The first wave of the COVID-19 pandemic in Spain: characterisation of cases and risk factors for severe outcomes, as at 27 April 2020

Background The first wave of the coronavirus disease (COVID-19) pandemic spread rapidly in Spain, one of Europe’s most affected countries. A national lockdown was implemented on 15 March 2020. Aim To describe reported cases and the impact of national lockdown, and to identify disease severity risk factors. Methods National surveillance data were used to describe PCR-confirmed cases as at 27 April 2020. We compared case characteristics by severity categories (hospitalisation, admission to intensive care unit (ICU), death) and identified severity risk factors using multivariable regression. Results The epidemic peaked on 20 March. Of 218,652 COVID-19 cases, 45.4% were hospitalised, 4.6% were admitted to ICU and 11.9% died. Among those who died, 94.8% had at least one underlying disease. Healthcare workers (HCWs) represented 22.9% of cases. Males were more likely to have severe outcomes than females. Cardiovascular disease was a consistent risk factor. Patients with pneumonia had higher odds of hospitalisation (odds ratio (OR): 26.63; 95% confidence interval (CI): 25.03–28.33). The strongest predictor of death was age ≥ 80 years (OR: 28.4; 95% CI: 19.85–40.78). Among underlying diseases, chronic renal disease had highest odds of death (OR: 1.47; 95% CI: 1.29–1.68). Conclusions COVID-19 case numbers began declining 6 days after the national lockdown. The first wave of the COVID-19 pandemic in Spain had a severe impact on elderly people. Patients with cardiovascular or renal conditions were at higher risk for severe outcomes. A high proportion of cases were HCWs. Enhanced surveillance and control measures in these subgroups are crucial during future COVID-19 waves.

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Tourism Impacts, Tourism-Phobia and Gentrification in Historic Centers: The Cases of Málaga (Spain) and Gdansk (Poland)

Sustainability ◽

10.3390/su13010408 ◽

2021 ◽

Vol 13 (1) ◽

pp. 408

Author(s):

Fernando Almeida-García ◽

Rafael Cortés-Macías ◽

Krzysztof Parzych

Keyword(s):

Comparative Research ◽

Control Measures ◽

Tourism Impacts ◽

Tourist Destinations ◽

Tourist Flows ◽

Tourist Accommodation ◽

And Control ◽

The Impact ◽

Urban Characteristics

This study analyzes the role of residents in urban tourist destinations affected by the increase in tourist flows, which have generated various problems such as tourism, gentrification and the emergence of tourism as a threat to residents. The role of residents in tourist destinations has not been analyzed regularly during the development process of destinations. We study two cases of historic centers in European cities, with the aim of comparing tourism problems, which are common to most European urban destinations. This study was conducted by administering surveys amongst residents of these historic centers (378 in Málaga, Spain, and 380 in Gdansk, Poland). These cities show a similar demographic size and urban characteristics. This is the first comparative research on tourism-phobia and gentrification in destinations, a field of analysis that is still not studied much. We develop specific scales to measure gentrification and tourism-phobia; moreover, we study the impact of some tourist problems that affect residents (noise, dirt, occupation of public spaces, etc.), and we show the spatial distribution of tourism-phobia. The same analysis instruments are used for both cities. The results of this study show that the tourism-phobia situation is different in the analyzed destinations. It is more intense in the case of Málaga than in Gdansk. The two historic centers are especially affected by the processes of increased tourist flows and the growth of new forms of tourist accommodation. The research results show that the residents’ annoyance caused by tourism gentrification is more intense than tourism-phobia. Both case studies highlight the residents’ complaints regarding the inadequate management of problems by public stakeholders and control measures.

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Improving knowledge, attitudes and practice to prevent COVID-19 transmission in healthcare workers and the public in Thailand

BMC Public Health ◽

10.1186/s12889-021-10768-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Rapeephan R. Maude ◽

Monnaphat Jongdeepaisal ◽

Sumawadee Skuntaniyom ◽

Thanomvong Muntajit ◽

Stuart D. Blacksell ◽

...

Keyword(s):

General Public ◽

Prevention And Control ◽

Healthcare Workers ◽

Infection Prevention ◽

Control Measures ◽

Infection Prevention And Control ◽

The Public ◽

Educational Videos ◽

Prevention And Control Measures ◽

And Control

Abstract Background Key infection prevention and control measures to limit transmission of COVID-19 include social distancing, hand hygiene, use of facemasks and personal protective equipment. However, these have limited or no impact if not applied correctly through lack of knowledge, inappropriate attitude or incorrect practice. In order to maximise the impact of infection prevention and control measures on COVID-19 spread, we undertook a study to assess and improve knowledge, attitudes and practice among 119 healthcare workers and 100 general public in Thailand. The study setting was two inpatient hospitals providing COVID-19 testing and treatment. Detailed information on knowledge, attitudes and practice among the general public and healthcare workers regarding COVID-19 transmission and its prevention were obtained from a combination of questionnaires and observations. Results Knowledge of the main transmission routes, commonest symptoms and recommended prevention methods was mostly very high (> 80%) in both groups. There was lower awareness of aerosols, food and drink and pets as sources of transmission; of the correct duration for handwashing; recommended distance for social/physical distancing; and about recommended types of face coverings. Information sources most used and most trusted were the workplace, work colleagues, health workers and television. The results were used to produce a set of targeted educational videos which addressed many of these gaps with subsequent improvements on retesting in a number of areas. This included improvements in handwashing practice with an increase in the number of areas correctly washed in 65.5% of the public, and 57.9% of healthcare workers. The videos were then further optimized with feedback from participants followed by another round of retesting. Conclusions Detailed information on gaps in knowledge, attitudes and practice among the general public and healthcare workers regarding COVID-19 transmission and its prevention were obtained from a combination of questionnaires and observations. This was used to produce targeted educational videos which addressed these gaps with subsequent improvements on retesting. The resulting videos were then disseminated as a resource to aid in efforts to fight COVID-19 in Thailand and worldwide.

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Rapid decline of neutralizing antibodies against SARS-CoV-2 among infected healthcare workers

Nature Communications ◽

10.1038/s41467-021-21111-9 ◽

2021 ◽

Vol 12 (1) ◽

Cited By ~ 16

Author(s):

Stéphane Marot ◽

◽

Isabelle Malet ◽

Valentin Leducq ◽

Karen Zafilaza ◽

...

Keyword(s):

Neutralizing Antibodies ◽

Healthcare Workers ◽

Disease Onset ◽

Control Measures ◽

Infection Prevention And Control ◽

Rapid Decline ◽

Prevention And Control Measures ◽

Few Data ◽

Antibody Levels ◽

And Control

AbstractThere are only few data concerning persistence of neutralizing antibodies (NAbs) among SARS-CoV-2-infected healthcare workers (HCW). These individuals are particularly exposed to SARS-CoV-2 infection and at potential risk of reinfection. We followed 26 HCW with mild COVID-19 three weeks (D21), two months (M2) and three months (M3) after the onset of symptoms. All the HCW had anti-receptor binding domain (RBD) IgA at D21, decreasing to 38.5% at M3 (p < 0.0001). Concomitantly a significant decrease in NAb titers was observed between D21 and M2 (p = 0.03) and between D21 and M3 (p < 0.0001). Here, we report that SARS-CoV-2 can elicit a NAb response correlated with anti-RBD antibody levels. However, this neutralizing activity declines, and may even be lost, in association with a decrease in systemic IgA antibody levels, from two months after disease onset. This short-lasting humoral protection supports strong recommendations to maintain infection prevention and control measures in HCW, and suggests that periodic boosts of SARS-CoV-2 vaccination may be required.

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The Impact of COVID-19 on Pedestrian Flow Patterns in Urban POIs—An Example from Beijing

ISPRS International Journal of Geo-Information ◽

10.3390/ijgi10070479 ◽

2021 ◽

Vol 10 (7) ◽

pp. 479

Author(s):

Yihang Li ◽

Liyan Xu

Keyword(s):

Prevention And Control ◽

Control Period ◽

Flow Patterns ◽

Control Measures ◽

Pedestrian Flow ◽

Prevention Measures ◽

Government Control ◽

Functional Categories ◽

And Control ◽

The Impact

The COVID-19 pandemic is a major challenge for society as a whole, and analyzing the impact of the spread of the epidemic and government control measures on the travel patterns of urban residents can provide powerful help for city managers to designate top-level epidemic prevention policies and specific epidemic prevention measures. This study investigates whether it is more appropriate to use groups of POIs with similar pedestrian flow patterns as the unit of study rather than functional categories of POIs. In this study, we analyzed the hour-by-hour pedestrian flow data of key locations in Beijing before, during, and after the strict epidemic prevention and control period, and we found that the pedestrian flow patterns differed greatly in different periods by using a composite clustering index; we interpreted the clustering results from two perspectives: groups of pedestrian flow patterns and functional categories. The results show that depending on the specific stage of epidemic prevention and control, the number of unique pedestrian flow patterns decreased from four before the epidemic to two during the strict control stage and then increased to six during the initial resumption of work. The restrictions on movement are correlated with most of the visitations, and the release of restrictions led to an increase in the variety of unique pedestrian flow patterns compared to that in the pre-restriction period, even though the overall number of visitations decreased, indicating that social restrictions led to differences in the flow patterns of POIs and increased social distance.

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ESTIMATION OF SARS-COV-2 SPECIFIC ANTIBODIES SEROPREVALENCE IN HEALTHCARE WORKERS IN DISTRICT UDAIPUR, INDIA

10.36106/ijar/8102221 ◽

2021 ◽

pp. 61-63

Author(s):

Shelesh Kumar Swami ◽

Nitesh Kumar Chauhan ◽

Shuchi Goyal ◽

A.K. Verma ◽

Shweta Biyani

Keyword(s):

Healthcare Workers ◽

Clinical Symptoms ◽

Control Measures ◽

Rt Pcr ◽

High Seroprevalence ◽

Know How ◽

Novel Coronavirus ◽

And Control ◽

Infection Eradication ◽

Cumulative Prevalence

Background:Current pandemic caused by Novel coronavirus (COVID-19) causes clinical symptoms from fever to acute respiratory distress syndrome but may remain mild or asymptomatic. To evaluate the cumulative prevalence of SARSCoV-2 infection in a community and know how immune response develops in the population, reliable assay alongwith RT-PCR for detection of SARS-CoV 2 antibodies is needed. Healthcare workers (HCWs) represent a high-risk populat - ion for infection with SARS-CoV-2. Methods: We evaluated total antibodies recognizing the SARS CoV 2 receptor binding domain (S1-RBD) - - - or the Spike protein over a period of six months in a total of 310 healthcare workers engaged in hospital using SARS-CoV-2 Total antibody assay kit. Findings: The overall seroprevalence found in our analysis was 41.93%. In case of males the percentage positive was found to be signicantly higher at 43.91%, compared to females at 36.25%. Seroprevalence was signicantly higher in 50 years above age group in comparison to 20-50 years old aged healthcare workers. The seroprevalence was higher in doctors, nursing staff and lab technicians than other healthcare professionals as 44.6%. Conclusions: This study showed high seroprevalence of SARS-CoV-2 in healthcare workers which means remaining proportion of the healthcare workers are still susceptible to the infection. Good compliance to infection eradication and control measures, adequate PPEs, and early detection and isolation of healthcare workers infected with SARS-CoV-2 are mandatory to reduce the risk of SARS-CoV-2 infection.

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Risk Factors for Occupational Transmission of Tuberculosis among Healthcare Workers in Zambia

International Journal of TROPICAL DISEASE & Health ◽

10.9734/ijtdh/2020/v41i1130335 ◽

2020 ◽

pp. 59-65

Author(s):

Namaunga Kasumu Chisompola ◽

Kapambwe Mwape Kamanga ◽

Pipina Vlahakis Matafwali

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Healthcare Workers ◽

Critical Role ◽

Nosocomial Transmission ◽

Infection Prevention And Control ◽

Original Research ◽

Healthcare Facilities ◽

Prolonged Contact ◽

And Control

Healthcare workers (HCWs) play a critical role in the management and control of nosocomial transmission of tuberculosis (TB). At the same time, working in TB healthcare facilities such as hospital wards, diagnostic and treatment facilities increases the risk of acquiring TB due to occupational exposure in HCWs. The risk is further heightened in high TB prevalence populations, such as Zambia, as HCWs are exposed both occupationally and in the community. This review aims to provide a better understanding of the risk factors associated with occupational transmission of TB in HCWs in Zambia, by synthesising available data on TB in HCWs in Zambia and the surrounding region. A search of peer reviewed original research on the transmission of TB among HCWs in Zambia was conducted in PubMed and Google Scholar. Studies were eligible for inclusion in the analysis if they described TB amongst HCWs in Zambia, risk factors for TB in HCWs, and nosocomial transmission of TB in Zambia and the surrounding region. The prevalence of TB in HCWs has been demonstrated to be higher than that of the general population. Transmission of TB in healthcare facilities is driven by several factors centred on the lack of adherence to TB infection prevention and control (IPC) practices. Nosocomial transmission of TB in HCWs is further driven by the HIV epidemic and the rise in lifestyle diseases such as diabetes mellitus. However, there is very scarce data on the association of diabetes mellitus and TB among HCWs in Zambia. Prolonged contact with TB patients on wards has been demonstrated to play a vital role in occupational transmission of TB amongst nurses in Zambia. To curb the transmission of TB in HCWs several measures will require implementation such as; administrative support, IPC training and annual TB and HIV screening for all HCWs.

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Hospital Readmission in Patients With COVID-19

10.21203/rs.3.rs-658872/v1 ◽

2021 ◽

Author(s):

Neda Rahimian ◽

Mahshid Heidari ◽

Nahid Hashemi-Madani ◽

Nader Tavakoli ◽

Moammad E Khamseh

Keyword(s):

Risk Factors ◽

Hospital Readmission ◽

Underlying Disease ◽

Control Groups ◽

Factors Associated ◽

Infection Age ◽

Discharge Plan ◽

Matched Case ◽

And Control ◽

Control Study

Abstract Objective: During the COVID-19 pandemic, the demand for hospital beds has exceeded substantially. Thus, we aimed to conduct this study to identify factors associated with the risk of readmission in order to introduce the best discharge plan for patients with high risk of hospital readmission. Method: This is a multicenter, case-control study included 1357 patients hospitalized with COVID-19 infection. Age-sex-matched case and control groups were paired at 1:2 ratios. COVID-19 readmission rate was assessed. Moreover, Logistic regression analysis was applied to determine the factors associated with readmission. Results: Of the 1357 patients, 99 (7.29%) subjects were readmitted. The most common cause of readmission was respiratory distress. The median (IQR) of the interval between hospital discharge and the second admission was 5 (2-16) days. Upon adjusting with the main risk factors, having at least one underlying disease and being treated with the corticosteroid (GC) were significantly associated with a higher rate of readmission (OR: 2.76, 95% CI :1.30- 5.87) and (OR:8.24, 95% CI :3.72- 18.22), respectively.Conclusion: Identification of Risk factors of COVID 19 readmission will improve resource utilization and patient care.

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Risk of Plasmodium falciparum infection in south-west Burkina Faso - potential impact of expanding eligibility for seasonal malaria chemoprevention

10.21203/rs.3.rs-900546/v1 ◽

2021 ◽

Author(s):

Anne L Wilson ◽

Steve W Lindsay ◽

Alfred Tiono ◽

Jean Baptiste Yaro ◽

Hilary Ranson ◽

...

Keyword(s):

Risk Factors ◽

Plasmodium Falciparum ◽

Burkina Faso ◽

Malaria Transmission ◽

Malaria Control ◽

Control Measures ◽

Sub Saharan Africa ◽

South West ◽

Seasonal Malaria Chemoprevention ◽

The Impact

Abstract Background Burkina Faso has one of the highest malaria burdens in sub-Saharan Africa despite the mass deployment of insecticide-treated nets (ITNs) and use of seasonal malaria chemoprevention (SMC) in children aged up to 5 years. Identification of risk factors for Plasmodium falciparum infection in rural Burkina Faso could help to identify and target malaria control measures. Methods A cross-sectional survey of 1,199 children and adults was conducted during the peak malaria transmission season in south-west Burkina Faso in 2017. Logistic regression was used to identify risk factors for microscopically confirmed P. falciparum infection. A malaria transmission dynamic model was used to determine the impact on malaria cases averted of administering SMC to children aged 5–15 year old. Results P. falciparum prevalence was 32.8% in the study population. Children aged 5 to < 10 years old were at 3.74 times the odds (95% CI = 2.68–5.22, p < 0.001) and children aged 10 to 15 years old at 3.14 times the odds (95% CI = 1.20–8.21, p = 0.02) of P. falciparum infection compared to children aged less than 5 years old. Administration of SMC to children aged up to 10 years is predicted to avert an additional 57 malaria cases per 1000 population per year (9.4% reduction) and administration to children aged up to 15 years would avert an additional 89 malaria cases per 1000 population per year (14.6% reduction) in the Cascades Region, assuming coverage of pyrethroid-piperonyl butoxide ITNs. Conclusion Malaria infections were high in all age strata, although highest in children aged 5 to 15 years, despite roll out of core malaria control interventions. Given the burden of infection in school-age children, extension of the eligibility criteria for SMC could help reduce the burden of malaria in Burkina Faso and other countries in the region.

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Collaboration: the key to investigations of emerging and re-emerging diseases

Eastern Mediterranean Health Journal ◽

10.26719/1996.2.1.30 ◽

2021 ◽

Vol 2 (1) ◽

pp. 30-36

Author(s):

Douglas L. Hatch ◽

Imam Z. Imam

Keyword(s):

Scientific Work ◽

Emerging Diseases ◽

Control Measures ◽

Quality Of Data ◽

International Agencies ◽

Effective Interventions ◽

Extensive Field ◽

Outbreak Investigations ◽

And Control ◽

The Impact

Countries need teams of well trained epidemiologists with extensive field experience to work with clinicians and laboratory scientists to conduct prompt and effective outbreak investigations of epidemics. To identify these outbreaks of possible emerging or re-emerging problems, existing surveillance must be strengthened and the quality of data validated routinely. In addition, ministry of health officials and international agencies need an open, collaborative, scientific work environment. The best environment to design effective interventions and control measures to limit the impact of these newly identified problems on the public’s health is one of cooperation and collaboration

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Prevalence of active tuberculosis disease among healthcare workers and support staff in healthcare settings of the Amhara region, Ethiopia

PLoS ONE ◽

10.1371/journal.pone.0253177 ◽

2021 ◽

Vol 16 (6) ◽

pp. e0253177

Author(s):

Melashu Balew Shiferaw ◽

Mulusew Alemneh Sinishaw ◽

Desalegne Amare ◽

Genetu Alem ◽

Dawit Asefa ◽

...

Keyword(s):

Prevention And Control ◽

Healthcare Workers ◽

Support Staff ◽

Control Measures ◽

Health Centers ◽

Amhara Region ◽

Healthcare Settings ◽

Prevention And Control Measures ◽

Study Participants ◽

And Control

Background Health care workers (HCWs) are at an increased risk of acquiring tuberculosis (TB) compared to the general population, because of the frequent face to face contact or potential exposure to TB through shared air or space with infectious patient(s), regardless of economic setting and local TB incidence. Information on the burden of active TB disease among HCWs will help guide control measures, can be utilized to evaluate the effectiveness of TB infection prevention programs in the health care setting, and guide necessary actions. However, data on TB among HCW in Ethiopia is limited. Therefore, this study aimed to determine the prevalence of active TB disease among healthcare workers and support staff in healthcare settings in the Amhara region of Ethiopia. Methods A cross-sectional study design was used to recruit a total of 580 randomly selected study participants in the Amhara region. Data were collected over four months in selected hospitals and health centers. Implementation of TB prevention and control measures was evaluated using a standardized checklist. The main outcome indicator was active TB as measured by a laboratory diagnosis using GeneXpert technology. Results A total of 580 study participants were enrolled. The mean age was 31.3 (±7.8 standard deviation) years, with about two-thirds (65.3%) aged between 18–24 years. A total of 9 (1.6%) MTB cases were detected, 4 (1.4%) in HCWs and 5 (1.7%) in support staff, which did not significantly differ (P = 0.50). About 90% of the participants had not received TB infection prevention and control training ever. More than half (54%) of the study participants worked in poorly ventilated rooms. Triage of coughing patients was not practiced in 32% of the studied facilities (health centers and hospitals). Conclusions The magnitude of TB among healthcare workers and support staff in healthcare settings was higher than in the general population (140 per 100000 population). The status of implementation of tuberculosis prevention and control measures indicated missed opportunities. Hence, strict implementation of developed infection control plans of TB in healthcare settings needs to be improved.

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