Mitigate COVID-19 Transmission Research Articles

The potential of local exhaust combined with mixing and displacement ventilation systems to mitigate COVID-19 transmission risks

The performance of two types of air diffusers, a perforated duct and a low-velocity unit coupled with local exhausts, on airborne transmission and cross-infection was investigated in a meeting room. The effect of air diffusers’ locations on airborne transmission was investigated. Six local exhausts were installed above six workstations at 2.0 m height. Respiratory-generated airborne pathogens were simulated using SF6 in the exhaled air of the manikin acting as an infected person. The SF6 concentration in the inhaled air of five susceptible persons remained steady with perforated duct located on the ceiling and at 1.7 m height attached to the corridor wall, but fluctuated greatly when perforated duct were located on the floor, although with a much lower concentration level. The perforated duct under the warm window showed the best potential for mitigating airborne transmission. The concentration in the inhaled air was varied with horizontally supplied low-velocity unit, but much steadier with low-velocity unit at 1.7 m attached to the wall. With an adjusted airflow pattern from low-velocity unit, the inhaled concentration was much lower and uniform among the five susceptible persons. The contaminant removal effectiveness (CRE) was 4.3 with perforated duct under a warm window on the floor. With an adjusted airflow pattern from low-velocity unit, the CRE was much more consistent and increased from 2.1 to 3.9 with an airflow rate from 61 l/s to 116 l/s. The infection probability was the lowest with the perforated duct on the floor and adjusted low-velocity unit.

Assessing COVID-19 transmission risk: Roommate and unit mate exposures at an inpatient behavioral health facility

Inpatient psychiatric facilities have an inherently increased risk of infection transmission. This study aimed to evaluate the impact of roommate and unit mate exposures on COVID-19 transmission to inform on safest isolation practices. A single-center retrospective study was conducted among patients hospitalized in six units of an inpatient behavioral health hospital from July 2020 through August 2023. We compared the risk of COVID-19 acquisition after exposure among patients with a contagious roommate versus those exposed to a contagious unit mate. During the study period, the conversion rate was 10.05% overall, 24.4% for roommates, and 9.3% for unit mates; patients exposed to a roommate were at 3.14 times higher odds (95% confidence interval, 1.42-6.92) of acquiring COVID-19 after exposure. On unit-stratified analysis, patients exposed to a roommate on the geropsychiatric unit had the highest risk of post-exposure conversion compared to unit mate exposed patients (odds ratio 6.38, 95% confidence interval 1.75-23.22). Logistic regression analysis identified a non-significant risk associated with increased time in group therapy. Exposure to a COVID-19 contagious roommate significantly increases the risk of COVID-19 acquisition among exposed patients receiving inpatient psychiatric care. Cohorting contagious and exposed individuals and avoiding multi-bedded rooms may successfully mitigate COVID-19 transmission risk during psychiatric care.

A case-control study of behavioural and built environment determinants of COVID-19 transmission in sheltered markets

BackgroundIn July 2021, amid occasional COVID-19 community transmission, an outbreak in a seafood wholesale centre propagated secondary clusters in sheltered markets in Singapore. This period offers a unique chance to study COVID-19 transmission risk factors related to environmental features and personal behaviours in markets. Only 40 % of the population was vaccinated during this period. MethodsA two-tier case-control study was conducted. The first tier entailed site assessments of markets where primary cases, presumed to have acquired COVID-19 at the seafood wholesale centre, worked. Markets with secondary cases (case markets) were compared against those without (control markets). The second tier comprised telephone questionnaires administered to individuals who worked at or visited the three markets with the highest number of secondary cases, with respondents either testing positive or negative for SARS-CoV-2. ResultsAssessment of 38 markets showed that markets “seeded” with more primary cases were more likely to experience a secondary outbreak (adjusted odds ratio, aOR: 2.0; 95 % confidence interval, CI: 1.3–4.7). From 333 visitor responses, maintaining social distancing (aOR: 0.34; 95 % CI: 0.11–1.06) and completing vaccination (aOR: 0.25; 95 % CI: 0.07–0.95) decreased infection risk, while using public washrooms increased the risk (aOR: 3.12; 95 % CI: 0.87–11.00). Among 86 staff responses, statistically significant risk factors were gender and mask type: male staff (aOR: 0.14; 95 % CI: 0.02–0.62) and those wearing surgical/N95 masks (aOR: 0.10; 95 % CI: 0.01–0.71) had lower infection risk. Wider aisles of the markets correlated with a higher chance of secondary transmission (aOR: 2.5; 95 % CI: 1.3–6.7). ConclusionThese findings underscore the importance of considering both built environment features and individual behaviours in devising effective measures to mitigate COVID-19 transmission in markets and community hubs in general. The observed association of wider market aisles with increased risk could be attributed to these facilitating the gathering and intermingling of more individuals, underlining the importance of maintaining social distancing. The identified individual risk factors among different populations within the market environment highlight the need for population-specific measures for infection prevention.

Revisiting the complex time-varying effect of non-pharmaceutical interventions on COVID-19 transmission in the United States.

Although the global COVID-19 emergency ended, the real-world effects of multiple non-pharmaceutical interventions (NPIs) and the relative contribution of individual NPIs over time were poorly understood, limiting the mitigation of future potential epidemics. Based on four large-scale datasets including epidemic parameters, virus variants, vaccines, and meteorological factors across 51 states in the United States from August 2020 to July 2022, we established a Bayesian hierarchical model with a spike-and-slab prior to assessing the time-varying effect of NPIs and vaccination on mitigating COVID-19 transmission and identifying important NPIs in the context of different variants pandemic. We found that (i) the empirical reduction in reproduction number attributable to integrated NPIs was 52.0% (95%CI: 44.4, 58.5%) by August and September 2020, whereas the reduction continuously decreased due to the relaxation of NPIs in following months; (ii) international travel restrictions, stay-at-home requirements, and restrictions on gathering size were important NPIs with the relative contribution higher than 12.5%; (iii) vaccination alone could not mitigate transmission when the fully vaccination coverage was less than 60%, but it could effectively synergize with NPIs; (iv) even with fully vaccination coverage >60%, combined use of NPIs and vaccination failed to reduce the reproduction number below 1 in many states by February 2022 because of elimination of above NPIs, following with a resurgence of COVID-19 after March 2022. Our results suggest that NPIs and vaccination had a high synergy effect and eliminating NPIs should consider their relative effectiveness, vaccination coverage, and emerging variants.

Abstract WP52: Evaluation of Post Stroke Telehealth Services in Texas (Vast-1)

Background: Shortly after AHA/ASA released an updated policy on stroke care systems, COVID-19 disrupted these systems. Lockdowns and social distancing were considered critical to mitigate COVID-19 transmission but altered public perceptions about stroke medical care. As a result, telehealth expanded rapidly across Texas. However, little is known how to optimally integrate telehealth services into the continuum of stroke care. Methods: To identify barriers and facilitators of post-acute stroke telehealth services among stroke survivors’ facilities of the Lone Star Stroke Consortium (LSSC) Research Consortium, we conducted semi-structured interviews with stroke providers and focus groups with patients. Audiotapes were transcribed, and files prepared for analysis. Using a grounded theory approach, we performed data analysis to allow theory to emerge from data. Two independent reviewers read transcripts, developed coding using an iterative consensus building, verified codes, developed concepts, and created categories. Constant comparison process found emerging themes within each category. Results: We enrolled 23 providers and 34 patients. Access, telemedicine encounter and technology were revealed as major categories of post-acute stroke telehealth among providers and patients. Facilitators of access included increased accessibility and elimination of barriers. Reliable internet connection and technological skills were barriers for both groups. Patients and providers identified virtual visits as good. However, full medical exam, including cognitive evaluation, was a barrier for patients and providers. Technology increased ability to communicate with patients and providers. Barriers included constrains of internet services, lack of documentation for virtual visits, and lack of telemedicine platform. Conclusion: Our study will contribute to future telehealth services integration into continuum of stroke care.

The impact of COVID-19 vaccine reactions on secondary vaccine hesitancy

BackgroundPrimary and booster vaccinations are critical for mitigating COVID-19 transmission, morbidity, and mortality. Future booster vaccine campaigns rely on an increased understanding of vaccine hesitancy. ObjectiveTo evaluate self-reported allergic and skin vaccine reactions as factors potentially associated with vaccine hesitancy in a nationwide vaccine allergy registry. MethodsResponses to survey questions concerning COVID-19 vaccine perceptions, coded from free text by 2 independent reviewers. Multivariable logistic regression models were used to determine the association between changed negative perception and respondent demographics, vaccination history, and reaction characteristics. ResultsA total of 993 individuals (median of 46 years [IQR, 36-59], 88% female, 82% White) self-reported reactions to COVID-19 vaccination. Reactions included the following: delayed large local skin reaction (40%), hives/urticaria (32%), immediate large local skin reaction (3%), swelling (3%), anaphylaxis (2%), and other or unspecified (20%). Most respondents were initially unconcerned about the safety of COVID-19 vaccines (56%). After reactions, 401 of 993 (40%) report negative change in perception of vaccination, with more than half of these respondents (n = 211, 53%) citing their reasoning as a negative experience with adverse effects. Of 102 individuals asked about future vaccination, 79 (77%) indicated that they were unlikely or very unlikely to receive future COVID-19 vaccinations. Increased negative perception after reaction was associated with younger age, later COVID-19 vaccination dose number, and reaction type. ConclusionOur findings reveal that an individual's experience with allergic or cutaneous adverse effects after COVID-19 vaccination affects attitudes and decision-making regarding future vaccination, even in initially non-hesitant individuals. Further investigation of secondary vaccine hesitancy is necessary for adapting public health messaging to this important population.

Effectiveness of Mask Distribution and Community Counseling in Covid-19 Prevention: A Mixed-Methods Study


 
 
 
 This research investigates the effectiveness of distributing masks and providing counseling to local communities in preventing the spread of Covid-19. Employing a mixed-methods approach, the study utilizes a quasi-experimental design to compare outcomes between intervention and control groups. Participants from diverse communities receive masks through distribution channels and participate in counseling sessions covering Covid-19 prevention strategies. Quantitative data, including surveys on mask usage and infection rates, are complemented by qualitative data from focus group discussions and interviews to provide a comprehensive analysis. Findings indicate a significant reduction in infection rates and improvements in mask usage and community knowledge among intervention groups. Implications for public health policy and practice are discussed, highlighting the importance of multifaceted interventions and community engagement in pandemic response efforts. Limitations of the study include the quasi-experimental design and reliance on self-reported data. Overall, the research contributes to our understanding of effective strategies for mitigating Covid-19 transmission and building resilient communities in the face of pandemics.
 
 
 
 

Prevalence and Correlates of Physical Inactivity Among Individuals with HIV During the First COVID-19 Wave: A Cross-sectional Survey.

Physical activity is associated with improved health outcomes among people with HIV (PWH). In the recent pandemic context, policies designed to mitigate COVID-19 transmission may result in an increase in sedentary lifestyle and decreased physical activity. In this study, we aimed to characterize self-reported physical activity and factors associated with physical inactivity during the first wave of the COVID-19 pandemic among a sample of PWH engaged in care. We also described whether psychological coping strategies measured by the Brief COPE differed based on physical activity levels. Among 260 surveyed PWH in two HIV clinics in the US Northeast, 28.5% (n = 74) met the criteria for being physically active according to the Centers for Disease Control and Prevention (CDC)'s physical activity guidelines. Receiving care in New Haven, CT, presence of a detectable HIV viral load, every day tobacco use, and unhealthy alcohol use were associated with physical inactivity. Problem-focused coping, emotion-focused coping, and avoidance-focused coping strategies were found to be protective against physical inactivity. In adjusted analysis, only problem-focused coping continued to be significantly associated with lower odds of reporting physical inactivity. Efforts are urgently needed to promote physical activity among PWH, including among those without problem-focused coping strategies.

The impact of restricted access on the need and demand for specialist dental services - A consideration for future needs assessments.

The COVID-19 pandemic forced NHS Dental Services to adapt quickly and implement measures which would safeguard essential care provision, whilst mitigating COVID-19 transmission risks. However, these changes impacted on both dental access, and onward referrals for specialist care. A longitudinal study design is used to offer descriptive analysis of referrals sent across three referral groups (orthodontics, paediatric dentistry, suspected cancers) across three time-matched periods (1st July to 31st December in 2019, 2020 and 2021). Anonymised data, extracted from an electronic referral management system (eRMS), are considered. Number of referrals, reasons for referral, Indices of Multiple Deprivation for each referral are discussed. Referrals reduced from 2019 to 2020. Proportionally, the greatest reduction in onward referral was observed amongst individuals from the lowest socioeconomic positions, across all groups. Although mandated to conduct only 62.5% of the 2019 activity, the 2021 referrals exceeded 2019 figures. Proportions referred from the lowest socioeconomic position were still slightly lower across all three groups. Referrals from the lowest socioeconomic groups decreased in 2020, followed by a rebound in 2021, despite a reduction in mandated clinical activity. There are potential implications for future oral health needs assessments that should be considered when developing interventions to enhance access for vulnerable populations as we emerge from the COVID-19 pandemic.

Wearable Wireless Sensor Network for Mitigating COVID-19 Transmission Through Physical Distancing

The global community is currently facing a critical situation with the widespread transmission of the Covid-19 virus. The rapid increase in Covid-19 cases has necessitated immediate action and treatment. As the World Health Organization (WHO) recommended, maintaining a minimum distance of one meter between individuals is an effective preventive measure to avoid transmission through respiratory droplets. To address this issue, this paper introduces a cost-effective design and implementation of a wearable wireless sensor network using the ESP32 microcontroller and Bluetooth Low-Energy (BLE) technology that promotes physical distancing and contact tracing to mitigate the spread of COVID-19. In this research, we have determined that the safe distance between individuals is 1.5 meters. Proximity testing has indicated that an RSSI value of -62 dBm corresponds to a distance below 1.5 meters. Hence, we set -62 dBm as the distance threshold between wearable devices to ensure safe physical distancing. These wearable wireless sensor network devices are intended to assist individuals in maintaining a safe distance from others, thereby reducing the risk of COVID-19 transmission.

Drowsy Eyes and Face Mask Detection for Car Drivers using the Embedded System

Efforts to prevent the spread of the COVID-19 virus have underscored the critical importance of mask-wearing as a preventive measure. Concurrently, road traffic accidents, often resulting from human error, have emerged as a significant contributor to global mortality rates. This study endeavors to address these pressing issues by employing advanced Deep Learning techniques to detect mask usage and identify drowsy eyes, thus contributing to the prevention of COVID-19 and accidents due to driver fatigue. To achieve this objective, an embedded system was developed, utilizing the integration of hardware and software components. The system effectively utilizes MobileNetV2 for face mask detection and employs HOG and SVM algorithms for drowsy eye detection. By seamlessly integrating these detection systems into a single embedded device, the simultaneous detection of both mask usage and drowsy eyes is made possible. The results demonstrates a commendable accuracy rate of 80% for face mask detection and 75% for drowsy eye detection. Furthermore, the mask detection component exhibits a remarkable training accuracy of 99%, while the drowsy eye detection component demonstrates an 80% training accuracy, affirming the system's efficacy in precisely identifying masks and drowsy eyes. The proposed embedded system offers potential applications in enhancing road safety. Its capability to effectively detect drowsy eyes and mask usage in car drivers contributes significantly to preventing accidents due to driver fatigue. Additionally, it plays a vital role in mitigating COVID-19 transmission by promoting widespread mask-wearing among individuals. This study exemplifies the potential of integrating Deep Learning methodologies with embedded systems, thus paving the way for future research and development in the realm of driver safety and virus prevention.

COVID-19 outbreaks in long-term care facilities—a nationwide population-based cohort study in Taiwan, May–July 2021

Long-term care facilities (LTCFs) are high-risk settings for the novel coronavirus disease (COVID-19). The aim of the study was to describe the extent and the impacts of 2021 COVID-19 outbreaks on LTCFs in Taiwan. We retrospectively analyzed the data of each COVID-19 outbreak in LTCFs from May 15 to July 31, 2021 in Taiwan. We characterized the features of LTCFs with outbreaks and compared the characteristics of infected staff members and residents of the affected LTCFs. COVID-19 outbreaks were reported in 16 LTCFs (0.9%). The outbreak was significantly associated with LTCFs with ≥50 beds [adjusted odds ratio (aOR), 6.3; 95%confidence interval [CI], 1.9-21.1] and location of Taipei metropolitan area (aOR, 4.6; 95%CI, 1.7-12.8). Resident cases accounted for 75.4% (203/269) of confirmed cases affected by outbreaks. The 30-day all-cause mortality was 24.2% for residents only and was significantly associated with age ≥65 years [adjusted hazard ratio (aHR, 4.3; 95%CI, 1.7-10.5)], presence of symptoms on diagnosis (aHR, 2.2; 95%CI, 1.3-3.7), and LTCF occupancy rate ≥80% (aHR, 3.0, 95%CI, 1.3-7.4). COVID-19 outbreaks have a critical impact on residents in LTCFs owing to the advanced age and high prevalence of chronic comorbidities in this population. Multi-pronged infection control measures and mass testing are vital for mitigating COVID-19 transmission in LTCFs.

The economics of the COVID-19 pandemic: economic evaluation of government mitigation and suppression policies, health system innovations, and models of care.

The COVID-19 pandemic has impacted the scope of health economics literature, which will increasingly examine value beyond health care interventions such as government policy and broad health system innovations. The study analyzes economic evaluations and methodologies evaluating government policies suppressing or mitigating transmission and reducing COVID-19, broad health system innovations, and models of care. This can facilitate future economic evaluations and assist government and public health policy decisions during pandemics. The Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) was used. Methodological quality was quantified using the scoring criteria in European Journal of Health Economics, Consolidated Health Economic Evaluation Reporting Standards (CHEERS) 2022 Checklist and the National Institute for Health and Care Excellence's (NICE) Cost Benefit Analysis Checklist. PUBMED, Medline, and Google Scholar were searched from 2020-2021. Cost utility analysis (CUA) and cost benefit analysis (CBA) analyzing mortality, morbidity, quality adjusted life year (QALY) gained, national income loss, and value of production effectively evaluate government policies suppressing or mitigating COVID-19 transmission, disease, and impacting national income loss. The WHO's pandemic economic framework facilitates economic evaluations of social and movement restrictions. Social return on investment (SROI) links benefits to health and broader social improvements. Multi-criteria decision analysis (MCDA) can facilitate vaccine prioritization, equitable health access, and technology evaluation. Social welfare function (SWF) can account for social inequalities and population-wide policy impact. It is a generalization of CBA, and operationally, it is equal to an equity-weighted CBA. It can provide governments with a guideline for achieving the optimal distribution of income, which is vital during pandemics. Economic evaluations of broad health system innovations and care models addressing COVID-19 effectively use cost effectiveness analysis (CEA) that utilize decision trees and Monte Carlo models, and CUAs that effectively utilize decision trees and Markov models, respectively. These methodologies are very instructive for governments, in addition to their current use of CBA and the value of a statistical life analytical tool. CUA and CBA effectively evaluate government policies suppressing or mitigating COVID-19 transmission, disease, and impacts on national income loss. CEA and CUA effectively evaluate broad health system innovations and care models addressing COVID-19. The WHO's framework, SROI, MCDA, and SWF can also facilitate government decision-making during pandemics. The online version contains supplementary material available at 10.1007/s10389-023-01919-z.

Pregnant individual's lived experience of cannabis use during the COVID-19 pandemic: a qualitative study.

Quantitative studies indicate that the COVID-19 pandemic has contributed to increased rates of prenatal cannabis use. However, little is known about how the pandemic has impacted cannabis use from the perspective of pregnant individuals themselves. Our objective was to characterize COVID-19-related changes in cannabis use among pregnant individuals who used cannabis during the pandemic. We conducted 18 focus groups (from 11/17/2021 to 12/17/2021) with Black and White pregnant individuals aged 18+ who self-reported prenatal cannabis use during universal screening at entrance to prenatal care (at ~8 weeks gestation) in Kaiser Permanente Northern California. Virtual focus groups were transcribed and analyzed using thematic analysis. The sample of 53 pregnant individuals (23 Black, 30 White) was 30.3 years old (SD = 5.2) on average, and most (70%) self-reported daily versus weekly or monthly prenatal cannabis use. Major themes regarding the impact of the pandemic on cannabis use included increases in use (resulting from depression, anxiety, stress, boredom), and changes in social use (less sharing of smoked cannabis products), modes of use (from smoking to other modes due to respiratory concerns) and source (from storefront retailers to delivery). Coping with mental health symptoms and stress were identified drivers of perceived pandemic-related increases in prenatal cannabis use in 2021. Pregnant individuals adapted their use in ways consistent with public health recommendations to decrease social contact and reduce or quit smoking to mitigate COVID-19 transmission and harms. Proactive, mental health outreach for pregnant individuals during future pandemic waves may reduce prenatal cannabis use.

Integrating socio-cultural value system into health services in response to Covid-19 patients’ self-isolation in Indonesia

This article studies the synergistic sociocultural value system to handle COVID-19 patients in self-isolation in Indonesia, to find an effective formula in COVID-19 spread control. The problems studied here is the response carried out and the constraints faced by the Indonesian government related to the self-isolation policy. Why and how does the Indonesians’ sociocultural value system contribute to COVID-19 patient response? Through the survey conducted via Google Forms, in-depth interviews, focus group discussions and literature study, it is found that the Indonesian government issued the self-isolation regulation for COVID-19 patients to mitigate the rapid and massive COVID-19 transmission. However, many constraints are found in the policy implementation, including; people’s insufficient knowledge and understanding of COVID-19, leading to negative implications for the COVID-19 survivors or patients’ perception, causing social stigmatisation for COVID-19 survivors or patients; COVID-19 task force’s limited access to medicine, medical instrument and hospital facilities. Meanwhile, the Indonesians’ strong socio-cultural values like tolerance, mutual aid, and communal work, including among the educated people in urban society, may be potentially integrated into the health service to respond to COVID-19 patients with their self-isolation. Therefore, their integration and empowerment can be a solution to mitigating COVID-19 transmission in Indonesia.

Ensuring equity in mental health and psychosocial support during the COVID-19 pandemic and beyond

Populations affected by armed conflict and other humanitarian crises are at elevated risk for mental health problems. While the COVID-19 pandemic has had broadly deleterious effects on livelihoods, economic well-being, and population health worldwide, vulnerable groups have been disproportionately impacted by the pandemic. Providing mental health and psychosocial support (MHPSS) services during these times to vulnerable groups, especially in low- and middle-income countries and humanitarian settings, is essential. In an effort to comply with the public health response to the pandemic and mitigate COVID-19 transmission, significant implementation adaptations were made to service delivery during the pandemic. This short report describes several strategies to ensure that equity was central to these adaptations and public health responses, and provides recommendations for ensuring continuity of this progress post-pandemic. Examples and key lessons learned are given related to strategies to increase access to MHPSS services, improve meaningful stakeholder engagement, develop and support community networks, and implement community-based psychosocial support groups. They come from diverse settings of Bangladesh, Colombia, Ecuador, and Lebanon. The COVID-19 pandemic has highlighted the importance of preventing and treating MHPSS issues. It also has created opportunities for innovative programming to address overlooked problems, improve the quality of services provided, and increase focus on equity. It is vital that we use the momentum and attention generated around MHPSS services during the COVID-19 pandemic to continue to build and improve existing MHPSS services in more equitable ways for vulnerable populations.

“It was like you were being literally punished for getting sick”: formerly incarcerated people’s perspectives on liberty restrictions during COVID-19

Background COVID-19 has greatly impacted the health of incarcerated individuals in the US. The goal of this study was to examine perspectives of recently incarcerated individuals on greater restrictions on liberty to mitigate COVID-19 transmission. Methods We conducted semi-structured phone interviews from August through October 2021 with 21 people who had been incarcerated in Bureau of Prisons (BOP) facilities during the pandemic. Transcripts were coded and analyzed, using a thematic analysis approach. Results Many facilities implemented universal “lockdowns,” with time out of the cell often limited to one hour per day, with participants reporting not being able to meet all essential needs such as showers and calling loved ones. Several study participants reported that repurposed spaces and tents created for quarantine and isolation provided “unlivable conditions.” Participants reported receiving no medical attention while in isolation, and staff using spaces designated for disciplinary purposes (e.g., solitary housing units) for public health isolation purposes. This resulted in the conflation of isolation and discipline, which discouraged symptom reporting. Some participants felt guilty over potentially causing another lockdown by not reporting their symptoms. Programming was frequently stopped or curtailed and communication with the outside was limited. Some participants relayed that staff threatened to punish noncompliance with masking and testing. Liberty restrictions were purportedly rationalized by staff with the idea that incarcerated people should not expect freedoms, while those incarcerated blamed staff for bringing COVID-19 into the facility. Conclusions Our results highlighted how actions by staff and administrators decreased the legitimacy of the facilities’ COVID-19 response and were sometimes counterproductive. Legitimacy is key in building trust and obtaining cooperation with otherwise unpleasant but necessary restrictive measures. To prepare for future outbreaks facilities must consider the impact of liberty-restricting decisions on residents and build legitimacy for these decisions by communicating justifications to the extent possible.

Teledentistry use during the COVID-19 pandemic: perceptions and practices of Ontario dentists

BackgroundTeledentistry has demonstrated to expedite oral health consultations, diagnosis, and treatment planning while mitigating COVID-19 transmission risk in dental offices. However, the use of teledentistry by clinicians remains suboptimal. Therefore, this study aimed to determine the perceptions and practices of teledentistry among dentists during the COVID-19 pandemic in Ontario, Canada, and identify associated factors.MethodsA cross-sectional study using an online 39 item survey was conducted among Ontario dentists in December 2021. The questionnaire inquired about socio-demographic attributes, as well as perceptions of teledentistry use during the pandemic, and its future application. Descriptive statistics including frequency distribution of categorical variables and univariate analysis of continuous variables were conducted. Chi-square test was used determine the associations between professionals’ attributes such as age, gender, years of practice, and location of practice, and respondents use of teledentistry. SPSS Version 28.0 was used for statistical analysis.ResultsOverall, 456 dentists completed the survey. The majority were general dentists (91%), worked in private practices (94%), were between 55 and 64 years old (33%), and had over 16 years of professional experience (72%). Approximately 49.3% reported using teledentistry; 13% started before the pandemic, and 36% during the pandemic. The most common reason for non-utilization was a lack of interest (54%). Respondents identified patient triage, consultation, and patient education as the three most important uses of teledentistry. Female dentists (p < 0.05), dentist working in private practice (p < 0.05), and those who worked in a single dental office (p < 0.05) adopted teledentistry more during the pandemic. Respondents who accessed more resources were more likely to report greater utilization of teledentistry, while those who reported being unconformable with teledentistry (p < 0.05) reported less utilization. Additionally, participants who reported feeling comfortable discussing teledentistry with others (p < 0.05), were more inclined to use it in the future.ConclusionsParticipants expressed mixed perceptions toward teledentistry with more than half indicating it is reliable for patient triaging and patient follow-ups. Despite the increased utilization during the COVID-19 pandemic, participants' lack of interest in teledentistry emerged as a barrier to its use. More education and knowledge dissemination about teledentistry's areas of application and technical aspects of use can increase interest in this tool, which may lead to a greater uptake by dental professionals.

Routine saliva testing for SARS-CoV-2 in children: Methods for partnering with community childcare centers.

While considerable attention was placed on SARS-CoV-2 testing and surveillance programs in the K-12 setting, younger age groups in childcare centers were largely overlooked. Childcare facilities are vital to communities, allowing parents/guardians to remain at work and providing safe environments for both children and staff. Therefore, early in the COVID-19 pandemic (October 2020), we established a PCR-based COVID-19 surveillance program in childcare facilities, testing children and staff with the goal of collecting actionable public health data and aiding communities in the progressive resumption of standard operations and ways of life. In this study we describe the development of a weekly saliva testing program and provide early results from our experience implementing this in childcare centers. We enrolled children (aged 6 months to 7 years) and staff at seven childcare facilities and trained participants in saliva collection using video chat technology. Weekly surveys were sent out to assess exposures, symptoms, and vaccination status changes. Participants submitted weekly saliva samples at school. Samples were transported to a partnering clinical laboratory or RT-PCR testing using SalivaDirect and results were uploaded to each participant's online patient portal within 24 h. SARS-CoV-2 screening and routine testing programs have focused less on the childcare population, resulting in knowledge gaps in this critical age group, especially as many are still ineligible for vaccination. SalivaDirect testing for SARS-CoV-2 provides a feasible method of asymptomatic screening and symptomatic testing for children and childcare center staff. Given the relative aversion to nasal swabs in younger age groups, an at-home saliva collection method provides an attractive alternative, especially as a routine surveillance tool. Results can be shared rapidly electronically through participants' private medical chart portals, and video chat technology allows for discussion and instruction between investigators and participants. This study fosters a cooperative partnership with participating childcare centers, parents/guardians, and staff with the goal of mitigating COVID-19 transmission in childcare centers. Age-related challenges in saliva collection can be overcome by working with parents/guardians to conceptualize new collection strategies and by offering parents/guardians continued virtual guidance and support.

Modeling and Global Sensitivity Analysis of Strategies to Mitigate Covid-19 Transmission on a Structured College Campus

In response to the COVID-19 pandemic, many higher educational institutions moved their courses on-line in hopes of slowing disease spread. The advent of multiple highly-effective vaccines offers the promise of a return to “normal” in-person operations, but it is not clear if—or for how long—campuses should employ non-pharmaceutical interventions such as requiring masks or capping the size of in-person courses. In this study, we develop and fine-tune a model of COVID-19 spread to UC Merced’s student and faculty population. We perform a global sensitivity analysis to consider how both pharmaceutical and non-pharmaceutical interventions impact disease spread. Our work reveals that vaccines alone may not be sufficient to eradicate disease dynamics and that significant contact with an infectious surrounding community will maintain infections on-campus. Our work provides a foundation for higher-education planning allowing campuses to balance the benefits of in-person instruction with the ability to quarantine/isolate infectious individuals.