scholarly journals Modeling the frequency and number of persons to test to detect and control COVID-19 outbreaks in congregate settings

2020 ◽  
Author(s):  
Prabasaj Paul ◽  
Emily Mosites ◽  
Rebecca L. Laws ◽  
Heather Scobie ◽  
Rachel B. Slayton ◽  
...  
Keyword(s):  
Disease Transmission ◽  
Diagnostic Testing ◽  
Turnaround Time ◽  
Detection Sensitivity ◽  
Outbreak Detection ◽  
Test Characteristics ◽  
Minimum Number ◽  
Facility Size ◽  
And Control ◽  
Wide Testing

AbstractBackgroundCongregate settings are at risk for coronavirus disease 2019 (COVID-19) outbreaks. Diagnostic testing can be used as a tool in these settings to identify outbreaks and to control transmission.MethodsWe used transmission modeling to estimate the minimum number of persons to test and the optimal frequency to detect small outbreaks of COVID-19 in a congregate facility. We also estimated the frequency of testing needed to interrupt transmission within a facility.ResultsThe number of people to test and frequency of testing needed depended on turnaround time, facility size, and test characteristics. Parameters are calculated for a variety of scenarios. In a facility of 100 people, 26 randomly selected individuals would need to be tested at least every 6 days to identify a true underlying prevalence of at least 5%, with test sensitivity of 85%, and greater than 95% outbreak detection sensitivity. Disease transmission could be interrupted with universal, facility-wide testing with rapid turnaround every three days.ConclusionsTesting a subset of individuals in congregate settings can improve early detection of small outbreaks of COVID-19. Frequent universal diagnostic testing can be used to interrupt transmission within a facility, but its efficacy is reliant on rapid turnaround of results for isolation of infected individuals.

THE 2019 NOVEL PANDEMIC OF CORONAVIRUS DISEASE (COVID-19): A STUDY OF EXISTING EVIDENCE IN THE INDIAN POPULATION

2020 ◽  
Vol 7 (2) ◽  
pp. 199-204
Author(s):  
Shrikant Verma ◽  
Mohammad Abbas ◽  
Sushma Verma ◽  
Syed Tasleem Raza ◽  
Farzana Mahdi
Keyword(s):  
Disease Transmission ◽  
Indian Population ◽  
Respiratory Infections ◽  
Clinical Signs ◽  
Case Fatality ◽  
Public Health Emergency ◽  
The World ◽  
And Control ◽  
General Wellbeing ◽  
Different Parts

A novel spillover coronavirus (nCoV), with its epicenter in Wuhan, China's People's Republic, has emerged as an international public health emergency. This began as an outbreak in December 2019, and till November eighth, 2020, there have been 8.5 million affirmed instances of novel Covid disease2019 (COVID-19) in India, with 1,26,611 deaths, resulting in an overall case fatality rate of 1.48 percent. Coronavirus clinical signs are fundamentally the same as those of other respiratory infections. In different parts of the world, the quantity of research center affirmed cases and related passings are rising consistently. The COVID- 19 is an arising pandemic-responsible viral infection. Coronavirus has influenced huge parts of the total populace, which has prompted a global general wellbeing crisis, setting all health associations on high attentive. This review sums up the overall landmass, virology, pathogenesis, the study of disease transmission, clinical introduction, determination, treatment, and control of COVID-19 with the reference to India.

Communicable and Other Infectious Diseases

2020 ◽  
Author(s):  
Markus Frischhut
Keyword(s):  
Public Health ◽  
European Union ◽  
Infectious Diseases ◽  
Disease Transmission ◽  
Eu Law ◽  
The European Union ◽  
Ethical Perspective ◽  
Health Measures ◽  
Environment Agency ◽  
And Control

This chapter discusses the most important features of EU law on infectious diseases. Communicable diseases not only cross borders, they also often require measures that cross different areas of policy because of different vectors for disease transmission. The relevant EU law cannot be attributed to one sectoral policy only, and thus various EU agencies participate in protecting public health. The key agency is the European Centre for Disease Prevention and Control. Other important agencies include the European Environment Agency; European Food Safety Authority; and the Consumers, Health, Agriculture and Food Executive Agency. However, while integration at the EU level has facilitated protection of the public's health, it also has created potential conflicts among the different objectives of the European Union. The internal market promotes the free movement of products, but public health measures can require restrictions of trade. Other conflicts can arise if protective public health measures conflict with individual human rights. The chapter then considers risk assessment and the different tools of risk management used in dealing with the challenges of infectious diseases. It also turns to the external and ethical perspective and the role the European Union takes in global health.

scholarly journals 458. Molecular SARS-CoV-2 Testing During the COVID-19 Outbreak: Experiences of a Hospital in Southeast Michigan, USA

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S296-S297
Author(s):  
Trini A Mathew ◽  
Jonathan Hopkins ◽  
Diane Kamerer ◽  
Shagufta N Ali ◽  
Daniel Ortiz ◽  
...  
Keyword(s):  
Clinical Features ◽  
Diagnostic Testing ◽  
Beaumont Hospital ◽  
High Capacity ◽  
Turnaround Time ◽  
Molecular Diagnostic ◽  
The Novel ◽  
Repeat Testing ◽  
Asymptomatic Patients ◽  
Novel Coronavirus

Abstract Background The novel Coronavirus SARS CoV-2 (COVID-19) outbreak was complicated by the lack of diagnostic testing kits. In early March 2020, leadership at Beaumont Hospital, Royal Oak Michigan (Beaumont) identified the need to develop high capacity testing modalities with appropriate sensitivity and specificity and rapid turnaround time. We describe the molecular diagnostic testing experience since initial rollout on March 16, 2020 at Beaumont, and results of repeat testing during the peak of the COVID-19 pandemic in MI. Methods Beaumont is an 1100 bed hospital in Southeast MI. In March, testing was initially performed with the EUA Luminex NxTAG CoV Extended Panel until March 28, 2020 when testing was converted to the EUA Cepheid Xpert Xpress SARS-CoV-2 for quicker turnaround times. Each assay was validated with a combination of patient samples and contrived specimens. Results During the initial week of testing there was > 20 % specimen positivity. As the prevalence grew the positivity rate reached 68% by the end of March (Figure 1). Many state and hospital initiatives were implemented during the outbreak, including social distancing and screening of asymptomatic patients to increase case-finding and prevent transmission. We also adopted a process for clinical review of symptomatic patients who initially tested negative for SARS-CoV-2 by a group of infectious disease physicians (Figure 2). This process was expanded to include other trained clinicians who were redeployed from other departments in the hospital. Repeat testing was performed to allow consideration of discontinuation of isolation precautions. During the surge of community cases from March 16 to April 30, 2020, we identified patients with negative PCR tests who subsequently had repeat testing based on clinical evaluation, with 7.1% (39/551) returning positive for SARS- CoV2. Of the patients who expired due to COVID-19 during this period, 4.3% (9/206) initially tested negative before ultimately testing positive. Figure 1 BH RO testing Epicurve Figure 2: Screening tool for repeat COVID19 testing and precautions Conclusion Many state and hospital initiatives helped us flatten the curve for COVID-19. Our hospital testing experience indicate that repeat testing may be warranted for those patients with clinical features suggestive of COVID-19. We will further analyze these cases and clinical features that prompted repeat testing. Disclosures All Authors: No reported disclosures

scholarly journals An Investigation of the General Population’s Self-Reported Hand Hygiene Behaviour and Compliance in a Cross-European Setting

2021 ◽  
Vol 18 (5) ◽  
pp. 2402
Author(s):  
Aaron Lawson ◽  
Marie Vaganay-Miller ◽  
Robert Cameron
Keyword(s):  
General Population ◽  
Hand Hygiene ◽  
Disease Transmission ◽  
Communicable Disease ◽  
Hygiene Practice ◽  
Hygiene Behaviour ◽  
Level Of Understanding ◽  
The Uk ◽  
Travel Abroad ◽  
And Control

Every year, thousands of people from the UK travel to other countries for work and leisure. Europe, and particularly Spain, is one of the most popular travel destinations for people from the UK. However, it is known that travel to other countries can enhance the risk of communicable disease transmission from person to person, especially when a new one emerges. Adequate hand hygiene behaviour and compliance is widely accepted as being a simple, effective method in preventing the spread of communicable diseases that may be contracted during travel abroad. There is a well-established body of work investigating hand hygiene practice and compliance in community settings, but no recent studies have examined the hand hygiene practice and compliance of the general population when travelling abroad or in a cross-European context. The findings of this study indicated that most UK members of the general population when travelling abroad have a good level of understanding of the importance of adequate hand hygiene practice and compliance and its role regarding communicable disease prevention and control. As such, self-reported levels of compliance were high. Similar findings were made for Spanish members of the general population. However, while self-reported perceptions of adequacy of hand hygiene performance were relatively high, particularly among UK respondents, this was not supported by responses specifically focused on hand hygiene behaviour. However, differences in self-reported adequacy regarding the importance of handwashing versus hand drying, the number of steps that should be followed and the length of time that should be spent washing and drying hands were found for each group. This suggests that self-reported compliance may reflect intention to practice hand hygiene rather than true compliance. It also suggests that there are gaps in knowledge regarding the adequate method of hand hygiene among the cohort as a whole, and indeed these differences may account be a factor in for the high transmission rates of communicable disease when travelling abroad.

scholarly journals Infection Prevention Considerations for a Multi-Mission Convention Center Field Hospital in Baltimore, Maryland during the COVID-19 Pandemic

2021 ◽  
pp. 1-21
Author(s):  
Jennifer A. Jones ◽  
Zishan K. Siddiqui ◽  
Charles Callahan ◽  
Surbhi Leekha ◽  
Sharon Smyth ◽  
...  
Keyword(s):  
Best Practices ◽  
Infection Prevention ◽  
Diagnostic Testing ◽  
The United States ◽  
Infection Prevention And Control ◽  
Field Hospital ◽  
First Case ◽  
Convention Center ◽  
Set Up ◽  
And Control

Abstract The state of Maryland identified its first case of COVID-19 on March 5, 2020. The Baltimore Convention Center (BCCFH) quickly became a selected location to set up a 250-bed inpatient Field Hospital and Alternate Care Site. In contrast to other field hospitals throughout the United States, the BCCFH remained open throughout the pandemic and took on additional COVID-19 missions, including community SARS-CoV-2 diagnostic testing, monoclonal antibody infusions for COVID-19 outpatients, and community COVID-19 vaccinations. At the time of publication, the BCCFH had cared for 1,478 COVID-19 inpatients, performed 108,155 COVID-19 tests, infused 2,166 COVID-19 patients, and administered 115,169 doses of COVID-19 vaccine. To prevent the spread of pathogens during operations, infection prevention and control guidelines were essential to ensure the safety of staff and patients. Through multi-agency collaboration, utilization of infection prevention best practices, and answering what we describe as “PPE-ESP”, an operational framework was established to reduce infection risks for those providing or receiving care at the BCCFH during the COVID-19 pandemic.

A point-of-care diagnostic for differentiating Ebola from endemic febrile diseases

2018 ◽  
Vol 10 (471) ◽  
pp. eaat0944 ◽  
Author(s):  
David Sebba ◽  
Alexander G. Lastovich ◽  
Melody Kuroda ◽  
Eric Fallows ◽  
Joshua Johnson ◽  
...  
Keyword(s):  
Ebola Virus ◽  
Clinical Symptoms ◽  
Point Of Care ◽  
Hemorrhagic Fever ◽  
Diagnostic Methods ◽  
Outbreak Detection ◽  
Molecular Diagnostic ◽  
Clinical Samples ◽  
Live Virus ◽  
And Control

Hemorrhagic fever outbreaks such as Ebola are difficult to detect and control because of the lack of low-cost, easily deployable diagnostics and because initial clinical symptoms mimic other endemic diseases such as malaria. Current molecular diagnostic methods such as polymerase chain reaction require trained personnel and laboratory infrastructure, hindering diagnostics at the point of need. Although rapid tests such as lateral flow can be broadly deployed, they are typically not well-suited for differentiating among multiple diseases presenting with similar symptoms. Early detection and control of Ebola outbreaks require simple, easy-to-use assays that can detect and differentiate infection with Ebola virus from other more common febrile diseases. Here, we developed and tested an immunoassay technology that uses surface-enhanced Raman scattering (SERS) tags to simultaneously detect antigens from Ebola, Lassa, and malaria within a single blood sample. Results are provided in <30 min for individual or batched samples. Using 190 clinical samples collected from the 2014 West African Ebola outbreak, along with 163 malaria positives and 233 negative controls, we demonstrated Ebola detection with 90.0% sensitivity and 97.9% specificity and malaria detection with 100.0% sensitivity and 99.6% specificity. These results, along with corresponding live virus and nonhuman primate testing of an Ebola, Lassa, and malaria 3-plex assay, indicate the potential of the SERS technology as an important tool for outbreak detection and clinical triage in low-resource settings.

scholarly journals The attainment of herd immunity with a reducing risk of contact infection in modelling 

2021 ◽  
Author(s):  
Kian Boon Law ◽  
Kalaiarasu M Peariasamy ◽  
Hishamshah Ibrahim ◽  
Noor Hisham Abdullah
Keyword(s):  
Infectious Disease ◽  
Disease Transmission ◽  
Herd Immunity ◽  
Sir Model ◽  
Mixed Population ◽  
Transmission Model ◽  
Force Of Infection ◽  
Initial Stage ◽  
And Control ◽  
Model Features

Abstract The risk of contact infection among susceptible individuals in a randomly mixed population can be reduced by the presence of immune individuals and this principle forms the fundamental of herd immunity. The conventional susceptible-infectious-recovered (SIR) model features an infection-induced herd immunity model, but does not include the reducing risk of contact infection among susceptible individuals in the transmission model, therefore tends to overestimate the transmission dynamics of infectious diseases. Here we show that the reducing risk of contact infection among susceptible individuals can be achieved by incorporating the proportion of susceptible individuals (model A) or the inverse of proportion of recovered individuals (model B) in the force of infection of the SIR model. We numerically simulated the conventional SIR model and both new SIR models A and B under the exact condition with a basic reproduction number of 3·0. Prior to the numerical simulation, the threshold for the eradication of infectious disease through herd immunity was expected to be 0·667 (66·7%) for all three models. All three models performed likewise at the initial stage of disease transmission. In the conventional SIR model, the infectious disease subsided when 94·0 % of the population had been infected and recovered, way above the expected threshold for eradication and control of the infectious disease. Both models A and B simulated the infectious disease to diminish when 66·7% and 75·6% of the population had been infected, showing herd immunity might protect more susceptible individuals from the infectious disease as compared to the projection generated by the conventional SIR. Our study shows that model A provides a better framework for modelling herd immunity through vaccination, while model B provides a better framework for modelling herd immunity through infection. Both models overcome the insufficiency of the conventional SIR model in attaining the effect of herd immunity in modelling outputs, which is important and relevant for modelling infectious disease, such as the COVID-19 in a randomly mixed population.

scholarly journals Mounting a Regional Response to the COVID-19 Pandemic: Another Reason to “Keep” Your Lab

2020 ◽  
Vol 144 (11) ◽  
pp. 1321-1324
Author(s):  
Tamera A. Paczos
Keyword(s):  
Health System ◽  
Medical Center ◽  
Academic Medical Center ◽  
Diagnostic Testing ◽  
Turnaround Time ◽  
Test Method ◽  
Regional Health ◽  
The Core ◽  
Local Access ◽  
Average Turnaround Time

Context.— Declining reimbursement shifts hospital laboratories from system assets to cost centers. This has resulted in increased outsourcing of laboratory services, which can jeopardize a hospital systems' ability to respond to a health care crisis. Objectives.— To demonstrate that investment in a core laboratory serving an academic medical center equipped a regional health system to respond to the Coronavirus disease 2019 (COVID-19) pandemic. Design.— COVID-19 diagnostic testing data were analyzed. Volumes were evaluated by result date (March 16, 2020–May 6, 2020), and the average of received-to-verified turnaround time was calculated and compared for in-house and send-out testing, and different in-house testing methodologies. Results.— Daily viral diagnostic testing capacity increased by greater than 3000% (from 21 tests per day to 658 tests per day). Total viral diagnostic testing reported by the core laboratory increased by 128 times during 22 days of test method validation and 826 times during the analysis period, while average turnaround time per day for send-out testing increased from 3.7 days to 21 days. Decreased overall average turnaround time was observed at the core laboratory (0.45 days) versus send-out testing (7.63 days) (P &lt; .001). Conclusions.— Investment in a core laboratory provided the health system with the necessary expertise and resources to mount a robust response to the pandemic. Local access to testing allowed rapid triage of patients and conservation of scarce personal protective equipment (PPE). In addition, the core laboratory was able to support regional health departments and several hospitals outside of the system.

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