Comparison of Low-Cost Particulate Matter Sensors for Indoor Air Monitoring during COVID-19 Lockdown.

This study shows the results of air monitoring in high- and low-occupancy rooms using two combinations of sensors, AeroTrak8220(TSI)/OPC-N3 (AlphaSense, Great Notley, UK) and OPC-N3/PMS5003 (Plantower, Beijing, China), respectively. The tests were conducted in a flat in Warsaw during the restrictions imposed due to the COVID-19 lockdown. The results showed that OPC-N3 underestimates the PN (particle number concentration) by about 2-3 times compared to the AeroTrak8220. Subsequently, the OPC-N3 was compared with another low-cost sensor, the PMS5003. Both devices showed similar efficiency in PN estimation, whereas PM (particulate matter) concentration estimation differed significantly. Moreover, the relationship among the PM1-PM2.5-PM10 readings obtained with the PMS5003 appeared improbably linear regarding the natural indoor conditions. The correlation of PM concentrations obtained with the PMS5003 suggests an oversimplified calculation method of PM. The studies also demonstrated that PM1, PM2.5, and PM10 concentrations in the high- to low-occupancy rooms were about 3, 2, and 1.5 times, respectively. On the other hand, the use of an air purifier considerably reduced the PM concentrations to similar levels in both rooms. All the sensors showed that frying and toast-making were the major sources of particulate matter, about 10 times higher compared to average levels. Considerably lower particle levels were measured in the low-occupancy room.

A model respiratory personal protective programme for the New Zealand healthcare industry.

In the absence of advice from the workplace regulator, a model respiratory protection programme for healthcare workers is presented based in healthcare and wider industry experience. Hospital and other healthcare institutions can use this as a basis for their programmes in preparation for the next infective disease outbreak.

Searching for Digital Technologies in Containment and Mitigation Strategies: Experience from South Korea COVID-19.

Background: Korea has achieved health policy objectives in pandemic management so far, namely minimizing mortality, flattening the epidemic curve, and limiting the socio-economic burden of its measures. The key to the Korean government's success in combating COVID-19 lies with the latest digital technologies (DTs). The prompt and effective application of DTs facilitates both containment as well as mitigation strategies and their sub-policy measures. Methods: This article uses an experiential analysis based on an exploratory case study - analysis on field applications of the government's interventions. Information is collected by qualitative methods such as literature analysis, meeting materials, and a review of various government reports (including internal ones) along with academic and professional experiences of the authors. Findings: The article presents the unique Korean health policy approaches in the COVID-19 crisis. First, DTs allow the Korean government to embrace various policy measures together listed in containment strategy, namely altering and warning, epidemiological investigation, quarantine of contacts, case-finding, social distancing, and mask-wearing. Second, DTs allow Korea to integrate containment and mitigation strategies simultaneously. Along with the above measures in containment, healthcare service, medical treatment, and prophylaxis (presymptomatic testing) within mitigation are utilized to prevent a COVID-19 spread. Conclusions: Korea develops DTs in an integrated manner in the early pandemic stage under strong and coordinated government leadership. Above all, the DTs' functions in each pandemic developmental stage are continuously upgraded. Instead of prioritizing policy measures or strategies, therefore, Korea can implement diverse policies simultaneously by integrating DTs effectively. During the COVID-19 outbreak, DTs work as the enablers to connect these two strategies and their measures in Korea. Recommendations: DTs should be at the center of the disaster management paradigm, especially during a pandemic. DTs are facilitators and integrators of containing and mitigating strategies and their policy measures.

Impact of the COVID-19 pandemic on cytology practice: An international survey in the Asia-Pacific region.

BACKGROUND: The purpose of the current study was to examine the impact of coronavirus disease 2019 (COVID-19) on various aspects of cytology practice in the Asia-Pacific region. METHODS: An online questionnaire was distributed to cytopathology laboratories in 24 Asia-Pacific countries to explore the impact of restrictive measures on access to health care, use of general and personal protective equipment (PPE), and changes in cytology workflow and workload from February to April 2020. RESULTS: A total of 167 cytopathology laboratories from 24 countries responded to the survey; the majority reported that restrictive measures that limited the accessibility of health care services had been implemented in their cities and/or countries (80.8%) and their hospitals (83.8%). The respondents noted that COVID-19 had an impact on the cytologic workflow as well as the workload. Approximately one-half of the participants reported the implementation of new biosafety protocols (54.5%) as well as improvements in laboratory facilities (47.3%). Rearrangement or redeployment of the workforce was reported in 53.3% and 34.1% of laboratories, respectively. The majority of the respondents reported a significant reduction (>10%) in caseload associated with both gynecological (82.0%) and nongynecological specimens (78.4%). Most laboratories reported no significant change in the malignancy rates of both gynecological (67.7%) and nongynecological specimens (58.7%) compared with the same period in 2019. CONCLUSIONS: The results of the survey demonstrated that the COVID-19 pandemic resulted in a significant reduction in the number of cytology specimens examined along with the need to implement new biosafety protocols. These findings underscore the need for the worldwide standardization of biosafety protocols and cytology practice.

On Pause for the Pandemic: Health Issues Sidelined Amid COVID-19 Response.

Any physician can look out over the COVID-19 landscape and see important areas of health care tied to their specialty that are being downplayed or ignored as resources pour into fighting the pandemic and scared patients chose not to come to their doctors' offices.

Business Closures, Stay-at-Home Restrictions, and COVID-19 Testing Outcomes in New York City.

INTRODUCTION: In response to the coronavirus disease 2019 (COVID-19) pandemic, New York City closed all nonessential businesses and restricted the out-of-home activities of residents as of March 22, 2020. This order affected different neighborhoods differently, as stores and workplaces are not randomly distributed across the city, and different populations may have responded differently to the out-of-home restrictions. This study examines how the business closures and activity restrictions affected COVID-19 testing results. An evaluation of whether such actions slowed the spread of the pandemic is a crucial step in designing effective public health policies. METHODS: Daily data on the fraction of COVID-19 tests yielding a positive result at the zip code level were analyzed in relation to the number of visits to local businesses (based on smartphone location) and the number of smartphones that stayed fixed at their home location. The regression model also included vectors of fixed effects for the day of the week, the calendar date, and the zip code of residence. RESULTS: A large number of visits to local businesses increased the positivity rate of COVID-19 tests, while a large number of smartphones that stayed at home decreased it. A doubling in the relative number of visits increases the positivity rate by about 12.4 percentage points (95% CI, 5.3 to 19.6). A doubling in the relative number of stay-at-home devices lowered it by 2.0 percentage points (95% CI, -2.9 to -1.2). The business closures and out-of-home activity restrictions decreased the positivity rate, accounting for approximately 25% of the decline observed in April and May 2020. CONCLUSION: Policy measures decreased the likelihood of positive results in COVID-19 tests. These specific policy tools may be successfully used when comparable health crises arise in the future.

Continuous physiological monitoring using wearable technology to inform individual management of infectious diseases, public health and outbreak responses.

Optimal management of infectious diseases is guided by up-to-date information at the individual and public health levels. For infections of global importance, including emerging pandemics such as COVID-19 or prevalent endemic diseases such as dengue, identifying patients at risk of severe disease and clinical deterioration can be challenging, considering that the majority present with a mild illness. In our article, we describe the use of wearable technology for continuous physiological monitoring in healthcare settings. Deployment of wearables in hospital settings for the management of infectious diseases, or in the community to support syndromic surveillance during outbreaks, could provide significant, cost-effective advantages and improve healthcare delivery. We highlight a range of promising technologies employed by wearable devices and discuss the technical and ethical issues relating to implementation in the clinic, focusing on low- and middle- income countries. Finally, we propose a set of essential criteria for the rollout of wearable technology for clinical use.

Decision tree machine learning applied to bovine tuberculosis risk factors to aid disease control decision making.

Identifying and understanding the risk factors for endemic bovine tuberculosis (TB) in cattle herds is critical for the control of this disease. Exploratory machine learning techniques can uncover complex non-linear relationships and interactions within disease causation webs, and enhance our knowledge of TB risk factors and how they are interrelated. Classification tree analysis was used to reveal associations between predictors of TB in England and each of the three surveillance risk areas (High Risk, Edge, and Low Risk) in 2016, identifying the highest risk herds. The main classifying predictor for farms in England overall related to the TB prevalence in the 100 nearest cattle herds. In the High Risk and Edge areas it was the number of slaughterhouse destinations and in the Low Risk area it was the number of cattle tested in surveillance tests. How long ago the last confirmed incident was resolved was the most frequent classifier in trees; if within two years, leading to the highest risk group of herds in the High Risk and Low Risk areas. At least two different slaughterhouse destinations led to the highest risk group of herds in England, whereas in the Edge area it was a combination of no contiguous low-risk neighbours (i.e. in a 1 km radius) and a minimum proportion of 6-23 month-old cattle in November. A threshold value of prevalence in 100 nearest neighbours increased the risk in all areas, although the value was specific to each area. Having low-risk contiguous neighbours reduced the risk in the Edge and High Risk areas, whereas high-risk ones increased the risk in England overall and in the Edge area specifically. The best classification tree models informed multivariable binomial logistic regression models in each area, adding statistical inference outputs. These two approaches showed similar predictive performance although there were some disparities regarding what constituted high-risk predictors. Decision tree machine learning approaches can identify risk factors from webs of causation: information which may then be used to inform decision making for disease control purposes.

Controlling hepatitis E virus in the pig production sector: Assessment of the technical and behavioural feasibility of on-farm risk mitigation strategies.

Hepatitis E virus (HEV) is a zoonotic agent with pigs as the main reservoir in industrialised countries. Recent studies conducted on pig farms, in experimental conditions or through modelling approaches, have led to a better understanding of the spread of HEV on pig farms. The findings have also made it possible to define a set of measures to reduce HEV prevalence and the risk of marketing contaminated products. The objective of this study was to assess the feasibility of a set of HEV control strategies on pig farms. Individual semi-structured interviews were conducted with farmers, veterinarians and farming advisors to collect general data, their level of knowledge of HEV, their opinion on the technical feasibility of certain changes in practices, their perception of the respective responsibilities of the different stakeholders, and their feelings about the importance of the issue, following the framework of the Theory of Planned Behaviour. The interviews made it possible to highlight potential barriers and preferred motivators for the implementation of on-farm risk mitigation strategies. Barriers included lack of knowledge, scientific gaps, perceived inability to control HEV, and low perception of the importance of the issue. Motivators included professional satisfaction, family recognition, and the opportunity to achieve higher quality standards. Three clusters of stakeholders were also identified, with a group of leaders who could help unlock reluctance and disseminate innovations. This type of behavioural approach appeared useful to help risk managers facilitate zoonotic control on pig farms.

Field assessment of potential sugar feeding stations for disseminating bacteria in a paratransgenic approach to control malaria.

BACKGROUND: Using bacteria to express and deliver anti-parasite molecules in mosquitoes is among the list of genetic tools to control malaria. The introduction and spread of transgenic bacteria through wild adult mosquitoes is one of the major challenges of this strategy. In prospect of future field experiments, an open field study with blank (without bacteria) attractive sugar bait (ASB) was performed under the assumption that transgenic bacteria would be spread to all sugar fed mosquitoes. METHODS: Two types of ASB stations were developed, one with clay pots (CP) placed at mosquito resting sites and one with window entry traps (WET) placed inside inhabited houses. The ASB consisted in either glucose, honey or fruit cocktail solutions. In addition, mark-release-recapture (MRR) experiment of mosquitoes after feeding them with glucose was also conducted to check the proportion of the mosquito population that can be reached by the two ASB stations as well as its suitability to complement the ASB stations for disseminating bacteria. RESULTS: Overall, 88% of the mosquitoes were collected in the WET_ASB. The CP_ASB stations were much less attractive with the highest average of 82 ± 11 mosquitoes/day in the CP near the wood piles. The proportions of sugar fed mosquitoes upon ASB were low in both type of ASB stations, ~ 2% and ~ 14% in WET and CP, respectively. Honey solution was the most attractive solution compared to the glucose and the fruit cocktail solutions. The recapture rate in the MRR experiment was low: ~ 4.1% over 7 days. CONCLUSION: The WET_ASB looks promising to disseminate transgenic bacteria to endophilic West Africa Anopheles mosquito. However, this feeding station may not be fully effective and could be combined with the CP_ASB to also target outdoor resting mosquitoes. Overall, efforts are needed to improve the mosquito-feeding rates upon ASB.

An overview of control strategy and diagnostic technology for foot-and-mouth disease in China.

Foot-and-mouth disease (FMD) is one of most contagious animal diseases. It affects millions of cloven-hoofed animals and causes huge economic losses in many countries of the world. There are seven serotypes of which three (O, A and Asia 1) are endemic in China. Efficient control of FMD in China is crucial for the prevention and control of FMD in Asia and throughout the world. For the control of FMD, a powerful veterinary administration, a well-trained veterinary staff, a system of rapid and accurate diagnostic procedures and, in many countries, compulsory vaccination of susceptible animals are indispensable. This article strives to outline the Chinese animal disease control and prevention system, in particular for FMD, with the emphasis on diagnostic procedures applied in Chinese laboratories. In addition, new technologies for FMD diagnosis, which are currently in the phase of development or in the process of validation in Chinese laboratories, are described, such as lateral flow devices (LFD), Mab-based ELISAs, reverse transcription loop-mediated isothermal amplification (RT-LAMP) and gold nanopariticle immuno-PCR (GNP-IPCR).

Outcomes of antiretroviral treatment programs in rural Southern Africa.

BACKGROUND: Data on outcomes of antiretroviral treatment (ART) programs in rural sub-Saharan African are scarce. We describe early losses and long-term outcomes in 6 rural programs in Southern Africa with limited access to viral load monitoring and second-line ART. METHODS: Patients aged ≥16 years starting ART in 2 programs each in Zimbabwe, Mozambique, and Lesotho were included. We evaluated risk factors for no follow-up after starting ART and mortality and loss to follow-up (LTFU) over 3 years of ART, using logistic regression and competing risk models. Odds ratios and subdistribution hazard ratios, adjusted for gender, age category, CD4 category, and World Health Organization stage at start of ART are reported. RESULTS: Among 7725 patients, 449 (5.8%) did not return after initiation of ART. During 9575 person-years, 698 (9.6%) of those with at least 1 follow-up visit died, and 1319 (18.1%) were LTFU. At 3 years, the cumulative incidence of death and LTFU were 12.5% (11.5%-13.5%) and 25.4% (24.0%-26.9%), respectively, with important differences between countries as follows: in Zimbabwe 75.1% (72.8%-77.3%) were alive and on ART at 3 years compared with 55.4% (52.8%-58.0%) in Lesotho and 51.6% (48.0%-55.2%) in Mozambique. In all settings, young age and male gender predicted LTFU, whereas advanced clinical stage and low baseline CD4 counts predicted death. CONCLUSIONS: In African ART programs with limited access to second-line treatment, mortality, and LTFU are high in the first 3 years of ART. Low retention in care is a major threat to the sustainability of ART delivery in Southern Africa, particularly in rural sites.

Appropriate technology for rural India - solar decontamination of water for emergency settings and small communities.

A commercial solar water heating system was evaluated for its effectiveness in decontaminating drinking water with a view to use in emergency situations. A total of 18 seeding experiments carried out over 6 months with 10(5) to 10(7)Escherichia coli/ml showed that the solar heater produced 125 l of bacteriologically safe water in 4 h when the ambient temperature was above 30 degrees C, with a holding time of at least 2 h. The solar water heating system is inexpensive, easy to transport and set up and could provide safer drinking water for 50 people a day. It would be effective in the decrease and prevention of waterborne disease in emergency situations, and is appropriate for use in small communities.

Climate-based health monitoring systems for eco-climatic conditions associated with infectious diseases.

Despite a century of confidence and optimism in modern medicine and technology inspired by their often successful prevention and control efforts, infectious diseases remain an omnipresent, conspicuous major challenge to public health. Effective detection and control of infectious diseases require predictive and proactive efficient methods that provide early warning of an epidemic activity. Of particular relevance to these efforts is linking information at the landscape and coarser scales to data at the scale of the epidemic activity. In recent years, landscape epidemiology has used satellite remote sensing and geographic information systems as the technology capable of providing, from local to global scales, spatial and temporal climatic patterns that may influence the intensity of a vector-borne disease and predicts risk conditions associated with an epidemic. This article provides a condensed, and selective look at classical material and recent research about remote sensing and GIS (geographic information system) applications in public health.

Methods for studying private sector supply of public health products in developing countries: a conceptual framework and review.

The private sector is an important supplier of public health products (PHPs) in developing countries. Although there are concerns about the quality and affordability of these products, private providers also offer possibilities for expanding access to key commodities. This paper proposes a conceptual framework for understanding the public health implications of private sales of PHPs. It reviews methods for studying these sales, together with their advantages and shortcomings. Ten methods are identified which can be used for studying the behaviour of providers and consumers. The effects of seasonal variation are discussed, together with the challenges of creating a sampling frame and studying illicit behaviour. We conclude that relatively little is known about the sales of PHPs, that more is known about contraceptives and drugs than about the newer products, and that the demand side of the market has been studied in greater depth than the behaviour of suppliers. The existing toolbox is biased towards formal providers, and thus, probably towards understanding the provision of PHPs to those who are better off. Methods for studying the supply of PHPs in outlets used by poor people is a priority area for further methodological development.

The cost of upgrading cross-infection control in twelve community dental service surgeries, 1988-1989.

A retrospective survey was established in 1989 to cost the upgrading of cross-infection control methods in twelve community dental service surgeries. The capital and maintenance expenditure averaged 3244.85 pounds per surgery, indicating that the costs might be less than currently projected.