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Niu KY, Cheng YC, Chan CW, Chaou CH, Yen CC, Fang CT. SARS-CoV-2 rapid antigen testing positive rate in community testing stations as an indicator for COVID-19 epidemic trend, Taipei, Taiwan, May to August 2021. J Formos Med Assoc 2024; 123:716-719. [PMID: 38044208 DOI: 10.1016/j.jfma.2023.10.027] [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: 08/28/2023] [Revised: 10/23/2023] [Accepted: 10/31/2023] [Indexed: 12/05/2023] Open
Abstract
BACKGROUND Real-time surveillance of COVID-19 in large-scale community outbreaks presents challenges. Simple counts of the daily confirmed cases can be misleading due to constraints from bottlenecks in access to care or laboratory testing. This study aimed to investigate the role of the SARS-CoV-2 antigen rapid diagnostic test (Ag-RDT) in addressing these challenges for real-time COVID-19 surveillance. METHODS This study included the results of 86,933 SARS-CoV-2 Ag-RDT and real-time reverse transcription polymerase chain reaction (RT-PCR) tests. These were conducted at four community testing stations within the Taipei metropolitan area during a community COVID-19 outbreak spanning from May 17, 2021, to August 9, 2021. We examined the correlation between the positive rates of Ag-RDT tests and the epidemic curve of laboratory-confirmed COVID-19 cases by onset date to examine its role in real-time surveillance. RESULTS During the 85-day study period, the trend of Ag-RDT test positive rates paralleled that of the epidemic curve. The correlation between the Ag-RDT positive rate and the number of cases (Pearson correlation coefficient: 0.968) is comparable to that of the RT-PCR positive rate (Pearson correlation coefficient: 0.964). The Ag-RDT positive rate exhibited a more advanced leading trend, with Ag-RDT leading by 3 days in comparison to the 2-day lead for RT-PCR. CONCLUSION The positive rate of SARS-CoV-2 Ag-RDT tests at community testing stations serves as a good surrogate for assessing virus activity within the community and a useful tool for real-time COVID-19 surveillance. It is a robust indicator of the outbreak trend and near-term numbers of cases. This finding may facilitate the management of subsequent outbreaks of emerging infectious diseases.
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Affiliation(s)
- Kuang-Yu Niu
- Department of Emergency Medicine, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Yu-Chen Cheng
- Department of Laboratory Medicine, New Taipei Municipal Tucheng Hospital, New Taipei City, Taiwan
| | - Cheng-Wei Chan
- Department of Emergency Medicine, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan; Department of Emergency Medicine, New Taipei City Hospital, New Taipei City, Taiwan
| | - Chung-Hsien Chaou
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Chang Gung Medical Education Research Centre, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Chieh-Ching Yen
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Department of Emergency Medicine, New Taipei Municipal Tucheng Hospital, New Taipei City, Taiwan
| | - Chi-Tai Fang
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
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Dudley L, Couper I, Kannangarage NW, Naidoo S, Ribas CR, Koller TS, Young T. COVID-19 preparedness and response in rural and remote areas: A scoping review. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002602. [PMID: 37967067 PMCID: PMC10651055 DOI: 10.1371/journal.pgph.0002602] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 10/23/2023] [Indexed: 11/17/2023]
Abstract
This scoping review used the Arksey and O'Malley approach to explore COVID-19 preparedness and response in rural and remote areas to identify lessons to inform future health preparedness and response planning. A search of scientific and grey literature for rural COVID-19 preparedness and responses identified 5 668 articles published between 2019 and early 2022. A total of 293 articles were included, of which 160 (54.5%) were from high income countries and 106 (36.2%) from middle income countries. Studies focused mostly on the Maintenance of Essential Health Services (63; 21.5%), Surveillance, epidemiological investigation, contact tracing and adjustment of public health and social measures (60; 20.5%), Coordination and Planning (32; 10.9%); Case Management (30; 10.2%), Social Determinants of Health (29; 10%) and Risk Communication (22; 7.5%). Rural health systems were less prepared and national COVID-19 responses were often not adequately tailored to rural areas. Promising COVID-19 responses involved local leaders and communities, were collaborative and multisectoral, and engaged local cultures. Non-pharmaceutical interventions were applied less, support for access to water and sanitation at scale was weak, and more targeted approaches to the isolation of cases and quarantine of contacts were preferable to blanket lockdowns. Rural pharmacists, community health workers and agricultural extension workers assisted in overcoming shortages of health professionals. Vaccination coverage was hindered by weaker rural health systems. Digital technology enabled better coordination, communication, and access to health services, yet for some was inaccessible. Rural livelihoods and food security were affected through disruptions to local labour markets, farm produce markets and input supply chains. Important lessons include the need for rural proofing national health preparedness and response and optimizing synergies between top-down planning with localised planning and coordination. Equity-oriented rural health systems strengthening and action on rural social determinants is essential to better prepare for and respond to future outbreaks.
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Affiliation(s)
- Lilian Dudley
- Division of Health Systems and Public Health, Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | - Ian Couper
- Ukwanda Centre for Rural Health, Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | | | - Selvan Naidoo
- Ukwanda Centre for Rural Health, Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | - Clara Rodriguez Ribas
- Health Emergencies Program, World Health Organisation, Headquarters, Geneva, Switzerland
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Theadora Swift Koller
- Department for Gender, Equity and Human Rights, Director General’s Office, World Health Organization, Headquarters, Geneva, Switzerland
| | - Taryn Young
- Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, Cape Town, South Africa
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Xie G, Wang L, Zhang J. How are countries responding differently to COVID-19: a systematic review of guidelines on isolation measures. Front Public Health 2023; 11:1190519. [PMID: 37719732 PMCID: PMC10502310 DOI: 10.3389/fpubh.2023.1190519] [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: 03/21/2023] [Accepted: 08/08/2023] [Indexed: 09/19/2023] Open
Abstract
Introduction Isolation strategies have been implemented in numerous countries worldwide during the ongoing community transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, various countries and organizations have implemented their isolation measures at varying intensities, even during the same period. Therefore, we systematically reviewed the key information contained in currently available guidelines regarding the isolation of the general population, aiming to better identify the heterogeneity of the current isolation strategies. Methods We conducted searches in four evidence-based medicine (EBM) databases and five guideline websites to identify guidelines, guidance, protocols, and policy documents published by authoritative advisory bodies or healthcare organizations, which provided information on the implementation of isolation for general populations with COVID-19. One author extracted data using a standardized data extraction checklist, and a second author double-checked all extractions for completeness and correctness. Discrepancies were resolved through discussion. The information extracted from the included articles was summarized both narratively and using tables. Results We included 15 articles that provided information on isolation measures recommended by nine different countries and organizations. The included articles consistently recommended isolating individuals with a positive COVID-19 test, regardless of the presence of symptoms. However, there were variations in the duration of isolation, and substantial differences also existed in the criteria for ending the isolation of COVID-19 patients. Conclusion Different countries and organizations have substantial differences in their isolation policies. This reminds us that scientifically sound guidelines on isolation that balance the risk of prematurely ending isolation with the burden of prolonged isolation are a crucial topic of discussion when faced with a pandemic.
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Affiliation(s)
- Guangmei Xie
- Reproductive Medicine Center, Gansu Maternal and Child Health Care Hospital, Lanzhou, Gansu, China
- Reproductive Medicine Center, Gansu Provincial Central Hospital, Lanzhou, Gansu, China
| | - Li Wang
- Reproductive Medicine Center, Gansu Maternal and Child Health Care Hospital, Lanzhou, Gansu, China
- Reproductive Medicine Center, Gansu Provincial Central Hospital, Lanzhou, Gansu, China
| | - Jun Zhang
- School of Nursing, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
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Lefferts B, Bruden D, Plumb ID, Hodges E, Bates E, January G, Bruce MG. Effectiveness of the COVID-19 vaccines on preventing symptomatic SARS-CoV-2 infections and hospitalizations in Southwestern Alaska, January-December 2021. Vaccine 2023; 41:3544-3549. [PMID: 37150620 PMCID: PMC10150184 DOI: 10.1016/j.vaccine.2023.04.070] [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: 02/23/2023] [Revised: 04/24/2023] [Accepted: 04/25/2023] [Indexed: 05/09/2023]
Abstract
The population in rural southwest Alaska has been disproportionately affected by COVID-19. To assess the benefit of COVID-19 vaccines, we analyzed data from the regional health system. We estimated vaccine effectiveness (VE) during January 16-December 3, 2021, against symptomatic SARS-CoV-2 infection after a primary series or booster dose, and overall VE against hospitalization. VE of a primary series against symptomatic infection among adult residents was 91.3% (95% CI: 85.7, 95.2) during January 16-May 7, 2021, 50.3% (95% CI, 41.1%-58.8%) during July 17-September 24, and 37.0% (95% CI, 27.8-45.0) during September 25-December 3, 2021; VE of a booster dose during September 25-December 3, 2021, was 92.1% (95% CI: 87.2-95.2). During the overall study period, VE against hospitalization was 91.9% (95% CI: 85.4-95.5). COVID-19 vaccination offered strong protection against hospitalization and a booster dose restored protection against symptomatic infection.
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Affiliation(s)
| | - Dana Bruden
- Centers for Disease Control & Prevention, United States
| | - Ian D Plumb
- Centers for Disease Control & Prevention, United States
| | - Ellen Hodges
- Yukon-Kuskokwim Health Corporation, United States
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Murphy C, Wong JY, Cowling BJ. Nonpharmaceutical interventions for managing SARS-CoV-2. Curr Opin Pulm Med 2023; 29:184-190. [PMID: 36856551 PMCID: PMC10090342 DOI: 10.1097/mcp.0000000000000949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
PURPOSE OF REVIEW Initial response strategies to the COVID-19 pandemic were heavily reliant on nonpharmaceutical interventions (NPIs), a set of measures implemented to slow or even stop the spread of infection. Here, we reviewed key measures used during the COVID-19 pandemic. RECENT FINDINGS Some NPIs were successful in reducing the transmission of SARS-CoV-2. Personal protective measures such as face masks were widely used, and likely had some effect on transmission. The development and production of rapid antigen tests allowed self-diagnosis in the community, informing isolation and quarantine measures. Community-wide measures such as school closures, workplace closures and complete stay-at-home orders were able to reduce contacts and prevent transmission. They were widely used in the pandemic and contributed to reduce transmission in the community; however, there were also negative unintended consequences in the society and economy. SUMMARY NPIs slowed the spread of SARS-CoV-2 and are essential for pandemic preparedness and response. Understanding which measures are more effective at reducing transmission with lower costs is imperative.
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Affiliation(s)
- Caitriona Murphy
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam
| | - Jessica Y. Wong
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam
| | - 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, Pokfulam
- Laboratory of Data Discovery for Health Limited, Hong Kong Science and Technology Park, New Territories, Hong Kong Special Administrative Region, China
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Sugiharto VA, Gatrell SK, Chen HW, Blazek GR, Cherry AM, Schilling M. Performance Evaluation of Five Rapid At-Home COVID-19 Antigen Tests against the Omicron Variant. Microbiol Spectr 2023; 11:e0228622. [PMID: 36519888 PMCID: PMC9927253 DOI: 10.1128/spectrum.02286-22] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Rapid coronavirus disease 2019 (COVID-19) antigen tests can be used to aid in quickly identifying positive cases, which can help mitigate the spread of COVID-19 infection. Using previously characterized Omicron-positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), non-Omicron-positive SARS-CoV-2, and negative samples, we evaluated five brands of at-home rapid COVID-19 antigen tests (On/Go at-home COVID-19 rapid antigen self-test, iHealth COVID-19 antigen rapid test, QuickVue SARS antigen test, Abbott BinaxNOW COVID-19 card home test, and InBios SCoV-2 Ag detect rapid self-test). Our results showed that these rapid tests had similar levels of sensitivity to Omicron and non-Omicron variants (On/Go, 76.4% and 71.0%; iHealth, 73.0% and 71.0%; QuickVue, 84.3% and 74.3%; BinaxNOW, 69.7% and 71.0%; and InBios, 66.3% and 64.5%, respectively). In conclusion, rapid COVID-19 antigen tests can continue to be used as part of public health measures to combat the spread of the Omicron variant, as their sensitivity was not significantly affected. IMPORTANCE The emergence of the Omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is due to mutations as part of the virus evolution process. These mutations might affect the sensitivity of diagnostic tests that are currently being used to detect the virus. Because rapid coronavirus disease 2019 (COVID-19) antigen tests are commonly used in the general population, it is important to assess their performance in detecting the Omicron variant. Here, we compared the performance of five brands of rapid tests against Omicron and non-Omicron variants using nasopharyngeal swab samples in viral transport media. Our result found no difference in their performance, suggesting no reduction in sensitivity when used to detect the Omicron variant.
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Affiliation(s)
- Victor A. Sugiharto
- Naval Medical Research Center, Silver Spring, Maryland, USA
- Henry M. Jackson Foundation, Bethesda, Maryland, USA
| | - Stephanie K. Gatrell
- Naval Medical Research Center, Silver Spring, Maryland, USA
- Leidos, Reston, Virginia, USA
| | - Hua-Wei Chen
- Naval Medical Research Center, Silver Spring, Maryland, USA
- Henry M. Jackson Foundation, Bethesda, Maryland, USA
| | - Gabrielle R. Blazek
- Naval Medical Research Center, Silver Spring, Maryland, USA
- Henry M. Jackson Foundation, Bethesda, Maryland, USA
| | - Amanda M. Cherry
- Naval Medical Research Center, Silver Spring, Maryland, USA
- Leidos, Reston, Virginia, USA
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Stokes W, Berenger BM, Venner AA, Deslandes V, Shaw JLV. Point of care molecular and antigen detection tests for COVID-19: current status and future prospects. Expert Rev Mol Diagn 2022; 22:797-809. [PMID: 36093682 DOI: 10.1080/14737159.2022.2122712] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Detection of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) has been critical to support and management of the COVID-19 pandemic. Point of care testing (POCT) for SARS-CoV-2 has been a widely used tool for detection of SARS-CoV-2. AREAS COVERED POCT nucleic acid amplification tests (NAATs) and rapid antigen tests (RATs) have been the most readily used POCT for SARS-CoV-2. Here, current knowledge on the utility of POCT NAATs and RATs for SARS-CoV-2 are reviewed and discussed alongside aspects of quality assurance factors that must be considered for successful and safe implementation of POCT. EXPERT OPINION Use cases for implementation of POCT must be evidence based, regardless of the test used. A quality assurance framework must be in place to ensure accuracy and safety of POCT.
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Affiliation(s)
- William Stokes
- Alberta Precision Laboratories, Alberta, Canada.,Department of Pathology and Laboratory Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Byron M Berenger
- Alberta Precision Laboratories, Alberta, Canada.,Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Allison A Venner
- Alberta Precision Laboratories, Alberta, Canada.,Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Vincent Deslandes
- Eastern Ontario Regional Laboratories Association, Ottawa, Ontario, Canada.,Department of Pathology and Laboratory Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada.,Department of Pathology and Laboratory Medicine, The University of Ottawa, Ottawa, Ontario, Canada
| | - Julie L V Shaw
- Eastern Ontario Regional Laboratories Association, Ottawa, Ontario, Canada.,Department of Pathology and Laboratory Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada.,Department of Pathology and Laboratory Medicine, The University of Ottawa, Ottawa, Ontario, Canada
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COVID-19 isolation strategies: What have we learned. Travel Med Infect Dis 2022; 49:102416. [PMID: 35952965 PMCID: PMC9359599 DOI: 10.1016/j.tmaid.2022.102416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 07/13/2022] [Accepted: 07/30/2022] [Indexed: 12/05/2022]
Abstract
Since the start of the COVID-19 pandemic, infection prevention and control policies have significantly differed between different public health organization and have been complicated by the emergence of new data on Variants of Concern (VOC). Here, we try to highlight the different strategies for isolating patients with COVID-19 and point-out the evolution of such strategies over time, mainly for mildly or moderately severe SARS-CoV-2 infected patients.
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Rao A, Bassit L, Lin J, Verma K, Bowers HB, Pachura K, Greenleaf M, Sullivan J, Lai E, Creager RS, Pribyl T, Blackwood J, Piantadosi AL, Schinazi R, Martin GS, Lam WA. Assessment of the Abbott BinaxNOW SARS-CoV-2 rapid antigen test against viral variants of concern. iScience 2022; 25:103968. [PMID: 35224469 PMCID: PMC8863348 DOI: 10.1016/j.isci.2022.103968] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 01/26/2022] [Accepted: 02/18/2022] [Indexed: 02/05/2023] Open
Abstract
As the emergence of SARS-CoV-2 variants brings the global pandemic to new levels, the performance of current rapid antigen tests against variants of concern and interest (VOC/I) is of significant public health concern. Here, we report assessment of the Abbot BinaxNOW COVID-19 Antigen Self-Test. Using genetically sequenced remnant clinical samples collected from individuals positive for SARS-CoV-2, we assessed the performance of BinaxNOW against the variants that currently pose public health threats. We measured the limit of detection of BinaxNOW against various VOC/I in a blinded manner. BinaxNOW successfully detected the Omicron (B.1.1.529), Mu (B.1.621), Delta (B.1.617.2), Lambda (C.37), Gamma (P.1), Alpha (B.1.1.7), Beta (B.1.351), Eta (B.1.525), and P.2 variants and at low viral concentrations. BinaxNOW also detected the Omicron variant in individual remnant clinical samples. Overall, these data indicate that this inexpensive and simple-to-use, FDA-authorized and broadly distributed rapid test can reliably detect Omicron, Delta, and other VOC/I. Pooled remnant clinical samples with variants of concern are tested using BinaxNOW BinaxNOW detects live and heat-inactivated virus in pooled and individual samples BinaxNOW sensitivity slightly lower against Omicron variant in laboratory tests BinaxNOW remains a useful public health tool to combat the COVID-19 pandemic
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Affiliation(s)
- Anuradha Rao
- Emory University School of Medicine, Emory University, Room 448, Atlanta, GA 30322, USA
| | - Leda Bassit
- Emory University School of Medicine, Emory University, Room 448, Atlanta, GA 30322, USA
| | - Jessica Lin
- Emory University School of Medicine, Emory University, Room 448, Atlanta, GA 30322, USA.,Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - Kiran Verma
- Emory University School of Medicine, Emory University, Room 448, Atlanta, GA 30322, USA
| | - Heather B Bowers
- Emory University School of Medicine, Emory University, Room 448, Atlanta, GA 30322, USA
| | - Kimberly Pachura
- Emory University School of Medicine, Emory University, Room 448, Atlanta, GA 30322, USA
| | - Morgan Greenleaf
- Emory University School of Medicine, Emory University, Room 448, Atlanta, GA 30322, USA
| | - Julie Sullivan
- Emory University School of Medicine, Emory University, Room 448, Atlanta, GA 30322, USA
| | - Eric Lai
- Personalized Science, LLC, Burlington, VT, 05403
| | | | | | | | - Anne L Piantadosi
- Emory University School of Medicine, Emory University, Room 448, Atlanta, GA 30322, USA
| | - Raymond Schinazi
- Emory University School of Medicine, Emory University, Room 448, Atlanta, GA 30322, USA
| | - Greg S Martin
- Emory University School of Medicine, Emory University, Room 448, Atlanta, GA 30322, USA
| | - Wilbur A Lam
- Emory University School of Medicine, Emory University, Room 448, Atlanta, GA 30322, USA.,Georgia Institute of Technology, Atlanta, GA 30332, USA
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