scholarly journals Assessing the impact of secondary school reopening strategies on within-school COVID-19 transmission and absences: a modelling study

2021 ◽  
Author(s):  
Trystan Leng ◽  
Edward M. Hill ◽  
Robin N. Thompson ◽  
Michael J. Tildesley ◽  
Matt J. Keeling ◽  
...  
Keyword(s):  
Secondary School ◽  
High Volume ◽  
Rapid Testing ◽  
Repeated Testing ◽  
Positive Polymerase Chain Reaction ◽  
Testing Strategies ◽  
Targeted Testing ◽  
Polymerase Chain ◽  
Lateral Flow Tests ◽  
The Impact

AbstractBackgroundStrategies involving rapid testing have been suggested as a way of reopening schools that minimises absences while controlling transmission. We assess the likely impact of rapid testing strategies using lateral flow tests (LFTs) on infections and absences in secondary schools, compared to a policy of isolating year group bubbles upon a pupil returning a positive polymerase chain reaction (PCR) test.MethodsWe developed an individual-based model of a secondary school formed of exclusive year group bubbles (five year groups, with 200 pupils per year). By simulating infections over the course of a seven-week half-term, we compared the impact of differing strategies on transmission, absences, and testing volume. We also considered the sensitivity of results to underlying model assumptions.FindingsRepeated testing of year-group bubbles following case detection or regular mass-testing strategies result in a modest increase in infections compared to the policy of isolating year-group bubbles, but substantially reduce absences. When combined these two testing strategies can reduce infections to levels lower than would occur under year-group isolation, although such a policy requires a high volume of testing.InterpretationOur results highlight the conflict between the goals of minimising within-school transmission, minimising absences and minimising testing burden. While mass and targeted testing strategies can reduce school transmission and absences, it may lead to a large number of daily tests.

scholarly journals 444. Coronavirus Disease 2019 (COVID-19) Among Healthcare Workers in Southeast Michigan

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S289-S290
Author(s):  
Amit T Vahia ◽  
Zohra Sarfraz Chaudhry ◽  
Allison J Weinmann ◽  
Linoj Samuel ◽  
Robert Tibbetts ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Health Care Organization ◽  
High Volume ◽  
The United States ◽  
Care Organization ◽  
Patient Contact ◽  
Upper Respiratory Tract ◽  
Positive Polymerase Chain Reaction ◽  
Job Category ◽  
The Impact

Abstract Background Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, has significantly impacted Michigan, with over 60,000 cases and 5,700 deaths to date. During the surge, Metropolitan Detroit was the epicenter of the outbreak, accounting for 80% of cases and 86% of deaths statewide. Healthcare workers (HCW) are particularly at risk; however, rates of infection based on job category has not been described previously in the United States. We describe the impact of the outbreak on our workforce. Background Michigan COVID Figure 1 Methods This was a retrospective review of employees with COVID-19 at Henry Ford Health System (HFHS), a comprehensive, integrated, health care organization in Southeast Michigan includes 5 hospitals and 9 emergency departments from 3/10/2020–6/10/2020. Employees exhibiting symptoms and/or signs consistent with COVID-19 infection were referred to employee health and tested for SARS-CoV-2. All employees with positive polymerase chain reaction (PCR) of upper respiratory tract were included. Data were obtained from a dedicated analytics dashboard that tracked all testing and results for employees. Rate (number positives/total tested) of infection for each job category was determined. Results A total 5352 (16%) of 33538 employees were tested, of whom 1036 (19%) tested positive. The number of infected workers represents approximately 3.1 % of the workforce. The sharp increase of COVID-19 admissions correlated with the rise in HCW COVID-19 positivity (Figure 1). The number of HCW tested largely correlated with the disease burden at each hospital (Figure2). Table 1 shows total population of symptomatic HCW tested and demonstrates volume of testing and positivity were higher among HCW with close patient contact. The positivity rates in specific clinical support staff are shown in Table 2. Notably, there were high rates of positivity among non-clinical business and management employees tested suggesting community-transmission. Table 1 Table 2 Figure 2 Conclusion COVID-19 risk is highest among HCW in high volume settings with close patient contact. Community exposure may be an important factor that contributes to this risk. Strategies to minimize transmission in healthcare settings should be combined with HCW education emphasizing measures to avoid exposure within the community. Disclosures All Authors: No reported disclosures

scholarly journals When intuition falters: repeated testing accuracy during an epidemic

2021 ◽  
Author(s):  
James A. Hay ◽  
Joel Hellewell ◽  
Xueting Qiu
Keyword(s):  
Impact Test ◽  
Infected Individual ◽  
Repeated Testing ◽  
Testing Strategies ◽  
Controversial Topic ◽  
Testing Accuracy ◽  
Antigen Tests ◽  
Lateral Flow Tests ◽  
Sensitivity Specificity ◽  
Over Time

AbstractWidespread, repeated testing using rapid antigen tests to proactively detect asymptomatic SARS-CoV-2 infections has been a promising yet controversial topic during the COVID-19 pandemic. Concerns have been raised over whether currently authorized lateral flow tests are sufficiently sensitive and specific to detect enough infections to impact transmission whilst minimizing unnecessary isolation of false positives. These concerns have often been illustrated using simple, textbook calculations of positivity rates and positive predictive value assuming fixed values for sensitivity, specificity and prevalence. However, we argue that evaluating repeated testing strategies requires the consideration of three additional factors: new infections continue to arise depending on the incidence rate, isolating positive individuals reduces prevalence in the tested population, and each infected individual is tested multiple times during their infection course. We provide a simple mathematical model with an online interface to illustrate how these three factors impact test positivity rates and the number of isolating individuals over time. These results highlight the potential pitfalls of using inappropriate textbook-style calculations to evaluate statistics arising from repeated testing strategies during an epidemic.

scholarly journals Initial Observations of COVID-19 in US Children

2020 ◽  
Vol 10 (10) ◽  
pp. 902-905
Author(s):  
Rabia Agha ◽  
Tsoline Kojaoghlanian ◽  
Jeffrey R. Avner
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Retrospective Chart Review ◽  
Signs And Symptoms ◽  
Respiratory Illness ◽  
Polymerase Chain Reaction Test ◽  
Positive Polymerase Chain Reaction ◽  
Targeted Testing ◽  
Polymerase Chain ◽  
Chain Reaction Test ◽  
Us Children

Coronavirus disease (COVID-19) has affected children differently from adults worldwide. Data on the clinical presentation of the infection in children are limited. We present a detailed account of pediatric inpatients infected with severe acute respiratory syndrome coronavirus 2 virus at our institution during widespread local transmission, aiming to understand disease presentation and outcomes. A retrospective chart review was performed of children, ages 0 to 18 years, with a positive polymerase chain reaction test for severe acute respiratory syndrome coronavirus 2 on nasopharyngeal specimens admitted to our hospital over a 4-week period. We present clinical data from 22 patients and highlight the variability of the presentation. In our study, most children presented without respiratory illness or symptoms suggestive of COVID-19; many were identified only because of universal testing. Because children may have variable signs and symptoms of COVID-19 infection, targeted testing may miss some cases.

scholarly journals Frequency of routine testing for COVID-19 in high-risk environments to reduce workplace outbreaks

2020 ◽  
Author(s):  
Elizabeth T Chin ◽  
Benjamin Q Huynh ◽  
Matthew Murrill ◽  
Sanjay Basu ◽  
Nathan C Lo
Keyword(s):  
Active Infection ◽  
Chain Reaction ◽  
Routine Testing ◽  
Polymerase Chain Reaction Testing ◽  
Risk Environments ◽  
Testing Strategies ◽  
Returning To Work ◽  
Frequent Testing ◽  
Polymerase Chain ◽  
The Impact

AbstractShelter-in-place policies have been considered effective in mitigating the transmission of the virus SARS-CoV-2. To end such policies, routine testing and self-quarantine of those testing positive for active infection have been proposed, yet it remains unclear how often routine testing would need to be performed among workers returning to workplaces, and how effective this strategy would be to meaningfully prevent continued transmission of the virus. We simulated SARS-CoV-2 polymerase chain reaction testing to estimate the frequency of testing needed to avert continued epidemic propagation as shelter-in-place orders are relaxed. We find that testing strategies less frequent than daily (e.g. weekly testing or testing once prior to returning to work) are unlikely to prevent workforce outbreaks without additional interventions. Even given unlimited testing capacity, the impact of frequent testing may not be sufficient to reliably relax shelter-in-place policies without risking continued epidemic propagation, unless other measures are instituted to complement testing and self-isolation.

scholarly journals Field Evaluation of the Performance of Two Rapid Diagnostic Tests for Meningitis in Niger and Burkina Faso

2021 ◽  
Vol 9 (4) ◽  
pp. 832 ◽  
Author(s):  
Marc Rondy ◽  
Mamadou Tamboura ◽  
Fati Sidikou ◽  
Issaka Yameogo ◽  
Kambire Dinanibe ◽  
...  
Keyword(s):  
Burkina Faso ◽  
Field Evaluation ◽  
Health Centers ◽  
Outbreak Detection ◽  
Health Staff ◽  
Chain Reaction ◽  
Predictive Values ◽  
Independent Evaluation ◽  
Polymerase Chain ◽  
Lateral Flow Tests

New lateral flow tests for the diagnosis of Neisseria meningitidis (Nm) (serogroups A, C, W, X, and Y), MeningoSpeed, and Streptococcus pneumoniae (Sp), PneumoSpeed, developed to support rapid outbreak detection in Africa, have shown good performance under laboratory conditions. We conducted an independent evaluation of both tests under field conditions in Burkina Faso and Niger, in 2018–2019. The tests were performed in the cerebrospinal fluid of suspected meningitis cases from health centers in alert districts and compared to reverse transcription polymerase chain reaction tests performed at national reference laboratories (NRLs). Health staff were interviewed about feasibility. A total of 327 cases were tested at the NRLs, with 26% confirmed Nm (NmC 63% and NmX 37%) and 8% Sp. Sensitivity and specificity were, respectively, 95% (95% CI: 89–99) and 90% (95% CI: 86–94) for Nm and 92% (95% CI: 75–99) and 99% (95% CI: 97–100) for Sp. Positive and negative predictive values were, respectively, 77% (95% CI: 68–85) and 98% (95% CI: 95–100) for Nm and 86% (95% CI: 67–96) and 99% (95% CI: 98–100) for Sp. Concordance showed 82% agreement for Nm and 97% for Sp. Interviewed staff evaluated the tests as easy to use and to interpret and were confident in their readings. Results suggest overall good performance of both tests and potential usefulness in meningitis outbreak detection.

scholarly journals Testing Strategies of the In Vitro Micronucleus Assay for the Genotoxicity Assessment of Nanomaterials in BEAS-2B Cells

Nanomaterials ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1929
Author(s):  
Tereza Cervena ◽  
Andrea Rossnerova ◽  
Tana Zavodna ◽  
Jitka Sikorova ◽  
Kristyna Vrbova ◽  
...  
Keyword(s):  
Cytochalasin B ◽  
Culture Media ◽  
Methodological Approach ◽  
Micronucleus Assay ◽  
Toxicity Testing ◽  
In Vitro Toxicity ◽  
Testing Strategies ◽  
Transmission Electron ◽  
The Impact

The evaluation of the frequency of micronuclei (MN) is a broadly utilised approach in in vitro toxicity testing. Nevertheless, the specific properties of nanomaterials (NMs) give rise to concerns regarding the optimal methodological variants of the MN assay. In bronchial epithelial cells (BEAS-2B), we tested the genotoxicity of five types of NMs (TiO2: NM101, NM103; SiO2: NM200; Ag: NM300K, NM302) using four variants of MN protocols, differing in the time of exposure and the application of cytochalasin-B combined with the simultaneous and delayed co-treatment with NMs. Using transmission electron microscopy, we evaluated the impact of cytochalasin-B on the transport of NMs into the cells. To assess the behaviour of NMs in a culture media for individual testing conditions, we used dynamic light scattering measurement. The presence of NMs in the cells, their intracellular aggregation and dispersion properties were comparable when tests with or without cytochalasin-B were performed. The genotoxic potential of various TiO2 and Ag particles differed (NM101 < NM103 and NM302 < NM300K, respectively). The application of cytochalasin-B tended to increase the percentage of aberrant cells. In conclusion, the comparison of the testing strategies revealed that the level of DNA damage induced by NMs is affected by the selected methodological approach. This fact should be considered in the interpretation of the results of genotoxicity tests.

The underrepresentation of female participants in studies assessing the impact of high-dose exercise on cardiovascular outcomes: a scoping review

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
S Pallikadavath ◽  
R Patel ◽  
CL Kemp ◽  
M Hafejee ◽  
N Peckham ◽  
...  
Keyword(s):  
Scoping Review ◽  
High Volume ◽  
Cardiovascular Outcomes ◽  
High Dose ◽  
Funding Sources ◽  
Review Protocol ◽  
The Mean ◽  
The Impact ◽  
Over Time ◽  
Funding Acknowledgements

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Cardiovascular adaptations as a result of exercise conducted at high-intensity and high-volume are often termed the ‘Athlete’s heart’. Studies have shown that these cardiovascular adaptations vary between sexes. It is important that both sexes are well represented in this literature. However, many studies assessing the impact of high-dose exercise on cardiovascular outcomes under-recruit female participants. Purpose This scoping review aimed to evaluate the representation of females in studies assessing the impact of high-dose exercise on cardiovascular outcomes and demonstrate how this has changed over time. Methods The scoping review protocol as outlined by Arksey and O’Malley was used. OVID and EMBASE databases were searched and studies independently reviewed by two reviewers. Studies must have investigated the effects of high-dose exercise on cardiovascular outcomes. To assess how the recruitment of females has changed over time, two methods were used. One, the median study date was used to categorise studies into two groups. Two, studies were divided into deciles to form ten equal groups over the study period. Mean percentage of female recruitment and percentage of studies that failed to include females were calculated. Results Overall, 250 studies were included. Over half the studies (50.8%, n = 127) did not include female participants. Only 3.2% (n = 8) did not include male participants. Overall, mean percentage recruitment was 18.2%. The mean percentage of recruitment was 14.5% before 2011 and 21.8% after 2011. The most recent decile of studies demonstrated the highest mean percentage of female recruitment (29.3%) and lowest number of studies that did not include female participants (26.9%). Conclusion Female participants are significantly underrepresented in studies assessing cardiovascular outcomes caused by high-dose exercise. The most recent studies show that female recruitment may be improving, however, this still falls significantly short for equal representation. Risk factors, progression and management of cardiovascular diseases vary between sexes, hence, translating findings from male dominated data is not appropriate. Future investigators should aim to establish barriers and strategies to optimise fair recruitment. Mean percentage females recruited per study (%) Percentage studies that do not include women (%) Overall (n = 250) 18.2 50.8 (n = 127) Studies before 2011 (n = 121) 14.5 59.5 (n = 72) Studies after 2011 (n = 129) 21.8 42.6 (n = 55) Table 1: Female recruitment characteristics. The year 2011 (median study year) was chosen as this divides all included studies into two equal groups.

scholarly journals Relative Validity of an Italian EPIC Food Frequency Questionnaire for Dietary Factors in Children and Adolescents. A Rizzoli Orthopedic Institute Study

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1245
Author(s):  
Inge Huybrechts ◽  
Rossella Miglio ◽  
Lorenza Mistura ◽  
Sara Grioni ◽  
Irene Pozzebon ◽  
...  
Keyword(s):  
Secondary School ◽  
Children And Adolescents ◽  
Food Frequency Questionnaire ◽  
Dietary Factors ◽  
Food Groups ◽  
Food Frequency ◽  
Relative Validity ◽  
Diary Method ◽  
Italian Children ◽  
The Impact

Dietary factors play a major role in the development of non-communicable diseases, however little is known regarding the impact of nutrition on rare diseases like sarcomas. This Rizzoli Orthopedic Institute study aimed to evaluate the relative validity of a Food Frequency Questionnaire (FFQ) to measure the consumption of foods in comparison with a 3-days diary diet in a healthy Italian student population aged between 12 and 17 years. An extended version (including food groups for children) of the semi-quantitative FFQ used in the European Prospective Investigation into Cancer and Nutrition (EPIC) was administered. The validity of the FFQ was assessed by comparing the intakes from the FFQ against the 3-day diary method. 254 Italian subjects were included in the analyses: 128 females; 126 males; 116 from High Secondary School (14–17 years); 138 from Low Secondary School (12–13 years). Mean and median intakes are overall higher in the FFQs than in the food diaries. Spearman correlations adjusted for within-person variability were highest for legumes, vegetables and coffee/tea (>0.5), followed by potatoes, meat, fruits, breakfast cereals, biscuits and candies, and milk/yoghurts (>0.4). Moderate correlations were found for alcoholic drinks, soft drinks, juices, and grains (>0.3). For some food groups, such as fish, potatoes, and bread, correlations tend to become higher when stratifying the analyses for age group. These results demonstrate that the adapted EPIC COS FFQ validated in Italian adults is also appropriate and well understood by Italian children and adolescents.

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