scholarly journals Integrated Genomic Surveillance reveals extensive onward transmission of travel-imported SARS-CoV-2 infections in the community

2021 ◽  
Author(s):  
Torsten Houwaart ◽  
Samir Belhaj ◽  
Emran Tawalbeh ◽  
Dirk Nagels ◽  
Patrick Finzer ◽  
...  
Keyword(s):  
Pathogen Transmission ◽  
European Countries ◽  
Contact Tracing ◽  
Structured Interviews ◽  
Large Clusters ◽  
Cluster 2

Integration of genomic surveillance with contact tracing provides a powerful tool for the reconstruction of person-to-person pathogen transmission chains. We report two large clusters of SARS-CoV-2 cases ("Delta" clade, 110 cases combined) detected in July 2021 by Integrated Genomic Surveillance in Düsseldorf. Structured interviews and deep contact tracing demonstrated an association to a single SARS-CoV-2 infected return traveller (Cluster 1) and to return travel from Catalonia and other European countries (Cluster 2), highlighting the importance of containing travel-imported SARS-CoV-2 infections.

scholarly journals Molecular Epidemiology of Large COVID-19 Clusters at an Academic Medical Center, March–October 2020

2021 ◽  
Vol 1 (S1) ◽  
pp. s10-s11
Author(s):  
Takaaki Kobayashi ◽  
Miguel Ortiz ◽  
Stephanie Holley ◽  
William Etienne ◽  
Kyle Jenn ◽  
...  
Keyword(s):  
Molecular Epidemiology ◽  
Medical Center ◽  
Academic Medical Center ◽  
Outbreak Detection ◽  
Contact Tracing ◽  
Serial Testing ◽  
Academic Medical ◽  
Community Exposure ◽  
Large Clusters ◽  
Cluster 2

Background: COVID-19 in hospitalized patients may be the result of community acquisition or in-hospital transmission. Molecular epidemiology can help confirm hospital COVID-19 transmission and outbreaks. We describe large COVID-19 clusters identified in our hospital and apply molecular epidemiology to confirm outbreaks. Methods: The University of Iowa Hospitals and Clinics is an 811-bed academic medical center. We identified large clusters involving patients with hospital onset COVID-19 detected during March–October 2020. Large clusters included ≥10 individuals (patients, visitors, or HCWs) with a laboratory confirmed COVID-19 diagnosis (RT-PCR) and an epidemiologic link. Epidemiologic links were defined as hospitalization, work, or visiting in the same unit during the incubation or infectious period for the index case. Hospital onset was defined as a COVID-19 diagnosis ≥14 days from admission date. Admission screening has been conducted since May 2020 and serial testing (every 5 days) since July 2020. Nasopharyngeal swab specimens were retrieved for viral whole-genome sequencing (WGS). Cluster patients with a pairwise difference in ≤5 mutations were considered part of an outbreak. WGS was performed using Oxford Nanopore Technology and protocols from the ARTIC network. Results: We identified 2 large clusters involving patients with hospital-onset COVID-19. Cluster 1: 2 hospital-onset cases were identified in a medical-surgical unit in June 2020. Source and contact tracing revealed 4 additional patients, 1 visitor, and 13 employees with COVID-19. Median age for patients was 62 (range, 38–79), and all were male. In total, 17 samples (6 patients, 1 visitor, and 10 HCWs) were available for WGS. Cluster 2: A hospital-onset case was identified via serial testing in a non–COVID-19 intensive care unit in September 2020. Source investigation, contact tracing, and serial testing revealed 3 additional patients, and 8 HCWs. One HCW also had a community exposure. Patient median age was 60 years (range, 48–68) and all were male. In total, 11 samples (4 patients and 7 HCWs) were sequenced. Using WGS, cluster 1 was confirmed to be an outbreak: WGS showed 0–5 mutations in between samples. Cluster 2 was also an outbreak: WGS showed less diversity (0–3 mutations) and ruled out the HCW with a community exposure (20 mutations of difference). Conclusion: Whole-genome sequencing confirmed the outbreaks identified using classic epidemiologic methods. Serial testing allowed for early outbreak detection. Early outbreak detection and implementation of control measures may decrease outbreak size and genetic diversity.Funding: NoDisclosures: None

scholarly journals Normative positions towards COVID-19 contact-tracing apps: findings from a large-scale qualitative study in nine European countries

2021 ◽  
pp. 1-14
Author(s):  
Federica Lucivero ◽  
Luca Marelli ◽  
Nora Hangel ◽  
Bettina Maria Zimmermann ◽  
Barbara Prainsack ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Large Scale ◽  
European Countries ◽  
Contact Tracing

scholarly journals ‘It’s much more grey than black and white’: clinical geneticists’ views on the oversight of consumer genomics in Europe

2020 ◽  
Vol 17 (2) ◽  
pp. 129-140
Author(s):  
Louiza Kalokairinou ◽  
Pascal Borry ◽  
Heidi C Howard
Keyword(s):  
Iterative Process ◽  
Healthcare Professionals ◽  
Quality Standards ◽  
Healthcare Setting ◽  
European Countries ◽  
Structured Interviews ◽  
Genetic Tests ◽  
Black And White ◽  
Direct To Consumer ◽  
Risks And Benefits

Aim: Direct-to-consumer (DTC) genetic tests (GT) have created controversy regarding their risks and benefits. In view of recent regulatory developments, this article aims to explore the attitudes of European clinical geneticists toward the oversight of DTC GT. Materials & methods: Fifteen semi-structured interviews were performed with clinical geneticists based in ten European countries. The transcripts were thematically analysized in an iterative process. Results & conclusion: Respondents strongly supported quality standards for DTC GT equal to those applied within the healthcare setting. Despite participants unanimously considering the involvement of healthcare professionals to be important, mandatory medical supervision was controversial. In this regard, promoting education and truth-in-advertising was considered as being key in maintaining a balance between protecting consumers and promoting their autonomy.

scholarly journals European influence in ITU-R: the end of an era of dominance?

Info ◽  
2014 ◽  
Vol 16 (4) ◽  
pp. 1-17 ◽  
Author(s):  
Mohamed Ali El-Moghazi ◽  
Jason Whalley ◽  
James Irvine
Keyword(s):  
European Countries ◽  
Current Debate ◽  
Structured Interviews ◽  
Allocation Mechanism ◽  
African Countries ◽  
Content Type ◽  
Key Stakeholders ◽  
The World ◽  
Spectrum Policy

Purpose – The purpose of this paper is to examine the influence of the European countries in Region 1 of the Radio Sector of the International Telecommunications Union (ITU-R). More specifically, the focus is on the World Radiocommunication Conference 2012 meeting to explore whether European influence is in decline. Design/methodology/approach – This article adopts in-depth case study of the 700-MHz issue. Qualitative data are drawn from semi-structured interviews with key stakeholders who participated at the World Radiocommunication Conference 2012 meeting. Findings – This article concludes that the influence of European countries in the ITU-R in Region 1 has changed. The influence of Arab and African countries has increased, with that of European countries declining. However, European countries remain more influential than their African and Arab counterparts. Research limitations/implications – This article sheds light on an often overlooked but pivotal element of the international spectrum allocation mechanism. Originality/value – This article sheds light on important developments in the international spectrum policy that are largely overlooked in the current debate.

scholarly journals The economics of COVID-19: initial empirical evidence on how family firms in five European countries cope with the corona crisis

2020 ◽  
Vol 26 (5) ◽  
pp. 1067-1092 ◽  
Author(s):  
Sascha Kraus ◽  
Thomas Clauss ◽  
Matthias Breier ◽  
Johanna Gast ◽  
Alessandro Zardini ◽  
...  
Keyword(s):  
Empirical Study ◽  
Cultural Change ◽  
Business Models ◽  
Family Firms ◽  
European Countries ◽  
Structured Interviews ◽  
Content Type ◽  
Long Run ◽  
Short Period ◽  
Novel Coronavirus

PurposeWithin a very short period of time, the worldwide pandemic triggered by the novel coronavirus has not only claimed numerous lives but also caused severe limitations to daily private as well as business life. Just about every company has been affected in one way or another. This first empirical study on the effects of the COVID-19 crisis on family firms allows initial conclusions to be drawn about family firm crisis management.Design/methodology/approachExploratory qualitative research design based on 27 semi-structured interviews with key informants of family firms of all sizes in five Western European countries that are in different stages of the crisis.FindingsThe COVID-19 crisis represents a new type and quality of challenge for companies. These companies are applying measures that can be assigned to three different strategies to adapt to the crisis in the short term and emerge from it stronger in the long run. Our findings show how companies in all industries and of all sizes adapt their business models to changing environmental conditions within a short period of time. Finally, the findings also show that the crisis is bringing about a significant yet unintended cultural change. On the one hand, a stronger solidarity and cohesion within the company was observed, while on the other hand, the crisis has led to a tentative digitalization.Originality/valueTo the knowledge of the authors, this is the first empirical study in the management realm on the impacts of COVID-19 on (family) firms. It provides cross-national evidence of family firms' current reactions to the crisis.

scholarly journals Why is it so difficult to implement a longitudinal clinical reasoning curriculum? A multicenter interview study on the barriers perceived by European health professions educators

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Małgorzata Sudacka ◽  
Martin Adler ◽  
Steven J. Durning ◽  
Samuel Edelbring ◽  
Ada Frankowska ◽  
...  
Keyword(s):  
Clinical Reasoning ◽  
Qualitative Content Analysis ◽  
Core Competency ◽  
Health Professions ◽  
International Perspective ◽  
European Countries ◽  
Structured Interviews ◽  
Depth Analysis ◽  
European Health ◽  
The Many

Abstract Background Effective clinical reasoning is a core competency of health professionals that is necessary to assure patients’ safety. Unfortunately, adoption of longitudinal clinical reasoning curricula is still infrequent. This study explores the barriers that hinder the explicit teaching of clinical reasoning from a new international perspective. Methods The context of this study was a European project whose aim is to develop a longitudinal clinical reasoning curriculum. We collected data in semi-structured interviews with responders from several European countries who represent various health professions and have different backgrounds, roles and experience. We performed a qualitative content analysis of the gathered data and constructed a coding frame using a combined deductive/inductive approach. The identified themes were validated by parallel coding and in group discussions among project members. Results A total of 29 respondents from five European countries participated in the interviews; the majority of them represent medicine and nursing sciences. We grouped the identified barriers into eight general themes: Time, Culture, Motivation, Clinical Reasoning as a Concept, Teaching, Assessment, Infrastructure and Others. Subthemes included issues with discussing errors and providing feedback, awareness of clinical reasoning teaching methods, and tensions between the groups of professionals involved. Conclusions This study provides an in-depth analysis of the barriers that hinder the teaching of explicit clinical reasoning. The opinions are presented from the perspective of several European higher education institutions. The identified barriers are complex and should be treated holistically due to the many interconnections between the identified barriers. Progress in implementation is hampered by the presence of reciprocal causal chains that aggravate this situation. Further research could investigate the perceptual differences between health professions regarding the barriers to clinical reasoning. The collected insights on the complexity and diversity of these barriers will help when rolling out a long-term agenda for overcoming the factors that inhibit the implementation of clinical reasoning curricula.

scholarly journals Correlation of National and Healthcare Workers COVID-19 Infection Data; Implications for Large-scale Viral Testing Programs

2020 ◽  
Author(s):  
Dan Wu ◽  
Pol Mac Aonghusa ◽  
Donal O'Shea
Keyword(s):  
Time Series ◽  
Disease Progression ◽  
Healthcare Workers ◽  
Large Scale ◽  
Pathogen Transmission ◽  
Entire Population ◽  
Contact Tracing ◽  
Smoothing Function ◽  
Healthcare Facilities ◽  
National Population

Time analysis of the course of an infectious disease epidemic is a critical way to understand the dynamics of pathogen transmission and the effect of population scale interventions. Computational methods have been applied to the progression of the COVID-19 outbreak in five different countries (Ireland, Germany, UK, South Korea and Iceland) using their reported daily infection data. A Gaussian convolution smoothing function constructed a continuous epidemic line profile that was segmented into longitudinal time series of mathematically fitted individual logistic curves. The time series of fitted curves allowed comparison of disease progression with differences in decreasing daily infection numbers following the epidemic peak being of specific interest. A positive relationship between rate of declining infections and countries with comprehensive COVID-19 testing regimes existed. In contrast, extended epidemic timeframes were recorded for those least prepared for large scale testing and contact tracing. As many countries continue to struggle to implement population wide testing it is prudent to explore additional measures that could be employed. Comparative analysis of healthcare worker (HCW) infection data from Ireland shows it closely related to that of the entire population with respect to trends of daily infection numbers and growth rates over a 57-day period. With 31.6% of all test-confirmed infections in healthcare workers (all employees of healthcare facilities), they represent a concentrated 3% subset of the national population which if exhaustively tested (regardless of symptom status) could provide valuable information on disease progression in the entire population (or set). Mathematically, national population and HCWs can be viewed as a set and subset with significant influences on each other, with solidarity between both an essential ingredient for ending this crisis.

Contact tracing for sexually transmitted infections in New South Wales, Australia

Sexual Health ◽  
2007 ◽  
Vol 4 (1) ◽  
pp. 21 ◽  
Author(s):  
Melissa McCarthy ◽  
Lewis J. Haddow ◽  
Virginia Furner ◽  
Adrian Mindel
Keyword(s):  
Sexually Transmitted Infections ◽  
Health Care Providers ◽  
Contact Tracing ◽  
Care Providers ◽  
Structured Interviews ◽  
Sexually Transmitted ◽  
South Wales ◽  
Included Patient ◽  
Current Contact ◽  
Sexual Health Clinics

Background: Contact tracing is an important strategy in the control of sexually transmitted infections (STI) because it encourages individuals who may be unaware they have been exposed to an infection to be tested and treated. The aim of this study was to review STI contact tracing procedures in NSW by sexual health clinics (SHC), public health units (PHU) and general practitioners (GP). Methods: A questionnaire study carried out in 2004–2005 of SHC, PHU and a random sample of GP in NSW. SHC and PHU participated in structured interviews and GP completed questionnaires at educational workshops or through a mail-out. Interviews and questionnaires addressed current contact tracing practice and methods of improving the service. Results: All 35 SHC, 6/18 (33%) PHU and 172/212 (81%) of the GP who responded to the survey undertook contact tracing for STI. Chlamydia was the STI most commonly traced by SHC (34/35, 97%) and GP (165/172, 96%). HIV was the STI most commonly traced by PHU (5/6, 83%). Only 23/172 (13%) GP were familiar with the ‘Australasian contact tracing manual’. The commonest barriers to tracing for SHC and GP included patient reluctance (SHC 60%, GP 71%), and the lack of contact details for partners (SHC 46%, GP 60%). GP identified the availability of information for patients (82%) and more training (55%) as necessary resources for optimal contact tracing. Conclusions: SHC and GP frequently undertook contact tracing for some STI; PHU do so less frequently. Barriers to contact tracing are similar for all health-care providers. For GP, there is a need for increased training and the development of written policies and agreed pathways for referral.

scholarly journals Example C: Using online respondent-driven detection for communicable disease control

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
Y B Helms ◽  
N Hamdiui ◽  
R Eilers ◽  
C J P A Hoebe ◽  
N Dukers ◽  
...  
Keyword(s):  
Public Health ◽  
Mixed Methods Research ◽  
Time Pressure ◽  
Communicable Disease ◽  
Public Health Practice ◽  
Contact Tracing ◽  
Personal Contact ◽  
Health Practice ◽  
Structured Interviews ◽  
Online Questionnaire

Abstract Online respondent-driven detection (online-RDD) is a novel method of case-finding that may enhance contact tracing (CT). However, the opportunities and barriers of online-RDD for public health practice have not yet been investigated from the perspective of public health professionals (PHPs). Therefore, it is unclear what the potential strengths and limitations of online-RDD for CT are. We conducted a sequential exploratory mixed methods research. First, we conducted semi-structured interviews with Dutch PHPs involved in CT. Questions were derived from the diffusion of innovations theory. Second, we distributed an online-questionnaire to 260 Dutch PHPs to study the main findings in a larger population. We used hypothetical scenario’s (scabies, shigella, and mumps) to elicit PHPs’ perceptions of online-RDD. Twelve interviews were held. Response rate to the online-questionnaire was 31% (n = 70). Four themes related to characteristics of online-RDD that influenced PHPs’ intention to adopt online-RDD emerged: advantages over traditional CT, task conflicts and opportunity costs, public health risks, and situational compatibility. PHPs believed online-RDD may enhance CT through increased reach, low-key communication options, and saving time. Limitations were foreseen in the delivery of measures, supporting patients and contacts, missing information and contacts, and causing unrest. Online-RDD may be particularly applicable in situations with digitally skilled and literate target populations, low urgency, low time-pressure, and a simple perspective for action. A majority of PHPs (70%) had a positive adoption intention towards online-RDD. PHPs perceived online-RDD as beneficial to public health practice. Further development of online-RDD should focus on facilitating opportunities for personal contact between PHPs, patients and contacts. A comparative study of ‘traditional’ CT and online-RDD could yield further insights in the potential of online-RDD for public health practice.

scholarly journals Online respondent-driven detection for enhanced contact tracing of close-contact infectious diseases: benefits and barriers for public health practice

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yannick B. Helms ◽  
Nora Hamdiui ◽  
Renske Eilers ◽  
Christian Hoebe ◽  
Nicole Dukers-Muijrers ◽  
...  
Keyword(s):  
Public Health ◽  
Infectious Diseases ◽  
Large Scale ◽  
Close Contact ◽  
Public Health Practice ◽  
Contact Tracing ◽  
Health Practice ◽  
Structured Interviews ◽  
Online Questionnaire ◽  
Index Cases

Abstract Background Online respondent-driven detection (RDD) is a novel method of case finding that can enhance contact tracing (CT). However, the advantages and challenges of RDD for CT have not yet been investigated from the perspective of public health professionals (PHPs). Therefore, it remains unclear if, and under what circumstances, PHPs are willing to apply RDD for CT. Methods Between March and April 2019, we conducted semi-structured interviews with Dutch PHPs responsible for CT in practice. Questions were derived from the ‘diffusion of innovations’ theory. Between May and June 2019, we distributed an online questionnaire among 260 Dutch PHPs to quantify the main qualitative findings. Using different hypothetical scenarios, we assessed anticipated advantages and challenges of RDD, and PHPs’ intention to apply RDD for CT. Results Twelve interviews were held, and 70 PHPs completed the online questionnaire. A majority of questionnaire respondents (71%) had a positive intention towards using RDD for CT. Anticipated advantages of RDD were ‘accommodating easy and autonomous participation in CT of index cases and contact persons’, and ‘reaching contact persons more efficiently’. Anticipated challenges were ‘limited opportunities for PHPs to support, motivate, and coordinate the execution of CT’, ‘not being able to adequately convey measures to index cases and contact persons’, and ‘anticipated unrest among index cases and contact persons’. Circumstances under which PHPs anticipated RDD applicable for CT included index cases and contact persons being reluctant to share information directly with PHPs, digitally skilled and literate persons being involved, and large scale CT. Circumstances under which PHPs anticipated RDD less applicable for CT included severe consequences of missing information or contact persons for individual or public health, involvement of complex or impactful measures for index cases and contact persons, and a disease being perceived as severe or sensitive by index cases and their contact persons. Conclusions PHPs generally perceived RDD as a potentially beneficial method for public health practice, that may help overcome challenges present in traditional CT, and could be used during outbreaks of infectious diseases that spread via close contact. The circumstances under which CT is performed, appear to strongly influence PHPs’ intention to use RDD for CT.

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