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Alrawas L, Tridane A, Benrhmach G. A novel approach to model the role of mobility suppression and vaccinations in containing epidemics in a network of cities. Infect Dis Model 2024; 9:397-410. [PMID: 38385016 PMCID: PMC10879667 DOI: 10.1016/j.idm.2024.01.005] [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: 10/05/2023] [Revised: 12/12/2023] [Accepted: 01/14/2024] [Indexed: 02/23/2024] Open
Abstract
This paper presents a comprehensive agent-based model for the spread of an infection in a network of cities. Directional mobility is defined between each two cities and can take different values. The work examines the role that such mobility levels play in containing the infection with various vaccination coverage and age distributions. The results indicate that mobility reduction is sufficient to control the disease under all circumstances and full lockdowns are not a necessity. It has to be reduced to different ratios depending on the vaccination level and age distribution. A key finding is that increasing vaccination coverage above a certain level does not affect the mobility suppression level required to control the infection anymore for the cases of young population and heterogeneous age distributions. By investigating several migration and commuting patterns, it is found that shutting mobility in a few local places is favored against reducing mobility over the entire country network. In addition, commuting -and not migration-influences the spread level of the infection. The work offers an exclusive combined network-based and agent-based model that makes use of randomly generated mobility matrices.
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Affiliation(s)
- Leen Alrawas
- Department of Physics, New York University Abu Dhabi, Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Abdessamad Tridane
- Department of Mathematical Sciences, United Arab Emirates University, Al Ain, Abu Dhabi, United Arab Emirates
- Emirates Center for Mobility Research, United Arab Emirates University, Al Ain, Abu Dhabi, United Arab Emirates
| | - Ghassane Benrhmach
- Department of Statistics and Business Analytics, United Arab Emirates University, Al Ain, Abu Dhabi, United Arab Emirates
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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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Nisar MI, Ansari N, Amin M, Khalid F, Shahid S, Mahesar M, Mansoor M, Qazi MF, Hotwani A, Rehman N, Ashraf A, Ahmed Z, Ahmed A, Memon A, Jehan F. Secondary attack rates and determinants of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) household transmission in Pakistan: A case-ascertained prospective, longitudinal study. J Infect Public Health 2024; 17:889-896. [PMID: 38564817 PMCID: PMC11009119 DOI: 10.1016/j.jiph.2024.03.024] [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: 03/01/2023] [Revised: 03/13/2024] [Accepted: 03/21/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Households are considered ideal settings for studying the transmission dynamics of an infectious disease. METHODS A prospective study was conducted, based on the World Health Organization FFX protocol from October 2020 to January,2021. Household contacts of laboratory-confirmed index cases were followed up for their symptomatic history, nasal swabs for RT-PCR,and blood samples for anti-SARS CoV-2 antibodies were collected at enrollment and days 7, 14 and 28. We estimated secondary attack rate (SAR), effective household case cluster size and determinants of secondary infection among susceptible household contacts using multivariable logistic regression. RESULTS We enrolled 77 index cases and their 543 contacts. Out of these, 252 contacts were susceptible at the time of enrollment. There were 77 household clusters, out of which, transmission took place in 20 (25.9%) giving rise to 34 cases. The acquired secondary attack rate (SAR) was 14.0% (95% CI 9.0-18.0). The effective household case cluster size was 0.46 (95%CI 0.33,0.56). Reported symptoms of nausea and vomiting (aOR, 7.9; 95% CI, 1.4-45.5) and fatigue (aOR, 9.3; 95% CI, 3.8-22.7) were associated with SARS-CoV-2 transmission. CONCLUSIONS We observed a low SARS-CoV-2 secondary attack rate in the backdrop of high seroprevalence and asymptomatic transmission among households in Karachi, Pakistan.
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Affiliation(s)
- Muhammad Imran Nisar
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan.
| | - Nadia Ansari
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Mashal Amin
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Farah Khalid
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Shahira Shahid
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Marvi Mahesar
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Maryam Mansoor
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | | | - Aneeta Hotwani
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Najeeb Rehman
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Arslan Ashraf
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Zahoor Ahmed
- Health Department, Government of Sindh, Karachi, Pakistan
| | - Ashfaque Ahmed
- Health Department, Government of Sindh, Karachi, Pakistan
| | - Arslan Memon
- Health Department, Government of Sindh, Karachi, Pakistan
| | - Fyezah Jehan
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
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Johannesen N, Tang-Andersen Martinello A, Meyer BB, Vestergaard ET, Andersen AL, Jensen TL. Substantial transmission of SARS-CoV-2 through casual contact in retail stores: Evidence from matched administrative microdata on card payments and testing. Proc Natl Acad Sci U S A 2024; 121:e2317589121. [PMID: 38630715 PMCID: PMC11047087 DOI: 10.1073/pnas.2317589121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 03/21/2024] [Indexed: 04/19/2024] Open
Abstract
This paper presents quasiexperimental evidence of Covid-19 transmission through casual contact between customers in retail stores. For a large sample of individuals in Denmark, we match card payment data, indicating exactly where and when each individual made purchases, with Covid-19 test data, indicating when each individual was tested and whether the test was positive. The resulting dataset identifies more than 100,000 instances where an infected individual made a purchase in a store and, in each instance, allows us to track the infection dynamics of other individuals who made purchases in the same store around the same time. We estimate transmissions by comparing the infection rate of exposed customers, who made a purchase within 5 min of an infected individual, and nonexposed customers, who made a purchase in the same store 16 to 30 min before. We find that exposure to an infected individual in a store increases the infection rate by around 0.12 percentage points (P < 0.001) between day 3 and day 7 after exposure. The estimates imply that transmissions in stores contributed around 0.04 to the reproduction number for the average infected individual and significantly more in the period where Omicron was the dominant variant.
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Affiliation(s)
- Niels Johannesen
- Saïd Business School, Oxford University, OxfordOX1 1HP, United Kingdom
- Department of Economics, University of Copenhagen, CopenhagenK 1353, Denmark
- Center for Economic Behavior and Inequality, University of Copenhagen, CopenhagenK 1353, Denmark
| | | | | | | | - Asger Lau Andersen
- Department of Economics, University of Copenhagen, CopenhagenK 1353, Denmark
- Center for Economic Behavior and Inequality, University of Copenhagen, CopenhagenK 1353, Denmark
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Gohil VS, Shah VR, Shukla RP. Household secondary attack rate amongst the susceptible contacts of COVID-19 cases and its epidemiological profile: A retrospective study from central Gujarat, India. J Family Med Prim Care 2024; 13:1448-1453. [PMID: 38827718 PMCID: PMC11141985 DOI: 10.4103/jfmpc.jfmpc_1474_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 12/13/2023] [Accepted: 12/17/2023] [Indexed: 06/04/2024] Open
Abstract
Introduction Secondary attack rate (SAR) is a proportion of primary contacts developing the diseases within the incubation period upon exposure to a primary case among the total susceptible household contacts. The epidemiological profile and SAR will help in understanding the transmission dynamics of COVID-19 for further strengthening preventive and effective control measures. Objectives of the Study The study was conducted with the primary objective to estimate the household SAR of COVID-19 cases at Mahisagar District, Gujarat, and to study the epidemiological profile of primary and secondary cases of COVID-19. Methodology A retrospective study was conducted to estimate SAR among 245 confirmed cases of COVID-19 and 898 susceptible household contacts in Mahisagar district through telephonic interview and questionnaire by the Investigator team. Results The household SAR was calculated from the current study in Mahisagar district, Gujarat, and was 13.9%. Among primary cases, 74.7% males were affected, and among secondary cases, 52.8% females were affected. The SAR among elderly was 23.9%, and the SAR among children was 3.9%. 74.1% household contacts had developed disease among symptomatic contacts as compared to asymptomatic household contacts. Conclusion The household SAR in Mahisagar district, Gujarat, was found to be 13.9%. In primary cases, more males, and in secondary cases, more females were found to be affected. The household SAR was increased in elderly as compared to the younger age group. The SAR was more among the contacts of symptomatic cases than asymptomatic cases. Overall hospitalization in public hospitals was more than that in private hospitals.
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Affiliation(s)
- Vaidehi S. Gohil
- Community Medicine Department, Dr. M. K. Shah Medical College, Ahmedabad, Gujarat, India
| | - Venu R. Shah
- Community Medicine Department GCS Medical College, Ahmedabad, Gujarat, India
| | - Rujul P. Shukla
- Community Medicine Department, Ananya Medical College, Ahmedabad, Gujarat, India
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Ma T, Chen C, Wang J, Wang H, Zhao Y, Zhu Y, Yan Z, Ding S, Ding J. Parametric analysis of the transmission dynamics during indigenous aggregated outbreaks caused by five SARS-CoV-2 strains in Nanjing, China. Front Public Health 2024; 12:1358577. [PMID: 38525336 PMCID: PMC10959284 DOI: 10.3389/fpubh.2024.1358577] [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: 12/20/2023] [Accepted: 02/26/2024] [Indexed: 03/26/2024] Open
Abstract
Background SARS-CoV-2 strains have been of great concern due to their high infectivity and antibody evasion. Methods In this study, data were collected on indigenous aggregated outbreaks in Nanjing from January 2020 to December 2022, caused by five strains including the original strain, the Delta variant, and the Omicron variant (BA.2, BA.5.2, and BF.7). The basic epidemiological characteristics of infected individuals were described and then parametric analysis of transmission dynamics was performed, including the calculation of incubation period, serial interval (SI), the basic reproductive number (R0), and the household secondary attack rate (HSAR). Finally, we compared the trends of transmission dynamic parameters of different strains. Results The incubation period for the original strain, the Delta variant, Omicron BA.2, Omicron BA.5.2, and Omicron BF.7 were 6 d (95% CI: 3.5-7.5 d), 5 d (95% CI: 4.0-6.0 d), 3 d (95% CI: 3.0-4.0 d), 3 d (95% CI: 3.0-3.0 d), and 2 d (95% CI: 2.0-3.0 d), respectively; Also, the SI of the five strains were 5.69 d, 4.79 d, 2.7 d, 2.12 d, and 2.43 d, respectively. Notably, the incubation period and SI of the five had both a progressive shortening trend (p < 0.001); Moreover, R0 of the five were 2.39 (95% CI: 1.30-4.29), 3.73 (95% CI: 2.66-5.15), 5.28 (95% CI: 3.52-8.10), 5.54 (95% CI: 2.69-11.17), 7.39 (95% CI: 2.97-18.76), with an increasing trend gradually (p < 0.01); HSAR of the five were 25.5% (95% CI: 20.1-31.7%), 27.4% (95% CI: 22.0-33.4%), 42.9% (95% CI: 34.3-51.8%), 53.1% (95% CI: 45.0-60.9%), 41.4% (95% CI, 25.5-59.3%), also with an increasing trend (p < 0.001). Conclusion Compared to the original strain, the incubation period and SI decreased while R0 and HSAR increased, suggesting that transmission in the population was faster and the scope of the population was wider. Overall, it's crucial to keep implementing comprehensive measures like monitoring and alert systems, herd immunization plans, and outbreak control.
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Affiliation(s)
- Tao Ma
- Department of Acute Infectious Diseases Control and Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China
| | - Cong Chen
- Wujin District Center for Disease Control and Prevention, Changzhou, China
- Jiangsu Field Epidemiology Training Program, Jiangsu Provincial Centre for Disease Control and Prevention, Nanjing, China
| | - Junjun Wang
- Department of Acute Infectious Diseases Control and Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China
| | - Hengxue Wang
- Department of Acute Infectious Diseases Control and Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China
| | - Yueyuan Zhao
- Department of Acute Infectious Diseases Control and Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China
| | - Yuanzhao Zhu
- Department of Acute Infectious Diseases Control and Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China
| | - Zikang Yan
- Department of Acute Infectious Diseases Control and Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China
| | - Songning Ding
- Department of Acute Infectious Diseases Control and Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China
| | - Jie Ding
- Department of Acute Infectious Diseases Control and Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China
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Pung R, Russell TW, Kucharski AJ. Detecting changes in generation and serial intervals under varying pathogen biology, contact patterns and outbreak response. PLoS Comput Biol 2024; 20:e1011967. [PMID: 38517931 PMCID: PMC10990235 DOI: 10.1371/journal.pcbi.1011967] [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: 06/25/2023] [Revised: 04/03/2024] [Accepted: 03/04/2024] [Indexed: 03/24/2024] Open
Abstract
The epidemiological characteristics of SARS-CoV-2 transmission have changed over the pandemic due to emergence of new variants. A decrease in the generation or serial intervals would imply a shortened transmission timescale and, hence, outbreak response measures would need to expand at a faster rate. However, there are challenges in measuring these intervals. Alongside epidemiological changes, factors like varying delays in outbreak response, social contact patterns, dependence on the growth phase of an outbreak, and effects of exposure to multiple infectors can also influence measured generation or serial intervals. To guide real-time interpretation of variant data, we simulated concurrent changes in the aforementioned factors and estimated the statistical power to detect a change in the generation and serial interval. We compared our findings to the reported decrease or lack thereof in the generation and serial intervals of different SARS-CoV-2 variants. Our study helps to clarify contradictory outbreak observations and informs the required sample sizes under certain outbreak conditions to ensure that future studies of generation and serial intervals are adequately powered.
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Affiliation(s)
- Rachael Pung
- Ministry of Health, Singapore, Singapore
- Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Timothy W. Russell
- Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Adam J. Kucharski
- Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Seabra SG, Merca F, Pereira B, Fonseca I, Carvalho AC, Brito V, Alves D, Libin P, Martins MRO, Miranda MNS, Pingarilho M, Pimentel V, Abecasis AB. Serological screening in a large-scale municipal survey in Cascais, Portugal, during the first waves of the COVID-19 pandemic: lessons for future pandemic preparedness efforts. Front Public Health 2024; 12:1326125. [PMID: 38371240 PMCID: PMC10869482 DOI: 10.3389/fpubh.2024.1326125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 01/11/2024] [Indexed: 02/20/2024] Open
Abstract
Background Serological surveys for SARS-CoV-2 were used early in the COVID-19 pandemic to assess epidemiological scenarios. In the municipality of Cascais (Portugal), serological testing combined with a comprehensive socio-demographic, clinical and behavioral questionnaire was offered to residents between May 2020 and beginning of 2021. In this study, we analyze the factors associated with adherence to this municipal initiative, as well as the sociodemographic profile and chronic diseases clinical correlates associated to seropositivity. We aim to contribute with relevant information for future pandemic preparedness efforts. Methods This was a cross-sectional study with non-probabilistic sampling. Citizens residing in Cascais Municipality went voluntarily to blood collection centers to participate in the serological survey. The proportion of participants, stratified by socio-demographic variables, was compared to the census proportions to identify the groups with lower levels of adherence to the survey. Univariate and multivariate logistic regression were used to identify socio-demographic, clinical and behavioral factors associated with seropositivity. Results From May 2020 to February 2021, 19,608 participants (9.2% of the residents of Cascais) were included in the study. Based on the comparison to census data, groups with lower adherence to this survey were men, the youngest and the oldest age groups, individuals with lower levels of education and unemployed/inactive. Significant predictors of a reactive (positive) serological test were younger age, being employed or a student, and living in larger households. Individuals with chronic diseases generally showed lower seroprevalence. Conclusion The groups with low adherence to this voluntary study, as well as the socio-economic contexts identified as more at risk of viral transmission, may be targeted in future pandemic situations. We also found that the individuals with chronic diseases, perceiving higher risk of serious illness, adopted protective behaviors that limited infection rates, revealing that health education on preventive measures was effective for these patients.
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Affiliation(s)
- Sofia G. Seabra
- Global Health and Tropical Medicine, GHTM, Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, Instituto de Higiene e Medicina Tropical, IHMT, Universidade NOVA de Lisboa, UNL, Rua da Junqueira 100, Lisbon, Portugal
| | - Francisco Merca
- Global Health and Tropical Medicine, GHTM, Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, Instituto de Higiene e Medicina Tropical, IHMT, Universidade NOVA de Lisboa, UNL, Rua da Junqueira 100, Lisbon, Portugal
- Artificial Intelligence Research Lab, Vrije Universiteit Brussels (VUB), Pleinlaan 2, Brussel, Belgium
| | - Bernardo Pereira
- Global Health and Tropical Medicine, GHTM, Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, Instituto de Higiene e Medicina Tropical, IHMT, Universidade NOVA de Lisboa, UNL, Rua da Junqueira 100, Lisbon, Portugal
| | - Ivo Fonseca
- Global Health and Tropical Medicine, GHTM, Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, Instituto de Higiene e Medicina Tropical, IHMT, Universidade NOVA de Lisboa, UNL, Rua da Junqueira 100, Lisbon, Portugal
| | | | - Vera Brito
- Câmara Municipal de Cascais, Cascais, Portugal
| | - Daniela Alves
- Global Health and Tropical Medicine, GHTM, Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, Instituto de Higiene e Medicina Tropical, IHMT, Universidade NOVA de Lisboa, UNL, Rua da Junqueira 100, Lisbon, Portugal
| | - Pieter Libin
- Artificial Intelligence Research Lab, Vrije Universiteit Brussels (VUB), Pleinlaan 2, Brussel, Belgium
- Interuniversity Institute of Biostatistics and Statistical Bioinformatics, Data Science Institute, Hasselt University, Hasselt, Belgium
| | - M. Rosário O. Martins
- Global Health and Tropical Medicine, GHTM, Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, Instituto de Higiene e Medicina Tropical, IHMT, Universidade NOVA de Lisboa, UNL, Rua da Junqueira 100, Lisbon, Portugal
| | - Mafalda N. S. Miranda
- Global Health and Tropical Medicine, GHTM, Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, Instituto de Higiene e Medicina Tropical, IHMT, Universidade NOVA de Lisboa, UNL, Rua da Junqueira 100, Lisbon, Portugal
| | - Marta Pingarilho
- Global Health and Tropical Medicine, GHTM, Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, Instituto de Higiene e Medicina Tropical, IHMT, Universidade NOVA de Lisboa, UNL, Rua da Junqueira 100, Lisbon, Portugal
| | - Victor Pimentel
- Global Health and Tropical Medicine, GHTM, Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, Instituto de Higiene e Medicina Tropical, IHMT, Universidade NOVA de Lisboa, UNL, Rua da Junqueira 100, Lisbon, Portugal
| | - Ana B. Abecasis
- Global Health and Tropical Medicine, GHTM, Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, Instituto de Higiene e Medicina Tropical, IHMT, Universidade NOVA de Lisboa, UNL, Rua da Junqueira 100, Lisbon, Portugal
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Boldea O, Alipoor A, Pei S, Shaman J, Rozhnova G. Age-specific transmission dynamics of SARS-CoV-2 during the first 2 years of the pandemic. PNAS NEXUS 2024; 3:pgae024. [PMID: 38312225 PMCID: PMC10837015 DOI: 10.1093/pnasnexus/pgae024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 01/09/2024] [Indexed: 02/06/2024]
Abstract
During its first 2 years, the SARS-CoV-2 pandemic manifested as multiple waves shaped by complex interactions between variants of concern, non-pharmaceutical interventions, and the immunological landscape of the population. Understanding how the age-specific epidemiology of SARS-CoV-2 has evolved throughout the pandemic is crucial for informing policy decisions. In this article, we aimed to develop an inference-based modeling approach to reconstruct the burden of true infections and hospital admissions in children, adolescents, and adults over the seven waves of four variants (wild-type, Alpha, Delta, and Omicron BA.1) during the first 2 years of the pandemic, using the Netherlands as the motivating example. We find that reported cases are a considerable underestimate and a generally poor predictor of true infection burden, especially because case reporting differs by age. The contribution of children and adolescents to total infection and hospitalization burden increased with successive variants and was largest during the Omicron BA.1 period. However, the ratio of hospitalizations to infections decreased with each subsequent variant in all age categories. Before the Delta period, almost all infections were primary infections occurring in naive individuals. During the Delta and Omicron BA.1 periods, primary infections were common in children but relatively rare in adults who experienced either reinfections or breakthrough infections. Our approach can be used to understand age-specific epidemiology through successive waves in other countries where random community surveys uncovering true SARS-CoV-2 dynamics are absent but basic surveillance and statistics data are available.
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Affiliation(s)
- Otilia Boldea
- Department of Econometrics and OR, Tilburg School of Economics and Management, Tilburg University, Tilburg 5037 AB, The Netherlands
| | - Amir Alipoor
- Department of Econometrics and OR, Tilburg School of Economics and Management, Tilburg University, Tilburg 5037 AB, The Netherlands
| | - Sen Pei
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
| | - Jeffrey Shaman
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
- Columbia Climate School, Columbia University, New York, NY 10025, USA
| | - Ganna Rozhnova
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht 3584 CX, The Netherlands
- Center for Complex Systems Studies (CCSS), Utrecht University, Utrecht 3584 CE, The Netherlands
- Faculdade de Ciências, Universidade de Lisboa, Lisbon PT1749-016, Portugal
- BioISI—Biosystems & Integrative Sciences Institute, Faculdade de Ciências, Universidade de Lisboa, Lisbon PT1749-016, Portugal
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Muhsen K, Waight PA, Kirsebom F, Andrews N, Letley L, Gower CM, Skarnes C, Quinot C, Lunt R, Bernal JL, Flasche S, Miller E. Association between COVID-19 Vaccination and SARS-CoV-2 Infection among Household Contacts of Infected Individuals: A Prospective Household Study in England. Vaccines (Basel) 2024; 12:113. [PMID: 38400097 PMCID: PMC10892628 DOI: 10.3390/vaccines12020113] [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: 12/04/2023] [Revised: 01/07/2024] [Accepted: 01/18/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND We investigated whether COVID-19 vaccination reduced SARS-CoV-2 infection risk among adult household contacts of COVID-19 index cases during the Alpha, Delta, and Omicron waves in England. METHODS Between February 2021 and February 2022, SARS-CoV-2 RT-PCR nasal swabs were collected from COVID-19-confirmed index cases aged ≥20 years and their household contacts at enrolment and three and seven days thereafter. Generalized Estimating Equations models were fitted with SARS-CoV-2 positivity as the outcome and household contacts' vaccination status as the main exposure while adjusting for confounders. RESULTS SARS-CoV-2 infection was confirmed in 238/472 household contacts (50.4%) aged ≥20 years. The adjusted relative risk (95% confidence interval) of infection in vaccinated versus unvaccinated household contacts was 0.50 (0.35-0.72) and 0.69 (0.53-0.90) for receipt of two doses 8-90 and >90 days ago, respectively, and 0.34 (0.23-0.50) for vaccination with three doses 8-151 days ago. Primary vaccination protected household contacts against infection during the Alpha and Delta waves, but only three doses protected during the Omicron wave. Vaccination with three doses in the index case independently reduced contacts' infection risk: 0.45 (0.23-0.89). CONCLUSIONS Vaccination of household contacts reduces their risk of infection under conditions of household exposure though, for Omicron, only after a booster dose.
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Affiliation(s)
- Khitam Muhsen
- Department of Epidemiology and Preventive Medicine, School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv 6139001, Israel
- London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK; (S.F.); (E.M.)
| | - Pauline A. Waight
- UK Health Security Agency, 61 Colindale Avenue, London NW9 5EU, UK; (P.A.W.); (F.K.); (N.A.); (C.S.); (J.L.B.)
| | - Freja Kirsebom
- UK Health Security Agency, 61 Colindale Avenue, London NW9 5EU, UK; (P.A.W.); (F.K.); (N.A.); (C.S.); (J.L.B.)
| | - Nick Andrews
- UK Health Security Agency, 61 Colindale Avenue, London NW9 5EU, UK; (P.A.W.); (F.K.); (N.A.); (C.S.); (J.L.B.)
| | - Louise Letley
- UK Health Security Agency, 61 Colindale Avenue, London NW9 5EU, UK; (P.A.W.); (F.K.); (N.A.); (C.S.); (J.L.B.)
| | - Charlotte M. Gower
- UK Health Security Agency, 61 Colindale Avenue, London NW9 5EU, UK; (P.A.W.); (F.K.); (N.A.); (C.S.); (J.L.B.)
| | - Catriona Skarnes
- UK Health Security Agency, 61 Colindale Avenue, London NW9 5EU, UK; (P.A.W.); (F.K.); (N.A.); (C.S.); (J.L.B.)
| | - Catherine Quinot
- UK Health Security Agency, 61 Colindale Avenue, London NW9 5EU, UK; (P.A.W.); (F.K.); (N.A.); (C.S.); (J.L.B.)
| | - Rachel Lunt
- UK Health Security Agency, 61 Colindale Avenue, London NW9 5EU, UK; (P.A.W.); (F.K.); (N.A.); (C.S.); (J.L.B.)
| | - Jamie Lopez Bernal
- UK Health Security Agency, 61 Colindale Avenue, London NW9 5EU, UK; (P.A.W.); (F.K.); (N.A.); (C.S.); (J.L.B.)
- NIHR Health Protection Research Unit in Respiratory Infections, Imperial College London, London SW7 2AZ, UK
| | - Stefan Flasche
- London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK; (S.F.); (E.M.)
| | - Elizabeth Miller
- London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK; (S.F.); (E.M.)
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11
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Huguet-Torres A, Castro-Sánchez E, Capitán-Moyano L, Sánchez-Rodríguez C, Bennasar-Veny M, Yáñez AM. Personal protective measures and settings on the risk of SARS-COV-2 community transmission: a case-control study. Front Public Health 2024; 11:1327082. [PMID: 38259788 PMCID: PMC10801386 DOI: 10.3389/fpubh.2023.1327082] [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: 10/24/2023] [Accepted: 12/14/2023] [Indexed: 01/24/2024] Open
Abstract
Background During the SARS-CoV-2 pandemic, nurses of primary health care has been an important role in Spain. Even so, the data obtained in the tracing have been scarcely used to investigate the possible mechanisms of transmission. Few studies focused on community transmission, evaluating the effectiveness of individual protective measures and exposure environment. The main aim of the study was to evaluate the association between individual protective measures and SARS-CoV-2 transmission in the community and to compare secondary attack rates in different exposure settings. Methods A case-control study from contact tracing of SARS-CoV-2 index patients. COVID-19 contact tracing was led by nurses at the COVID-19 Coordinating Centre in Majorca (Spain). During the systematic tracing, additional information for this study was collected from the index patient (social-demographic variables, symptoms, the number of close contacts). And also, the following variables from their close contacts: contact place, ventilation characteristics mask-wearing, type of mask, duration of contact, shortest distance, case-contact relationship, household members, and handwashing, the test result for SARS-CoV-2 diagnostic. Close contacts with a positive test for SARS-CoV-2 were classified as "cases" and those negative as "controls." Results A total of 1,778 close contacts from 463 index patients were identified. No significant differences were observed between the sexes but between age groups. Overall Secondary Attack Rate (SAR) was 24.0% (95% CI: 22.0-26.0%), 36.9% (95% CI: 33.2-40.6%) in closed spaces without ventilation and 50.7% (95% CI: 45.6-55.8%) in exposure time > 24 h. A total of 49.2% of infections occurred among household members. Multivariate logistic regression analysis showed that open-air setting (OR 0.43, 95% CI: 0.27-0.71), exposure for less than 1 h (OR 0.19, 95% CI: 0.11-0.32), and wearing a mask (OR 0.49, 95% CI: 0.28-0.85) had a protective effect transmission of SARS-CoV-2 in the community. Conclusion Ventilation of the space, mask-wearing and shorter exposure time were associated with a lower risk of transmission in the community. The data obtained allowed an assessment of community transmission mechanisms and could have helped to improve and streamline tracing by identifying close contacts at higher risk.
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Affiliation(s)
- Aina Huguet-Torres
- Department of Nursing and Physiotherapy, University of Balearic Islands, Palma, Spain
- Research Group on Global Health, University of Balearic Islands, Palma, Spain
| | - Enrique Castro-Sánchez
- Research Group on Global Health, University of Balearic Islands, Palma, Spain
- College of Business, Arts, and Social Sciences, Brunel University London, Uxbridge, United Kingdom
- Imperial College London, London, United Kingdom
| | - Laura Capitán-Moyano
- Department of Nursing and Physiotherapy, University of Balearic Islands, Palma, Spain
- Research Group on Global Health, University of Balearic Islands, Palma, Spain
| | - Cristian Sánchez-Rodríguez
- Research Group on Global Health, University of Balearic Islands, Palma, Spain
- Hospital Sant Joan de Déu, Palma, Spain
| | - Miquel Bennasar-Veny
- Department of Nursing and Physiotherapy, University of Balearic Islands, Palma, Spain
- Research Group on Global Health, University of Balearic Islands, Palma, Spain
- Research Group on Global Health and Lifestyle, Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Carlos III Institute of Health (ISCIII), Madrid, Spain
| | - Aina M Yáñez
- Department of Nursing and Physiotherapy, University of Balearic Islands, Palma, Spain
- Research Group on Global Health, University of Balearic Islands, Palma, Spain
- Research Group on Global Health and Lifestyle, Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
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12
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Chung MK, Hart B, Santillana M, Patel CJ. Pediatric and Young Adult Household Transmission of the Initial Waves of SARS-CoV-2 in the United States: Administrative Claims Study. J Med Internet Res 2024; 26:e44249. [PMID: 37967280 PMCID: PMC10768807 DOI: 10.2196/44249] [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: 11/11/2022] [Revised: 07/18/2023] [Accepted: 10/29/2023] [Indexed: 11/17/2023] Open
Abstract
BACKGROUND The correlates responsible for the temporal changes of intrahousehold SARS-CoV-2 transmission in the United States have been understudied mainly due to a lack of available surveillance data. Specifically, early analyses of SARS-CoV-2 household secondary attack rates (SARs) were small in sample size and conducted cross-sectionally at single time points. From these limited data, it has been difficult to assess the role that different risk factors have had on intrahousehold disease transmission in different stages of the ongoing COVID-19 pandemic, particularly in children and youth. OBJECTIVE This study aimed to estimate the transmission dynamic and infectivity of SARS-CoV-2 among pediatric and young adult index cases (age 0 to 25 years) in the United States through the initial waves of the pandemic. METHODS Using administrative claims, we analyzed 19 million SARS-CoV-2 test records between January 2020 and February 2021. We identified 36,241 households with pediatric index cases and calculated household SARs utilizing complete case information. Using a retrospective cohort design, we estimated the household SARS-CoV-2 transmission between 4 index age groups (0 to 4 years, 5 to 11 years, 12 to 17 years, and 18 to 25 years) while adjusting for sex, family size, quarter of first SARS-CoV-2 positive record, and residential regions of the index cases. RESULTS After filtering all household records for greater than one member in a household and missing information, only 36,241 (0.85%) of 4,270,130 households with a pediatric case remained in the analysis. Index cases aged between 0 and 17 years were a minority of the total index cases (n=11,484, 11%). The overall SAR of SARS-CoV-2 was 23.04% (95% CI 21.88-24.19). As a comparison, the SAR for all ages (0 to 65+ years) was 32.4% (95% CI 32.1-32.8), higher than the SAR for the population between 0 and 25 years of age. The highest SAR of 38.3% was observed in April 2020 (95% CI 31.6-45), while the lowest SAR of 15.6% was observed in September 2020 (95% CI 13.9-17.3). It consistently decreased from 32% to 21.1% as the age of index groups increased. In a multiple logistic regression analysis, we found that the youngest pediatric age group (0 to 4 years) had 1.69 times (95% CI 1.42-2.00) the odds of SARS-CoV-2 transmission to any family members when compared with the oldest group (18 to 25 years). Family size was significantly associated with household viral transmission (odds ratio 2.66, 95% CI 2.58-2.74). CONCLUSIONS Using retrospective claims data, the pediatric index transmission of SARS-CoV-2 during the initial waves of the COVID-19 pandemic in the United States was associated with location and family characteristics. Pediatric SAR (0 to 25 years) was less than the SAR for all age other groups. Less than 1% (n=36,241) of all household data were retained in the retrospective study for complete case analysis, perhaps biasing our findings. We have provided measures of baseline household pediatric transmission for tracking and comparing the infectivity of later SARS-CoV-2 variants.
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Affiliation(s)
- Ming Kei Chung
- Department of Biomedical Informatics, Harvard Medical School, Harvard University, Boston, MA, United States
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
- Institute of Environment, Energy, and Sustainability, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Brian Hart
- Optum Labs, Eden Prairie, MN, United States
| | - Mauricio Santillana
- Machine Intelligence Group for the Betterment of Health and the Environment, Network Science Institute, Northeastern University, Boston, MA, United States
| | - Chirag J Patel
- Department of Biomedical Informatics, Harvard Medical School, Harvard University, Boston, MA, United States
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13
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Chan LYH, Rø G, Midtbø JE, Di Ruscio F, Watle SSV, Juvet LK, Littmann J, Aavitsland P, Nygård KM, Berg AS, Bukholm G, Kristoffersen AB, Engø-Monsen K, Engebretsen S, Swanson D, Palomares ADL, Lindstrøm JC, Frigessi A, de Blasio BF. Modeling geographic vaccination strategies for COVID-19 in Norway. PLoS Comput Biol 2024; 20:e1011426. [PMID: 38295111 PMCID: PMC10861074 DOI: 10.1371/journal.pcbi.1011426] [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: 08/10/2023] [Revised: 02/12/2024] [Accepted: 01/08/2024] [Indexed: 02/02/2024] Open
Abstract
Vaccination was a key intervention in controlling the COVID-19 pandemic globally. In early 2021, Norway faced significant regional variations in COVID-19 incidence and prevalence, with large differences in population density, necessitating efficient vaccine allocation to reduce infections and severe outcomes. This study explored alternative vaccination strategies to minimize health outcomes (infections, hospitalizations, ICU admissions, deaths) by varying regions prioritized, extra doses prioritized, and implementation start time. Using two models (individual-based and meta-population), we simulated COVID-19 transmission during the primary vaccination period in Norway, covering the first 7 months of 2021. We investigated alternative strategies to allocate more vaccine doses to regions with a higher force of infection. We also examined the robustness of our results and highlighted potential structural differences between the two models. Our findings suggest that early vaccine prioritization could reduce COVID-19 related health outcomes by 8% to 20% compared to a baseline strategy without geographic prioritization. For minimizing infections, hospitalizations, or ICU admissions, the best strategy was to initially allocate all available vaccine doses to fewer high-risk municipalities, comprising approximately one-fourth of the population. For minimizing deaths, a moderate level of geographic prioritization, with approximately one-third of the population receiving doubled doses, gave the best outcomes by balancing the trade-off between vaccinating younger people in high-risk areas and older people in low-risk areas. The actual strategy implemented in Norway was a two-step moderate level aimed at maintaining the balance and ensuring ethical considerations and public trust. However, it did not offer significant advantages over the baseline strategy without geographic prioritization. Earlier implementation of geographic prioritization could have more effectively addressed the main wave of infections, substantially reducing the national burden of the pandemic.
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Affiliation(s)
- Louis Yat Hin Chan
- Department of Method Development and Analytics, Norwegian Institute of Public Health, Oslo, Norway
| | - Gunnar Rø
- Department of Method Development and Analytics, Norwegian Institute of Public Health, Oslo, Norway
| | - Jørgen Eriksson Midtbø
- Department of Method Development and Analytics, Norwegian Institute of Public Health, Oslo, Norway
| | - Francesco Di Ruscio
- Department of Method Development and Analytics, Norwegian Institute of Public Health, Oslo, Norway
| | | | - Lene Kristine Juvet
- Department of Infection Control and Vaccines, Norwegian Institute of Public Health, Oslo, Norway
| | - Jasper Littmann
- Division of Infection Control, Norwegian Institute of Public Health, Oslo, Norway
- Bergen Centre for Ethics and Priority Setting (BCEPS), University of Bergen, Bergen, Norway
| | - Preben Aavitsland
- Division of Infection Control, Norwegian Institute of Public Health, Oslo, Norway
- Pandemic Centre, University of Bergen, Bergen, Norway
| | - Karin Maria Nygård
- Department of Infectious Diseases and Preparedness, Norwegian Institute of Public Health, Oslo, Norway
| | - Are Stuwitz Berg
- Department of Infection Control and Vaccines, Norwegian Institute of Public Health, Oslo, Norway
| | - Geir Bukholm
- Division of Infection Control, Norwegian Institute of Public Health, Oslo, Norway
- Faculty of Chemistry, Biotechnology and Food Sciences, Norwegian University of Life Sciences, Ås, Norway
| | | | | | | | - David Swanson
- Department of Biostatistics, MD Anderson Cancer Center, University of Texas, Houston, Texas, United States of America
| | | | | | - Arnoldo Frigessi
- Oslo Centre for Biostatistics and Epidemiology, University of Oslo and Oslo University Hospital, Oslo, Norway
| | - Birgitte Freiesleben de Blasio
- Department of Method Development and Analytics, Norwegian Institute of Public Health, Oslo, Norway
- Oslo Centre for Biostatistics and Epidemiology, University of Oslo and Oslo University Hospital, Oslo, Norway
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14
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Ackerman M, Holmes CS, Antigua JR, Riback LR, Zhang C, Walker JG, Vickerman P, Travers A, Linder M, Day R, Fox AD, Cunningham CO, Akiyama MJ. Mitigation through on-site testing & education among formerly incarcerated individuals against Covid-19 - The MOSAIC study: Design and rationale. Contemp Clin Trials 2024; 136:107406. [PMID: 38097063 PMCID: PMC11055630 DOI: 10.1016/j.cct.2023.107406] [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: 08/31/2023] [Revised: 11/29/2023] [Accepted: 12/02/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND Many of the largest COVID-19 outbreaks in the United States have occurred at carceral facilities. Criminal legal system (CLS)-involved individuals typically face structural barriers accessing medical care post-release. Improving COVID-19 testing and education for CLS-involved individuals could improve health outcomes for this vulnerable population and the communities to which they return. Community-based organizations (CBO) and community health workers (CHWs) fill care gaps by connecting CLS-involved individuals with essential re-entry services. The MOSAIC study will: 1) test an onsite CHW-led SARS-CoV-2 testing and education intervention in a reentry CBO and 2) model the cost-effectiveness of this intervention compared to standard care. METHODS We will recruit 250 CLS-involved individuals who have left incarceration in the prior 90 days. Participants will be randomized to receive onsite Point-of-Care testing and education (O-PoC) or Standard of Care (SoC). Over one year, participants will complete quarterly questionnaires and biweekly short surveys through a mobile application, and be tested for SARS-CoV-2 quarterly, either at the CBO (O-PoC) or an offsite community testing site (SoC). O-PoC will also receive COVID-19 mitigation counseling and education from the CHW. Our primary outcome is the proportion of SARS-CoV-2 tests performed with results received by participants. Secondary outcomes include adherence to mitigation behaviors and cost-effectiveness of the intervention. DISCUSSION The MOSAIC study will offer insight into cost effective strategies for SARS-CoV-2 testing and education for CLS-involved individuals. The study will also contribute to the growing literature on CHW's role in health education, supportive counseling, and building trust between patients and healthcare organizations.
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Affiliation(s)
- Maxwell Ackerman
- Albert Einstein College of Medicine, Montefiore Medical Center, Morris Park Ave, Bronx, NY 10467, United States of America
| | - Connor S Holmes
- Albert Einstein College of Medicine, Montefiore Medical Center, Morris Park Ave, Bronx, NY 10467, United States of America
| | - Jordy Rojas Antigua
- Albert Einstein College of Medicine, Montefiore Medical Center, Morris Park Ave, Bronx, NY 10467, United States of America
| | - Lindsey R Riback
- Albert Einstein College of Medicine, Montefiore Medical Center, Morris Park Ave, Bronx, NY 10467, United States of America
| | - Chenshu Zhang
- Albert Einstein College of Medicine, Montefiore Medical Center, Morris Park Ave, Bronx, NY 10467, United States of America
| | - Josephine G Walker
- Bristol Medical School, Population Health Sciences, University of Bristol, Queens Road, Bristol BS8 1QU, UK
| | - Peter Vickerman
- Bristol Medical School, Population Health Sciences, University of Bristol, Queens Road, Bristol BS8 1QU, UK
| | - Ann Travers
- The Fortune Society, 2976 Northern Blvd, Long Island City, NY 11101, United States of America
| | - Micaela Linder
- The Fortune Society, 2976 Northern Blvd, Long Island City, NY 11101, United States of America
| | - Ronald Day
- The Fortune Society, 2976 Northern Blvd, Long Island City, NY 11101, United States of America
| | - Aaron D Fox
- Albert Einstein College of Medicine, Montefiore Medical Center, Morris Park Ave, Bronx, NY 10467, United States of America
| | - Chinazo O Cunningham
- Albert Einstein College of Medicine, Montefiore Medical Center, Morris Park Ave, Bronx, NY 10467, United States of America
| | - Matthew J Akiyama
- Albert Einstein College of Medicine, Montefiore Medical Center, Morris Park Ave, Bronx, NY 10467, United States of America.
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15
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Zhu W, Yuan S, Mao S, Chen J, Zheng Y, Jiang X, Yu X, Jiang C, Fang Q, Wang W, Yuan Z, Yao Y. Relationship of close contact settings with transmission and infection during the SARS-CoV-2 Omicron BA.2 epidemic in Shanghai. BMJ Glob Health 2023; 8:e012289. [PMID: 38135296 DOI: 10.1136/bmjgh-2023-012289] [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: 03/13/2023] [Accepted: 10/07/2023] [Indexed: 12/24/2023] Open
Abstract
INTRODUCTION We analysed case-contact clusters during the Omicron BA.2 epidemic in Shanghai to assess the risk of infection of contacts in different settings and to evaluate the effect of demographic factors on the association of infectivity and susceptibility to the Omicron variant. METHODS Data on the settings and frequency of contact, demographic characteristics and comorbidities of index cases, contacts and secondary cases were analysed. Independent effect of multiple variables on the risk for transmission and infection was evaluated using generalised estimating equations. RESULTS From 1 March to 1 June 2022, we identified 450 770 close contacts of 90 885 index cases. The risk for infection was greater for contacts in farmers' markets (fixed locations where farmers gather to sell products, adjusted OR (aOR): 3.62; 95% CI 2.87 to 4.55) and households (aOR: 2.68; 95% CI 2.15 to 3.35). Children (0-4 years) and elderly adults (60 years and above) had higher risk for infection and transmission. During the course of the epidemic, the risk for infection and transmission in different age groups initially increased, and then decreased on about 21 April (17th day of citywide home quarantine). Compared with medical workers (reference, aOR: 1.00), unemployed contacts (aOR: 1.77; 95% CI 1.53 to 2.04) and preschoolers (aOR: 1.61; 95% CI 1.26 to 2.05) had the highest risk for infection; delivery workers (aOR: 1.90, 95% CI 1.51 to 2.40) and public service workers (aOR: 1.85; 95% CI 1.64 to 2.10) had the highest risk for transmission. Contacts who had comorbidities (aOR: 1.10; 95% CI 1.09 to 1.12) had a higher risk for infection, particularly those with lung diseases or immune deficiency. CONCLUSION Farmers' markets and households were the main setting for transmission of Omicron. Children, the elderly, delivery workers and public service workers had the highest risk for transmission and infection. These findings should be considered when implementing targeted interventions.
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Affiliation(s)
- Wenlong Zhu
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China
| | - Shiying Yuan
- Department of Infectious Disease Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Shenghua Mao
- Department of Infectious Disease Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Jian Chen
- Department of Infectious Disease Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Yaxu Zheng
- Department of Infectious Disease Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Xianjin Jiang
- Department of Infectious Disease Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Xiao Yu
- Department of Infectious Disease Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Chenyan Jiang
- Department of Infectious Disease Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Qiwen Fang
- Department of Infectious Disease Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Weibing Wang
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Zheng'an Yuan
- Department of Infectious Disease Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Ye Yao
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China
- Department of Biostatics, School of Public Health, Fudan University, Shanghai, China
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16
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Chung PC, Chen KJ, Chang HM, Chan TC. Evaluating the Effectiveness of School Closure in COVID-19-Related Syndromes From Community-Based Syndromic Surveillance: Longitudinal Observational Study. Interact J Med Res 2023; 12:e44606. [PMID: 38100192 PMCID: PMC10727480 DOI: 10.2196/44606] [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: 11/25/2022] [Revised: 09/27/2023] [Accepted: 11/30/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND During the COVID-19 pandemic, a school closure policy was adopted to prevent cluster transmission in schools and subsequent household transmission. However, the effectiveness of school closure is not consistent in studies conducted in different countries. OBJECTIVE This study aimed to explore the association between school closure and the daily standardized incidence of COVID-19-related syndromes in an outpatient syndromic surveillance system. METHODS We calculated the incidence of COVID-19-related syndromes derived from a community-based syndromic surveillance system between the first week of January and the second or fourth weeks after school closure in 2021 and 2022 in Taipei City, Taiwan. The effect of school closure on the standardized incidence of COVID-19-related syndromes was evaluated by interrupted time series analysis using an autoregressive integrated moving average with a distributed lag function. The exogenous variables were changes in human mobility measured by Google COVID-19 community mobility reports. Furthermore, the models quantified the influence of different age groups and the hierarchy of medical facilities, such as clinics or community hospitals. RESULTS School closure was only negatively and significantly associated with the overall standardized incidence of COVID-19-related syndromes in 2021 for 2 weeks after the intervention (coefficient -1.24, 95% CI -2.40 to -0.08). However, in different age groups, school closure had a significantly negative association with the standardized incidence among people aged 13-18 years and ≥65 years for 2 weeks after the intervention in clinics in 2021. In community hospitals, school closure was significantly positively associated with the standardized incidence among people aged 19-24 years in 2021. In 2022, 2 weeks after the intervention, school closure had a significantly negative association with the standardized incidence among people aged 0-6, 7-12, and 19-24 years in community hospitals and aged >45 years in clinics. Furthermore, the standardized incidence was positively associated with movement change toward grocery and pharmacy stores in all age groups in 2022. In addition, movement changes toward residences were significantly positively associated with the standardized incidence among all age groups. CONCLUSIONS Overall, school closure effectively suppresses COVID-19-related syndromes in students owing to the reduction of physical contact. In addition, school closure has a spillover effect on elderly people who stay at home.
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Affiliation(s)
- Ping-Chen Chung
- Department of Dentistry, Puzi Hospital, Ministry of Health and Welfare, Chiayi County, Taiwan
| | - Kevin J Chen
- Department of Health, Taipei City Government, Taipei City, Taiwan
| | - Hui-Mei Chang
- Department of Health, Taipei City Government, Taipei City, Taiwan
| | - Ta-Chien Chan
- Research Center for Humanities and Social Sciences, Academia Sinica, Taipei City, Taiwan
- Institute of Public Health, School of Medicine, National Yang Ming Chiao Tung University, Taipei City, Taiwan
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17
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Bahgat MM, Nasraa MH, Nadeem R, Amer K, Hassan WA, ELGarhy FM, Reda S, Fasemore AM, Förstner KU, Abd-Elshafy DN. Sensitivities of a Rapid Test Versus an ELISA Kit for Detecting Anti-SARS-CoV-2 IgM/IgG in Sera from an Egyptian Cohort. Curr Microbiol 2023; 81:24. [PMID: 38032503 DOI: 10.1007/s00284-023-03473-z] [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: 02/13/2023] [Accepted: 09/02/2023] [Indexed: 12/01/2023]
Abstract
This study aimed to compare diagnostic sensitivities of a rapid test (Rt) and an ELISA kit for detecting anti-SARS-CoV-2 IgM/IgG in virus-RT-PCR-positive (VPP) and virus-RT-PCR-unchecked (VPU) subjects in an Egyptian cohort during the first wave of SARS-CoV-2 infection. The results revealed higher sensitivity of the Rt for detecting IgM/IgG in the VPP subjects. Both the Rt and ELISA showed identical sensitivities for IgM detection in the VPU subjects. The ELISA was more sensitive for detecting IgG in the VPU subjects. Generally, within both the VPP and the VPU groups, Rt was more sensitive for detecting IgM/IgG among the symptomatic (S) compared to asymptomatic (AS) subjects than ELISA. Within the VPP group, the Rt was more sensitive for detecting both IgM/IgG among the AS subjects than ELISA. In the VPU group, the Rt was more sensitive for detecting IgM among the S subjects than ELISA. The ELISA was more sensitive for detecting IgM/IgG among AS subjects than the Rt. From these results we concluded that, despite the limitation of sample size, this study indicates suitability of the used Rt for detecting anti-SARS-CoV-2 IgM/IgG among S subjects and sheds light on possibility of relying on the used ELISA for IgG detection among AS human subjects.
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Affiliation(s)
- Mahmoud Mohamed Bahgat
- Research Group Immune-and Bio-Markers for Infection, The Centre of Excellence for Advanced Science, The National Research Centre, Giza, 12622, Egypt.
- Environmental Virology Laboratory, Department of Water Pollution Research, Institute of Environmental Research and Climate Changes, The National Research Centre, Giza, 12622, Egypt.
- Department of Therapeutic Chemistry, Institute of Pharmaceutical and Drug Industries Research, The National Research Centre, Giza, 12622, Egypt.
| | - Mohamed Hassan Nasraa
- Research Group Immune-and Bio-Markers for Infection, The Centre of Excellence for Advanced Science, The National Research Centre, Giza, 12622, Egypt
- Environmental Virology Laboratory, Department of Water Pollution Research, Institute of Environmental Research and Climate Changes, The National Research Centre, Giza, 12622, Egypt
| | - Rola Nadeem
- Research Group Immune-and Bio-Markers for Infection, The Centre of Excellence for Advanced Science, The National Research Centre, Giza, 12622, Egypt
- Environmental Virology Laboratory, Department of Water Pollution Research, Institute of Environmental Research and Climate Changes, The National Research Centre, Giza, 12622, Egypt
| | - Khaled Amer
- Egypt Center for Research and Regenerative Medicine, Cairo, Egypt
| | - Wael A Hassan
- Egypt Center for Research and Regenerative Medicine, Cairo, Egypt
| | - Fadya M ELGarhy
- Egypt Center for Research and Regenerative Medicine, Cairo, Egypt
| | - Salem Reda
- Egypt Center for Research and Regenerative Medicine, Cairo, Egypt
| | - Akinyemi M Fasemore
- University of Würzburg, Würzburg, Germany
- ZB MED-Information Centre for Life Sciences, Cologne, Germany
| | - Konrad U Förstner
- ZB MED-Information Centre for Life Sciences, Cologne, Germany
- TH Köln-University of Applied Sciences, Cologne, Germany
| | - Dina Nadeem Abd-Elshafy
- Research Group Immune-and Bio-Markers for Infection, The Centre of Excellence for Advanced Science, The National Research Centre, Giza, 12622, Egypt
- Environmental Virology Laboratory, Department of Water Pollution Research, Institute of Environmental Research and Climate Changes, The National Research Centre, Giza, 12622, Egypt
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18
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Ali KM, Rashid PMA, Ali AM, Tofiq AM, Salih GF, Dana OI, Rostam HM. Clinical outcomes and phylogenetic analysis in reflection with three predominant clades of SARS-CoV-2 variants. Eur J Clin Invest 2023; 53:e14004. [PMID: 37036255 DOI: 10.1111/eci.14004] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 03/29/2023] [Accepted: 04/07/2023] [Indexed: 04/11/2023]
Abstract
BACKGROUND The pandemic of coronavirus disease 2019 (COVID-19) has a broad spectrum of clinical manifestations. The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) undergoes continuous evolution, resulting in the emergence of several variants. Each variant has a different severity and mortality rate. MATERIALS AND METHODS In this study, 1174 COVID-19 patients were studied for mortality and severity over three SARS-CoV-2 predominating variant periods in 2021 and 2022 in Sulaimani Province, Iraq. In each period, a representative, variant virus was subjected to phylogenetic and molecular and clinical analysis. RESULTS Phylogenetic analysis revealed three SARS-CoV-2 variants, belonging to: Delta B.1.617.2, Omicron BA.1.17.2, and Omicron BA.5.6. The Delta variants showed more severe symptoms and a lower PCR-Ct value than Omicron variants regardless of gender, and only 4.3% of the cases were asymptomatic. The mortality rate was lower with Omicron (.5% for BA.5.2 and 1.3% for BA.1.17.2) compared with Delta variants (2.5%). The higher mortality rate with Delta variants was in males (2.84%), while that with Omicron BA1.17.2 and BA.5.2 was in females, 1.05% and .0%, respectively. Age group (≥70) years had the highest mortality rate; however, it was (.0%) in the age group (30-49) years with Omicron variants, compared with (.96%) in Delta variants. CONCLUSIONS There has been a surge in COVID-19 infection in the city due to the predominant lineages of SARS-CoV-2, B.1.617, Omicron BA.1.17.2 and Omicron BA.5.6, respectively. A higher PCR-Ct value and severity of the Delta variant over Omicron BA.1.17.2 and/or BA.5.2 variants were significantly correlated with a higher death rate in the same order.
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Affiliation(s)
- Kameran M Ali
- Medical Laboratory Technology Department, Kalar Technical College, Sulaimani Polytechnic University, Kalar, Iraq
| | - Peshnyar M A Rashid
- Medical Laboratory Science Department, Komar University of Science and Technology, Sulaimania, Iraq
| | - Ayad M Ali
- Department of Chemistry, University of Garmian, Kalar, Iraq
| | - Ahmed M Tofiq
- Department of Biology, College of Education, University of Garmian, Head of International Academic Relations (IRO), Kalar, Iraq
| | - Gaza F Salih
- Biology Department, College of Science, University of Sulaimani, Sulaimania, Iraq
| | - Omer I Dana
- College of Veterinary Medicine, University of Sulaimani, Sulaimani, Iraq
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19
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Anderson TL, Nande A, Merenstein C, Raynor B, Oommen A, Kelly BJ, Levy MZ, Hill AL. Quantifying individual-level heterogeneity in infectiousness and susceptibility through household studies. Epidemics 2023; 44:100710. [PMID: 37556994 PMCID: PMC10594662 DOI: 10.1016/j.epidem.2023.100710] [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: 12/01/2022] [Revised: 03/17/2023] [Accepted: 07/18/2023] [Indexed: 08/11/2023] Open
Abstract
The spread of SARS-CoV-2, like that of many other pathogens, is governed by heterogeneity. "Superspreading," or "over-dispersion," is an important factor in transmission, yet it is hard to quantify. Estimates from contact tracing data are prone to potential biases due to the increased likelihood of detecting large clusters of cases, and may reflect variation in contact behavior more than biological heterogeneity. In contrast, the average number of secondary infections per contact is routinely estimated from household surveys, and these studies can minimize biases by testing all members of a household. However, the models used to analyze household transmission data typically assume that infectiousness and susceptibility are the same for all individuals or vary only with predetermined traits such as age. Here we develop and apply a combined forward simulation and inference method to quantify the degree of inter-individual variation in both infectiousness and susceptibility from observations of the distribution of infections in household surveys. First, analyzing simulated data, we show our method can reliably ascertain the presence, type, and amount of these heterogeneities given data from a sufficiently large sample of households. We then analyze a collection of household studies of COVID-19 from diverse settings around the world, and find strong evidence for large heterogeneity in both the infectiousness and susceptibility of individuals. Our results also provide a framework to improve the design of studies to evaluate household interventions in the presence of realistic heterogeneity between individuals.
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Affiliation(s)
- Thayer L Anderson
- Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD 21218, United States of America
| | - Anjalika Nande
- Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD 21218, United States of America
| | - Carter Merenstein
- Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States of America
| | - Brinkley Raynor
- Department of Biostatistics, Epidemiology, & Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States of America
| | - Anisha Oommen
- Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD 21218, United States of America; Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21218, United States of America
| | - Brendan J Kelly
- Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States of America; Department of Biostatistics, Epidemiology, & Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States of America; Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States of America
| | - Michael Z Levy
- Department of Biostatistics, Epidemiology, & Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States of America
| | - Alison L Hill
- Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD 21218, United States of America; Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21218, United States of America.
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20
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Wang X, Zhang J, Wu Y, Xu Y, Zheng J. SIgA in various pulmonary diseases. Eur J Med Res 2023; 28:299. [PMID: 37635240 PMCID: PMC10464380 DOI: 10.1186/s40001-023-01282-5] [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: 12/03/2022] [Accepted: 08/12/2023] [Indexed: 08/29/2023] Open
Abstract
Secretory immunoglobulin A (SIgA) is one of the most abundant immunoglobulin subtypes among mucosa, which plays an indispensable role in the first-line protection against invading pathogens and antigens. Therefore, the role of respiratory SIgA in respiratory mucosal immune diseases has attracted more and more attention. Although the role of SIgA in intestinal mucosal immunity has been widely studied, the cell types responsible for SIgA and the interactions between cells are still unclear. Here, we conducted a wide search of relevant studies and sorted out the relationship between SIgA and some pulmonary diseases (COPD, asthma, tuberculosis, idiopathic pulmonary fibrosis, COVID-19, lung cancer), which found SIgA is involved in the pathogenesis and progression of various lung diseases, intending to provide new ideas for the prevention, diagnosis, and treatment of related lung diseases.
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Affiliation(s)
- Xintian Wang
- Department of Respiratory Medicine, Affiliated Hospital of Jiangsu University, No. 438, Jiefang Road, Jingkou District, Zhenjiang, Jiangsu China
| | - Jun Zhang
- Department of Respiratory and Critical Care Medicine, Aoyang Hospital Affiliated to Jiangsu University, No. 279, Jingang Avenue, Zhangjiagang, Suzhou, Jiangsu China
| | - Yan Wu
- Department of Respiratory Medicine, Affiliated Hospital of Jiangsu University, No. 438, Jiefang Road, Jingkou District, Zhenjiang, Jiangsu China
| | - Yuncong Xu
- Department of Respiratory Medicine, Affiliated Hospital of Jiangsu University, No. 438, Jiefang Road, Jingkou District, Zhenjiang, Jiangsu China
| | - Jinxu Zheng
- Department of Respiratory Medicine, Affiliated Hospital of Jiangsu University, No. 438, Jiefang Road, Jingkou District, Zhenjiang, Jiangsu China
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21
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Gao C, Jiang JJ, Mao JF, Yu XH, Zheng XF, Zhang JC. Risk factors of infection among close contacts of COVID-19: A systematic review and meta-analysis. Medicine (Baltimore) 2023; 102:e34314. [PMID: 37478226 PMCID: PMC10662811 DOI: 10.1097/md.0000000000034314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 06/22/2023] [Indexed: 07/23/2023] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) was first detected in December 2019, and declared as a pandemic by the World Health Organization (WHO) on March 11, 2020. The current management of COVID-19 is based generally on supportive therapy and treatment to prevent respiratory failure. METHODS PubMed, Web of Science, Embase, CNKI, and other databases were searched by computer, and relevant literature published from December 2019 to November 2022 on the influencing factors of infection in close contacts with novel coronavirus pneumonia was collected. Meta-analysis was carried out after literature screening, quality assessment, and data extraction. RESULTS A total of 425 articles were retrieved and 11 were included. Meta-analysis showed that there were 6 risk factors, and the combined OR value and 95% CI of each influencing factor were 5.23 (3.20, 8.57) for family members, 1.63 (0.56, 4.77) for regular contact, 2.14 (0.62, 7.32) for the elderly, 0.58 (0.001569.89) for cohabitation, 1.97 (1.02, 3.82) for women and 0.75 (0.01, 54.07) for others. The Deeks' funnel diagram indicates that there is no potential publication bias among the included studies. CONCLUSION Family members and gender differences are the risk factors of infection among close contacts, and it cannot be proved that there are differences in infection among frequent contact, advanced age, and living together.
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Affiliation(s)
- Chun Gao
- Department of Gastroenterology, The 940 Hospital of Joint Logisitic Support Forces of PLA, Lanzhou, China
- First School of Clinical Medical, Gansu University of Chinese Medicine, Lanzhou, China
| | - Jing-Jing Jiang
- Department of Gastroenterology, The 940 Hospital of Joint Logisitic Support Forces of PLA, Lanzhou, China
- First School of Clinical Medical, Gansu University of Chinese Medicine, Lanzhou, China
| | - Jun-Feng Mao
- Department of Nuclear Medicine, The 940 Hospital of Joint Logisitic Support Forces of PLA, Lanzhou, China
| | - Xiao-Hui Yu
- Department of Gastroenterology, The 940 Hospital of Joint Logisitic Support Forces of PLA, Lanzhou, China
| | - Xiao-Feng Zheng
- Department of Gastroenterology, Lanzhou University Second Hospital, Lanzhou, China
| | - Jiu-Cong Zhang
- Department of Gastroenterology, The 940 Hospital of Joint Logisitic Support Forces of PLA, Lanzhou, China
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22
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Zhang N, Liu L, Dou Z, Liu X, Yang X, Miao D, Guo Y, Gu S, Li Y, Qian H, Wei J. Close contact behaviors of university and school students in 10 indoor environments. JOURNAL OF HAZARDOUS MATERIALS 2023; 458:132069. [PMID: 37463561 DOI: 10.1016/j.jhazmat.2023.132069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 05/24/2023] [Accepted: 07/13/2023] [Indexed: 07/20/2023]
Abstract
Close contact routes, including short-range airborne and large-droplet routes, play an important role in the transmission of SARS-CoV-2 in indoor environments. However, the exposure risk of such routes is difficult to quantify due to the lack of data on the close contact behavior of individuals. In this study, a digital wearable device, based on semi-supervised learning, was developed to automatically record human close contact behavior. We collected 337,056 s of indoor close contact of school and university students from 194.5 h of depth video recordings in 10 types of indoor environments. The correlation between aerosol exposure and close contact behaviors was then evaluated. Individuals in restaurants had the highest close contact ratio (64%), as well as the highest probability of face-to-face pattern (78%) during close contact. Accordingly, university students showed greater exposure potential in dormitories than school students in homes, however, a lower exposure was observed in classrooms and postgraduate student offices in comparison with school students in classrooms. In addition, restaurants had the highest aerosol exposure volume for both short-range inhalation and direct deposition on the facial mucosa. Thus, the classroom was established as the primary indoor environment where school students are exposed to aerosols.
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Affiliation(s)
- Nan Zhang
- Beijing Key Laboratory of Green Built Environment and Energy Efficient Technology, Beijing University of Technology, Beijing, China
| | - Li Liu
- School of Architecture, Tsinghua University, Beijing, China
| | - Zhiyang Dou
- Department of Computer Science, The University of Hong Kong, Hong Kong, China
| | - Xiyue Liu
- Beijing Key Laboratory of Green Built Environment and Energy Efficient Technology, Beijing University of Technology, Beijing, China
| | - Xueze Yang
- Beijing Key Laboratory of Green Built Environment and Energy Efficient Technology, Beijing University of Technology, Beijing, China
| | - Doudou Miao
- Beijing Key Laboratory of Green Built Environment and Energy Efficient Technology, Beijing University of Technology, Beijing, China
| | - Yong Guo
- Department of Building Science, Tsinghua University, Beijing, China
| | - Silan Gu
- Thee First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Yuguo Li
- Department of Mechanical Engineering, The University of Hong Kong, Hong Kong, China
| | - Hua Qian
- School of Energy and Environment, Southeast University, Nanjing, China
| | - Jianjian Wei
- Institute of Refrigeration and Cryogenics, Key Laboratory of Refrigeration and Cryogenic Technology of Zhejiang Province, Zhejiang University, Hangzhou, China.
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23
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Babu TM, Feldstein LR, Saydah S, Acker Z, Boisvert CL, Briggs-Hagen M, Carone M, Casto A, Cox SN, Ehmen B, Englund JA, Fortmann SP, Frivold CJ, Groom H, Han PD, Kuntz JL, Lockwood T, Midgley CM, Mularski RA, Ogilvie T, Reich SL, Schmidt MA, Smith N, Starita L, Stone J, Vandermeer M, Weil AA, Wolf CR, Chu HY, Naleway AL. CASCADIA: a prospective community-based study protocol for assessing SARS-CoV-2 vaccine effectiveness in children and adults using a remote nasal swab collection and web-based survey design. BMJ Open 2023; 13:e071446. [PMID: 37451722 PMCID: PMC10350906 DOI: 10.1136/bmjopen-2022-071446] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 06/13/2023] [Indexed: 07/18/2023] Open
Abstract
INTRODUCTION Although SARS-CoV-2 vaccines were first approved under Emergency Use Authorization by the Food and Drug Administration in late 2020 for adults, authorisation for young children 6 months to <5 years of age did not occur until 2022. These authorisations were based on clinical trials, understanding real-world vaccine effectiveness (VE) in the setting of emerging variants is critical. The primary goal of this study is to evaluate SARS-CoV-2 VE against infection among children aged >6 months and adults aged <50 years. METHODS CASCADIA is a 4-year community-based prospective study of SARS-CoV-2 VE among 3500 adults and paediatric populations aged 6 months to 49 years in Oregon and Washington, USA. At enrolment and regular intervals, participants complete a sociodemographic questionnaire. Individuals provide a blood sample at enrolment and annually thereafter, with optional blood draws every 6 months and after infection and vaccination. Participants complete weekly self-collection of anterior nasal swabs and symptom questionnaires. Swabs are tested for SARS-CoV-2 and other respiratory pathogens by reverse transcription-PCR, with results of selected pathogens returned to participants; nasal swabs with SARS-CoV-2 detected will undergo whole genome sequencing. Participants who test positive for SARS-CoV-2 undergo serial swab collection every 3 days for 21 days. Serum samples are tested for SARS-CoV-2 antibody by binding and neutralisation assays. ANALYSIS The primary outcome is SARS-CoV-2 infection. Cox regression models will be used to estimate the incidence rate ratio associated with SARS-CoV-2 vaccination among the paediatric and adult population, controlling for demographic factors and other potential confounders. ETHICS AND DISSEMINATION All study materials including the protocol, consent forms, data collection instruments, participant communication and recruitment materials, were approved by the Kaiser Permanente Interregional Institutional Review Board, the IRB of record for the study. Results will be disseminated through peer-reviewed publications, presentations, participant newsletters and appropriate general news media.
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Affiliation(s)
- Tara M Babu
- Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, Washington, USA
| | - Leora R Feldstein
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Sharon Saydah
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Zachary Acker
- Brotman Baty Institute for Precision Medicine, University of Washington, Seattle, Washington, USA
| | | | - Melissa Briggs-Hagen
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Marco Carone
- Department of Biostatistics, University of Washington, Seattle, Washington, USA
| | - Amanda Casto
- Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, Washington, USA
| | - Sarah N Cox
- Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, Washington, USA
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Brenna Ehmen
- Brotman Baty Institute for Precision Medicine, University of Washington, Seattle, Washington, USA
| | - Janet A Englund
- Department of Pediatrics, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Stephen P Fortmann
- Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon, USA
| | - Collrane J Frivold
- Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, Washington, USA
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Holly Groom
- Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon, USA
| | - Peter D Han
- Brotman Baty Institute for Precision Medicine, University of Washington, Seattle, Washington, USA
| | - Jennifer L Kuntz
- Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon, USA
| | - Tina Lockwood
- Brotman Baty Institute for Precision Medicine, University of Washington, Seattle, Washington, USA
- Department of Pathology, University of Washington, Seattle, Washington, USA
| | - Claire M Midgley
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Richard A Mularski
- Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon, USA
| | - Tara Ogilvie
- Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, Washington, USA
| | - Sacha L Reich
- Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon, USA
| | - Mark A Schmidt
- Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon, USA
| | - Ning Smith
- Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon, USA
| | - Lea Starita
- Brotman Baty Institute for Precision Medicine, University of Washington, Seattle, Washington, USA
- Genome Sciences, University of Washington, Seattle, Washington, USA
| | - Jeremy Stone
- Brotman Baty Institute for Precision Medicine, University of Washington, Seattle, Washington, USA
| | - Meredith Vandermeer
- Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon, USA
| | - Ana A Weil
- Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, Washington, USA
| | - Caitlin R Wolf
- Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, Washington, USA
| | - Helen Y Chu
- Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, Washington, USA
| | - Allison L Naleway
- Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon, USA
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24
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Choi S, Kim C, Park KH, Kim JH. Direct indicators of social distancing effectiveness in COVID-19 outbreak stages: a correlational analysis of case contacts and population mobility in Korea. Epidemiol Health 2023; 45:e2023065. [PMID: 37448123 PMCID: PMC10876423 DOI: 10.4178/epih.e2023065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 01/25/2023] [Indexed: 07/15/2023] Open
Abstract
OBJECTIVES The effectiveness of social distancing during the coronavirus disease 2019 (COVID-19) pandemic has been evaluated using the magnitude of changes in population mobility. This study aimed to investigate a direct indicator-namely, the number of close contacts per patient with confirmed COVID-19. METHODS From week 7, 2020 to week 43, 2021, population movement changes were calculated from the data of two Korean telecommunication companies and Google in accordance with social distancing stringency levels. Data on confirmed cases and their close contacts among residents of Gyeonggi Province, Korea were combined at each stage. Pearson correlation analysis was conducted to compare the movement data with the change in the number of contacts for each confirmed case calculated by stratification according to age group. The reference value of the population movement data was set using the value before mid-February 2020, considering each data's characteristics. RESULTS In the age group of 18 or younger, the number of close contacts per confirmed case decreased or increased when the stringency level was strengthened or relaxed, respectively. In adults, the correlation was relatively low, with no correlation between the change in the number of close contacts per confirmed case and the change in population movement after the commencement of vaccination for adults. CONCLUSIONS The effectiveness of governmental social distancing policies against COVID-19 can be evaluated using the number of close contacts per confirmed case as a direct indicator, especially for each age group. Such an analysis can facilitate policy changes for specific groups.
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Affiliation(s)
- Sojin Choi
- Gyeonggi Infectious Disease Control Center, Health Bureau, Gyeonggi Provincial Government, Suwon, Korea
| | - Chanhee Kim
- Gyeonggi Infectious Disease Control Center, Health Bureau, Gyeonggi Provincial Government, Suwon, Korea
| | - Kun-Hee Park
- Gyeonggi Infectious Disease Control Center, Health Bureau, Gyeonggi Provincial Government, Suwon, Korea
| | - Jong-Hun Kim
- Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon, Korea
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25
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Islam F, Alvi Y, Ahmad M, Ahmed F, Rahman A, Singh FHD, Das AK, Dudeja M, Gupta E, Agarwalla R, Alam I, Roy S. Household transmission dynamics of COVID-19 among residents of Delhi, India: a prospective case-ascertained study. IJID REGIONS 2023; 7:22-30. [PMID: 36852156 PMCID: PMC9946776 DOI: 10.1016/j.ijregi.2023.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 02/13/2023] [Accepted: 02/14/2023] [Indexed: 02/25/2023]
Abstract
Objective The aim of this study was to observe the secondary infection rate and transmission dynamics of COVID-19 among household contacts, and their associations with various factors across four dimensions of interaction. Methods This was a case-ascertained study among unvaccinated household contacts of a laboratory-confirmed COVID-19 case in New Delhi between December 2020 and July 2021. For this study, 99 index cases and their 316 household contacts were interviewed and sampled (blood and oro-nasal swab) on days 1, 7, 14, and 28. Results The secondary infection rate among unvaccinated household contacts was 44.6% (95% confidence interval (CI) 39.1-50.1). The predictors of secondary infection among individual contact levels were: being female (odds ratio (OR) 2.13), increasing age (OR 1.01), symptoms at baseline (OR 3.39), and symptoms during follow-up (OR 3.18). Among index cases, age of the primary case (OR 1.03) and symptoms during follow-up (OR 6.29) were significantly associated with secondary infection. Among household-level and contact patterns, having more rooms (OR 4.44) and taking care of the index case (OR 2.02) were significantly associated with secondary infection. Conclusion A high secondary infection rate highlights the need to adopt strict measures and advocate COVID-19-appropriate behaviors. A targeted approach for higher-risk household contacts would efficiently limit infections among susceptible contacts.
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Affiliation(s)
- Farzana Islam
- Department of Community Medicine, Hamdard Institute of Medical Science and Research, New Delhi, India
| | - Yasir Alvi
- Department of Community Medicine, Hamdard Institute of Medical Science and Research, New Delhi, India
| | | | - Faheem Ahmed
- Department of Community Medicine, Hamdard Institute of Medical Science and Research, New Delhi, India.,Department of Public Health, King Khalid University, Abha, Kingdom of Saudi Arabia
| | | | - Farishta Hannah D Singh
- Department of Community Medicine, Hamdard Institute of Medical Science and Research, New Delhi, India
| | - Ayan Kumar Das
- Department of Microbiology, Hamdard Institute of Medical Science and Research, New Delhi, India
| | - Mridu Dudeja
- Department of Microbiology, Hamdard Institute of Medical Science and Research, New Delhi, India
| | - Ekta Gupta
- Scientist-E, National Institute of Cancer Prevention and Research, ICMR, Noida, India
| | - Rashmi Agarwalla
- Department of Community and Family Medicine, All India Institute of Medical Science, Guwahati, India
| | - Iqbal Alam
- Department of Physiology, Hamdard Institute of Medical Science and Research, New Delhi, India
| | - Sushovan Roy
- Department of Community Medicine, Hamdard Institute of Medical Science and Research, New Delhi, India
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26
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Liu Y, Chai YH, Wu YF, Zhang YW, Wang L, Yang L, Shi YH, Wang LL, Zhang LS, Chen Y, Fan R, Wen YH, Yang H, Li L, Liu YH, Zheng HZ, Jiang JJ, Qian H, Tao RJ, Qian YC, Wang LW, Chen RC, Xu JF, Wang C. Risk factors associated with indoor transmission during home quarantine of COVID-19 patients. Front Public Health 2023; 11:1170085. [PMID: 37250088 PMCID: PMC10213781 DOI: 10.3389/fpubh.2023.1170085] [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: 02/20/2023] [Accepted: 04/13/2023] [Indexed: 05/31/2023] Open
Abstract
Purpose The study aimed to identify potential risk factors for family transmission and to provide precautionary guidelines for the general public during novel Coronavirus disease 2019 (COVID-19) waves. Methods A retrospective cohort study with numerous COVID-19 patients recruited was conducted in Shanghai. Epidemiological data including transmission details, demographics, vaccination status, symptoms, comorbidities, antigen test, living environment, residential ventilation, disinfection and medical treatment of each participant were collected and risk factors for family transmission were determined. Results A total of 2,334 COVID-19 patients participated. Compared with non-cohabitation infected patients, cohabitated ones were younger (p = 0.019), more commonly unvaccinated (p = 0.048) or exposed to infections (p < 0.001), and had higher rates of symptoms (p = 0.003) or shared living room (p < 0.001). Risk factors analysis showed that the 2019-nCov antigen positive (OR = 1.86, 95%CI 1.40-2.48, p < 0.001), symptoms development (OR = 1.86, 95%CI 1.34-2.58, p < 0.001), direct contact exposure (OR = 1.47, 95%CI 1.09-1.96, p = 0.010) were independent risk factors for the cohabitant transmission of COVID-19, and a separate room with a separate toilet could reduce the risk of family transmission (OR = 0.62, 95%CI 0.41-0.92, p = 0.018). Conclusion Patients showing negative 2019-nCov antigen tests, being asymptomatic, living in a separate room with a separate toilet, or actively avoiding direct contact with cohabitants were at low risk of family transmission, and the study recommended that avoiding direct contact and residential disinfection could reduce the risk of all cohabitants within the same house being infected with COVID-19.
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Affiliation(s)
- Yang Liu
- Institute of Respiratory Medicine, School of Medicine, Tongji University, Shanghai, China
| | - Yan-Hua Chai
- Institute of Respiratory Medicine, School of Medicine, Tongji University, Shanghai, China
| | - Yi-Fan Wu
- Institute of Respiratory Medicine, School of Medicine, Tongji University, Shanghai, China
| | - Yu-Wei Zhang
- Institute of Respiratory Medicine, School of Medicine, Tongji University, Shanghai, China
| | - Ling Wang
- Institute of Respiratory Medicine, School of Medicine, Tongji University, Shanghai, China
| | - Ling Yang
- Institute of Respiratory Medicine, School of Medicine, Tongji University, Shanghai, China
| | - Yi-Han Shi
- Institute of Respiratory Medicine, School of Medicine, Tongji University, Shanghai, China
| | - Le-Le Wang
- Institute of Respiratory Medicine, School of Medicine, Tongji University, Shanghai, China
| | - Li-Sha Zhang
- Institute of Respiratory Medicine, School of Medicine, Tongji University, Shanghai, China
| | - Yan Chen
- Institute of Respiratory Medicine, School of Medicine, Tongji University, Shanghai, China
| | - Rui Fan
- Institute of Respiratory Medicine, School of Medicine, Tongji University, Shanghai, China
| | - Yu-Hua Wen
- Institute of Respiratory Medicine, School of Medicine, Tongji University, Shanghai, China
| | - Heng Yang
- Institute of Respiratory Medicine, School of Medicine, Tongji University, Shanghai, China
| | - Li Li
- Department of Respiratory Medicine, Baoshan District Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai, China
| | - Yi-Han Liu
- Institute of Respiratory Medicine, School of Medicine, Tongji University, Shanghai, China
| | - Hui-Zhen Zheng
- Institute of Respiratory Medicine, School of Medicine, Tongji University, Shanghai, China
| | - Ji-Jin Jiang
- Institute of Respiratory Medicine, School of Medicine, Tongji University, Shanghai, China
| | - Hao Qian
- Institute of Respiratory Medicine, School of Medicine, Tongji University, Shanghai, China
| | - Ru-Jia Tao
- Institute of Respiratory Medicine, School of Medicine, Tongji University, Shanghai, China
| | - Ye-Chang Qian
- Department of Respiratory Medicine, Baoshan District Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai, China
| | - Ling-Wei Wang
- Shenzhen Institute of Respiratory Disease, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China
- Shenzhen Clinical Research Centre for Respirology, Shenzhen People’s Hospital, Shenzhen, China
| | - Rong-Chang Chen
- Shenzhen Institute of Respiratory Disease, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China
- Shenzhen Clinical Research Centre for Respirology, Shenzhen People’s Hospital, Shenzhen, China
| | - Jin-Fu Xu
- Institute of Respiratory Medicine, School of Medicine, Tongji University, Shanghai, China
| | - Chen Wang
- National Center for Respiratory Medicine, Beijing, China
- National Clinical Research Center for Respiratory Disease, Beijing, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
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Whitfield CA, van Tongeren M, Han Y, Wei H, Daniels S, Regan M, Denning DW, Verma A, Pellis L, Hall I. Modelling the impact of non-pharmaceutical interventions on workplace transmission of SARS-CoV-2 in the home-delivery sector. PLoS One 2023; 18:e0284805. [PMID: 37146037 PMCID: PMC10162531 DOI: 10.1371/journal.pone.0284805] [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: 11/11/2022] [Accepted: 04/06/2023] [Indexed: 05/07/2023] Open
Abstract
OBJECTIVE We aimed to use mathematical models of SARS-COV-2 to assess the potential efficacy of non-pharmaceutical interventions on transmission in the parcel delivery and logistics sector. METHODS We devloped a network-based model of workplace contacts based on data and consultations from companies in the parcel delivery and logistics sectors. We used these in stochastic simulations of disease transmission to predict the probability of workplace outbreaks in this settings. Individuals in the model have different viral load trajectories based on SARS-CoV-2 in-host dynamics, which couple to their infectiousness and test positive probability over time, in order to determine the impact of testing and isolation measures. RESULTS The baseline model (without any interventions) showed different workplace infection rates for staff in different job roles. Based on our assumptions of contact patterns in the parcel delivery work setting we found that when a delivery driver was the index case, on average they infect only 0.14 other employees, while for warehouse and office workers this went up to 0.65 and 2.24 respectively. In the LIDD setting this was predicted to be 1.40, 0.98, and 1.34 respectively. Nonetheless, the vast majority of simulations resulted in 0 secondary cases among customers (even without contact-free delivery). Our results showed that a combination of social distancing, office staff working from home, and fixed driver pairings (all interventions carried out by the companies we consulted) reduce the risk of workplace outbreaks by 3-4 times. CONCLUSION This work suggests that, without interventions, significant transmission could have occured in these workplaces, but that these posed minimal risk to customers. We found that identifying and isolating regular close-contacts of infectious individuals (i.e. house-share, carpools, or delivery pairs) is an efficient measure for stopping workplace outbreaks. Regular testing can make these isolation measures even more effective but also increases the number of staff isolating at one time. It is therefore more efficient to use these isolation measures in addition to social distancing and contact reduction interventions, rather than instead of, as these reduce both transmission and the number of people needing to isolate at one time.
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Affiliation(s)
- Carl A. Whitfield
- Department of Mathematics, University of Manchester, Manchester, England
- Division of Infection, Immunity & Respiratory Medicine, School of Biological Sciences, University of Manchester, Manchester, England
- Manchester Academic Health Science Centre, University of Manchester, Manchester, England
| | - Martie van Tongeren
- Manchester Academic Health Science Centre, University of Manchester, Manchester, England
- Division of Population Health, Health Services Research & Primary Care, School of Health Sciences, University of Manchester, Manchester, England
| | - Yang Han
- Department of Mathematics, University of Manchester, Manchester, England
| | - Hua Wei
- Manchester Academic Health Science Centre, University of Manchester, Manchester, England
- Division of Population Health, Health Services Research & Primary Care, School of Health Sciences, University of Manchester, Manchester, England
| | - Sarah Daniels
- Manchester Academic Health Science Centre, University of Manchester, Manchester, England
- Division of Population Health, Health Services Research & Primary Care, School of Health Sciences, University of Manchester, Manchester, England
| | - Martyn Regan
- Manchester Academic Health Science Centre, University of Manchester, Manchester, England
- Division of Population Health, Health Services Research & Primary Care, School of Health Sciences, University of Manchester, Manchester, England
- National COVID-19 Response Centre, UK Health Security Agency, London, England
| | - David W. Denning
- Division of Infection, Immunity & Respiratory Medicine, School of Biological Sciences, University of Manchester, Manchester, England
- Manchester Academic Health Science Centre, University of Manchester, Manchester, England
| | - Arpana Verma
- Manchester Academic Health Science Centre, University of Manchester, Manchester, England
- Division of Population Health, Health Services Research & Primary Care, School of Health Sciences, University of Manchester, Manchester, England
| | - Lorenzo Pellis
- Department of Mathematics, University of Manchester, Manchester, England
| | - Ian Hall
- Department of Mathematics, University of Manchester, Manchester, England
- Manchester Academic Health Science Centre, University of Manchester, Manchester, England
- Public Health Advice, Guidance and Expertise, UK Health Security Agency, London, England
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28
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Zhu Y, Xia Y, Pickering J, Bowen AC, Short KR. The role of children in transmission of SARS-CoV-2 variants of concern within households: an updated systematic review and meta-analysis, as at 30 June 2022. Euro Surveill 2023; 28:2200624. [PMID: 37140450 PMCID: PMC10161681 DOI: 10.2807/1560-7917.es.2023.28.18.2200624] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 03/17/2023] [Indexed: 05/05/2023] Open
Abstract
BackgroundMeta-analyses and single-site studies have established that children are less infectious than adults within a household when positive for ancestral SARS-CoV-2. In addition, children appear less susceptible to infection when exposed to ancestral SARS-CoV-2 within a household. The emergence of SARS-CoV-2 variants of concern (VOC) has been associated with an increased number of paediatric infections worldwide. However, the role of children in the household transmission of VOC, relative to the ancestral virus, remains unclear.AimWe aimed to evaluate children's role in household transmission of SARS-CoV-2 VOC.MethodsWe perform a meta-analysis of the role of children in household transmission of both ancestral SARS-CoV-2 and SARS-CoV-2 VOC.ResultsUnlike with the ancestral virus, children infected with VOC spread SARS-CoV-2 to an equivalent number of household contacts as infected adults and were equally as likely to acquire SARS-CoV-2 VOC from an infected family member. Interestingly, the same was observed when unvaccinated children exposed to VOC were compared with unvaccinated adults exposed to VOC.ConclusionsThese data suggest that the emergence of VOC was associated with a fundamental shift in the epidemiology of SARS-CoV-2. It is unlikely that this is solely the result of age-dependent differences in vaccination during the VOC period and may instead reflect virus evolution over the course of the pandemic.
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Affiliation(s)
- Yanshan Zhu
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Australia
- Wesfarmer's Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Nedlands, Perth, Australia
- These authors contributed equally to this manuscript
| | - Yao Xia
- Department of Microbiology, State Key Laboratory of Emerging Infectious Diseases, Carol Yu Centre for Infection, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China
- These authors contributed equally to this manuscript
| | - Janessa Pickering
- Wesfarmer's Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Nedlands, Perth, Australia
| | - Asha C Bowen
- Wesfarmer's Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Nedlands, Perth, Australia
- Department of Infectious Diseases, Perth Children's Hospital, Nedlands, Perth, Australia
| | - Kirsty R Short
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Australia
- Australian Infectious Diseases Research Centre, The University of Queensland, Brisbane, Australia
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29
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Wong KLM, Gimma A, Coletti P, Faes C, Beutels P, Hens N, Jaeger VK, Karch A, Johnson H, Edmunds WJ, Jarvis CI. Social contact patterns during the COVID-19 pandemic in 21 European countries - evidence from a two-year study. BMC Infect Dis 2023; 23:268. [PMID: 37101123 PMCID: PMC10132446 DOI: 10.1186/s12879-023-08214-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 03/31/2023] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND Most countries have enacted some restrictions to reduce social contacts to slow down disease transmission during the COVID-19 pandemic. For nearly two years, individuals likely also adopted new behaviours to avoid pathogen exposure based on personal circumstances. We aimed to understand the way in which different factors affect social contacts - a critical step to improving future pandemic responses. METHODS The analysis was based on repeated cross-sectional contact survey data collected in a standardized international study from 21 European countries between March 2020 and March 2022. We calculated the mean daily contacts reported using a clustered bootstrap by country and by settings (at home, at work, or in other settings). Where data were available, contact rates during the study period were compared with rates recorded prior to the pandemic. We fitted censored individual-level generalized additive mixed models to examine the effects of various factors on the number of social contacts. RESULTS The survey recorded 463,336 observations from 96,456 participants. In all countries where comparison data were available, contact rates over the previous two years were substantially lower than those seen prior to the pandemic (approximately from over 10 to < 5), predominantly due to fewer contacts outside the home. Government restrictions imposed immediate effect on contacts, and these effects lingered after the restrictions were lifted. Across countries, the relationships between national policy, individual perceptions, or personal circumstances determining contacts varied. CONCLUSIONS Our study, coordinated at the regional level, provides important insights into the understanding of the factors associated with social contacts to support future infectious disease outbreak responses.
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Affiliation(s)
- Kerry L M Wong
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| | - Amy Gimma
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Pietro Coletti
- Data Science Institute, I-Biostat, Hasselt University, Agoralaan Gebouw D, 3590, Diepenbeek, Belgium
| | - Christel Faes
- Data Science Institute, I-Biostat, Hasselt University, Agoralaan Gebouw D, 3590, Diepenbeek, Belgium
| | - Philippe Beutels
- Centre for Health Economics Research and Modelling Infectious Diseases, Vaccine and Infectious Disease Institute, University of Antwerp, Universiteitsplein 1, 2610, Wilrijk, Belgium
- School of Public Health and Community Medicine, The University of New South Wales, Sydney, Australia
| | - Niel Hens
- Data Science Institute, I-Biostat, Hasselt University, Agoralaan Gebouw D, 3590, Diepenbeek, Belgium
- Centre for Health Economics Research and Modelling Infectious Diseases, Vaccine and Infectious Disease Institute, University of Antwerp, Universiteitsplein 1, 2610, Wilrijk, Belgium
| | - Veronika K Jaeger
- Institute of Epidemiology and Social Medicine, University of Muenster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany
| | - Andre Karch
- Institute of Epidemiology and Social Medicine, University of Muenster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany
| | - Helen Johnson
- European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| | - WJohn Edmunds
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Christopher I Jarvis
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
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30
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Cetinkale Z, Aydin N. Health Care Logistics Network Design and Analysis on Pandemic Outbreaks: Insights From COVID-19. TRANSPORTATION RESEARCH RECORD 2023; 2677:674-703. [PMID: 37153192 PMCID: PMC10149596 DOI: 10.1177/03611981221099015] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Health care systems throughout the world are under pressure as a result of COVID-19. It is over two years since the first case was announced in China and health care providers are continuing to struggle with this fatal infectious disease in intensive care units and inpatient wards. Meanwhile, the burden of postponed routine medical procedures has become greater as the pandemic has progressed. We believe that establishing separate health care institutions for infected and non-infected patients would provide safer and better quality health care services. The aim of this study is to find the appropriate number and location of dedicated health care institutions which would only treat individuals infected by a pandemic during an outbreak. For this purpose, a decision-making framework including two multi-objective mixed-integer programming models is developed. At the strategic level, the locations of designated pandemic hospitals are optimized. At the tactical level, we determine the locations and operation durations of temporary isolation centers which treat mildly and moderately symptomatic patients. The developed framework provides assessments of the distance that infected patients travel, the routine medical services expected to be disrupted, two-way distances between new facilities (designated pandemic hospitals and isolation centers), and the infection risk in the population. To demonstrate the applicability of the suggested models, we perform a case study for the European side of Istanbul. In the base case, seven designated pandemic hospitals and four isolation centers are established. In sensitivity analyses, 23 cases are analyzed and compared to provide support to decision makers.
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Affiliation(s)
- Zeynep Cetinkale
- Turkish Airlines, İstanbul,
Turkey
- Department of Industrial Engineering,
Yildiz Technical University, Istanbul, Turkey
- Zeynep Cetinkale,
| | - Nezir Aydin
- Department of Industrial Engineering,
Yildiz Technical University, Istanbul, Turkey
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Gulley C, Kepler KL, Ngai S, Waechter H, Fitzhenry R, Thompson CN, Fine A, Reddy V. Clustering of SARS-CoV-2 in Households in New York City: A Building-Level Analysis, March-December 2020. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2023; 29:587-595. [PMID: 36943404 DOI: 10.1097/phh.0000000000001728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
OBJECTIVES To identify the proportion of coronavirus disease 2019 (COVID-19) cases that occurred within households or buildings in New York City (NYC) beginning in March 2020 during the first stay-at-home order to determine transmission attributable to these settings and inform targeted prevention strategies. DESIGN The residential addresses of cases were geocoded (converting descriptive addresses to latitude and longitude coordinates) and used to identify clusters of cases residing in unique buildings based on building identification number (BIN), a unique building identifier. Household clusters were defined as 2 or more cases within 2 weeks of onset or diagnosis date in the same BIN with the same unit number, last name, or in a single-family home. Building clusters were defined as 3 or more cases with onset date or diagnosis date within 2 weeks in the same BIN who do not reside in the same household. SETTING NYC from March to December 2020. PARTICIPANTS NYC residents with a positive SARS-CoV-2 nucleic acid amplification or antigen test result with a specimen collected during March 1, 2020, to December 31, 2020. MAIN OUTCOME MEASURE The proportion of NYC COVID-19 cases in a household or building cluster. RESULTS The BIN analysis identified 65 343 building and household clusters: 17 139 (26%) building clusters and 48 204 (74%) household clusters. A substantial proportion of NYC COVID-19 cases (43%) were potentially attributable to household transmission in the first 9 months of the pandemic. CONCLUSIONS Geocoded address matching assisted in identifying COVID-19 household clusters. Close contact transmission within a household or building cluster was found in 43% of noncongregate cases with a valid residential NYC address. The BIN analysis should be utilized to identify disease clustering for improved surveillance.
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Affiliation(s)
- Catherine Gulley
- New York City Department of Health and Mental Hygiene, Queens, New York. Ms Gulley is now with JBS International, Rockville, Maryland
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32
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Tsang TK, Huang X, Wang C, Chen S, Yang B, Cauchemez S, Cowling BJ. The effect of variation of individual infectiousness on SARS-CoV-2 transmission in households. eLife 2023; 12:82611. [PMID: 36880191 PMCID: PMC9991055 DOI: 10.7554/elife.82611] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 02/20/2023] [Indexed: 02/25/2023] Open
Abstract
Quantifying variation of individual infectiousness is critical to inform disease control. Previous studies reported substantial heterogeneity in transmission of many infectious diseases including SARS-CoV-2. However, those results are difficult to interpret since the number of contacts is rarely considered in such approaches. Here, we analyze data from 17 SARS-CoV-2 household transmission studies conducted in periods dominated by ancestral strains, in which the number of contacts was known. By fitting individual-based household transmission models to these data, accounting for number of contacts and baseline transmission probabilities, the pooled estimate suggests that the 20% most infectious cases have 3.1-fold (95% confidence interval: 2.2- to 4.2-fold) higher infectiousness than average cases, which is consistent with the observed heterogeneity in viral shedding. Household data can inform the estimation of transmission heterogeneity, which is important for epidemic management.
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Affiliation(s)
- Tim K Tsang
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong KongHong KongChina
- Laboratory of Data Discovery for HealthHong KongChina
| | - Xiaotong Huang
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong KongHong KongChina
| | - Can Wang
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong KongHong KongChina
| | - Sijie Chen
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong KongHong KongChina
| | - Bingyi Yang
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong KongHong KongChina
| | - Simon Cauchemez
- Mathematical Modelling of Infectious Diseases Unit, Institut PasteurParisFrance
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da Fonseca Lima EJ, Leite RD. COVID-19 vaccination in children: a public health priority. J Pediatr (Rio J) 2023; 99 Suppl 1:S28-S36. [PMID: 36564007 PMCID: PMC9767816 DOI: 10.1016/j.jped.2022.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 11/20/2022] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE Covid-19 had a direct impact on children's health. The aim of this review was to analyze epidemiological and clinical data, the consequences of the pandemic, and vaccination aspects in this group. SOURCES OF DATA The searches were carried out from January 2020 to November 2022, in the MEDLINE databases (PubMed) and publications of the Brazilian Ministry of Health and the Brazilian Society of Pediatrics. SUMMARY OF FINDINGS Covid-19 has a mild presentation in most children; however, the infection can progress to the severe form and, in some cases, to MIS-C. The prevalence of the so-called long Covid in children was 25.24%. Moreover, several indirect impacts occurred on the health of children and adolescents. Vaccination played a crucial role in enabling the reduction of severe disease and mortality rates. Children and adolescents, as a special population, were excluded from the initial clinical trials and, therefore, vaccination was introduced later in this group. Despite its importance, there have been difficulties in the efficient implementation of vaccination in the pediatric population. The CoronaVac vaccines are authorized in Brazil for children over three years of age and the pediatric presentations of the Pfizer vaccine have shown significant effectiveness and safety. CONCLUSIONS Covid-19 in the pediatric age group was responsible for the illness and deaths of a significant number of children. For successful immunization, major barriers have to be overcome. Real-world data on the safety and efficacy of several pediatric vaccines is emphasized, and the authors need a uniform message about the importance of immunization for all children.
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Affiliation(s)
- Eduardo Jorge da Fonseca Lima
- Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife, PE, Brazil; Faculdade Pernambucana de Saúde (FPS), Recife, PE, Brazil.
| | - Robério Dias Leite
- Universidade Federal do Ceará, Departamento de Saúde da Mulher, da Criança e do Adolescente, Fortaleza, CE, Brazil; Hospital São José de Doenças Infecciosas da Secretaria de Saúde do Estado do Ceará, Fortaleza, CE, Brazil
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Aditya RS, Yusuf A, Alrazeeni DM, Almutairi RL, Solikhah FK, Rahmatika QT, Kotijah S. “We are Tired but Do Not Give Up” the Dilemma and Challenges of Primary Nurses Facing the Omicron Variant: Qualitative Research. J Multidiscip Healthc 2023; 16:797-809. [PMID: 37006344 PMCID: PMC10065016 DOI: 10.2147/jmdh.s404177] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 03/08/2023] [Indexed: 03/29/2023] Open
Abstract
Background Everyone becomes aware due to the epidemic, especially primary department nurses. The significance of their experiences teaches nurses how to take care of themselves and be successful in their caregiving. Objective The purpose of this study was to investigate the perceptions of nurses working in primary care settings in rural regions during the omicron variant pandemic. Methods On the basis of the Nvivo 12 analytic approach, extensive semi-structured interviews were used to perform this qualitative study. 20 interviews later, data saturation had been reached. Data collecting was place from February to March 2022 for a month. The following participant characteristics were discovered through semi-structured interviews with 20 nurse participants. Ages of the participants, who were split between eight men and twelve women, varied from 28 to 43 years (average age 36.4 years). The majority (75% of them) had a vocational education, and their years of experience ranged from five to fifteen (average 11 years). Results 4 topics and 7 sub-themes' results. The results' fundamental message is: The Nursing Clinical Practice Dilemma, school district, virus type uncertainty Indigenous peoples do not adhere to the concept of the afterlife. Must Be Excited and Alert; School Cluster; Virus Type Confusion; Non-Belief in Covid; and the Dilemma of Nursing in Clinical Practice are the Overarching Themes of This Study. Conclusion Making innovations to increase motivation thereby reducing mental and physical fatigue are the implications of the results of this study. Further exploration of the readiness of nurses to treat patients in the main department is believed to be beneficial for the results of this study.
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Affiliation(s)
- Ronal Surya Aditya
- Department of Public Health, State University of Malang, Malang, Indonesia
| | - Ah Yusuf
- Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
- Correspondence: Ah Yusuf, Email
| | | | - Reem Lafi Almutairi
- Department of Public Health, School of Public Health and Health Informatics, Hail University, Hail, Saudi Arabia
| | | | | | - Siti Kotijah
- Department of Nursing, Universitas Bina Sehat PPNI, Mojokerto, Indonesia
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35
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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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36
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Zhang N, Hu T, Shang S, Zhang S, Jia W, Chen J, Zhang Z, Su B, Wang Z, Cheng R, Li Y. Local travel behaviour under continuing COVID-19 waves- A proxy for pandemic fatigue? TRANSPORTATION RESEARCH INTERDISCIPLINARY PERSPECTIVES 2023; 18:100757. [PMID: 36694823 PMCID: PMC9850857 DOI: 10.1016/j.trip.2023.100757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 01/06/2023] [Accepted: 01/14/2023] [Indexed: 06/11/2023]
Abstract
COVID-19 continues to threaten the world. Relaxing local travel behaviours on preventing the spread of COVID-19, may increase the infection risk in subsequent waves of SARS-CoV-2 transmission. In this study, we analysed changes in the travel behaviour of different population groups (adult, child, student, elderly) during four pandemic waves in Hong Kong before January 2021, by 4-billion second-by-second smartcard records of subway. A significant continuous relaxation in human travel behaviour was observed during the four waves of SARS-CoV-2 transmission. Residents sharply reduced their local travel by 51.9%, 50.1%, 27.6%, and 20.5% from the first to fourth pandemic waves, respectively. The population flow in residential areas, workplaces, schools, shopping areas, amusement areas and border areas, decreased on average by 30.3%, 33.5%, 41.9%, 58.1%, 85.4% and 99.6%, respectively, during the pandemic weeks. We also found that many other cities around the world experienced a similar relaxation trend in local travel behaviour, by comparing traffic congestion data during the pandemic with data from the same period in 2019. The quantitative pandemic fatigue in local travel behaviour could help governments partially predicting personal protective behaviours, and thus to suggest more accurate interventions during subsequent waves, especially for highly infectious virus variants such as Omicron.
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Affiliation(s)
- Nan Zhang
- Beijing Key Laboratory of Green Built Environment and Energy Efficient Technology, Beijing University of Technology, Beijing, China
| | - Tingrui Hu
- Beijing Key Laboratory of Green Built Environment and Energy Efficient Technology, Beijing University of Technology, Beijing, China
| | - Shujia Shang
- Beijing Key Laboratory of Green Built Environment and Energy Efficient Technology, Beijing University of Technology, Beijing, China
| | - Shiyao Zhang
- The Sifakis Research Institute for Trustworthy Autonomous Systems, Southern University of Science and Technology, Shenzhen 518055, China
| | - Wei Jia
- Department of Mechanical Engineering, The University of Hong Kong, Hong Kong SAR, China
| | - Jinhang Chen
- Faculty of Information Technology, Beijing University of Technology, Beijing, China
| | - Zixuan Zhang
- Beijing Key Laboratory of Green Built Environment and Energy Efficient Technology, Beijing University of Technology, Beijing, China
| | - Boni Su
- China Electric Power Planning & Engineering Institute, Beijing, China
| | - Zhenyu Wang
- College of Economics and Management, Beijing University of Technology, Beijing, China
| | - Reynold Cheng
- Department of Computer Science, The University of Hong Kong, Hong Kong SAR, China
| | - Yuguo Li
- Department of Mechanical Engineering, The University of Hong Kong, Hong Kong SAR, China
- School of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
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37
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Shang S, Jia W, Zhang S, Su B, Cheng R, Li Y, Zhang N. Changes on local travel behaviors under travel reduction-related interventions during COVID-19 pandemic: a case study in Hong Kong. CITY AND BUILT ENVIRONMENT 2023; 1:5. [PMCID: PMC9985955 DOI: 10.1007/s44213-023-00006-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
The emerging Omicron variant poses a serious threat to human health. Public transports play a critical role in infection spread. Based on the data of nearly 4 billion smartcard uses, between January 1, 2019 and January 31, 2021 from the Mass Transit Railway Corporation of Hong Kong, we analyzed the subway travel behavior of different population groups (adults, children, students and senior citizens) due to the COVID-19 pandemic and human travel behavior under different interventions (e.g. work suspension, school closure). Due to the pandemic, the number of MTR passengers (the daily number of passengers in close proximity in subway carriages) decreased by 37.4% (40.8%) for adults, 80.3% (78.5%) for children, 71.6% (71.6%) for students, and 33.5% (36.1%) for senior citizens. Due to work from home (school suspension), the number of contacted adults (students/children) in the same carriage during the rush hours decreased by 39.6% (38.6%/43.2%). If all workers, students, and children were encouraged to commute avoiding rush hours, the possible repeated contacts during rush hour of adults, children and students decreased by 73.3%, 77.9% and 79.5%, respectively. Since adults accounted for 87.3% of the total number of subway passengers during the pandemic, work from home and staggered shift pattern of workers can reduce the infection risk effectively. Our objective is to find the changes of local travel behavior due to the pandemic. From the perspective of public transports, the results provide a scientific support for COVID-19 prevention and control in cities.
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Affiliation(s)
- Shujia Shang
- grid.28703.3e0000 0000 9040 3743Beijing Key Laboratory of Green Built Environment and Energy Efficient Technology, Beijing University of Technology, Beijing, China
| | - Wei Jia
- grid.194645.b0000000121742757Department of Mechanical Engineering, The University of Hong Kong, Hong Kong, China
| | - Shiyao Zhang
- grid.263817.90000 0004 1773 1790The Research Institute for Trustworthy Autonomous Systems, Southern University of Science and Technology, Shenzhen, 518055 China
| | - Boni Su
- grid.467472.4China Electric Power Planning & Engineering Institute, Beijing, China
| | - Reynold Cheng
- grid.194645.b0000000121742757Department of Computer Science, The University of Hong Kong, Hong Kong, SAR China
| | - Yuguo Li
- grid.194645.b0000000121742757Department of Mechanical Engineering, The University of Hong Kong, Hong Kong, China ,grid.194645.b0000000121742757School of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, SAR China
| | - Nan Zhang
- grid.28703.3e0000 0000 9040 3743Beijing Key Laboratory of Green Built Environment and Energy Efficient Technology, Beijing University of Technology, Beijing, China
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38
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Wang BG, Wang ZC, Wu Y, Xiong Y, Zhang J, Ma Z. A mathematical model reveals the influence of NPIs and vaccination on SARS-CoV-2 Omicron Variant. NONLINEAR DYNAMICS 2023; 111:3937-3952. [PMID: 36339320 PMCID: PMC9628561 DOI: 10.1007/s11071-022-07985-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 09/19/2022] [Indexed: 05/10/2023]
Abstract
An SVEIR SARS-CoV-2 Omicron variant model is proposed to provide some insights to coordinate non-pharmaceutical interventions (NPIs) and vaccination. Mathematically, we define the basic reproduction number R 0 and the effective reproduction number R e to measure the infection potential of Omicron variant and formulate an optimal disease control strategy. Our inversion results imply that the sick period of Omicron variant in the United States is longer than that of Delta variant in India. The decrease in the infectious period of the infection with infectiousness implies that the risk of hospitalization is reduced; but the increasing period of the infection with non-infectiousness signifies that Omicron variant lengthens the period of nucleic acid test being negative. Optimistically, Omicron's death rate is only a quarter of Delta's. Moreover, we forecast that the cumulative cases will exceed 100 million in the United States on February 28, 2022, and the daily confirmed cases will reach a peak on February 2, 2022. The results of parameters sensitivity analysis imply that NPIs are helpful to reduce the number of confirmed cases. In particular, NPIs are indispensable even if all the people were vaccinated when the efficiency of vaccine is relatively low. By simulating the relationships of the effective reproduction number R e , the vaccination rate and the efficacy of vaccine, we find that it is impossible to achieve the herd immunity without NPIs while the efficiency of vaccine is lower than 88.7 % . Therefore, the herd immunity area is defined by the evolution of relationships between the vaccination rate and the efficacy of vaccine. Finally, we present that the disease-induced mortality rate demonstrates the periodic oscillation and an almost periodic function is deduced to match the curve. A discussion completes the paper.
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Affiliation(s)
- Bin-Guo Wang
- School of Mathematics and Statistics, Lanzhou University, Lanzhou, Gansu 730000 People’s Republic of China
| | - Zhi-Cheng Wang
- School of Mathematics and Statistics, Lanzhou University, Lanzhou, Gansu 730000 People’s Republic of China
| | - Yan Wu
- School of Mathematics and Statistics, Lanzhou University, Lanzhou, Gansu 730000 People’s Republic of China
| | - Yongping Xiong
- School of Mathematics and Statistics, Lanzhou University, Lanzhou, Gansu 730000 People’s Republic of China
| | - Jiangqian Zhang
- School of Mathematics and Statistics, Lanzhou University, Lanzhou, Gansu 730000 People’s Republic of China
| | - Zhuihui Ma
- School of Mathematics and Statistics, Lanzhou University, Lanzhou, Gansu 730000 People’s Republic of China
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39
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Sieber J, Schmidthaler K, Kopanja S, Weseslindtner L, Stiasny K, Götzinger F, Graf A, Krotka P, Hoz J, Schoof A, Dwivedi V, Frischer T, Szépfalusi Z. Limited role of children in transmission of SARS-CoV-2 virus in households-Immunological analysis of 26 familial clusters. Pediatr Allergy Immunol 2023; 34:e13913. [PMID: 36705043 PMCID: PMC10107319 DOI: 10.1111/pai.13913] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 11/23/2022] [Accepted: 01/03/2023] [Indexed: 01/28/2023]
Abstract
BACKGROUND The impact of children on the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains uncertain. This study provides an insight into distinct patterns of SARS-CoV-2 household transmission in case of pediatric and adult index cases as well as age-dependent susceptibility to SARS-CoV-2 infection. METHODS Immune analysis, medical interviewing, and contact tracing of 26 families with confirmed SARS-CoV-2 infection cases have been conducted. Blood samples were analyzed serologically with the use of a SARS-CoV-2-specific IgG assay and virus neutralization test (VNT). Uni- and multivariable linear regression and mixed effect logistic regression models were used to describe potential risk factors for higher contagiousness and susceptibility to SARS-CoV-2 infection. RESULTS SARS-CoV-2 infection could be confirmed in 67 of 124 family members. Fourteen children and 11 adults could be defined as index cases in their households. Forty of 82 exposed family members were defined as secondarily infected. The mean secondary attack rate in households was 0.48 and was significantly higher in households with adult than with pediatric index cases (0.85 vs 0.19; p < 0.0001). The age (grouped into child and adult) of index case, severity of disease, and occurrence of lower respiratory symptoms in index cases were significantly associated with secondary transmission rates in households. Children seem to be equally susceptible to acquire a SARS-CoV-2 infection as adults, but they suffer milder courses of the disease or remain asymptomatic. CONCLUSION SARS-CoV-2 transmission from infected children to other household members occurred rarely in the first wave of the pandemic, despite close physical contact and the lack of hygienic measures.
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Affiliation(s)
- Justyna Sieber
- Division of Paediatric Pulmonology, Allergy and Endocrinology, Department of Paediatrics and Adolescent Medicine, Comprehensive Centre of Paediatrics, Medical University of Vienna, Vienna, Austria.,Department of Clinical Immunology, Wroclaw Medical University, Wroclaw, Poland
| | - Klara Schmidthaler
- Division of Paediatric Pulmonology, Allergy and Endocrinology, Department of Paediatrics and Adolescent Medicine, Comprehensive Centre of Paediatrics, Medical University of Vienna, Vienna, Austria
| | - Sonja Kopanja
- Division of Paediatric Pulmonology, Allergy and Endocrinology, Department of Paediatrics and Adolescent Medicine, Comprehensive Centre of Paediatrics, Medical University of Vienna, Vienna, Austria
| | | | - Karin Stiasny
- Center for Virology, Medical University of Vienna, Vienna, Austria
| | - Florian Götzinger
- Department of Paediatrics and Adolescent Medicine, Klinik Ottakring, Vienna, Austria
| | - Alexandra Graf
- Section for Medical Statistics, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Austria
| | - Pavla Krotka
- Section for Medical Statistics, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Austria
| | - Jakub Hoz
- Division of Paediatric Pulmonology, Allergy and Endocrinology, Department of Paediatrics and Adolescent Medicine, Comprehensive Centre of Paediatrics, Medical University of Vienna, Vienna, Austria
| | - Anja Schoof
- Division of Paediatric Pulmonology, Allergy and Endocrinology, Department of Paediatrics and Adolescent Medicine, Comprehensive Centre of Paediatrics, Medical University of Vienna, Vienna, Austria
| | - Varsha Dwivedi
- Division of Paediatric Pulmonology, Allergy and Endocrinology, Department of Paediatrics and Adolescent Medicine, Comprehensive Centre of Paediatrics, Medical University of Vienna, Vienna, Austria
| | | | - Zsolt Szépfalusi
- Division of Paediatric Pulmonology, Allergy and Endocrinology, Department of Paediatrics and Adolescent Medicine, Comprehensive Centre of Paediatrics, Medical University of Vienna, Vienna, Austria
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40
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Ramírez Varela A, Contreras-Arrieta S, Tamayo-Cabeza G, Salas Zapata L, Caballero-Díaz Y, Hernández Florez LJ, Benavidez AP, Laajaj R, De la Hoz F, Buitrago Gutierrez G, Restrepo S, Behrentz E. Risk factors for SARS-CoV-2 transmission in close contacts of adults at high risk of infection due to occupation: results from the contact tracing strategy of the CoVIDA epidemiological surveillance study in Bogotá, Colombia, in 2020-2021. BMJ Open 2022; 12:e062487. [PMID: 36564109 PMCID: PMC9791111 DOI: 10.1136/bmjopen-2022-062487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES To estimate the risk factors for SARS-CoV-2 transmission in close contacts of adults at high risk of infection due to occupation, participants of the CoVIDA study, in Bogotá D.C., Colombia. SETTING The CoVIDA study was the largest COVID-19 intensified sentinel epidemiological surveillance study in Colombia thus far, performing over 60 000 RT-PCR tests for SARS-CoV-2 infection. The study implemented a contact tracing strategy (via telephone call) to support traditional surveillance actions performed by the local health authority. PARTICIPANTS Close contacts of participants from the CoVIDA study. PRIMARY AND SECONDARY OUTCOME MEASURES SARS-CoV-2 testing results were obtained (RT-PCR with CoVIDA or self-reported results). The secondary attack rate (SAR) was calculated using contacts and primary cases features. RESULTS The CoVIDA study performed 1257 contact tracing procedures on primary cases. A total of 5551 close contacts were identified and 1050 secondary cases (21.1%) were found. The highest SAR was found in close contacts: (1) who were spouses (SAR=32.7%; 95% CI 29.1% to 36.4%), (2) of informally employed or unemployed primary cases (SAR=29.1%; 95% CI 25.5% to 32.8%), (3) of symptomatic primary cases (SAR of 25.9%; 95% CI 24.0% to 27.9%) and (4) living in households with more than three people (SAR=22.2%; 95% CI 20.7% to 23.8%). The spouses (OR 3.85; 95% CI 2.60 to 5.70), relatives (OR 1.89; 95% CI 1.33 to 2.70) and close contacts of a symptomatic primary case (OR 1.48; 95% CI 1.24 to 1.77) had an increased risk of being secondary cases compared with non-relatives and close contacts of an asymptomatic index case, respectively. CONCLUSIONS Contact tracing strategies must focus on households with socioeconomic vulnerabilities to guarantee isolation and testing to stop the spread of the disease.
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Affiliation(s)
| | | | | | - Leonardo Salas Zapata
- Observatorio de Salud, Secretaría Distrital de Salud de Bogotá, Bogotá D.C, Colombia
| | | | | | | | - Rachid Laajaj
- Department of Economics, Universidad de los Andes, Bogotá DC, Colombia
| | - Fernando De la Hoz
- Departamento de Salud Pública, Universidad Nacional de Colombia, Bogotá DC, Colombia
| | | | - Silvia Restrepo
- Department of Food and Chemical Engineering, Universidad de los Andes, Bogotá, Colombia
| | - Eduardo Behrentz
- Vicerrectoría Administrativa y Financiera, Universidad de los Andes, Bogotá DC, Colombia
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41
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Wang C, Huang X, Lau EHY, Cowling BJ, Tsang TK. Association Between Population-Level Factors and Household Secondary Attack Rate of SARS-CoV-2: A Systematic Review and Meta-analysis. Open Forum Infect Dis 2022; 10:ofac676. [PMID: 36655186 PMCID: PMC9835764 DOI: 10.1093/ofid/ofac676] [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: 09/02/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022] Open
Abstract
Background Accurate estimation of household secondary attack rate (SAR) is crucial to understand the transmissibility of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The impact of population-level factors, such as transmission intensity in the community, on SAR estimates is rarely explored. Methods In this study, we included articles with original data to compute the household SAR. To determine the impact of transmission intensity in the community on household SAR estimates, we explored the association between SAR estimates and the incidence rate of cases by country during the study period. Results We identified 163 studies to extract data on SARs from 326 031 cases and 2 009 859 household contacts. The correlation between the incidence rate of cases during the study period and SAR estimates was 0.37 (95% CI, 0.24-0.49). We found that doubling the incidence rate of cases during the study period was associated with a 1.2% (95% CI, 0.5%-1.8%) higher household SAR. Conclusions Our findings suggest that the incidence rate of cases during the study period is associated with higher SAR. Ignoring this factor may overestimate SARs, especially for regions with high incidences, which further impacts control policies and epidemiological characterization of emerging variants.
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Affiliation(s)
- Can Wang
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Xiaotong Huang
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Eric H Y Lau
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China,Laboratory of Data Discovery for Health Limited, Hong Kong Science and Technology Park, New Territories, Hong Kong Special Administrative Region, China
| | - Benjamin J Cowling
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China,Laboratory of Data Discovery for Health Limited, Hong Kong Science and Technology Park, New Territories, Hong Kong Special Administrative Region, China
| | - Tim K Tsang
- Correspondence: Tim K. Tsang, PhD, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 7 Sassoon Road, Pokfulam, Hong Kong Special Administrative Region, China ()
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42
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Nashebi R, Sari M, Kotil S. Using a real-world network to model the trade-off between stay-at-home restriction, vaccination, social distancing and working hours on COVID-19 dynamics. PeerJ 2022; 10:e14353. [PMID: 36540805 PMCID: PMC9760027 DOI: 10.7717/peerj.14353] [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: 04/18/2022] [Accepted: 10/17/2022] [Indexed: 12/23/2022] Open
Abstract
Background Human behaviour, economic activity, vaccination, and social distancing are inseparably entangled in epidemic management. This study aims to investigate the effects of various parameters such as stay-at-home restrictions, work hours, vaccination, and social distance on the containment of pandemics such as COVID-19. Methods To achieve this, we have developed an agent based model based on a time-dynamic graph with stochastic transmission events. The graph is constructed from a real-world social network. The edges of graph have been categorized into three categories: home, workplaces, and social environment. The conditions needed to mitigate the spread of wild-type COVID-19 and the delta variant have been analyzed. Our purposeful agent based model has carefully executed tens of thousands of individual-based simulations. We propose simple relationships for the trade-offs between effective reproduction number (R e), transmission rate, working hours, vaccination, and stay-at-home restrictions. Results We have found that the effect of a 13.6% increase in vaccination for wild-type (WT) COVID-19 is equivalent to reducing four hours of work or a one-day stay-at-home restriction. For the delta, 20.2% vaccination has the same effect. Also, since we can keep track of household and non-household infections, we observed that the change in household transmission rate does not significantly alter the R e. Household infections are not limited by transmission rate due to the high frequency of connections. For the specifications of COVID-19, the R e depends on the non-household transmissions rate. Conclusions Our findings highlight that decreasing working hours is the least effective among the non-pharmaceutical interventions. Our results suggest that policymakers decrease work-related activities as a last resort and should probably not do so when the effects are minimal, as shown. Furthermore, the enforcement of stay-at-home restrictions is moderately effective and can be used in conjunction with other measures if absolutely necessary.
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Affiliation(s)
- Ramin Nashebi
- Department of Mathematics, Yildiz Technical University, Istanbul, Turkey
| | - Murat Sari
- Department of Mathematics, Yildiz Technical University, Istanbul, Turkey,Department of Mathematics Engineering, Faculty of Science and Letters, Istanbul Technical University, Istanbul, Turkey
| | - Seyfullah Kotil
- Department of Biophysics, School of Medicine, Bahcesehir University, Istanbul, Turkey
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43
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Wing K, Grint DJ, Mathur R, Gibbs HP, Hickman G, Nightingale E, Schultze A, Forbes H, Nafilyan V, Bhaskaran K, Williamson E, House T, Pellis L, Herrett E, Gautam N, Curtis HJ, Rentsch CT, Wong AYS, MacKenna B, Mehrkar A, Bacon S, Douglas IJ, Evans SJW, Tomlinson L, Goldacre B, Eggo RM. Association between household composition and severe COVID-19 outcomes in older people by ethnicity: an observational cohort study using the OpenSAFELY platform. Int J Epidemiol 2022; 51:1745-1760. [PMID: 35962974 PMCID: PMC9384728 DOI: 10.1093/ije/dyac158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 07/22/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Ethnic differences in the risk of severe COVID-19 may be linked to household composition. We quantified the association between household composition and risk of severe COVID-19 by ethnicity for older individuals. METHODS With the approval of NHS England, we analysed ethnic differences in the association between household composition and severe COVID-19 in people aged 67 or over in England. We defined households by number of age-based generations living together, and used multivariable Cox regression stratified by location and wave of the pandemic and accounted for age, sex, comorbidities, smoking, obesity, housing density and deprivation. We included 2 692 223 people over 67 years in Wave 1 (1 February 2020-31 August 2020) and 2 731 427 in Wave 2 (1 September 2020-31 January 2021). RESULTS Multigenerational living was associated with increased risk of severe COVID-19 for White and South Asian older people in both waves [e.g. Wave 2, 67+ living with three other generations vs 67+-year-olds only: White hazard ratio (HR) 1.61 95% CI 1.38-1.87, South Asian HR 1.76 95% CI 1.48-2.10], with a trend for increased risks of severe COVID-19 with increasing generations in Wave 2. There was also an increased risk of severe COVID-19 in Wave 1 associated with living alone for White (HR 1.35 95% CI 1.30-1.41), South Asian (HR 1.47 95% CI 1.18-1.84) and Other (HR 1.72 95% CI 0.99-2.97) ethnicities, an effect that persisted for White older people in Wave 2. CONCLUSIONS Both multigenerational living and living alone were associated with severe COVID-19 in older adults. Older South Asian people are over-represented within multigenerational households in England, especially in the most deprived settings, whereas a substantial proportion of White older people live alone. The number of generations in a household, number of occupants, ethnicity and deprivation status are important considerations in the continued roll-out of COVID-19 vaccination and targeting of interventions for future pandemics.
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Affiliation(s)
- Kevin Wing
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Daniel J Grint
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Rohini Mathur
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Hamish P Gibbs
- Department of Geography, University College London, London, UK
| | - George Hickman
- The DataLab, University of Oxford Nuffield Department of Primary Care Health Sciences, Oxford, UK
| | - Emily Nightingale
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Anna Schultze
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Harriet Forbes
- Population Health Sciences, University of Bristol, Bristol, UK
| | - Vahé Nafilyan
- Health Modelling Hub, Office of National Statistics, Newport, UK
| | - Krishnan Bhaskaran
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Elizabeth Williamson
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Thomas House
- Department of Mathematics, University of Manchester, Manchester, UK
| | - Lorenzo Pellis
- Department of Mathematics, University of Manchester, Manchester, UK
| | - Emily Herrett
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Nileesa Gautam
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
- Aetion Inc, Boston, USA
| | - Helen J Curtis
- The DataLab, University of Oxford Nuffield Department of Primary Care Health Sciences, Oxford, UK
| | - Christopher T Rentsch
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Angel Y S Wong
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Brian MacKenna
- The DataLab, University of Oxford Nuffield Department of Primary Care Health Sciences, Oxford, UK
| | - Amir Mehrkar
- The DataLab, University of Oxford Nuffield Department of Primary Care Health Sciences, Oxford, UK
| | - Seb Bacon
- The DataLab, University of Oxford Nuffield Department of Primary Care Health Sciences, Oxford, UK
| | - Ian J Douglas
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Stephen J W Evans
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Laurie Tomlinson
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Ben Goldacre
- The DataLab, University of Oxford Nuffield Department of Primary Care Health Sciences, Oxford, UK
| | - Rosalind M Eggo
- The DataLab, University of Oxford Nuffield Department of Primary Care Health Sciences, Oxford, UK
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Anderson TL, Nande A, Merenstein C, Raynor B, Oommen A, Kelly BJ, Levy MZ, Hill AL. Quantifying individual-level heterogeneity in infectiousness and susceptibility through household studies. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2022:2022.12.02.22281853. [PMID: 36523404 PMCID: PMC9753792 DOI: 10.1101/2022.12.02.22281853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
The spread of SARS-CoV-2, like that of many other pathogens, is governed by heterogeneity. "Superspreading," or "over-dispersion," is an important factor in transmission, yet it is hard to quantify. Estimates from contact tracing data are prone to potential biases due to the increased likelihood of detecting large clusters of cases, and may reflect variation in contact behavior more than biological heterogeneity. In contrast, the average number of secondary infections per contact is routinely estimated from household surveys, and these studies can minimize biases by testing all members of a household. However, the models used to analyze household transmission data typically assume that infectiousness and susceptibility are the same for all individuals or vary only with predetermined traits such as age. Here we develop and apply a combined forward simulation and inference method to quantify the degree of inter-individual variation in both infectiousness and susceptibility from observations of the distribution of infections in household surveys. First, analyzing simulated data, we show our method can reliably ascertain the presence, type, and amount of these heterogeneities with data from a sufficiently large sample of households. We then analyze a collection of household studies of COVID-19 from diverse settings around the world, and find strong evidence for large heterogeneity in both the infectiousness and susceptibility of individuals. Our results also provide a framework to improve the design of studies to evaluate household interventions in the presence of realistic heterogeneity between individuals.
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Affiliation(s)
- Thayer L Anderson
- Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD 21218
| | - Anjalika Nande
- Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD 21218
| | - Carter Merenstein
- Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - Brinkley Raynor
- Department of Biostatistics, Epidemiology, & Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - Anisha Oommen
- Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD 21218
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21218
| | - Brendan J Kelly
- Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - Michael Z Levy
- Department of Biostatistics, Epidemiology, & Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - Alison L Hill
- Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD 21218
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21218
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45
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Hammond V, Butchard M, Stablein H, Jack S. COVID-19 in one region of New Zealand: a descriptive epidemiological study. Aust N Z J Public Health 2022; 46:745-750. [PMID: 36190206 PMCID: PMC9874785 DOI: 10.1111/1753-6405.13305] [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: 11/01/2021] [Revised: 01/01/2022] [Accepted: 08/01/2022] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVE To describe the epidemiology of COVID-19 in one region of New Zealand in the context of the national lockdown and provide a reference for comparing infection dynamics and control measures between SARS-Cov-2 strains. Methods: Epidemiological linking and analysis of COVID-19 cases and their close contacts residing in the geographical area served by the Southern District Health Board (SDHB). Results: From 13 March to 5 April 5 2020, 186 cases were laboratory-confirmed with wild-type Sars-Cov-2 in SDHB. Overall, 35·1% of cases were attributable to household transmission, 27·0% to non-household, 25·4% to overseas travel and 12·4% had no known epidemiological links. The highest secondary attack rate was observed in households during lockdown (15·3%, 95%CI 10·4-21·5). The mean serial interval in 50 exclusive infector-infectee pairs was 4·0 days (95%CI 3·2-4·7days), and the mean incubation period was 3.4 days (95%CI 2·7-4·2). CONCLUSIONS The SARS-CoV-2 incubation period may be shorter than early estimates that were limited by uncertainties in exposure history or small sample sizes. IMPLICATIONS FOR PUBLIC HEALTH The continuation of household transmission during lockdown highlights the need for effective home-based quarantine guidance. Our findings of a short incubation period highlight the need to contact trace and isolate as rapidly as possible.
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Affiliation(s)
- Vanessa Hammond
- Public Health South, Southern District Health Board, Dunedin, New Zealand,Correspondence to: Vanessa Hammond, Public Health South, Southern District Health Board, Private Bag 1921, Dunedin 9054, New Zealand
| | - Michael Butchard
- Public Health South, Southern District Health Board, Dunedin, New Zealand
| | - Hohepa Stablein
- Capital & Coast District Health Board, Wellington, New Zealand
| | - Susan Jack
- Public Health South, Southern District Health Board, Dunedin, New Zealand
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46
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Lima EJDF. COVID-19 and Pediatrics: a look into the past and the future. REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2022. [DOI: 10.1590/1806-9304202200040001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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47
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Yang K, Deng J, Tuo X, Fan S, Yue Y, Liu H, Liu Z, Zhang S, Wang L, Dai R, Zhao Y. Analysis of the close contact management mode and epidemiological characteristics of COVID-19 in Chengdu, China. One Health 2022; 15:100420. [PMID: 35910302 PMCID: PMC9323207 DOI: 10.1016/j.onehlt.2022.100420] [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: 06/07/2022] [Revised: 07/20/2022] [Accepted: 07/21/2022] [Indexed: 11/19/2022] Open
Abstract
With the development of the novel coronavirus disease 2019 (COVID-19) epidemic and the increase in cases, as a potential source of infection, the risk of close contact has gradually increased. However, few studies have analyzed the tracking and management of cross-regional personnel. In this study, we hope to understand the effectiveness and feasibility of existing close contact management measures in Chengdu, so as to provide a reference for further prevention and control of the epidemic. The close contact management mode and epidemiological characteristics of 40,425 close contacts from January 22, 2020, to March 1, 2022, in Chengdu, China, were analyzed. The relationship with index cases was mainly co-passengers (57.58%) and relatives (7.20%), and the frequency of contact was mainly occasional contact (70.39%). A total of 400 (0.99%) close contacts were converted into cases, which were mainly found in the first and second nucleic acid tests (53.69%), and the contact mode was mainly by sharing transportation (63.82%). In terms of close contact management time, both the supposed ((11.93 ± 3.00) days vs. (11.92 ± 7.24) days) and actual ((13.74 ± 17.47) days vs. (12.60 ± 4.35) days) isolation times in Chengdu were longer than those of the outer cities (P < 0.001). For the local clustered epidemics in Chengdu, the relationship with indexed cases was mainly colleagues (12.70%). The tracing and management of close contacts is a two-way management measure that requires cooperation among departments. Enhancing existing monitoring and response capabilities can control the spread of the epidemic to a certain extent.
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Affiliation(s)
- Kai Yang
- Chengdu Workstation for Emerging Infectious Disease Control and Prevention, Chinese Academy of Medical Sciences, Chengdu, Sichuan, People's Republic of China
| | - Jiali Deng
- Department of Orthopaedics, Chengdu Medical College, Sichuan, People's Republic of China
| | - Xiaoli Tuo
- Chengdu Workstation for Emerging Infectious Disease Control and Prevention, Chinese Academy of Medical Sciences, Chengdu, Sichuan, People's Republic of China
- Corresponding author.
| | - Shuangfeng Fan
- Chengdu Workstation for Emerging Infectious Disease Control and Prevention, Chinese Academy of Medical Sciences, Chengdu, Sichuan, People's Republic of China
| | - Yong Yue
- Chengdu Workstation for Emerging Infectious Disease Control and Prevention, Chinese Academy of Medical Sciences, Chengdu, Sichuan, People's Republic of China
| | - Hui Liu
- Chengdu Workstation for Emerging Infectious Disease Control and Prevention, Chinese Academy of Medical Sciences, Chengdu, Sichuan, People's Republic of China
| | - Zhijian Liu
- Department of Infectious Disease Control, Center for Disease Control and Prevention of Chenghua District, Chengdu, Sichuan, People's Republic of China
| | - Shuang Zhang
- Chengdu Workstation for Emerging Infectious Disease Control and Prevention, Chinese Academy of Medical Sciences, Chengdu, Sichuan, People's Republic of China
| | - Lingyi Wang
- Chengdu Workstation for Emerging Infectious Disease Control and Prevention, Chinese Academy of Medical Sciences, Chengdu, Sichuan, People's Republic of China
| | - Rong Dai
- Chengdu Workstation for Emerging Infectious Disease Control and Prevention, Chinese Academy of Medical Sciences, Chengdu, Sichuan, People's Republic of China
| | - Yao Zhao
- Chengdu Workstation for Emerging Infectious Disease Control and Prevention, Chinese Academy of Medical Sciences, Chengdu, Sichuan, People's Republic of China
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Wang J, Ma T, Ding S, Xu K, Zhang M, Zhang Z, Dai Q, Tao S, Wang H, Cheng X, He M, Du X, Feng Z, Yang H, Wang R, Xie C, Xu Y, Liu L, Chen X, Li C, Wu W, Ye S, Yang S, Fan H, Zhou N, Ding J. Dynamic characteristics of a COVID-19 outbreak in Nanjing, Jiangsu province, China. Front Public Health 2022; 10:933075. [PMID: 36483256 PMCID: PMC9723226 DOI: 10.3389/fpubh.2022.933075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 09/21/2022] [Indexed: 12/13/2022] Open
Abstract
Objectives Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) lineage B.1.617.2 (also named the Delta variant) was declared as a variant of concern by the World Health Organization (WHO). This study aimed to describe the outbreak that occurred in Nanjing city triggered by the Delta variant through the epidemiological parameters and to understand the evolving epidemiology of the Delta variant. Methods We collected the data of all COVID-19 cases during the outbreak from 20 July 2021 to 24 August 2021 and estimated the distribution of serial interval, basic and time-dependent reproduction numbers (R0 and Rt), and household secondary attack rate (SAR). We also analyzed the cycle threshold (Ct) values of infections. Results A total of 235 cases have been confirmed. The mean value of serial interval was estimated to be 4.79 days with the Weibull distribution. The R0 was 3.73 [95% confidence interval (CI), 2.66-5.15] as estimated by the exponential growth (EG) method. The Rt decreased from 4.36 on 20 July 2021 to below 1 on 1 August 2021 as estimated by the Bayesian approach. We estimated the household SAR as 27.35% (95% CI, 22.04-33.39%), and the median Ct value of open reading frame 1ab (ORF1ab) genes and nucleocapsid protein (N) genes as 25.25 [interquartile range (IQR), 20.53-29.50] and 23.85 (IQR, 18.70-28.70), respectively. Conclusions The Delta variant is more aggressive and transmissible than the original virus types, so continuous non-pharmaceutical interventions are still needed.
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Affiliation(s)
- Junjun Wang
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China,Chinese Field Epidemiology Training Program, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Tao Ma
- Department of Acute Infectious Diseases Control and Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China
| | - Songning Ding
- Department of Acute Infectious Diseases Control and Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China
| | - Ke Xu
- Department of Acute Infectious Diseases Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Min Zhang
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China
| | - Zhong Zhang
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China
| | - Qigang Dai
- Department of Acute Infectious Diseases Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Shilong Tao
- Jiangning District Center for Disease Control and Prevention, Nanjing, China
| | - Hengxue Wang
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China
| | - Xiaoqing Cheng
- Chinese Field Epidemiology Training Program, Chinese Center for Disease Control and Prevention, Beijing, China,Department of Acute Infectious Diseases Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Min He
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China
| | - Xuefei Du
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China
| | - Zhi Feng
- Jiangning District Center for Disease Control and Prevention, Nanjing, China
| | - Huafeng Yang
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China
| | - Rong Wang
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China
| | - Chaoyong Xie
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China
| | - Yuanyuan Xu
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China
| | - Li Liu
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China
| | - Xupeng Chen
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China
| | - Chen Li
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China
| | - Wen Wu
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China
| | - Sheng Ye
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China
| | - Sheng Yang
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China
| | - Huafeng Fan
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China
| | - Nan Zhou
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China,*Correspondence: Jie Ding
| | - Jie Ding
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China,Nan Zhou
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49
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Lee HJ, Lee HK, Kim YR. The impact of caregivers on nosocomial transmission during a COVID-19 outbreak in a community-based hospital in South Korea. PLoS One 2022; 17:e0277816. [PMID: 36409747 PMCID: PMC9678252 DOI: 10.1371/journal.pone.0277816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 11/03/2022] [Indexed: 11/22/2022] Open
Abstract
The COVID-19 pandemic becomes a cause of concern for hospital transmission. Caregivers may play an important role as vectors for nosocomial infections; however, infection control for caregivers often is neglected. A nosocomial COVID-19 outbreak occurred in a 768-bed hospital from March 20, 2020, to April 14, 2020. We conducted a retrospective chart review and epidemiologic investigation on all cases. A total of 54 cases of laboratory-confirmed COVID-19 occurred in the community-based hospital. They included 26 (48.1%) patients, 21 (38.9%) caregivers, and 7 (13.0%) healthcare workers. These 21 caregivers cared for 18 patients, and of these, 9 were positive for COVID-19, 6 were negative, and 3 died before testing. Of the 6 negative patients, 3 had no exposure because the caregiver began to show symptoms at least 5 days after their discharge. Of the 9 positive patients, 4 cases of transmission took place from patient to caregiver (one patient transmitted COVID-19 to two caregivers), and 6 cases of transmission occurred from caregiver to patient. Of the 54 hospital-acquired cases, 38 occurred in the 8th-floor ward and 8 occurred in the 4th-floor ward. The index case of each ward was a caregiver. Counting the number of cases where transmission occurred only between patients and their own caregivers, 9 patients were suspected of having exposure to COVID-19 from their own caregivers. Six patients (66.7%) were infected by COVID-19-confirmed caregivers, and 3 patients were uninfected. Fewer patients among the infected were able to perform independent activities compared to uninfected patients. Not only patients and healthcare workers but also caregivers groups may be vulnerable to COVID-19 and be transmission sources of nosocomial outbreaks. Therefore, infection control programs for caregivers in addition to patients and healthcare workers can be equally important.
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Affiliation(s)
- Hyo-Jin Lee
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hae Kook Lee
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yang Ree Kim
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
- * E-mail:
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50
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Yan X, Xiao W, Zhou S, Wang X, Wang Z, Zhao M, Li T, Jia Z, Zhang B, Shui T. A four-generation family transmission chain of COVID-19 along the China-Myanmar border in October to November 2021. Front Public Health 2022; 10:1004817. [PMID: 36466467 PMCID: PMC9714430 DOI: 10.3389/fpubh.2022.1004817] [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: 07/27/2022] [Accepted: 10/26/2022] [Indexed: 11/19/2022] Open
Abstract
Background Foreign imported patients and within-household transmission have been the focus and difficulty of coronavirus disease 2019 (COVID-19) prevention and control, which has also posed challenges to border areas' management. However, household transmission caused by foreign imported cases has not been reported in China's border areas. This study aimed to reveal a clear family clustering transmission chain of COVID-19 caused by contact with Myanmar refugees along the China-Myanmar border during an outbreak in October to November 2021. Methods During the outbreak, detailed epidemiological investigations were conducted on confirmed patients with COVID-19 and their close contacts in daily activities. Patients were immediately transported to a designated hospital for treatment and quarantine, and their close contacts were quarantined at designated sites. Regular nucleic acid testing and SARS-CoV-2 antibody testing were provided to them. Results A clear four-generation family clustering transmission involving five patients with COVID-19 was found along the China-Myanmar border. The index case (Patient A) was infected by brief conversations with Myanmar refugees across border fences during work. His wife (Patient B) and 9-month-old daughter (Patient C) were second-generation cases infected by daily contact with him. His 2-year-old daughter (Patient D) was the third-generation case infected by her mother and sister during quarantine in the same room and then transmitted the virus to her grandmother (Patient E, the fourth-generation case) who looked after her after Patients B and C were diagnosed and transported to the hospital. The household secondary attack rate was 80.0%, the average latent period was 4 days, and the generation time was 3 days. Ten of 942 close contacts (1.1%) of this family had positive IgM antibody during the medical observation period. In total 73.9% (696/942) of them were positive for IgG antibody and 8.3% (58/696) had IgG levels over 20 S/CO (optical density of the sample/cut-off value of the reagent). Conclusion This typical transmission chain indicated that it is essential to strengthen COVID-19 prevention and control in border areas, and explore more effective children care approaches in quarantine sites.
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Affiliation(s)
- Xiangyu Yan
- School of Public Health, Peking University, Beijing, China
| | - Wei Xiao
- Mang City Center for Disease Control and Prevention, Mang, China
| | - Saipeng Zhou
- Mang City Center for Disease Control and Prevention, Mang, China
| | - Xuechun Wang
- School of Public Health, Peking University, Beijing, China
| | - ZeKun Wang
- School of Public Health, Peking University, Beijing, China
| | - Mingchen Zhao
- School of Public Health, Peking University, Beijing, China
| | - Tao Li
- School of Public Health, Peking University, Beijing, China,Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhongwei Jia
- School of Public Health, Peking University, Beijing, China,Center for Intelligent Public Health, Institute for Artificial Intelligence, Peking University, Beijing, China,Center for Drug Abuse Control and Prevention, National Institute of Health Data Science, Peking University, Beijing, China,Peking University Clinical Research Institute, Beijing, China
| | - Bo Zhang
- School of Public Health, Peking University, Beijing, China,*Correspondence: Bo Zhang
| | - Tiejun Shui
- Yunnan Center for Disease Control and Prevention, Kunming, China,Tiejun Shui
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