Coronavirus Disease 2019 Transmission Research Articles

Epidemiology of Household Transmission of COVID-19 among Patients Attending Outpatient Clinics of Teaching Hospital in Cairo, Egypt

Abstract Background Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). People in closed settings with COVID-19 patients, such as household contacts, were more likely to become infected. Household studies can provide informative data for COVID-19 prevention and control. Aim to identify the epidemiological features of household transmission in a sample of patients attending the family medicine clinic of a tertiary hospital in Egypt, and to calculate the household COVID19 secondary clinical attack rate for the recruited patients. Materials and Methods An observational follow-up study was conducted among a sample of 180 primary probable COVID-19 cases attending a tertiary hospital in Cairo, Egypt and their 395 household contacts. The modified WHO case reporting form was used for follow-up of primary probable COVID-19 cases, and the modified WHO contact reporting form was used for their household contacts follow-up. Follow-up phone calls were conducted after 7, 10, and 14 days after attending to the hospital. Results The mean household Secondary clinical attack rate is 65.3 ± 29.9 (95 CI: 60.5% - 70.1%). There was a significant statistical association between reporting symptoms consistent with COVID-19 and sharing a room with the primary case, being not vaccinated, not using Personal protective equipment (PPE) as well as taking care of a primary case (p < 0.001). Conclusion and Recommendations Secondary clinical attack rate among the household contacts was high; more than the average reported rates globally. Vaccination and using PPE had important roles in lowering the risk of reporting symptoms consistent with COVID-19 among household contacts, yet the overall rate of using PPE was low and vaccination coverage was low compared to the rates reported globally. which necessitates more efforts to increase awareness of household transmission and how to safely care for a home-isolated COVID-19 case. The presence of co-morbidities increased the risk of hospitalization among symptomatic contacts This gives an alert to increase the awareness of cases with comorbidities about warning signs that necessitate early hospitalization for a better prognosis. about using PPE among household contacts with a COVID-19 case and also about the importance of vaccination against COVID- 19.

COVID-19 control protocol for rhinologic surgery

In January 2020, 14 medical staff members engaged in endona- sal endoscopic pituitary surgery at a hospital in Wuhan, China, were infected with a novel infection, coronavirus disease 2019 (COVID-19) (1). Since the nasal mucosa is a potential source of COVID-19 infection (2), close attention has been paid to infection control in rhinologic surgery during the COVID-19 pandemic (3). There are also many reports from other countries on COVID-19 infection among otolaryngologists, and these reports suggest that the risk of COVID-19 transmission is particularly high in rhinologic surgery (4,5). On the other hand, Sanmark et al. showed that the observed aerosol exposure during rhinologic surgery is lower or similar to exposures during coughing (6).

Trends in weight gain recorded in English primary care before and during the Coronavirus-19 pandemic: An observational cohort study using the OpenSAFELY platform.

Obesity and rapid weight gain are established risk factors for noncommunicable diseases and have emerged as independent risk factors for severe disease following Coronavirus Disease 2019 (COVID-19) infection. Restrictions imposed to reduce COVID-19 transmission resulted in profound societal changes that impacted many health behaviours, including physical activity and nutrition, associated with rate of weight gain. We investigated which clinical and sociodemographic characteristics were associated with rapid weight gain and the greatest acceleration in rate of weight gain during the pandemic among adults registered with an English National Health Service (NHS) general practitioner (GP) during the COVID-19 pandemic. With the approval of NHS England, we used the OpenSAFELY platform inside TPP to conduct an observational cohort study of routinely collected electronic healthcare records. We investigated changes in body mass index (BMI) values recorded in English primary care between March 2015 and March 2022. We extracted data on 17,742,365 adults aged 18 to 90 years old (50.1% female, 76.1% white British) registered with an English primary care practice. We estimated individual rates of weight gain before (δ-prepandemic) and during (δ-pandemic) the pandemic and identified individuals with rapid weight gain (>0.5 kg/m2/year) in each period. We also estimated the change in rate of weight gain between the prepandemic and pandemic period (δ-change = δ-pandemic-δ-prepandemic) and defined extreme accelerators as the 10% of individuals with the greatest increase in their rate of weight gain (δ-change ≥1.84 kg/m2/year) between these periods. We estimated associations with these outcomes using multivariable logistic regression adjusted for age, sex, index of multiple deprivation (IMD), and ethnicity. P-values were generated in regression models. The median BMI of our study population was 27.8 kg/m2, interquartile range (IQR) [24.3, 32.1] in 2019 (March 2019 to February 2020) and 28.0 kg/m2, IQR [24.4, 32.6] in 2021. Rapid pandemic weight gain was associated with sex, age, and IMD. Male sex (male versus female: adjusted odds ratio (aOR) 0.76, 95% confidence interval (95% CI) [0.76, 0.76], p < 0.001), older age (e.g., 50 to 59 years versus 18 to 29 years: aOR 0.60, 95% CI [0.60, 0.61], p < 0.001]); and living in less deprived areas (least-deprived-IMD-quintile versus most-deprived: aOR 0.77, 95% CI [0.77, 0.78] p < 0.001) reduced the odds of rapid weight gain. Compared to white British individuals, all other ethnicities had lower odds of rapid pandemic weight gain (e.g., Indian versus white British: aOR 0.69, 95% CI [0.68, 0.70], p < 0.001). Long-term conditions (LTCs) increased the odds, with mental health conditions having the greatest effect (e.g., depression (aOR 1.18, 95% CI [1.17, 1.18], p < 0.001)). Similar characteristics increased odds of extreme acceleration in the rate of weight gain between the prepandemic and pandemic periods. However, changes in healthcare activity during the pandemic may have introduced new bias to the data. We found female sex, younger age, deprivation, white British ethnicity, and mental health conditions were associated with rapid pandemic weight gain and extreme acceleration in rate of weight gain between the prepandemic and pandemic periods. Our findings highlight the need to incorporate sociodemographic, physical, and mental health characteristics when formulating research, policies, and interventions targeting BMI in the period of post pandemic service restoration and in future pandemic planning.

Dynamics analysis and optimal control of delayed SEIR model in COVID-19 epidemic

The coronavirus disease 2019 (COVID-19) remains serious around the world and causes huge deaths and economic losses. Understanding the transmission dynamics of diseases and providing effective control strategies play important roles in the prevention of epidemic diseases. In this paper, to investigate the effect of delays on the transmission of COVID-19, we propose a delayed SEIR model to describe COVID-19 virus transmission, where two delays indicating the incubation and recovery periods are introduced. For this system, we prove its solutions are nonnegative and ultimately bounded with the nonnegative initial conditions. Furthermore, we calculate the disease-free and endemic equilibrium points and analyze the asymptotical stability and the existence of Hopf bifurcations at these equilibrium points. Then, by taking the weighted sum of the opposite number of recovered individuals at the terminal time, the number of exposed and infected individuals during the time horizon, and the system cost of control measures as the cost function, we present a delay optimal control problem, where two controls represent the social contact and the pharmaceutical intervention. Necessary optimality conditions of this optimal control problem are exploited to characterize the optimal control strategies. Finally, numerical simulations are performed to verify the theoretical analysis of the stability and Hopf bifurcations at the equilibrium points and to illustrate the effectiveness of the obtained optimal strategies in controlling the COVID-19 epidemic.

The effects of public health and social measures (PHSM) implemented during the COVID‐19 pandemic: An overview of systematic reviews

AbstractIntroductionTo systematically review the effectiveness and unintended health and socioeconomic consequences of public health and social measures (PHSM) aimed at reducing the scale and risk of transmission of coronavirus disease 2019 (COVID‐19).MethodsThis review followed guidance about overviews of reviews in the Cochrane handbook for systematic reviews of interventions and used the Epistemonikos database's COVID‐19 Living Overview of Evidence repository as a primary search source. Methodological quality was evaluated using the Measurement Tool to Assess Systematic Reviews (AMSTAR 2) checklist.ResultsA total of 94 reviews were included, of which eight (9%) had “moderate” to “high” confidence ratings on the AMSTAR 2. Of 16 reviews (17%) reporting applying the GRADE framework, none found high certainty evidence for any of our outcomes of interest. Across the 94 reviews, the most frequently examined PHSM were personal protection (n = 18, 19%). Within multicomponent interventions, so‐called “lockdown” was the most frequently examined component (n = 39, 41%). The most frequently reported outcome category was non‐COVID‐19‐related health outcomes (n = 58, 62%). Only five (5%) reviews reported on socioeconomic outcomes. Findings from the eight reviews with moderate or high confidence ratings on AMSTAR 2 are narratively summarized. There is low‐certainty evidence that multicomponent interventions may reduce the transmission of COVID‐19 in different settings. For active surveillance and response measures, low‐certainty evidence suggests that routine testing of residents and staff in long‐term care facilities may reduce the number of infections, hospitalizations, and deaths among residents. We found very low‐certainty evidence about the effectiveness of personal protection measures, travel‐related control measures, and environmental measures. Unintended consequences were rarely examined by those eight reviews.ConclusionWe found predominantly low‐ to very low‐certainty evidence regarding the effectiveness and unintended consequences of PHSM in controlling the risk and scale of COVID‐19 transmission. There is a need to improve the conduct and reporting of systematic reviews.

Fractional epidemic model of coronavirus disease with vaccination and crowding effects

Most of the countries in the world are affected by the coronavirus epidemic that put people in danger, with many infected cases and deaths. The crowding factor plays a significant role in the transmission of coronavirus disease. On the other hand, the vaccines of the covid-19 played a decisive role in the control of coronavirus infection. In this paper, a fractional order epidemic model (SIVR) of coronavirus disease is proposed by considering the effects of crowding and vaccination because the transmission of this infection is highly influenced by these two factors. The nonlinear incidence rate with the inclusion of these effects is a better approach to understand and analyse the dynamics of the model. The positivity and boundedness of the fractional order model is ensured by applying some standard results of Mittag Leffler function and Laplace transformation. The equilibrium points are described analytically. The existence and uniqueness of the non-integer order model is also confirmed by using results of the fixed-point theory. Stability analysis is carried out for the system at both the steady states by using Jacobian matrix theory, Routh–Hurwitz criterion and Volterra-type Lyapunov functions. Basic reproductive number is calculated by using next generation matrix. It is verified that disease-free equilibrium is locally asymptotically stable if R0<1\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$${R}_{0}<1$$\\end{document} and endemic equilibrium is locally asymptotically stable if R0>1\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$${R}_{0}>1$$\\end{document}. Moreover, the disease-free equilibrium is globally asymptotically stable if R0<1\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$${R}_{0}<1$$\\end{document} and endemic equilibrium is globally asymptotically stable if R0>1\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$${R}_{0}>1$$\\end{document}. The non-standard finite difference (NSFD) scheme is developed to approximate the solutions of the system. The simulated graphs are presented to show the key features of the NSFD approach. It is proved that non-standard finite difference approach preserves the positivity and boundedness properties of model. The simulated graphs show that the implementation of control strategies reduced the infected population and increase the recovered population. The impact of fractional order parameter α\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\alpha$$\\end{document} is described by the graphical templates. The future trends of the virus transmission are predicted under some control measures. The current work will be a value addition in the literature. The article is closed by some useful concluding remarks.

The impact of implementing barrier curtain placement in reducing nosocomial COVID-19 clusters at a tertiary care facility

Abstract Objective: This study aimed to asses the impact of a physical barrier-based infection prevention and control (IPC) intervention in patient wards at a tertiary care center on patient-to-patient coronavirus disease-2019 (COVID-19) transmission and cluster formation. Materials and Methods: A quasi-experimental study was conducted at a 1300-bedded South Indian tertiary care center. Barrier curtains were deployed between ward beds, accompanied by a social interaction protocol, at eight locations, each containing eleven 4-bedded cubicles accommodating 44 patient beds. A surveillance team daily audited adherence to mask usage, barrier curtains, and the social interaction protocol using a predefined checklist. An effective implementation hybrid design was employed to evaluate clinical impact (cluster formation) and implementation effectiveness (adherence to interventions) between the pre-implementation and post-implementation phases. Results: During the pre-implementation and post-implementation periods, 2398 and 1024 positive COVID-19 cases were recorded in the selected areas, respectively, with an average monthly positivity rate of 40%. The number of clusters decreased from three clusters with an average of 11.3 positive cases per cluster in the pre-implementation period to no clusters in the post-implementation period. Implementation effectiveness showed compliance rates of 90% for barrier curtain placement and 100% for the social interaction protocol. Conclusion: This study confirms that physical barriers, specifically curtains, are effective measures against nosocomial COVID-19 transmission. It underscores the importance of adopting context-specific, cost-effective strategies, especially in low-to-middle-income countries, and provides a strong rationale for further research and implementation of such interventions.

Control System UV-C Lamp and Room Temperature Based Internet of Things

At the beginning of 2020, the world was shocked by the emergence of a new virus, Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-nCoV- 2) and the name of the disease is Coronavirus Disease 2019 (COVID-19). Common symptoms of COVID-19 are acute respiratory distress, fever, cough and shortness of breath. One of the efforts to overcome the transmission of COVID-19 is by sterilizing the room. This research designs an automatic room sterilization device using UV-C lamps that can be controlled using the Blynk application. There are 2 working principles of this tool, namely automatic, the lamp will turn on according to a predetermined setpoint and manual, the lamp will turn on manually like a normal lamp. Hardware used to make this tool are NodeMCU ESP8266, DHT11 sensor, PIR sensor, UV-C lamp, and Relay. As for the software used are Arduino IDE and Blynk Application. This research has 3 tests, the first is testing the lamp automation system where the UV-C lamp response is in accordance with the notification in the Blynk application. The second test is a human detection system with a PIR sensor where the sensor can detect with a maximum radius of 5m. The third test of room temperature monitoring system with DHT11 sensor with digital thermometer comparison tool. The average error value is 0.88% with the accuracy of the DHT11 sensor of 99.12%

Suppression of the alpha, delta, and omicron variants of SARS-Cov-2 in Taiwan.

Taiwan was a coronavirus disease 2019 (COVID-19) outlier, with an extraordinarily long transmission-free record: 253 days without locally transmitted infections while the rest of the world battled wave after wave of infection. The appearance of the alpha variant in May 2021, closely followed by the delta variant, disrupted this transmission-free streak. However, despite low vaccination coverage (<1%), outbreaks were well-controlled. This study analyzed the time to border closure and conducted one-sample t test to compare between Taiwan and Non-Taiwan countries prior to vaccine introduction. The study also collected case data to observe the dynamics of omicron transmission. Time-varying reproduction number,Rt, was calculated and was used to reflect infection impact at specified time points and model trends of future incidence. The study analyzed and compare the time to border closure in Taiwan and non-Taiwan countries. The mean times to any border closure from the first domestic case within each country were -21 and 5.98 days, respectively (P < .0001). The Taiwanese government invested in quick and effective contact tracing with a precise quarantine strategy in lieu of a strict lockdown. Residents followed recommendations based on self-discipline and unity. The self-discipline in action is evidenced in Google mobility reports. The central and local governments worked together to enact non-pharmaceutical interventions (NPIs), including universal masking, social distancing, limited unnecessary gatherings, systematic contact tracing, and enhanced quarantine measures. The people cooperated actively with pandemic-prevention regulations, including vaccination and preventive NPIs. This article describes four key factors underlying Taiwan's success in controlling COVID-19 transmission: quick responses; effective control measures with new technologies and rolling knowledge updates; unity and cooperation among Taiwanese government agencies, private companies and organizations, and individual citizens; and Taiwanese self-discipline.

Characteristics of a large outbreak arising from a school field trip after COVID-19 restrictions were eased in 2022.

This study analyzed a large outbreak of coronavirus disease 2019 (COVID-19) that occurred during a high school field trip in the Jeonbuk region and aimed to identify risk factors for COVID-19 infection, with the goal of preventing such outbreaks in the future. A retrospective cohort study of 737 participants, including 668 students and 69 staff at High School A, was designed to describe the epidemiological characteristics of this large COVID-19 outbreak. Logistic regression analysis was performed to calculate relative risks (odds ratios [ORs]) and 95% confidence intervals (CIs). There were 190 confirmed cases (174 students, 16 staff), with an attack rate of 25.8%. Small outbreaks were decreasing before the field trip, but this trend reversed after the trip, leading to larger outbreaks. Logistic regression showed an OR of 2.39 (95% CI, 1.66-3.43; p<0.05) for COVID-19 infection among field trip participants. Among them, 11th graders had an OR of 2.32 (95% CI, 1.53-3.52; p<0.05) compared to 10th graders, while no significant risk difference was found within same-grade teams. There was a high risk for COVID-19 transmission during extracurricular activities with a large number of participants, such as field trips, even after the nationwide Omicron variant epidemic subsided. Even when students are separated into teams and follow different routes, it is challenging to design routes that entirely prevent contact between teams. Thus, programs should be designed carefully, and students with symptoms should be identified before and during the program to isolate them promptly.

Knowledge, attitudes, and practices toward COVID-19 and its prevention among medical and dental students in an educational institution in Telangana.

Coronavirus disease 2019 (COVID-19) emerged as a global pandemic, threatening millions of lives worldwide. Everyone was overwhelmed by the plethora of information from different sources, creating confusion, misconceptions, and panic in the community. This study aimed to estimate the knowledge, attitudes, and practices (KAP) among medical and dental students toward COVID-19 and to identify factors influencing them. A cross-sectional study was conducted among undergraduate students enrolled in MBBS and BDS courses, and KAP scores were calculated using a self-administered questionnaire. The statistical analysis was done by unpaired t test and one-way analysis of variance. MBBS students had higher KAP scores when compared with BDS students. Knowledge gaps were discovered in the areas of COVID-19 transmission through blood, World Health Organization (WHO)-designated variants of concern, disinfectant usage, and mandatory vaccination. A majority (91.33%) of the students had a positive attitude toward COVID-19. Better knowledge and practice scores were significantly associated with vaccinated students and those who trusted government website resources. Curriculum modifications and creative teaching strategies can fill the lacunae in the KAP scores. Medical and dental students, as torchbearers of the healthcare fraternity, can play a critical role in raising awareness during public health emergencies.

Wastewater Surveillance of SARS-CoV-2 RNA in a Prison Facility

Prison populations are unlikely to have access to prompt, effective medical care as the general population. Therefore, vaccination and effective surveillance systems have been recommended to mitigate coronavirus disease 2019 (COVID-19) transmission in prison settings. This pilot study aimed to assess the application of wastewater-based epidemiology (WBE) in a prison to act as an early warning tool for COVID-19 transmission. In this study, weekly wastewater samples (n = 21) were collected for 21 weeks from a prison facility in New Orleans, LA, USA, and analyzed for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and the results were compared with the number of confirmed cases during the same period. SARS-CoV-2 was concentrated using two methods and quantified via RT-qPCR using CDC N1 and N2 assays. Overall, SARS-CoV-2 was detected in eight samples (38%). An equal number of samples tested positive for SARS-CoV-2 using the two concentrating methods, indicating the effectiveness of both methods for building-scale WBE. Despite limited clinical testing in the studied prison facility, instances of SARS-CoV-2 detection in wastewater prior to the diagnosis of COVID-19 depict the potential use of wastewater surveillance in detecting the presence of early and averting outbreaks in asymptomatic COVID-19 patients.

Effect of COVID-19 protective measures on the epidemiology characteristics of rotavirus, adenovirus, and coinfections among pediatric patients with acute gastroenteritis in Hangzhou, China.

Human rotavirus (RV) and adenovirus (AdV) have been recognized as common enteric viruses associated with viral acute gastroenteritis (AGE) in children aged<5 years. However, with the transmission of coronavirus disease 2019 (COVID-19) has been suppressed due to various aggressive and effective anti-epidemic measures, the prevalence of other viruses has also been affected. Therefore, this study aimed to investigate the impact of COVID-19 on the epidemiological characterization of RV, AdV, and coinfections among children with AGE in a hospital in Hangzhou from 2019 to 2023. The overall changes, seasonal distribution, and age distribution of enteroviruses were analyzed based on 5 years of records. All data were analyzed using SPSS 27.0. A total of 102,049 samples were analyzed from January 2019 to August 2023, and among them 15,911 (15.59%) were positive specimens, 11,646 (11.41%) were RV-positive, 4,057 (3.98%) were AdV-positive, and 208 (0.20%) were coinfection. The positive rate among males was 15.54%, while among females was 15.66% with a male-to-female ratio of 1.42:1. There was no significant difference in the positive rates of enterovirus infection between males and females. Significant associations were found between the month group and RV/AdV infection, with RV detection peaking in winter (74.18%) and early spring (29.22%), while AdV has a high prevalence in summer (16.03%) and spring (12.71%). The age group was also found to be significantly associated with RV/AdV infection, with RV being most prevalent in the 1-3-year-old age group (16.99%), while AdV was highest in the 3-5-year-old age group (8.10%).IMPORTANCEThis study highlights the epidemiological changes of rotavirus (RV), adenovirus (AdV), and coinfections in children with acute gastroenteritis (AGE) before, during, and after coronavirus disease 2019 (COVID-19) periods. There was a highly statistically significant difference in the positive rates of RV-positive, AdV-positive, and coinfection (P < 0.001), indicating that RV remains the main pathogen causing AGE. It emphasizes the importance of continuous surveillance of RV and AdV at both local and global levels. Regular surveillance of prevalent rotavirus strains will facilitate the development of new inactivated rotavirus vaccines and aid in disease prevention and control.

Variation in response to the coronavirus disease 2019 (COVID-19) at US dental school clinics.

Although the threat of coronavirus disease 2019 (COVID-19) was the same at different US dental schools, the response wasn't. There is no study that documents the variation in mitigation strategies, COVID-19 transmission, and clinical educational changes at US Dental schools during the ongoing pandemic that began in 2020 in the US. The current study was approved as exempt research (project number HUM00199261). Our survey of Associate Dean's of Clinical Operations was individually emailed in July 2021. There were no reminders and descriptive statistics were calculated using Microsoft Excel. We received 46 completed surveys from the 68 sent out. Note that 65.2% of respondents reported requiring N95 masks for aerosol-generating procedures. Note that 38.9% of respondents said they required student partnering as chairside dental assistants for aerosol-generating procedures. Note that 37.7% of respondents began using alternate cubicles. A total of 6.52% of schools reported a transmission of the severe acute respiratory syndrome coronavirus 2 virus from patient to provider. There were no reported transmissions from provider to patient or from patient to patient. In our study, we found a lot of similarities between the approach taken by Dental School Clinics across the US to mitigate the risks of COVID-19, however, we also observed many differences.

COVID-19 vaccination and transmission patterns among pregnant and postnatal women during the fifth wave of COVID-19 in a tertiary hospital in Hong Kong.

Vaccination is a key strategy to control the coronavirus disease 2019 (COVID-19) pandemic. Safety concerns strongly influence vaccine hesitancy. Disease transmission during pregnancy could exacerbate risks of preterm birth and perinatal mortality. This study examined patterns of vaccination and transmission among pregnant and postnatal women during the fifth wave of COVID-19 in Hong Kong. The Antenatal Record System and Clinical Management System of the Hospital Authority was used to retrieve information concerning the demographic characteristics, vaccination history, COVID-19 status, and obstetric outcomes of women who were booked for delivery at Queen Mary Hospital in Hong Kong and had attended the booking antenatal visit from 1 July 2021 to 30 June 2022. Among 2396 women in the cohort, 2006 (83.7%), 1843 (76.9%), and 831 (34.7%) had received the first, second, and third doses of COVID-19 vaccine, respectively. Among 1012 women who had received the second dose, 684 (67.6%) women were overdue for their third dose. There were 265 (11.1%) reported COVID-19 cases. Women aged 20 to 29 years had a low vaccination rate but the highest disease rate (19.1%). The disease rate was more than tenfold higher in women who had no (20.3%) or incomplete (18.8%) vaccination, compared with women who had complete vaccination (2.1%; P<0.001). Acceptance of COVID-19 vaccination was low in pregnant women. Urgent measures are needed to promote vaccination among pregnant women before the next wave of COVID-19.

A severe acute respiratory coronavirus virus 2 (SARS-CoV-2) nosocomial cluster with inter-facility spread: Lessons learned.

Despite infection control guidance, sporadic nosocomial coronavirus disease 2019 (COVID-19) outbreaks occur. We describe a complex severe acute respiratory coronavirus virus 2 (SARS-CoV-2) cluster with interfacility spread during the SARS-CoV-2 δ (delta) pandemic surge in the Midwest. This study was conducted in (1) a hematology-oncology ward in a regional academic medical center and (2) a geographically distant acute rehabilitation hospital. We conducted contact tracing for each COVID-19 case to identify healthcare exposures within 14 days prior to diagnosis. Liberal testing was performed for asymptomatic carriage for patients and staff. Whole-genome sequencing was conducted for all available clinical isolates from patients and healthcare workers (HCWs) to identify transmission clusters. In the immunosuppressed ward, 19 cases (4 patients, 15 HCWs) shared a genetically related SARS-CoV-2 isolate. Of these 4 patients, 3 died in the hospital or within 1 week of discharge. The suspected index case was a patient with new dyspnea, diagnosed during preprocedure screening. In the rehabilitation hospital, 20 cases (5 patients and 15 HCWs) positive for COVID-19, of whom 2 patients and 3 HCWs had an isolate genetically related to the above cluster. The suspected index case was a patient from the immune suppressed ward whose positive status was not detected at admission to the rehabilitation facility. Our response to this cluster included the following interventions in both settings: restricting visitors, restricting learners, restricting overflow admissions, enforcing strict compliance with escalated PPE, access to on-site free and frequent testing for staff, and testing all patients prior to hospital discharge and transfer to other facilities. Stringent infection control measures can prevent nosocomial COVID-19 transmission in healthcare facilities with high-risk patients during pandemic surges. These interventions were successful in ending these outbreaks.

Patients' knowledge about dental emergencies, COVID-19 transmission, and required preparations in dental settings.

The Coronavirus disease 2019 (COVID-19) pandemics negatively affected the delivery of dental care. The study objective was to assess the knowledge of emergency dental treatments, the transmission routes of COVID-19 in the dental settings, necessary precautions to prevent disease transmission, and the associations between demographic factors and the mentioned domains among Iranian dental patients. This was a cross-sectional study conducted in October 2021. A systematic random sampling approach was used to select 244 participants who had sought services at the dental clinic of Tehran University of Medical Sciences before and during the pandemic. Data was collected using a combination of interviewer-administered and self-administered questionnaire. Three backward stepwise multiple logistic regression analyses were conducted to determine the associations between background factors (age, sex, education level, living status, history of dental visits, history of COVID-19 vaccination, and past COVID-19 infection) and knowledge about emergency dental treatments, knowledge about COVID-19 transmission routes, and knowledge about necessary preparations in dental settings. The mean (SD) scores for knowledge of emergency dental treatments, COVID-19 transmission routes, and essential preparations in dental settings measured on a 100-point scale were 77 (15.4), 84.2 (12.3), and 93.3 (12.1), respectively. Good knowledge of emergency dental treatments was associated with being under 55 years old (p = 0.03). Good knowledge of COVID-19 transmission routes was associated with living with individuals at a high risk of COVID-19 (p = 0.014) and having received the COVID-19 vaccine (p = 0.013). After adjusting for age, among participants aged 30 years and older, good knowledge of necessary preparations in dental settings was associated with being female (p = 0.012) and having received the COVID-19 vaccine (p = 0.001). Patients who sought care at the dental clinic of Tehran University of Medical Sciences had good knowledge about the transmission routes of COVID-19 and the required preparations in dental settings, and limited knowledge about dental emergency treatments.

Knowledge about COVID-19 among the General Population Dhanmondi Area in Dhaka City, Bangladesh

Background: Bangladesh is one of the most affected countries with Coronavirus disease 2019 (COVID-19) pandemic.For the prevention of the disease, COVID appropriate behaviour should be followed by the all concerned. Objective: Toassess knowledge of the general mass on etiology, transmission and prevention of COVID-19. Methods: A descriptive,cross sectional study was conducted among 267 adults selected through accidental sampling technique using semi-structured interviewer administered questionnaire through face-to-face interview after obtaining informed verbalconsent. Strict confidentiality and other ethical issues was maintained. Results: As many as 228(85.39%) respondentswere males, while 256(95.88%) respondents were Muslim, 150(56.18%) were married, 36(3.48%) had no formaleducation, 61(22.85%) were rickshaw-pullers, all had heard about COVID-19. Of 267, 256(98.88%) of the respondentshad idea about the causation of COVID-19, three fourth 193(75.39%) respondents knew that the disease was caused byan infectious agent, majority 237(87.64%) of the respondents had knowledge about transmission of the disease fromperson to person through droplet infection during sneezing and coughing (64.56%). Vulnerability to the disease was221(82.77%) in geriatric group, high vulnerability was in persons with co-morbidity like diabetes mellitus (65.84%),hypertension (32.92%), cancer (9.88%), bronchial asthma (9.88%) and in pregnant women (8.23%); 242(90.64%) ofrespondents opined that COVID-19 could be prevented by using mask (91.32%), frequent hand washing (70.66%),maintenance of physical distance (58.26%) and by vaccination (47.93%). Conclusion: General mass has adequateknowledge about the causation of COVID-19 with nature of causative agent with a clear conception of transmissionof COVID-19 and measure for its prevention.

COVID-19 outbreak at a residential apartment building in Northern Ontario, Canada.

In February 2021, a cluster of Beta variant (B.1.351) coronavirus disease 2019 (COVID-19) cases were identified in an apartment building located in Northern Ontario, Canada. Most cases had no known contact with each other. Objectives of this multi-component outbreak investigation were to better understand the social and environmental factors that facilitated the transmission of COVID-19 through this multi-unit residential building (MURB). A case-control study examined building-specific exposures and resident behaviours that may have increased the odds of being a case. A professional engineer assessed the building's heating, ventilation, and air-conditioning (HVAC) systems. Whole-genome sequencing and an in-depth genomic analysis were performed. Forty-five outbreak-confirmed cases were identified. From the case-control study, being on the upper floors (OR: 10.4; 95% CI: 1.63-66.9) and within three adjacent vertical lines (OR: 28.3; 3.57-225) were both significantly associated with being a case of COVID-19, after adjusting for age. There were no significant differences in reported behaviours, use of shared spaces, or precautions taken between cases and controls. An assessment of the building's ventilation found uncontrolled air leakage between apartment units. A single genomic cluster was identified, where most sequences were identical to one another. Findings from the multiple components of this investigation are suggestive of aerosol transmission between units.

Assessment of patients’ knowledge, attitude and practice of cross-infection control in the dental clinic during COVID-19 pandemic

Background: The emergence of coronavirus disease 2019 (COVID-19), a highly contagious disease that causes viral respiratory illness, has changed the lifestyle of humans worldwide. Dental practitioners and patients are at high risk of infection during their routine practice due to their exposure to saliva, blood, and droplet production.&#x0D; Aim: To gain insight into the patient’s viewpoint regarding the practice, altitude, and knowledge of COVID-19 and its transmission and cross-infection in dental clinics.&#x0D; Methods: This was cross–sectional analytic survey in dentistry during the COVID-19 pandemic. A self-administered close-ended questionnaire consisting of 32 variables was distributed among the study participants. The data were analysed using the Statistical Package for the Social Sciences (SPSS) version 25. The level of significance was p ≤ 0.05.&#x0D; Results: The age of the participants varied from 20 - 58 years, with a mean age of 34.6 ±5. The majority (89.3%) felt COVID-19 was a highly contagious disease, while 50.0% of the respondents believed that the most common route of COVID-19 transmission in dentistry is through aerosols. The majority, 78.6%, recorded good knowledge of infection control following the COVID-19 outbreak. The number of married patients who had good knowledge of cross-infection control was 118, which was statistically significant.&#x0D; Conclusion: From the study, it is evident that the patients possess a good range of knowledge in both preventive and cross-infection protocols to follow during the COVID-19 pandemic. However, the same cannot be said about the practice.