Strict Isolation Measures Research Articles

Epidemiology of childhood bone and joint disease during the COVID-19 pandemic in New Zealand.

It is unknown whether social distancing impacts frequency of presentation and severity of childhood bone and joint infection (BJI). In New Zealand, the COVID-19 disease elimination strategy involved strict social isolation policies spanning March 2020-September 2022. Examination of this period may provide insight around risk factors for BJI. A retrospective review of all patients < 16 years with presumed acute haematogenous osteomyelitis (AHO) or septic arthritis (SA) treated in the Auckland region was performed between 2018 and 2023. Frequency and severity of presentations has been examined before, during, and after periods of social restriction. Severe cases included those with intensive care admission, recurrent infection, or multiple surgeries. Pre-hospital experience, length of stay, and disease outcomes have also been assessed. A total of 563 cases met inclusion criteria. Compared to the pre-pandemic period, monthly case averages reduced between April 2020 to September 2022 (10.1 vs. 7.9 cases/month, p = 0.008). Separating cases by causative microbiology shows a statistically significant drop in culture negative and Kingella kingae mediated BJI cases (4.2 vs. 2.9 cases/month, p = 0.006) but not for cases secondary to Staphylococcus aureus and Streptococcus pyogenes (4.2 vs. 3.9 cases/month, p = 0.6). The frequency of severe disease reduced during this period (5.6 vs. 4.1 cases/month, p = 0.01) together with lower rates of recurrent infection (9% vs. 4%, p = 0.03). The COVID-19 management strategy in New Zealand utilised strict social isolation, mask wearing, and hand hygiene measures to control disease spread between 2020 and 2022. These measures coincided with reduction in frequency and severity of presentations for childhood BJI.

ARIMA Analysis of PM Concentrations during the COVID-19 Isolation in a High-Altitude Latin American Megacity

The COVID-19 pandemic precipitated a unique period of social isolation, presenting an unprecedented opportunity to scrutinize the influence of human activities on urban air quality. This study employs ARIMA models to explore the impact of COVID-19 isolation measures on the PM10 and PM2.5 concentrations in a high-altitude Latin American megacity (Bogota, Colombia). Three isolation scenarios were examined: strict (5 months), sectorized (1 months), and flexible (2 months). Our findings indicate that strict isolation measures exert a more pronounced effect on the short-term simulated concentrations of PM10 and PM2.5 (PM10: −47.3%; PM2.5: −54%) compared to the long-term effects (PM10: −29.4%; PM2.5: −28.3%). The ARIMA models suggest that strict isolation measures tend to diminish the persistence of the PM10 and PM2.5 concentrations over time, both in the short and long term. In the short term, strict isolation measures appear to augment the variation in the PM10 and PM2.5 concentrations, with a more substantial increase observed for PM2.5. Conversely, in the long term, these measures seem to reduce the variations in the PM concentrations, indicating a more stable behavior that is less susceptible to abrupt peaks. The differences in the reduction in the PM10 and PM2.5 concentrations between the strict and flexible isolation scenarios were 23.8% and 12.8%, respectively. This research provides valuable insights into the potential for strategic isolation measures to improve the air quality in urban environments.

Social Experiences and Health Needs of Patients with Severe Mental Illness and their Caregivers during the first year of the COVID-19 pandemic in Spain

Background The strict isolation measures for the population imposed by the health authorities caused a prolonged disruption of informal social support networks. Both this new social situation and the decrease in accessibility to health care have generated new needs in people with severe mental illness (SMI) and their caregivers. Objectives This study provides insight into life experiences and health needs of a population with SMI during the first year of the COVID-19 pandemic in Spain. Methods Qualitative design using semi-structured dyadic interviews, conducted from January through December 2022. A purposive sampling of patients with SMI and their caregivers was carried out through key informants in rural and urban localities in southern Spain. Verbatims were identified and classified by triangulation after the evaluation of the interview transcripts. The codes were defined through content analysis using the NVivo software. Results Semi-structured dyadic interviews (21), identifying three main categories: 1. Social isolation: increased, causing greater personal vulnerability, exacerbation of psychiatric symptoms and exhaustion in caregivers. 2. Accessibility to Health Services : decreased with fewer face-to-face consultations, with difficulty in managing urgent situations and telephone attention in decompensated and disabled patients. 3. Continuity of healthcare: decreased with distrust in health professionals due to lack of communication between primary care and the hospital Conclusion COVID-19 confinement exacerbated loneliness and worse health self-perception in SMI people. Greater formal social support was required. GPs role is key to avoiding delays in appointments and lack of coordination between primary and specialised care.

Rapid response redevelopment: a study of an English-to-Chinese translation course moving online

Abstract In early 2020, the tertiary sector in Australia, as in many other parts of the world, was confronted with a series of unforeseen challenges arising from the coronavirus epidemic. As governments responded to the crisis by implementing increasingly strict social distancing and isolation measures, universities had little choice but to adapt their courses for online delivery. The ensuing chaos and confusion prompted academics and support staff to adapt quickly to changing delivery while continuing to offer high-quality teaching and learning experiences. This mixed-methods study explores the approaches that were adopted in a translation course that moved fully online and examines students’ engagement with and evaluation of the new course design. The findings reveal that it is possible to maintain high levels of student satisfaction by ensuring a clearly structured course design in an online mode with interactive and engaging course materials. This has implications for university lecturers wishing to redesign courses in an online or blended format, especially under time pressure.

A predictive model of perceived stress during the first wave of the COVID-19 pandemic in university students Ecuadorians.

The situation caused by the confinement due to the COVID-19 pandemic and the mobility restriction implemented by governments worldwide had a significant impact on people's routines. Stressors are known to increase emotional imbalance, uncertainty, and frustration in the general population. This study explores the factors that predispose to the risk of perceived stress from COVID-19 and determines the underlying mediating mechanisms in the Ecuadorian population. The cross-sectional study an incidental non-probabilistic sample of n = 977 participating student volunteers from the four regions of the Republic of Ecuador (68.6% women and 31.4% men). Data on emotional regulation (ERQ), perceived stress (PSS), active procrastination (APS), diagnosis and symptoms related to COVID-19, social isolation, coexistence, and a sociodemographic questionnaire (biological sex, marital status, and age) were recruited. Statistical analysis was based on a structural equation model. The risk of suffering perceived stress in the COVID-19 pandemic was higher for single women who have lived longer in social isolation, have lived with more people, have poor emotional regulation and high rates of procrastination. This structural model is similar in all Ecuadorian regions χ2 = 21.54 (p = 0.760), RMSEA = 0.001 (95%CI, 0.00-0.02), CFI = 0.998; TLI = 0.999; SRMR = 0.020. Although our findings are consistent and revealing for the scientific community, the lack of discrimination of the data due to strict isolation measures, taken at different periods by the Ecuadorian government against positive cases of COVID-19, is discussed. The research was applied to the university population, it would be representative to extend the study to schools and colleges. We consider this work as a starting point for the creation of preventive models against perceived stress in the university environment in the event of health emergencies.

Analysis of Strict Social Isolation (SSI-Lockdown) Measures Impacts on Atmospheric Pollutant Emissions and Health Risks on Roads with Intense Vehicle Flow in the City of Fortaleza-Ceara/Brazil

In early 2020, governments of many countries adopted strict social isolation (SSI) measures to contain the spread of the SARS-CoV-2 Disease (COVID-19). Thus, the present work aimed to evaluate the influence of those SSI measures on atmospheric pollutants emissions and their potential health risks in the city of Fortaleza - Ceará. To this end, static and dynamic analyses were carried out in order to investigate the levels of some atmospheric pollutants found in four main avenues during SSI and post-SSI periods. In addition, some health indicators were investigated by analyzing potential Particulate Matter (PM) deposition in the respiratory tract of populations exposed to those environments. Our results for both dynamic and static analyses show that all pollutant concentrations from those avenues displayed an increase between SSI and the post-SSI period. The total PM2.5 dose deposited in the respiratory tract and potential total PM10 respiratory deposition showed increases between the SSI and post-SSI periods. The inhaled-dose numbers also showed considerable increases for all avenues when comparing SSI and post-SSI periods. According to our results, SSI contributed to decreases in atmospheric pollutant emissions, in potential particulate matter respiratory tract deposition and, consequently, in the inhaled particulate matter dose.

COVID-19 epidemic phases and morbidity in different areas of Chinese mainland, 2020.

In the early stage of COVID-19 epidemic, the Chinese mainland once effectively controlled the epidemic, but COVID-19 eventually spread faster and faster in the world. The purpose of this study is to clarify the differences in the epidemic data of COVID-19 in different areas and phases in Chinese mainland in 2020, and to analyze the possible factors affecting the occurrence and development of the epidemic. We divided the Chinese mainland into areas I, I and III, and divided the epidemic process into phases I to IV: limited cases, accelerated increase, decelerated increase and containment phases. We also combined phases II and III as outbreak phase. The epidemic data included the duration of different phases, the numbers of confirmed cases, asymptomatic infections, and the proportion of imported cases from abroad. In area I, II and III, only area I has a Phase I, and the Phase II and III of area I are longer. In Phase IV, there is a 17-day case clearing period in area I, while that in area II and III are 2 and 0 days, respectively. In phase III or the whole outbreak phase, the average daily increase of confirmed cases in area I was higher than that in areas II and III (P = 0.009 and P = 0.001 in phase III; P = 0.034 and P = 0.002 in the whole outbreak phase), and the average daily in-hospital cases were most in area I and least in area III (P = 0.000, P = 0.000, and P = 0.000 in phase III; P = 0.000, P = 0.000, and P = 0.009 in the whole outbreak phase). The average number of daily in-hospital COVID-19 cases in phase III was more than that in phase II in each area (P = 0.000, P = 0.000, and P = 0.001). In phase IV, from March 18, 2020 to January 1, 2021, the increase of confirmed cases in area III was higher than areas I and II (both P = 0.000), and the imported cases from abroad in Chinese mainland accounted for more than 55-61%. From June 16 to July 2, 2020, the number of new asymptomatic infections in area III was higher than that in area II (P = 0.000), while there was zero in area I. From July 3, 2020 to January 1, 2021, the increased COVID-19 cases in area III were 3534, while only 14 and 0, respectively, in areas I and II. The worst epidemic areas in Chinese mainland before March 18, 2020 and after June 15, 2020 were area I and area III, respectively, and area III had become the main battlefield for Chinese mainland to fight against imported epidemic since March 18, 2020. In Wuhan, human COVID-19 infection might occur before December 8, 2019, while the outbreak might occur before January 16 or even 10, 2020. Insufficient understanding of COVID-19 hindered the implementation of early effective isolation measures, leading to COVID-19 outbreak in Wuhan, and strict isolation measures were effective in controlling the epidemic. The import of foreign COVID-19 cases has made it difficult to control the epidemic of area III. When humans are once again faced with potentially infectious new diseases, it is appropriate to first and foremost take strict quarantine measures as soon as possible, and mutual cooperation between regions should be explored to combat the epidemic.

Optimal Vaccination Policies for COVID-19 Considering Vaccine Doses Delays

This work introduces a methodology to determine an optimal vaccination strategy for the COVID-19 disease with limited vaccination capacity, considering the delays between vaccine doses in order to minimize the number of deaths. The evolution of the pandemic in the city of Tandil, province of Buenos Aires, Argentina, is studied through a compartmental model, where the parameters involved are calibrated according to official data. An auxiliary age-structured optimal control problem is introduced, where optimal policies are obtained taking into account the characteristics of the vaccine and the vaccination capacity. Through numerical simulations, the policy obtained is compared with other feasible strategies, considering or not strict isolation measures.

Vertical Transmission of Severe Acute Respiratory Syndrome Coronavirus 2: Current Evidence and Perspectives

Vertical Transmission of Severe Acute Respiratory Syndrome Coronavirus 2: Current Evidence and Perspectives

Can Ship Travel Contain COVID-19 Outbreak After Re-Opening: A Bayesian Meta-analysis.

Large gatherings of people on cruise ships and warships are often at high risk of COVID-19 infections. To assess the transmissibility of SARS-CoV-2 on warships and cruise ships and to quantify the effectiveness of the containment measures, the transmission coefficient (β), basic reproductive number (R0), and time to deploy containment measures were estimated by the Bayesian Susceptible-Exposed-Infected-Recovered model. A meta-analysis was conducted to predict vaccine protection with or without non-pharmaceutical interventions (NPIs). The analysis showed that implementing NPIs during voyages could reduce the transmission coefficients of SARS-CoV-2 by 50%. Two weeks into the voyage of a cruise that begins with 1 infected passenger out of a total of 3,711 passengers, we estimate there would be 45 (95% CI:25-71), 33 (95% CI:20-52), 18 (95% CI:11-26), 9 (95% CI:6-12), 4 (95% CI:3-5), and 2 (95% CI:2-2) final cases under 0%, 10%, 30%, 50%, 70%, and 90% vaccine protection, respectively, without NPIs. The timeliness of strict NPIs along with implementing strict quarantine and isolation measures is imperative to contain COVID-19 cases in cruise ships. The spread of COVID-19 on ships was predicted to be limited in scenarios corresponding to at least 70% protection from prior vaccination, across all passengers and crew.

Changes of air pollutants and simulation of a heavy pollution process during COVID-19 in Shenyang.

During COVID-19, Shenyang implemented strict household isolation measures, resulting in a sharp reduction in anthropogenic emission sources, providing an opportunity to explore the impact of human activities on air pollution. The period from January to April of 2020 was divided into normal period, blockade period and resumption period. Combined with meteorological and pollutant data, mathematical statistics and spatial analysis methods were used to compare with the same period of 2015–2019. The results showed that PM2.5, PM10, NO2 and O3 increased by 32.6%, 13.2%, 4.65% and 22.7% in the normal period, among which the western area changed significantly. During the blockade period, the concentration of pollutants decreased by 35.79%, 35.87%, 32.45% and -4.84%, of which the central area changed significantly. During the resumption period, the concentration of pollutants increased by 21.8%, 8.7%, 5.7% and -6.3%, and the area with the largest change was located in the western. During the blockade period, a heavy pollution occurred with PM2.5 as the main pollutant. The WRF-Chem model and the HYSPLIT model were used to reproduce the pollution occurrence process. The result showed that winds circulated as zonal winds during the pollution process at high altitudes. These winds were controlled by straight westerly and weak northwesterly airflows in front of the high pressure, and the ground was located behind the warm low pressure. Weather conditions were relatively stable. Thus, high temperatures (average > 10 ℃), high humidity (40%-60%) and slow wind (2 m/s) conditions prevailed for a long time in the Shenyang area. The unfavorable meteorological conditions lead to the occurrence of pollution. The backward trajectory showed that the potential source areas were concentrated in the urban agglomeration around Shenyang, and sporadic contributions came from North Korea.

P1609: VERY LOW MORTALITY IN DOUBLE VACCINATED IMMUNOCOMPROMISED HAEMATOLOGY PATIENTS INFECTED WITH SARS-COV-2.

Background: Patients with immunocompromising haematological neoplasms (HN) are reported to be at high risk of death from SARS-CoV-2 (COVID19). However, many studies were conducted prior to widespread immunisation and availability of effective antiviral strategies. Here, we report outcomes of patients with HN presenting with COVID19 infection in the setting of high vaccination rates and effective COVID19 therapies, in a population that had low prior exposure to COVID19 due to national border controls and strict isolation measures. Aims: To ascertain the rate of COVID19 mortality and severe disease in a cohort of patients with HN, and identify factors associated with severity, including, immunisation status, use of antiviral therapies and likely viral strain. Methods: An observational study was conducted at an Australian tertiary hospital network servicing a population of 1.3 million. Adults with HN who tested positive for COVID19 were included. Patient and disease characteristics, vaccination status, therapy, hospital admission data and outcomes were extracted from hospital records. Associations with disease severity were examined using Chi-squared with p-values adjusted for multiple testing by Benjamini-Hochberg procedure. Results: Between January 2020- February 2022, 75 patients with HN and COVID19 infection were identified. Median age 70 y (range 18-91) with 60% male. Underlying HN included: indolent lymphoma 26, myeloma 25, aggressive lymphoma 7, myelodysplastic syndrome 6, myeloproliferative neoplasm 4, chronic myeloid leukaemia 4 and acute myeloid leukaemia 3. Grade 3+ neutropenia <3 months prior to infection was identified in 15, anti-CD20 antibody therapy < 6 months in 14 and AuSCT <2 years in 4. At COVID19 diagnosis, 10 were unvaccinated for COVID19, 3 had received a single dose, 43 had received 2 doses and 19 had received 3 doses. 54 patients were diagnosed with COVID19 when Omicron strain was the dominant strain circulating. 21 tested positive to COVID19 when the Delta strain was dominant. Other COVID19 strains were very unlikely to be present given the low prevalence in Victoria during the period of study. 37 patients were admitted to hospital with a median length of stay of 8 days (range 3 -33). Of these patients, 4 were admitted to ICU with 2 patients requiring intubation. Another patient received non-invasive ventilation in a high dependency ward. The median length of stay in ICU was 5 days (range 2-11). Therapies used in hospitalised patients were administered according to institutional protocol and included sotrovimab, dexamethasone, remdesivir and baricitinib. 4 patients died with 3 (4%) of these directly attributed to COVID19 infection and one due to myeloma. Of 4 patients admitted to ICU, three were unvaccinated. Factors associated with hospitalisation included age ≥70 (p = 0.002), receiving <2 vaccinations against COVID19 (p = 0.012) and likely non-Omicron strain (p = 0.012). The underlying haematological condition, prior anti-CD20 therapy, presence of recent neutropenia or use of Sotrovimab was not found to impact on the likelihood of severe disease or hospital admission. Image:Summary/Conclusion: Within our cohort of patients with haematological cancer diagnosed with COVID19 infection, the role of immunisations and presence of the Omicron strain within the community has resulted in a mortality rate of 4% which is lower than the rates observed in previous studies. Hospitalisation occurred in 48% of the patients, with risk factors of older age, being non- or partially vaccinated and likely non-Omicron strain of COVID19 identified.

Psychological Impact and Its Correlates Following COVID-19 Pandemic Among Medical Students

Background: The continuous spread of novel coronavirus (COVID-19) pandemic, home quarantine, strict isolation measures and delays in opening educational institutions across the country is expected to influence the mental health of college students. The aim of our study is to assess the psychological impact and its correlates following the COVID-19 lockdown period, among the MBBS exam going students of a private medical college, Puducherry. Methods: A Descriptive Cross-Sectional Study was conducted among Undergraduate students in a private medical college of Puducherry between January-March 2021. Around 204 exam going students from Pre-final and Final year MBBS were enrolled in the study with their consent. Depression, Anxiety, and Stress among the study participants following the COVID 19 lockdown period was assessed using Depression Anxiety Stress Scale (DASS 21). Data was captured and Spearman`s correlation, Ordinal logistics regression was applied to find the predictors of Depression, Anxiety and Stress. Results: Among 204 study participants, the distribution was almost equal between Pre-Final (52%) and Final year (48%) MBBS students. Prevalence of Stress, Anxiety and Depression among students was found to be 38.2%, 52.8% and 48% respectively. Practicing regular physical activity, history of contact with COVID19 patients, year of MBBS were found to be predictors of Stress, Anxiety and Depression. It was also found that Stress level increases with increase in age. Conclusion: Around half of the study participants have either of the psychological impact following COVID 19 lockdown period that may adversely affect their performance in university exams. Still, there is a scope of further research that could be planned by applying interventions to improve the mental health status of the students.

ESCMID guidelines on testing for SARS-CoV-2 in asymptomatic individuals to prevent transmission in the health care setting

ScopeThis guideline addresses the indications for direct testing of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in asymptomatic individuals in health care facilities, with the aim to prevent SARS-CoV-2 transmissions in these settings. The benefit of testing asymptomatic individuals to create a safe environment for patients and health care workers must be weighed against potential unintended consequences, including delaying necessary treatments owing to false positive results and lower quality of care owing to strict isolation measures. MethodsA total of nine PICOs (population, intervention, comparison, outcome) on the topic of testing asymptomatic individuals was selected by the panel members. Subsequently, a literature search for existing guidelines and systematic reviews was performed on PubMed, Epistemonikos, and RecMap using relevant filters available in each database. Data on article/recommendation type, setting, target population, intervention, and quality of the evidence were extracted. Credibility of the systematic reviews was evaluated using the AMSTAR tool, and level of agreement with available recommendation was evaluated with the AGREE II score. Because the evidence available from systematic reviews was deemed insufficiently updated to formulate relevant recommendations, an additional search targeting relevant guidance documents from major public health institutions and original studies was performed. Provisional recommendations were discussed via web conferences until agreement was reached, and final recommendations were formulated according to the GRADE approach. RecommendationsRecommendations were formulated regarding systematic testing in asymptomatic individuals upon admission to a health care setting, during hospital stay, before elective procedures, and before scheduled nonsurgical procedures. Moreover, recommendations regarding testing of asymptomatic visitors, personal caregivers, and health care workers in health care facilities were presented. Recommendations also were given on contact tracing in asymptomatic patients or health care workers and the possibility of a negative screening test to shorten the quarantine period. Furthermore, if applicable, recommendations were specified to transmission rate and vaccination coverage.

Will multi-industry supply chains' resilience under the impact of COVID-19 pandemic be different? A perspective from China's highway freight transport

The pandemic caused by coronavirus disease 2019(COVID-19) continues to disrupt the global supply chain system, bringing new risks and challenges. The uncertainty created by COVID-19 makes it is difficult for various industries to deal with the pandemic. Since the pandemic, the supply chain's resilience has been discussed and examined in some studies. However, most existing works start from a single industry perspective or pay more attention to the disturbance caused by changes in the production side. Supply chain networks of different industries, mainly transport networks, are relatively limited under the epidemic's impact. In this paper, from the perspective of highway freight transport, a comprehensive competitiveness evaluation framework was proposed to reveal and the disruption and resilience of the supply chain under the outbreak based on nine indexes with five dimensions, including efficiency, capacity, activity, connectivity, and negotiability. Based on the availability of the data(Large-scale truck trajectory), we sorted out seven categories of Chinese industries(related to highway transport) and divided them into four categories respectively: (a) Slight disruption and worse resilience; (b) Slight disruption and remarkable resilience; (c) Serious disruption and worse resilience; (d) Serious disruption and remarkable resilience. The measurement results of supply chain network performance show that the industries (cold-chain, general products, and other industries) dominated by “Efficiency - Negotiability - Connectivity” are slightly disrupted (about 33%), forming a spatial diffusion with Wuhan(the city where the pandemic first broke out) as the disrupted center, spreading outward in a circle structure. Simultaneously, five urban agglomerations surrounding it have been impacted. By contrast, due to the strict isolation measures, the industries (building materials, construction, engineering, and high-value products industry) more vulnerable to be disrupted seriously (about 82%) tend to be the pattern of “Capacity - Activity”. However, a large-scale centralized disruption was observed in the Triangle of Central China urban agglomeration was presented, resulting in almost stagnation of industry development. Meanwhile, as the future of the pandemic remains uncertain, the supply chain represented by the engineering industry, construction industry, etc are deserved to be paid more attention in line with they are prone to large-scale centralized damage due to the disruption of a single city node.

Prolonged SARS-CoV-2 nucleic acid conversion time in military personnel outbreaks with presence of specific IgG antibodies.

Coronavirus disease 2019 (COVID-19) is transmitted person-to-person mainly by close contact or droplets from respiratory tract. However, the actual time of viral shedding is still uncertain as well as the different routes of transmission. We aimed to characterize RNA shedding from nasopharyngeal and rectal samples in prolonged cases of mild COVID-19 in young male soldiers. Seventy patients from three different military locations were monitored after recommending to follow more strict isolation measures to prevent the spread of the virus. Then, nasopharyngeal, rectal, and blood samples were taken. SARS-CoV-2 RNA was detected by RT-PCR and specific antibodies by chemiluminescent immunoassays. The median nucleic acid conversion time (NACT) was 60 days (IQR: 7–85 days). Rectal swabs were taken in 60 % of patients. Seven patients (10 %) were positive in nasopharyngeal and rectal swabs, and five (7.14 %) remained positive in rectal swabs, but negative in nasopharyngeal samples. Four patients (5.71 %) that had been discharged, were positive again after 15 days. No significant difference was found in nucleic acid conversion time between age groups nor clinical classification. Maintaining distancing among different positive patients is essential as a possible re-exposure to the virus could cause a longer nucleic acid conversion time in SARS-COV-2 infections.

Perioperative management of non-deferrable oncologic surgeries during COVID-19 pandemic in Madrid, Spain. Is it safe?

IntroductionSurgical treatment during Covid-19 pandemic is controversial. Currently, most clinical guidelines advise to defer surgical patients during the Covid-19 pandemic, although the supporting data is sparse. We assumed that a Covid-19-free hospital, on the back of strong isolation measures and targeted screening, could reduce complications and enable us to continue treating high-risk patients.MethodsProspective study with retrospective analysis of 355 patients who had undergone nondeferrable oncological surgery between March 16th, 2020, and April 14th, 2020, at our institution. The aim of the study was to assess the hospital restructuring and surgical protocols to be able to safely handle non-deferrable surgeries during the first wave of the Covid-19 pandemic. We implemented structural changes and an updated surgical-anesthetic protocol in order to isolate Covid-19 patients from other surgical patients. Comprehensive targeted screening for Covid-19 patients was made. PCR tests were requested for suspected Covid-19 patients. We analyzed mortality and complications related to both surgery and Covid-19 during hospital admission and also 15 and 30 days after surgery. We compared it with a sample of similar patients in the pre-pandemic period.ResultsOf the 355 patients enrolled in our study, 21 were removed due to Covid-19 infection, leaving a total of 334 patients in our final analysis. Post-operative complications were found in 37 patients (11.07%). Two patients died after surgery (0.6%). At the end of the study, Covid-19-related adverse outcomes were detected in six patients (1.79%). When comparing the complications of our original sample with the complications that occurred in the pre-covid era, we found no statistically significant differences.ConclusionsOur results show that the surgical treatment of oncologic patients during the Covid-19 pandemic is safe, as long as the hospital performs surgeries under strict isolation measures and a robust screening method. It is necessary to select Covid-19 free hospitals for this matter in this and future pandemics.

The delay of breast cancer diagnosis during the COVID-19 pandemic in São Paulo, Brazil.

ABSTRACTObjective To evaluate the impact of COVID-19 pandemic on breast cancer diagnosis in a breast imaging center.Methods This was a retrospective cohort study that included women submitted to breast exams and procedures in a private hospital in São Paulo, SP, Brazil, as from the period of most strict social isolation measures, in 2020 (separated in first period of social isolation, March 24 to June 21, 2020, and second period, June 22 to December 31, 2020), as compared to the same period in 2019. The number of exams, cancer detection rates, pathologic findings and risk factors were analyzed.Results A total of 32,144 patients were included in the study. Breast imaging exams and procedures decreased by 78.9% in the first period, and 2.7% in the second period, in 2020. By the end of 2020, the number of breast cancer lesions detected was just six cases less than in 2019, although the number of patients submitted to mammograms was 35% lower.Conclusion There was a drop in number of breast exams and cancer diagnoses in the first 90 days of the pandemic. The decrease in diagnosis of cancer was partially compensated in the second period, but the number of patients submitted to mammograms by the end of 2020 was lower, still considering a large number of patients with delayed exams.

Government Epidemic Prevention and Economic Growth Path Under Public Health Emergency: Theoretical Model and Simulation Analysis.

This paper constructs a partial equilibrium model under public health emergency shocks based on economic growth theory, and investigates the relationship between government intervention and virus transmission and economic growth path. We found that both close contacts tracing measures and isolation measures are beneficial to human capital stock and economic output per capita, and the effect of close contact tracing measures is better than that of isolation measures. For infectious diseases of different intensities, economic growth pathways differed across interventions. For low contagious public health emergencies, the focus should be on the coordination of isolation and tracing measures. For highly contagious public health emergencies, strict isolation, and tracing measures have limited effect in repairing the negative economic impact of the outbreak. The theoretical model provides a basic paradigm for the future researches to study economic growth under health emergencies, with good scalability and robustness.

Variation of COVID-19 Specific Immunoglobulin's and Some Inflammatory Factors in COVID-19 Patients in the Sabratha Isolation Center, Western Libya

Background: Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a global pandemic causing significant mortality and morbidity and implementation of strict isolation measures. Serological testing can diagnose illness by detecting antibodies (IgM and IgG). Testing antibodies against SARS-CoV-2 is rapid and sensitive for the auxiliary diagnosis of COVID-19. The serum levels of CRP, D-dimers, and ferritin, which may be used in risk stratification to predict severe and fatal COVID-19 in hospitalized patients. Objectives The present study aimed to investigate the variations in COVID-19 Specific Immunoglobulin's and Some Inflammatory factors in COVID-19 Patients in Sabratha isolation center, Western Libya. Subjects and Methods: Sixty Confirmed COVID-19 patients hospitalized in the Isolation Centre located in Sabratha city, Libya from the 2nd October 2020 to the 2nd June 2021, were enrolled in this prospective study. Covid-19 patients were defined as positive cases after the detection of SARS-CoV-2 RNA in oro-nasopharyngeal swab samples. Data collected included demographic, clinical, and biological factors. Also, 30 healthy individuals without any chronic disease or respiratory symptoms were recruited for the control group. Blood samples were collected by vein puncture 5 ml of venous blood was withdrawn from each participant in the study by using disposable syringes under the aseptic technique; they were then transferred to a sterile tube for estimating biochemical parameters. Biochemical parameters were determined using automated COBAS E411 and INTEGRA 400 machines in the Sabratha Isolation Centre laboratory. The statistical significance of differences between groups was evaluated with the Kruskal-Wallis H test. Results: The results showed that patients with COVID-19 had a significant (P&lt;0.0001) increase in IgM levels at 0 day, 14 days, and 21 days, respectively compared with the healthy individuals. Also, IgG levels were showed a gradual significantly (P&lt;0.0001) increase during COVID-19 Virus Infection among COVID-19 patients at 0 day, 14 days, and 21 days compared with the controls. In addition, coronavirus infection caused a significant (P&lt;0.0001) increase in D-dimer, CRP, and Ferritin levels compared with the healthy control individuals. Conclusion: It can be concluded that coronavirus infection caused a significant increase in IgM, IgG, D-dimer, CRP, and Ferritin levels at different periods compared to the controls. Further studies are needed to confirm these results. COVID-19 Specific Immunoglobulin's and Some Inflammatory factors in COVID-19 Patients These changes in IgM, IgG, D-dimer, CRP, and Ferritin levels during COVID-19 Virus Infection among COVID-19 patients may help the clinicians to better understand the COVID-19 and provide more clinical treatment options.