Healthcare policies, precautionary measures and outcomes of mass gathering events in the era of COVID-19 pandemic: Expedited review

Wastewater surveillance for SARS-CoV-2 during a mass sporting event in the City of Cape Town, Western Cape

Background

Wastewater surveillance has become an important public health tool with numerous research studies indicating its potential for monitoring coronavirus disease 2019 (COVID-19) outbreaks. The aim of this study was to apply wastewater surveillance as an indicator for COVID-19 to monitor the impact of a mass sporting event in the City of Cape Town. The study compared the same event over 2 years (2022 and 2023).

Methods

Weekly grab wastewater samples were collected from wastewater treatment plants in the City of Cape Town, and quantitative reverse transcription-polymerase chain reaction used to quantify severe acute respiratory syndrome 2 (SARS-CoV-2) RNA in wastewater.

Results

Our findings show a statistically significant correlation (rho = 0.68, p = 0.01) between clinical cases and concentrations of SARS-CoV-2 RNA in wastewater in the 2022 study period. During this specific period, a rise in clinical cases was observed 2 weeks after the event and the peaks in clinical cases coincided with the peaks in SARS-CoV-2 RNA level in wastewater. The study also found a statistically significant positive correlation (R 2 = 0.03, F (1,208) = 6.56, p = 0.01) between the SARS-CoV-2 RNA in wastewater and the 2022 event of the marathon hosted in the city.

Conclusion

Due to the decrease in clinical testing and the country being a popular destination for mass gatherings such as sporting events, the results from this study indicate the potential of wastewater surveillance providing supplementary information to form part of public health risk evaluations for mass gatherings.

Changes in the Presentation and Severity of Acute Appendicitis: A Comparison of the COVID-19 Pandemic and Post-Pandemic Eras

BACKGROUND

The restrictions during the COVID-19 pandemic, along with people's avoidance of hospital exposure, led to a reduction in medical consultations and delays in care seeking. Numerous reports have shown a decrease in the number of appendectomies performed and an increased incidence of complicated appendicitis during the pandemic. We aimed to investigate these findings during and after the cessation of COVID-19-related restrictions.

METHODS

This retrospective cohort study was conducted in a single centre, including consecutive adult patients who underwent appendectomy for acute appendicitis during three different periods: the pandemic cohort (7 March-30 June 2020), the post-pandemic cohort (7 March-30 June 2022) and the pre-pandemic control cohort (7 March-30 June 2019). A total of 103 patients were included and divided into the three cohorts. The patients' demographics, clinical presentation, investigations, and operative data were compared.

RESULTS

The three groups did not differ significantly regarding demographics, clinical characteristics, or the number of appendectomies. However, a duration of symptoms at presentation of less than 2 days was significantly more frequent in the pre-pandemic and post-pandemic groups than the pandemic group (p = 0.001). The interval between admission and operation was significantly shorter in the post-pandemic group than in the pandemic group. The pandemic group also showed a higher incidence of complicated appendicitis compared to the others (p = 0.025).

CONCLUSIONS

The termination of the COVID-19 pandemic and its related restrictions promoted the earlier presentation of acute appendicitis cases and lowered the incidence of complicated appendicitis. This emphasises the impact of the COVID-19 pandemic on acute appendicitis.

Shared social identity and social norms shape risk-taking at mass gatherings

Shared social identity and social norms are often un(der)recognized within mass gatherings health literature, yet they can increase infectious disease transmission by motivating people to engage in risk-taking behaviours. Across three experiments (Ntotal = 1551), we investigated how shared social identities, perceived norms of resource-sharing, and perceived riskiness of sharing interact to shape decisions that can lead to disease transmission. In Experiment 1 (N = 528), we examined how shared social identity and perceived descriptive norms affect the likelihood of crowd members sharing resources that may contribute to disease spread. We then replicated this in Experiment 2 (N = 511) using perceived injunctive norms. In Experiment 3 (N = 512), we explored how high shared social identity, perceived norms, and perceived health risks of resource-sharing impact the likelihood of sharing that may, in turn, increase infectious disease transmission at mass gatherings. We found that high shared social identity interacts with perceived descriptive and injunctive norms, and low health risk perceptions, to increase the likelihood of accepting resources and giving resources at mass gatherings. We discuss the theoretical and practical implications for researchers, practitioners, and policymakers to build effective strategies to mitigate infectious disease transmission at mass gatherings.

Trends of fear and anger on YouTube during the initial stage of the COVID-19 outbreak in South Korea

BACKGROUND

The COVID-19 pandemic has been the most widespread and threatening health crisis experienced by the Korean society. Faced with an unprecedented threat to survival, society has been gripped by social fear and anger, questioning the culpability of this pandemic. This study explored the correlation between social cognitions and negative emotions and their changes in response to the severe events stemming from the COVID-19 pandemic in South Korea.

METHODS

The analysis was based on a cognitive-emotional model that links fear and anger to the social causes that trigger them and used discursive content from comments posted on YouTube's COVID-19-related videos. A total of 182,915 comments from 1,200 videos were collected between January and December 2020. We performed data analyses and visualizations using R, Netminer 4.0, and Gephi software and calculated Pearson's correlation coefficients between emotions.

RESULTS

YouTube videos were analyzed for keywords indicating cognitive assessments of major events related to COVID-19 and keywords indicating negative emotions. Eight topics were identified through topic modeling: causes and risks, perceptions of China, media and information, infection prevention rules, economic activity, school and infection, political leaders, and religion, politics, and infection. The correlation coefficient between fear and anger was 0.462 (p < .001), indicating a moderate linear relationship between the two emotions. Fear was the highest from January to March in the first year of the COVID-19 outbreak, while anger occurred before and after the outbreak, with fluctuations in both emotions during this period.

CONCLUSIONS

This study confirmed that social cognitions and negative emotions are intertwined in response to major events related to the COVID-19 pandemic, with each emotion varying individually rather than being ambiguously mixed. These findings could aid in developing social cognition-emotion-based public health strategies through education and communication during future pandemic outbreaks.

Investigation of an international water polo tournament in Czechia as a potential source for early introduction of the SARS-CoV-2 Omicron variant into Belgium, Switzerland and Germany, November 2021

BackgroundThe earliest recognised infections by the SARS-CoV-2 Omicron variant (Pango lineage B.1.1.529) in Belgium and Switzerland suggested a connection to an international water polo tournament, held 12-14 November 2021 in Brno, Czechia.AimTo study the arrival and subsequent spread of the Omicron variant in Belgium and Switzerland, and understand the overall importance of this international sporting event on the number of infections in the two countries.MethodsWe performed intensive forward and backward contact tracing in both countries, supplemented by phylogenetic investigations using virus sequences of the suspected infection chain archived in public databases.ResultsThrough contact tracing, we identified two and one infected athletes of the Belgian and Swiss water polo teams, respectively, and subsequently also three athletes from Germany. In Belgium and Switzerland, four and three secondary infections, and three and one confirmed tertiary infections were identified. Phylogenetic investigation demonstrated that this sporting event played a role as the source of infection, but without a direct link with infections from South Africa and not as a superspreading event; the virus was found to already be circulating at that time in the countries involved.ConclusionThe SARS-CoV-2 Omicron variant started to circulate in Europe several weeks before its identification in South Africa on 24 November 2021. Accordingly, it can be assumed that travel restrictions are usually implemented too late to prevent the spread of newly detected SARS-CoV-2 variants to other regions. Phylogenetic analysis may modify the perception of an apparently clear result of intensive contact tracing.