Droplet Route Research Articles

Mumps in Poland in 2021.

Mumps is a contagious viral disease occurring mainly in children, the source of infection being the sick/infected person. Since 2003, vaccination against mumps has been mandatory in Poland, performed according to a two-dose schedule. As part of the Public Health Immunization Program (PSO), the MMR combination vaccine (against measles, mumps and rubella) is used for the entire population of children. The aim of this study was to evaluate epidemiological indicators of mumps in Poland in 2021 compared to previous years, taking into account the impact of the COVID-19 pandemic. The analysis of the epidemiological situation of mumps in Poland in 2021 was based on the interpretation of data from the bulletin , "Infectious diseases and poisonings in Poland in 2021" and , "Immunization in Poland in 2021". 484 cases of mumps were registered in Poland in 2021. The total incidence was 1.3 per 100,000 residents, which was lower than in 2020. The highest incidence of 1.8 per 100,000 residents was registered in Pomorskie Province, and the lowest incidence of 0.7 in Lower Silesia Province. The highest incidence (6.4/100 thousand) was recorded in children aged 0-4 and 5-9. The incidence rate for men (1.4/100,000) was higher than for women (1.1). In 2021, there were 9 patients hospitalized due to mumps, this was more than in 2020. The decrease in the number of cases of mumps in 2021 remained related to the ongoing pandemic - the restrictions introduced during the pandemic period led to a decrease in the number of cases not only of COVID-19, but also of other diseases spread by the droplet route, including mumps. The number of registered cases based on the reports of diagnosing physicians may be underestimating the actual number of cases due to the continued difficult access of patients to primary care physicians.

Clinical management and supervision of Influenza – systematic review

The main aim of the following study is to review current knowledge on Influenza.
 Influenza, also known as the flu, is an acute, infectious disease which attacks the respiratory system. The disease is caused by the influenza virus, of which there are 3 types. The most common is type A of influenza virus. It is transmitted between people by the droplet route, with cases occurring particularly frequently during seasonal epidemics. This is why the most important form of prevention is maintaining personal hygiene and isolation of sick people. Another form of prevention is a vaccine for the influenza virus developed with new variants every year. The flu causes a variety of symptoms from many systems but can also be asymptomatic. Diagnosis of the illness is based on clinical criteria and the results of diagnostic tests for which there are established criteria of legitimacy. Most common and sufficient curation for an illness is a symptomatic treatment but there is also a causal treatment for influenza. However certain conditions are required for its implementation. Influenza is usually a mild disease, but there are present cases of serious complications. Groups particularly exposed to severe and complicated courses of the disease are pregnant women, children and patients with multimorbidities. Currently, the co-occurrence of influenza with Covid-19 infection is particularly dangerous, which constitutes a new challenge for the global health care system.

Impact of respiratory aerosol size and number distribution on the relative importance of different routes in SARS-CoV-2 transmission.

Exploring the relative importance of different routes in SARS-CoV-2 transmission is crucial in infection prevention. However, even in the same environmental setting, the relative importance of different routes has varied in different studies. We hypothesize that respiratory aerosol size and number distribution might play a key role. In this study, size and number distribution of respiratory droplets emitted from breathing, talking, and coughing were identified from PubMed and Web of Science. The infection risk of SARS-CoV-2 via airborne, droplet, and fomite transmission routes was modeled in a household and a healthcare setting. The relative importance of three routes varied with different size distributions in both settings. Generally, the contribution of the airborne route increased with the volume percentage of respirable droplets emitted. And the increase of the total number of emitted droplets leads to an increase in the contribution of tdroplet route. In the healthcare setting, as the total number of emitted droplets increased from 110 to 4,973, the contribution of droplet route increased from 62.24% to 98.11%. Next, by considering the combination of breathing, coughing, and talking when the infected person was asymptomatic, the airborne route predominated over the droplet and contact routes. When the infected person had developed symptoms, that is, cough, the droplet route played a dominant role in SARS-CoV-2 transmission. In conclusion, risk analyses will be improved with improved sampling methods that enable characterization of viruses within respiratory droplets of different sizes.

International Travel-Related COVID-19 Infection and Outbreak from Wedding Ceremony: First Case in Turkey

SARS-CoV-2 virus is a new and highly contagious respiratory virus that transmission by droplet route. Here we reported international travel-related SARS CoV-2 transmission, and then cause an outbreak by the wedding ceremony. Two index passenger groups include three families who come from Paris to İstanbul to attend the wedding ceremony transmitted COVID-19 infection to Turkey. During the wedding ceremony and later period, they were in close contact with about 350 persons. Clinical pictures COVID-19 infection occurred in 53 relatives. PCR positivity was found in 35 hospitalized cases. The infection spread to four cities in Turkey. The most frequent symptoms of 35 confirmed cases were dizziness (77%), fever (57.1%), joint and muscle pain (57.1%), loss of smell (45.7%) and loss of taste (42.9%), and shore throat (37.1%), dry cough (34.3%), diarrhea (25.7%), rhinorrhea (14.3%) and dyspnea (8.5%). 48 cases (90.5%) were mild-moderate. Severe pneumonia was developed, intensive care and intubation need in five cases (9.4%), and four of them were died (7.5%). 
 COVID-19 virus can be easily acquired during plane travel and transmitted to other persons with unprotected contact. The infection prevention rules should be strictly applied for the protection from disease. Persons should avoid attend gatherings, even with their family or relatives, and should stay at home. The wedding and other social activities should be postponed after the pandemic.

CFD analysis of the air supply rate influence on the aerosol dispersion in a university lecture room

The airborne droplet route has been recognized as the main pathway of infection transmission in indoor environments, drawing the attention to a proper design of Heating, Ventilation and Air Conditioning (HVAC) systems. This is particularly relevant for gathering spaces such as schools and universities, due to the high crowding levels and the long exposure times. Using 3D Computational Fluid Dynamics (CFD) numerical simulations based on a Eulerian-Lagrangian approach and validated against velocity measurements, the present study investigates the distribution over time of airborne droplets (aerosol) emitted in correspondence of the teacher position inside a lecture room, during a 2-h speaking activity (so reproducing a 2-h lesson), as a function of different air supply rates from the HVAC system. As the aim of the paper is to provide useful information for proper design and operation of HVAC systems, the room has been assumed to be empty. Results show that increasing the air supply rate is not always an effective solution to reduce aerosol concentration in correspondence of the positions occupied by the students attending the lesson. In fact, for the specific case under investigation, the aerosol concentration around the classroom seats does not always decrease when increasing the supply rates, even though the overall number of particles in the room decreases. This behaviour is mainly due to the asymmetric disposition of the seats with respect to the diffusers and extraction grilles, and underlines the importance of CFD approaches in investigating the fluid dynamics in indoor environments.

A case report: Hypoxic ischemic encephalopathy & pneumonia in a neonate after SARS-CoV-2 intrauterine transmission.

Severe acute respiratory coronavirus 2 (SARS-CoV-2) is primarily transmitted via respiratory droplet or aerosol route. However, there is mounting evidence for intrauterine transmission. We report on a late preterm infant with suspected intrauterine acquisition of SARS-CoV-2 who experienced birth depression, hypoxic ischemic encephalopathy, multisystem organ involvement, and late onset COVID-19 pneumonia [22].

Increasing contributions of airborne route in SARS-CoV-2 omicron variant transmission compared with the ancestral strain

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant has become the dominant lineage worldwide. Experimental studies have shown that SARS-CoV-2 Omicron variant is more stable on various environmental surfaces than the ancestral strains of SARS-CoV-2. However, the influences on the role of the contact route in SARS-CoV-2 transmission are still unknown. In this study, we built a Markov chain model to simulate the transmission of the Omicron and ancestral strains of SARS-CoV-2 within a household over a 1-day period from multiple pathways; that is, airborne, droplet, and contact routes. We assumed that there were two adults and one child in the household, and that one of the adults was infected with SARS-CoV-2. We assumed two scenarios. (1) Asymptomatic/presymptomatic infection, and (2) symptomatic infection. During asymptomatic/presymptomatic infection, the contact route contributing the most (37%–45%), followed by the airborne (34%–38%) and droplet routes (21%–28%). During symptomatic infection, the droplet route was the dominant pathway (48%–71%), followed by the contact route (25%–42%), with the airborne route playing a negligible role (<10%). Compared to the ancestral strain, although the contribution of the contact route increased in Omicron variant transmission, the increase was slight, from 25%–41% to 30%–45%. With the growing concern about the increase in the proportion of asymptomatic/presymptomatic infection in Omicron strain transmissions, the airborne route, rather than the fomite route, should be of focus. Our findings suggest the importance of ventilation in the SARS-CoV-2 Omicron variant prevention in building environment.

A Self-generated Chemotaxis-inspired routing method for digital microfluidic cooling of hotspots in integrated circuits

Effective thermal management is of great significance for the reliability of the high-density-power electronics such as the three-dimensional integrated circuits (3DICs). Cooling method based on digital microfluidic (DMF) driven by electrowetting-on-dielectric (EWOD) has been regarded as a promising solution to the effective thermal management of 3DICs. Compared with other traditional cooling methods, DMF has advantages of lower power consumption and especially adaptive cooling ability which can achieve accurate cooling for hot spots inside the 3DICs. However, there are hardly any researches investigating into the droplet routing methods for DMF cooling systems. In this paper, we propose a droplet route optimization method inspired by the self-generated chemotaxis which aims to achieve real-time and parallel routing for multiple coolant droplets to search and cool hot spots. Based on the proposed thermal model of integrated circuit and DMF cooling system, various cooling cases have been simulated with different configurations (e.g., the cooling route and the inlet number). Numerical results show that the proposed self-generated chemotaxis-inspired algorithm (SCA) is capable of searching multiple hot spots based on the real-time temperature profiles and realizing multiple droplets routing simultaneously (i.e., parallel routing and cooling). Compared with traditional ant-colony-algorithm route and direct route, the SCA route provides the best temperature mitigation performance in appropriate inlet-configuration, and its cooling performance can be further improved as the inlet number increases.

SARS-CoV-2 Infection and Liver Involvement

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an enveloped, single-stranded RNA virus that can also be transmitted from person to person via the droplet (secretions shed when speaking, sneezing, or coughing) route, suspended droplet nuclei, and the mucous membranes of the eyes, nose, and mouth after touching a contaminated surface. It enters the cells through the angiotensin converting enzyme 2 (ACE- 2) receptor. Although non-specific respiratory symptoms such as fever, loss of smell/taste, runny nose, and cough are most common, SARS-CoV-2 can lead to a systemic and multiorgan involvement, including the gastrointestinal tract. The liver is the second most frequently involved organ after the lung. Gastrointestinal symptoms such as diarrhea, anorexia, nausea, vomiting, loss of appetite and abdominal pain are also common. Abnormal liver function enzyme levels may also be observed. The liver is affected by direct infection of hepatocytes, medical therapy of the management, or by indirect means if there is an underlying co-morbid disease. However, there are significant differences between studies in the reporting of gastrointestinal and liver symptoms. The most frequently reported gastrointestinal symptom in COVID-19 disease is diarrhea, reported in 1-36% of patients. In this review, it is aimed to review the current data on the effects of COVID-19 on the liver.

Environmental Factors and the Risk of Developing Type 1 Diabetes-Old Disease and New Data.

Simple SummaryDespite many studies, the risk factors of type 1 diabetes (T1DM) in children and adolescents are still not fully understood and remain a big challenge. Therefore, an extensive online search for scientific research on factors related to diabetes has been performed for the identification of new factors of unexplained etiology. A better understanding of the role of viral, bacterial, and yeast-like fungi infections related to the risk of T1DM in children and adolescents and the identification of new risk factors, especially those spread by the droplet route, is of great importance for people and families with diabetes.The incidence of type 1 diabetes (T1D) is increasing worldwide. The onset of T1D usually occurs in childhood and is caused by the selective destruction of insulin-producing pancreatic islet cells (β-cells) by autoreactive T cells, leading to insulin deficiency. Despite advanced research and enormous progress in medicine, the causes of T1D are still not fully understood. Therefore, an extensive online search for scientific research on environmental factors associated with diabetes and the identification of new factors of unexplained etiology has been carried out using the PubMed, Cochrane, and Embase databases. The search results were limited to the past 11 years of research and discovered 143 manuscripts published between 2011 and 2022. Additionally, 21 manuscripts from between 2000 and 2010 and 3 manuscripts from 1974 to 2000 were referenced for historical reference as the first studies showcasing a certain phenomenon or mechanism. More and more scientists are inclined to believe that environmental factors are responsible for the increased incidence of diabetes. Research results show that higher T1D incidence is associated with vitamin D deficiency, a colder climate, and pollution of the environment, as well as the influence of viral, bacterial, and yeast-like fungi infections. The key viral infections affecting the risk of developing T1DM are rubella virus, mumps virus, Coxsackie virus, cytomegalovirus, and enterovirus. Since 2020, i.e., from the beginning of the COVID-19 pandemic, more and more studies have been looking for a link between Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and diabetes development. A better understanding of the role of viral, bacterial, and yeast-like fungi infections related to the risk of T1DM in children and adolescents and the identification of new risk factors, especially those spread by the droplet route, is of great importance for people and families with diabetes.

Evaluating COVID-19-Environment Fit.

Spring came and went; the COVID-19 pandemic is still an inhabitant of the world, and its tendency to infect individuals is preserved in numbers; so, does the case fatality rate continues to increase. While a long list of facts provided by the clinical and medical sciences have remained unable to resolve the problem, recognizing environmental issues concerning COVID-19 resistance and adaptation might be a flash of lighting the nature of COVID-19 and its ideas of fitness. Here, we summarize the current state of the science of environment related to the causative pathogen of COVID-19, SARS-CoV-2, as follows. SARS-CoV-2 i. survives in water, ii. mainly spreads via the droplet route, and to a lesser extent, from touching contaminated surfaces, iii. transmission via droplets occurs within the interpersonal distance of two meters and beyond, iv. can more easily spread and cause more severe phenotypes of disease under higher-polluted, low-temperature, and low-humidity conditions, v. can spread under high-temperature conditions, and vi. transmission might be moderated by pollen-derived immune responses and lockdown-mediated air quality improvement. (www.actabiomedica.it)

COVID-19 immunizations in occupational medicine

This article discusses issues related to exposure to SARS-CoV-2 in the work environment and employee's vaccination against COVID-19. The new SARS-CoV-2 coronavirus identified as the etiologic agent of COVID-19 prompted the World Health Organization (WHO) to declare a pandemic in March 2020. The droplet route transmits the virus. Therefore, health care workers in contact with sick people and anyone employed in direct contact with large numbers of people are particularly vulnerable to infection. The introduction of COVID-19 vaccination removes the need for quarantine, reduces the risk of disease, limits transmission within the workplace, and reduces sickness absence. The role of the occupational health services is to promote vaccination against COVID-19 by providing reliable information on the safety and efficacy of immunization and organizing and carrying out vaccination in workplaces. Med Pr. 2021;72(6):701-10.

392. 3D-DOSS – Using Digital Twins and Spatiotemporal Data Mapping for Infectious Disease Surveillance and Outbreak Investigations

BackgroundThe COVID-19 pandemic has brought to light the importance of contact tracing in outbreak management. Digital technologies have been leveraged to enhance contact tracing in community settings. However, within complex hospital environments, where patient and staff movement and interpersonal interactions are central to care delivery, tools for contact tracing and cluster detection remain limited. We aimed to develop a system to promptly, identify contacts in infectious disease exposures and detect infectious disease clusters. MethodsWe prototyped a 3D mapping tool 3-Dimensional Disease Outbreak Surveillance System (3D-DOSS), to have a spatial representation of patients in the hospital inpatient locations. Based on the AutoCAD drawings, the hospital physical spaces are built within a game-development software to obtain accurate digital replicas. This concept borrows from the way gamers interact with the virtual world/space, to mimic the interactions in physical space, like the SIMS franchise. Clinical, laboratory and patient movement data is then integrated into the virtual map to develop syndromic and disease surveillance systems. Risk assignment to individuals exposed is through mathematical modeling based on distance coordinates, room type and ventilation parameters and whether the disease is transmitted via contact, droplet or airborne route. ResultsWe have mapped acute respiratory illness (ARI) data for the period September to December 2018. We identified an influenza cluster of 10 patients in November 2018. In a COVID-19 exposure involving a healthcare worker (HCW), we identified 44 primary and 162 secondary contacts who were then managed as per our standard exposure management protocols. MDRO outbreaks could also be mapped.ConclusionThrough early identification of at-risk contacts and detection of infectious disease clusters, the system can potentially facilitate interventions to prevent onward transmission. The system can also support security, environmental cleaning, bed assignment and other operational processes. Simulations of novel diseases outbreaks can enhance preparedness planning as health systems that had been better prepared have been more resilient in this current pandemic. Disclosures All Authors: No reported disclosures

Public awareness of contagious diseases

Introduction: Restrictions against the COVID-19 pandemic have resulted in a decrease in other contagious diseases. However, their prevention and treatment are still a topical issue.&#x0D; Purpose: To present the public awareness on infectious diseases taking into account the knowledge of people with medical education.&#x0D; Material and method: The study was conducted by means of the author's questionnaire. 158 questionnaires were collected and analysed.&#x0D; Results: Men and women of different age took part in the survey. Half of the respondents had medical education. The analysis showed that as many as 89.2% of the respondents were aware of the pathogenic factor of influenza, which is the virus. Only a small percentage of respondents had information regarding the number of influenza infections in Poland (10.8%) and worldwide (21.5%). Medics were aware of this in 10.0% and 28.8% respectively. Influenza was admitted by 81.0% of the respondents, while for other infectious disease (except COVID-19) the result was 75.3%. The respondents indicated as the most common route of transmission of infectious diseases the droplet route (66.5%), while fever was the typical symptom (81.0%). Washing hands turned out to be the most important prophylactic behaviour of respondents (50.6%) and especially of students (93.7%).&#x0D; Conclusions: Awareness of infectious diseases among Poles is not at the highest level. Those with medical education have slightly higher knowledge, but it is necessary to introduce educational programmes and update knowledge.

Safety of healthcare workers undertaking transport and retrieval of patients on extracorporeal membrane oxygenation during the peak of COVID-19 pandemic in the State of Qatar

Background: Transport and retrieval of patients on extracorporeal membrane oxygenation (ECMO) support can be hazardous to patients and healthcare workers (HCWs). COVID-19 is highly contagious and can be transmitted by contact, droplet, or airborne route. Transport of COVID-19 patients exposes HCWs and the public to infection risks, hence strict measures must be in place to ensure everyone's safety. ECMO cannulation and transportation is considered an aerosol generating procedure and can pose significant risks to HCWs. In addition, close contact with the patient in the confined space of the ambulance may put HCWs at increased risk of exposure and infection. Methods: Between March 1st and September 30th 2020, a total of 32 episodes of COVID-19 ECMO transport were undertaken by the Medical Intensive Care Unit (MICU) and Ambulance Service. We reviewed the incidence of COVID-19 infection among HCWs involved in these missions. The transport clinical team is composed of ECMO consultant, two ECMO nurses, a perfusionist and a Critical Care Paramedic (CCP). Due to staff shortage and clinical needs, a respiratory therapist did not attend to the majority of cases. A crew of two paramedics supports the clinical team with their intensive care ambulance. Results: The number of clinical staff involved in the COVID-19 ECMO transport during that period is shown in . The duration of clinical staff’s exposure to the infected patient in the back of the ambulance is demonstrated in . MICU staff underwent COVID-19 serology tests every 2 weeks as per local policy. None of the clinical staff involved in these transfers and retrievals of COVID-19 positive patients tested positive after 2 weeks of transport. Conclusion: Strict infection prevention and personal protective measures are mandatory to avoid cross-infection and were carefully adhered to during all the missions. They translated into the well-being of the clinical staff involved in the transfer and retrievals of COVID-19 positive patients.

The COVID-19 Pandemic and Face Shields: A Review

Abstract Introduction The coronavirus disease 2019 (COVID-19) pandemic has placed personal protective equipment (PPE) for health care workers (HCW) in the spotlight. HCW's face has been reported to be the body part most commonly contaminated by body fluids. The aim of this narrative review to examine the current evidence on face shield as a PPE for droplet or aerosol prevention. Methods A literature search was conducted on the PubMed, MedLine, and Embase databases, with the keywords "face shield", "visor", and "droplet precaution". Biblio graphic search was also under taken. Results Respiratory droplet is particle with diameter greater than 5 µm, while aerosol are ≤ 5 µm according to the World Health Organisation. However, infection is not neatly separated into the dichotomy of droplet versus air borne transmission route. Modelling and simulation have shown the importance of the conjunctival mucosa as a route of transmission of disease in blood splashes, droplets and aerosols containing virus. The limited reports from SARS, COVID-19 and influenza season supports its use. However, HCW do not routinely use face shield if they consider the procedures to be unlikely to be associated with potential contamination. They also erroneously believe that prescription glasses is adequate protection. The issues associated with eye shield use, may be less of a problem with face shield. Conclusion Transmission of viruses is multimodal, and the conjunctival mucosa presents a real risk for viral transmission. Eye and face protection is important to prevent transmission of COVID-19.

Managing pediatric otorhinolaryngology patients in coronavirus disease-19 pandemic – A real challenge to the clinicians

The novel coronavirus disease (COVID-19) pandemic is posing unprecedented challenges among the otolaryngologists during managing the pediatric patients. COVID-19 infection is caused by novel coronavirus called severe acute respiratory syndrome coronavirus-2. This infection is transmitted primarily through human contact and by droplet route. The pediatric otolaryngologists have a critical role for managing nose, paranasal sinus, ears, oral cavity, pharynx, and larynx, which are important sites for generating aerosols and virus transmission. Asymptomatic pediatric patients have high risk for viral shedding. In COVID-19 pandemic, the surgical procedure by pediatric otolaryngologists should be limited to the emergency condition. The surgical interventions should limit the viral dissemination. This review article provides an overview of common methods to limit the viral transmission to the otolaryngologists and assisting health-care staffs from COVID-19 infections during the management of the pediatric patients.

PERISCOPIC VIEW ON COVID 19 INFECTION: A REVIEW

Recently, the world has experienced an unprecedented health risk. The unknown coronavirus (SARS-CoV-2 causing COVID-19) is causing a pandemic infection as announced by World Health Organization. It emerged from Wuhan, China in December 2019 and spread worldwide. The SARS-CoV-2 originated in bats and through yet unknown intermediary animals was transmitted to humans in&nbsp;Wuhan. There have been around 3,935,559 reported cases of&nbsp;coronavirus&nbsp;disease 2019 (COVID-2019) and 271,170 reported deaths to date (08/05/2020). It spreads mainly through the droplet route by inhalation or contact. Incubation period 1-14 d. Asymptomatic or patients with mild symptoms is most common of the cases; case fatality nearly 2-3%). The major symptoms are fever, dry cough, fatigue and muscle pain; less common symptoms reported are runny nose, sore throat, diarrhea, chills and hemoptysis. The SARS-CoV-2 infection is a life-threatening complication of acute respiratory distress syndrome (ARDS); in severe cases with other co-morbidities, which most commonly occurs more often in elderly or immunocompromised individuals with underlying diseases. Severe expression of the infection needs treatment in the intensive care unit with indications of acute lung inflammation, ARDS, sepsis and septic shock. Diagnosis&nbsp;of virus in respiratory secretions is done by special molecular tests. This review presents information about history, etiology, pathogenesis, clinical diagnostics, treatment and prevention of the infection. At present, the effective antiviral drug or vaccine is not yet available and the number of infections/death tolls surging day by day, so updated knowledge of this infection is always needed prevention for fighting the virus.

SARS-CoV, MERS-CoV, SARS-CoV-2 Comparison of Three Emerging Coronaviruses

: In December 2019, in Wuhan, China began the outbreak of the new severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) epidemic. As a result of rapid spread, it turned into a pandemic announced by WHO on March 11, 2020. SARS-CoV-2 is an etiological factor of a new disease called COVID-19. The virus is transmitted mainly through the droplet route. In most cases, it causes mild symptoms such as fever, dry cough, weakness, and muscle pain; less common symptoms include sore throat, runny nose, diarrhea, and chills. However, among people with impaired immunity and comorbidities, as well as among older people, it leads to life-threatening complications in the form of acute respiratory distress syndrome (ARDS), sepsis, and septic shock. Moreover, SARS-CoV-2 is the third highly pathogenic in humans and easily spreading coronavirus after the virus of a severe acute respiratory syndrome (SARS) in 2002 - 2003 and virus of the Middle East respiratory syndrome (MERS) in 2012. This review summarizes current information on the emergence, origin, diversity, and common characteristics, as well as the epidemiology of the above three highly contagious coronaviruses.

Novel role of plastic wrap in COVID-19

The coronavirus disease 2019 pandemic is spreading across the world rapidly and poses unprecedented challenges to health care systems. It is transmitted primarily by the droplet route, although surface contact may play an important role as well.1 Although people are aware of universal mask wearing to reduce respiratory droplet transmission, contact transmission, particularly indirectly, is a danger that is often overlooked. There are some sources of nonnegligible routes for indirect contact in hospitals, such as keyboards and elevator buttons often used daily by frontline health care workers.