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Background: COVID-19 (coronavirus disease 2019) outbreaks in workplace settings have been investigated to understand how transmission occurred. However, there is limited data looking at COVID-19 transmission in conference settings in England, particularly where an outbreak did not occur. The aim of this work was to investigate COVID-19 infection risk factors and control measures at a large conference, with a known case but no reported onward transmission to inform prevention of future outbreaks of respiratory infections in conferences and similar settings. Methods: This cross-sectional study was part of a wider COVID-19 Outbreak Investigation to Understand Transmission (COVID-OUT) study. A two-day in-person conference on SARS-CoV-2 transmission and environment was held at a university conference centre on 17-November 18, 2021, in England, with about 100 delegates. A questionnaire survey was conducted among 50 conference attendees to identify any confirmed cases and understand transmission, history of COVID-19 symptoms, testing and vaccination. Results: One person met the definition of a confirmed case at the conference. This case was most likely infectious when attending the conference, however there were no known secondary cases. All respondents reported receiving at least two doses of a COVID-19 vaccine before the conference and an increased frequency of handwashing/sanitising hands during the study period in comparison to before the pandemic. Prior to the conference, a COVID-19 risk assessment including a review of the ventilation at the site was completed. All attendees were advised to take an LFD test before travelling to the conference, wear face coverings, and maintain 1-m distance during the conference. Conclusion: A multipronged approach, encouraging attendee behaviours (regular hand washing, mask wearing, being vaccinated against COVID-19) and introducing control measures at the conference site (ventilation, sufficient spacing capacity, combined with prior knowledge of COVID-19 transmission, were effective in limiting the spread of COVID-19 in this setting.
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Introduction: Females suffer greater lifetime risk of stroke and greater morbidity and mortality from stroke compared with males. This study's objective was to identify differences in metabolomic profiling of females and males with stroke and which differences were associated with neurological outcome. Methods: Females and males with acute ischemic stroke enrolled in the Emergency Medicine Specimen Bank at a comprehensive stroke center provided whole blood samples upon arrival for mass spectrometry-based metabolomics. We used descriptive statistics to characterize the cohort. A linear regression model was fit for individual metabolites to determine differences in relative abundance between males and females while controlling for covariates (age, race/ethnicity, postmenopausal status, cardiovascular risk factors, depression, time between sample collection and last known well, and initial National Institutes of Health Stroke Scale [NIHSS] score). For each differentially expressed metabolite, a linear regression model was fit to determine the association between the metabolite and NIHSS at 24 hours after admission while controlling for the covariates and acute treatments. Results: After adjusting for covariates, eight metabolites differed in females and males with a stroke. These included amino acids or their metabolites (proline and tryptophan), nucleotides (guanosine diphosphate [GDP], and inosine-3',5'-cyclic monophosphate), citrate, dehydroascorbate, choline, and acylcarnitine-(5-OH). GDP and dehydroascorbate were significantly associated with 24-hour NIHSS (p = 0.0991). Conclusions: Few metabolites were differentially abundant in blood after a stroke when comparing females with males and controlling for confounders, but the interactions between biological sex and GDP, as well as biological sex and dehydroascorbate, were associated with 24-hour neurological function. This has important implications for future studies that evaluate the therapeutic potential of these metabolites in ischemic stroke.
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An outbreak of SARS-CoV-2 (1 March to 10 May 2021) with an attack rate of 26.5% among approximately 1150 workers at a storage and distribution centre in England prompted a multidisciplinary outbreak investigation (5 May to 6 August 2021), with the aim of better understanding worker- and workplace-related risk factors for viral transmission in the warehousing sector. Overall, environmental factors (e.g., ventilation, humidity and temperature) were assessed to be appropriate at the facility. Nevertheless, 39 (51.3%) surface samples from across the site tested positive for low/ very low levels of SARS-CoV-2 RNA (Ct value ≥ 32.0 for all). Among the study participants, of whom 35.6% were confirmed or suspected cases, 95.5% reported having received COVID-19 prevention training, 100.0% reported handwashing, and 80.0% reported use of face coverings at work. Notably, 43.9% and 19.0% reported working with a symptomatic and a positive contact respectively. Furthermore, 80.5% and 46.3% had concerns regarding reduction in their income and future unemployment, respectively, due to self-isolation. The findings of this study suggest that, in addition to targeted workplace infection control measures and tailored work area specific risk assessments, an enhanced and equitable sick leave policy may help limit presenteeism and viral transmission in large workplaces.