scholarly journals End-to-end SARS-CoV-2 transmission risks in sport: Current evidence and practical recommendations

2021 ◽  
Vol 33 (1) ◽  
pp. 1-17
Author(s):  
Ben Jones ◽  
Gemma Phillips ◽  
Federica Valeriani ◽  
Thomas Edwards ◽  
Emily Adams ◽  
...  
Keyword(s):  
Face Mask ◽  
Scenario Planning ◽  
Mitigation Strategies ◽  
Transmission Risk ◽  
Current Evidence ◽  
Indoor Environments ◽  
Video Footage ◽  
Symptom Screening ◽  
End To End ◽  
Community Sports

The coronavirus disease 2019 (COVID-19) pandemic has caused disruption to professional and recreational sports across the world. The SARS-CoV-2 virus can be transmitted by relatively large respiratory droplets that behave ballistically, and exhaled aerosol droplets, which potentially pose a greater risk. This review provides a summary of end-to-end SARS-CoV-2 transmission risk factors for sport and an overview of transmission mechanisms to be considered by all stakeholders. The risk of SARS-CoV-2 transmission is greatest indoors, and primarily influenced by the ventilation of the environment and the close proximity of individuals. The SARS-CoV-2 transmission risks outdoors, e.g. via water, and from fomites, appear less than initially thought. Mitigation strategies include good end-to-end scenario planning of activities to optimise physical distancing, face mask wearing and hygiene practice of individuals, the environment and equipment. The identification and removal of infectious individuals should be undertaken by means of the taking of temperature and COVID-19 symptom screening, and the use of diagnostic monitoring tests to identify asymptomatic individuals. Using adequate video footage, data from proximity technology and subject interviews, the identification and isolation of ‘close contacts’ should also be undertaken to limit SARS-CoV-2 transmission within sporting environments and into the wider community. Sports should aim to undertake activities outdoors where possible, given the lower SARS-CoV-2 transmission risk, in comparison to indoor environments.

scholarly journals Aerosol transport measurements and assessment of risk from infectious aerosols: a case study of two German cash-and-carry hardware/DIY stores

2021 ◽  
Author(s):  
eberhard Bodenschatz ◽  
Gholamhossein Bagheri ◽  
Bardia Hejazi ◽  
Birte Thiede ◽  
Oliver Schlenczek
Keyword(s):  
Upper Bound ◽  
Disease Transmission ◽  
Face Mask ◽  
Indoor Environments ◽  
Aerosol Dynamics ◽  
Direct Exposure ◽  
Decay Times ◽  
Dominant Feature ◽  
Aerosol Dispersion ◽  
Cash And Carry

We report experimental results on aerosol dispersion in two large German cash-and-carry hardware/DIY stores to better understand the factors contributing to disease transmission by infectious human aerosols in large indoor environments. We examined the transport of aerosols similar in size to human respiratory aerosols (0.3μm-10μm) in representative locations, such as high-traffic areas and restrooms. In restrooms, the observed decay of aerosol concentrations was consistent with well-mixed air exchange. In all other locations, fast decay times were measured, which were found to be independent of aerosol size (typically a few minutes). From this, we conclude that in the main retail areas, including at checkouts, rapid turbulent mixing and advection is the dominant feature in aerosol dynamics. With this, the upper bound of risk for airborne disease transmission to a susceptible is determined by direct exposure to the exhalation cloud of an infectious. For the example of the SARS-CoV-2 virus, we find when speaking without a face mask and aerosol sizes up to an exhalation (wet) diameter of 50μm, a distance of 1.5me to be unsafe. However, at the smallest distance between an infectious and a susceptible, while wearing typical surgical masks and for all sizes of exhaled aerosol, the upper bound of infection risk is only ∼ 5% and decreases further by a factor of 100 (∼ 0.05%) for typical FFP2 masks for a duration of 20 min. This upper bound is very conservative and we expect the actual risk for typical encounters to be much lower. The risks found here are comparable to what might be expected in calm outdoor weather.

scholarly journals Restarting elective endoscopy safely amidst an evolving pandemic and the impact of patient perception

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Christopher Nguyen ◽  
Kevin T. Kline ◽  
Shehzad Merwat ◽  
Sheharyar Merwat ◽  
Gurinder Luthra ◽  
...  
Keyword(s):  
Risk Mitigation ◽  
Mitigation Strategies ◽  
Transmission Risk ◽  
Dynamic Monitoring ◽  
Successful Model ◽  
Outpatient Procedures ◽  
Risk Patients ◽  
Risk Mitigation Strategies ◽  
Spread Of Infection ◽  
The Impact

Abstract Background The COVID-19 pandemic has led to disruptions in elective and outpatient procedures. Guidance from the Centers for Medicare and Medicaid Services provided a framework for gradual reopening of outpatient clinical operations. As the infrastructure to restart endoscopy has been more clearly described, patient concerns regarding viral transmission during the procedure have been identified. Moreover, the efficacy of the measures in preventing transmission have not been clearly delineated. Methods We identified patients with pandemic-related procedure cancellations from 3/16/2020 to 4/20/2020. Patients were stratified into tier groups (1–4) by urgency. Procedures were performed using our hospital risk mitigation strategies to minimize transmission risk. Patients who subsequently developed symptoms or tested for COVID-19 were recorded. Results Among patients requiring emergent procedures, 57.14% could be scheduled at their originally intended interval. COVID-19 concerns represented the most common rescheduling barrier. No patients who underwent post-procedure testing were positive for COVID-19. No cases of endoscopy staff transmission were identified. Conclusions Non-COVID-19 related patient care during the pandemic is a challenging process that evolved with the spread of infection, requiring dynamic monitoring and protocol optimization. We describe our successful model for reopening endoscopy suites using a tier-based system for safe reintroduction of elective procedures while minimizing transmission to patients and staff. Important barriers included financial and transmission concerns that need to be addressed to enable the return to pre-pandemic utilization of elective endoscopic procedures.

scholarly journals Perception and awareness of COVID-19 among health science students and staff of Kuwait University: An online cross-sectional study

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 566
Author(s):  
Walid Alali ◽  
Wadha AlFouzan ◽  
Dhuha Alajmi ◽  
Haya Al-Tawalah ◽  
Khalid Kheirallah ◽  
...  
Keyword(s):  
Social Stigma ◽  
Face Mask ◽  
Health Science ◽  
Vaccine Uptake ◽  
Transmission Risk ◽  
Science Students ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Kuwait University ◽  
Health Science Students

Background: Coronavirus disease 2019 (COVID-19) pandemic is unprecedented. Health science students are the future frontliners to fight pandemics. Awareness and perception toward COVID-19 among health science students and staff at Kuwait University was assessed. Methods: Between June and July 2020, an online questionnaire was distributed to all students and staff at HCS.  The questionnaire was divided into six sections: socio-demography, risk and awareness, preparedness and prevention, source of information, policies, and social stigma.  Results: A total of 592 students and 162 staff completed the questionnaire. The prevalence of self-reported chronic condition among students and staff was 14.0% and 19.1%, respectively. Moreover, self-reported COVID-19 prevalence among students and staff was 2.7% and 1.2%, respectively. Interestingly, 54% of students and 38.3% of staff reported that they knew someone within their immediate social environment who have been/are infected with SARS-CoV-2. Among students, 92.4% wore face mask in indoor places (outside of their home) ‘often/all the time’ compared to wearing it outdoors (69.3%); whereas, for staff, it was more common to wear it outdoor than in indoor places (75.9% vs. 81.5%). Willingness to take COVID-19 vaccine was indicated by 50% of students ‘strongly agreed’ and an additional 25.8% agreed to taking it. Interest vaccine uptake was lower among staff (28.4% and 34.6% strongly agreed or agreed, respectively). Participants strongly agreed or agreed (72.5% and 19.6% of students as well as 68.5% and 22.2% of staff) that wearing face mask in public should be obligatory. More than 18% of students and staff indicated that they would avoid contact with COVID-19 infected people. Conclusions: Responses of students and staff were mostly similar and showed that they follow precautionary measures to control spread of COVID-19, understand the viral transmission risk, and willing to raise awareness to reduce social stigma.

scholarly journals Increasing Temperature and Relative Humidity Accelerates Inactivation of SARS-CoV-2 on Surfaces

mSphere ◽  
2020 ◽  
Vol 5 (4) ◽  
Author(s):  
Jennifer Biryukov ◽  
Jeremy A. Boydston ◽  
Rebecca A. Dunning ◽  
John J. Yeager ◽  
Stewart Wood ◽  
...  
Keyword(s):  
Relative Humidity ◽  
Culture Media ◽  
Mitigation Strategies ◽  
Accurate Estimation ◽  
Clinical Settings ◽  
Indoor Environments ◽  
Type Stainless Steel ◽  
Contact Transmission ◽  
The Stability ◽  
Increasing Temperature

ABSTRACT Coronavirus disease 2019 (COVID-19) was first identified in China in late 2019 and is caused by newly identified severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Previous studies had reported the stability of SARS-CoV-2 in cell culture media and deposited onto surfaces under a limited set of environmental conditions. Here, we broadly investigated the effects of relative humidity, temperature, and droplet size on the stability of SARS-CoV-2 in a simulated clinically relevant matrix dried on nonporous surfaces. The results show that SARS-CoV-2 decayed more rapidly when either humidity or temperature was increased but that droplet volume (1 to 50 μl) and surface type (stainless steel, plastic, or nitrile glove) did not significantly impact decay rate. At room temperature (24°C), virus half-life ranged from 6.3 to 18.6 h depending on the relative humidity but was reduced to 1.0 to 8.9 h when the temperature was increased to 35°C. These findings suggest that a potential for fomite transmission may persist for hours to days in indoor environments and have implications for assessment of the risk posed by surface contamination in indoor environments. IMPORTANCE Mitigating the transmission of SARS-CoV-2 in clinical settings and public spaces is critically important to reduce the number of COVID-19 cases while effective vaccines and therapeutics are under development. SARS-CoV-2 transmission is thought to primarily occur through direct person-to-person transfer of infectious respiratory droplets or through aerosol-generating medical procedures. However, contact with contaminated surfaces may also play a significant role. In this context, understanding the factors contributing to SARS-CoV-2 persistence on surfaces will enable a more accurate estimation of the risk of contact transmission and inform mitigation strategies. To this end, we have developed a simple mathematical model that can be used to estimate virus decay on nonporous surfaces under a range of conditions and which may be utilized operationally to identify indoor environments in which the virus is most persistent.

scholarly journals Decision Algorithm for Prescribing SGLT2 Inhibitors and GLP-1 Receptor Agonists for Diabetic Kidney Disease

2020 ◽  
Vol 15 (11) ◽  
pp. 1678-1688 ◽  
Author(s):  
Jiahua Li ◽  
Oltjon Albajrami ◽  
Min Zhuo ◽  
Chelsea E. Hawley ◽  
Julie M. Paik
Keyword(s):  
Kidney Disease ◽  
Kidney Failure ◽  
Diabetic Kidney Disease ◽  
Diabetes Management ◽  
Mitigation Strategies ◽  
Current Evidence ◽  
Atherosclerotic Cardiovascular Disease ◽  
Decision Algorithm ◽  
Diabetic Kidney ◽  
Kidney Protection

Diabetic kidney disease and its comorbid conditions, including atherosclerotic cardiovascular disease, heart failure, diabetes, and obesity, are interconnected conditions that compound the risk of kidney failure and cardiovascular mortality, and exponentiate health care costs. Sodium glucose cotransporter 2 inhibitor (SGLT2i) and glucagon-like peptide 1 receptor agonist (GLP-1 RA) are novel diabetes medications that prevent cardiovascular events and kidney failure. Clinical trials exploring the cardiovascular and kidney outcomes of SGLT2i and GLP-1 RA have fundamentally shifted the treatment paradigm of diabetes. Clinical guidelines for diabetes management recommend a more holistic approach beyond glycemic control and emphasize heart and kidney protection of SGLT2i and GLP-1 RA. However, the adoption of prescribing SGLT2i and GLP-1 RA for patients with diabetes and high cardiovascular and kidney risk has been slow. In this review, we provide a decision-making tool to help clinicians determine when to consider SGLT2i and GLP-1 RA for heart and kidney protection. First, we discuss a comprehensive risk assessment for patients with diabetic kidney disease. We compare the effectiveness of SGLT2i and GLP-1 RA for different risk categories. Then, we present a decision algorithm using cardiovascular and kidney failure risk stratification and the strength of current evidence for the use of SGLT2i and GLP-1 RA. Lastly, we review the adverse effects of SGLT2i and GLP-1 RA and propose mitigation strategies.

scholarly journals Characterization of aerosol and assessment of the risk of transmission of SARS-COV-2 VIRUS in a natural thermal cave

2021 ◽  
Vol 312 ◽  
pp. 12004
Author(s):  
Mauro Scungio ◽  
Giulia Parlani
Keyword(s):  
Mechanical Ventilation ◽  
Skin Diseases ◽  
Ventilation System ◽  
Research Work ◽  
Substantial Reduction ◽  
Transmission Risk ◽  
Indoor Environments ◽  
Particle Size Distributions ◽  
Unique Chemical

Thermal caves represent an environment characterized by unique chemical-physical properties, often used by customers for treatment and care of musculoskeletal, respiratory and skin diseases. The recent pandemic caused by COVID-19 has imposed the need to investigate the potential transmission scenario of SARS-CoV-2 virus also in such atypical and poorly studied indoor environments. This research work was carried out inside a natural thermal cave located in Italy where a waterfall of sulfur-sulfate-bicarbonate-alkaline earth mineral thermal water creates a warm-humid environment with 100% humidity and 48°C temperature. A characterization of the aerosol was carried out in terms of number, surface area and mass, as well as particle size distributions. The physical characteristics of the aerosol were measured inside the natural thermal cave and in other immediately adjacent areas in two different days and in two distinct moments by means of an optical spectrometer. The data obtained showed a predominance of particles with a diameter greater than 8 μm, associated with a low ability of penetration in the human respiratory system. Subsequently, through a model recently proposed in scientific literature, it was evaluated the airborne transmission risk of SARS-CoV-2 inside the cave by quantifying the probability of infection due to exposure in a microenvironment in presence of a SARS-CoV-2 infected subject. The infection risk was evaluated for different scenarios obtained combining parameters such as physical, breathing or talking activities of the occupants, simultaneous or non-simultaneous access to the cave and mechanical ventilation activated or non-activated. In terms of the risk of SARS-CoV-2 infection, evaluated under the hypotheses of the model, it was highlighted the decisive effect of the mechanical ventilation system on the risk of contagion: for all the hypothesized scenarios, there is a substantial reduction in the risk of contagion considering the ventilation system active. Furthermore, the adoption of social distancing measures such as non-simultaneous access to the cave makes the risk of contagion extremely low, according to the assumptions underlying the model, even with the mechanical ventilation system not active.

scholarly journals At what age should infants and young children wear a face mask to protect against COVID-19?

2021 ◽  
Author(s):  
Rosemary Horne ◽  
Sally Baddock ◽  
Prem Fort ◽  
Peter Blair
Keyword(s):  
Young Children ◽  
Protective Effect ◽  
Strong Evidence ◽  
Face Mask ◽  
Current Evidence ◽  
Physiological Evidence ◽  
The Individual ◽  
Infants And Young Children

Face masks are strongly recommended as a tool in the fight against COVID-19 and in adults there is very strong evidence that wearing a face mask is protective to the individual and also aids in decreasing the spread of the virus. There is less evidence for the protective effect of wearing face masks in children and the age at which children are recommended to wear masks differs widely between organisations and countries. This review summarises the current evidence of the benefits and disadvantages of children wearing a face mask, the physiological evidence of face covering in young children and the differences in recommendations between organisations and where there might be consensus.

scholarly journals Assessment of Airborne Disease Transmission Risk and Energy Impact of HVAC Mitigation Strategies

2021 ◽  
Author(s):  
Michael J. Risbeck ◽  
Martin Z. Bazant ◽  
Zhanhong Jiang ◽  
Young M. Lee ◽  
Kirk H. Drees ◽  
...  
Keyword(s):  
Disease Transmission ◽  
Significant Risk ◽  
Mitigation Strategies ◽  
Transmission Risk ◽  
Disease Spread ◽  
Particle Removal ◽  
Outdoor Air ◽  
Common Basis ◽  
Air Ventilation ◽  
Airborne Disease

The COVID-19 pandemic has focused renewed attention on the ways in which building HVAC systems may be operated to mitigate the risk of airborne disease transmission. The most common suggestion is to increase outdoor-air ventilation rates so as to dilute the concentrations of infectious aerosol particles indoors. Although this strategy does reduce the likelihood of disease spread, it is often much more costly than other strategies that provide equivalent particle removal or deactivation. To address this tradeoff and arrive at practical recommendations, we explain how different mitigation strategies can be expressed in terms of equivalent outdoor air (EOA) to provide a common basis for energy analysis. We then show the effects of each strategy on EOA delivery and energy cost in simulations of realistic buildings in a variety of climates. Key findings are that in-duct filtration is often the most efficient mitigation strategy, while significant risk reduction generally requires increasing total airflow to the system, either through adjusted HVAC setpoints or standalone disinfection devices.

Perception and awareness of COVID-19 among health science students at Kuwait University: An online cross-sectional study (Preprint)

2021 ◽  
Author(s):  
Walid Alali
Keyword(s):  
Social Stigma ◽  
Face Mask ◽  
Health Science ◽  
Transmission Risk ◽  
Science Students ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Kuwait University ◽  
Infected People ◽  
Health Science Students

BACKGROUND Coronavirus disease 2019 (COVID-19) pandemic is unprecedented. Health science students are the future frontliners to fight pandemics. OBJECTIVE Awareness and perception toward COVID-19 among health science students at Kuwait University was assessed. METHODS Between June and July 2020, an online questionnaire was distributed to all students at HCS. The questionnaire was divided into six sections: socio-demography, risk and awareness, preparedness and prevention, source of information, policies, and social stigma. RESULTS A total of 592 students completed the questionnaire. The self-reported COVID-19 prevalence among students was 2.7%. About 54% of students reported that they knew someone within their immediate social environment who have been/are infected with SARS-CoV-2. The prevalence of self-reported chronic condition among students was 14.0% including 42.2% reported having a form of asthma. Among students, 92.4% wore face mask in indoor places (outside of their home) ‘often/all the time’ compared to wearing it outdoors (69.3%). Students indicated a great deal of trust in official government press releases and consultation with healthcare workers. On COVID-19 vaccination, 50% of students ‘strongly agreed’ to uptake it with an additional 25.8% ‘agreed’ to taking it. Participants strongly agreed or agreed (72.5% and 19.6%, respectively) that wearing face mask in public should be obligatory. More than 18% of students indicated that they would avoid contact with COVID-19 infected people. CONCLUSIONS : Responses of students showed that they follow precautionary measures to control spread of COVID-19, understand the viral transmission risk, and willing to uptake the COVID-19 vaccine.

The Potential for Airborne Transmission of SARS-CoV-2 in Sport: A Cricket Case Study

2021 ◽  
Author(s):  
Rory England ◽  
Nicholas Peirce ◽  
Thamindu Wedatilake ◽  
Joseph Torresi ◽  
Simon Kemp ◽  
...  
Keyword(s):  
Risk Factors ◽  
Relative Orientation ◽  
Transmission Risk ◽  
Risk Category ◽  
Airborne Transmission ◽  
Event Duration ◽  
Factors Affecting ◽  
Video Footage ◽  
Compound Effect

AbstractA review of risk factors affecting airborne transmission of SARS-CoV-2 was synthesised into an ‘easy-to-apply’ visual framework. Using this framework, video footage from two cricket matches were visually analysed, one pre-COVID-19 pandemic and one ‘COVID-19 aware’ game in early 2020. The number of opportunities for one participant to be exposed to biological secretions belonging to another participant was recorded as an exposure, as was the estimated severity of exposure as defined from literature. Events were rated based upon distance between subjects, relative orientation of the subjects, droplet generating activity performed (e. g., talking) and event duration. In analysis we reviewed each risk category independently and the compound effect of an exposure i. e., the product of the scores across all categories. With the application of generic, non-cricket specific, social distancing recommendations and general COVID-19 awareness, the number of exposures per 100 balls was reduced by 70%. More impressive was the decrease in the most severe compound ratings (those with two or more categories scored with the highest severity) which was 98% and the reduction in exposures with a proximity <1 m, 96%. Analysis of the factors effecting transmission risk indicated that cricket was likely to present a low risk, although this conclusion was somewhat arbitrary omitting a comparison with a non-cricketing activity.

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