scholarly journals SIREN protocol: Impact of detectable anti-SARS-CoV-2 on the subsequent incidence of COVID-19 in 100,000 healthcare workers: do antibody positive healthcare workers have less reinfection than antibody negative healthcare workers?

2020 ◽  
Author(s):  
S. Wallace ◽  
V. Hall ◽  
A. Charlett ◽  
P.D. Kirwan ◽  
M.J. Cole ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Large Scale ◽  
Antibody Test ◽  
Study Entry ◽  
Contact Tracing ◽  
Staff Members ◽  
Viral Culture ◽  
The Uk ◽  
Prospective Longitudinal ◽  
The Impact

AbstractBackgroundThe overall risk of reinfection in individuals who have previously had COVID-19 is unknown. To determine if prior SARS-CoV-2 infection (as determined by at least one positive commercial antibody test performed in a laboratory) in healthcare workers confers future immunity to reinfection, we are undertaking a large-scale prospective longitudinal cohort study of healthcare staff across the United Kingdom.MethodsPopulation and Setting: staff members of healthcare organisations working in hospitals in the UKAt recruitment, participants will have their serum tested for anti-SARS-CoV-2 at baseline and using these results will be initially allocated to either antibody positive or antibody negative cohorts. Participants will undergo antibody and viral RNA testing at 1-4 weekly intervals throughout the study period, and based on these results may move between cohorts. Any results from testing undertaken for other reasons (e.g. symptoms, contact tracing etc.) or prior to study entry will also be included. Individuals will complete enrolment and fortnightly questionnaires on exposures and symptoms. Follow-up will be for at least 12 months from study entry.OutcomeThe primary outcome of interest is a reinfection with SARS -CoV-2 during the study period. Secondary outcomes will include incidence and prevalence (both RNA and antibody) of SARS-CoV-2, viral genomics, viral culture, symptom history and antibody/neutralising antibody titres.ConclusionThis large study will help us to understand the impact of the presence of antibodies on the risk of reinfection with SARS-CoV-2; the results will have substantial implications in terms of national and international policy, as well as for risk management of contacts of COVID-19 cases.Trial RegistrationIRAS ID 284460, HRA and Health and Care Research Wales approval granted 22 May 2020.

scholarly journals Determining the optimal strategy for reopening schools, work and society in the UK: balancing earlier opening and the impact of test and trace strategies with the risk of occurrence of a secondary COVID-19 pandemic wave

2020 ◽  
Author(s):  
Jasmina Panovska-Griffiths ◽  
Cliff Kerr ◽  
Robyn Margaret Stuart ◽  
Dina Mistry ◽  
Daniel Klein ◽  
...  
Keyword(s):  
Large Scale ◽  
Reproduction Number ◽  
Epidemiological Data ◽  
Contact Tracing ◽  
Cumulative Number ◽  
Social Distancing ◽  
Uk Government ◽  
The Uk ◽  
The Impact ◽  
Pandemic Wave

Background In order to slow down the spread of SARS-CoV-2, the virus causing the COVID-19 pandemic, the UK government has imposed strict physical distancing (lockdown) measures including school 'dismissals' since 23 March 2020. As evidence is emerging that these measures may have slowed the spread of the pandemic, it is important to assess the impact of any changes in strategy, including scenarios for school reopening and broader relaxation of social distancing. This work uses an individual-based model to predict the impact of a suite of possible strategies to reopen schools in the UK, including that currently proposed by the UK government. Methods We use Covasim, a stochastic agent-based model for transmission of COVID-19, calibrated to the UK epidemic. The model describes individuals' contact networks stratified as household, school, work and community layers, and uses demographic and epidemiological data from the UK. We simulate a range of different school reopening strategies with a society-wide relaxation of lockdown measures and in the presence of different non-pharmaceutical interventions, to estimate the number of new infections, cumulative cases and deaths, as well as the effective reproduction number with different strategies. To account for uncertainties within the stochastic simulation, we also simulated different levels of infectiousness of children and young adults under 20 years old compared to older ages. Findings We found that with increased levels of testing of people (between 25% and 72% of symptomatic people tested at some point during an active COVID-19 infection depending on scenarios) and effective contact-tracing and isolation for infected individuals, an epidemic rebound may be prevented across all reopening scenarios, with the effective reproduction number (R) remaining below one and the cumulative number of new infections and deaths significantly lower than they would be if testing did not increase. If UK schools reopen in phases from June 2020, prevention of a second wave would require testing 51% of symptomatic infections, tracing of 40% of their contacts, and isolation of symptomatic and diagnosed cases. However, without such measures, reopening of schools together with gradual relaxing of the lockdown measures are likely to induce a secondary pandemic wave, as are other scenarios for reopening. When infectiousness of <20 year olds was varied from 100% to 50% of that of older ages, our findings remained unchanged. Interpretation To prevent a secondary COVID-19 wave, relaxation of social distancing including reopening schools in the UK must be implemented alongside an active large-scale population-wide testing of symptomatic individuals and effective tracing of their contacts, followed by isolation of symptomatic and diagnosed individuals. Such combined measures have a greater likelihood of controlling the transmission of SARS-CoV-2 and preventing a large number of COVID-19 deaths than reopening schools and society with the current level of implementation of testing and isolation of infected individuals.

scholarly journals Digital proximity tracing on empirical contact networks for pandemic control

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
G. Cencetti ◽  
G. Santin ◽  
A. Longa ◽  
E. Pigani ◽  
A. Barrat ◽  
...  
Keyword(s):  
Large Scale ◽  
Disease Outbreaks ◽  
Physical Distance ◽  
Contact Tracing ◽  
Reproductive Number ◽  
Modeling Framework ◽  
Infectious Disease Outbreaks ◽  
Contact Patterns ◽  
Contact Data ◽  
The Impact

AbstractDigital contact tracing is a relevant tool to control infectious disease outbreaks, including the COVID-19 epidemic. Early work evaluating digital contact tracing omitted important features and heterogeneities of real-world contact patterns influencing contagion dynamics. We fill this gap with a modeling framework informed by empirical high-resolution contact data to analyze the impact of digital contact tracing in the COVID-19 pandemic. We investigate how well contact tracing apps, coupled with the quarantine of identified contacts, can mitigate the spread in real environments. We find that restrictive policies are more effective in containing the epidemic but come at the cost of unnecessary large-scale quarantines. Policy evaluation through their efficiency and cost results in optimized solutions which only consider contacts longer than 15–20 minutes and closer than 2–3 meters to be at risk. Our results show that isolation and tracing can help control re-emerging outbreaks when some conditions are met: (i) a reduction of the reproductive number through masks and physical distance; (ii) a low-delay isolation of infected individuals; (iii) a high compliance. Finally, we observe the inefficacy of a less privacy-preserving tracing involving second order contacts. Our results may inform digital contact tracing efforts currently being implemented across several countries worldwide.

The complication of cyber manhunt: How cyber manhunt further complicated the ethical conflict between breaching the confidentiality and endangering the society in face of the COVID-19 pandemic (Preprint)

2021 ◽  
Author(s):  
Yen-Chang Chen ◽  
Yen-Yuan Chen
Keyword(s):  
Public Health ◽  
Large Scale ◽  
Health Workers ◽  
Early Stage ◽  
Personal Information ◽  
Public Health Intervention ◽  
Contact Tracing ◽  
Online Activity ◽  
Contact Investigation ◽  
The Impact

UNSTRUCTURED While health care and public health workers are working on measures to mitigate the COVID-19 pandemic, there is an unprecedentedly large number of people spending much more time indoors, and relying heavily on the Internet as their lifeline. What has been overlooked is the influence of the increasing online activities on public health issues. In this article, we pointed out how a large-scale online activity called cyber manhunt may threaten to offset the efficacy of contact tracing investigation, a public health intervention considered highly effective in limiting further transmission in the early stage of a highly contagious disease outbreak such as the COVID-19 pandemic. In the first section, we presented a case to show how personal information obtained from contact investigation and disclosed in part on the media provoked a vehement cyber manhunt. We then discussed the possible reasons why netizens collaborate to reveal anonymized personal information about contact investigation, and specify, from the perspective of public health and public health ethics, four problems of cyber manhunt, including the lack of legitimate public health goals, the concerns about privacy breach, the impact of misinformation, and social inequality. Based on our analysis, we concluded that more moral weight may be given to protecting one's confidentiality, especially in an era with the rapid advance of digital and information technologies.

Trust, efficacy and ethicacy when testing prisoners for COVID-19

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Steve Lambert ◽  
Dean Wilkinson
Keyword(s):  
Large Scale ◽  
Current System ◽  
Epidemiological Studies ◽  
Careful Consideration ◽  
Power Relationships ◽  
England And Wales ◽  
Content Type ◽  
Large Scale Testing ◽  
The Uk ◽  
The Impact

Purpose The outbreak of the severe acute respiratory syndrome coronavirus 2 virus and subsequent COVID-19 illness has had a major impact on all levels of society internationally. The extent of the impact of COVID-19 on prison staff and prisoners in England and Wales is unknown. Testing for COVID-19 both asymptomatic and symptomatic, as well as for antibodies, to date, has been minimal. The purpose of this paper is to explore the widespread testing of COVID-19 in prisons poses philosophical and ethical questions around trust, efficacy and ethicacy. Design/methodology/approach This paper is both descriptive, providing an overview of the widespread testing of COVID-19 in prisoners in England and Wales, and conceptual in that it discusses and argues the issues associated with large-scale testing. This paper provides a discussion, using comparative studies, of the issues associated with large-scale testing of prisoners across the prison estate in England and Wales (120 prisons). The issues identified in this paper are contextualised through the lens of COVID-19, but they are equally transferrable to epidemiological studies of any pandemic. Given the prevalence of COVID-19 globally and the lack of information about its spread in prisons, at the time of writing this paper, there is a programme of asymptomatic testing of prisoners. However, there remains a paucity of data on the spread of COVID-19 in prisons because of the progress with the ongoing testing programme. Findings The authors argue that the widespread testing of prisoners requires careful consideration of the details regarding who is included in testing, how consent is gained and how tests are administered. This paper outlines and argues the importance of considering the complex nuance of power relationships within the prison system, among prisoner officers, medical staff and prisoners and the detrimental consequences. Practical implications The widespread testing of COVID-19 presents ethical and practical challenges. Careful planning is required when considering the ethics of who should be included in COVID-19 testing, how consent will be gained, who and how tests will be administered and very practical challenges around the recording and assigning of COVID-19 test kits inside the prison. The current system for the general population requires scanning of barcodes and registration using a mobile number; these facilities are not permitted inside a prison. Originality/value This paper looks at the issues associated with mass testing of prisoners for COVID-19. According to the authors’ knowledge, there has not been any research that looks at the issues of testing either in the UK or internationally. The literature available details countries’ responses to the pandemic rather and scientific papers on the development of vaccines. Therefore, this paper is an original review of some of the practicalities that need to be addressed to ensure that testing can be as successful as possible.

scholarly journals Efficacy of contact tracing for the containment of the 2019 novel coronavirus (COVID-19)

2020 ◽  
pp. jech-2020-214051 ◽  
Author(s):  
Matt J Keeling ◽  
T Deirdre Hollingsworth ◽  
Jonathan M Read
Keyword(s):  
Close Contact ◽  
Control Measure ◽  
Disease Outbreaks ◽  
Contact Tracing ◽  
Public Health Response ◽  
Central Public Health ◽  
Increased Risk ◽  
Novel Coronavirus ◽  
The Uk ◽  
The Impact

ObjectiveContact tracing is a central public health response to infectious disease outbreaks, especially in the early stages of an outbreak when specific treatments are limited. Importation of novel coronavirus (COVID-19) from China and elsewhere into the UK highlights the need to understand the impact of contact tracing as a control measure.DesignDetailed survey information on social encounters from over 5800 respondents is coupled to predictive models of contact tracing and control. This is used to investigate the likely efficacy of contact tracing and the distribution of secondary cases that may go untraced.ResultsTaking recent estimates for COVID-19 transmission we predict that under effective contact tracing less than 1 in 6 cases will generate any subsequent untraced infections, although this comes at a high logistical burden with an average of 36 individuals traced per case. Changes to the definition of a close contact can reduce this burden, but with increased risk of untraced cases; we find that tracing using a contact definition requiring more than 4 hours of contact is unlikely to control spread.ConclusionsThe current contact tracing strategy within the UK is likely to identify a sufficient proportion of infected individuals such that subsequent spread could be prevented, although the ultimate success will depend on the rapid detection of cases and isolation of contacts. Given the burden of tracing a large number of contacts to find new cases, there is the potential the system could be overwhelmed if imports of infection occur at a rapid rate.

UK Fiscal Prospects

2010 ◽  
Vol 213 ◽  
pp. F66-F70 ◽  
Author(s):  
Ray Barrell ◽  
Simon Kirby
Keyword(s):  
Large Scale ◽  
Radical Change ◽  
Policy Framework ◽  
Budget Process ◽  
Spare Capacity ◽  
Intention To Move ◽  
The Government ◽  
The Uk ◽  
The Impact ◽  
The Relationship

The UK is restructuring the fiscal policy framework once again, with an intention to move toward independent assessment and forecasting in the budget process. At the same time a large-scale, if delayed, fiscal consolidation is planned at a time when there is significant spare capacity in the economy. Economic growth is also projected to be below trend, at least this year and perhaps next. It is unusual to see a fiscal tightening when the output gap appears to be widening. These policy settings should be seen in the context of the most radical change in the nature of the relationship between the government and the economy for at least thirty years. This note assesses the impact of the new programme on the economy as well as setting out a projection for the medium-term public finances.

The impact of time-varying CO 2 injection rate on large scale storage in the UK Bunter Sandstone

2018 ◽  
Vol 68 ◽  
pp. 77-85 ◽  
Author(s):  
Clea Kolster ◽  
Simeon Agada ◽  
Niall Mac Dowell ◽  
Samuel Krevor
Keyword(s):  
Large Scale ◽  
Injection Rate ◽  
Time Varying ◽  
The Uk ◽  
The Impact

scholarly journals SARS-CoV-2 transmission and control in a hospital setting: an individual-based modelling study

2020 ◽  
Author(s):  
Qimin Huang ◽  
Anirban Mondal ◽  
Xiaobing Jiang ◽  
Mary Ann Horn ◽  
Fei Fan ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Hospital Setting ◽  
Credible Interval ◽  
Contact Tracing ◽  
Global Public Health ◽  
Minimal Impact ◽  
Social Distancing ◽  
Work Related ◽  
The Impact ◽  
Outbreak Size

Background: Development of strategies for mitigating the severity of COVID-19 is now a top global public health priority. We sought to assess strategies for mitigating the COVID-19 outbreak in a hospital setting via the use of non-pharmaceutical interventions such as social distancing, self-isolation, tracing and quarantine, wearing facial masks/ personal protective equipment. Methods: We developed an individual-based model for COVID-19 transmission among healthcare workers in a hospital setting. We calibrated the model using data of a COVID-19 outbreak in a hospital unit in Wuhan in a Bayesian framework. The calibrated model was used to simulate different intervention scenarios and estimate the impact of different interventions on outbreak size and workday loss. Results: We estimated that work-related stress increases susceptibility to COVID-19 infection among healthcare workers by 52% (90% Credible Interval (CrI): 16.4% - 93.0%). The use of high efficacy facial masks was shown to be able to reduce infection cases and workday loss by 80% (90% CrI: 73.1% - 85.7%) and 87% (CrI: 80.0% - 92.5%), respectively. The use of social distancing alone, through reduced contacts between healthcare workers, had a marginal impact on the outbreak. A strict quarantine policy with the isolation of symptomatic cases and a high fraction of pre-symptomatic/ asymptomatic cases (via contact tracing or high test rate), could only prolong outbreak duration with minimal impact on the outbreak size. Our results indicated that a quarantine policy should be coupled with other interventions to achieve its effect. The effectiveness of all these interventions was shown to increase with their early implementation. Conclusions: Our analysis shows that a COVID-19 outbreak in a hospital's non-COVID-19 unit can be controlled or mitigated by the use of existing non-pharmaceutical measures.

Recruiting breast cancer patients for mHealth research: Obstacles to clinic-based recruitment for a mobile phone app intervention study

2020 ◽  
Vol 17 (6) ◽  
pp. 675-683
Author(s):  
Alisha Gupta ◽  
Gabrielle Ocker ◽  
Philip I Chow
Keyword(s):  
Breast Cancer ◽  
Mental Health ◽  
Pilot Study ◽  
Cancer Patients ◽  
Large Scale ◽  
Newly Diagnosed ◽  
Breast Cancer Patients ◽  
Pilot Studies ◽  
Staff Members ◽  
The Impact

Background Nearly half of newly diagnosed breast cancer patients will report clinically significant symptoms of depression and/or anxiety within the first year of diagnosis. Research on the trajectory of distress in cancer patients suggests that targeting patients early in the diagnostic pathway could be particularly impactful. Given the recent rise of smartphone adoption, apps are a convenient and accessible platform from which to deliver mental health support; however, little research has examined their potential impact among newly diagnosed cancer patients. One reason is likely due to the obstacles associated with in-clinic recruitment of newly diagnosed cancer patients for mHealth pilot studies. Methods This article draws from our experiences of a recently completed pilot study to test a suite of mental health apps in newly diagnosed breast cancer patients. Recruitment strategies included in-clinic pamphlets, flyers, and direct communication with clinicians. Surgical oncologists and research staff members approached eligible patients after a medical appointment. Research team members met with patients to provide informed consent and review the study schedule. Results Four domains of in-clinic recruitment challenges emerged: (a) coordination with clinic staff, (b) perceived burden among breast cancer patients, (c) limitations regarding the adoption and use of technology, and (d) availability of resources. Potential solutions are provided for each challenge. Conclusion Recruitment of newly diagnosed cancer patients is a major challenge to conducting mobile intervention studies for researchers on a pilot-study budget. To realize the impact of mobile interventions for the most vulnerable cancer patient populations, health researchers must address barriers to in-clinic recruitment to provide vital preliminary data in proposals of large-scale research projects.

scholarly journals Impact assessment in higher education: a strategic view from the UK

2018 ◽  
Vol 119 (1/2) ◽  
pp. 94-100 ◽  
Author(s):  
Ruth L. Ayres
Keyword(s):  
Higher Education ◽  
Impact Assessment ◽  
Large Scale ◽  
Learning Experience ◽  
Content Type ◽  
Perspective Drawing ◽  
Assessment In Higher Education ◽  
The Uk ◽  
Strategic Perspective ◽  
The Impact

Purpose This paper focuses on the importance of impact in higher education from a strategic perspective, exploring its value to institutions, learners and prospective students in today’s higher education context, using the UK as a case study. The increasing prominence of impact assessment in higher education is discussed, with consideration given to the operational structures, tools and approaches which can be adopted to monitor and evaluate the impact of any strategic project or initiative introduced by a higher education provider. Design/methodology/approach This paper presents a strategic view of impact assessment in today’s higher education landscape. Findings The significance of impact assessment in higher education is discussed from a strategic perspective, drawing upon relevant studies, UK Government policy and initiatives. Consideration is given to the tools and approaches that can be adopted by higher education providers in assessing the impact of any strategic initiatives and projects that have been implemented. Originality/value The paper is of value to 'any higher education provider that is currently undertaking, or planning to deliver large-scale strategic projects and initiatives which have been designed to enhance the student learning experience.

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