantonsspital Aarau, Aarau 5001, Switzerland
| | - Jannis Kountouras
- Department of Internal Medicine, Second Medical Clinic, Ippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, 54642 Macedonia, Greece
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21
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Affiliation(s)
- Hans L Rieder
- Tuberculosis Consultant Services, Jetzikofenstr. 123038, Kirchlindach, Switzerland.
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