Adjusting Reported COVID-19 Deaths for the Prevailing Routine Death Surveillance in India

In India, the “low mortality” narrative based on the reported COVID-19 deaths may be causing more harm than benefit. The extent to which COVID-19 deaths get reported depends on the coverage of routine death surveillance [death registration along with medical certification of cause of death (MCCD)] and the errors in MCCD. In India, the coverage of routine death surveillance is 18.1%. This is compounded by the fact that COVID-19 death reporting is focused among reported cases and the case detection ratio is low. To adjust for the coverage of routine death surveillance and errors in MCCD, we calculated a correction (multiplication) factor at national and state level to produce an estimated number of COVID-19 deaths. As on July 31, 2020, we calculated the infection fatality ratio (IFR) for India (0.58:100–1.16:100) using these estimated COVID-19 deaths; this is comparable with the IFR range in countries with near perfect routine death surveillance. We recommend the release of excess deaths data during COVID-19 (at least in states with high death registration) and post-mortem COVID-19 testing as a surveillance activity for a better understanding of under-reporting. In its absence, we should adjust reported COVID-19 deaths for the coverage of routine death surveillance and errors in MCCD. This way we will have a clear idea of the true burden of deaths and our public health response will never be inadequate. We recommend that “reported” or “estimated” is added before the COVID-19 death data and related indicators for better clarity and interpretation.

Consequences of the COVID-19 Outbreak Lockdown on Non-Viral Infectious Agents as Reported by a Laboratory-Based Surveillance System at the IHU Méditerranée Infection, Marseille, France

The objective of this paper is to describe the surveillance system MIDaS and to show how this system has been used for evaluating the consequences of the French COVID-19 lockdown on the bacterial mix of AP-HM and the antibiotic resistance. MIDas is a kind of surveillance activity hub, allowing the automatic construction of surveillance control boards. We investigated the diversity and resistance of bacterial agents from respiratory, blood, and urine samples during the lockdown period (from week 12 to 35 of 2020), using the same period of years from 2017 to 2019 as control. Taking into account the drop in patient recruitment, several species have exhibited significant changes in their relative abundance (either increasing or decreasing) with changes up to 9%. The changes were more important for respiratory and urine samples than for blood samples. The relative abundance in respiratory samples for the whole studied period was higher during the lockdown. A significant increase in the percentage of wild phenotypes during the lockdown was observed for several species. The use of the MIDaS syndromic collection and surveillance system made it possible to efficiently detect, analyze, and follow changes of the microbiological population as during the lockdown period.

Abi3 regulates microglial ramification and dynamic tissue surveillance in vivo.

A rare coding variant of Abelson-interactor gene family member 3 (Abi3) is associated with increased risk of late-onset Alzheimer's Disease (AD). Although Abi3 is recognised as a core microglial gene, its role in microglia is largely unknown. Here we demonstrate that Abi3 is crucial for normal microglial morphology, distribution, and homeostatic tissue surveillance activity in vivo.

A Qualitative Assessment of Stress Among Frontline Health Workers During COVID-19 Pandemic

Introduction: Being on the frontline, health care workers are most likely to get exposed to all kinds of stress in the ongoing Coronavirus-2019 pandemic. Both physical and mental stress could influence their well-being and also affect their work efficiency. There is a need of active intervention to restore and maintain the mental health of the frontline health workers. Thus, it is essential to gain an insight into their problems so that it would enable to identify appropriate solutions. Aim: To get an insight into the stress experienced by the COVID-19 community surveillance workers and to explore the perceptions of stress related trigger factors and coping strategies. Materials and Methods: This qualitative study was based on “Focus Group Discussion (FGD)” method and was associated with Nilratan Sircar Medical College & Hospital Kolkata. The participants were COVID-19 community surveillance workers who mainly comprised of “honorary health workers” and “100 days field workers (18-55 years)”, employed in 5 different urban health centers in the Kolkata corporation area during April to June 2020. A total of 55 participants were included in the study in five sessions. Researchers took notes during the session, which was also recorded verbatim. Discussions were mainly conducted over four key areas namely positive aspects of COVID-19 surveillance activities, stress related to surveillance activities, precipitating factors related to stress and coping strategies for these stressful periods. Data was summarised and analysed qualitatively. Results: Participants felt that “they provided service to the society and understood their importance in breaking the chain of transmission”. “This job gave them pride of being a part of health system along with income generation”. However, they also expressed about the stressful situation related to the surveillance activity like social ostracisation, verbal and even physical abuse. Inadequate supply of Personal Protective Equipment (PPE) was revealed. Most of the surveillance workers were informally trained thus they sought help for formal training for surveillance activity. Conclusion: Although the frontline health care workers felt proud to be involved in the surveillance work, almost all of them expressed apprehension against social stigmatisation, verbal and physical abuse. The need for formal training in surveillance work was evident.

Household transmission in people infected with SARS-CoV-2 (COVID-19) in Lima-Perú

ABSTRACTObjectiveDescribe the characteristics of SARS-CoV-2 infection among household members with a confirmed primary case of COVID-19 in low burden districts in Metropolitan Lima.Materials and MethodsA retrospective, secondary database review study was conducted. The information was collected from an epidemiological surveillance activity in close contacts (co-inhabitants) in 52 households in Metropolitan Lima with only one member with COVID-19. A reevaluation was carried out in 10 households. Epidemiological and clinical variables were evaluated and its association with the result of the rapid serological test (presence of IgG, IgM or both).ResultsSecondary cases were found in 40 households, which represents an average of 49.9% identification per household. A secondary attack rate of 53.0% (125 cases) was found among cohabitants, with 77.6% of cases being symptomatic (symptomatic / asymptomatic ratio: 3.5). The presence of fever and / or chills was found in 40.0% of people with a positive result, followed by a sore throat, in 39.2%. Ageusia and anosmia were present in 22.4% and 20.8% of cases, respectively. A reevaluation in 40 family members 33.6 ± 2.7 days after the first evaluation, show the persistence of positive IgM and IgG in the 20 positive cases in the first evaluation.ConclusionHaving a primary case of COVID-19 in home, the secondary attack rate of this infection is 53%; however, in a significant proportion of households evaluated there was no positive case, beyond the primary case. The epidemiological and clinical characteristics found in this case were in accordance with what has already been reported in other international series.

Police surveillance over prostitution as an intrinsic element of ethical discipline in the conditions of regulation

The authors examine the aspects of law enforcement practice of the local police authorities of the Russian Empire with regards to surveillance over prostitution in the conditions of its regulation since the late XIX century. Emphasis is made on analysis of the activity of police in Nizhny Novgorod Governorate, which was among the first alongside the capital to establish medical-police committee. However, attention is focused not on the sanitary control, but rather surveillance carried out by the police officers over prostitutes and persons involved in organization of prostitution, multiple administrative norms and rules regulating such activity. The research is based on dialectical method of cognition that allows examining police surveillance over prostitution in evolution and interconnection of all its manifestations. The events and facts related to the process of regulation of prostitution were studied in accordance with the principle of historicism, Formal-legal method was applies in analyzing the departmental regulatory legal acts and police law enforcement practice of surveillance activity. The authors’ main contribution consists in examination and introduction into the scientific discourse of archival sources that helped to restore the mechanism of surveillance activity, which includes a range of organizational measures of local police authorities over prostitution and its organization.

Diarrhoeal disease surveillance in Papua New Guinea: findings and challenges

Diarrhoeal diseases are among the leading causes of morbidity and mortality in the Western Pacific Region. However, data on the major causes of infectious diarrhoea are limited in many countries within the Region, including Papua New Guinea. In 2013–2014, we conducted surveillance for acute diarrhoeal illness in four provinces in Papua New Guinea. One rural health clinic from each province participated in the surveillance activity. Samples were sent to central laboratories and batch analysed for bacterial and viral gastrointestinal pathogens that are commonly associated with diarrhoea. Across the four sites, the most commonly detected pathogens were Shigella spp., Campylobacter spp. and rotavirus. In this paper, we report the results of the surveillance activity and the challenges that we faced. The lessons learnt may be applicable to other parts of the Region with a similar socioeconomic status.

SUBJECTS OF STATE CONTROL AND SURVEILLANCE ACTIVITY IN HOUSING AND COMMUNAL SERVICES AND THEIR COMPETENCE

The article reveals the actual problems of state control and supervision in housing and communal services. Organizational shortcomings and systemic contradictions arising in the activities of state housing supervision bodies are considered. The authors touched upon the gaps and shortcomings of legislation in the sphere of state regulation and management of housing and communal services. The article reveals certain aspects of the structure of state bodies in the housing and utilities sector and related industries that can lead to conflicts of interest in the implementation of various Supervisory functions. In conclusion, it is concluded that the state housing supervision and licensing control in the subjects of the Russian Federation has a number of organizational shortcomings and gaps in the regulatory legal support for the activities of the relevant structures.

Microglial motility in Alzheimer’s disease and after Aβ42 immunotherapy: a human post-mortem study

Microglial function is highly dependent on cell motility, with baseline motility required for homeostatic surveillance activity and directed motility to migrate towards a source of injury. Experimental evidence suggests impaired microglial motility in Alzheimer’s disease (AD) and therefore we have investigated whether the expression of proteins associated with motility is altered in AD and affected by the Aβ immunotherapy using post-mortem brain tissue of 32 controls, 44 AD cases, and 16 AD cases from our unique group of patients immunised against Aβ42 (iAD). Sections of brain were immunolabelled and quantified for (i) the motility-related microglial proteins Iba1, cofilin 1 (CFL1), coronin-1a (CORO1A) and P2RY12, and (ii) pan-Aβ, Aβ42 and phosphorylated tau (ptau). The neuroinflammatory environment was characterised using Meso Scale Discovery multiplex assays. The expression of all four motility-related proteins was unmodified in AD compared with controls, whereas Iba1 and P2RY12, the homeostatic markers, were increased in the iAD group compared with AD. Iba1 and P2RY12 showed significant positive correlations with Aβ in controls but not in the AD or iAD groups. Pro- and anti-inflammatory proteins were increased in AD, whereas immunotherapy appears to result in a slightly less pro-inflammatory environment. Our findings suggest that as Aβ appears during the ageing process, the homeostatic Iba1 and P2RY12 –positive microglia respond to Aβ, but this response is absent in AD. Aβ-immunisation promoted increased Iba1 and P2RY12 expression, likely reflecting increased baseline microglial motility but without restoring the profile observed in controls.

Temporal (1948–2012) and Dynamic Evolution of the Wouri Estuary Coastline within the Gulf of Guinea

The Wouri estuary is located in the Gulf of Guinea on the Atlantic coast of Cameroon’s coastline plain (3°49′ and 4°04′ north latitude and 9°20′ to 9°40′ east longitude), and is strongly influenced by coastal dynamics that have remained unquantified over a long period of time. This study analyzed the historical evolution of the Wouri estuarine coastline between 1948 and 2012. Variations in the estuarine evolution of the Wouri were studied from (i) minute topographic extracts from 1948, (ii) 1996–1999 nautical charts, and (iii) 2012 spatial map vectors. The net temporal spatial variation rates were calculated using the statistical methods of the Digital Shoreline Analysis System (DSAS). These change rates were also calculated over two time intervals (1948–1996 and 1996–2012) and over a 64-year period (1948–2012). The study reveals highly disparate results. Indeed, kinematics show that the Wouri estuary was dominated by erosion in its downstream section, with 262.83 ha for –3.2 m/year and 110.56 ha for –5.8 m/year between 1948–1996 and 1996–2012 respectively, and by accretion on the other hand in its upstream section, with 239.17 ha for 4.3 m/year in zone 5 between 1948–1996 and 150.82 ha for 12.6 m/year in zone 4 between 1996–2012. Thus, over the 64-year period (1948–2012), we have a dominance of variation by erosion downstream and conversely by accretion upstream, marked by the presence of amplifying factors (anthropogenic pressure and climate change) of the rate of variation of morphological evolution at the beginning of the 21st century, as compared to the middle-20th century. The observed development of sediment loss and accumulation, both influences and will influence, the sediment regime along the Wouri estuarine coastline. There is a need to develop a systematic sub-regional coastal surveillance activity to effectively manage Cameroon’s coastline system.