scholarly journals Source and symptoms of COVID-19 among hospital workers in Milan

2020 ◽  
Vol 70 (9) ◽  
pp. 672-679 ◽  
Author(s):  
S Mandić-Rajčević ◽  
F Masci ◽  
E Crespi ◽  
S Franchetti ◽  
A Longo ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Case Series ◽  
Nursing Assistants ◽  
Vulnerable Groups ◽  
Contact Tracing ◽  
Public Healthcare ◽  
Nasopharyngeal Swab ◽  
Infection Rates ◽  
Sources Of Infection ◽  
Close Contacts

Abstract Background Healthcare workers (HCWs) are commonly infected by SARS-CoV-2 and represent one of the most vulnerable groups. Adequate prevention strategies are necessary to guarantee HCWs’ safety, as well as to prevent dissemination of the infection among patients. Aims To describe a case series of SARS-CoV-2-positive HCWs in a large public healthcare organization in Milan (Italy) during the most devastating weeks of the epidemic and analyse the sources, symptoms and duration of SARS-CoV-2 infection. Methods This study included 172 SARS-CoV-2-positive HCWs who were infected between the 25th of February and the 7th of April 2020. A nasopharyngeal swab (NPS) and RT-PCR were used to indicate. Results Initially, the most common sources of infection were other positive HCWs (49%). Medical doctors and nursing assistants were most frequently infected, with infection rates of 53/1000 and 50/1000, respectively. COVID-19 departments were less affected than internal medicine, surgery, intensive care, or emergency room. The most commonly reported symptom was mild cough, while loss of smell (anosmia) and loss of taste (ageusia) were reported as moderate and severe by 30–40% of HCWs. The time necessary for 50% of workers to recover from the infection was 23 days, while it took 41 days for 95% of HCWs to become virus-free. Conclusions HCWs are commonly infected due to close contacts with other positive HCWs, and non-COVID departments were most affected. Most HCWs were asymptomatic or subclinical but contact tracing and testing of asymptomatic HCWs help identify and isolate infected workers.

scholarly journals COVID-19 healthcare policies in Ireland: A rapid review of the initial pandemic response

2021 ◽  
pp. 140349482110083
Author(s):  
Noreen O’leary ◽  
Liz Kingston ◽  
Anne Griffin ◽  
Ann-marie Morrissey ◽  
Maria Noonan ◽  
...  
Keyword(s):  
Policy Development ◽  
Healthcare Workers ◽  
Target Population ◽  
Analysis Data ◽  
Healthcare Services ◽  
Vulnerable Groups ◽  
Contact Tracing ◽  
Rapid Review ◽  
Infection Prevention And Control ◽  
Public Healthcare

Aims: Healthcare systems urgently required policies to guide the response to the COVID-19 pandemic. The aim of this review was to document the healthcare policies developed during the initial wave of widespread COVID-19 transmission in Ireland. We further sought to determine the key focus and impact of these policies. Methods: We conducted a rapid review of COVID-19 healthcare policies published from 28 January to 31 May 2020. Key information including the focus of the policy, target population and impact on service delivery was extracted from included policies. During analysis, data was grouped under descriptive categories and narrative summaries were developed for each category. Results: We identified 61 healthcare policies relating to COVID-19. We developed six category headings to describe the focus and impact of these policies: infection prevention and control ( n = 19), residential care settings ( n = 12), maintaining non-COVID-19 healthcare services and supports ( n = 12), testing and contact tracing ( n = 7), guidance for healthcare workers concerning COVID-19 ( n = 6), and treating COVID-19 ( n = 5). Conclusions: This review has identified lessons for policy development and implementation to help prepare for future healthcare emergencies. Factors to consider include support of vulnerable groups during and in the aftermath of the pandemic, providing psychological supports for healthcare workers and investment in public healthcare services such as contact tracing for future emergencies. While pandemic conditions necessitate the speedy development of policies, effective communication and adequate resourcing is required to ensure policy implementation.

scholarly journals 42. Outbreak of SARS-CoV-2 in Hospitalized Hemodialysis Patients: an Epidemiologic and Genomic Investigation

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S31-S31
Author(s):  
Charles E Marvil ◽  
Anne Piantadosi ◽  
Aaron Preston ◽  
Andrew Webster ◽  
Jeannette Guarner ◽  
...  
Keyword(s):  
Phylogenetic Tree ◽  
Healthcare Workers ◽  
The State ◽  
Outbreak Investigation ◽  
Contact Tracing ◽  
Nasopharyngeal Swab ◽  
Prevention Measures ◽  
Nursing Unit ◽  
Hemodialysis Session ◽  
Inpatient Nursing

Abstract Background Healthcare-associated transmission of SARS-CoV-2 is relatively rare and may be difficult to quantify. We performed an epidemiological investigation and SARS-CoV-2 genome sequencing to define the source and scope of a SARS-CoV-2 outbreak in a cluster of hospitalized patients Methods We conducted an outbreak investigation after identifying hospital-onset COVID-19 in patients receiving hemodialysis in January 2021. Electronic medical record review, staff interviews, review of employee schedule logs, and contact tracing were used to determine the outbreak timeline and identify exposed healthcare workers (HCW). SARS-CoV-2 genomes were sequenced from residual nasopharyngeal swab samples from 6 individuals in the outbreak investigation and compared to sequences from 14 patients in the same facility, 54 patients in nearby facilities, and 375 publicly available sequences from individuals in the state of Georgia. Results Eight patients with hospital-onset COVID-19 were identified (Cases 1-8); all were receiving hemodialysis and 5 were bedded in a single inpatient nursing unit. Among 53 potentially exposed HCW, 29 underwent testing and 5 were positive (Cases 9-13). The suspected index patient (Case 1) was found to have been coughing and inconsistently wearing a mask during a hemodialysis session on the same day that 6 of the 7 other patients and one HCW (Case 10) were in close proximity in the hemodialysis unit (Figure 1A). Further investigation revealed lack of use of curtain barriers in the hemodialysis bays, inconsistent use of personal protective equipment by HCW, and overcrowding of staff breakrooms. Among the 6 samples available for phylogenetic analysis, SARS-CoV-2 sequences from 5 (4 patients and 1 HCW, Case 9) were identical and at least 4 SNPs removed from the next closest sequence in this study, supporting a transmission cluster (Figure 1B). The sequence from the sixth sample (HCW Case 10) was phylogenetically distinct, indicating an independent source of infection. Figure 1 Exposure and onset of symptoms for the 6 cases in the outbreak with samples available for SARS-CoV-2 sequencing. Four patients with hospital-onset COVID-19 (Cases 1-4) were receiving hemodialysis and bedded in a single inpatient nursing unit, with two exposed healthcare workers (Cases 9-10). (A). Phylogenetic tree of SARS-CoV-2 genomes from individuals in this outbreak investigation (red), as well as 14 patients in the same facility and 54 patients in nearby facilities between 12/12/2020 and 1/13/2021 (blue). These were aligned with 375 publicly available sequences from individuals in the state of Georgia from the same time period using MAFFT. A maximum-likelihood phylogenetic tree was generated under a generalized time-reversible model with 1,000 bootstrap replicates using IQtree v2.0.3 and visualized and annotated using Interactive Tree of Life (iTOL) v4 (B). Conclusion Lack of appropriate respiratory hygiene led to SARS-CoV-2 transmission during a single hemodialysis session, based on clinical and genomic epidemiology. Use of appropriate PPE for both patients and HCW and other infection prevention measures are critical to prevent SARS-CoV-2 transmission. Disclosures All Authors: No reported disclosures

The first 2 months of COVID-19 contact tracing in the Northern Territory of Australia, March–April 2020

2020 ◽  
Vol 44 ◽  
Author(s):  
Anthony DK Draper ◽  
Karen E Dempsey ◽  
Rowena H Boyd ◽  
Emma M Childs ◽  
Hayley M Black ◽  
...  
Keyword(s):  
Disease Control ◽  
Healthcare Workers ◽  
Northern Territory ◽  
Contact Tracing ◽  
Cruise Ship ◽  
Disease Symptoms ◽  
Household Contacts ◽  
Close Contacts

The Northern Territory (NT) Centre for Disease Control (CDC) undertook contact tracing of all notified cases of coronavirus disease 2019 (COVID-19) within the Territory. There were 28 cases of COVID-19 notified in the NT between 1 March and 30 April 2020. In total 527 people were identified as close contacts over the same period; 493 were successfully contacted; 445 were located in the NT and were subsequently quarantined and monitored for disease symptoms daily for 14 days after contact with a confirmed COVID-19 case. Of these 445 close contacts, 4 tested positive for COVID-19 after developing symptoms; 2/46 contacts who were cruise ship passengers (4.3%, 95% CI 0.5–14.8%) and 2/51 household contacts (3.9%, 95% CI 0.5–13.5%). None of the 326 aircraft passengers or 4 healthcare workers who were being monitored in the NT as close contacts became cases.

scholarly journals A New System for Surveillance and Digital Contact Tracing for COVID-19: Spatiotemporal Reporting Over Network and GPS

10.2196/19457 ◽  
2020 ◽  
Vol 8 (6) ◽  
pp. e19457 ◽  
Author(s):  
Shaoxiong Wang ◽  
Shuizi Ding ◽  
Li Xiong
Keyword(s):  
Health Surveillance ◽  
Contact Tracing ◽  
Modern World ◽  
Media Technology ◽  
Suitable Alternative ◽  
Individual Privacy ◽  
Rapid Control ◽  
Sources Of Infection ◽  
Current Systems ◽  
Close Contacts

The current pandemic of the coronavirus disease (COVID-19) has highlighted the importance of rapid control of the transmission of infectious diseases. This is particularly important for COVID-19, where many individuals are asymptomatic or have only mild symptoms but can still spread the disease. Current systems for controlling transmission rely on patients to report their symptoms to medical professionals and be able to recall and trace all their contacts from the previous few days. This is unrealistic in the modern world. However, existing smartphone-based GPS and social media technology may provide a suitable alternative. We, therefore, developed a mini-program within the app WeChat. This analyzes data from all users and traces close contacts of all patients. This permits early tracing and quarantine of potential sources of infection. Data from the mini-program can also be merged with other data to predict epidemic trends, calculate individual and population risks, and provide recommendations for individual and population protection action. It may also improve our understanding of how the disease spreads. However, there are a number of unresolved questions about the use of smartphone data for health surveillance, including how to protect individual privacy and provide safeguards against data breaches.

scholarly journals Tracing contacts to evaluate the transmission of COVID-19 from highly exposed individuals in public transportation

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Caio Ponte ◽  
Humberto A. Carmona ◽  
Erneson A. Oliveira ◽  
Carlos Caminha ◽  
Antonio S. Lima ◽  
...  
Keyword(s):  
Public Transportation ◽  
Healthcare Workers ◽  
Time Windows ◽  
Mean Field ◽  
Contact Tracing ◽  
Reproduction Numbers ◽  
Consecutive Time ◽  
Longitudinal Comparison ◽  
The City ◽  
Close Contacts

AbstractWe investigate, through a data-driven contact tracing model, the transmission of COVID-19 inside buses during distinct phases of the pandemic in a large Brazilian city. From this microscopic approach, we recover the networks of close contacts within consecutive time windows. A longitudinal comparison is then performed by upscaling the traced contacts with the transmission computed from a mean-field compartmental model for the entire city. Our results show that the effective reproduction numbers inside the buses, $$Re^{bus}$$ R e bus , and in the city, $$Re^{city}$$ R e city , followed a compatible behavior during the first wave of the local outbreak. Moreover, by distinguishing the close contacts of healthcare workers in the buses, we discovered that their transmission, $$Re^{health}$$ R e health , during the same period, was systematically higher than $$Re^{bus}$$ R e bus . This result reinforces the need for special public transportation policies for highly exposed groups of people.

scholarly journals Epidemiological characteristics of COVID-19 cases among Indians residing in Kuwait

2021 ◽  
Author(s):  
Jagan K. Baskaradoss ◽  
Aishah Alsumait ◽  
Shaheer Malik ◽  
Jitendra Ariga ◽  
Amrita Geevarghese ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Contact Tracing ◽  
Indian Community ◽  
Asymptomatic Patients ◽  
Serial Interval ◽  
The World ◽  
Early Increase ◽  
The Mean ◽  
Epidemiological Characteristics ◽  
Close Contacts

Background: The coronavirus disease 2019 (COVID-19) pandemic has rapidly spread to most countries around the world. Disproportionate spread of COVID-19 among the Indian community in Kuwait prompted heightened surveillance in this community. Aims: To study the epidemiological characteristics of COVID-19 patients and their contacts among the Indian community in Kuwait. Methods: Data collection was done as a part of contact tracing efforts undertaken by the Kuwaiti Ministry of Health. Results: We analysed contact-tracing data for the initial 1348 laboratory-confirmed Indian patients and 6357 contacts (5681 close and 676 casual). The mean (standard deviation) age of the patients was 39.43 (10.5) years and 76.5% of the cases were asymptomatic or had only mild symptoms. Asymptomatic patients were significantly older [40.05 (10.42) years] than patients with severe symptoms [37.54 (10.54) years] (P = 0.024). About 70% of the patients were living in shared accommodation. Most of the close contacts were living in the same household, as compared with casual contacts, who were primarily workplace contacts (P < 0.001). Among the different occupations, healthcare workers had the highest proportion of cases (18.4%). Among the 216 pairs of cases with a clear relationship between the index and secondary cases, the mean serial interval was estimated to be 3.89 (3.69) days, with a median of 3 and interquartile range of 1–5 days. Conclusion: An early increase in the number of COVID-19 cases among the Indian community could be primarily attributed to crowded living conditions and the high proportion of healthcare workers in this community.

scholarly journals A New System for Surveillance and Digital Contact Tracing for COVID-19: Spatiotemporal Reporting Over Network and GPS (Preprint)

2020 ◽  
Author(s):  
Shaoxiong Wang ◽  
Shuizi Ding ◽  
Li Xiong
Keyword(s):  
Health Surveillance ◽  
Contact Tracing ◽  
Modern World ◽  
Media Technology ◽  
Suitable Alternative ◽  
Individual Privacy ◽  
Rapid Control ◽  
Sources Of Infection ◽  
Current Systems ◽  
Close Contacts

UNSTRUCTURED The current pandemic of the coronavirus disease (COVID-19) has highlighted the importance of rapid control of the transmission of infectious diseases. This is particularly important for COVID-19, where many individuals are asymptomatic or have only mild symptoms but can still spread the disease. Current systems for controlling transmission rely on patients to report their symptoms to medical professionals and be able to recall and trace all their contacts from the previous few days. This is unrealistic in the modern world. However, existing smartphone-based GPS and social media technology may provide a suitable alternative. We, therefore, developed a mini-program within the app WeChat. This analyzes data from all users and traces close contacts of all patients. This permits early tracing and quarantine of potential sources of infection. Data from the mini-program can also be merged with other data to predict epidemic trends, calculate individual and population risks, and provide recommendations for individual and population protection action. It may also improve our understanding of how the disease spreads. However, there are a number of unresolved questions about the use of smartphone data for health surveillance, including how to protect individual privacy and provide safeguards against data breaches.

scholarly journals The successful use of volunteers to enhance NHS Test and Trace contact tracing of in-patients with Covid-19: a Pilot Study

2021 ◽  
Author(s):  
Rachel Foster ◽  
Bing Jones ◽  
Ian Carey ◽  
Andzelika Duda ◽  
Abigail Reynolds ◽  
...  
Keyword(s):  
Medical Student ◽  
False Negative ◽  
Severity Of Illness ◽  
Contact Tracing ◽  
Face To Face ◽  
Communication Problems ◽  
Student Volunteers ◽  
Sources Of Infection ◽  
The Uk ◽  
Close Contacts

AbstractContact tracing in the UK for Covid-19 is performed by NHS Test and Trace (NHSTT) via telephone or email. This study estimates how many patients who have been admitted to hospital are not reached by NHSTT and the number of their contacts who were not advised to self-isolate.Medical Student volunteers conducted face to face interviews with patients diagnosed with Covid-19 on an infectious diseases ward. Data on their close contacts were sent to NHSTT.20 cases were enrolled. 13(65%) did not engage with NHSTT, 4(20%) because they had no positive PCR, 9(45%) because of severity of illness, language or intellectual difficulties. 49 close contacts were identified of whom 33(67%) were from cases who had not engaged with NHSTT. “Backwards” contacts tracing information was collected from 11(55%) cases and 8(40%) gave detailed information.These data suggest that NHSTT fails to engage nearly two thirds of Covid-19 in-patients and fails to advise two thirds of their close contacts to self isolate.Volunteers used face to face interviews to overcome false negative tests, illness and communication problems to identify both close contacts and data on sources of infection.

scholarly journals Contact Screening for Healthcare Workers Exposed to Patients with COVID-19

2020 ◽  
Vol 17 (23) ◽  
pp. 9082
Author(s):  
Luca Coppeta ◽  
Giuseppina Somma ◽  
Lorenzo Ippoliti ◽  
Cristiana Ferrari ◽  
Iacopo D’Alessandro ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Close Contact ◽  
Clinical History ◽  
Contact Tracing ◽  
Nasopharyngeal Swab ◽  
Major Route ◽  
Risk Of Exposure ◽  
Polymerase Chain ◽  
Main Determinants ◽  
Selection Of

In China and Italy, many cases of coronavirus disease 2019 (COVID-19) have occurred among healthcare workers (HCWs). Prompt identification, isolation and contact tracing of COVID-19 cases are key elements in controlling the COVID-19 pandemic. The aim of this study was to evaluate the rate of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection among HCWs exposed to patients with COVID-19 in relation to the main determinants of exposure. To assess the risk of exposure, we performed active symptom monitoring in 1006 HCWs identified as contacts of COVID19 cases. The presence of symptoms was statistically associated with a positive nasopharyngeal swab result. Only one subject was asymptomatic at the time of positive test. These data suggest that clinical history may help in the selection of subjects to be investigated by means of reverse transcriptase-polymerase chain reaction (RT-PCR) in the case of a shortage of diagnostic resources. We found that close contact (within 2 m for 15 min or more) was not statistically related to contagion. Regarding the use of personal protective equipment (PPE), only the use of facial masks was inversely related to the chance of becoming infected (p < 0.01). In conclusion, our data show that unprotected contacts between HCWs should be considered a major route of HCW contagion, suggesting that the use of facial masks should be implemented even in settings where known patients with COVID-19 are not present.

scholarly journals Tracing contacts to evaluate the transmission of COVID-19 from highly exposed individuals in public transportation

2021 ◽  
Author(s):  
Caio Ponte ◽  
Humberto Carmona ◽  
Erneson Oliveira ◽  
Carlos Caminha ◽  
Antonio Lima Neto ◽  
...  
Keyword(s):  
Public Transportation ◽  
Healthcare Workers ◽  
Time Windows ◽  
Mean Field ◽  
Contact Tracing ◽  
Reproduction Numbers ◽  
Consecutive Time ◽  
Longitudinal Comparison ◽  
The City ◽  
Close Contacts

We investigate, through a data-driven contact tracing model, the transmission of COVID-19 inside buses during distinct phases of the pandemic in a large Brazilian city. From this microscopic approach, we recover the networks of close contacts within consecutive time windows. A longitudinal comparison is then performed by upscaling the traced contacts with the transmission computed from a mean-field compartmental model for the entire city. Our results show that the effective reproduction numbers inside the buses, Rebus, and in the city, Recity, followed a compatible behavior during the first wave of the local outbreak. Moreover, by distinguishing the close contacts of healthcare workers in the buses, we discovered that their transmission, Rehealth, during the same period, was systematically higher than Rebus. This result reinforces the need for special public transportation policies for highly exposed groups of people.

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