Community Spread Research Articles

Urban Green Spaces on Maternal Sleep Quality One Year Postpartum Amid COVID-19 Alert Level Changes

Abstract Background Benefits of green spaces (GS) on sleep quality were found, particularly for mothers, which, in turn, contributed to maternal health and offspring development. However, the COVID-19 pandemic imposed restrictions on environmental access, potentially altering the influence of urban GS on sleep quality. This study aims to explore the impact of urban GS on maternal sleep quality one year postpartum during the pandemic. Methods Participants were drawn from the Longitudinal Examination across Prenatal and Postpartum Health in Taiwan study, tracking individuals from early pregnancy across five hospitals in Taipei since 2011. We utilized data spanning from 2019 to 2024, with May 2021 (the initial soft lockdown due to community spread) serving as the cutoff point to delineate early and late pandemic stages. Self-reported sleep quality one year postpartum was assessed using the Pittsburgh Sleep Quality Index. Residential GS was evaluated using the Normalized Difference Vegetation Index (NDVI) within various radii (250m to 2000m). Multiple logistic regression was utilized. Results From the 311 participants, in the early stage of the pandemic, an increase of 0.1 units in NDVI within a 250m radius during both prenatal and postnatal periods (0-12 months) was associated with improved maternal sleep quality (OR = 1.57; 95% CI = 1.08, 2.32, and OR = 1.58; 95% CI = 1.07, 2.30) after adjustments. The impact diminished as the radius increased. Additionally, no significant association was found during the late stage of the pandemic across any of the studied radii. Conclusions The findings suggest a positive correlation between proximity to urban GS and maternal sleep quality during the early stages of the pandemic, with more significant benefits observed at shorter distances, likely due to restricted movement and access. These results underscore the importance of proximity in urban planning and environmental improvement initiatives aimed at enhancing maternal and child health. Key messages • Urban green spaces significantly enhance maternal sleep quality one year postpartum in the early stages of the pandemic, highlighting the importance of proximity for health benefits. • As the radius of green spaces decreased, their positive impact on maternal sleep quality during the early pandemic intensified, underscoring the need for adaptive urban planning strategies.

Optimizing RT-qPCR Detection of Enveloped and Non-enveloped Viruses in Wastewater: A Comparative Study in Grenada

Abstract Introduction/Objective Wastewater-based epidemiology (WBE) is an effective methodology to monitor the community spread of pathogens and has successfully been used to identify potential outbreaks. Most standardized methodologies used in WBE for the detection of viruses have been validated for non-enveloped viruses; therefore, there is a need for the development of a standardized protocol for the detection of both enveloped (such as SARS- CoV-2) and non-enveloped viruses (such as Hepatitis A). Wastewater seeded with Pseudomonas syringae bacteriophage (Φ6), an enveloped virus surrogate, and coliphage MS2, a non-enveloped virus surrogate, were used to evaluate the efficiency of four different aluminium flocculation methods. Untreated wastewater spiked with known amounts of surrogates was used as a control for viral recovery. Methods/Case Report Four different viral concentration methods were used. Method 1: AlCl3 flocculation at pH 3.5 followed by centrifugation, resuspension with 10% beef extract and filtered with a 0.22 μm filter. Method 2: AlCl3 flocculation at pH 6.0 followed by room temperature agitation, centrifugation, and resuspension with 3% beef extract. Method 3: Mixed method protocol-AlCl3 flocculation at pH 3.5 followed by room temperature agitation, centrifugation, resuspension with 3% beef extract. Method 4: Mixed method protocol-AlCl3 flocculation at pH 6.0 followed by centrifugation, resuspension with 10% beef extract filtered with a 0.22 μm filter. Viral RNA was extracted after concentration, and reverse-transcription quantitative polymerase chain reaction (RT- qPCR) was performed. Results (if a Case Study enter NA) The average Ct reduction of untreated wastewater compared to spiked was calculated for each method. The highest recovery of both Φ6 and MS2 was obtained using Method 3 (mixed protocol) with a significant difference at 95% confidence in the recovery of Φ6 (p= 0.0029) and MS2 (p= 0.0225). Conclusion Previous results from our lab demonstrate the importance of pH during the flocculation step of viral concentration using different methods of concentration. Here, the results suggest that the increased contact time between virus and the flocs is also critical. This can facilitate the implementation of WBE in Grenada to monitor and track potential viral outbreaks of both enveloped and non-enveloped viruses such as SARS-CoV-2 and Hepatitis A.

Overdose as a complex contagion: modelling the community spread of overdose events following law enforcement efforts to disrupt the drug market

BackgroundThe opioid overdose mortality crisis in the USA is an ongoing public health epidemic. Ongoing law enforcement strategies to disrupt local unregulated drug markets can have an iatrogenic effect of...

Multimodal surveillance of Care-related infections by Alert microorganisms in Ospedali Riuniti di Vittoria e Comiso ASP Ragusa

Background: monitoring the incidence and surveillance of alert microorganism infections detected in inpatients of the Ospedali Riuniti di Vittoria and Comiso in 2023. Objectives: early identification and implementation of shared pathways aimed at prevention and control of care-related infections. the spread of colonization and infections; promotion and implementation of effective risk assessment programs. Methods: a multicenter study was conducted on 79 patients with infections with Alert microorganisms, in ordinary hospitalization, day service, and day hospital, of the "R. Guzzardi" hospitals of Vittoria and "R. Margherita" of Comiso. Sample stratification was performed according to gender, females 51.9% and males 48%, and the four age groups: 18-40 (4.8%), 41-60 (9.5%), 61-80 (45.2%), >80 (40.5%), x̄ 51.90. The calculated mortality rate was n.16 (20.25%). The types, number and frequency of use of invasive devices were described (n.68, 86%, including 64.5% urinary bladder catheter). Results: the operating unit in which there is significant positivity to Alert infections is the UOC of Internal Medicine (40.5%), followed by RSA (16.46%) and ICU (8.86%), table1. The most representative Alert is Acinetobacter baumannii (24.05%), other microorganisms isolated are Klebsiella P. (22.78%), Escherichia c. (21.52%), and Staphylococcus A. (18.99%). In addition, a significant correlation between microorganisms and sample type is confirmed (p=0.019). Inpatient days are proportional to the care complexity index (p=0.0021). In addition, there is no correlation between inpatient days and microorganism type. Conclusions: the reduction of inpatient time and the move toward territorial continuity of care will promote the community spread of selected antibiotic-resistant bacteria in the hospital. Surveillance measures include early identification of patients positive to Alerts, active follow-up of colonized patients, isolation of colonized/infected patients, and adoption of contact precautions in the management of such patients.

Real-Time Monitoring of SARS-CoV-2 Variants in Oklahoma Wastewater through Allele-Specific RT-qPCR

During the COVID-19 pandemic, wastewater surveillance was used to monitor community transmission of SARS-CoV-2. As new genetic variants emerged, the need for timely identification of these variants in wastewater became an important focus. In response to increased reports of Omicron transmission across the United States, the Oklahoma Wastewater Surveillance team utilized allele-specific RT-qPCR assays to detect and differentiate variants, such as Omicron, from other variants found in wastewater in Oklahoma. The PCR assays showed presence of the Omicron variant in Oklahoma on average two weeks before official reports, which was confirmed through genomic sequencing of selected wastewater samples. Through continued surveillance from November 2021 to January 2022, we also demonstrated the transition from prevalence of the Delta variant to prevalence of the Omicron variant in local communities. We further assessed how this transition correlated with certain demographic factors characterizing each community. Our results highlight RT-qPCR assays as a rapid, simple, and cost-effective method for monitoring the community spread of SARS-CoV-2 genetic variants in wastewater. Additionally, they demonstrate that specific demographic factors such as ethnic composition and household income can correlate with the timing of SARS-CoV-2 variant introduction and spread.

COVID-19 mutations: An overview.

The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) belongs to the genus Beta coronavirus and the family of Coronaviridae. It is a positive-sense, non-segmented single-strand RNA virus. Four common types of human coronaviruses circulate globally, particularly in the fall and winter seasons. They are responsible for 10%-30% of all mild upper respiratory tract infections in adults. These are 229E, NL63 of the Alfacoronaviridae family, OC43, and HKU1 of the Betacoronaviridae family. However, there are three highly pathogenic human coronaviruses: SARS-CoV-2, Middle East respiratory syndrome coronavirus, and the latest pandemic caused by the SARS-CoV-2 infection. All viruses, including SARS-CoV-2, have the inherent tendency to evolve. SARS-CoV-2 is still evolving in humans. Additionally, due to the development of herd immunity, prior infection, use of medication, vaccination, and antibodies, the viruses are facing immune pressure. During the replication process and due to immune pressure, the virus may undergo mutations. Several SARS-CoV-2 variants, including the variants of concern (VOCs), such as B.1.1.7 (Alpha), B.1.351 (Beta), B.1.617/B.1.617.2 (Delta), P.1 (Gamma), and B.1.1.529 (Omicron) have been reported from various parts of the world. These VOCs contain several important mutations; some of them are on the spike proteins. These mutations may lead to enhanced infectivity, transmissibility, and decreased neutralization efficacy by monoclonal antibodies, convalescent sera, or vaccines. Mutations may also lead to a failure of detection by molecular diagnostic tests, leading to a delayed diagnosis, increased community spread, and delayed treatment. We searched PubMed, EMBASE, Covariant, the Stanford variant Database, and the CINAHL from December 2019 to February 2023 using the following search terms: VOC, SARS-CoV-2, Omicron, mutations in SARS-CoV-2, etc. This review discusses the various mutations and their impact on infectivity, transmissibility, and neutralization efficacy.

Regional and temporal genotype profiling of Clostridioides difficile in a multi-institutional study in Japan

Clostridioides difficile, a cause of healthcare-associated infections, poses a significant global health threat. This multi-institutional retrospective study focuses on epidemic dynamics, emphasizing minor and toxin-negative clinical isolates through high-resolution genotyping. The genotype of the C. difficile clinical isolates during 2005 to 2022 was gathered from 14 hospitals across Japan (N = 982). The total number of unique genotypes was 294. Some genotypes were identified in every hospital (cross-regional genotypes), while others were unique to a specific hospital or those in close geographic proximity (region-specific genotypes). Notably, a hospital located in a sparsely populated prefecture exhibited the highest prevalence of region-specific genotypes. The isolation rate of cross-regional genotypes positively correlated with the human mobility flow. A 6-month interval analysis at a university hospital from 2019 to 2021 revealed a temporal transition of the genotype dominance. The frequent isolation of identical genotypes over a brief timeframe did not always align with the current criteria for defining nosocomial outbreaks. This study highlights the presence of diverse indigenous C. difficile strains in regional environments. The cross-regional strains may have a higher competency to spread in the human community. The longitudinal analysis underscores the need for further investigation into potential nosocomial spread.

Immunogenicity and transmission-blocking potential of quiescin sulfhydryl oxidase in Plasmodium vivax.

Transmission-blocking vaccines (TBVs) can effectively prevent the community's spread of malaria by targeting the antigens of mosquito sexual stage parasites. At present, only a few candidate antigens have demonstrated transmission-blocking activity (TBA) potential in P. vivax. Quiescin-sulfhydryl oxidase (QSOX) is a sexual stage protein in the rodent malaria parasite Plasmodium berghei and is associated with a critical role in protein folding by introducing disulfides into unfolded reduced proteins. Here, we reported the immunogenicity and transmission-blocking potency of the PvQSOX in P. vivax. The full-length recombinant PvQSOX protein (rPvQSOX) was expressed in the Escherichia coli expression system. The anti-rPvQSOX antibodies were generated following immunization with the rPvQSOX in rabbits. A parasite integration of the pvqsox gene into the P. berghei pbqsox gene knockout genome was developed to express full-length PvQSOX protein in P. berghei (Pv-Tr-PbQSOX). In western blot, the anti-rPvQSOX antibodies recognized the native PvQSOX protein expressed in transgenic P. berghei gametocyte and ookinete. In indirect immunofluorescence assays, the fluorescence signal was detected in the sexual stages, including gametocyte, gamete, zygote, and ookinete. Anti-rPvQSOX IgGs obviously inhibited the ookinetes and oocysts development both in vivo and in vitro using transgenic parasites. Direct membrane feeding assays of anti-rPvQSOX antibodies were conducted using four field P. vivax isolates (named isolates #1-4) in Thailand. Oocyst density in mosquitoes was significantly reduced by 32.00, 85.96, 43.52, and 66.03% with rabbit anti-rPvQSOX antibodies, respectively. The anti-rPvQSOX antibodies also showed a modest reduction of infection prevalence by 15, 15, 20, and 22.22%, respectively, as compared to the control, while the effect was insignificant. The variation in the DMFA results may be unrelated to the genetic polymorphisms. Compared to the P.vivax Salvador (Sal) I strain sequences, the pvqsox in isolate #1 showed no amino acid substitution, whereas isolates #2, #3, and #4 all had the M361I substitution. Our results suggest that PvQSOX could serve as a potential P. vivax TBVs candidate, which warrants further evaluation and optimization.

Ventilation does not affect close-range transmission of influenza virus in a ferret playpen setup

Sustained community spread of influenza viruses relies on efficient person-to-person transmission. Current experimental transmission systems do not mimic environmental conditions (e.g., air exchange rates, flow patterns), host behaviors, or exposure durations relevant to real-world settings. Therefore, results from these traditional systems may not be representative of influenza virus transmission in humans. To address this pitfall, we developed a close-range transmission setup that implements a play-based scenario and used it to investigate the impact of ventilation rates on transmission. In this setup, four immunologically naive recipient ferrets were exposed to a donor ferret infected with a genetically barcoded 2009 H1N1 virus (H1N1pdm09) for 4 h. The ferrets interacted in a shared space that included toys, similar to a childcare setting. Transmission efficiency was assessed under low and high ventilation, with air exchange rates of ~1.3 h-1 and 23 h-1, respectively. Transmission efficiencies observed in three independent replicate studies were similar between ventilation conditions. The presence of infectious virus or viral RNA on surfaces and in air throughout the exposure area was also not impacted by the ventilation rate. While high viral genetic diversity in donor ferret nasal washes was maintained during infection, recipient ferret nasal washes displayed low diversity, revealing a narrow transmission bottleneck regardless of ventilation rate. Examining the frequency and duration of ferret physical touches revealed no link between these interactions and a successful transmission event. Our findings indicate that exposures characterized by frequent, close-range interactions and the presence of fomites can overcome the benefits of increased ventilation.

Mucosal immunization with ChAd-SARS-CoV-2-S prevents sequential transmission of SARS-CoV-2 to unvaccinated hamsters.

COVID-19 vaccines have successfully reduced severe disease and death after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Nonetheless, COVID-19 vaccines are variably effective in preventing transmission and symptomatic SARS-CoV-2 infection. Here, we evaluated the impact of mucosal or intramuscular vaccine immunization on airborne infection and transmission of SARS-CoV-2 in Syrian hamsters. Immunization of the primary contact hamsters with a mucosal chimpanzee adenoviral-vectored vaccine (ChAd-CoV-2-S), but not intramuscular messenger RNA (mRNA) vaccine, reduced infectious virus titers ~100-fold and 100,000-fold in the upper and lower respiratory tract of the primary contact hamster following SARS-CoV-2 exposure. This reduction in virus titer in the mucosal immunized contact animals was sufficient to eliminate subsequent transmission to vaccinated and unvaccinated hamsters. In contrast, sequential transmission occurred after systemic immunization with the mRNA vaccine. Thus, immunization with a mucosal COVID-19 vaccine protects against cycles of respiratory transmission of SARS-CoV-2 and can potentially limit the community spread of the virus.

A Review of COVID-19 Hotels in New York City During the Early 2020 Outbreak: An Alternative Care Model.

New York City (NYC) was the epicenter of the early USCOVID-19 pandemic. From March to May 2020, overburdened healthcare centers precipitated an emergent need for non-traditional facilities to meet patient care demands. Given travel restrictions and NYC's underutilized tourist infrastructure, hotels were available to support emergency response needs. This article describes the process by which NYC's non-medical COVID-19 hotel programs were selected, mobilized, and operated, including lessons learned. NYC agencies and organizations collaborated, creating an interagency initiative that activated hotels to provide safe isolation and quarantine spaces for those diagnosed with or exposed to COVID-19, aiming to reduce community spread, increase capacity for NYC's strained healthcare system, and mitigate interagency redundancy. Interagency groups addressed hotel challenges, including infection prevention and control; behavioral health, intellectual, and developmental disorders; social determinants of health; and coordination, operations, and planning. NYC's COVID-19 hotel program successfully supported overburdened hospitals by providing alternate locations for non-inpatient COVID-19 individuals. Community engagement required a methodical approach, balancing quality assurance with efficient access. An interagency coordinating body developed and shared clinical criteria for hotel admissions, infection prevention and control (IPC) procedures, and discharge plans, enhancing the program's ability to scale and address complex needs. Lessons learned from this program can be applied for smoother implementation of similar programs in the future.

Detection of Urinary Analytes due to Schistosoma haematobium Infection among School Children for Possible Application in Screening for Urinary Schistosomiasis

Study’s Novelty/Excerpt This study introduces an approach for the rapid screening and diagnosis of urinary schistosomiasis using urinalysis in remote communities, where advanced diagnostic techniques are often unavailable. By analyzing 600 school children across six Local Government Areas in Kaduna State, Nigeria, the research highlights significant associations between urinary schistosomiasis and specific urinalysis indicators, such as leukocytes, proteinuria, and micro-hematuria. This method not only demonstrates the feasibility of immediate treatment initiation but also underscores the potential for preventing the chronicity and further community spread of the disease, addressing a critical gap in current public health strategies for rural settings. Full Abstract Urinary schistosomiasis is a disease that has persisted for a long time among children in Nigeria and other African countries. The persistence of schistosomiasis in people living in rural communities is attributed to the abundance of unsafe water bodies where both children and adults engage in activities such as irrigation, bathing, fishing, washing, or fetching water for domestic use. The lack of adequate community-based screening and treatment of infected cases has contributed to the continuous spread of schistosomiasis from endemic communities to new areas. Urinalysis can serve as a rapid method for screening for urinary schistosomiasis among populations in remote locations, enabling immediate treatment and the prevention of its transmission. In this study, 600 school children who gave their consent were enrolled across six Local Government Areas in Kaduna State, Nigeria. A fresh 10mL urine sample was collected from each subject, and eleven analytes were immediately determined upon submission using urine reagent test strips (SG11100-Uric 11V, Guilin Zhonghui Technology Co., Ltd, China). The urine samples underwent centrifugation at 3000 revolutions per minute for 5 minutes, and the sediment from each sample was examined microscopically for Schistosoma haematobium eggs. The data were analyzed statistically at a 95% confidence interval using IBM SPSS Version 23. The overall prevalence of urinary schistosomiasis among the children in the six LGAs of Kaduna State was 6.8%, with heavy infections at 2.2% and light infections at 4.7%. Significant associations were found between urinary schistosomiasis and the presence of leukocytes (18.5%, χ2=47.596, df=1, P=0.000, OR=8.822), proteinuria (23.1%, χ2=17.287, df=1, P=0.000, OR=4.959), and micro-hematuria (49.3%, χ2=213.184, df=1, P=0.000, OR=63.695). This study demonstrates that urinalysis can be effectively utilized for screening urinary schistosomiasis in remote communities where advanced techniques like microscopy may not be available, facilitating prompt treatment initiation. Therefore, early detection and treatment are crucial in preventing the chronicity and community spread of the disease.

Transmission Patterns of Co-Circulation of Omicron Sub-Lineages in Hong Kong SAR, China, a City with Rigorous Social Distancing Measures, in 2022.

This study aimed to characterize the changing landscape of circulating SARS-CoV-2 lineages in the local community of Hong Kong throughout 2022. We examined how adjustments to quarantine arrangements influenced the transmission pattern of Omicron variants in a city with relatively rigorous social distancing measures at that time. In 2022, a total of 4684 local SARS-CoV-2 genomes were sequenced using the Oxford Nanopore GridION sequencer. SARS-CoV-2 consensus genomes were generated by MAFFT, and the maximum likelihood phylogeny of these genomes was determined using IQ-TREE. The dynamic changes in lineages were depicted in a time tree created by Nextstrain. Statistical analysis was conducted to assess the correlation between changes in the number of lineages and adjustments to quarantine arrangements. By the end of 2022, a total of 83 SARS-CoV-2 lineages were identified in the community. The increase in the number of new lineages was significantly associated with the relaxation of quarantine arrangements (One-way ANOVA, F(5, 47) = 18.233, p < 0.001)). Over time, Omicron BA.5 sub-lineages replaced BA.2.2 and became the predominant Omicron variants in Hong Kong. The influx of new lineages reshaped the dynamics of Omicron variants in the community without fluctuating the death rate and hospitalization rate (One-way ANOVA, F(5, 47) = 2.037, p = 0.091). This study revealed that even with an extended mandatory quarantine period for incoming travelers, it may not be feasible to completely prevent the introduction and subsequent community spread of highly contagious Omicron variants. Ongoing molecular surveillance of COVID-19 remains essential to monitor the emergence of new recombinant variants.

Sick Leave and Absence Rate of Hospital Workers During the Sixth to Eighth Wave of COVID-19 in Japan

Abstract Background There are several reports of breakthrough infections of severe acute respiratory syndrome coronavirus 2 in vaccinated individuals and reinfections in previously infected individuals. Although the coronavirus disease (COVID-19) pandemic has increased the incidence of infections at healthcare facilities, the association between the increase in community spread and absence rate of hospital workers due to COVID-19 infection-related sick leave has not yet been fully elucidated. Method We reviewed the case files of patients with COVID-19 diagnosed at the Jikei University Katsushika Medical Center, Tokyo, Japan, between January 1, 2022, and February 28, 2023. The obtained data was used to determine the number of COVID-19 admissions and absence rate of hospital workers due to COVID-19 infection-related sick leave during the sixth to eighth wave of the COVID-19 pandemic. Results Of 1899 patients with confirmed COVID-19, 397 (20.9%) were hospital workers. Of the 397 patients, 71, 156, and 119 contracted the infection during the sixth (January–March 2022), seventh (July–September 2022), and eighth wave (November 2022–February 2023), respectively. The absence rate of hospital workers due to COVID-19 was 6.3%, excluding leaves of absence due to close contact in the seventh wave, which had the highest number of infections. Conclusions Given the difficulty of maintaining a usual work schedule during the COVID-19 outbreak, it may be necessary to re-evaluate the backgrounds of healthcare workers at high risk of contracting COVID-19 and to make aggressive adjustments to their work schedules by distributing assignments and restricting leave.

Is SARS-CoV-2 elimination or mitigation best? Regional and disease characteristics determine the recommended strategy.

Public health responses to the COVID-19 pandemic varied across the world. Some countries (e.g. mainland China, New Zealand and Taiwan) implemented elimination strategies involving strict travel measures and periods of rigorous non-pharmaceutical interventions (NPIs) in the community, aiming to achieve periods with no disease spread; while others (e.g. many European countries and the USA) implemented mitigation strategies involving less strict NPIs for prolonged periods, aiming to limit community spread. Travel measures and community NPIs have high economic and social costs, and there is a need for guidelines that evaluate the appropriateness of an elimination or mitigation strategy in regional contexts. To guide decisions, we identify key criteria and provide indicators and visualizations to help answer each question. Considerations include determining whether disease elimination is: (1) necessary to ensure healthcare provision; (2) feasible from an epidemiological point of view and (3) cost-effective when considering, in particular, the economic costs of travel measures and treating infections. We discuss our recommendations by considering the regional and economic variability of Canadian provinces and territories, and the epidemiological characteristics of different SARS-CoV-2 variants. While elimination may be a preferable strategy for regions with limited healthcare capacity, low travel volumes, and few ports of entry, mitigation may be more feasible in large urban areas with dense infrastructure, strong economies, and with high connectivity to other regions.

Mathematical Model for Mitigating the Community Spread of COVID – 19 in Afikpo North LGA of Ebonyi State, Nigeria

Mathematical Model for Mitigating the Community Spread of COVID – 19 in Afikpo North LGA of Ebonyi State, Nigeria

Explaining the impact of mutations on quantification of SARS-CoV-2 in wastewater

Wastewater surveillance is an effective tool for monitoring community spread of COVID-19 and other diseases. Quantitative PCR (qPCR) analysis for wastewater surveillance is more susceptible to mutations in target genome regions than binary PCR analysis for clinical surveillance. The SARS-CoV-2 concentrations in wastewater estimated by N1 and N2 qPCR assays started to diverge around July 2022 in data from different sampling sites, analytical methods, and analytical laboratories in Japan. On the basis of clinical genomic surveillance data and experimental data, we demonstrate that the divergence is due to two mutations in the N1 probe region, which can cause underestimation of viral concentrations. We further show that this inaccuracy can be alleviated if the qPCR data are analyzed with the second derivative method or the Cy0 method instead of the crossing point method.

Community-Centric Approach: Bhabinkamtibmas Strategies in Mitigating Covid-19 Transmission Within The Cultural Landscape Of Hukurila

The escalation of Covid-19 in Indonesia, including Maluku, underscores varying levels of public awareness concerning health protocols, notably non-compliance with mask-wearing, public gatherings, and other breaches of Covid-19 regulations. This article delves into the pivotal role of Bhabinkamtibmas, an integral part of the police force, in addressing these community issues. The research aims to elucidate Bhabinkamtibmas' strategies in curtailing the virus's spread in the indigenous community of Negeri Hukurila, employing a community-centric approach with qualitative methods like in-depth interviews, observations, and document studies. Research findings highlight Bhabinkamtibmas' active participation in health education, mask distribution, and vaccination programs. They are also integral to the 3T strategy, establishing health centres, innovating health protocols in restaurants, fortifying places of worship, conducting vaccinations, implementing colour zoning, and forming Covid-19 data task forces. Bhabinkamtibmas goes beyond education, fostering security and discipline in the community's adherence to health protocols during the pandemic. Collaborating with Babinsa, they actively curb virus spread through socializing health protocols, participating in evacuations, and overseeing quarantine measures. Despite distinct roles, Bhabinkamtibmas and Babinsa maintain synergy, underscoring the need for community involvement and cross-institutional collaboration for optimal Covid-19 management.

Using Crowdsourced Data to Assess the Impact of Shelter-in-Place Orders (SIPO) during COVID-19: Lessons from a Small Island Developing State

Without the availability of a vaccine (at the time of writing) to control the spread of the COVID-19 virus, countries must rely largely on lockdown measures to limit population movement and community spread. The case of COVID-19 in small island territories is particularly important given their vulnerabilities to external shocks, limited capacity to prepare for and respond to a health crisis, and a population susceptible to non-communicable diseases. This article utilise novel crowdsourced cell phone data gathered by Facebook Data for Good and difference-in-differences estimation as well as event studies to examine the effectiveness of shelter-in-place orders (SIPOs) on population movement patterns across Trinidad and Tobago. We find that most SIPOs result in reductions in population movement patterns across the country, the most effective being the closure of all public places and non-essential businesses. Also, the relaxation of these measures does not readily result in increasing population movement patterns, indicating relative embeddedness in population movement. Our results further suggest that voluntary compliance, adaptive behaviour among citizens, government transparency and public information can also be important motivations for reduced population movement during the pandemic.

SARS-CoV-2 variant introduction following spring break travel and transmission mitigation strategies.

University spring break carries a two-pronged SARS-CoV-2 variant transmission risk. Circulating variants from universities can spread to spring break destinations, and variants from spring break destinations can spread to universities and surrounding communities. Therefore, it is critical to implement SARS-CoV-2 variant surveillance and testing strategies to limit community spread before and after spring break to mitigate virus transmission and facilitate universities safely returning to in-person teaching. We examined the SARS-CoV-2 positivity rate and changes in variant lineages before and after the university spring break for two consecutive years. 155 samples were sequenced across four time periods: pre- and post-spring break 2021 and pre- and post-spring break 2022; following whole genome sequencing, samples were assigned clades. The clades were then paired with positivity and testing data from over 50,000 samples. In 2021, the number of variants in the observed population increased from four to nine over spring break, with variants of concern being responsible for most of the cases; Alpha percent composition increased from 22.2% to 56.4%. In 2022, the number of clades in the population increased only from two to three, all of which were Omicron or a sub-lineage of Omicron. However, phylogenetic analysis showed the emergence of distantly related sub-lineages. 2022 saw a greater increase in positivity than 2021, which coincided with a milder mitigation strategy. Analysis of social media data provided insight into student travel destinations and how those travel events may have impacted spread. We show the role that repetitive testing can play in transmission mitigation, reducing community spread, and maintaining in-person education. We identified that distantly related lineages were brought to the area after spring break travel regardless of the presence of a dominant variant of concern.