Outbreak of COVID-19 in a family, Wenzhou, China

A COVID-19 outbreak with a high attack rate among inpatients in a psychiatric hospital in Wenzhou, China

Background

Since the emergence of COVID-19, China has taken strict prevention and control measures against the disease. At the end of 2022, when the government optimized and relaxed the COVID-19 prevention and control policy, a new wave of the epidemic appeared. This paper reports an outbreak of COVID-19 among inpatients in a psychiatric hospital in Wenzhou, China.

Methods

The case definition of COVID-19 was established. Throat swab specimens were collected and examined by RT-PCT. Questionnaires were distributed to hospitalized patients. Survey data were collected and analyzed.

Results

Of 902 inpatients in our hospital, 762 became infected with COVID-19, an attack rate of 84.5%. The outbreak occurred from 10 December, 2022 to January 18, 2023. Twenty patients died, yielding a case fatality rate of 2.6%. Most of the dead were among elderly people with underlying diseases, and 19 of the deceased were over 65 years old.

Conclusion

Our investigation showed that the outbreak of COVID-19 among hospitalized patients had the characteristics of high incidence, strong infectivity, and rapid transmission. Infectious sources were introduced into the hospital from the community and spread within the hospital, resulting in an outbreak. In addition, special attention should be paid to elderly people with underlying diseases when treating patients with COVID-19 in the future.

Perceived stress and influencing factors for the people at high risk to COVID-19 in centralized quarantine camps in Wenzhou, China

BACKGROUND

This study was designed to assess stress levels and related factors during the coronavirus disease 2019 (COVID-19) epidemic among individuals in centralized quarantine camps in Wenzhou, China.

METHODS

The survey was conducted using a questionnaire. The questionnaire included questions on sociodemographic characteristics, life events related to the COVID-19 and stressful situations, as well as Perceived Stress Scale-14. Participants included close contacts of patients with COVID-19 or at-risk individuals in quarantine camps. Multivariate logistic regression was used to analyze different factors affecting perceived stress.

RESULTS

The prevalence of high stress among quarantine camp participants was 37.45%. Of the 881 respondents, 51.99% were concerned about the difficulty of controlling the epidemic, 46.20% were concerned about the health of themselves and their family members and 39.61% were concerned about not being able to leave their homes. Multivariate logistic regression analysis revealed statistically significant differences in the prevalence of stress among different groups for certain variables, including occupation, education level and knowledge of COVID-19 (all P < 0.05). Our study found that at-risk individuals and close contacts experienced high levels of stress in quarantine camps during the COVID-19 pandemic.

CONCLUSIONS

These findings suggest that centralized quarantine policies should be adapted and optimized to minimize negative psychological effects on quarantined individuals.

The Arab COVID-19 Anxiety Syndrome Scale (C-19ASS): COVID-19 anxiety syndrome and psychological symptoms in the Saudi Arabian population

INTRODUCTION

The COVID-19 Anxiety Syndrome Scale (C-19ASS) is a reliable scale assessing dysfunctional coping strategies activated in response to COVID-19 fear and threat. The present study aimed to provide a validation of the Arabic version of the C-19ASS and to explore the association between the C-19ASS and psychological symptoms syndrome.

METHOD

In Study 1, a community sample of 404 participants completed the Arabic version of the C-19ASS and results were subjected to an exploratory factor analysis. In Study 2, a community sample of 903 participants completed the Arabic version of the C-19ASS and a series of measures assessing depressed mood and anhedonia, generalized anxiety and health anxiety. Internal consistency, construct validity and incremental validity were assessed. Associations between C-19ASS and psychological symptoms were assessed.

RESULTS

Factor analysis identified a two-factor solution (i.e., C-19ASS-Perseveration and C-19ASS-Avoidance), and confirmatory factor analysis suggested a two-factor model best fits the data. The Arabic version of the C-19ASS showed good internal consistency, good construct and incremental validity. COVID-19 anxiety syndrome was associated with more severe anxiety symptoms, depressive symptoms and health anxiety. Females had higher levels of COVID-19 anxiety syndrome than males. Participants diagnosed with COVID-19, and those who had experienced loss as a consequence of COVID-19, had higher levels of COVID-19 anxiety syndrome (Perseveration).

CONCLUSIONS

The Arabic version of the C-19ASS appears to be a reliable and valid measure of the COVID-19 anxiety syndrome. The COVID-19 anxiety syndrome could be a suitable therapeutic target to improve psychological recovery during the COVID-19 pandemic among Arabs.

Epidemiological and Clinical Characteristics of COVID-19 Outbreak in a Mental Hospital in Wenzhou, China, December 2022-January 2023

Background

Coronavirus disease (COVID-19) mainly caused by the Omicron virus strain currently is still prevalent worldwide, and many medical institutions have experienced COVID-19 outbreaks in the past three years.

Objective

This article reported COVID-19 outbreak among health care workers in a mental hospital to clarify the epidemiological and clinical characteristics of COVID-19 outbreak in a medical institution, to assess the susceptible factors related to COVID-19 among these personnel and to evaluate the effect of COVID-19 vaccine on the medical workers.

Methods

A uniform questionnaire was used to investigate all employees, including age, gender, department, time of onset, clinical symptoms, vaccination status. At the same, the results of laboratory testing, chest computed tomography (CT) and/or X-ray examination were collected.

Results

Among 1047 hospital employees, 842 cases were diagnosed as COVID-19, with a total attack rate of 80.42%. The attack rate of doctors, nurses, medical technicians, and administrators (83.50-90.67%) was higher than that of logistics departments (56.81%). Out of the 842 patients, 9 were hospitalized; 833 were non-hospitalized patients who belong to mild or moderate cases. No deaths were reported. The full vaccination rate and booster rate of COVID-19 vaccine were 78.26% and 80.87%, respectively. There was no significant correlation between the attack rate and COVID-19 vaccine (χ2 = 3.41 P > 0.05).

Conclusion

This is an outbreak of COVID-19 with a high attack rate among employees in a mental hospital. The attack rate of medical personnel is higher than that of logistics personnel, which may be related to opportunities and duration of contact with infected individuals. COVID-19 vaccine has no significant protective effect on patients with mild or moderate symptoms 13 months after the full vaccination. It is suggested that they should be timely boostered with COVID-19 vaccine to maintain their immunity to the disease.

COVID-19 exposure and depression-anxiety levels among Saudi adults in the Jazan region: a study with a predominantly female and undergraduate sample

Background

The COVID-19 pandemic has caused significant mental health challenges worldwide, as evidenced by numerous studies indicating high levels of depression and anxiety among individuals. However, the extent of mental health disorders following the pandemic and the association between anxiety and depression and COVID-19 exposure levels in the Jazan region of the Kingdom of Saudi Arabia have received little research attention.

Methods

A convenience sample of 377 participants, predominantly female (85.4%) with undergraduate education (74.5%) and Saudi nationality (92.8%), was included in the study. The study utilized a self-administered questionnaire to collect data from participants between 1st August and 8th September 2022. The questionnaire consisted of four parts, including demographic characteristics, COVID-19 exposure, the Patient Health Questionnaire-9 (PHQ-9) for depression assessment, and the Generalized Anxiety Disorders-7 (GAD-7) for anxiety evaluation. Statistical techniques such as descriptive statistics, independent t-tests, ANOVA (Analysis of Variance), and regression analysis were employed to analyze the collected data.

Results

The mean age of the study participants was 30.97 years (SD = 9.072). The mean score for COVID-19 exposure was 2.98 (SD = 1.48). The mean level of depression was 7.83 (SD = 6.43), with 20% of participants experiencing moderate to severe depression. Additionally, the study found that the mean score of anxiety level among participants was 6.75 (SD = 6.57), with 26% of the participants experiencing moderate to severe anxiety. Independent t-test revealed significant differences in mean depression and anxiety scores between participants with varying COVID-19 exposure levels (p = 0.001). The regression analysis demonstrated that anxiety levels were significant predictors of depression (p < 0.001). There is a significant difference in the depression mean between participants with high levels of anxiety (≥10) compared to others with levels <10. Furthermore, significant predictors of anxiety levels included either student or unemployment status (p < 0.001), increased age (≥35) (p = 0.049), female gender (p = 0.009), marital status of not being married, divorced, or widowed (p = 0.004), low monthly income (p = 0.019), and increased depression level (p < 0.001).

Conclusion

This study provides evidence of significant depression and anxiety levels among participants, with higher COVID-19 infection exposure correlating with increased scores for both. Anxiety was identified as a significant predictor of depression. Demographic factors, such as employment status, age, gender, and marital status, played a role in influencing anxiety levels. The findings highlight the need for targeted mental health interventions to address the psychological impact of COVID-19 infection exposure and support affected individuals effectively.

Impacting factors and sources of perceived stress by home-quarantined residents in Shanghai during COVID-19 epidemic

BACKGROUND

Home-quarantine is one of the most common measures implemented to prevent or minimize the transmission of COVID-19 among communities. This study assessed stress levels of the home-quarantined residents in Shanghai during a massive wave of COVID-19 epidemic this year, explored the stress sources perceived by the respondents, and analyzed the association between each of the sociodemographic factors and the stress level.

METHODS

This online survey was launched during April 23 - 30, 2022, the early stage of a massive wave of COVID-19 in Shanghai, China. Participants were quarantined-residents negative for COVID-19. They were asked to list some situations that were their major concerns and perceived stressful, in addition to sociodemographic and COVID-19 related information. Moreover, they were asked to complete the Perceived Stress Scale-14 (PSS-14) for the assessment of stress level.

RESULTS

A total of 488 valid questionnaires were collected from 192 male and 296 female respondents. Overall, 207 persons (42.42%) presented high stress level (PSS-14 score ≥43). The top three concerns perceived stressful by respondents are "not allowed to go outdoors", "uncertain duration of the epidemic", and "lack of food supply". Fewer than 50% of the respondents perceived the other situations stressful. Higher proportions of young adults (≤ 29 years old), males, unemployed, singles, and those with low income (≤ 1999 yuan/month) perceived high stress compared to their counterparts, none of COVID-19 related factors is associated with the stress level, including location of residence, result of nucleic acid test, knowledge about COVID-19, whether vaccinated, and quarantine duration.

CONCLUSION

Home-quarantine applied to people negative for COVID-19 led to a lot of major concerns that may be perceived stressful, whereas the virus-related factors did not show significant impact on mental health of the respondents.

Tackling COVID-19 Using Antiviral Nanocoating's-Recent Progress and Future Challenges

In the current situation of the global coronavirus disease 2019 (COVID-19) pandemic, there is a worldwide demand for the protection of regular handling surfaces from viral transmission to restrict the spread of COVID-19 infection. To tackle this challenge, researchers and scientists are continuously working on novel antiviral nanocoatings to make various substrates capable of arresting the spread of such pathogens. These nanocoatings systems include metal/metal oxide nanoparticles, electrospun antiviral polymer nanofibers, antiviral polymer nanoparticles, graphene family nanomaterials, and etched nanostructures. The antiviral mechanism of these systems involves depletion of the spike glycoprotein that anchors to surfaces by the nanocoating and makes the spike glycoprotein and viral nucleotides inactive; however, the nature of the interaction between the spike proteins and virus depends on the type of nanostructure and a surface charge over the coating surface. In this article, the current scenario of COVID-19 and how it can be tackled using antiviral nanocoatings from the further transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), along with their different mode of action, are discussed. Additionally, it is also highlighted different types of nanocoatings developed for various substrates to encounter transmission of SARS-CoV-2, future research areas along with the current challenges related to it, and how these challenges can be resolved.

Coronavirus disease 2019 in proportion to population: a historical analysis of Saudi Arabia

BACKGROUND

Saudi Arabia is one of the countries seriously affected by coronavirus disease 2019 (COVID-19) worldwide. With a few cases in early March, the daily spread of this disease increased to nearly 5000 at one point in time during the first wave to mid-June 2020. With committed efforts and public health interventions, it has been controlled to nearly 1000 by the end of August 2020 and less than 217 by November 28, 2020; thereafter, reporting declines and small increases. However, by December 2021, a third wave started, lasting for 2 months, during which the infection rate increased rapidly. By April 1, 2022, the number of infected persons in the country was 750,998, with 9047 deaths, 7131 active, and approximately 400 critical cases. This analysis of COVID-19 statistics of the Ministry of Health of Saudi Arabia (March 2020-April 2022) is carried out along with population data to extract patient proportions per 100,000 persons to illustrate the hypothesized social and community impact, which influences families and households.

RESULTS

The results showed a high rate of infection and mortality, but with recovery. These rates varied across localities and cities. A few cities with higher population densities are less affected by the spread of the epidemic. However, few localities and upcoming cities/townships were severely affected. These effects are explained as the percentage of the population affected, which exposes the impact on societies, families, and individual members. With concerted efforts, they are brought under control through recovery and adopting mitigation methods.

CONCLUSIONS

Localities could be classified into four categories based on the proportion of the infected population: rapidly increasing, moderately increasing, declining, and stabilizing. Moreover, differential proportions of the affected population have implications at social and familial levels. Analysis and understanding of these trends, considering the base population, are important for policy building and intervention strategies accounting for grassroots-level demographics, which might serve as a tool to enhance interventions at population and family levels. Strategies for awareness creation and compassionate care are essential to address the psychosocial impact of health emergencies, as proved by the Ministry of Health, Saudi Arabia.

COVID-19 in Saudi Arabia: An Overview

BACKGROUND

Saudi Arabia, a prominent Arabian country, has 35. 3 million persons living in 2.2 million square kilometers, undergone serious threats recently due to the COVID-19 pandemic. With the built-in infrastructure and disciplined lifestyle, the country could address this pandemic.

AIMS

This analysis of COVID-19 cases in Saudi Arabia attempts to assess the situation, explore its global percentage share, percentage of population affected, and local distribution from the beginning of infection until recently, tracing historical developments and changes.

DATA AND METHODS

This analysis made use of data released by the Ministry of Health on a daily basis for a number of parameters. They are compiled on an excel sheet on a daily basis: the dataset has undergone rigorous analysis along with the trends and patterns; proportion to the world statistics and geographic distribution.

RESULTS

COVID-19 spread rapidly in the country with periodic variations, during June-August, 2020. But, recoveries accelerated in the period, thus bridging the gap of increasing infections. In comparison with the world statistics, the country proportions are lower, while the percentage of population affected is similar. It appears that the intensity varied across all 13 administrative areas.

CONCLUSION

COVID-19 transmission since March 2020 is considered to be widespread, creating excess burden on the public health system, delineated into stages (early infection, rapid spread, declining, stabilizing, and second wave). Control measures are set, stage-wise, without impinging upon normal life but to ensure that the proportion of globally affected persons is lesser than the population share: credit goes to the Ministry of Health. Area-wise spread depends largely on population density and development infrastructure dimensions. Ultimately, the disciplined life in compliance with law and order paved the way for effective program implementation and epidemic control.

Characteristics Associated With Household Transmission of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in Ontario, Canada: A Cohort Study

BACKGROUND

Within-household transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been identified as one of the main sources of spread of coronavirus disease 2019 (COVID-19) after lockdown restrictions and self-isolation guidelines are implemented. Secondary attack rates among household contacts are estimated to be 5-10 times higher than among non-household contacts, but it is unclear which individuals are more prone to transmit infection within their households.

METHODS

Using address matching, a cohort was assembled of all individuals with laboratory-confirmed COVID-19 residing in private households in Ontario, Canada. Descriptive analyses were performed to compare characteristics of cases in households that experienced secondary transmission versus those that did not. Logistic regression models were fit to determine index case characteristics and neighborhood characteristics associated with transmission.

RESULTS

Between January and July 2020, there were 26 714 individuals with COVID-19 residing in 21 226 households. Longer testing delays (≥5 vs 0 days; odds ratio [OR], 3.02; 95% confidence interval [CI], 2.53-3.60) and male gender (OR, 1.28; 95% CI, 1.18-1.38) were associated with greater odds of household secondary transmission, while being a healthcare worker (OR, .56; 95% CI, .50-.62) was associated with lower odds of transmission. Neighborhoods with larger average family size and a higher proportion of households with multiple persons per room were also associated with greater odds of transmission.

CONCLUSIONS

It is important for individuals to get tested for SARS-CoV-2 infection as soon as symptoms appear, and to isolate away from household contacts; this is particularly important in neighborhoods with large family sizes and/or crowded households.

Intra-Household and Close-Contact SARS-CoV-2 Transmission Among Children - a Systematic Review

Introduction: The outbreak of the novel coronavirus disease (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to a range of emergency measures worldwide. Early in the pandemic, children were suspected to act as drivers of the COVID-19 spread in the population, which was based on experiences with influenza virus and other respiratory pathogens. Consequently, closures of schools and kindergartens were implemented in many countries around the world, alongside with other non-pharmaceutical interventions for transmission control. Given the grave and multifaceted consequences of contact restriction measures for children, it is crucial to better understand the effect size of these incisive actions for the COVID-19 pandemic. Therefore, we systematically review the current evidence on transmission of SARS-CoV-2 to and by children. Data Sources: PubMed and preprints uploaded on medRxiv. Study Selection: Original research articles, case reports, brief communications, and commentaries were included into the analysis. Each title or abstract was independently reviewed to identify relevant articles. Studies in other languages than English were not included. Data Extraction: Two reviewers independently reviewed the selected studies. Extracted data included citation of each study, type of healthcare setting, location of the study, characteristics of patient population, and reported outcomes. Results: Data on transmission of SARS-CoV-2 on or by children is scarce. Several studies show a lower seropositivity of children compared to adults, suggesting a lower susceptibility of especially younger children. Most insight currently comes from household studies suggesting, that children are predominantly infected by their household contacts. The contagiousness however, seems to be comparable between children and adults, based on our meta-analysis of included studies. Conclusions: Larger and systematic studies are urgently needed to better understand the age dependent patterns of SARS-CoV-2 transmission and thereby design more effective non-pharmaceutical interventions to reduce disease transmission.