Travel restrictions and SARS-CoV-2 transmission: an effective distance approach to estimate impact.

OBJECTIVE: To estimate the effect of airline travel restrictions on the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) importation. METHODS: We extracted passenger volume data for the entire global airline network, as well as the dates of the implementation of travel restrictions and the observation of the first case of coronavirus disease (COVID-19) in each country or territory, from publicly available sources. We calculated effective distance between every airport and the city of Wuhan, China. We modelled the risk of SARS-CoV-2 importation by estimating survival probability, expressing median time of importation as a function of effective distance. We calculated the relative change in importation risk under three different hypothetical scenarios that all resulted in different passenger volumes. FINDINGS: We identified 28 countries with imported cases of COVID-19 as at 26 February 2020. The arrival time of the virus at these countries ranged from 39 to 80 days since identification of the first case in Wuhan. Our analysis of relative change in risk indicated that strategies of reducing global passenger volume and imposing travel restrictions at a further 10 hub airports would be equally effective in reducing the risk of importation of SARS-CoV-2; however, this reduction is very limited with a close-to-zero median relative change in risk. CONCLUSION: The hypothetical variations in observed travel restrictions were not sufficient to prevent the global spread of SARS-CoV-2; further research should also consider travel by land and sea. Our study highlights the importance of strengthening local capacities for disease monitoring and control.

Network Model for Optimal Aircraft Location for Human Organ Transportation Activities.

BACKGROUND: The efficiency of transport phases is a key factor in successful organ transplant operations. Reliability, safety, and punctuality must be in compliance with the European Union and national frameworks and be consistent with economic, quantitative, and level-of-service parameters. In this study we investigated the optimal numbers and locations of aircraft in the Italian territory by comparing performance indexes related to different time intervals and service design scenarios. METHODS: An integer linear programming model is described as an optimal service solution for covering the demand for extraregional organ transport by air between June 2015 and May 2016. Restrictions on aircraft utilization and actual length of the missions in cases of incompatible activities are the relevant input data of the model. RESULTS: Based on mission durations and their origin and destination, the model returns the optimal number and location of aircraft in various scenarios. The performance parameters required by law and the need to guarantee the service from/to the whole territory, together with the transplant figures performed and transplant center locations, have been taken into account to determine the most efficient spatial and numerical allocation. CONCLUSION: The efficient design of an urgency-based service such as the transportation of organs for transplant purposes is not an easy task. Nevertheless, knowledge of the logistic chain and continuous monitoring and update of data and performance parameters can allow for collection of useful information to guarantee a high-performing service.

Comparing public concern and support for drone regulation to the current legal framework.

In this study we assess the extent to which the regulations governing the use of drones in the United States address the concerns held by the public they are meant to protect. In general, respondents were most supportive of those regulations that could be categorized as limiting one's exposure to an unwanted drone. The most popular policies were those that protected personal privacy, while the least popular were those that hampered drones used for public safety. The largest discrepancy was found to be respondents' preference for laws protecting personal privacy compared with the lack of regulatory constraints currently in place. Federal regulators have only begun to introduce regulations on how drones can be used in our national airspace, with additional regulations for other types and sizes of drones likely to be introduced in the future. The results of this study may be utilized by regulators and lawmakers to create a regulatory structure that effectively mitigates risk and supports the public interest.

Drones in medicine-The rise of the machines.

This is a medical kitty hawk moment. Drones are pilotless aircrafts that were initially used exclusively by the military but are now also used for various scientific purposes, public safety, and in commercial industries. The healthcare industry in particular can benefit from their technical capabilities and ease of use. Common drone applications in medicine include the provision disaster assessments when other means of access are severely restricted; delivering aid packages, medicines, vaccines, blood and other medical supplies to remote areas; providing safe transport of disease test samples and test kits in areas with high contagion; and potential for providing rapid access to automated external defibrillators for patients in cardiac arrest. Drones are also showing early potential to benefit geriatric medicine by providing mobility assistance to elderly populations using robot-like technology. Looking further to the future, drones with diagnostic imaging capabilities may have a role in assessing health in remote communities using telemedicine technology. The Federal Aviation Administration (FAA) in the United States and the European Aviation Safety Agency (EASA) in the European Union are some examples of legislative bodies with regulatory authority over drone usage. These agencies oversee all technical, safety, security and administrative issues related to drones. It is important that drones continue to meet or exceed the requirements specified in each of these regulatory areas. The FAA is challenged with keeping pace legislatively with the rapid advances in drone technology. This relative lag has been perceived as slowing the proliferation of drone use. Despite these regulatory limitations, drones are showing significant potential for transforming healthcare and medicine in the 21st century.

Control of Communicable Diseases. Final rule.

The Centers for Disease Control and Prevention (CDC), within the Department of Health and Human Services (HHS), is issuing this final rule (FR) to amend its regulations governing its domestic (interstate) and foreign quarantine regulations to best protect the public health of the United States. These amendments have been made to aid public health responses to outbreaks of new or re-emerging communicable diseases and to accord due process to individuals subject to Federal public health orders. In response to public comment received, the updated provisions in this final rule clarify various safeguards to prevent the importation and spread of communicable diseases affecting human health into the United States and interstate.