Index Case Of COVID-19 Research Articles

Snapshot of Anti-SARS-CoV-2 IgG Antibodies in COVID-19 Recovered Patients in Guinea.

Background: Because the regular vaccine campaign started in Guinea one year after the COVID-19 index case, the profile of naturally acquired immunity following primary SARS-CoV-2 infection needs to be deepened. Methods: Blood samples were collected once from 200 patients (90% of African extraction) who were recovered from COVID-19 for at least ~2.4 months (72 days), and their sera were tested for IgG antibodies to SARS-CoV-2 using an in-house ELISA assay against the Receptor Binding Domain (RBD) of the SARS-CoV-2 spike1 protein (RBD/S1-IH kit). Results: Results revealed that 73% of sera (146/200) were positive for IgG to SARS-CoV-2 with an Optical Density (OD) ranging from 0.13 to 1.19 and a median value of 0.56 (IC95: 0.51-0.61). The median OD value at 3 months (1.040) suddenly decreased thereafter and remained stable around OD 0.5 until 15 months post-infection. The OD median value was slightly higher in males compared to females (0.62 vs. 0.49), but the difference was not statistically significant (p-value: 0.073). In contrast, the OD median value was significantly higher among the 60-100 age group (0.87) compared to other groups, with a noteworthy odds ratio compared to the 0-20 age group (OR: 9.69, p-value: 0.044*). Results from the RBD/S1-IH ELISA kit demonstrated superior concordance with the whole spike1 protein ELISA commercial kit compared to a nucleoprotein ELISA commercial kit. Furthermore, anti-spike1 protein ELISAs (whole spike1 and RBD/S1) revealed higher seropositivity rates. Conclusions: These findings underscore the necessity for additional insights into naturally acquired immunity against COVID-19 and emphasize the relevance of specific ELISA kits for accurate seropositivity rates.

Rekindling Tradition in a Pandemic: A Qualitative Study of the Use of Traditional Herbal Mixtures Among High-Risk Groups During the Early Outbreak of COVID-19 in the South-South Region of Nigeria

On 27 February 2020, Nigeria reported its COVID-19 index case from Italy. The first 30 days saw the recording of 81 cases. In the first 60 days, this number rose to 1 337 for people over 50 and with serious underlying medical illnesses that were made worse by the COVID-19 infection. In this study, we investigated the use of traditional herbal mixtures by older people and people with chronic medical conditions in the prevention, management and control of COVID-19 in the South-South region of Nigeria, with Bayelsa State as a case study. Using purposive and snowball sampling techniques, we sampled and interviewed 21 participants, with interviews taking place at the health centres and the homes of older persons. The data were analysed thematically using content analysis with the aid of an Atlas.ti. The findings indicate that the majority of the participants used at least one traditional herbal mixture to prevent COVID-19 infection, and that the fear of contracting COVID-19 was the major factor for its use during the pandemic. The most commonly used herbal mixtures during the COVID-19 pandemic were a combination of “dogoyaro”, lime fruit and leaves, lemon, ginger, garlic, mango leaves and bark, pawpaw leaf and seed, soursop leaf, bitter leaf, scent leaf, lemongrass and moringa leaf. We concluded that older persons and people with underlying health conditions in particular relied on traditional herbal mixtures in the management and prevention of COVID-19 during the early outbreak of the pandemic in Nigeria.

STATISTICAL MODELLING OF COVID-19 CASES IN NIGERIA WITH A NEGATIVE BINOMIAL AUTOREGRESSIVE MODEL

Coronavirus disease (COVID-19) is a deadly global pandemic caused by a virus of the family coronaviridae. It is an infectious disease which affects respiratory systems and causes people to experience mild to moderate symptoms and sometimes severe cases of the disease which usually resulted into death especially among those patients with other comorbidity conditions and elderly with immunosenescence effects. Nigeria registered its index case of COVID-19 on 27th February 2020. Subsequently, the number of reported cases were on increasing trend. Numerous studies on modelling the sporadic increase cases or spread of SARS-COV-2 using different methodologies were documented in literature. However, issues relating to over-dispersed problem and the presence of autocorrelation were not well handled in such methods. In this present study, the modelling of the spread of SARS-CoV-2 in Nigeria was done using a Negative Binomial Autoregressive model. Study data were collected on a daily basis from the update released by the Nigeria Centre for Disease Control from 1st April, 2020 to 29th May, 2021. The results showed that the number of confirmed SARS-CoV-2 cases increased comparatively between April-2020 to June-2020. However, the number of reported cases dropped steadily between July-2020 to Nov-2020. The data were over-dispersed and the presence of autocorrelation was observed. The results revealed that among the four NBAR estimated candidate models, NBAR (1) returned the lowest Akaike Information Criterion. Thus, NBAR (1) is the most parsimonious NBAR model for the data. Therefore, NBAR (1) can be used in predicting daily cases of SARS-CoV-2 in Nigeria

Community engagement; the master key to preventing Nigeria’s obvious pandemic fatigue and the next COVID-19 wave

The index case of COVID-19 in Nigeria was in February 2020. The pandemic has resulted in severe social, economic, and public health challenge in Nigeria. Nigeria has experienced pandemic fatigue (PF) characterized by its low testing capacity, poor public adherence to COVID-19 preventive measures, and the urge to return to normal. This viewpoint examines Nigeria’s obvious PF amongst Nigerians and believed that community engagement would be a master key to reducing Nigeria’s PF and preventing another wave of the pandemic in Nigeria. Community engagement (CE) is a viable way for monitoring the spread of the SARS-CoV-2. CE is cost-effective, improves the chances of people voluntarily presenting themselves for COVID-19 testing at the grass-root level, and could halt the spread of COVID-19 in Nigeria especially with the detection of the delta and omicron variants in Nigeria.

P071 A case series of rheumatic disease patients diagnosed with COVID-19 Feb 2020 to March 2021 at the hospital that reported London’s index case of COVID-19

Background/AimsThe aim of this study is to describe demographics features and outcomes of patients with rheumatic diseases diagnosed with COVID-19 in a single hospital.MethodsPatients with rheumatic diseases and COVID-19 were identified via rheumatology outpatient and inpatient hospital admissions between February 2020 and March 2021. Data was collected retrospectively using the electronic medical records system and in-person and telephone consultations. The data was entered into the COVID-19 Global Rheumatology Alliance (GRA) Registry. Data collected included age, gender, ethnicity, smoker status, rheumatic disease, co-morbidities, drug history and vaccine status. Patient outcome was recorded as mortality, recovered (including days to recovery) or symptoms persisting over 90 days (>90). Requirement for hospital admission was also recorded. Comparison was made to the published GRA Registry data.ResultsForty-three patients were identified; 33 Female (77%),10 (23%) male. Median age 52. 22 Caucasian, 12 Black, 3 mixed race, 2 Asian, 2 Hispanic and 5 unknown. Rheumatoid arthritis (14 patients; 33%) was the most common disease. Other diagnoses included psoriatic arthritis (6; 14%), systemic lupus erythematosus (4: 9%), Sjogrens syndrome (4: 9%) and ankylosing spondylitis (4; 9%). The most common disease modifying antirheumatic drug (DMARD) was methotrexate (35%) followed by hydroxychloroquine (33%). Eight patients were taking steroids (19%). Factors associated with hospitalisation were older age (57% age ≥ 52 vs 40% < 52), multiple co-morbidities (71% ≥ 2 co-morbidities vs 35% < 2 co-morbidities) and black ethnicity (75% black vs 26% of caucasian). These risk factors for morbidity are similar to the UK background population and published COVID-19 GRA data. There was no increased risk of hospitalisation between different DMARDs (53% on methotrexate required admission vs 50% on hydroxychloroquine). 71% of patients on steroids required admission. The overall study cohort had a 49% hospital admission rate. Similar risk factors were identified for persistence of symptoms > 90; 27% of black patients vs 5% of caucasian and 24% of patients with > 2 co-morbidities vs 10% of patients with < 2 co-morbidities. Age did not follow the same trend as hospitalisation; 10% of patients age ≥ 52 vs 20% of patients < 52 had symptoms > 90. 15% on methotrexate had a recovery time > 90 vs 7% on hydroxychloroquine and 14% on steroids. The overall cohort had a 17% rate of patients having symptoms > 90. Mortality rate within the cohort was 5% (2 patients).ConclusionA case-series of 43 patients with rheumatic diseases and COVID-19 was conducted. The risk factors for hospitalisation, mortality and persistence >90 were similar to other studies. Most significantly the findings show a correlation between black ethnicity and increased risk of all mortality, hospitalisation and symptoms > 90. There was no difference in hospitalisation and different DMARDs.Disclosure J. Pilcher: None. G. Yanni: None. P. Lutalo: None. L. Pollard: None.

The Index Case of Covid-19 in Delta State, Nigeria: A Case Report

Background: Coronavirus disease (COVID-19) is a fatal respiratory infection that has spread rapidly around the world since it was first discovered in China in late 2019. Several management options and experiences have been observed across health systems globally including Nigeria. We report the progression and evolving clinical scenario of the first case of COVID-19 in Delta State, Nigeria.Methods: We reviewed the hospital admission case record of the first case of COVID- 19 in a 50-year-old male managed at the isolation centre of the Delta State University Teaching Hospital, Oghara, Delta State. All relevant information about the patient’s clinical characteristics, investigations, treatment and outcome were obtained and documented.Results: The patient was positive for COVID-19 and was placed on a wide-range of medications and supportive therapy. No baseline laboratory investigations were done throughout the period due to lack of a designated infectious disease laboratory to provide services at the time. Patient’s overall wellbeing was based on physical assessment and monitoring of vital signs: temperature, pulse rate, respiratory rate, blood pressure and oxygen saturation (SPO2). Although he became symptom-free by the 12th day of admission, the laboratory report was persistently positive for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV-2) until the 35th day of admission when he became negative.Conclusion: This report showed that the patient had complete resolution of clinical symptoms without concomitant viral clearance. Also, intensive supportive care contributed to a favourable outcome in this patient. The need for improved surveillance and response systems to ensure better patient outcome is recommended.&#x0D; Keywords: COVID-19; Case Report; Index Case; Coronavirus; Delta State

Early phase of COVID-19 epidemic in Albania

PurposeThe index case of COVID-19 was diagnosed on March 8th with symptoms onset identified on March 6th, with a travel history within Italy. During the first month the number of identified imported cases was 25. The first 291 laboratory-confirmed cases of the COVID -19 outbreak are used to characterize the epidemiological pattern and estimate the epidemiological parameters such as serial interval, basic and effective reproduction numbers and to evaluate the effectiveness of first timely disease spread containment measures.Methods & MaterialsEpidemiological data were collected through case-based disease COVID -19 surveillance, outbreak investigation and contact tracing data for every confirmed case comprising information on demographics, travel history, date of symptom onset, clinical symptoms, laboratory results, hospitalization, and contacts details. Estimates of the reproduction number and serial interval were performed in R statistical software using R packages developed by the R Epidemics Consortium.ResultsPublic health authorities were able to identify and trace an average of 10 close contacts per for every positive case. The number of transmission events reported per infector ranges from 1 to 16, with 30% having two secondary cases per infector. The median value of every positive case was with 2 secondary infected cases (mean 3.3, standard deviation 3.2). Based on 43 pairs of primary infectors and secondary cases the mean serial interval was estimated 4.8 days (standard deviation 3.9). The basic reproduction number has been estimated at 2.19 (95% CI 1.6 to 2.8), while effective reproduction number showed a decreasing trend by the second week and reaching a plateau around the critical value during the first month. The social distance measures such as were implemented March 12 going to a total lockdown on March 15 with all travels suspended.ConclusionFollowing the detection of the first COVID -19 case, Albania acted swiftly to implement immediate social distancing and lockdown measures. Such drastic measures had a huge effect on COVID-19 control in the beginning. However, the trend of effective reproduction numbers show a plateau for almost the last two weeks of the month with no signs of further decline.

COVID COVID – 19: CURRENT LANDSCAPE AND COMMUNITY PARTICIPATION

On February 29, 2020, in Ecuador, the index case of COVID-19 was officially confirmed through a press conference by the Minister of Health of the time; establishing, a definition of epidemic, which caused the government to declare a health emergency on March 16, 2020, through a state of exception in the national territory, which included a curfew, restriction of mobility by the number of plates, quarantine and social isolation. Previously, the W.H.O. On March 11, 2020, it had declared a global pandemic of COVID - 19, after the first case officially reported on December 31, 2019, in a food market in the city of Wuhan, Hubei province, in the great Asian country of China. Because COVID-19 is a disease that directly affects human beings, it has become a real public health problem, regardless of ethnicity, sex, creed, age, and social class; Faced with this situation, the need for intrinsic participation between citizens and local health authorities in an organized manner is established, through the application and development of Community Epidemiology, as an alternative to health promotion and disease prevention. , with community participation in the health system, based on equity, solidarity and innovation.

The multi-level factors influencing the development and impact of COVID-19 response in a university community: A review of the experiences of Kabale University in southwestern Uganda.

The index case of COVID-19 in Uganda was reported on 20th March 2020. The first confirmed imported case of COVID-19 in Kigezi sub- region South Western Uganda, where Kabale University is located, was reported on April 24th 2020. On August 2nd 2020 the first COVID-19 community case was recorded in the Kigezi Sub-region. Right from the early days of the threat of COVID-19 spread in Uganda, Kabale University put in place multiple mechanisms and interventions to contain the pandemic including: A COVID-19 Study Group: set up in February 2020 to study the disease, carry out risk assessment and advise the University on how to be prepared to handle cases if the disease were to reach the environment of the University. A multidisciplinary Kabale University COVID-19 Task Force: set up on 30th March 2020 to advise the University on preparations to ensure safe continuity of business at the university during a possible outbreak of COVID-2019 by designing and implementing appropriate infection prevention and control (IPC) measures, the Standard Operating Procedures (SOPs), for the University community. COVID-19 Knowledge Attitudes &amp; Practice (KAP) Study –to inform planning for safe maintenance of business continuity at the university in the face of the COVID-19 outbreak. Following a national lockdown, the purpose of the study was to guide development of necessary measures to be undertaken to minimize the spread of COVID-19 among students, staff and visitors when re-opening of the University became imminent. The study revealed high levels of knowledge (84% correct rate of response); an overall positive attitude (77% positive rate of response); but only moderate COVID-19 preventive practices (68.8% correct rate of preventive practice). Knowledge was higher among male students (p=0.033); students older than 20 years (p=0.000); and students taking health related courses such as Medicine or Nursing (p=0.019). Attitudes about COVID-19 were better among female students (p=0.034); and in students older than 20 years (p=0.000). Age and sex are significant predictors of COVID-19 prevention practices (p=0.001, p=0.000 respectively). These findings informed the need for: Effective behavioral change communication: to alert the university and the neighboring communities about COVID-19. The strategies to be used to achieve this were; Internal memos to the university community through e-mail, social media and written notices placed in strategic areas, Radio talk shows through several FM radio stations in Kabale town and, Branded health literacy print-outs in form of posters, leaflets and brochures. Promotion of good respiratory and oral and hand hygiene – to discourage; haphazard spitting, ejecting or smearing nasal mucus on public places, sneezing or coughing in public without protection, and promotion of frequent handwashing. Random COVID-19 testing – One such test in June 2021 revealed positivity rate of 17.8% Development of the Kabale University COVID-19 Standard Operating Procedures. The order of personal prevention priorities emphasized in the SOPs were; face masking, hand washing with running water and soap or disinfectant, hand sanitizing with 70% alcohol and, keeping a physical distance of at least 2 meters from one another etc. With vaccination, this order has now been revised to give top priority to vaccination, although we still equally emphasize maintenance of the previous strategies.

Sequence analysis for SNP detection and phylogenetic reconstruction of SARS-cov-2 isolated from Nigerian COVID-19 cases

BackgroundCoronaviruses are a group of viruses that belong to the Family Coronaviridae, genus Betacoronavirus. In December 2019, a new coronavirus disease (COVID-19) characterized by severe respiratory symptoms was discovered. The causative pathogen was a novel coronavirus known as 2019-nCoV and later as SARS-CoV-2. Within two months of its discovery, COVID-19 became a pandemic causing widespread morbidity and mortality. MethodologyWhole genome sequence data of SARS-CoV-2 isolated from Nigerian COVID-19 cases were retrieved by downloading from GISAID database. A total of 18 sequences that satisfied quality assurance (length ≥29,700 nts and number of unknown bases denoted as “N” ≤ 5%) were used for the study. In addition, genome sequence of SARS-CoV-2 obtained from Nigeria's COVID-19 index case (Accession ID: EPI_ISL_413550) and the reference genome (Accession NC_ 045512.2) were obtained from GISAID and the GenBank databases, respectively. Multiple sequence alignment (MSA) was done in MAFFT (Version 7.471) while SNP calling was implemented in DnaSP (Version 6.12.03), respectively and then visualized in Jalview (Version 2.11.1.0). Phylogenetic analysis was with MEGA X software. ResultsNigerian SARS-CoV-2 had 99.9% genomic similarity with four large conserved genomic regions. A total of 66 SNPs were identified out of which 31 were informative. Nucleotide diversity assessment gave Pi = 0.00048 and average SNP frequency of 2.22 SNPs per 1000 nts. Non-coding genomic regions particularly 5′UTR and 3′UTR had a SNP density of 3.77 and 35.4, respectively. The region with the highest SNP density was ORF10 with a frequency of 8.55 SNPs/1000 nts). This value was significantly higher (P < 0.01) than that of the spike gene, the region of greatest interest in SARS-CoV-2 genomics. Majority (72.2%) of viruses in Nigeria are of L lineage with preponderance of D614G mutation which accounted for 11 (61.1%) out of the 18 viral sequences. Nigeria SARS-CoV-2 revealed 3 major clades namely Oyo, Ekiti and Osun on a maximum likelihood phylogenetic tree. Conclusion and RecommendationThere was a preponderance of L lineage (to include the new lineage scheme) and D614G mutants. Nigerian SARS-CoV-2 genome revealed ORF1ab as the region containing the highest SNP density as compared to the spike gene. The implication of this distribution of SNPs for the empirical lower infectivity of SARS-CoV-2 in Nigeria is discussed. This also underscores the need for more aggressive testing and treatment of COVID-19 in Nigeria. Additionally, attempt to produce testing kits for COVID-19 in Nigeria should consider the conserved regions identified in this study. Strict adherence to COVID-19 preventive measure is recommended in view of Nigerian SARS-CoV-2 phylogenetic clustering pattern, which suggests intensive community transmission possibly rooted in communal culture characteristic of many ethnicities in Nigeria.

401. Natural History of Shedding and Household Transmission of Severe Acute Respiratory Syndrome Coronavirus 2 Using Intensive High-Resolution Sampling

BackgroundIn order to mitigate the spread of SARS-CoV-2 and the COVID-19 pandemic, public health officials have recommended self-isolation, self-quarantine of exposed household contacts (HHC), and mask use to limit viral spread within households and communities. While household transmission of SARS-CoV-2 is common, risk factors for HHC transmission are poorly understood.MethodsIn this prospective cohort study, we enrolled 37 households with at least one reverse transcription polymerase chain reaction-confirmed (RT-PCR) COVID-19 index case from March 2020 - March 2021, in order to calculate secondary attack rates (SAR) and define risk factors for secondary infections. Participants were tested daily for SARS-CoV-2 via RT-PCR, using self-collected lower nasal samples. Households were followed until all members tested negative for seven consecutive days. We collected demographics, medical conditions, relationship to index case, and socioeconomic indicators. Subgroup data analysis was conducted and stratified by positivity status.ResultsOf 99 enrolled participants, 37 were index cases and 62 were household contacts (HHC), of whom 25 HHC were infected (40.3%). Secondary attack rate (SAR) was highest among adults caring for a parent (n=4/4, 100%) and parents of index cases (5/10, 50%). Households whose income came from service work had greater risk of transmission compared to households whose primary income was technology (n=5/7; 71.4% vs 3/8; 37.5% respectively). Pediatric contacts were at lower risk of infection when compared to adult contacts (n=5/18, 27.8% vs n=20/44, 45.5% respectively).ConclusionThis study suggests that household transmission represents a key source of community-based infection of SARS-CoV-2. Allocating resources for education/training regarding prevention among infected individuals and their close contacts will be critical for control of future outbreaks of SARS-CoV-2.Disclosures All Authors: No reported disclosures

411. Significance of a Known Epidemiological Link to a COVID-19 Index Case and Severity of COVID-19 Infection

Abstract Background Several factors have been associated with severity of COVID-19 disease, but there remains a paucity of data surrounding whether the nature of exposure is impactful. Evidence demonstrating the correlation between initial viral exposure dose and disease severity exists for many viral infections. Observational studies have suggested that the exposure context, which can be considered a proxy for magnitude of viral inoculum, may influence severity of COVID-19 infection. We aimed to assess whether having a known exposure, as a proxy for higher inoculum dose to COVID-19, was associated with more severe outcomes for individuals hospitalized with COVID-19. Methods We created a retrospective cohort of community-dwelling adults hospitalized for COVID-19 in south-central Ontario from April 1, 2020 - January 14, 2021. Individuals or next of kin were contacted to ascertain exposure history. The primary outcome was death, intensive care unit (ICU) admission, or mechanical ventilation (MV) within 30 days of admission. A multivariable logistic regression model was used to determine whether a known exposure was associated with worse outcomes. Results 1097 individuals with community acquired COVID-19 required hospitalization; of these, 942 (86%) had available exposure data. In this group, the median age was 65, 44% were women, 84% lived in a private residence, 59% had a frailty score (FS) of 1 – 3 while 40% had a FS of 4 – 9, and 28% had a known exposure. Overall, the primary outcome occurred in 368/942 (39%) patients. Having a known exposure was not associated with worse outcome (OR 1.14, 95% CI 0.84–1.54, p = 0.41). Male gender (OR 1.41, 95% CI 1.06–1.89; p = 0.018), age (OR 1.01/year, 95% CI 1.00–1.03, p = 0.03), frailty (OR 1.22/point, 95% CI 1.09–1.36, p = 0.001) and living with at least one other person (OR 1.57, 95% CI 1.09–2.28, p = 0.017) were all associated with death, ICU admission, or MV within 30 days of admission. Conclusion While having a known exposure to a person with COVID-19 was not associated with worse outcome, the identified increased severity of illness associated with cohabitation suggests context of exposure may have a role in disease severity. This data and future studies can be used to guide public health recommendations to not only minimize transmission, but severity of COVID-19 infection. Disclosures All Authors: No reported disclosures

Impact of Delta Variant and Vaccination on SARS-CoV-2 Secondary Attack Rate Among Household Close Contacts

SUMMARYBackgroundImpact of the Delta variant and vaccination on SARS-CoV-2 transmission remains unclear. In Singapore, quarantine of all close contacts, including entry and exit PCR testing, provided the opportunity to determine risk of infection by the Delta variant compared to other variants, vaccine efficacy against SARS-CoV-2 acquisition, symptomatic or severe COVID-19, and risk factors associated with SARS-CoV-2 acquisition and symptomatic disease.MethodsThis retrospective cohort study included all close contacts between September 1, 2020 and May 31, 2021. Regardless of symptoms, all were quarantined for 14 days with entry and exit PCR testing. Household contacts were defined as individuals who shared a residence with a Covid-19 index case. Secondary attack rates among household close contacts of Delta variant-infected indexes and other variant-infected indexes were derived from prevalence of diagnosed cases among contacts. Relative risk ratios and bootstrapping at the cluster level was used to determine risk of infection by the Delta variant compared to other variants and vaccine efficacy against SARS-CoV-2 acquisition, symptomatic or severe COVID-19. Logistic regression using generalized estimating equations was used to determine risk factors associated with SARS-CoV-2 acquisition and symptomatic diseaseFindingsOf 1024 household contacts linked to 301 PCR-confirmed index cases, 753 (73.5%) were linked to Delta-infected indexes and 248 (24.2%) were exposed to indexes with other variants. Household secondary attack rate among unvaccinated Delta-exposed contacts was 25.8% (95% boostrap confidence interval [BCI] 20.6–31.5%) compared with 12.9% (95%BCI 7.0–20.0%) among other variant-exposed contacts. Unvaccinated Delta-exposed contacts were more likely to be infected than those exposed to other variants (Relative risk 2.01, 95%CI 1.24–3.84). Among Delta-exposed contacts, complete vaccination had a vaccine effectiveness of 56.4% (95%BCI 32.6–75.8%) against acquisition, 64.1% (95%BCI 37.8–85.4%) against symptomatic disease and 100% against severe disease. Among Delta-exposed contacts, vaccination status (adjusted odds ratio [aOR] 0.33, 95% robust confidence interval [RCI] 0.17–0.63) and older age of the index (aOR 1.20 per decade, 95%RCI 1.03–1.39) was associated with increased risk of SARS-CoV-2 acquisition by the contact. Vaccination status of the index was not associated with a statistically-significant difference for contact SARS-CoV-2 acquisition (aOR 0.73, 95%RCI 0.38–1.40).InterpretationIncreased risk of SARS-CoV-2 Delta acquisition compared with other variants was reduced with vaccination. Close-contacts of vaccinated Delta-infected indexes did not have statistically significant reduced risk of acquisition compared with unvaccinated Delta-infected indexes.

346 Mariner Self-Classification of Contact-Type With COVID-19 Index Case and Subsequent Infection on Ships

Early cruise line outbreaks of SARS-CoV-2 focused attention on the risk of transmission aboard ships. While cruise ship travel was suspended, many other segments within the maritime industry, including shipping, infrastructure maintenance, and food production continued. Ships became isolated congregate residential and working environments while at sea. To further understand transmission aboard ships, we examined mariners’ self-classification of contact with an index case during several independent COVID-19 case investigations.

COVID-19 Hard Lockdown in South Africa: Lessons for Climate Stakeholders Pursuing the Thirteenth Sustainable Development Goal

As a result of South Africa recording its first COVID-19 index case in March 2020, the country imposed one of the strictest lockdowns globally. The lockdown unearthed vital lessons that climate practitioners both in South Africa – the largest emitter of greenhouse gases on the African continent – and globally can draw from to facilitate the achievement of the thirteenth Sustainable Development Goal (SDG 13). Drawing on secondary data analysis of media reports regarding South Africa’s strategy to tackle the ongoing COVID-19 pandemic, with particular emphasis on the hard lockdown, three themes emerged. These were rephrased to align appropriately with the discourse on climate change (CC). These include changing the distant framing narrative of CC, prioritizing green growth and utilizing credible messengers. Each theme is discussed critically in terms of how it will aid climate policy developers and practitioners in facilitating the attainment of SDG 13.

Communicating COVID-19 to rural dwellers: Revisiting the role of traditional media in crisis communication

The recording of the index case of COVID-19 in Nigeria prompted the government to activate emergency communication strategies across the country. This study examines the awareness of the COVID-19 virus amongst rural dwellers and the importance of traditional media in health crisis communication amongst the residents of Ebonyi state. An adult sample size of 95 persons (32 male and 63 female) was assessed. The study adopts an in-depth interview as the research design. Data were generated using an interview guide and analysed thematically. The results show that rural dwellers are aware of the virus and the compliance level is high. There is a huge dependence on traditional media like town crier as the source of information amongst rural dwellers. The present study highlights the need to include rural dwellers in crisis communication planning and the integration of traditional media in future crisis communication planning.

Efficacy of COVID-19 outbreak management in a skilled nursing facility based on serial testing for early detection and control

SARS-CoV-2 has a high risk of outbreak in long-term skilled nursing facilities (SNF). Coronavirus disease (COVID-19) has high mortality rates among the elderly with chronic health conditions. Following identification of COVID-19 index case in a SNF, serial point-prevalence was implemented with reverse transcription–polymerase chain reaction (RT-PCR) and immunochromatographic assays. Active surveillance and early isolation of infected patients were implemented. Out of 23 SNF residents and 26 healthcare workers (HCW), 18 (78%) and 12 (46%) tested positive for SARS-CoV-2, respectively. High proportion (38%) of positive patients were asymptomatic and RT-PCR was positive up to six days before symptoms. Five (21.74%) residents were hospitalized with COVID-19, and 2 (9%) died; only 1 (4%) HCW needed to be hospitalized and no staff members died. Active surveillance helped COVID-19 control and management in a SNF. Testing symptomatic individuals only may fail to identify and isolate all persons contributing to transmission. In high-risk elderly, only symptoms screening may not be enough for outbreak control.

Coronavirus Disease (COVID-19) the African Story: A Review

Corona virus disease (COVID-19) is a global health threat that put panic in the minds of people worldwide. Although, the disease originate from China, but its effect covers the whole world. This review is to assess the effect of COVID-19 in the African continent. Data from already published researches were obtained, through which it was found that, Africa had its first confirmed index case of COVID-19 on the 14th of February, 2020, from Egypt, second case on 25th February, 2020, from Algeria while the 3rd was in Nigeria on the 27th of the same month. From there, the cases continue to spread throughout the continent. The review also highlighted on some factors that were thought can put Africa at higher risk of COVID-19; these include Africa China relation, which accounts for an average of 8 flights per day between the two regions, according to an investigation in 2018; endemic diseases that are common in the region and inefficient health system, among others. It was also observed according to the review that, world health organization (WHO) tried to upgrade the laboratory capacity for COVID-19 test in the continent at the time the disease hit the region. For that reason, between February 2nd and 10th March 2020, the laboratory capacity for COVID-19 test were raised, from 2 to 40 across the continent, WHO also provided 42,000 PCR test kits and 195,000 sample collection kits at around the same time. According to the review, as reported in WHO corona virus disease situation report of 9th July, 2020, at a point, in the progress of the disease in Africa, there were 493,131 cases with 11,643 deaths, indicating 25% cases increase and 18% deaths increase over a week. Based on the review, it can be concluded that, African countries are also victims of COVID-19, as a lot of them are still battling with the disease to date.

Redesigning Educational Delivery Systems: The Needs and Options for Continuous Learning during the Coronavirus (COVID-19) Pandemic in Nigeria

Education has been one of the worst-hit sectors of the economy since the detection of the first index case of Covid-19 in Nigeria on February 27, 2020. Like many affected countries of the world, the Federal government of Nigeria has taken several necessary precautionary measures to curtail the spread of the disease. This has led to the suspension of all educational activities especially in-class teaching and learning processes. This paper studied the state of education in Nigeria and the effort of government towards continuous education in comparison to the measures put in place by other developing countries during the COVID-19 pandemic. The paper equally reviewed five different available and popular online learning platforms that can be implemented by the government to provide start-up educational programs that would help to keep students on course by learning remotely from home throughout the period of Covid-19 pandemic. These include Distance Learning, Social media, Virtual Classroom, M-Learning, and Flipped classroom. Implementation of these online forms of education will successfully offer alternatives and ensure continuous education presently and in the future. The recommendations of this study would be useful even for other developing countries that are yet to discover any alternative to the disrupted in-class learning activities so that their students will start to learn from home.

Could changes in the airborne pollutant particulate matter acting as a viral vector have exerted selective pressure to cause COVID-19 evolution?

Air pollution with particulate matter has been implicated in the incidence and the mortality due to COVID-19 infection. The levels of particulate matter have been shown to have decreased after regional and national lockdowns in a number of countries. COVID-19 possesses an elevated reproduction number (R0) due to its high transmission rate. COVID-19 genes have been found adherent to particulate matter which has been suggested as a vector for this virus’ transmission. Following lockdown in China, the original viral Clade D steadily decreased mirroring the decline in particulate matter. Two months after the COVID-19 index case was reported in Wuhan early December 2019, a persistent mutation was noted at the D614 gene position of the viral spike protein establishing the Clade G variant. Clade G started to appear early in February and steadily attained predominance after lockdown in late February. It may be postulated that the changes in the source of airborne particulate matter, possibly derived from tobacco smoking (66% of Chinese males are smokers), may have contributed to the appearance of Clade G. Once the pandemic spread beyond China, in all countries affected except for Iceland, a consistent pattern arose whereby the initial viral Clade D outbreak was rapidly displaced by Clade G. It is hypothesized that changes in the source of COVID-19’s vector in the form of particulate matter may have contributed to natural selection favouring Clade G. The “open orientation” of Clade G spike protein’s three peptides as opposed to the “closed orientation” of the Clade D may have allowed easier adherence of the viral mutant to cells and as a corollary also to particulate matter. There may also have been differences between both viral Clades in the spike protein’s hydrophobic properties. Experimental research on the hypothesis that particulate matter may potentially act as a COVID-19 vector needs to be undertaken. Besides the potential vector effect, the deleterious effects of particulate matter on respiratory immunity and cardiovascular health are well known and consequently airborne pollution in all its forms should be addressed on a global scale.