Regressing SARS-CoV-2 Sewage Measurements Onto COVID-19 Burden in the Population: A Proof-of-Concept for Quantitative Environmental Surveillance

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an RNA virus, a member of the coronavirus family of respiratory viruses that includes severe acute respiratory syndrome coronavirus 1 (SARS-CoV-1) and the Middle East respiratory syndrome (MERS). It has had an acute and dramatic impact on health care systems, economies, and societies of affected countries during the past 8 months. Widespread testing and tracing efforts are being employed in many countries in attempts to contain and mitigate this pandemic. Recent data has indicated that fecal shedding of SARS-CoV-2 is common and that the virus RNA can be detected in wastewater. This indicates that wastewater monitoring may provide a potentially efficient tool for the epidemiological surveillance of SARS-CoV-2 infection in large populations at relevant scales. In particular, this provides important means of (i) estimating the extent of outbreaks and their spatial distributions, based primarily on in-sewer measurements, (ii) managing the early-warning system quantitatively and efficiently, and (iii) verifying disease elimination. Here we report different virus concentration methods using polyethylene glycol (PEG), alum, or filtration techniques as well as different RNA extraction methodologies, providing important insights regarding the detection of SARS-CoV-2 RNA in sewage. Virus RNA particles were detected in wastewater in several geographic locations in Israel. In addition, a correlation of virus RNA concentration to morbidity was detected in Bnei-Barak city during April 2020. This study presents a proof of concept for the use of direct raw sewage-associated virus data, during the pandemic in the country as a potential epidemiological tool.

Download Full-text

Regressing SARS-CoV-2 sewage measurements onto COVID-19 burden in the population: a proof-of-concept for quantitative environmental surveillance

10.1101/2020.04.26.20073569 ◽

2020 ◽

Cited By ~ 14

Author(s):

Itay Bar-Or ◽

Karin Yaniv ◽

Marilou Shagan ◽

Eden Ozer ◽

Oran Erster ◽

...

Keyword(s):

Rna Virus ◽

Health Care Systems ◽

Warning System ◽

Clinical Syndrome ◽

Epidemiological Surveillance ◽

Virus Concentration ◽

Proof Of Concept ◽

Infected People ◽

Concentration Method ◽

Care Systems

AbstractSARS-CoV-2 is an RNA virus, a member of the coronavirus family of respiratory viruses that includes SARS-CoV-1 and MERS. COVID-19, the clinical syndrome caused by SARSCoV-2, has evolved into a global pandemic with more than 2,900,000 people infected. It has had an acute and dramatic impact on health care systems, economies, and societies of affected countries within these few months. Widespread testing and tracing efforts are employed in many countries in order to contain and mitigate this pandemic. Recent data has indicated that fecal shedding of SARS-CoV-2 is common, and that the virus can be detected in wastewater. This indicates that wastewater monitoring is a potentially efficient tool for epidemiological surveillance of SARS-CoV-2 infection in large populations at relevant scales. Collecting raw sewage data, representing specific districts, and crosslinking this data with the number of infected people from each location, will enable us to derive and provide quantitative surveillance tools. In particular, this will provide important means to (i) estimate the extent of outbreaks and their spatial distributions, based primarily on in-sewer measurements (ii) manage the early-warning system quantitatively and efficiently (and similarly, verify disease elimination). Here we report the development of a virus concentration method using PEG or alum, providing an important a tool for detection of SARS-CoV-2 RNA in sewage and relating it to the local populations and geographic information. This will provide a proof of concept for the use of sewage associated virus data as a reliable epidemiological tool.

Download Full-text

Pregnancy management in coronavirus disease – Challenges in developing countries

10.25259/jrhm_58_2020 ◽

2021 ◽

Vol 2 ◽

pp. 18

Author(s):

Narendra Malhotra ◽

Ruchika Garg ◽

Saroj Singh ◽

Prabhat Agrawal ◽

Jaideep Malhotra ◽

...

Keyword(s):

Health Care ◽

Developing Countries ◽

Severe Acute Respiratory Syndrome ◽

Health Care Systems ◽

Hubei Province ◽

The World ◽

Care Systems ◽

The Usa

Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus (SARS-CoV) infection, first identified in December 2019 in Wuhan, a city in the Hubei Province of China. The infection has spread in more than 150 countries and is a pandemic. Governments across the world have adopted rigorous measures to reduce both the spread by lockdown and cancelling most visas. It has detrimental effects on health-care systems and on the whole economy of world including the USA.

Download Full-text

A cohort-based emergency plan to maintain functionality in a clinical laboratory during the 2020 COVID-19 epidemic outbreak

Journal of Laboratory Medicine ◽

10.1515/labmed-2020-0035 ◽

2020 ◽

Vol 44 (3) ◽

pp. 113-115

Author(s):

Gerhard Pütz ◽

Manuela Müller ◽

Karl Winkler

Keyword(s):

Health Care ◽

Critical Care ◽

Severe Acute Respiratory Syndrome ◽

Clinical Laboratory ◽

Health Care Systems ◽

Emergency Planning ◽

Epidemic Outbreak ◽

Emergency Plan ◽

Model Calculations ◽

Care Systems

Abstract Objectives Clinical laboratory analyses are essential part of critical care. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)/coronavirus disease 2019 (COVID-19)-confirmed cases were doubling in Germany every 3 days during March 2020. Health care systems are preparing for an epidemic crisis. Methods We outline a cohort-based emergency planning. The plan is based on three independent self-sufficient cohorts that maintain duty for 7 days, followed by quarantine-like rest for 14 days. COVID-19-infected and otherwise ill personnel will be replaced by a tactical reserve, which is again replaced by recovered staff. Results We switched to the outlined system when incidence of confirmed COVID-19 cases surpassed 50/100,000 residents. Our parameter spectrum was reduced to the essential analyses in agreement with our clinical colleagues. So far the system works well. In model calculations, the system is robust to maintain essential laboratory functionality even when incidence of COVID-19 is higher than that currently observed in the most severely hit countries. Conclusions We outline a cohort-based emergency planning to maintain essential functionality of a clinical laboratory while minimizing the risk of spreading infection with COVID-19 among our workforce during the COVID-19 epidemic faced in 2020.

Download Full-text

Impact of COVID-19 on Lung Transplant Activity in Germany—A Cross-Sectional Survey

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-0040-1715436 ◽

2020 ◽

Author(s):

Sebastian Michel ◽

Christian Witt ◽

Jens Gottlieb ◽

Clemens Aigner

Keyword(s):

Health Care ◽

Patient Safety ◽

Severe Acute Respiratory Syndrome ◽

Lung Transplant ◽

Health Care Systems ◽

Time Frame ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Variable Extent ◽

Care Systems

AbstractThe current COVID-19 pandemia affects health care systems worldwide, however, to a variable extent depending on the caseload in each country. We aimed to provide a cross-sectional overview of current limitations or adaptions in lung transplant programs in Germany in from January to May 2020 due to the COVID-19 pandemia caused by severe acute respiratory syndrome coronavirus 2. A cross-sectional survey assessing various aspects of lung transplant activity was sent to all active lung transplant programs (n = 12) in Germany. Eight centers (66%) responded to the survey within the requested time frame. Four centers (50%) reported their activity is not restricted at all and four centers (50%) reported on moderate general limitations. The overall lung transplant activity in Germany from January to May 2020 contains 128 bilateral and 11 single lung transplantations, which is similar to the same period in the year 2019 (126 bilateral transplantations and 12 single lung transplantations). The results suggest that the influence of the COVID-19 pandemia on lung transplantation activity in Germany has been moderate so far. Nevertheless, adaptions such as extensive testing of donors and recipients were introduced to reduce the likelihood of infections and increase patient safety. Alertness to changes in COVID-19 reproduction rates might be required until effective antiviral therapy or vaccination is available.

Download Full-text

Continuous monitoring of SARS-CoV-2 RNA in urban wastewater from Porto, Portugal: sampling and analysis protocols

10.1101/2021.04.06.21254994 ◽

2021 ◽

Author(s):

Maria Paola Tomasino ◽

Miguel Semedo ◽

Pedro Vieira ◽

Elza Ferraz ◽

Adelaide Rocha ◽

...

Keyword(s):

Continuous Monitoring ◽

Wastewater Treatment Plants ◽

Rna Virus ◽

Rna Extraction ◽

Temporal Trends ◽

Virus Concentration ◽

Successful Implementation ◽

Study Region ◽

Untreated Wastewater ◽

Clinical Surveillance

AbstractResearch on the emerging COVID-19 pandemic is demonstrating that wastewater infrastructures can be used as public health observatories of virus circulation in human communities. Important efforts are being organized worldwide to implement sewage-based surveillance of SARS-CoV-2 that can be used for preventive or early warning purposes, informing preparedness and response measures. However, its successful implementation requires important and iterative methodological improvements, as well as the establishment of standardized methods. The aim of this study was to develop a continuous monitoring protocol for SARS-CoV-2 in wastewater, that could be used to model virus circulation within the communities, complementing the current clinical surveillance. Specific objectives included (1) optimization and validation of a sensitive method for virus quantification; (2) monitoring the time-evolution of SARS-CoV-2 in wastewater from two wastewater treatment plants (WWTPs) in the city of Porto, Portugal. Untreated wastewater samples were collected weekly from the two WWTPs between May 2020 and March 2021, encompassing two COVID-19 incidence peaks in the region (mid-November 2020 and mid-January 2021). In the first stage of this study, we compared, optimized and selected a sampling and analysis protocol that included RNA virus concentration through centrifugation, RNA extraction from both liquid and solid fractions and quantification by reverse transcription quantitative PCR (RT-qPCR). In the second stage, we used the selected methodology to track SARS-CoV-2 in the collected wastewater over time. SARS-CoV-2 RNA was detected in 39 and 37 out of 48 liquid and solid fraction samples of untreated wastewater, respectively. The copy numbers varied throughout the study between 0 and 0.15 copies/ng RNA and a good fit was observed between the SARS-CoV-2 RNA concentration in the untreated wastewater and the COVID-19 temporal trends in the study region. In agreement with the recent literature, the results from this study support the use of wastewater-based surveillance to complement clinical testing and evaluate temporal and spatial trends of the current pandemic.

Download Full-text

Genetics of Severe Acute Respiratory Syndrome Coronavirus-2 and Diagnosis of Coronavirus Disease-2019: An Overview

Journal of Health Management ◽

10.1177/0972063420935548 ◽

2020 ◽

Vol 22 (2) ◽

pp. 236-247

Author(s):

Anshuman Sewda ◽

Shiv Dutt Gupta

Keyword(s):

Severe Acute Respiratory Syndrome ◽

Rna Virus ◽

Infected Individual ◽

Structural Proteins ◽

Epidemiological Surveillance ◽

Host Immune System ◽

Angiotensin Converting Enzyme 2 ◽

Containment Measures ◽

Rapid Tests ◽

Specific Antigens

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is a positive sense, single-stranded RNA virus, responsible for the ‘coronavirus disease-2019’ (COVID-19) pandemic. SARS-CoV-2 belongs to the sarbecovirus (lineage-B) sub-genus within the betacoronavirus genus of the coronaviridae family. SARS-CoV-2 shares similarities with SARS-CoV, which was responsible for the 2003 SARS epidemic. SARS-CoV-2 binds with great affinity to the Angiotensin Converting Enzyme-2 receptors on human cells, and its ~30 kilobases long RNA genome hijacks the host machinery and compromises the host immune system with the help of accessory proteins, such as non-structural proteins, resulting in a widespread infection. The spike protein is responsible for the contagious nature of SARS-CoV-2 and, together with the nucleocapsid protein, elicits the host inflammatory response. Several real-time reverse transcriptase polymerase chain reaction (rRT-PCR) tests have been developed to confirm SARS-CoV-2 infection in suspected cases of COVID-19. Furthermore, rapid tests based on SARS-CoV-2-specific antigens and antibodies have been developed to conduct epidemiological surveillance of the hotspot regions that are worst affected by the COVID-19 pandemic. Until effective measures to prevent the occurrence or spread of COVID-19 pandemic are developed, containment measures are being taken, such as isolation of confirmed COVID-19 patients, quarantine of individuals who may have come in contact with a SARS-CoV-2 infected individual, community-wide social distancing, state/nation-wide lockdown, etc. Several vaccines and drugs are being tested that could target the viral structural proteins, non-structural proteins or associated SARS-CoV-2 sub-genomic RNA regions.

Download Full-text

Recommendations for Gynecological Endoscopic Surgery during COVID-19 Pandemic

Indian Journal of Cardiovascular Disease in Women WINCARS ◽

10.1055/s-0040-1716818 ◽

2020 ◽

Vol 5 (03) ◽

pp. 239-242

Author(s):

Amrutha Kakollu ◽

Anupama Hari

Keyword(s):

Health Care ◽

Laparoscopic Surgery ◽

Severe Acute Respiratory Syndrome ◽

Endoscopic Surgery ◽

Health Care Professionals ◽

Health Care Systems ◽

Viral Transmission ◽

Gas Leakage ◽

Use Of Resources ◽

Care Systems

AbstractThe presence of coronavirus disease 2019 (COVID-19) continues to overwhelm health-care systems with numerous concerns around the safety of patients as well as health-care professionals. It is essential to allow for judicious use of resources and emphasize allotting maximum staff and resources to care for the affected. To this end, most centers are choosing to defer elective procedures and perform only emergency surgeries. The safety of all theater staff is of utmost importance, and the risks of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral transmission should be curbed when operating. In particular, there are concerns relating to the transmission of COVID-19 during gynecological laparoscopic surgery, arising from the possible generation of contaminated aerosols from gas leakage and the creation of smoke from the use of electrosurgical devices. The aim of this paper is to review the evidence available as of today for recommendations to follow while performing gynecological procedures.

Download Full-text

Impact of Smoking on Women During the Covid-19 Pandemic

Frontiers in Medicine ◽

10.3389/fmed.2021.584061 ◽

2021 ◽

Vol 8 ◽

Author(s):

Florin Dumitru Mihaltan ◽

Armand-Gabriel Rajnoveanu ◽

Ruxandra-Mioara Rajnoveanu

Keyword(s):

Risk Factors ◽

Health Care ◽

Risk Factor ◽

Severe Acute Respiratory Syndrome ◽

Health Effects ◽

Health Care Systems ◽

Male Gender ◽

Point Of View ◽

Care Systems ◽

Important Challenge

The coronavirus disease 2019 (COVID-19) brought in 2020 an important challenge for health-care systems and authorities. Smoking and its influence on this disease remain, after months of the pandemic, one of the debatable risk factors. From the literature point of view, the focus of most articles is on smoking as a possible general risk factor for all analyzed populations. Women tend to represent a more significant population in exposed occupations. In our mini-review, we try to dig deeper, looking for gender-related health effects of smoking in this pandemic context, its effects on the infection with this novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), on illness severity, and on the rate of hospitalization and mortality. Despite the fact that the male gender is reported in many articles as a predictor of a poor outcome, we suggest that further research is needed to confirm or deny these relationships. Moreover, studies focusing specifically on women in these study populations are required.

Download Full-text

Evaluation of a SARS-CoV-2 Capture IgM Antibody Assay in Convalescent Sera

Microbiology Spectrum ◽

10.1128/spectrum.00458-21 ◽

2021 ◽

Author(s):

Binh Ha ◽

Samadhan Jadhao ◽

Laila Hussaini ◽

Theda Gibson ◽

Kathy Stephens ◽

...

Keyword(s):

Health Care ◽

Severe Acute Respiratory Syndrome ◽

Health Care Systems ◽

Antibody Assay ◽

Past Infection ◽

Igm Antibody ◽

Care Systems

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has inflicted tremendous loss of lives, overwhelmed health care systems, and disrupted all aspects of life worldwide since its emergence in Wuhan, China, in December 2019. Detecting current and past infection by PCR or serology is important to understanding and controlling SARS-CoV-2.

Download Full-text