Household Quarantine of Second Degree Contacts Is an Effective Non- Pharmaceutical Intervention to Prevent Tertiary Cases in the Current Pandemic

2021 ◽  
Author(s):  
Josef A. I. Weigl ◽  
Anna-Katharina Feddersen ◽  
Mona Stern
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort ◽  
Field Data ◽  
Health Department ◽  
Real Field ◽  
Northern Germany ◽  
Limited Efficacy ◽  
County Health Department ◽  
The Impact ◽  
Second Degree

Abstract Background: Given the characteristics of SARS-CoV2 in regard to transmission before the onset of symptoms and varying manifestation indices according to age, isolation and quarantine have limited efficacy in the current pandemic. Household quarantine in second degree contacts (Hh-Q2°) outside the case household was so far only addressed by modellers. There is no publication based on field data in the literature.Methods: In a retrospective cohort study on real field data from a county health department (CHD), all PCR-confirmed cases and related contact persons put into quarantine were analysed. Hh-Q2° was used in our CHD from the beginning of the pandemic.Results: From 9 March to 8 December 2020, 353 PCR-confirmed cases were registered in the CHD Ploen, Northern Germany: 225 (63.7%) primary, 107 (30.3%) secondary and 21 (5.9%) tertiary cases. The 107 secondary cases resulted out of 470 (22.8%) close or 1°contacts and 21 tertiary cases out of 179 (11.7%) indirect or 2°contacts put into quarantine. The efficacy of Hh-Q2° was 51.5% (11.7%/22.8%) of the efficacy of quarantine in 1°contacts; 16.4% of all converted cases in quarantined persons were ascertained by Hh-Q2°. One in ten 1°contacts in households with tertiary cases remained asymptomatic.Conclusion: The impact of Hh-Q2° in preventing further spread of SARS-CoV2 was considerable. With half the conversion rate in 2°contacts in comparison to 1°contacts, the efficacy of Hh-Q2° is substantial. Hh-Q2° should urgently be used routinely to control the spread of SARS-CoV2 more efficiently and national authorities should include it in their guidelines.

scholarly journals Household quarantine of second degree contacts is an effective non-pharmaceutical intervention to prevent tertiary cases in the current SARS-CoV pandemic

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Josef A. I. Weigl ◽  
Anna-Katharina Feddersen ◽  
Mona Stern
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort ◽  
Field Data ◽  
Health Department ◽  
Real Field ◽  
Northern Germany ◽  
Limited Efficacy ◽  
County Health Department ◽  
The Impact ◽  
Second Degree

Abstract Background Given the characteristics of SARS-CoV2 with regard to transmission before the onset of symptoms and varying manifestation indices according to age, isolation and quarantine have limited efficacy in the current pandemic. Household quarantine in second degree contacts (Hh-Q2°) outside the case household has so far only been addressed by modellers. In the literature there is no publication based on field data. Methods In a retrospective cohort study on real field data from a county health department (CHD), all PCR-confirmed cases and related contact persons put into quarantine were analysed. Hh-Q2° was used in our CHD from the onset of the pandemic. Results From 9 March to 8 December 2020, 353 PCR-confirmed cases were registered in the CHD Ploen, Northern Germany: 225 (63.7%) primary, 107 (30.3%) secondary and 21 (5.9%) tertiary cases. The 107 secondary cases resulted out of 470 (22.8%) close or 1°contacts and 21 tertiary cases out of 179 (11.7%) indirect or 2°contacts put into quarantine. The efficacy of Hh-Q2° was 51.5% (11.7%/22.8%) of that of quarantine in 1°contacts; 16.4% of all converted cases in quarantined persons were ascertained by Hh-Q2°. One in ten 1°contacts in households with tertiary cases remained asymptomatic. Conclusion The impact of Hh-Q2° in preventing further spread of SARS-CoV2 was considerable. With half the conversion rate in 2°contacts compared to 1°contacts, the efficacy of Hh-Q2° is substantial. Hh-Q2° should definitely be used routinely to control the spread of SARS-CoV2 more efficiently and national authorities should include it in their guidelines.

scholarly journals Household quarantine of second degree contacts is an effective non-pharmaceutical intervention to prevent tertiary cases in the current SARS-CoV pandemic

2021 ◽  
Author(s):  
Josef A. I. Weigl ◽  
Anna-Katharina Feddersen ◽  
Mona Stern
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort ◽  
Field Data ◽  
Health Department ◽  
Real Field ◽  
Northern Germany ◽  
Limited Efficacy ◽  
County Health Department ◽  
The Impact ◽  
Second Degree

Abstract Background Given the characteristics of SARS-CoV2 with regard to transmission before the onset of symptoms and varying manifestation indices according to age, isolation and quarantine have limited efficacy in the current pandemic. Household quarantine in second degree contacts (Hh-Q2°) outside the case household has so far only been addressed by modellers. In the literature there is no publication based on field data. Methods In a retrospective cohort study on real field data from a county health department (CHD), all PCR-confirmed cases and related contact persons put into quarantine were analysed. Hh-Q2° was used in our CHD from the onset of the pandemic. Results From 9 March to 8 December 2020, 353 PCR-confirmed cases were registered in the CHD Ploen, Northern Germany: 225 (63.7%) primary, 107 (30.3%) secondary and 21 (5.9%) tertiary cases. The 107 secondary cases resulted out of 470 (22.8%) close or 1°contacts and 21 tertiary cases out of 179 (11.7%) indirect or 2°contacts put into quarantine. The efficacy of Hh-Q2° was 51.5% (11.7%/22.8%) of that of quarantine in 1°contacts; 16.4% of all converted cases in quarantined persons were ascertained by Hh-Q2°. One in ten 1°contacts in households with tertiary cases remained asymptomatic. Conclusion The impact of Hh-Q2° in preventing further spread of SARS-CoV2 was considerable. With 51% of the conversion rate in 2°contacts compared to 1°contacts, the efficacy of Hh-Q2° is substantial. Hh-Q2° should definitely be used routinely to control the spread of SARS-CoV2 more efficiently and national authorities should include it in their guidelines.

scholarly journals COVID-19 Inequalities: Individual and Area Socioeconomic Factors (Aragón, Spain)

2021 ◽  
Vol 18 (12) ◽  
pp. 6607
Author(s):  
Isabel Aguilar-Palacio ◽  
Lina Maldonado ◽  
Sara Malo ◽  
Raquel Sánchez-Recio ◽  
Iván Marcos-Campos ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort ◽  
Social Inequalities ◽  
Deprivation Level ◽  
Social Consequences ◽  
Multilevel Analyses ◽  
The Social ◽  
The Individual ◽  
The Impact ◽  
Second Wave

It is essential to understand the impact of social inequalities on the risk of COVID-19 infection in order to mitigate the social consequences of the pandemic. With this aim, the objective of our study was to analyze the effect of socioeconomic inequalities, both at the individual and area of residence levels, on the probability of COVID-19 confirmed infection, and its variations across three pandemic waves. We conducted a retrospective cohort study and included data from all individuals tested for COVID-19 during the three waves of the pandemic, from March to December 2020 (357,989 individuals) in Aragón (Spain). We studied the effect of inequalities on the risk of having a COVID-19 confirmed diagnosis after being tested using multilevel analyses with two levels of aggregation: individuals and basic healthcare area of residence (deprivation level and type of zone). Inequalities in the risk of COVID-19 confirmed infection were observed at both the individual and area level. There was a predominance of low-paid employees living in deprived areas. Workers with low salaries, unemployed and people on minimum integration income or who no longer receive the unemployment allowance, had a higher probability of COVID-19 infection than workers with salaries ≥ €18,000 per year. Inequalities were greater in women and in the second wave. The deprivation level of areas of residence influenced the risk of COVID-19 infection, especially in the second wave. It is necessary to develop individual and area coordinated measures by areas in the control, diagnosis and treatment of the epidemic, in order to avoid an increase in the already existing inequalities.

scholarly journals The impact of levothyroxine exposure on delivery outcome in hypothyroid pregnant women (PETAL study): A five-year retrospective cohort study

2021 ◽  
pp. 1753495X2110641
Author(s):  
Diana Oprea ◽  
Nadine Sauvé ◽  
Jean-Charles Pasquier
Keyword(s):  
Cohort Study ◽  
Pregnant Women ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Caesarean Delivery ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Singleton Pregnancy ◽  
Delivery Outcome ◽  
The Impact

Background Hypothyroidism affects 3% of pregnant women, and to date, no studies have addressed the impact levothyroxine-treated hypothyroidism on delivery outcome. Methods This retrospective cohort study was conducted among 750 women with a singleton pregnancy who gave birth between 2015 and 2019. Delivery modes were compared between 250 hypothyroid women exposed to levothyroxine and 500 euthyroid control women. The aim of this study was to determine the impact of levothyroxine exposure on delivery outcome. Results Multiple logistic regression showed no significant association between exposure to levothyroxine and the overall rate of caesarean delivery (aOR 1.1; 95% CI 0.8 to 1.6). Mean TSH concentrations were significantly higher throughout the pregnancy in hypothyroid women despite levothyroxine treatment. Maternal and neonatal outcomes in both groups were not different. Conclusion Hypothyroidism treated with levothyroxine during pregnancy according to local guidelines is not a significant risk factor for caesarean delivery.

scholarly journals Impact of Covid-19 on attendances for a 1st episode of reduced fetal movements: A retrospective observational study

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0253796
Author(s):  
Laia Marques-Fernandez ◽  
Swati Sharma ◽  
Una Mannu ◽  
Hsu Phern Chong
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort ◽  
Fold Increase ◽  
Stillbirth Rate ◽  
Hospital Records ◽  
Reduced Fetal Movements ◽  
Fetal Movements ◽  
Provision Of Care ◽  
The Impact ◽  
Primiparous Women

Background Prior studies have demonstrated an increased stillbirth rate. It was suggested that the COVID-19 pandemic may have impacted on attendances for reduced fetal movements. Thus, we sought to ascertain the impact of the pandemic on attendances for reduced fetal movements (RFM) in our unit, ultrasound provision for reduced fetal movements, and the stillbirth rate. Methods This was a single site retrospective cohort study involving all women complaining of a 1st episode of reduced fetal movements between 01/03/2020-30/04/2020 (COVID) to 01/03/2019-30/04/2019 (Pre-COVID). Data were retrieved from computerised hospital records and statistical analyses were performed using GraphPad Prism and SPSS. Results 22% (179/810) of women presented with a 1st episode of reduced fetal movements Pre-COVID compared to 18% (145/803) during COVID (p = 0.047). Primiparous women were significantly over-represented in this population with a 1.4-fold increase in attendances during COVID (67% vs 48%, p = 0.0005). Neither the total stillbirth rate nor the stillbirth rate amongst women who presented with reduced fetal movements changed during COVID. Ultrasound provision was not impacted by COVID with 95% of the scans performed according to local guidelines, compared to Pre-COVID (74%, p = 0.0001). Conclusions There is a significant decrease in 1st attendances for reduced fetal movements during COVID-19 pandemic. Primiparous women were 1.4 times more likely to attend with RFM. Women should be reassured that COVID-19 has not resulted in a decreased provision of care for RFM, and has not impacted on the stillbirth rate.

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