Isolation Facilities Research Articles

An Adaptive Information Security System for 5G-Enabled Smart Grid Based on Artificial Neural Network and Case-Based Learning Algorithms.

With the deployment of 5G Internet of Things (IoT) in the power system, the efficiency of smart grid is improved by increasing two-way interactions in different layers in smart grid. However, it introduces more attack interfaces that the traditional information security system in smart grid cannot response in time. The neuroscience-inspired models have shown their effectiveness in solving security and optimization problems in smart grid. How to improve the security mechanism in smart grid while taking into account the optimization of data transmission efficiency using neuroscience-inspired algorithms is the problem to be solved in this study. Therefore, an information security system based on artificial neural network (ANN) and improved multiple protection model is proposed. Based on the ANN algorithm, the link state sample space is used to train the model to obtain the optimal transmission path in 5G power communication network. Integrating the intelligent link state module, the zero-trust security protection platform using case-based learning algorithm is designed and taken as the first protection, the network security logical isolation facility is taken as the second protection, and the forward and backward isolation facilities are set as the third protection to achieve the strengthened security of 5G IoT in smart grid. The experimental results show the efficiency and effectiveness of the proposed algorithms. In addition, the experimental results also show that the proposed system can resist malicious terminal access, terminal hijacking, data tampering and eavesdropping, protocol fuzzy, and denial-of-service attacks, so as to reduce the security risks of 5G IoT in smart grid. Since the proposed system can be easily integrated into the existing smart grid structure in China, the proposed system can provide a reference for the design and implementation of 5G IoT in smart grid.

PELAKSANAAN ISOLASI MANDIRI (ISOMAN) DI FASILITAS ISOLASI MILIK PEMERINTAH DAERAH

Abstract: This study aims to evaluate the implementation of self-isolation in local government isolation facilities based on the perception of Covid-19 in Pekanbaru City. This research combines quantitative and qualitative research methods with sequential explanatory research. The quantitative method uses online surveys while the qualitative method uses documentation studies, in-depth interviews, and observations. Analysis of quantitative data was carried out using descriptive statistical analysis in the form of frequency tables and graphs. Qualitative analysis was carried out through data collection, data reduction, data presentation, and conclusion. Qualitative analysis is intended to explain the results of quantitative analysis. The results of the study found that there are infrastructures of local government isolation facilities that still need to be improved, namely: entertainment and internet facilities, sports and waste management, and infectious waste. Most of the respondents assessed that the service at the local government isolation facilities was very good (62.71%) but the fulfillment of patient needs for data and internet was 42.37%) and entertainment (66.10%) was still not good. Implementation of self-isolation at the local government facilities is influenced by community participation and compliance, enforcement of sanctions, financial support, availability of facilities, data, and information, and coordination between relevant stakeholders. Based on these findings, this study recommends several things, including improvement of infrastructure in the local government self-isolation facilities, the availability of government support for self-isolation patients, both financial and non-financial, strengthening coordination between the COVID-19 Task Force, and improving the quality of data and information.

Production of Radioactive Molecular Ions in Radiofrequency Quadrupole Gas-Reaction Cells

Limited types of radioactive molecules (RM) can be made inside hot-cavity targets at ISOL facilities like TRIUMF. However, extreme conditions in these targets present formidable unsolved challenges to efficient production and delivery of RM’s. Here we propose using RFQ gas-reaction cells to produce RM from radioactive ion beams (RIB) by room temperature RIB-gas chemical reactions at eV energies. Two options are possible: (1) using an ion reaction cell (IRC) that is a linear RFQ ion guide and reaction cell used as an ‘on-line ion source’, and (2) using the ARIEL RFQ cooler-buncher (ARQB). RFQ gas-cells are a controllable and efficient method to produce RM from chemical reactants that cannot be used in ISOL targets. This ‘online chemistry’ offers a way to enable groundbreaking Beyond Standard Model (BSM) physics research, using a wide diversity of new rare and exotic RM beams that would be difficult or impossible to produce in hot-cavity targets.

Clinical and Virological Characteristics of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) B.1.617.2 (Delta) Variant: A Prospective Cohort Study.

BackgroundData on the clinical and virological characteristics of the Delta variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are limited. This prospective cohort study compared the characteristics of the Delta variant to other variants.MethodsAdult patients with mild coronavirus disease 2019 (COVID-19) who agreed to daily saliva sampling at a community isolation facility in South Korea between July and August 2021 were enrolled. Scores of 28 COVID-19-related symptoms were recorded daily. The genomic RNA and subgenomic RNA from saliva samples were measured by real-time reverse-transcription polymerase chain reaction (PCR). Cell cultures were performed on saliva samples with positive genomic RNA results.ResultsA total of 141 patients (Delta group, n = 108 [77%]; non-Delta group, n = 33 [23%]) were enrolled. Myalgia was more common in the Delta group than in the non-Delta group (52% vs 27%, P = .03). Total symptom scores were significantly higher in the Delta group between days 3 and 10 after symptom onset. Initial genomic RNA titers were similar between the 2 groups; however, during the late course of disease, genomic RNA titers were higher in the Delta group. Negative conversion of subgenomic RNA was slower in the Delta group (median 9 vs 5 days; P < .001). The duration of viral shedding in terms of positive viral culture was also longer in the Delta group (median 5 vs 3 days; P = .002).ConclusionsCOVID-19 patients infected with the Delta variant exhibited prolonged viable viral shedding with more severe symptoms than those infected with non-Delta variants.

Kampo Medicine Promotes Early Recovery From Coronavirus Disease 2019-Related Olfactory Dysfunction: A Retrospective Observational Study.

Background: Olfactory dysfunction is a common symptom in patients with coronavirus disease 2019, and it significantly deteriorates patients’ quality of life. Effective treatments remain unknown. Purpose: To assess the effect of Japanese traditional (Kampo) medicine on coronavirus disease 2019-related olfactory dysfunction. Study Design: Retrospective observational study. Methods: In total, 87 patients aged ≥18 years with coronavirus disease 2019 and severe dysosmia or anosmia (Numeric Rating Scale, ≥7) at isolation facilities in Miyagi Prefecture, Japan, were enrolled from October 2020 to March 2021. Patients were divided into the Kampo group (N = 52) and the control group (N = 35) based on the treatment received. Changes in Numeric Rating Scale scores were evaluated at the first visit and 2 weeks after. Results: The median reduction in the olfactory dysfunction score at both 1 and 2 weeks after the first visit was significantly greater in the Kampo group (6 and 8, respectively; p = 0.03) than in the control group (3 and 7, respectively; p = 0.04). We defined improvement in olfactory dysfunction as a median reduction in the olfactory dysfunction score of ≥5. Multiple logistic regression analysis demonstrated that only Kampo treatment was significantly associated with improvement in olfactory dysfunction. Conclusion: This study suggests that Kampo medication promotes early recovery from coronavirus disease 2019-related olfactory dysfunction.

Emotional distress in COVID-19 patients in Maldives

Background and objectivesResearchers are exploring the epidemiology, clinical characteristics, treatment, vaccination and the challenges faced by healthcare authorities. However less focus is being paid towards the impact of COVID-19 on mental health of the patients. This study is a cross-sectional study, measuring the prevalence of emotional distress among patients with COVID-19 in the Maldivian population.MethodsThis study was conducted in Maldivian nations above 18 of age with COVID-19 who were admitted in isolation facilities. Patients who were on treatment for any other chronic medical conditions, severe and critical COVID-19 disease were excluded. This study was conducted over a period of 2 months by administering a local translated version of DASS21 questionnaire.ResultsThe total of 195 patients were included in this study. The mean age of the patients was 40 (CI at 95% 38–42) years. The respondents were 48.7% men and 51.3% women. Overall, 9% of patients with COVID-19 had depression while 23% of patients had anxiety and 12% of the patients had stress. There was a statistically significant relationship between gender and depression, anxiety and stress (p < 0.01). Symptomatic cases had a significantly higher level of stress than asymptomatic patients (p < 0.05), but no significant association was observed with symptomatic status and anxiety or depression.ConclusionThe management of patients with COVID-19 should be multi-disciplinary with special focus on the mental wellbeing of our patients. We should aim to establish proper communication with the patients in order to identify emotional distress and provide appropriate mental health care.

Airborne Transmission of SARS-CoV-2 Delta Variant within Tightly Monitored Isolation Facility, New Zealand (Aotearoa).

In New Zealand, international arrivals are quarantined and undergo severe acute respiratory syndrome coronavirus 2 screening; those who test positive are transferred to a managed isolation facility (MIF). Solo traveler A and person E from a 5-person travel group (BCDEF) tested positive. After transfer to the MIF, person A and group BCDEF occupied rooms >2 meters apart across a corridor. Persons B, C, and D subsequently tested positive; viral sequences matched A and were distinct from E. The MIF was the only shared location of persons A and B, C, and D, and they had no direct contact. Security camera footage revealed 4 brief episodes of simultaneous door opening during person A’s infectious period. This public health investigation demonstrates transmission from A to B, C, and D while in the MIF, with airborne transmission the most plausible explanation. These findings are of global importance for coronavirus disease public health interventions and infection control practices.

Research on the Experience of Urban Epidemic Prevention and Governance in Chang'an City in Tang Dynasty Based on the Analysis of Historical Data

Chinese cities have a history of at least five thousand years, and the city of Chang'an in the Tang Dynasty is a milestone. The planning and design of Chang'an City represented the most advanced level in the world at that time and laid the foundation for the design of China's capital city. With the global outbreak of the new crown virus COVID-19, it is even more necessary to enter the "post-epidemic era" for urban epidemic prevention and governance measures. In the history of the Tang Dynasty, there were 49 plague outbreaks, but they still created prosperous situations such as the "Excellent Governance during the Zhenguan Times" and " Flourishment Age of Kaiyuan Era". Based on the historical data and documentary interviews and analysis of the textual research, this article summarizes the urban epidemic prevention and management of the Tang Chang’an city from six aspects, including the site selection, water supply and drainage system, medical isolation facilities, lifang management system, landscaping and mainstream medical ideological guidance system, and summarize the advanced experience of typical capitals in ancient China to provide a reference for modern urban epidemic prevention and governance.

Heat Health Management in a Quarantine and Isolation Facility in the Tropics.

The Howard Springs Quarantine Facility (HSQF) is located in tropical Northern Australia and has 875 blocks of four rooms (3,500 rooms in total) spread over 67 hectares. The HSQF requires a large outdoor workforce walking outdoor pathways to provide individual care in the ambient climate. The personal protective equipment (PPE) required for the safety of quarantine workers varies between workgroups and limits body heat dissipation that anecdotally contributes to excessive sweating, which combined with heat stress symptoms of fatigue, headache, and irritability, likely increases the risk of workplace injuries including infection control breaches. The purpose of this study was the description of qualitative and quantitative assessment for HSQF workers exposed to tropical environmental conditions and provision of evidenced-based strategies to mitigate the risk of heat stress in an outdoor quarantine and isolation workforce. The study comprised two components - a cross-sectional physiological monitoring study of 18 workers (eight males/ten females; means: 41.4 years; 1.69m; 80.6kg) during a single shift in November 2020 and a subjective heat health survey completed by participants on a minimum of four occasions across the wet season/summer period from November 2020 through February 2021. The physiological monitoring included continuous core temperature monitoring and assessment of fluid balance. The mean apparent temperature across first-half and second-half of the shift was 34.7°C (SD = 0.8) and 35.6°C (SD = 1.9), respectively. Across the work shift (mean duration 10.1 hours), the mean core temperature of participants was 37.3°C (SD = 0.2) with a range of 37.0°C - 37.7°C. The mean maximal core temperature of participants was 37.7°C (SD = 0.3). In the survey, for the workforce in full PPE, 57% reported feeling moderately, severely, or unbearably hot compared to 49% of those in non-contact PPE, and the level of fatigue was reported as moderate to severe in just over 25% of the workforce in both groups. Heat stress is a significant risk in outdoor workers in the tropics and is amplified in the coronavirus disease 2019 (COVID-19) frontline workforce required to wear PPE in outdoor settings. A heat health program aimed at mitigating risk, including workplace education, limiting exposure times, encouraging hydration, buddy system, active cooling, and monitoring, is recommended to limit PPE breaches and other workplace injuries in this workforce.

Impact of Antibody Cocktail Therapy Combined with Casirivimab and Imdevimab on Clinical Outcome for patients with COVID-19 in A Real-Life Setting: A Single Institute Analysis

BackgroundRecent data from clinical trials suggest that antibody cocktail therapy, which combined casirivimab and imdevimab, is linked to the reduction of the risk of hospitalization or death among high-risk patients with COVID-19. However, it remains unclear how effective the therapy is in a real-life clinical practice.MethodsWe retrospectively analyzed patients with COVID-19 with high-risk factors who underwent the antibody cocktail therapy, compared with those who were not given the cocktail therapy while being isolated in nonmedical facilities during the same period.ResultsData from 55 patients who received the antibody cocktail therapy and 53 patients with initial isolation in nonmedical facilities were analyzed. A total of 22 (41.5 %) of 53 patients staying in isolation facilities were eventually hospitalized and received medical interventions. By contrast, 13 (23.6 %) of 55 patients who received the antibody cocktail therapy subsequently underwent further medical interventions. In multivariate analysis, the antibody cocktail therapy significantly reduced the need for further medical interventions by 70 % compared with isolation (odds ratio=0.30, 95%CI [0.10-0.87], p=0.027). Patients with percutaneous oxygen saturation 96% or higher were significantly favoured for the therapy and had an advantage.ConclusionThe results of this study indicate that the antibody cocktail therapy is associated with reducing burden on hospitals during the COVID-19 pandemic.

Airborne transmission of SARS-CoV-2 lineage B.1.617.2 (Delta variant) within a tightly monitored isolation facility

To mitigate importation of COVID-19 into Aotearoa New Zealand, international arrivals are quarantined and undergo SARS-CoV-2 screening, with those testing positive transferred to a managed isolation facility (MIF). Solo traveller A and individual E from a five-person travel group, BCDEF, had positive screening tests. Following transfer to the MIF, A and BCDEF occupied separate rooms on opposite sides of the corridor, over 2 metres apart. Individuals BCD subsequently tested positive, with viral sequences matching A and distinct from E.

Challenges of retrofitting the world’s biggest elevated water reservoir: Tala tank of Calcutta

The Tala water tank in Kolkata, India, is the largest water tank in the world with an active capacity of 41 Ml. The tank is an integral part of the first organised water supply system of the city since its commissioning in 1911. It was introduced to relieve the upstream supply pumps of stresses caused by fluctuating downstream demand. The tank structure is robust with an overall dimension of 97 m square and total 6 m height. The steel frame staging is supported on multiple types of trussed grouped columns with only one inlet-cum-delivery pipe. The tank was constructed in steel riveted joints and staged over 28 m from the ground level. The framed staging comprises 295 columns with a combined length of steel members measuring over 80 km. There are inclined rafters securing its walls by connecting to its floor. The bottom plate is made of flat steel riveted sheets of 6 m square panels. It has four compartments with an isolation facility. Kolkata Municipal Corporation has taken up a project to rehabilitate and retrofit this unique asset. This paper identifies the extremely technical and logistical challenges faced in the refurbishment and retrofitting of this engineering marvel.

Laser double optical resonance excitation-ionization of Mo with optogalvanic detection

We report on the first measurement of resonant three-step, two-colour ionization of atomic molybdenum, using a hollow cathode lamp (HCL) with optogalvanic detection. Wavelength scans were made for two specific transitions involved in the ionization pathways under investigation, namely 4d5(6S)5s 7S3–4d5(6S)5p 7P4 and 4d5(6S)5p 7P4–4d5(6S)6d 7D5. So-called ‘slow’ and ‘fast’ optogalvanic signals were respectively observed for each resonant quantum jump and for the simultaneous excitation of the two laser frequencies. This successful detection confirms the HCL as a cost effective spectroscopic investigation tool. In particular its use in the optogalvanic mode of operation allows one to precisely, easily and reliably tune the wavelength of one or more lasers to resonances of interest for experiments in the general domain of atomic vapour laser isotope selection (AVLIS). This activity has been undertaken in the framework of the Selective Production of Exotic Species (SPES) project at the ISOL facility of the Legnaro National Laboratories of INFN. These measurements are a necessary step towards the realization of the MOLAS subproject of SPES, whose aim is to verify the production of 99m technetium for medical application via laser ionization of the 99 uma isotope of Molibdenum.

Improving wellbeing for COVID-19 patients at Umm Salal Isolation and Recovery Facility through expressive drawing (Art Therapy): A Service/Quality Improvement Initiative

Background: COVID-19 has brought several patient challenges related to anxiety disorders impacting their wellbeing 1. According to Vaartio-Rajalin et al., 2, expressive art therapy (AT) has many advantages including mental health, physical, and social wellbeing. AT was introduced to COVID-19 patients on the 29th of May, 2021 as part of our Patient Wellbeing Programme launched at Umm Salal Isolation Facility (USIF) in Qatar. USIF provided patients with drawing tools to potentially promote health, social engagement, reduce symptoms of anxiety, depression, fatigue as well as addressing social detriments such as loneliness and isolation 1. Promoting group and individual identities was claimed advantageous when considering the multi-cultural and diverse patient groups housed in the facility 2. The study was initiated by the nursing team to evaluate the effectiveness of the AT activity on patients’ feelings of isolation, loneliness, and depression. Methods: This was a prospective cohort mixed-method study. Art materials were provided to establish patients’ engagement. Art stations were set up at the patients’ facility where multi-language instructions explaining the activity were made visible. The artwork was collected from voluntary participants (907) once a week and evaluated during the study period (13 weeks) which provided quantitative data. An existing general patient experience questionnaire (PEQ) was used to collate qualitative data to support the aim of the study. Data analysis was completed using Excel. Results: 907 artwork submissions were collected from a total population of 1,600 COVID-19 patients. The average rate of participation was 8% weekly, over 13 weeks (Figure 1). 150 PEQ&apos;s were received from 907 patients where 98% of respondents felt that AT supports patients’ wellbeing in a confined facility like USIF. Conclusion: AT has been shown to improve patients’ perceived well-being by reducing feelings of isolation, loneliness, and depression. Participation remained very moderate and ways of promoting more engagement and a higher uptake need to be found.

COVID-19 Waste Management Strategy: Hamad Medical Corporation Experience

Background: As the number of coronavirus disease (COVID-19) patients has rapidly increased around the world, the World Health Organization (WHO) declared the COVID-19 outbreak as a global pandemic in March 2020.1 The pandemic created a global crisis affecting all countries, business sectors, and citizens around the world in their everyday lives.2 Qatar&apos;s national policies and strategies focus on protecting the lives and the recovery of livelihoods. In line with this and to minimize the adverse impact on people&apos;s health and the environment, all types of wastes needed to be properly managed 3, especially at the time of a pandemic when everything might be contaminated. Methods: The Environmental Safety Section (ESS) under the Occupational Health and Safety (OHS) Department conducted a series of meetings with Hamad Medical Corporation (HMC) waste contractor and concerned departments to discuss the proper management of COVID-19 wastes generated from isolation and quarantine facilities. ESS staff provided training for nursing and housekeeping staff on the proper COVID-19 waste management from segregation, packaging, labeling, collection, and transport, and to strictly implement the System-Wide Incident Command Center (SWICC) memo.3Results: There was an increase in COVID-19 wastes from March to May 2020, with the highest amount recorded in the month of May as shown in Figure 1 due to the increase in COVID-19 patients, new COVID-19 facilities, improper segregation, and lack of training for the new staff and contractors. Conclusion: ESS-OHS collaborated with the COVID-19 management facilities for the proper waste collection and transportation. All applied strategies were effective and helped gradually to reduce the waste generated starting from August 2020.

Left Ventricular Ejection Time Measured by Echocardiography Differentiates Neurobehavioral Resilience and Vulnerability to Sleep Loss and Stress.

There are substantial individual differences (resilience and vulnerability) in performance resulting from sleep loss and psychosocial stress, but predictive potential biomarkers remain elusive. Similarly, marked changes in the cardiovascular system from sleep loss and stress include an increased risk for cardiovascular disease. It remains unknown whether key hemodynamic markers, including left ventricular ejection time (LVET), stroke volume (SV), heart rate (HR), cardiac index (CI), blood pressure (BP), and systemic vascular resistance index (SVRI), differ in resilient vs. vulnerable individuals and predict differential performance resilience with sleep loss and stress. We investigated for the first time whether the combination of total sleep deprivation (TSD) and psychological stress affected a comprehensive set of hemodynamic measures in healthy adults, and whether these measures differentiated neurobehavioral performance in resilient and vulnerable individuals. Thirty-two healthy adults (ages 27–53; 14 females) participated in a 5-day experiment in the Human Exploration Research Analog (HERA), a high-fidelity National Aeronautics and Space Administration (NASA) space analog isolation facility, consisting of two baseline nights, 39 h TSD, and two recovery nights. A modified Trier Social Stress Test induced psychological stress during TSD. Cardiovascular measure collection [SV, HR, CI, LVET, BP, and SVRI] and neurobehavioral performance testing (including a behavioral attention task and a rating of subjective sleepiness) occurred at six and 11 timepoints, respectively. Individuals with longer pre-study LVET (determined by a median split on pre-study LVET) tended to have poorer performance during TSD and stress. Resilient and vulnerable groups (determined by a median split on average TSD performance) showed significantly different profiles of SV, HR, CI, and LVET. Importantly, LVET at pre-study, but not other hemodynamic measures, reliably differentiated neurobehavioral performance during TSD and stress, and therefore may be a biomarker. Future studies should investigate whether the non-invasive marker, LVET, determines risk for adverse health outcomes.

Influence factors on injury severity of bicycle-motor vehicle crashes: A two-stage comparative analysis of urban and suburban areas in Beijing

Objective More attention should be given to bicycle-motor vehicle (BMV) crashes, as cyclists are at a higher risk of suffering injuries than motor vehicle users in a crash. This study aims to explore the factors influencing the injury severity of bicycle-motor vehicle (BMV) crashes in Beijing (China) and discusses the commonalities and differences between the urban and suburban areas. Methods Information regarding 1,136 crashes between bicycles and motor vehicles were collected using police reported data from 2014 to 2015. A two-stage approach integrating random parameters logit (RP-logit) model and two-step clustering (TSC) algorithm was proposed to investigate the significant influence factors and their combination characteristics. Specifically, the RP-logit model was first used to identify the significant influence factors of urban and suburban areas, and then the TSC algorithm was applied to reveal the combination characteristics of significant influence factors for the fatal crashes. Results Five factors were found to be statistically significant and had random effects on the injury severity in urban areas, i.e., type of motor vehicle, motor vehicle license ownership, type of bicycle, signal control mode and lighting condition; and seven factors were found to be statistically significant on the injury severity in suburban areas, i.e., type of motor vehicle, motor vehicle license ownership, physical isolation facility, signal control mode, weather, visibility and lighting condition. Based on TSC, the combination of significant factors showed different characteristics for fatal crashes in urban and suburban areas, in which two types of the scene including five factors should be concerned in urban areas while one type of scene containing four factors in suburban areas. Conclusions The results suggest that different influence factors and individual heterogeneity exist in the RP-logit model for injury severity analysis of BMV crashes in urban and suburban areas. It shows that in urban areas, heavy truck, light truck and bus significantly increase the likelihood of fatal injury than that of suburban areas. These findings can provide valuable reference information for BMV crashes response, such as heavy truck restriction, to facilitate regional safety measures for urban and suburban areas.

Mental health services at the Tokyo 2020 Olympic and Paralympic Games during the COVID-19 pandemic

Mental health services at the Tokyo 2020 Olympic and Paralympic Games during the COVID-19 pandemic

Sensitivity of wastewater-based epidemiology for detection of SARS-CoV-2 RNA in a low prevalence setting

To assist public health responses to COVID-19, wastewater-based epidemiology (WBE) is being utilised internationally to monitor SARS-CoV-2 infections at the community level. However, questions remain regarding the sensitivity of WBE and its use in low prevalence settings. In this study, we estimated the total number of COVID-19 cases required for detection of SARS-CoV-2 RNA in wastewater. To do this, we leveraged a unique situation where, over a 4-month period, all symptomatic and asymptomatic cases, in a population of approximately 120,000, were precisely known and mainly located in a single managed isolation and quarantine facility (MIQF) building. From 9 July to 6 November 2020, 24-hr composite wastewater samples (n = 113) were collected daily from the sewer outside the MIQF, and from the municipal wastewater treatment plant (WWTP) located 5 km downstream. New daily COVID-19 cases at the MIQF ranged from 0 to 17, and for most of the study period there were no cases outside the MIQF identified. SARS-CoV-2 RNA was detected in 54.0% (61/113) at the WWTP, compared to 95.6% (108/113) at the MIQF. We used logistic regression to estimate the shedding of SARS-CoV-2 RNA into wastewater based on four infectious shedding models. With a total of 5 and 10 COVID-19 infectious cases per 100,000 population (0.005% and 0.01% prevalence) the predicated probability of SARS-CoV-2 RNA detection at the WWTP was estimated to be 28 and 41%, respectively. When a proportional shedding model was used, this increased to 58% and 87% for 5 and 10 cases, respectively. In other words, when 10 individuals were actively shedding SARS-CoV-2 RNA in a catchment of 100,000 individuals, there was a high likelihood of detecting viral RNA in wastewater. SARS-CoV-2 RNA detections at the WWTP were associated with increasing COVID-19 cases. Our results show that WBE provides a reliable and sensitive platform for detecting infections at the community scale, even when case prevalence is low, and can be of use as an early warning system for community outbreaks.

Can proactive roles played by Community Medicine professionals in times of COVID-19 Pandemic bring the leadership of public health in India in the right hands?

Since the onset of the COVID-19 Pandemic, various public health measures have been in focus, viz. social distancing, hand hygiene, use of masks, screening of patients for COVID-19 symptoms, development of quarantine and isolation facilities, and public health surveillance. Most of these relate to the principles of prevention, early case detection, and primary care. In the ongoing fight against COVID-19, community medicine (CM) professionals are involved at various positions and have been leading from the front in a variety of activities, be it screening, patient care, surveillance, orientation and training of front line workers, community engagement, evidence generation through research, and development of guidelines. However, their engagement in policymaking has still been limited. The government should work more closely with CM professionals in order to stem the tide of COVID-19 or any such public health emergencies in the future by shifting the focus to preventive and promotive interventions. CM professionals should take a more proactive approach in getting involved in policymaking and demonstrate leadership through their actions to lead the national, state, and district-level public health teams through collaboration across disciplines and sectors. This will help bring the leadership of public health in India in the right hands for optimum population health and appropriate and timely health emergency response.