Coronavirus Disease 2019 Infection Rates Research Articles

Assessing community-level COVID-19 infection risk through three-generational household concentration in Nebraska, U.S.: An approach for COVID-19 prevention

The three-generational household was a focal point of concern for school and community the Coronavirus Disease 2019 (COVID-19) transmission. The current study, using small area data and household variables, reported an approach to neighborhood-level COVID-19 mitigation for school reopening and communities returning to normalcy. The study started with an age-stratified Poisson regression to examine the association between the proportion of three-generational households and COVID-19 infection rates based on data from 74 census tracts in Lancaster County, Nebraska, U.S. from March 5, 2020 to August 22, 2020, followed by mapping the model-based risk score by census tract in the study area. We explored the feasibility of using COVID-19 infection rates and vaccination rates to inform decision-making on school opening from March 5, 2020 to February 3, 2021. The overall infection rate increased by 3% for every unit increased in the percentage of three-generational households after controlling for other covariates in the model. The census tracts were classified into low-, medium-, and high-priority neighborhoods for potential community-based interventions, such as targeted messages for household hygiene and isolation strategies.

Ivermectin Prophylaxis Used for COVID-19: A Citywide, Prospective, Observational Study of 223,128 Subjects Using Propensity Score Matching.

Background: Ivermectin has demonstrated different mechanisms of action that potentially protect from both coronavirus disease 2019 (COVID-19) infection and COVID-19-related comorbidities. Based on the studies suggesting efficacy in prophylaxis combined with the known safety profile of ivermectin, a citywide prevention program using ivermectin for COVID-19 was implemented in Itajaí, a southern city in Brazil in the state of Santa Catarina. The objective of this study was to evaluate the impact of regular ivermectin use on subsequent COVID-19 infection and mortality rates.Materials and methods: We analyzed data from a prospective, observational study of the citywide COVID-19 prevention with ivermectin program, which was conducted between July 2020 and December 2020 in Itajaí, Brazil. Study design, institutional review board approval, and analysis of registry data occurred after completion of the program. The program consisted of inviting the entire population of Itajaí to a medical visit to enroll in the program and to compile baseline, personal, demographic, and medical information. In the absence of contraindications, ivermectin was offered as an optional treatment to be taken for two consecutive days every 15 days at a dose of 0.2 mg/kg/day. In cases where a participating citizen of Itajaí became ill with COVID-19, they were recommended not to use ivermectin or any other medication in early outpatient treatment. Clinical outcomes of infection, hospitalization, and death were automatically reported and entered into the registry in real time. Study analysis consisted of comparing ivermectin users with non-users using cohorts of infected patients propensity score-matched by age, sex, and comorbidities. COVID-19 infection and mortality rates were analyzed with and without the use of propensity score matching (PSM).Results: Of the 223,128 citizens of Itajaí considered for the study, a total of 159,561 subjects were included in the analysis: 113,845 (71.3%) regular ivermectin users and 45,716 (23.3%) non-users. Of these, 4,311 ivermectin users were infected, among which 4,197 were from the city of Itajaí (3.7% infection rate), and 3,034 non-users (from Itajaí) were infected (6.6% infection rate), with a 44% reduction in COVID-19 infection rate (risk ratio [RR], 0.56; 95% confidence interval (95% CI), 0.53-0.58; p < 0.0001). Using PSM, two cohorts of 3,034 subjects suffering from COVID-19 infection were compared. The regular use of ivermectin led to a 68% reduction in COVID-19 mortality (25 [0.8%] versus 79 [2.6%] among ivermectin non-users; RR, 0.32; 95% CI, 0.20-0.49; p < 0.0001). When adjusted for residual variables, reduction in mortality rate was 70% (RR, 0.30; 95% CI, 0.19-0.46; p < 0.0001). There was a 56% reduction in hospitalization rate (44 versus 99 hospitalizations among ivermectin users and non-users, respectively; RR, 0.44; 95% CI, 0.31-0.63; p < 0.0001). After adjustment for residual variables, reduction in hospitalization rate was 67% (RR, 0.33; 95% CI, 023-0.66; p < 0.0001).Conclusion: In this large PSM study, regular use of ivermectin as a prophylactic agent was associated with significantly reduced COVID-19 infection, hospitalization, and mortality rates.

SARS-CoV-2 vaccination in patients with inflammatory bowel disease: A systemic review and meta-analysis.

In the coronavirus disease 2019 (COVID-19) pandemic, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) vaccination has been effective in preventing COVID-19 infections and related mortality. The SARS-CoV-2 vaccination was also recommended by the international society for patients with inflammatory bowel disease (IBD). However, IBD patients were not recruited in prospective randomized clinical vaccine studies. To evaluate the efficacy and safety of SARS-CoV-2 vaccination in IBD patients, we conducted this systemic review and meta-analysis. We systematically searched PubMed, Medline, and the Cochrane Library for studies published between January 1, 2019, and September 9, 2021. Studies written in English reported the efficacy, seroconversion (anti-SARS-CoV-2 anti-spike (S) antibody titer beyond the threshold) rate, and adverse events after the SARS-CoV-2 vaccination in IBD patients. We extracted the author, date, study design, country, types of SARS-CoV-2 vaccination, number of IBD patients receiving SARS-CoV-2 vaccinations, and study outcomes. Published data from the enrolled studies were pooled to determine effect estimates. The study protocol was registered in PROSPERO (CRD42021264993). We analyzed findings from 27 454 IBD patients who received SARS-CoV-2 vaccinations in 11 studies that met the inclusion criteria. The post-SARS-CoV-2 vaccination COVID-19 infection rate was comparable between the IBD patients and non-IBD patients (odds ratio [OR], 1.28 [95% CI, 0.96-1.71]) and higher in nonvaccinated IBD patients compared with vaccinated IBD patients (OR, 8.63 [95% CI, 5.44-13.37]). The adverse event rate, severe adverse events, and mortality after the SARS-CoV-2 vaccination were 69%, 3%, and 0%, respectively. The SARS-CoV-2 vaccine is effective and tolerated in preventing COVID-19 infections in IBD patients. Over 98% of patients had seroconversion after receiving all doses of the SARS-CoV-2 vaccination, and the influence of biologics on vaccination was limited. The SARS-CoV-2 vaccination is recommended for IBD patients.

402. COVID-19 Infection in Nepal: Epidemiological Analysis from April 2020 to March 2021

BackgroundIn December 2019, SARS-CoV-2 or coronavirus disease 2019 (COVID-19) emerged from Wuhan, China. A global pandemic quickly unfolded, infecting >137 million people and causing >2.9 million deaths globally as of April 13, 2021. Before April 1, 2020, there were only five confirmed COVID-19 cases in Nepal. Like many countries around the world, the COVID-19 situation quickly escalated in Nepal. The purpose of this study was to determine the trends in COVID-19 cases and deaths in Nepal from April 2020 to March 2021.MethodsWe utilized epidemiological data from daily Situation Reports published by the Ministry of Health and Population (MOHP) of Nepal. Data were extracted or calculated from April 1, 2020 to March 31, 2021. Primary variables of interest were national and provincial daily cases, total cases, daily deaths, and total deaths.ResultsBetween April 1, 2020 to March 31, 2021, there were 277,304 cases. October 2020 had the highest monthly cases with 92,926 cases. During the one-year study period, the infection rate was 915 cases per 100,000 people. The largest single-day new cases was October 21, 2020 with 5,743 cases, which is calculated to 19 cases per 100,000 people. There were a total of 3,030 deaths. The largest daily new deaths was November 4, 2020 with 43 cases. June 10, 2020 had the highest number of people in quarantine with 172,266 people. October 23, 2020 had the highest number of active cases with 46,329 cases. By March 31, 2021, the percent of mortality was 1.1%, active infection was 0.5%, and recovery was 98.4%.ConclusionNepal had lower COVID-19 infection and case-fatality rates compared to other countries most affected by the pandemic. This was due to several factors, most notably early implementation of strict lockdown measures and closing of international borders on March 24, 2020 after the second confirmed COVID-19 case. As lockdown restrictions were lifted on July 7, 2020, COVID-19 cases and deaths in Nepal rose rapidly. As vaccination begun on January 27, 2021, cases started to slow down until the most recent outbreak coinciding with the second wave in its neighboring country, India. Now, infection and case-fatality rates in Nepal are at an all-time high, prompting further lockdowns on April 29, 2021.Disclosures All Authors: No reported disclosures

Low Incidence of COVID-19 Infection in Patients with Acute Myeloid Leukemia Undergoing Reduced Intensity/Venetoclax Based Treatment: Initial Results of the PACE Prospective Clinical Study from the UK Trials Acceleration Program

Low Incidence of COVID-19 Infection in Patients with Acute Myeloid Leukemia Undergoing Reduced Intensity/Venetoclax Based Treatment: Initial Results of the PACE Prospective Clinical Study from the UK Trials Acceleration Program

COVID-19 infection and hospitalization rate in Iranian multiple sclerosis patients: What we know by May 2021

Background: Despite investigations on the effect of disease modifying therapies (DMTs) used in multiple sclerosis (MS) on coronavirus disease 2019 (COVID-19); there are still controversies. Objective: We designed this study to evaluate the epidemiological features of covid-19 in a large sample of people with MS (pwMS) in Isfahan, Iran, as well as the association between DMTs, risk of COVID-19 infection and hospitalization. Methods: In an observational pwMS, we interviewed subjects on their MS and COVID-19 history. Results: 3050 subjects were included (74% female) with a mean age of 41.36. 423 (13.8%) had confirmed COVID-19 which shows that pwMS are at a higher risk of infection compared to the general population, No significant relationship was observed in COVID-19 infection when individual drugs. Dimethyl fumarate and rituximab had the lowest and the highest relative risks for hospitalization rate compared to other drugs, respectively. Conclusion: We found no evidence supporting a higher prevalence of COVID-19 in pwMS compared to the general population. However, our results show pwMS to be more prone to hospitalization compared to the general population, Therefore, it is advised to use safer treatment if possible until complete vaccination, and to postpone the use of rituximab.

How Iwate Prefecture in Japan maintained a low COVID-19 infection rate.

The first case of coronavirus disease 2019 (COVID-19) in Japan was confirmed on 16 January 2020. The first wave of cases peaked on 10 April 2020 (n = 710) and the second on 7 August 2020 (n = 1595). Iwate Prefecture in north-eastern Japan was the last prefecture to confirm a case of COVID-19, on 29 July 2020, 110 days after all other prefectures had confirmed cases. No cases were reported during the first wave.1 As of 21 September 2021, there had been 3469 cases (282.8/100 000 population) and 52 deaths (1.50% fatality rate) in Iwate and 1.7 million cases (1333.2/100 000 population) and 17 294 deaths (1.03% fatality rate) in Japan overall. This article discusses possible reasons for the low number of COVID-19 cases in Iwate.

Breakthrough infection after Covishield COVID-19 vaccine among health care workers at Patan Academy of Health Sciences, Nepal

Introduction: Coronavirus Disease 2019 (COVID-19) vaccines have an important role in the control and prevention of the pandemic. However, infection after vaccination, though uncommon, has been reported after partial or complete immunization. This study aims to find out vaccine breakthrough infection after the Covishield COVID-19 vaccine.&#x0D; Method: This cross-sectional survey was conducted among the health care workers (HCWs) from May 2021 to July 2021 at Patan Hospital, Patan Academy of Health Sciences, Nepal who received the Covishield vaccine. The data were collected using Google form and a printed questionnaire on COVID 19 breakthrough infection ≥2w after vaccination. The rate of breakthrough infection, hospitalization, and its association with age, gender, and working departments of HCWs was analyzed using SPSS. Ethical approval was obtained.&#x0D; Result: Out of 1462 HCWs approached, 880 completed the survey, among which 819 (93.1%) had a completed vaccination status. Infection after the first and before the second dose was 164 (18.7% of 880) and after two doses 131 (16%). The breakthrough infection occurred in 83 (10.1% of 819). There was no statistically significant association of breakthrough infection with age, gender, and working department of HCWs. Total 74 (8.4%) were managed by admission in hospital.&#x0D; Conclusion: The findings of this study reveal a low breakthrough infection rate after Covishield vaccination among HCWs at Patan Academy of Health Sciences, Kathmandu, Nepal. Overall, COVID-19 infection rates decreased after the first and second dose of the vaccine.

Sociocultural behavioral traits in modelling the prediction of COVID-19 infection rates

PurposeOver the past decades, many health authorities and public policy experts have traditionally relied on indicators that are dependent on a nation's economy, its health-care infrastructure advancements, and superiority in biomedical sciences and technology to predict potential infection rates should a health pandemic occur. One such commonly relied-upon indicator was that of the Global Health Security (GHS) Index. However, the coronavirus disease 2019 (COVID-19) pandemic has shown how such variables prove to be inaccurate in predicting the infection rates during a global health pandemic. Hence, this paper proposes the utilization of socio-cultural behavioral traits to predict a country's COVID-19 infection rates.Design/methodology/approachThis is achieved by proposing a model involving the classification and regression tree (CART) algorithm and a Poisson regression against the six selected cultural behavioral predictors consisting of individualism, power distance, masculinity, uncertainty avoidance, long-term orientation, and indulgence.FindingsThe results show that all the selected cultural behavioral predictors are significant in impacting COVID-19 infection rates. Furthermore, the model outperforms the conventional GHS Index model based on a means squared error comparison.Research limitations/implicationsThe authors hope that this study would continue promoting the use of cultures and behaviors in modeling the spread of health diseases.Practical implicationsThe authors hope that their works could prove beneficial to public office holders, as well as health experts working in health facilities, in better predicting potential outcomes during a health pandemic, thus allowing them to plan and allocate resources efficiently.Originality/valueThe results are a testament to the fact that sociocultural behavioral traits are more reliant predictors in modeling cross-national infection rates of global health pandemics, like that of COVID-19, as compared to economic-centric indicators.

Does diabetes mellitus mitigate the gender gap in COVID-19 mortality?

In this SARS-COV2-pandemic, diabetes mellitus (DM) soon emerged as one of the most prominent risk factors for a severe course of corona virus disease-2019 (COVID-19) and increased mortality due to hyperglycemia/insulin resistance, obesity, inflammation, altered immune status, and cardiovascular complications. In general, men are at a higher risk of severe or fatal COVID-19 disease irrespective of age, region and despite comparable infection rates in both sexes. In COVID-19, there is also a male predominance among hospitalized patients with diabetes, however, overall, data among patients with diabetes are ambiguous so far. Of note, similar to cardiovascular complications, women with type 2 diabetes (DM2) appear to lose their biological female advantage resulting in comparable death rates to those of men. The complex interplay of biological and behavioral factors, which may put men at greater risk of a severe or fatal course of COVID-19, and gender-related psychosocial factors, which may cause disadvantage to women concerning the infection rates, might explain why sex-disaggregated data among infected patients with diabetes are conflicting. Better knowledge on biological factors leading to functionally different immune responses and of gender-sensitive sociocultural determinants of COVID-19 infection rates may help to optimize prevention and management in the high-risk groups of men and women with diabetes.

A RANDOMIZED CONTROL STUDY TO EVALUATE THE ROLE OF HERBAL IMMUNOMODULATORS IN BOOSTING THE IMMUNITY AND OVERALL HEALTH OF HEALTHCARE WORKERS IN COVID-19 WARDS: AN EXPLORATORY, FEEDBACK CLINICAL STUDY

Objective: The objective of the study was to evaluate the role of the herbal immunomodulators Immusante and Guduchi in boosting the immunity and overall health of healthcare workers assigned to coronavirus disease 2019 (COVID-19) wards. Methods: An open-label, randomized, prospective, and single center clinical study was conducted among 100 healthcare workers assigned to COVID-19 wards. Eligible subjects (50 in each arm) were randomly assigned to either arm I (Immusante+Guduchi tablets) or arm II (treatment as per the institutional policy). Assessments after 30 days of treatment included respiratory symptoms, Adapted Immune Status Questionnaire (ISQ), improvement in quality of life (Short form 12 [SF-12] Health Survey), and safety and tolerability. Results: All 100 subjects completed the study as per the protocol. There were no respiratory symptoms in the subjects in arm 1. However, four subjects (8%) in arm II reported cough during the study period. A better Immune status improvement was seen through the adapted ISQ in arm I as compared to arm II. In each of the 8 SF-12 Health Survey domains, a statistically significant difference was observed in arm I compared to arm II. A retrospective assessment of COVID-19 infection showed only 8% of subjects as COVID-19 positive in arm I compared with 26% of subjects in arm II. Conclusion: Considering the positive trend observed in this study in terms of ISQ, SF-12, and COVID-19 infection rates, the combination of Immusante and Guduchi in healthcare workers at a high risk of contracting COVID-19 infection had a beneficial effect in boosting immunity and overall health.

Stroke Care During the First and the Second Waves of the COVID-19 Pandemic in a Community Hospital.

Objective: The coronavirus disease 2019 (COVID-19) infection may alter a stroke course; thus, we compared stroke course during subsequent pandemic waves in a stroke unit (SU) from a hospital located in a rural area.Methods: A retrospective study included all patients consecutively admitted to the SU between March 15 and May 31, 2020 (“first wave”), and between September 15 and November 30, 2020 (“second wave”). We compared demographic and clinical data, treatments, and outcomes of patients between the first and the second waves of the pandemic and between subjects with and without COVID-19.Results: During the “first wave,” 1.4% of 71 patients were hospitalized due to stroke/TIA, and 41.8% of 91 during the “second wave” were infected with SARS-CoV-2 (p < 0.001). During the “second wave,” more SU staff members were infected with COVID-19 than during the “first wave” (45.6 vs. 8.7%, p < 0.001). Nevertheless, more patients underwent intravenous thrombolysis (26.4 vs. 9.9%, p < 0.008) and endovascular thrombectomy (5.3 vs. 0.0%, p < 0.001) during the second than the first wave. Large vessel occlusion (LVO) (OR 8.74; 95% CI 1.60–47.82; p = 0.012) and higher 30-day mortality (OR 6.01; 95% CI 1.04–34.78; p = 0.045) were associated with patients infected with COVID-19. No differences regarding proportions between ischemic and hemorrhagic strokes and TIAs between both waves or subgroups with and without COVID-19 existed.Conclusion: Despite the greater COVID-19 infection rate among both SU patients and staff during the “second wave” of the pandemic, a higher percentage of reperfusion procedures has been performed then. COVID-19 infection was associated with a higher rate of the LVO and 30-day mortality.

Risk of COVID-19 Disease, Dialysis Unit Attributes, and Infection Control Strategy among London In-Center Hemodialysis Patients.

Patients receiving in-center hemodialysis treatment face unique challenges during the coronavirus disease 2019 (COVID-19) pandemic, specifically the need to attend for treatment that prevents self-isolation. Dialysis unit attributes and isolation strategies that might reduce dialysis center COVID-19 infection rates have not been previously examined. We explored the role of variables, including community disease burden, dialysis unit attributes (size and layout), and infection control strategies, on rates of COVID-19 among patients receiving in-center hemodialysis in London, United Kingdom, between March 2, 2020 and May 31, 2020. The two outcomes were defined as (1) a positive test for infection or admission with suspected COVID-19 and (2) admission to the hospital with suspected infection. Associations were examined using a discrete time multilevel time-to-event analysis. Data on 5755 patients dialyzing in 51 units were analyzed; 990 (17%) tested positive and 465 (8%) were admitted with suspected COVID-19 between March 2 and May 31, 2020. Outcomes were associated with age, diabetes, local community COVID-19 rates, and dialysis unit size. A greater number of available side rooms and the introduction of mask policies for asymptomatic patients were inversely associated with outcomes. No association was seen with sex, ethnicity, or deprivation indices, nor with any of the different isolation strategies. Rates of COVID-19 in the in-center hemodialysis population relate to individual factors, underlying community transmission, unit size, and layout.

COVID-19: a pandemic converged with global tobacco epidemic and widespread vaping—state of the evidence

This review highlights the convergence of three global health challenges at a crossroad where the pandemic of coronavirus disease 2019 (COVID-19) meets the tobacco epidemic and vaping. It begins with an overview of the current knowledge on the biology, pathophysiology and epidemiology of COVID-19. It then presents the state of smoking and vaping during the pandemic by summarizing the published data on prevalence, use patterns, product availability/accessibility, sales records and motivation to quit before and after the start of the pandemic. It highlights the state of evidence on the association of tobacco product use with COVID-19 infection and transmission rates, symptom severity and clinical outcomes. Also discussed are proposed biological mechanisms and behavioral factors that may modulate COVID-19 risk in tobacco product users. Furthermore, competing hypotheses on the protective effect of nicotine against COVID-19 as well as the claimed ‘smokers’ paradox’ are discussed. Considerations and challenges of COVID-19 vaccination in tobacco product users are underscored. Collectively, the present data show an ‘incomplete’ but rapidly shaping picture on the association of tobacco product use and COVID-19 infection, disease course and clinical outcomes. Evidence is also growing on the mechanisms by which tobacco product use may contribute to COVID-19 pathophysiology. Although we await definitive conclusions on the relative risk of COVID-19 infection in tobacco product users, compelling data confirm that many comorbidities associated with/caused by smoking predispose to COVID-19 infection, severe disease and poor prognosis. Additionally, it is becoming increasing clear that should smokers get the disease, they are more likely to have serious health consequences.

Trends in the distribution of COVID-19 deaths by age and race/ethnicity — United States, April 4–December 26, 2020

The coronavirus disease 2019 (COVID-19) pandemic has disproportionately affected racial and ethnic minority groups [1–5]. COVID-19 infection and mortality rates are higher among Hispanic/Latino, non-Hispanic Black, and non-Hispanic American Indian or Alaska Native (AI/AN) populations than non-Hispanic White populations [5]. Although most U.S. COVID-19 deaths have occurred among adults aged ≥65 years, younger persons represent a larger percentage of COVID-19 deaths in Hispanic/Latino, non-Hispanic Black, and non-Hispanic AI/AN populations [1]. These racial/ethnic groups also have younger age distributions across the population generally [3], and face increased risk of COVID-19 infection and related morbidity and mortality as a result of many different factors such as the degree of occupational exposure, housing or residential risk factors, the prevalence of preexisting health conditions, reduced access to care, and structural racism [1], [2], [3], [4]. The proportion of deaths by age and race/ethnicity has changed over the course of the pandemic, with a recent report demonstrating growing percentages among the Hispanic population from May through August 2020 [5]. However, that report did not examine changes in the distribution of COVID-19 deaths by race/ethnicity across age groups (or vice versa) over the course of the pandemic in 2020. Moreover, it is unknown how patterns by age and race/ethnicity may have changed more recently, over the most recent wave of the pandemic occurring at the end of 2020. To examine this, we describe weekly trends in COVID-19 deaths by age and race/ethnicity from April through December 26, 2020.

The Impact of Nutrition on the COVID-19 Pandemic and the Impact of the COVID-19 Pandemic on Nutrition.

The coronavirus disease 2019 (COVID-19) pandemic has had significant morbidity, mortality, social and financial implications for the global population. Despite this knowledge, we still know very little about how COVID-19 infection affects quality of life resulting from changes in nutritional behaviour and, conversely, how nutrition could modulate the epidemiology of COVID-19. In addition, the social isolation most have experienced due to the regulations imposed by governments during the COVID-19 pandemic may have also had effects on our nutritional behaviour. It is possible that nutritional interventions may have effects on the incidence of COVID-19 infection and mortality rates. The purpose of this review is to evaluate the current status of research on the topic of nutrition as it relates to the COVID-19 pandemic.

A prospective clinical evaluation of a patient isolation hood during the COVID-19 pandemic

BackgroundHealthcare workers (HCWs) have frequently become infected with severe acute respiratory syndrome coronavirus 2 whilst treating patients with coronavirus disease 2019 (COVID-19). A variety of novel devices have been proposed to reduce COVID-19 cross-contamination. ObjectivesThe aim of the study was (i) to test whether patients and HCWs thought that a novel patient isolation hood was safe and comfortable and (ii) to obtain COVID-19 infection data of hospital HCWs. MethodsThis is a prospective cohort study of 20 patients, entailing HCW/patient questionnaires and safety aspects of prototype isolation hoods. COVID-19 data of HCWs were prospectively collected. Assessment of the hood's safety and practicality and adverse event reporting was carried out. Outcome measuresThe outcome measures are as follows: questionnaire responses, adverse event reporting, rates of infections in HCWs during the study period (20/6/2020 to 21/7/2020), and COVID-19 infections in HCWs reported until the last recorded diagnosis of COVID-19 in HCWs (20/6/2020 to 27/9/2020). ResultsOf the 64 eligible individual HCW surveys, 60 surveys were overall favourable (>75% questions answered in favour of the isolation hood). HCWs were unanimous in perceiving the hood as safe (60/60), preferring its use (56/56), and understanding its potential COVID-19 cross-contamination minimisation (60/60). All eight patients who completed the questionnaire thought the isolation hood helped prevent COVID-19 cross infection and was safe and comfortable. There were no reported patient safety adverse events. The COVID-19 attack rate from 20/6/2020 to 27/9/2020 among registered nurses was as follows: intensive care units (ICUs), 2.2% (3/138); geriatric wards, 13.2% (26/197); and COVID-19 wards, 18.3% (32/175). The COVID-19 attack rate among medical staff was as follows: junior staff, 2.1% (24/932); senior staff, 0.7% (4/607); aged care/rehabilitation, 6.7% (2/30); and all ICU medical staff, 8.6% (3/35). ConclusionsThe isolation hood was preferred to standard care by HCWs and well tolerated by patients, and after the study, isolation hoods became part of standard ICU therapy. There was an association between being an ICU nurse and a low COVID-19 infection rate (no causality implied). ICU HCWs feel safer when treating patients with COVID-19 using an isolation hood.

Studying the social determinants of COVID-19 in a data vacuum.

Race‐based and other demographic information on COVID‐19 patients is not being collected consistently across provinces in Canada. Therefore, whether the burden of COVID‐19 is falling disproportionately on the shoulders of particular demographic groups is relatively unknown. In this article, we first provide an overview of the available geographic and demographic data related to COVID‐19. We then make creative use of these existing data to fill the vacuum and identify key demographic risk factors for COVID‐19 across Canada's health regions. Drawing on COVID‐19 counts and tabular census data, we examine the association between communities’ demographic composition and the number of COVID‐19 infections. COVID‐19 infections are higher in communities with larger shares of Black and low‐income residents. Our approach offers a way for researchers and policymakers to use existing data to identify communities nationwide that are vulnerable to the pandemic in the absence of more detailed demographic and more granular geographic data.

Are countries’ precautionary actions against COVID-19 effective? An assessment study of 175 countries worldwide

BackgroundThe coronavirus disease 2019 (COVID-19) pandemic has affected many countries negatively, particularly in terms of their health care and financial systems. Numerous countries have attempted to employ precautions to address this pandemic. This study was aimed at exploring and assessing the early precautionary actions taken by 175 countries on six continents to prevent the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). MethodsAn observational study utilizing available public data was conducted on the basis of data collected from December 31, 2019 until the end of April 2020 and then compared with data in January 2021. Several data were extracted, including information related to the date of the first reported case of SARS-CoV-2, total confirmed cases, total active cases and more. In addition, seven validated indicators were used to assess the countries’ preparedness and precautionary actions. ResultsA total of 175 countries were included in the study. The total COVID-19 infection rate increased exponentially and rapidly in North America and Europe from March to April. The application of precautions (indicators) varied between countries. School closures, quarantines and curfews were the most-applied indicators among all countries. As for the relationship between the indicators and their effects on the infection rate, Italy and Spain were the top countries in Europe and adopted all the indicators. Nevertheless, they faced high infection rates: 239,639 and 205,463 COVID-19 cases in Spain and Italy, respectively. ConclusionThe precautionary actions might have played a role in limiting the spread of COVID-19 in several countries. However, many countries might not benefit from applying these indicators.

Annual influenza vaccination effect on the susceptibility to COVID-19 infection.

We aimed to study the effect of seasonal influenza (flu) vaccination on the susceptibility to coronavirus disease 2019 (COVID-19). A total of 203 healthcare workers of a pandemic centre of Istanbul, Turkey, were included in this retrospective study. According to the presence or absence of flu vaccination, participants were divided into group 1 and group 2. A comparison of the rate of COVID-19 was done between these two groups. Also, the mean age and the sex ratio of females/males were evaluated and compared between these two groups. Group 1 participants (n = 65) were older than participants in group 2 (n = 138) (p < 0.05). Despite of this, interestingly, the COVID-19 infection rate was lower in the 1st group (in comparison to the 2nd group) (p < 0.05). Our study results showed that, even if low, the flu vaccination may have a protective effect on the susceptibility to COVID-19 infection. Using this beneficial adjuvant effect of the vaccine may help us in this unpredictable battle with the COVID-19 pandemic. Further studies are needed to confirm this assumption.