Coronavirus Spread Limitation Using Detective Smart System

Given the circumstances the world is going through due to the novel coronavirus (Covid-19); this paper proposes a new smart system that aims to reduce the spread of the virus. The proposed Covid-19 containment system is designed to be installed outside hospitals and medical centers. Additionally, it works at night as well as at daylight. The system is based on Deep Learning applied to pedestrian temperature data sets that are collected using thermal cameras. The data set is primarily of temperature of pedestrians around medical centers. The thermal cameras are paired with conventional cameras for image capturing and cross referencing the target pedestrian with an existing central database (Big Data). If target is positive, the system sends a text message to the potentially infected person's cell phone upon recognition. The advisory sent text may contain useful information such as the nearest testing or isolation facility. This proposed system is assumed to be linked with the bigger network of the country’s Covid-19 response efforts. The simulation results reveal that the system can achieve an average precision of 90% fever detection among pedestrians.

Incidence and transmission dynamics of Coronavirus Disease 2019 (COVID-19) among fresh recruits in a Training Establishment of Indian Armed Forces: An observational study

Introduction: In times of COVID-19, when all institutions remained closed even post lock-down, the Airmen Training School of Indian Air Force proceeded with the recruitment of airmen. The present study intends to explore the incidence and transmission dynamics of COVID-19 among these freshly recruits who were quarantined in barracks with each barrack serving as one cohort. Material and Methods: In an observational study, 2978 male Air Force recruits, between the age group of 18-22 years, in two batches between 1st to 31st July 2020, were followed up in the quarantine period post recruitment. Since the quarantine was unconventional in terms of being in barracks, special and unique precautions such as repeated screening, delegation of specific toilets per billets, three ply mask distributions, Bio-Medical Waste Disposal etc were paid utmost attention. The COVID 19 cases were treated at the in-house isolation facility and the contacts with the symptomatics tested with RT-PCR or RAT before release from quarantine. All individuals were monitored with active surveillance and the data was meticulously maintained with zero attrition. Incidence, Secondary Attack Rate (SAR), demographic characteristics and others aspects of transmission dynamics were analyzed. Results: The incidence and SAR was observed to be 8.1% (71 primary cases) and 15.59% (170 secondary cases). 64.7% of cases were symptomatic with an average of 15 days of hospitalization. The rate positivity of testing with RTPCR or RAT was 11.44%. Severity was more marked in the first batch than the second batch of recruits. The overall R0 was found to be 2.39. Conclusion: The results of the study revealed some interesting characteristics of COVID-19 transmission dynamics. The cumulative incidence was found to be higher than national average. The variations between the recruits from different part of the country and the two batches could be attributed to the travel distance and mode of conveyance. The study also validates the mild nature of the infection in young adults. Fair conclusion on the implication of good quarantine and isolation measures and regular surveillance for symptoms for early diagnosis has also been compellingly indicated from these observations.

Consequences of Migrating U.S. Contagious Facilities Into General Hospitals, 1900–1950

Until the 1880s, hospitals excluded contagious disease patients from admission because of the danger they posed to other patients; by the 1950s, contagious disease care had literally moved into the general hospital. This article correlates the changing isolation facility designs with changing disease incidence and prevention strategies. It argues that isolation moved into the hospital in stages that have consequence for isolation facility design today. Between the 1890s and 1940s, contagious disease care shifted from remote isolation hospitals (commonly known as pest houses) to separate contagious disease hospitals, to contagious disease “units” adjacent to or within a general hospital facility, and to isolation rooms included in nursing units. The architectural history of isolation facility designs shows that the integration of isolation facilities into general hospitals relied on the success of new aseptic nursing procedures that prevented contact transmission but which downgraded the need for spatial separation to prevent airborne transmission. In the second half of the 20th century, federal funding and standards made isolation rooms in the hospital the norm. This migration coincided with a historically unprecedented reduction in contagious disease incidence produced by successful vaccines and antibiotics. By the 1980s, the rise of new and antibiotic resistant diseases led to extensive redesigns of the in-house isolation rooms to make them more effective. This article suggests that it is time to rethink isolation not just at the detail level but in terms of its location in relation to the general hospital.

Challenges of Singapore’s First Acute Geriatric Isolation Facility During the COVID-19 Pandemic

Aim The COVID-19 pandemic has seen hospitals isolating suspect cases. Geriatric populations are at a risk of severe COVID-19 disease and often present with concomitant geriatric syndromes requiring holistic interdisciplinary care. However, isolation of older people poses challenges to care delivery. This study shares the experience of Singapore’s first acute geriatric isolation facility geriatric PARI (Pneumonia-Acute Respiratory Infection) ward and describes the geriatric-related outcomes and pitfalls in care delivery. Methods This is a retrospective cross-sectional study performed in 7 negative pressure isolation rooms in an acute care public hospital in Singapore. 100 patients admitted consecutively to the geriatric PARI ward were included. Patient demographics, presenting symptoms and geriatric-related adverse outcomes associated with hospitalisation were collected and analysed. Results Patients’ mean age was 86.4 years (standard deviation [SD]: 6.8) with significant comorbidities being hypertension (81%), hyperlipidaemia (74%) and renal disease (70%). 51% of patients had dementia and 24% had behaviour and psychological symptoms of dementia (BPSD). 27% of patients presented atypically with delirium and 15% presented with a fall. Delirium was associated with restraint use (OR: 3.88; p-value 0.01). Falls rate was 1.64 per 1000 occupied bed. 1 patient screened positive for COVID-19. Conclusions The geriatric PARI ward is essential for curbing nosocomial transmission of COVID-19. This is important in the older people with comorbidities who are more likely to develop morbidity and mortality. Our study reveals challenges in delivering person-centred care to the older patients in isolation rooms, especially in the management of delirium and falls prevention. Innovative strategies should be developed to minimise isolation-related adverse outcome.

Quarantine and isolation facility: A State Health Department’s response to the COVID-19 pandemic

Background: State Health Departments are at the helm of addressing the myriad needs during the COVID-19 pandemic, including those of vulnerable populations who do not have a place to self-isolate or quarantine to prevent the spread. An estimated 5,000 Arkansas residents face homelessness and are at increased risk of contracting and spreading COVID-19. Additionally, those living in multigenerational families face similar challenges.Objective: We share our experiences and lessons learned in planning, executing, and maintaining a quarantine and isolation facility for vulnerable population during the COVID-19 pandemic.Setting and patients: A 29-bed quarantine and isolation facility was instituted and maintained by the Arkansas Department of Health to meet the quarantine and isolation needs of vulnerable populations. Outcomes and conclusions: As the COVID-19 pandemic persists, need for a facility to meet quarantine and isolation requirements of vulnerable population is not just a critical mitigation strategy but is an ethical imperative.

OCULAR MANIFESTATIONS IN LABORATORY CONFIRMED COVID-19

Background: Scarce literature has been published thus far regarding ocular findings in the COVID-19. Methods: All patients were confirmed by SARS-CoV-2 real-time reverse transcriptase– polymerase chain reaction (RT-PCR) of nasopharynx or oropharynx swab specimens collected at an isolation facility, fever clinic, or hospital unit designated for suspected cases pending confirmation. Results: Overall, 25 patients (25.00%) had various ocular symptoms during COVID-19 infection. Among those with ocular symptoms, 19 patients (76.00%) presented with increased conjunctival discharge, including white mucoid (6 [24.00%]), thin watery (3 [12.00%]) and yellow-green purulent (11 [44.00%]) discharge, and with conjunctival congestion (2 [8.00%]). Other ocular manifestations contained ocular pain (3 [12.00%]), tearing (1 [4.00%]), and eyelid swelling (1 [4.00%]). Conclusion: We concluded that common ocular manifestations were conjunctival discharge, eye rubbing, and conjunctival congestion. Keywords: COVID-19, Ocular, Eye.

Successful Islet Outcomes Using Australia-Wide Donors: A National Centre Experience

Cold ischemia and hence travel time can adversely affect outcomes of islet isolation. The aim of this study was to compare the isolation and transplant outcomes of donor pancreata according to the distance from islet isolation facility. Principally, those within a 50 km radius of the centre were compared with those from regional areas within the state and those from interstate donors within Australia. Organ donors were categorised according to distance from National Pancreas Transplant Unit Westmead (NPTU). Donor characteristics were analysed statistically against islet isolation outcomes. These were age, BMI, cause and mechanism of death, days in ICU, gender, inotrope and steroid use, cold ischemia time (CIT) and retrieval surgical team. Between March 2007 and December 2020, 297 islet isolations were performed at our centre. A total of 149 donor pancreata were local area, and 148 non-local regions. Mean distance from the isolation facility was 780.05 km. Mean pancreas CIT was 401.07 ± 137.71 min and was significantly different between local and non-local groups (297.2 vs. 487.5 min, p < 0.01). Mean age of donors was 45.22 years, mean BMI was 28.82, sex ratio was 48:52 F:M and mean time in ICU was 3.07 days. There was no significant difference between local and non-local for these characteristics. The mean CIT resulting in islet transplantation was 297.1 ± 91.5 min and longest CIT resulting in transplantation was 676 min. There was no significant difference in islet isolation outcomes between local and non-local donors for characteristics other than CIT. There was also no significant effect of distance from the isolation facility on positive islet transplant outcomes (C-peptide > 0.2 at 1 month post-transplant). Conclusions: Distance from the isolation centre did not impact on isolation or transplant outcomes supporting the ongoing nationwide use of shipping pancreata for islet isolation and transplantation.

Nosocomial SARS-CoV-2 transmission in a neonatal unit in Botswana: chronic overcrowding meets a novel pathogen

We describe a cluster of six SARS-CoV-2 infections occurring in a crowded neonatal unit in Botswana, including presumed transmission among mothers, postnatal mother-to-neonate transmission and three neonate-to-healthcare worker transmissions. The affected neonate, born at 25 weeks’ gestation weighing 785 g, had a positive SARS-CoV-2 test at 3 weeks of age which coincided with new onset of hypoxaemia and worsening respiratory distress. Because no isolation facility could accommodate both patient and mother, they were separated for 10 days, during which time the patient was switched from breastmilk to formula. Her subsequent clinical course was marked by several weeks of supplemental oxygen, sepsis-like presentations requiring additional antibiotics and bronchopulmonary dysplasia. Despite these complications, adequate growth was achieved likely due to early initiation of nutrition. This nosocomial cluster highlights the vulnerabilities of neonates, caregivers and healthcare workers in an overcrowded environment, and underscores the importance of uninterrupted bonding and breast feeding, even during a pandemic.

Telemedicine versus Physical Examination in Patients’ Assessment during COVID-19 Pandemic: The Dubai Experience

<b><i>Introduction:</i></b> With the large number of cases during the COVID-19 pandemic, a smart tool was urgently needed to handle all the positive cases at proper time such as using the technology and implementing telemedicine for triage. <b><i>Objective:</i></b> The purpose of this study is to detect the accuracy and effectiveness of telemedicine as an assessment tool for triage compared to physical assessment. <b><i>Methods:</i></b> In a random sample of 1,086 COVID-19 positive cases during the pandemic in Dubai, all the patients were initially assessed by trained staff using telemedicine following a standardized guidelines and accordingly action was taken by sending the patient to an isolation facility or for hospital admission; the second phase of assessment was conducted physically at the facility. We compared the accuracy of assessment by telemedicine encounter versus physical assessment by detecting any changes of the initial action within 12 h. <b><i>Results:</i></b> Telemedicine was accurate in 1,080 out of 1,086 screened patients (99.4%). <b><i>Discussion:</i></b> Telemedicine offers fast and convenient response to patients needs with standardization of triage guidelines. Telemedicine has reduced exposure of the medical workers which reduced the possibility of infection as well as reduction of crowds at the medical centers. <b><i>Recommendations:</i></b> Telemedicine is very useful during the COVID-19 pandemic for following up the positive and suspected cases as well as cases with history of close contact with a confirmed positive case.