Management of a large outbreak of COVID-19 at a British Army training centre: lessons for the future

INTRODUCTION

The COVID-19 pandemic has posed major challenges for infection control within training centres, both civilian and military. Here we present a narrative review of an outbreak that occurred at the Royal Military Academy Sandhurst (RMAS) in January-March 2021, in the context of the circulating, highly transmissible SARS-CoV-2 variant B.1.1.7.

METHODS

Testing for SARS-CoV-2 was performed using a combination of reverse transcriptase PCR and Lateral Flow Devices (LFDs). Testing and isolation procedures were conducted in line with a pre-established symptom stratification system. Genomic sequencing was performed on 10 sample isolates.

RESULTS

By the end of the outbreak, 185 cases (153 Officer Cadets, 32 permanent staff) had contracted confirmed COVID-19. This represented 15% of the total RMAS population. This resulted in 0 deaths and 0 hospitalisations, but due to necessary isolation procedures did represent an estimated 12 959 person-days of lost training. 9 of 10 (90%) of sequenced isolates had a reportable lineage. All of those reported were found to be the Alpha lineage B.1.1.7.

CONCLUSIONS

We discuss the key lessons learnt from the after-action review by the Incident Management Team. These include the importance of multidisciplinary working, the utility of sync matrices to monitor outbreaks in real time, issues around Officer Cadets reporting symptoms, timing of high-risk training activities, infrastructure and use of LFDs. COVID-19 represents a vital learning opportunity to minimise the impact of potential future pandemics, which may produce considerably higher morbidity and mortality in military populations.

Analyzing antibiotic residues in honey samples using liquid chromatography-tandem mass spectrometry

This study aimed to present a sensitive, accurate, and precise analytical method for the determination of 32 antibiotics from 5 groups (sulfonamides, macrolides, aminoglycosides, tetracyclines, and quinolones) and some individual antibiotics (lincomycin, griseofulvin, and 5-hydroxy-flunixin) in 63 honey samples collected from Tehran market. In the presented method, the samples were hydrolyzed by 1% HFBA (hepta fluoro butyric acid) in water, purified on Strata XL polymeric reversed-phase cartridges, and finally analyzed by reversed-phase ion-pair liquid chromatography-electrospray ionization tandem mass spectrometry (RP-IP-LC-ESI-MS/MS). Good performance characteristics were gained for recovery, precision, range, and linearity, the limit of detections (LODs), and the limit of quantifications (LOQs). According to the presented results and considering the absence of permissible limits for antibiotics in honey, 74.6% of the tested samples had antibiotic residues more than the LOQ of the method. The results show that the validated method is suitable for simultaneously detecting antibiotic residues in honey.

The relation between the average diameter of CNTs on Ni-Cu @ a-C:H catalyst with the optical absorption edge and the optical dispersion parameters

In this study, the average diameter of the grown CNTs on Ni-Cu NPs @ a-C:H substrates were increased by increasing of Cu content. The obtained results indicated that by increase of Cu content, all films exhibited high-absorption spectra; therefore, we were facing an increase in the energy gap of films. The values of dT/dλ and dR/dλ measurements for grown CNTs with 75% Cu shown that maximum values of optical band gap correspond to with values of 2.48 eV and 2.90 eV, respectively. It can be seen that with increase of average diameter of the grown CNTs,  the values of Urbach energy of films were increased. The RBS and EDAX measurements were confirmed presence of Ni and Cu atoms into films. The films deposited with 75% Cu were more smooth. Films deposited with 75% Cu have more disordered. Films deposited with 75% Cu atoms have maximum values of the oscillator strength f and the dispersion energy E_d about of 0.108 eV² and 0.0543 eV, respectively.

Improvement in health indicators of islamic republic of iran in the years 2004 and 2008

BACKGROUND

As a performance evaluating program, healthcare indicators of the Islamic Republic of Iran at the end year of the 4th five-year socioeconomic strategic plan (2008) were evaluated in comparison with the same indicators at the 1st year of the 9th government (2004).

METHODS

The indicators were selected with the Delphi technique among the published indicators in the two period of time in 41 universities and in the country. Data gathering was done on the current health information system and were statistically analyzed assessing their trends.

RESULTS

The provinces of Sistan and Baluchistan (3.4%), Kerman (2.84%), Hormozgan (2.83%), Tehran (2.63%) and Qom (2.07%) had the highest rate of population growth over these years. Improving access to primary health care (PHC) in rural areas in Iran was evident during these years. The average hospital bed index in 1998 was one bed per 1000 population in the country and it was 1.62 in 2008. This Index was the highest in the province of Yazd and lowest in Ilam during both periods.

CONCLUSION

A significant ascending trend was observed for indicators in all medical universities. A promotion in healthcare indicators in the lesser developed provinces seems necessary.