Public Health Prevention Measures Research Articles

Challenges for Peritoneal Dialysis Centers Before and During the COVID-19 Pandemic in Mexico

Aim. We aimed at performing a situation analysis to identify challenges that Mexico's peritoneal dialysis centers (PDCs) have faced before and during the COVID-19 pandemic.Methods. From May–August 2021, we conducted a cross-sectional nationwide online survey with the heads of 136 PDCs at the Mexican Institute of Social Security. The survey gathered information about PDCs characteristics and the adaptations and challenges they faced before and during the COVID-19 pandemic. The response rate to the survey was 79.5% (136 out of 171 PDCs). We used descriptive statistics to analyze the data.Results. The survey responses suggest wide variations between PDCs regarding their number of patients, healthcare staff availability, and compliance with the International Society for Peritoneal Dialysis recommendations. In the pre-pandemic period, PDCs faced staff shortages (71.3%); scarcity of supplies (39.0%); catheter dysfunctions (29.4%); poor patient adherence to peritoneal dialysis (PD) (28.6%); and lack of patient support networks (25.7%). During the pandemic, PDCs faced emergent challenges, such as losing designated PDC areas within hospitals (61.0%), and staff and supply shortages (60.2%, 41.1%, respectively) because of a reallocation of human and physical resources towards the COVID-19 response. The pandemic prompted 86.7% of PDCs to implement preventive public health measures, delay non-urgent consultations and procedures (63.6%), and introduce telemedicine (37.3%). Additionally, fewer patients visited PDCs because of their fear of COVID-19 contagion (36.0%).Conclusions. Actions are urgently needed to ensure adherence to evidence-based PD guidelines and sufficient resources, including trained staff, supplies, and designated spaces to strengthen PDCs and provide safe and effective PD.

Functional Bakery Snacks for the Post-COVID-19 Market, Fortified with Omega-3 Fatty Acids

Flaxseed is a natural ingredient with health benefits because of its rich contents of omega-3 fatty acids and fiber. In this study, whole-meal sliced bread, chocolate cookies, and breadsticks, which were enriched with flaxseed (Linum usitatissimu) were produced as a natural enrichment source in order to provide functional baked goods. The three innovative products were tested as sources of omega-3 fatty acids in terms of α-linolenic acid according to EU 1924/2006 as well as for their in vitro antithrombotic/anti-inflammatory effect. The results showed that omega-3 fatty acids had high concentrations (>0.6 g per 100 g of product) in all products even after the heating treatment with constant stability during the time of consumption. All the enriched products exerted higher, but in different grade, in vitro antithrombotic/anti-inflammatory activity compared to the conventional products. The products were evaluated positively by a panel of potential consumers without significant differences compared to conventional corresponding products. Enriched bakery products with omega-3 fatty acids may represent a novel opportunity for the development of functional foods that can be locally consumed, thereby contributing to public health prevention measures that the post-COVID-19 era demands.

Social responsibility perspective in public response to the COVID-19 pandemic: a grounded theory approach

BackgroundCombating viral outbreaks extends beyond biomedical and clinical approaches; thus, public health prevention measures are equally important. Public engagement in preventive efforts can be viewed as the social responsibility of individuals in controlling an infectious disease and are subjected to change due to human behaviour. Understanding individuals’ perception of social responsibility is crucial and is not yet explored extensively in the academic literature. We adopted the grounded theory method to develop an explanatory substantive theory to illustrate the process of how individual responded to the outbreak from a social responsibility perspective.MethodsIn-depth interviews were conducted among 23 Malaysians either through telephone or face-to-face depending on the participant’s preference. Both purposive and theoretical sampling were used. Participants were invited to share their understanding, perceptions and activities during the COVID-19 pandemic. They were further probed about their perceptions on complying with the public health interventions imposed by the authorities. The interviews were audio-recorded and transcribed verbatim. Data was analysed via open coding, focus coding and theoretical coding, facilitated by memoing, sketching and modelling.ResultsStudy findings showed that, social responsibility is perceived within its role, the perceived societal role responsibility. In a particular context, an individual assumed only one of the many expected social roles with their perceived circle of responsibility. Individuals negotiated their actions from this perspective, after considering the perceived risk during the outbreak. The four types of behaviour depicted in the matrix diagram facilitate the understanding of the abstract concept of negotiation in the human decision-making process, and provide the spectrum of different behaviour in relation to public response to the COVID-19 pandemic.ConclusionsOur study adopted the grounded theory approach to develop a theoretical model that illustrates how individual response to COVID-19 preventive measures is determined by the negotiation between perceived societal role responsibility and perceived infection risk. This substantive theoretical model is abstract, thus has relevance for adoption within similar context of an outbreak.

Knowledge, attitude and perception of West Africans towards COVID-19: a survey to inform public health intervention

BackgroundThe first case of the novel coronavirus disease-2019 (COVID-19) in West Africa was first confirmed in Nigeria in February 2020. Since then, several public health interventions and preventive measures have been implemented to curtail transmission of the causative agent, the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Therefore, this study was performed to assess the knowledge, attitudes, and perceptions of West Africans towards COVID-19.MethodsAn online survey was conducted between 29 September to 29 October 2020 among West Africans. Thirty-three survey questions were designed to collect sociodemographic data and participants’ knowledge, attitude and perception towards COVID-19. The study targeted all West African nationals who were 18 years and above, and willing to participate in the study. Participants were either in-country or abroad.ResultsOverall, 1106 respondents (≥18 years) from 16 West African countries, with about 12.1% of them residing outside the West African subregion, participated in the survey. The respondents had an average COVID-19 knowledge score of 67.82 ± 8.31, with knowledge of the disease significantly associated with the country of residence (p = 0.00) and marginally (p = 0.05) so with settlement types (i.e., urban, suburban and rural areas). Most respondents (93.4%) could identify the main COVID-19 symptoms, and 73.20% would consult a healthcare professional if infected with SARS-CoV-2. Also, 75.2% of the respondents are willing to receive the COVID-19 vaccine, whereas 10.40% and 14.40% are unwilling and undecided, respectively. Perceptions of what constitute COVID-19 preventive measures were highly variable. Approximately, 8% of the respondents felt that their government responded excellently in managing the pandemic while a third felt that the response was just good. Also, more than half (54%) opined that isolation and treatment of COVID-19 patients is a way of curbing SARS-CoV-2 spread.ConclusionsMost West Africans have basic knowledge of COVID-19 and showed a positive attitude, with likely proactive practice towards the disease. However, results showed that these varied across countries and are influenced by the types of settlements. Therefore, the health and education authorities in various countries should develop focused measures capturing people in different settlements to improve their preventative measures when designing public health interventions for COVID-19 and any future epidemics or pandemics.

Epidemiological characteristics and spatiotemporal patterns of scrub typhus in Yunnan Province from 2006 to 2017

Scrub typhus is an acute infectious disease in humans. A temporal, spatial and epidemiologic study was conducted to understand the characteristics of scrub typhus in Yunnan, to assist public health prevention and control measures. Based on the data on all cases reported in Yunnan during 2006–2017, we characterized the epidemiological features. Spatio-temporal patterns and Q-type cluster method were adopted to analyze the incidence of scrub typhus in Yunnan. In total, 27,838 scrub typhus cases were reported in Yunnan during 2006–2017. Of these, 49.53% (13,787) were male and 50.47% (14,051) were female (P > 0.05). Most patients were farmers (71.70%) (P < 0.05) and children aged 0–5 years (13.16%) (P < 0.01), which accounted for 84.86% of the total cases. An almost 20-fold increase in the number of patients was observed in 2017 (6,337 cases) compared to 2006 (307 cases). Baoshan and Lincang had the most cases accounting for 41.94%, while Diqing had the lowest incidence (only 3 cases). Sixteen municipalities infected were classified into three groups numbered in sequence. The incidence of scrub typhus in Yunnan is high and the annual incidence increased noticeably over time. Our results also indicate that surveillance and public education need to be focused on Baoshan, Lincang and Dehong.

Stigma and blame related to COVID-19 pandemic: A case-study of editorial cartoons in Canada

The COVID-19 pandemic represents not only the spread of a highly contagious and potentially fatal virus, but also an outbreak of theories, rumors, discourses and representations trying to make sense of a crisis. In this article, we explore the issue of blame and stigma in the context of the COVID-19 pandemic in Canada. We do so by studying editorial cartoons published about COVID-19 in ten mainstream Canadian newspapers between January 2020 and March 2021. We identified 203 editorial cartoons that highlight common discourses which blame or stigmatize specific groups of people for the origin or transmission of COVID-19, or for their behavior during the pandemic. The cartoons focused on four groups: 1) people of Chinese origin or descent and of other national/geographic provenance (Americans, Canadians from specific provinces, urban residents); 2) international travelers; 3) people who do not respect the preventive measures to contain the pandemic; and 4) people who question or criticize the scientific discourses about COVID-19. Our analysis revealed an “othering process” common in times of pandemic. Our analysis of editorial cartoons in Canada also uncovered a moralization around the respect of the counter measures against COVID-19. These editorial cartoons largely divide the population into two groups: 1) “virtuous” people who are “selfless” and “smart” and who respect the public health preventive measures; 2) those who are “immoral”, “self-centered”, “silly” and even “stupid”, who do not respect the recommended measures to prevent the transmission of COVID-19. While negatively portraying these individuals may help promote adherence to the recommended measures, it also can exacerbate polarization. Analyzing editorial cartoons can be a useful approach to rapidly gather information on attitudes and feelings in the public at a specific time and place.

Is the Unequal COVID-19 Burden in Canada Due to Unequal Levels of Citizen Discipline across Provinces?

The unequal burden of the coronavirus disease 2019 (COVID-19) crisis (e.g., in terms of infection and death rates) across Canadian provinces is important and puzzling. Some have speculated that differences in levels of citizen compliance with public health preventive measures are central to understanding cross-provincial differences in pandemic-related health outcomes. However, no systematic empirical test of this hypothesis has been conducted. In this research, we make use of an exceptionally large dataset that includes 23 survey waves (N = 22,610) fielded in Canada across 12 months (April 2020–April 2021) to answer the question “Is there evidence of substantial cross-provincial differences in citizen compliance with basic public health measures designed to prevent the spread of infection?” We find that regional differences in self-reported behaviour are few and very modest, suggesting that interprovincial differences in COVID-19–related health outcomes have little to do with differences in citizen compliance, at least in the first year of the pandemic. These results have important implications. Although it is crucial that we continue to study regional variations related to the COVID-19 burden, public health agency officials, pundits, and politicians should be cautious when musing about the role of citizen compliance as the primary explanation of interprovincial pandemic health outcomes.

Improving Global TBI Tracking and Prevention: An Environmental Science Approach

Traumatic brain injury (TBI) has grown to pandemic proportions, placing a significant burden on global public health, socio-economic condition, and human capital resources. This paper examines the global spatial distribution of TBI using currently available data from research studies to advance a comprehensive review of TBI that integrates geospatial and environmental perspectives. It reveals significant geographic differences and socioeconomic gaps in global TBI incidence tracking, prevalence, and mortality rates. It proposes an environmental science approach to improving public awareness, tracking and prevention of TBI through the integration of environmental data using GIS. The use of GIS for accurate location-based mapping and integrated analysis of environmental data subsequently helps reveal risk factors for targeted research, education outreach, and more effective public health policy and preventative measures.

Influence of Social Determinants of Health on COVID-19 Infection in Socially Vulnerable Groups.

The coronavirus 2019 (COVID-19) pandemic has had a significant impact on the economy and health, especially for the most vulnerable social groups. The social determinants of health are one of the most relevant risks for becoming infected with COVID-19, due to the health consequences for those who are exposed to it. The objective of this study was to analyze the influence of social determinants in health on COVID-19 infection in vulnerable social groups. A transversal epidemiological study was carried out on 746 individuals in vulnerable situations living in conditions of extreme poverty in disadvantaged areas in the province of Almeria (southeast of Spain). Social determinants of health such access to drinking water (p < 0.001) and economic income (p = 0.04) influenced the infection of COVID-19. A binary logistic regression model showed that the significant predictors of COVID-19 infection were the lack of economic income and inaccessible drinking water. The government and social health services must be aware of this problem in order to play an active role in searching for solutions and implementing public health prevention measures to eliminate social inequalities in health.

A Multidisciplinary Approach to Health Prevention with the Emphasis on Multimorbidity in Post Conflict Serbia – Results of the Qualitative Research

In the period 2019-2021, the Serbian team (consisted form representatives of the Institute for Biological Research "Siniša Stanković", Institute of Public Health of Serbia "Dr Milan Jovanović Batut", Environmental Protection Agency, the Medical Faculty in Belgrade, Ministry of Health and the Institute of Social Sciences) conducted the research project on health prevention and multimorbidity in post conflict Serbia. Objective was to understand the perception of relevant actors about possible risk factors (environmental, behavioral, and socio-economic) for the occurrence of multimorbidity. Methodology applied in qualitative research was focus groups and interviews with the sampled population group representatives. Target population was health professionals, health providers’ and local municipalities’ management. The purposes of the research were: 1) insight into the main multimorbidity factors through the prism of stakeholders on the local level; 2) drafting recommendations on changing regulation and practice in public health prevention measures. Results of the research show that there is an agreement in the stakeholder perception that multimorbidity in Serbia is increasing and that preventive measures should be strengthened. All groups of predictors (environmental, behavioral, and socio-economic) are perceived as of equal importance. The research was the basis for development of the legislative and systemic recommendations.

Tuberculin conversion rate after BCG vaccination of apparently healthy infants in a resource-poor setting

Background: Although Bacillus Calmette Guerin (BCG) vaccine remains one of the most important public health preventive measures against tuberculosis (TB), the presence of a BCG scar may not imply an immune response. Tuberculin reactivity after BCG vaccination has been the most common measure of the effect of the BCG vaccine. Post-vaccination BCG-induced tuberculin reactivity ranges from no induration to an induration diameter of 15 mm. However, tuberculin conversion in infants is usually about 10 mm in more than 90% of infants tested at 12 weeks post-vaccination age. Objective: This study sought to assess the tuberculin conversion rate after BCG vaccination. Materials and Methods: It was a hospital-based cross-sectional study. Two hundred and eighty (280) infants aged 13 to 15 weeks who received BCG vaccination within one month of birth were enrolled. The BCG scar diameter was measured, and Mantoux test was done. Data were analyzed by using the Statistical Package for Social Sciences (SPSS), version 20 (Chicago Il). Results: Among the 280 BCG-vaccinated infants, tuberculin conversion rate was 64%, whereas scar failure rate was 28.9%. Overall, 75.9% of infants with a BCG scar had a positive Mantoux test. The BCG-vaccinated infants with a BCG scar were about six times more likely to have a tuberculin conversion than those without a BCG scar (OR =5.641, 95% C.I = 3.227 to 9.859). Conclusion: There was a 64% conversion rate among the BCG-vaccinated infants. The presence of the BCG scar correlated well with the tuberculin conversion rate.

The Appraisal and Endorsement of Individual and Public Preventive Measures to Combat COVID-19 and the Associated Psychological Predictors among Chinese Living in Canada

Aims: The study examines the factors related to the appraisal and adherence of the individual and public health preventive measures. Background: The effectiveness of the measures battling the pandemic was largely determined by the voluntary compliance of the public. Objectives: This study aimed to identify psychological perception factors related to the appraisal of individual measures and endorsement of public health measures during the early stage of the COVID-19 pandemic among Chinese living in Canada. Methods: A convenience sample of 656 participants completed an online survey. Nonparametric Kruskal Wallis tests were used to compare COVID perception variables (e.g., perceived susceptibility, fear, perceived severity, and information confusion) among different sociodemographic subgroups. Bootstrapped regression models were used to assess the association of these variables with outcome measures. Results: Compared to their counterpart groups, lower perceived susceptibility was reported by adults 65 years and older (p = .002) or retired (p = .015); greater fear was reported by females (p = .044), those with lower education (p = .001), and Mainland Chinese (p = .033); greater perceived severity was reported by individuals with lower education and smaller household size (ps = .003). Perceived susceptibility was inversely associated with individual measure appraisal (p = .032). Perceived severity was positively associated with individual measure appraisal (p = .005) and public measure endorsement (p &lt; .001). Conclusion: Individual behaviour measure appraisal was predicted by lower perceived susceptibility and higher perceived severity, whereas public health measure endorsement was related to higher perceived severity. These results inform the public and the policymakers about the critical factors that affect the preventive measure appraisal and endorsement.

Social risks, economic dynamics and the local politics of COVID-19 prevention in Eldoret town, Kenya

ABSTRACT A steady and consistent national and local government leadership is crucial in times of crisis. The trust in government – which can be so fragile – was strong in Eldoret town, a large municipal in western Kenya widely known for ethnic conflicts. In our interviews with 20 business people and 30 community members from Eldoret town, we found that the trust built early in the pandemic was broken due to individual leaders who eventually dismissed public health promotion and engaged in politics and corruption of funds for COVID-19 relief. When leadership was strong, locals in Eldoret town (and especially business owners) engaged in public health prevention measures for the greater good. But when leadership slipped, people complained and eventually ignored public health prevention measures at home, on the bus, and in businesses around town, causing the intensification of outbreaks. This was most common among those engaged in the formal economy as those in the informal economy were more likely to mistrust the government altogether. We show who falls through the cracks when government policy targets viral threats and suggest how local government and public health agencies might work to control COVID-19 infections while ensuring that all Eldoret residents are cared for.

Estimating the Impact of Low Influenza Activity in 2020 on Population Immunity and Future Influenza Seasons in the United States.

BackgroundInfluenza activity in the 2020–2021 season was remarkably low, likely due to implementation of public health preventive measures such as social distancing, mask wearing, and school closure. With waning immunity, the impact of low influenza activity in the 2020–2021 season on the following season is unknown.MethodsWe built a multistrain compartmental model that captures immunity over multiple influenza seasons in the United States. Compared with the counterfactual case, where influenza activity remained at the normal level in 2020–2021, we estimated the change in the number of hospitalizations when the transmission rate was decreased by 20% in 2020–2021. We varied the level of vaccine uptake and effectiveness in 2021–2022. We measured the change in population immunity over time by varying the number of seasons with lowered influenza activity.ResultsWith the lowered influenza activity in 2020–2021, the model estimated 102 000 (95% CI, 57 000–152 000) additional hospitalizations in 2021–2022, without changes in vaccine uptake and effectiveness. The estimated changes in hospitalizations varied depending on the level of vaccine uptake and effectiveness in the following year. Achieving a 50% increase in vaccine coverage was necessary to avert the expected increase in hospitalization in the next influenza season. If the low influenza activity were to continue over several seasons, population immunity would remain low during those seasons, with 48% of the population susceptible to influenza infection.ConclusionsOur study projected a large compensatory influenza season in 2021–2022 due to a light season in 2020–2021. However, higher influenza vaccine uptake would reduce this projected increase in influenza.

1321. Acquisition and Transmission of Streptococcus pneumoniae in Individuals Over the Age of 60 Years Residing in New Haven, CT, USA

BackgroundDespite the widespread use of pneumococcal conjugate vaccines, particularly in children, an important burden of pneumococcal disease remains in older adults. The acquisition and transmission rates of pneumococcus between older adults have not been well characterized.MethodsBetween October 2020-June 2021, couples living in the Greater New Haven Area were enrolled if both individuals were over the age of 60 years and did not have any individuals under the age of 60 years living in the household. Saliva samples and questionnaires regarding social patterns and medical history were obtained every 2 weeks for a period of 10 weeks. Following culture-enrichment, extracted DNA was tested using qPCR for pneumococcus-specific sequences piaB and lytA. Individuals were considered positive for pneumococcal carriage when qPCR Ct-values for piaB +/- lytA were less than 40.ResultsTo date, we have collected 495 saliva samples from 95 individuals (48 households). Of 495 saliva samples, 31 (5.9%) have tested positive for pneumococcus by either piaB only (n=9) or both lytA and piaB (n=22). Of 95 individuals, 16 (16.8%) (representing 13, or 27.1% households) have tested positive at least once. Six of the 16 (37.5%) carriers tested positive at multiple timepoints, though none were colonized at all 6 time points over the course of the 10 weeks of study enrolment. For 3 of the 48 (6.3%) households, both members of the couple were identified as carriers, though not necessarily at the same sampling moment.ConclusionThe preliminary findings of this longitudinal transmission model demonstrate evidence of pneumococcal acquisition among older adults measured by molecular tools. These transmission patterns and high rates of pneumococcal carriage in adults were observed during a period when the COVID-19 pandemic led to numerous preventative public health measures that may have reduced pneumococcal transmission (e.g., social distancing, mask wearing, bans on mass gatherings, restaurant closures, travel restrictions). Disclosures Anne Wyllie, PhD, Global Diagnostic Systems (Consultant)Pfizer (Advisor or Review Panel member, Research Grant or Support)PPS Health (Consultant)Tempus Labs, Inc (Research Grant or Support) Ronika Alexander-Parrish, RN, MAEd, Pfizer (Employee, Shareholder) Adriano Arguedas, MD, Pfizer (Employee) Bradford D. Gessner, MD, MPH, Pfizer Inc. (Employee) Daniel Weinberger, PhD, Affinivax (Consultant)Merck (Consultant, Grant/Research Support)Pfizer (Consultant, Grant/Research Support)

Seasonal shedding patterns of diverse henipavirus-related paramyxoviruses in Egyptian rousette bats

Bat-borne viruses in the Henipavirus genus have been associated with zoonotic diseases of high morbidity and mortality in Asia and Australia. In Africa, the Egyptian rousette bat species (Rousettus aegyptiacus) is an important viral host in which Henipavirus-related viral sequences have previously been identified. We expanded these findings by assessing the viral dynamics in a southern African bat population. A longitudinal study of henipavirus diversity and excretion dynamics identified 18 putative viral species circulating in a local population, three with differing seasonal dynamics, and the winter and spring periods posing a higher risk of virus spillover and transmission. The annual peaks in virus excretion are most likely driven by subadults and may be linked to the waning of maternal immunity and recolonization of the roost in early spring. These results provide insightful information into the bat-host relationship that can be extrapolated to other populations across Africa and be communicated to at-risk communities as a part of evidence-based public health education and prevention measures against pathogen spillover threats.

Adherence to COVID-19 Related Public Health Measures among Mania University Students Based on Health Belief Model

Background: Everyone has been affected by the coronavirus disease (COVID-19) epidemic, including students. Understanding public knowledge and adherence level to preventive measures is vital for prevention of COVID-19 pandemic. Aim: to assess adherence to COVID-19 related public health measures among Minia university students based on health belief model. Research design: a descriptive cross-sectional design was used. Setting: Minia University, which comprises (20) faculties. Sample: A systematic random sample consisted of 460 students Data collection Tools: 1st tool: Structured interview questionnaire: included questions related to socio-demographic characteristics, medical data and life style data. 2nd tool: COVID-19 Knowledge Assessment Questionnaire. 3rd tool: COVID-19 Health Belief Scale. 4th tool: Covid-19 Self-Efficacy Scale and the 5th tool: Adherence to COVID-19 related Public Health Measures Scale. Results: less than half of participants their age ranged from 21 – 23yrs. with mean age (21 ± 2.05 yrs.). More than two-thirds of them were knowledgeable about COVID-19 related public health preventive measures with mean score (21.45 ± 3.55). 60.6% of participants students were adherent to these measures. 70.2% of participants have high perceived susceptibility to get COVID-19 while 68.4% of them have high perceived severity. 70.7% of them have high self-efficacy to comply with those preventive measures. Conclusion: There was highly statistically significant relation between participants level of adherence and their perceived susceptibility, perceived severity, perceived barriers, their cues to adhere with those measures and their self-efficacy. Recommendations: Additional research studies in Egypt should be conducted with a broader geographic scope to assess over all community-level of adherence to preventive measures and to identify barriers of noncompliance with these measures.

Co-detection of the measles vaccine and wild-type virus by real-time PCR: public health laboratory protocol.

In rare cases vaccination with the measles virus vaccine genotype A (MeVA) may cause a vaccine reaction with clinical signs similar to infection with wild-type measles virus (MeVwt). Rapid differentiation between MeVA and MeVwt infection is important for taking adequate public health measures. Recently, a few MeVA real-time reverse-transcription quantitative PCR methods (RT-qPCRs) were described that can distinguish between MeVA and MeVwt. However, detection of MeVA does in theory not exclude infection with MeVwt. In the present study, we established a protocol for determination of co-infections with MeVA and MeVwt. To this end, MeVA RT-qPCRs were used in combination with the routine measles virus (MeV) RT-qPCR, and the results suggested that the differences between the RT-qPCR Ct values (delta Ct, ∆Ct) could be used as criteria. Subsequently, we tested samples from vaccine-associated measles cases that were confirmed by genotyping. In addition, experimental mixtures of MeVA and MeVwt were tested in different concentrations. All tested MeVA clinical samples had ∆Ct ≤3.6. The results of experimental mixtures showed a mean ∆Ct ≤2.8 for genotype A alone and >3.2 when combined with either genotype B3 or D8. The results of a receiver operator characteristic analysis indicated that the optimum ∆Ct for use as a cut-off value was 3.5, while with ∆Ct values of 2.9 and 3.7 sensitivity and specificity were respectively 1.00. Thus, ∆Ct could be used to exclude the presence of MeVwt if MeVA is detected and ∆Ct is <2.9, while ∆Ct >3.7 were highly suggestive of co-infection and ≥2.9 ∆Ct <3.7 warranted additional confirmation, such as next-generation sequencing. This RT-qPCR-based protocol could be used for the exclusion of infection with MeVwt in cases with vaccine-associated measles reaction, crucial for the timely implementation of public health prevention and control measures.

Surges of hospital-based rhinovirus infection during the 2020 coronavirus disease-19 (COVID-19) pandemic in Beijing, China

BackgroundA series of public health preventive measures has been widely implemented in Beijing to control the coronavirus disease-19 (COVID-19) pandemic since January 2020. An evaluation of the effects of these preventive measures on the spread of other respiratory viruses is necessary.MethodsRespiratory specimens collected from children with acute respiratory infections were tested by NxTAG™ respiratory pathogen panel assays during January 2017 and December 2020. Specimens characterized as rhinoviruses (RVs) were sequenced to identify the RV species and types. Then, the epidemiology results of respiratory pathogens in 2020 were compared with those from 2017 to 2019 using SPSS statistics 22.0.ResultsThe positive rates of adenovirus (ADV), influenza virus (flu), RVs, and respiratory syncytial virus (RSV) dropped abruptly by 86.31%, 94.67%, 94.59%, and 92.17%, respectively, from February to May 2020, compared with the average level in the same period during 2017–2019. Positive rates of RVs then steeply increased from June 2020 (13.77%), to an apex (37.25%) in August 2020, significantly higher than the average rates (22.51%) in August 2017–2019 (P = 0.005). The increase, especially in group ≥ 3 years, was accompanied by the reopening of schools and kindergartens after the 23rd and 24th week of 2020 in Beijing.ConclusionsWhereas the abrupt drop in viral pathogen positive rates from February to May 2020 revealed the remarkable effects of the COVID-19 preventive measures, the sharp increase in positive rates of RVs from the 23rd week of 2020 might be explained by the reopening of schools and kindergartens in Beijing.

Delivering public health interventions

Public health has faced unprecedented pressures from the dual demands of responding to the COVID-19 pandemic while maintaining delivery of essential public health services such as screening and vaccinations. At the beginning of the pandemic, public health efforts turned towards implementing appropriate preventative health measures to control or mitigate transmission, while the rollout of COVID-19 vaccines has started since late 2020. Preventative public health measures to control or mitigate transmission include observing hygiene guidelines; using personal protective equipment (such as masks); limiting contact through physical distancing measures, curfews, bans on non-essential persons' movement and closing schools, businesses, as well as regional and national borders. All these measures have been supported, with Find, Test, Trace, Isolate, and Support (FTTIS) services, but many countries have struggled to implement these successfully, even months into the pandemic. While organisations such as the ECDC have issued guidance on implementing such interventions depending on the epidemiological situation, national strategies have ultimately depended on the countries' priorities, political realities and weighing the benefits against the potential adverse effects (such as mental health, economic and social impacts) and there has been little coordination among the countries. International coordination in the area of vaccines has also not always worked effectively. This presentation will provide an overview of strategies on implementing effective public health measures, including FTTIS systems and COVID-19 vaccinations. A brief overview of key metrics to assess resilience in the area of public health delivery will also be provided.