Regressing SARS-CoV-2 sewage measurements onto COVID-19 burden in the population: a proof-of-concept for quantitative environmental surveillance

AbstractSARS-CoV-2 is an RNA virus, a member of the coronavirus family of respiratory viruses that includes SARS-CoV-1 and MERS. COVID-19, the clinical syndrome caused by SARSCoV-2, has evolved into a global pandemic with more than 2,900,000 people infected. It has had an acute and dramatic impact on health care systems, economies, and societies of affected countries within these few months. Widespread testing and tracing efforts are employed in many countries in order to contain and mitigate this pandemic. Recent data has indicated that fecal shedding of SARS-CoV-2 is common, and that the virus can be detected in wastewater. This indicates that wastewater monitoring is a potentially efficient tool for epidemiological surveillance of SARS-CoV-2 infection in large populations at relevant scales. Collecting raw sewage data, representing specific districts, and crosslinking this data with the number of infected people from each location, will enable us to derive and provide quantitative surveillance tools. In particular, this will provide important means to (i) estimate the extent of outbreaks and their spatial distributions, based primarily on in-sewer measurements (ii) manage the early-warning system quantitatively and efficiently (and similarly, verify disease elimination). Here we report the development of a virus concentration method using PEG or alum, providing an important a tool for detection of SARS-CoV-2 RNA in sewage and relating it to the local populations and geographic information. This will provide a proof of concept for the use of sewage associated virus data as a reliable epidemiological tool.

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Regressing SARS-CoV-2 Sewage Measurements Onto COVID-19 Burden in the Population: A Proof-of-Concept for Quantitative Environmental Surveillance

Frontiers in Public Health ◽

10.3389/fpubh.2021.561710 ◽

2022 ◽

Vol 9 ◽

Author(s):

Itay Bar-Or ◽

Karin Yaniv ◽

Marilou Shagan ◽

Eden Ozer ◽

Merav Weil ◽

...

Keyword(s):

Severe Acute Respiratory Syndrome ◽

Rna Virus ◽

Health Care Systems ◽

Rna Extraction ◽

Warning System ◽

Epidemiological Surveillance ◽

Virus Concentration ◽

Proof Of Concept ◽

Virus Rna ◽

Care Systems

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an RNA virus, a member of the coronavirus family of respiratory viruses that includes severe acute respiratory syndrome coronavirus 1 (SARS-CoV-1) and the Middle East respiratory syndrome (MERS). It has had an acute and dramatic impact on health care systems, economies, and societies of affected countries during the past 8 months. Widespread testing and tracing efforts are being employed in many countries in attempts to contain and mitigate this pandemic. Recent data has indicated that fecal shedding of SARS-CoV-2 is common and that the virus RNA can be detected in wastewater. This indicates that wastewater monitoring may provide a potentially efficient tool for the epidemiological surveillance of SARS-CoV-2 infection in large populations at relevant scales. In particular, this provides important means of (i) estimating the extent of outbreaks and their spatial distributions, based primarily on in-sewer measurements, (ii) managing the early-warning system quantitatively and efficiently, and (iii) verifying disease elimination. Here we report different virus concentration methods using polyethylene glycol (PEG), alum, or filtration techniques as well as different RNA extraction methodologies, providing important insights regarding the detection of SARS-CoV-2 RNA in sewage. Virus RNA particles were detected in wastewater in several geographic locations in Israel. In addition, a correlation of virus RNA concentration to morbidity was detected in Bnei-Barak city during April 2020. This study presents a proof of concept for the use of direct raw sewage-associated virus data, during the pandemic in the country as a potential epidemiological tool.

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The Role of Health Technology and Informatics in a Global Public Health Emergency: Practices and Implications From the COVID-19 Pandemic

JMIR Medical Informatics ◽

10.2196/19866 ◽

2020 ◽

Vol 8 (7) ◽

pp. e19866 ◽

Cited By ~ 5

Author(s):

Jiancheng Ye

Keyword(s):

Health Care ◽

Large Scale ◽

Health Care Systems ◽

Strong Support ◽

Global Public Health ◽

Infected People ◽

Health Technologies ◽

Care Systems ◽

Delivery Services ◽

And Control

At present, the coronavirus disease (COVID-19) is spreading around the world. It is a critical and important task to take thorough efforts to prevent and control the pandemic. Compared with severe acute respiratory syndrome and Middle East Respiratory Syndrome, COVID-19 spreads more rapidly owing to increased globalization, a longer incubation period, and unobvious symptoms. As the coronavirus has the characteristics of strong transmission and weak lethality, and since the large-scale increase of infected people may overwhelm health care systems, efforts are needed to treat critical patients, track and manage the health status of residents, and isolate suspected patients. The application of emerging health technologies and digital practices in health care, such as artificial intelligence, telemedicine or telehealth, mobile health, big data, 5G, and the Internet of Things, have become powerful “weapons” to fight against the pandemic and provide strong support in pandemic prevention and control. Applications and evaluations of all of these technologies, practices, and health delivery services are highlighted in this study.

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A Matter of Intent: A Social Obligation to Improve Criminal Procedures for Individuals with Dementia

The Journal of Law Medicine & Ethics ◽

10.1177/1073110520935345 ◽

2020 ◽

Vol 48 (2) ◽

pp. 318-327 ◽

Cited By ~ 1

Author(s):

Jalayne J. Arias ◽

Lauren S. Flicker

Keyword(s):

Criminal Behavior ◽

Psychiatric Illness ◽

Health Care Systems ◽

Criminal Liability ◽

Clinical Syndrome ◽

Cognitive Domains ◽

Social Obligation ◽

Care Systems ◽

Affirmative Defenses ◽

The Relationship

The relationship between dementia and criminal behavior perplexes legal and health care systems. Dementia is a progressive clinical syndrome defined by impairment in at least two cognitive domains that interferes with one's activities of daily. Dementia symptoms have been associated with behaviors that violate social norms and constitute criminal actions. A failure to address a gap in policies that support appropriate management of individuals with dementia reflects a failure in our social obligation to care for those who are most vulnerable amongst us. Categorical protections, informed by precedent models applied to juveniles and individuals with psychiatric illness, could help meet a social obligation to provide protections to individuals with dementia. We propose an approach that integrates affirmative defenses to mitigate criminal liability and sentencing restrictions to prevent cruel and unusual punishment.

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The Role of Health Technology and Informatics in a Global Public Health Emergency: Practices and Implications From the COVID-19 Pandemic (Preprint)

10.2196/preprints.19866 ◽

2020 ◽

Cited By ~ 1

Author(s):

Jiancheng Ye

Keyword(s):

Health Care ◽

Large Scale ◽

Health Care Systems ◽

Strong Support ◽

Global Public Health ◽

Infected People ◽

Health Technologies ◽

Care Systems ◽

Delivery Services ◽

And Control

UNSTRUCTURED At present, the coronavirus disease (COVID-19) is spreading around the world. It is a critical and important task to take thorough efforts to prevent and control the pandemic. Compared with severe acute respiratory syndrome and Middle East Respiratory Syndrome, COVID-19 spreads more rapidly owing to increased globalization, a longer incubation period, and unobvious symptoms. As the coronavirus has the characteristics of strong transmission and weak lethality, and since the large-scale increase of infected people may overwhelm health care systems, efforts are needed to treat critical patients, track and manage the health status of residents, and isolate suspected patients. The application of emerging health technologies and digital practices in health care, such as artificial intelligence, telemedicine or telehealth, mobile health, big data, 5G, and the Internet of Things, have become powerful “weapons” to fight against the pandemic and provide strong support in pandemic prevention and control. Applications and evaluations of all of these technologies, practices, and health delivery services are highlighted in this study.

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Diagnostics for COVID-19: A case for field-deployable, rapid molecular tests for community surveillance

Ghana Medical Journal ◽

10.4314/gmj.v54i4s.11 ◽

2020 ◽

Vol 54 (4s) ◽

pp. 71-76

Author(s):

Michael Frimpong ◽

Yaw A. Amoako ◽

Kwadwo B. Anim ◽

Hubert S. Ahor ◽

Richmond Yeboah ◽

...

Keyword(s):

Health Care ◽

Health Care Systems ◽

Absolute Number ◽

Contact Tracing ◽

Infected People ◽

Delay In Diagnosis ◽

Slowing Down ◽

Molecular Tests ◽

Care Systems ◽

Novel Coronavirus

Across the globe, the outbreak of the COVID-19 pandemic is causing distress with governments doing everything in their power to contain the spread of the novel coronavirus (SARS-CoV-2) to prevent morbidity and mortality. Actions are being implemented to keep health care systems from being overstretched and to curb the outbreak. Any policy responses aimed at slowing down the spread of the virus and mitigating its immediate effects on health care systems require a firm basis of information about the absolute number of currently infected people, growth rates, and locations/hotspots of infections. The only way to obtain this base of information is by conducting numerous tests in a targeted way. Currently, in Ghana, there is a centralized testing approach, that takes 4-5 days for samples to be shipped and tested at central reference laboratories with results communicated to the district, regional and nationalstakeholders. This delay in diagnosis increases the risk of ongoing transmission in communities and vulnerable institutions. We have validated, evaluated and deployed an innovative diagnostic tool on a mobile laboratory platform to accelerate the COVID-19 testing. A preliminary result of 74 samples from COVID-19 suspected cases has a positivity rate of 12% with a turn-around time of fewer than 3 hours from sample taking to reporting of results, significantly reducing the waiting time from days to hours, enabling expedient response by the health system for contact tracing to reduce transmission and additionally improving case management.

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The COVID-19 Pandemic: Defining the Clinical Syndrome and Describing an Empirical Response

Christian Journal for Global Health ◽

10.15566/cjgh.v7i1.365 ◽

2020 ◽

Vol 7 (1) ◽

pp. 37-44

Author(s):

Mandalam Seshadri ◽

Jacob John

Keyword(s):

Clinical Diagnosis ◽

Health Care Systems ◽

Clinical Syndrome ◽

The Novel ◽

Short Term ◽

Clinical Criteria ◽

The World ◽

Care Systems ◽

Lab Test ◽

Virus Testing

The novel corona virus infectious disease, COVID-19, is a pandemic now and is raging through several continents, posing a challenge to health-care systems of all the countries and disrupting lives and livelihoods across the world. The facilities for virus testing are available for only limited numbers in each country and each country excludes a large number of potentially infected subjects because the lab test is done for only certain categories. Nearly 80 % of those infected will therefore go undiagnosed. There is an urgent need therfore to define the clinical syndrome so that practitioners at the primary and secondary levels can make a confident clinical diagnosis and proceed to manage patients early and effectively. Chloroquine and hydroxychloroquine, both antimalarials have shown promise in limited trials in France and China. They are inexpensive, have been around for several decades in the prevention and treatment of malaria, have well-known side-effects and in the short term safe for use . We propose that practitioners make a preliminary clinical diagnosis of the COVID-19 syndrome based on simple clinical criteria and lab tests and proceed to manage patients and protect other family members and contacts by using isolation measures and short regimens of these anti malarial and other medications, anticipating results of more clinical trials.

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