Attribution of super-spreaders to the COVID-19 outbreak

PurposeIn Ghana, even though scholars and experts in the field of economics and finance have expressed their opinions and perceptions on the effect of the pandemic on the Ghana Stock Exchange, there has been no study conducted to that effect. This study, therefore, aimed at examining the impact of COVID-19 on the stock returns on the Ghana stock exchange. This would help policy makers and investors in making efficient decisions.Design/methodology/approachThe outbreak of the novel COVID-19 has been a thorn in the flesh of the world in its entirety, affecting many aspects of life including the stock market. This study, therefore, examined the impact of the outbreak on the stock returns of the Ghana Stock Exchange. The study utilized data from the All Share Prices of the Ghana stock exchange, commonly known as the Ghana stoke exchange composite index (GSECI) for analysis. The data covered the period before the outbreak of COVID-19 and during the outbreak. It was revealed that the Ghana stock exchange experienced better returns on the market before the outbreak of the virus. The outbreak of COVID-19 has led to wide variations in the market increasing the risk of investments. The exponential General Autoregressive Conditional Heteroscedasticity (EGARCH) (1, 1) model also reveals that the outbreak of COVID-19 has a significant negative effect on the returns in the market. The market in these periods of COVID-19 is highly volatile. It is recommended that investors should carefully consider risk mitigation strategies to enable them diversify their investments effectively and efficiently against the high risk associated with the market in this COVID-19 era.FindingsIt was revealed that the Ghana stock exchange experienced better returns on the market before the outbreak of the virus. The outbreak of COVID-19 has led to wide variations in the market increasing the risk of investments. The EGARCH (1, 1) model also revealed that the outbreak of COVID-19 had a significant negative effect on stock returns in the market. The market during these periods of COVID-19 was viewed as highly volatile.Research limitations/implicationsThe outbreak of COVID-19 is hence deduced to have a negative impact on the Ghana stock exchange. However, the knowledge of how the market has been affected by the disease, it is important that financial risk mitigation studies be undertaken. This goes beyond what this study has done. The study can further be expanded to include other important economic variables such as GDP, inflation, exchange rates and the likes in to the model.Practical implicationsInvestors should carefully consider risk mitigation strategies to enable them diversify their investments effectively and efficiently against the high risk associated with the market in this COVID-19 era.Social implicationsIt is also important that investors consider diversification of their investments in order to reduce the risk in their investments. It will be more appropriate for most investors to invest with companies such as banks and the telecommunications companies listed on the on the market. This is because most of the telecommunication companies in these times have taken advantage and are making good profit on their businesses. Likewise, some of the financial institutions are considered essential institution in these times. Investing in industries such as manufacturing and the oil and gas sector may be more risky.Originality/valueThe decline in economic and financial market indicators could be credited to the failure of most business entities, organizations and firms which are struggling to sustain their operations in these times of COVID-19. These also include firms listed on the Ghana stock exchange with whom investors transact their daily businesses. However, about 70% of the Ghanaian economy heavily depends on these business and firms found in the private and informal sector. According to the Ghana Statistics Service COVID-19 Business Tracker Survey, about 131,000 businesses expressed their uncertainties with the business environment and also faced the challenge of financial accessibility. The study is appropriate to unearth the true effect and offer policy interventions.

Background:Recent work demonstrated that detection of SARS-CoV-2 on the floor of long-term care facilities is associated with impending COVID-19 outbreaks. It is unknown if similar results will be observed in hospitals.Methods:Floor swabs were prospectively collected weekly from healthcare worker-only areas (eg, staff locker rooms) at two hospitals in Ontario, Canada for 39 weeks. Floor swabs were processed for SARS-CoV-2 using quantitative reverse-transcriptase polymerase chain reaction. Results were reported as percentage of positive floor swabs and viral copy number. Grouped fivefold cross-validation was used to evaluate model outbreak discrimination.Results:SARS-CoV-2 RNA was detected on 537 of 760 floor swabs (71%). At Hospital A, overall positivity was 90% (95% CI: 85%–93%; N = 280); at Hospital B, overall positivity was 60% (95% CI: 55%–64%; N = 480). There were four COVID-19 outbreaks at Hospital A and seven at Hospital B during the study period. The outbreaks consisted of primarily patient cases (ie, 140 patient cases and 4 staff cases). For every 10-fold increase in viral copies, there was a 22-fold higher odds of a COVID-19 outbreak (OR = 22.0, 95% CI 7.3, 91.8). The cross-validated area under the receiver operating curve for SARS-CoV-2 viral copies for predicting a contemporaneous outbreak was 0.86 (95% CI 0.82–0.90).Conclusion:Viral burden of SARS-CoV-2 on floors, even in healthcare worker-only areas, was strongly associated with COVID-19 outbreaks in those hospital wards. Built environment sampling may support hospital COVID-19 outbreak identification, fill gaps in traditional surveillance, and guide infection prevention and control measures.

BackgroundDuring the COVID-19 pandemic, non-therapeutic interventions (NPIs), such as traffic restrictions, work stoppages, and school suspensions, have led to a sharp decline in the concentration of air pollutants in the epidemic sites. However, few studies focused on the impact of air pollutant changes on the risk of nonaccidental death.MethodWe selected Yancheng City, China, as the study site and applied a Generalized Additive Model (GAM) based on the quasi-Poisson distribution to evaluate the impact of atmospheric pollutants exposure on the nonaccidental death of local residents. The time span of this study was set from January 1, 2013, to December 21, 2022, that is, before and after the outbreak of COVID-19.ResultsThe concentration of some air pollutants has greatly varied after the outbreak of COVID-19, with a significant decline for PM2.5 (− 43.4%), PM10 (− 38.5%), SO2 (− 62.9%), and NO2 (− 22.6%), but an increase for O3 (+ 4.3%). Comparative analysis showed that PM2.5 contributed to an increased risk of nonaccidental death after the outbreak of COVID-19. With an increase in PM2.5 by 10 µg/m³, the excess relative risks (ER) of nonaccidental death of residents increased by 1.01% (95%CI: 0.19%,1.84%). The stratified analysis revealed that air pollutants impacted nonaccidental deaths in both men and women before the outbreak of COVID-19. After the outbreak of COVID-19, PM10 had a significant effect on male nonaccidental deaths. The concentrations of PM2.5, PM10, and SO2 increased by 10 µg/m³, the ER of PM2.5, PM10, and SO2 on female nonaccidental death increased by 1.52% (0.38%,2.67%), 0.58% (0.02%,1.13%), and 15.09% (5.73%,25.28%), respectively. Before the outbreak of COVID-19, five air pollutants had an impact on the death of residents from cardiovascular disease (CVD). After the outbreak of COVID-19, only PM10 significantly affected the death risk of CVD. In addition, we discovered that PM2.5, PM10, and SO2 significantly impacted the risk of death due to respiratory diseases before and after the outbreak of COVID-19.ConclusionsAir pollutants have different effects on nonaccidental deaths before and after the COVID-19 outbreak. A decrease in air pollutant concentration due to the NPIs for COVID-19 had a significant effect on the reduction of the risk of nonaccidental death.

Changes in clinical laboratory operations and biosafety measures to mitigate biohazard risks during the COVID-19 pandemic

BackgroundEnvironmental surveillance of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) through wastewater has become a useful tool for population-level surveillance. Built environment sampling may provide a more spatially refined approach for surveillance in congregate living settings.MethodsWe conducted a prospective study in 10 long-term care homes (LTCHs) between September 2021 and November 2022. Floor surfaces were sampled weekly at multiple locations within each building and analyzed for the presence of SARS-CoV-2 using quantitative reverse transcriptase polymerase chain reaction. The primary outcome was the presence of a coronavirus disease 2019 (Covid-19) outbreak in the week that floor sampling was performed.ResultsOver the 14-month study period, we collected 4895 swabs at 10 LTCHs. During the study period, 23 Covid-19 outbreaks occurred with 119 cumulative weeks under outbreak. During outbreak periods, the proportion of floor swabs that were positive for SARS-CoV-2 was 54.3% (95% confidence interval [CI], 52 to 56.6), and during non-outbreak periods it was 22.3% (95% CI, 20.9 to 23.8). Using the proportion of floor swabs positive for SARS-CoV-2 to predict Covid-19 outbreak status in a given week, the area under the receiver-operating characteristic curve was 0.84 (95% CI, 0.78 to 0.9). Among 10 LTCHs with an outbreak and swabs performed in the prior week, eight had positive floor swabs exceeding 10% at least 5 days before outbreak identification. For seven of these eight LTCHs, positivity of floor swabs exceeded 10% more than 10 days before the outbreak was identified.ConclusionsDetection of SARS-CoV-2 on floors is strongly associated with Covid-19 outbreaks in LTCHs. These data suggest a potential role for floor sampling in improving early outbreak identification.

This study aims to provide empirical evidence on how higher education institutions (HEIs) teacher educators use SM in teaching during the Corona Virus Disease (Covid-19) outbreak. Evaluation of the factors that are the key to implementing the use of SM in education during the Covid-19 outbreak is essential. We used a survey aiming to answer the research questions of the study. The study participants are 297 faculty members from all over the Indonesian faculty of education and teacher training. The findings of the study reported that all hypotheses are significant. Facilitating Condition (FC) significantly predicts Perceived Ease of Use (PEU) and Perceived Usefulness (PU). Similarly, PEU is positively related to PU and Intention to Use (IU). PU also significantly determines IU. In addition, IU is significantly correlated with Actual Use (AU). The highest path coefficient is achieved by the relationship between the FC and PU. PEU and PU are the lowest relationship. Suggestions and recommendations are offered for the betterment of teaching and learning processes during the Covid-19 outbreak.

Objective The purpose of this study was to investigate the state of depression and anxiety and assciated factors of back-to-school college students during the outbreak of COVID-19, so as to provide theoretical basis for emotional counseling and psychological crisis intervention after long-term school closure due to epidemic outbreak. Methods Cluster sampling was used to select the first batch of 2 697 back-to-school students in a high vocational college. The survey content includes basic information questionnaire, Depression Self-rating Scale (SDS) and Anxiety Self-rating Scale (SAS). Results The detection rate of depression and anxiety was 31.8% and 10.4% respectively. Multivariate Logistic regression analysis showed that the risk of depression in female college students was 1.28 times higher than that in male students. The risk of depression among college students with family loss experience caused by the outbreak of COVID-19 was 1.30 times that of those without family loss experience caused by the outbreak of COVID-19. Outgoing personality ( OR = 0.62), neutral ( OR = 0.55) and mild temper ( OR = 0.46), moderate frequency of physical exercise per week (1–2 times: OR = 0.73, 3–4 times: OR = 0.65) were protective effects for depression in college students.Low frequency of breakfast were the risk effects for depression in college. The risk of anxiety among college students who was the only child in the family was 1.61 times higher than that who was not the only child in the family. The risk of anxiety among college students with family loss experience caused by the outbreak of COVID-19 was 1.45 times higher than that college students without family loss experience caused by the outbreak of COVID-19. Neutral temper, mild temper and physical exercise 1–2 times a week were associated with lower level of anxiety in college students ( OR = 0.67, 0.56, 0.67). Breakfast skipping ( OR = 2.03) was associated with higher levvel of anxiety in college students. Conlusions During the outbreak of COVID-19, the first batch of back-to-school college students presented high level of depression. Colleges are suggested to promptly carry out effective emotional relief and psychological intervention for students, especially those whose family suffered in COVID-19, the only child in the family, with poor breakfast eating habits, as well as breakfast skipping and lack of physical exercise. 【摘要】 目的 了解新型冠状病毒肺炎流行期间返校大学生抑郁、焦虑情绪现况及其影响因素, 为后续开展有效的情绪 疏导和心理干预提供依据。 方法采用整群抽样的方法对安徽中医药髙等专科学校首批返校的2 697名大学生进行自编 问卷调査, 内容包括基本信息、抑郁自评量表 (Self-rating Depression Scale, SDS) 和焦虑自评量表 (Self-rating Anxiety Scale, SAS) 等。 结果 首批返校大学生抑郁检出率为31.8%, 焦虑检出率为10.4%。多因素Logistic回归分析显示, 女生产生抑 郁情绪的风险是男生的1.28倍;因疫情致家庭损失的大学生产生抑郁情绪的风险是无家庭损失的1.30倍;外向性格 ( OR = 0.62)、中性脾气 ( OR = 0.55)及温和脾气 ( OR = 0.46)、每周体育锻炼次数适中 (1~2次:OR = 0.73;3~4次:OR = 0.65)与大 学生产生抑郁情绪呈负相关;早餐次数较少与大学生产生抑郁情绪呈正相关。独生子女大学生产生焦虑情绪风险是非独 生子女的1.61倍;因疫情致家庭损失的大学生产生焦虑情绪的风险是无家庭损失的1.45倍;中性脾气 ( OR = 0.67)及温和 脾气 ( OR = 0.56)、每周体育锻炼1~2次 ( OR = 0.67)与大学生产生焦虑情绪呈负相关;从来不吃早餐 ( OR = 2.03)与大学生 产生焦虑情绪呈正相关。 结论新冠肺炎流行期间, 首批返校大学生群体抑郁检出率较髙。学校应针对有因疫情所致损 失经历、独生子女、具有不良早餐习惯、缺乏体育锻炼的学生及时开展有效情绪疏解和心理干预。

Citation:Li Y, Qin Q, Sun Q, Sanford LD, Vgontzas AN, Tang X. Insomnia and psychological reactions during the COVID-19 outbreak in China. J Clin Sleep Med. 2020;16(8):1417–1418.

COVID-19 has changed the daily lives of citizens around the world and exposed the vulnerability of life and the functioning of cities. The pandemic has forced citizens to adapt to new models of remote work during quarantine and access to smart technology-based services. The article aims to assess citizens' perceptions of the technological solutions provided by smart cities and, in particular, the municipality of Paphos before and after the Covid-19 pandemic, as well as to evaluate their impact on citizens' mental health. The results of the study contribute to the understanding of the mental health benefits for citizens living in smart cities compared to people living in low-tech areas, revealing the potential positive effects of smart technologies, as well as the change in people's digital decision-making before and after the pandemic

BackgroundThe COVID-19 pandemic has created disruptions in HIV prevention and sexual health services for men who have sex with men (MSM).ObjectiveThis study compared HIV testing utilization in 3 different reference periods (period 1: before the COVID-19 outbreak, November 2019-January 2020; period 2: after the outbreak, February-April 2020; and period 3: after the pandemic was under initial control, May-July 2020). Factors associated with HIV testing utilization after the COVID-19 outbreak (combined periods 2 and 3) were also investigated.MethodsParticipants were MSM aged ≥18 years living in Shenzhen, China. Those self-reporting as HIV positive were excluded. A total of 595 participants recruited through multiple sources completed a self-administered online survey during August-September 2020. HIV testing utilization after the COVID-19 outbreak was the dependent variable, and multivariate logistic regression models were fitted.ResultsHIV testing utilization was significantly lower in period 2 than in period 1 (n=262 vs 363, 44.0% vs 61.0%, P<.001). However, HIV testing utilization was not significantly higher in period 3 than in period 2 (n=277 vs 262, 46.6% vs 44.0%, P=.21). The prevalence of HIV testing utilization after the COVID-19 outbreak was seen in 331 (55.6%) participants. After adjusting for significant background characteristics, condomless anal intercourse (CAI) with regular male sex partners (RPs; adjusted odds ratio [AOR] 2.15, 95% CI 1.29-3.57) and sexualized drug use (SDU; AOR 2.94, 95% CI 1.41-6.06) both before and after the COVID-19 outbreak, CAI with RPs (AOR 2.07, 95% CI 1.06-4.07) and nonregular male sex partners (NRPs; AOR 3.57, 95%CI: 1.43-8.89) only after the COVID-19 outbreak was positively associated with the dependent variable. Regarding HIV prevention service utilization, HIV testing utilization before the COVID-19 outbreak (AOR 10.75, 95% CI 7.22-16.02) and the use of sexually transmitted infection (STI) testing (AOR 7.02, 95% CI 4.10-12.02), other HIV/STI prevention (AOR 3.15, 95% CI 2.16-4.60), and preexposure prophylaxis (PrEP; AOR 3.58, 95% CI 1.54-8.34) after the COVID-19 outbreak were associated with higher HIV testing utilization. The current perceived risk of HIV infection was higher than that before the COVID-19 outbreak (AOR 1.15, 95% CI 1.01-1.30), and perceived COVID-19 preventive measures taken by HIV testing service providers to be effective (AOR 1.52, 95% CI 1.29-1.78) and perceived higher behavioral control to undergo HIV testing (AOR 1.18, 95% CI 1.00-1.40) were positively associated with HIV testing utilization. Concerns about COVID-19 infection during HIV testing (AOR 0.78, 95% CI 0.68-0.89), avoiding crowded places (AOR 0.68, 95% CI 0.48-0.98), and HIV testing service providers reducing their working hours (AOR 0.59, 95% CI 0.48-0.98) were negatively associated with the dependent variable.ConclusionsHIV testing utilization among Chinese MSM declined after the COVID-19 outbreak and did not increase after the pandemic was under initial control. Removing structural barriers to accessing HIV testing caused by COVID-19, modifying perceptions related to HIV testing, and making use of HIV self-testing (HIVST) might be useful strategies to improve HIV testing among MSM during the pandemic.

BackgroundIncreasing evidence indicated a clear association between COVID-19 pandemic and mental health. This study aimed to assess the dynamic change of mental burden during and after the COVID-19 outbreak and related predictive factors among Chinese undergraduate medical students.MethodsThis longitudinal survey was conducted among Chinese undergraduate medical students before, during, and after the COVID-19 outbreak. We focused on COVID-19 related mental burdens including psychological distress, stress reaction, and insomnia symptoms, and defined the sum score of the three specific mental burden indexes as the overall mental burden index. The prevalence of specific and overall mental burdens and their changing patterns at two phases of the pandemic (during vs. after the COVID-19 outbreak) were measured. In addition, multinomial logistic regressions were used to assess the associations between the psychosocial status before the pandemic and specific and overall mental burden changing patterns.ResultsOur findings showed that the prevalence of overall mental burden increased (from 27.46 to 37.28%) after the COVID-19 outbreak among the 863 Chinese undergraduate medical students who participated in the surveys at baseline, during, and after the COVID-19 outbreak. Specifically, the prevalence of stress reaction symptoms decreased (from 10.90 to 3.60%), while the rates of psychological distress (from 28.06 to 37.95%) and insomnia symptoms (from 12.54 to 20.71%) increased. Participants, with obsessive-compulsive symptoms, somatic symptoms, internet addiction, childhood adversity, stressful life events, and being neurotic were found to have a higher risk of developing mental burden in at least one survey (during or after the COVID-19 outbreak). Healthy family function and being extravert were found to positively impact mental burden.ConclusionPsychological distress, stress reaction and insomnia symptoms have been prevalent among Chinese undergraduate medical students during the COVID-19 outbreak, and the prevalence of overall mental burden increased after the COVID-19 outbreak. Some students, especially those with the risk factors noted above, exhibited persistent or progression symptoms. Continued mental health care was in demand for them even after the COVID-19 outbreak.

Impacts of PM2.5 before and after COVID-19 outbreak on emergency mental disorders: A population-based quasi-experimental and case-crossover study

Early warning COVID-19 outbreak in long-term care facilities using wastewater surveillance: correlation, prediction, and interaction with clinical and serological statuses

BackgroundMultiple psychological consequences of the COVID-19 outbreak and quarantine have been described. However, there is a lack of global conceptualization. We argue that the stressful aspects of the situation, the multiple environmental consequences of the outbreak, and the diversity of symptoms observed in such a situation, suggest that Adjustment disorder (AD) is a promising way to conceptualize the psychological consequences of the outbreak and quarantine. The first aim of the study was to validate the French version of the ADNM. The second aim was to set out adjustment difficulties resulting from COVID-19 outbreak and quarantine.MethodWe recruited 1010 (840 women, 170 men) who consented online to participate. They filled out the French ADNM, visual analogic scales, HADS, IES, and the COPE, to evaluate coping strategies.ResultsWe confirmed the factor structure of the ADNM and we found good psychometric properties. We found that 61.3% of participants presented an adjustment disorder related to COVID-19 outbreak. We found multiple risk factors and protective factors to AD due to quarantine and outbreak. We also identified the coping strategies negatively and positively associated with AD.ConclusionAdjustment disorder is a relevant concept to understand psychological manifestations caused by quarantine and outbreak. The French ANDM has good psychometric properties to evaluate such manifestations. The association between coping strategies and AD symptoms suggest that CBT may be the best intervention to help people suffering from AD.

Background: The full reopening of schools in September 2020 was associated with an increase in COVID-19 cases and outbreaks in educational settings across England. Methods: Primary and secondary schools reporting an outbreak (≥2 laboratory-confirmed cases within 14 days) to Public Health England (PHE) between 31 August and 18 October 2020 were contacted to complete an online questionnaire. Interpretation: There were 969 primary (n=450) and secondary school outbreaks (n=519) reported to PHE, representing 3% of primary schools and 15% of secondary schools in England. Of the 369 schools contacted, 190 geographically-representative schools completed the questionnaire; 2,425 cases were reported. Secondary school students (1.20%; 95%CI, 1.13-1.28%) had higher attack rates than primary school students (0.84%; 95%CI, 0.75-0.94%). Outbreaks were larger and across more year groups in secondary schools than in primary schools. When an outbreak occurred, attack rates were higher in staff (926/19,083; 4.85%; 95%CI, 4.55-5.17%) than students, especially among primary school teaching staff (9.81%; 95%CI, 8.90-10.82%) compared to secondary school teaching staff (3.97%; 95%CI, 3.79-5.69%). Staff represented 59% (471/799) of cases in primary school outbreaks and 27% (410/1515) in secondary schools (PConclusions: Secondary schools were more likely to be affected by a COVID-19 outbreak than primary schools and to experience larger outbreaks across multiple school years. The higher attack rate among teaching staff during an outbreak suggests that additional protective measures may be needed. Funding: PHE