Reverse Genetic Assessment of the Roles Played by the Spike Protein and ORF3 in Porcine Epidemic Diarrhea Virus Pathogenicity.

Porcine epidemic diarrhea virus is a swine pathogen that has been responsible for significant animal and economic losses worldwide in recent years. In this manuscript, we report the generation of a reverse genetics system C(RGS) for the highly virulent US PEDV strain Minnesota (PEDV-MN; GenBank accession number KF468752), which was based on the assembly and cloning of synthetic DNA, using vaccinia virus as a cloning vector. Viral rescue was only possible following the substitution of 2 nucleotides within the 5'UTR and 2 additional nucleotides within the spike gene, based on the sequence of the cell culture-adapted strains. Besides displaying a highly pathogenic phenotype in newborn piglets, in comparison with the parental virus, the rescued recombinant PEDV-MN was used to confirm that the PEDV spike gene has an important role in PEDV virulence and that the impact of an intact PEDV ORF3 on viral pathogenicity is modest. Moreover, a chimeric virus with a TGEV spike gene in the PEDV backbone generated with RGS was able to replicate efficiently in vivo and could be readily transmitted between piglets. Although this chimeric virus did not cause severe disease upon the initial infection of piglets, there was evidence of increasing pathogenicity upon transmission to contact piglets. The RGS described in this study constitutes a powerful tool with which to study PEDV pathogenesis and can be used to generate vaccines against porcine enteric coronaviruses. IMPORTANCE PEDV is a swine pathogen that is responsible for significant animal and economic losses worldwide. Highly pathogenic variants can lead to a mortality rate of up to 100% in newborn piglets. The generation of a reverse genetics system for a highly virulent PEDV strain originating from the United States is an important step in phenotypically characterizing PEDV. The synthetic PEDV mirrored the authentic isolate and displayed a highly pathogenic phenotype in newborn piglets. With this system, it was possible to characterize potential viral virulence factors. Our data revealed that an accessory gene (ORF3) has a limited impact on pathogenicity. However, as it is also now known for many coronaviruses, the PEDV spike gene is one of the main determinants of pathogenicity. Finally, we show that the spike gene of another porcine coronavirus, namely, TGEV, can be accommodated in the PEDV genome background, suggesting that similar viruses can emerge in the field via recombination.

Effectiveness of Emergent Ad Hoc Coordination Groups in Public Health Emergencies.

Whether emergent groups positively or negatively influence a disaster response remains inconclusive in the literature. We analyzed the effect of an emergent group on two interorganizational networks for information communication and resource coordination during a public health emergency response. Using the 2015 Middle East Respiratory Syndrome (MERS) Coronavirus in Korea as a study case, we identified an ad hoc entity that appeared in both networks. This emergent group, which consists of government officials and public health specialists, directed and coordinated organizations at the center of the response networks. We found that the emergent group positively contributed to efficient information communication but had no effect on the resource network's efficiency. Our interpretation is that the ad hoc entity was filling relational gaps in the information network, but was redundant in the resource network.

Research Note: Effects of Escherichia coli co-infection on the protective efficacy assessment of two common infectious bronchitis vaccines.

Avian infectious bronchitis (IB), a highly contagious disease hazardous to the poultry industry, is caused by an etiological agent called the infectious bronchitis virus (IBV). Some IBV strains (IBVs) alone usually do not cause high mortality in field conditions if not with secondary pathogens including Escherichia coli (E. coli). Herein, we established an IBV and E. coli co-infection model to evaluate the protective efficacy of two IBV vaccine strains against a new emerging genotype GVI-1 with mild virulence in experimental conditions. Chickens were inoculated with IBV field isolate ZQX (genotype GVI-1) and challenged 4 dlater with the E. coli strain MS160427 (serotype O8). Subsequently, these chickens were euthanized at seven days postchallenge (d.p.c.) with E. coli. An autopsy revealed that lesions in the IBV plus E. coli co-infection group were more severe than those in the IBV-infected group. This pathological model was used to assess the protective effect of two commonly used vaccine strains (H120 and 4/91) against the IBV ZQX strain, and a significantly better protective efficacy was observed for 4/91 compared with H120. Thus, IBV and E. coli co-infection could be employed in assessing the protective efficacy of IBV vaccines.

A study of rural chicken farmers, diseases and remedies in the Eastern Cape province of South Africa.

The source of emerging diseases and antimicrobial resistance is of increasing interest to epidemiologists. This paper looks at village chickens as such a source. In addition, infectious diseases constitute a major challenge to the growth and profitability of the rural poultry sector in Sub-Saharan Africa. A serological survey was conducted to estimate the apparent seroprevalence of selected chicken diseases in the Eastern Cape Province of South Africa alongside a sociological survey of poultry farmers and the remedies most commonly used to prevent diseases in their flocks. Sera collected from village chickens (n = 1007) in the province were screened for specific antibodies against Newcastle disease (ND), avian influenza (AI), avian infectious bronchitis (IB) and Mycoplasma gallisepticum (MG). The overall seroprevalence of ND, AI, IB and MG in the province was found to be 69.2 % (95 % CI 51.9-86.5%); 1.8 % (95 % CI 0.2-3.4%); 78.5 % (95 % CI 74.9-82%) and 55.8 % (95 % CI 41.3-70.3%) respectively with clustering found at the District level. Cross hemagglutination inhibition (HI) tests indicated that the chickens were exposed to the ND vaccine. AI ELISA-positive samples were tested using HIs against the H5, H6 and H7-subtypes, but only H6-specific antibodies were detected. Avian influenza strains shared the common ancestor responsible for the 2002 chicken outbreak in KwaZulu-Natal Province. The majority of chicken farmers were females and pensioners (69 % and 66.1 % respectively) and had a primary school education (47.1 %). Traditional remedies were commonly used by farmers (47.15 %) and among the remedies, Aloe plant (Aloe ferox Mill.) or ikhala (Xhosa) was the most commonly used product (28.23 %) for preventing and reducing mortalities among village chickens. The findings stress the importance of village chickens as a substitute for social welfare and highlight the exposure of village chickens to important chicken pathogens. The economic impact of these pathogens on the development of this sub-sector needs further investigation. Village chickens are a potential source of virulent Newcastle disease virus (NDV) because of the lack of vaccination and biosecurity. They may serve as amplification hosts which increases the probability that virulent NDV could spill over into commercial poultry flocks due to large amounts of circulating virus. The zoonotic threat of circulating H6N2 viruses raise concern due to their mutation and reassortment among chickens and a potential movement of infected birds within the province. Finally, the use of antibiotics by untrained chicken farmers constitute another major concern as it could serve as a source of antimicrobial resistance (AMR).

Plano estadual de contingência para enfrentamento do SARS-CoV-2 / State contingency plan for chartering SARS-CoV-2

A 3ª edição do Plano Estadual de Contingência para Enfrentamento do SARS-CoV-2 na Bahia, contém recomendações para o contexto atual desta emergência, conforme vem evoluindo as estratégias de enfrentamento norteadas pela OMS, MS e SESAB, com vistas a minimizar o impacto na Saúde Pública provocado pela introdução do vírus em território estadual.

Lethal zoonotic coronavirus infections of humans - comparative phylogenetics, epidemiology, transmission, and clinical features of coronavirus disease 2019, The Middle East respiratory syndrome and severe acute respiratory syndrome.

PURPOSE OF REVIEW: Severe acute respiratory syndrome-coronaviruses-2 (SARS-CoV-2), the cause of coronavirus disease 2019 (COVID-19), emerged as a new zoonotic pathogen of humans at the end of 2019 and rapidly developed into a global pandemic. Over 106 million COVID-19 cases including 2.3 million deaths have been reported to the WHO as of February 9, 2021. This review examines the epidemiology, transmission, clinical features, and phylogenetics of three lethal zoonotic coronavirus infections of humans: SARS-CoV-1, SARS-CoV-2, and The Middle East respiratory syndrome coronavirus (MERS-COV). RECENT FINDINGS: Bats appear to be the common natural source of SARS-like CoV including SARS-CoV-1 but their role in SARS-CoV-2 and MERS-CoV remains unclear. Civet cats and dromedary camels are the intermediary animal sources for SARS-CoV-1 and MERS-CoV infection, respectively whereas that of SARS-CoV-2 remains unclear. SARS-CoV-2 viral loads peak early on days 2-4 of symptom onset and thus high transmission occurs in the community, and asymptomatic and presymptomatic transmission occurs commonly. Nosocomial outbreaks are hallmarks of SARS-CoV-1 and MERS-CoV infections whereas these are less common in COVID-19. Several COVID-19 vaccines are now available. SUMMARY: Of the three lethal zoonotic coronavirus infections of humans, SARS-CoV-2 has caused a devastating global pandemic with over a million deaths. The emergence of genetic variants, such as D614G, N501Y (variants 1 and 2), has led to an increase in transmissibility and raises concern about the possibility of re-infection and impaired vaccine response. Continued global surveillance is essential for both SARS-CoV-2 and MERS-CoV, to monitor changing epidemiology due to viral variants.

The COVID-19 pandemic and contact tracing technologies, between upholding the right to health and personal data protection.

Countries responded to the COVID-19 pandemic with various levels of restrictions and lockdown in an effort to save lives and prevent the saturation and collapse of national health systems. Unfortunately, the blockades have entailed hefty socioeconomic costs. In order to contrast the spread of the virus, states have used contact tracing technology, in the form of mobile phone applications designed to track close contacts of those infected with COVID-19. Recent research has shown the effectiveness of this solution, particularly when used in conjunction with manual tracking. Nonetheless, the contact tracing app raises concerns due to the potential privacy implications. The authors have delved into the European legislation that protects privacy through the principles of proportionality and minimization, arguing that in order to quickly resolve the pandemic caused by COVID-19, one cannot blindly trust the exclusive help of technology. Instead, we need the involvement of health personnel, scientists, and no less importantly, the citizenry's sense of solidarity and the duty to abide by the rules of social distancing, the use of protective devices and hygiene rules to protect public health.

COVID-19 et Supplémentation en vitamine D / COVID-19 and Supplementation vitamin D

CONTEXTE: Le présent document ainsi que les constats qu'il énonce ont été rédigés dans le contexte de la crise sanitaire liée à la maladie à coronavirus (COVID-19) au Québec. L'objectif est de réaliser une recension des données publiées et de mobiliser les savoirs clés afin d'informer les décideurs publics et les professionnels de la santé et des services sociaux. Bien que les constats reposent sur un repérage exhaustif des données scientifiques publiées, l'évaluation de la qualité méthodologique des études et une appréciation du niveau de preuve scientifique par paramètre clinique d'intérêt, le processus ne repose pas sur une méthode systématique ni une validation externe selon les normes habituelles à l'INESSS. Par ailleurs, les positions ne découlent pas d'un processus de consultation élaboré. Dans les circonstances d'une telle crise de santé publique, l'INESSS reste à l'affût de toutes nouvelles données, qu'elles soient de nature scientifique ou contextuelle, susceptibles de lui faire modifier cette réponse. MÉTHODOLOGIE: Questions d'évaluation Comparativement aux standards de soins, est-ce qu'un supplément de vitamine D, chez les personnes ayant ou non une déficience ou une insuffisance, est efficace et sécuritaire pour, prévenir l'infection et les manifestations cliniques de la COVID-19? Traiter les patients (adulte, enfant, femme enceinte) COVID-19 confirmés dont l'état à l'amorce n'exige pas une hospitalisation? Traiter les patients (adulte, enfant, femme enceinte) COVID-19 confirmés dont l'état à l'amorce exige o une hospitalisation sans le recours à une oxygénothérapie; o une hospitalisation avec le recours à une oxygénothérapie non invasive (oxygène à faible débit, à haut débit, ventilation mécanique non invasive); o une hospitalisation avec le recours à une oxygénothérapie invasive (ventilation mécanique invasive, ECMO)? Quelle est la position des sociétés savantes, des agences règlementaires, des agences de santé publique et des agences d'évaluation des technologies en santé sur l'usage d'un supplément de vitamine D dans la prévention et le traitement de la COVID-19? Type de revue de littérature: Revue rapide. RÉSULTATS: ÉTAT ACTUEL DES CONNAISSANCES SCIENTIFIQUES. Données cliniques sur l'efficacité de la supplémentation en vitamine D dans le contexte de la COVID-19. Depuis l'instauration en mars 2020 de la recherche systématique en continu de la littérature scientifique sur les médicaments à visée thérapeutique, 42 027 notices ont été recensées dont 113 études cliniques où l'intervention étudiée portait sur la vitamine D. De ce nombre, 3 ECRA [Murai et al., 2021; Castillo et al., 2020; Rastogi et al., 2020] ont été retenus. Ces études sont décrites ci-dessous en fonction du type de prise en charge, soit la prophylaxie pré/post-exposition, ou le traitement de patient dont l'état de santé requiert ou non une hospitalisation. Seuls les paramètres d'intérêts sur l'évolution de la charge virale, l'amélioration ou la résolution des symptômes ou d'évolution clinique, le pronostic, l'innocuité ou la mortalité sont présentés. Supplémentation en vitamine D en prophylaxie: En date du 24 février 2021, aucun ECRA ni aucune étude observationnelle publiés n'ont été retracés par la recherche de la littérature scientifique sur les bénéfices cliniques associés à l'usage de vitamine D en prophylaxie pré- ou post- exposition au SARS-CoV-2. Par contre, il y a quelques essais cliniques actuellement enregistrés sur le site de ClinicalTrials, dont un essai comparatif à répartition aléatoire multicentrique à triple insu (PROTECT6 ) en cours de réalisation au sein de deux hôpitaux du Québec. Le principal objectif de cet essai est d'étudier les effets prophylactiques d'une supplémentation à hautes doses de vitamine D3 per os (bolus 100 000 UI suivi de 10 000 UI par semaine pendant 16 semaines) chez les travailleurs de la santé exposés à la COVID-19. Il est prévu que l'essai se termine en juin 2021. DISCUSSION: Au terme des travaux, il ressort qu'aucun ECRA ni aucune étude observationnelle publiés dans la littérature ne permettent d'évaluer l'effet d'une supplémentation en vitamine D utilisée en prophylaxie pré- ou post- exposition au SRAS-CoV-2 ni dans le traitement des sujets COVID-19 confirmés dont l'état n'exige pas une hospitalisation. Toutefois, en ce qui concerne les personnes atteintes de la COVID-19 dont l'état de santé requiert une hospitalisation, l'état actuel des connaissances scientifiques suggère qu'une supplémentation en vitamine D3 ne permet pas de réduire la durée d'hospitalisation et le nombre de nouveaux sujets ayant besoin de ventilation mécanique invasive et ne permet pas d'établir un lien en une supplémentation en vitamine D et les admissions aux soins intensifs ou la mortalité. Un supplément en vitamine D3 à raison de 60 000 UI par jour pendant 8 ou 14 jours, chez des personnes ayant une déficience en vitamine D, pourrait cependant permettre d'augmenter la proportion de sujets avec une négativation de la RTPCR sans toutefois avoir d'impact sur la durée moyenne avant la négativation de celle-ci. Il est toutefois important de souligner que les trois ECRA ont été réalisés sur des populations distinctes, hospitalisées pour une COVID-19 de sévérité variable, et avec différentes posologies et formes de vitamine D3 (calcifédiol ou cholécalciférol). Les profils d'innocuité et d'interactions médicamenteuses de la vitamine D sont aujourd'hui bien connus dans plusieurs contextes extérieurs à la COVID-19 [Euro-Pharm International Canada, 2018; Vifor Pharma, 2018]. Fondé sur 2 ECRA à double insu conduits au Brésil et en Inde dans le contexte de la COVID-19, la supplémentation de vitamine D3 à haute dose semble sécuritaire lorsque cette dernière est administrée en prise unique ou de manière quotidienne pendant une durée maximale de 14 jours chez des sujets adultes atteints de la COVID-19 et hospitalisés. Dans tous les documents consultés présentant des positions ou des recommandations cliniques, aucune organisation ne se prononce en faveur de l'usage de la vitamine D en prévention d'une infection par le SARS-CoV-2 ou comme traitement d'une telle infection en dehors d'un essai clinique, en raison d'une insuffisance de preuves. Compte tenu des risques potentiels d'effets indésirables, un suivi régulier des personnes recevant des doses de vitamine D supérieures à 4 000 UI par jour est également recommandé. Cette réponse rapide de l'INESSS comporte certaines limites qui méritent d'être soulignées. D'abord, l'analyse du niveau de preuve scientifique est basée sur 3 études primaires de type ECRA, elles aussi, empreintes de biais et de limites méthodologiques (y compris des déséquilibres dans les caractéristiques des sujets, dans la puissance statistique et dans les posologies et formes de vitamine D3 utilisées) affectant la confiance envers les résultats actuellement disponibles. Par ailleurs, le manque de résultats ne permet pas de conclure quant à d'éventuelles différences d'efficacité entre des sujets à différents stades de la maladie ou avec des niveaux de vitamine D différents au début des études (taux normal, insuffisance, déficience). Enfin, les constats ne découlent pas d'un processus de consultation élaboré. À la suite de l'analyse effectuée, la tendance pointe vers une absence de bénéfice de la supplémentation en vitamine D ayant 2021-03-08 15:16 22 un réel impact sur l'évolution clinique ou la mortalité liée à la COVID-19. Il faudra toutefois attendre les résultats d'ECRA supplémentaires dont la qualité méthodologique sera jugée acceptable avant d'infirmer ou confirmer une absence de bénéfices. L'efficacité et l'innocuité d'une supplémentation en vitamine D sont présentement évaluées dans plusieurs études cliniques en cours, soit en prophylaxie, chez des patients non hospitalisés ou chez des patients hospitalisés9 . En demeurant à l'affût de nouvelles données scientifiques, cette réponse rapide permet d'informer les professionnels de la santé et de les soutenir dans leur prise de décision clinique dans le contexte de la pandémie actuelle.

Comunicación de riesgos y participación comunitaria para la localización de contactos en el contexto de la COVID-19 / Risk communication and community engagement for COVID-19 contact tracing: interim guidance

La localización de contactos es un elemento clave del enfoque recomendado por la OMS para controlar la propagación de la COVID-19 e interrumpir las cadenas de transmisión de persona a persona. Si los principios de la comunicación de riesgos y participación comunitaria (CRPC) se incorporan de manera eficaz en las actividades de localización de contactos en el contexto de la COVID-19, se salvaguarda el cumplimiento de las actividades de localización de contactos y se frena o detiene la transmisión de dicha enfermedad, lo cual en última instancia reduce la mortalidad y la enfermedad y mitiga su incidencia negativa en los sistemas de atención de salud y las economías. En este documento se ofrecen orientaciones a las autoridades de salud en todos los niveles para que mejoren la tasa de éxito de la localización de contactos al asegurarse de que las actividades correspondientes se sustenten en los principios, la evidencia y las actividades de CRPC, y se suministran herramientas a los profesionales que participan en dicha localización a fin de asentar sus prácticas en los principios de la CRPC y mejorar igualmente su tasa de éxito.

¿Milagro cubano? / Cuban miracle?

La epidemia de la enfermedad por coronavirus Covid-19 ha puesto en tensión a los tres actores principales de su enfrentamiento: al gobierno, a los científicos y a la población. El gobierno con sus estructuras organizativas de diversos ministerios y sus recursos humanos, financieros y materiales. Los científicos que funcionan como asesores expertos y la población como sujetos responsables activos en su autocuidado, no como simples usuarios de servicios de atención a su salud. Las estadísticas de salud en relación con la enfermedad por coronavirus no son desalentadoras en comparación con las de otros países y regiones. Cuba tiene la tasa de mortalidad por 100 000 habitantes más baja de Latinoamérica, e incluso menor que algunos países con mayor nivel de desarrollo económico. La letalidad de la Covid-19 en Cuba también es relativamente baja, por ellos tenemos condiciones morales, éticas, científicas y políticas para exponer algunas ideas vinculadas a estos resultados los cuales demuestran que no se trata de un...(AU)

Liderazgo del sector salud de Paraguay para enfrentar la pandemia en el 2020 y una coyuntura para agilizar la reforma del sector con la cooperación técnica de la OPS/OMS / Leadership of the Paraguayan health sector to face the pandemic in 2020 and a situation to speed up the reform of the sector with the technical cooperation of PAHO / WHO

La Región de las Américas, con altos niveles de pobreza e inequidades; registra aproximadamente la mitad de los casos COVID-19 y de los fallecidos a escala mundial. Ubicado en Sudamérica, Paraguay, con un sistema de salud segmentado y fragmentado que recibe una de las menores inversiones en la Región, ofrecía un panorama complejo para enfrentar esta crisis. La preparación de la respuesta ante la pandemia que se enfrentó a las fragilidades de todo el sistema público de prestación de servicios, catalizó los esfuerzos que estaban siendo impulsados por el país apoyado por la cooperación técnica de la OPS/OMS para avanzar hacia una reforma del sector salud, posicionando a la salud como un derecho humano.

Lineamientos para el abordaje de casos positivos para secuenciación de SARS-CoV-2 para pacientes que asisten a hospitales privados, públicos y al Instituto Guatemalteco de Seguridad Social ­IGSS- / Guidelines for addressing positive cases for SARS-CoV-2 sequencing for patients attending private and public hospitals and the Guatemalan Social Security Institute -IGSS-

En los antecedentes se presentan estadísticas del COVID-19 a la fecha en la que se elaboró el documento (enero 2021) y aborda las tres mutaciones del virus conocidas hasta la fecha del documento. "La caracterización genética de patógenos virales es la base para el desarrollo de protocolos de diagnóstico, vacunas y medicamentos antivirales. Esta estrategia también es una herramienta útil en salud pública para el seguimiento a brotes y control de enfermedades mediante estudios de epidemiología molecular." "…la secuenciación genómica del SARS-CoV-2 y la liberación oportuna de la información no solo permitió la caracterización del agente etiológico involucrado en el brote inicial, sino también el desarrollo oportuno de protocolos de diagnóstico y seguimiento a la evolución de la pandemia de COVID-19. Así, la secuenciación genómica se ha convertido en una herramienta esencial para generar datos virológicos de SARS-CoV-2, para impulsar la respuesta de laboratorio, y entender mejor los patrones de dispersión y evolución de SARS-CoV-2" De manera que el objetivo del documento es: "Generar información genética mediante la vigilancia genómica de casos confirmados de COVID-19 de pacientes que asisten a los servicios de salud públicos y privados del país, así como del Instituto Guatemalteco de Seguridad Social ­IGSS-."

Feasibility, Utility, and Limitations of a Rapid Community Behavioral Diagnosis for Social Distancing During the 2020 Coronavirus Pandemic.

PURPOSE: To evaluate the feasibility, utility, and limitations of a rapid community behavioral diagnosis (RCBD) for social distancing behaviors to prevent coronavirus transmission during a global coronavirus pandemic. DESIGN: Using social media for recruitment, we partnered with a local community task force to administer a brief online survey. SETTING: Residential urban community. SAMPLE: Eighty-four community members, the majority of whom were white, female, college educated completed the survey. MEASURES: Theory of planned behavior constructs: behavioral intentions, attitudes, perceived norms, and perceived behavioral control for 3 social distancing behaviors: maintaining a 6-foot distance, avoiding places people congregate, and staying home as much as possible. ANALYSIS: Path analyses were conducted to understand significant determinants of intentions for each behavior to guide the development of locally tailored health promotion messages. RESULTS: The RCBD was implemented, and results were communicated to the community within 1 week. Intentions were high across the 3 behaviors but lowest for staying home as much as possible. Younger participants had lower intentions of maintaining a 6-foot distance than older participants. For each behavior, specific recommendations for health promotion messaging emerged based on how attitudes, norms, and perceived behavioral control related to intentions. CONCLUSION: In a situation where local community action is paramount for reducing coronavirus transmission, this RCBD process is feasible and useful for informing local health promotion.

Acesso e cuidados especializados / Coleção COVID-19 / Access and specialized care / COVID-19 Collection

A Coleção COVID-19 apresenta em seus livros diferentes temas e debates. O Volume 5 ­ Acesso e Cuidados Especializados traz reflexões sobre a saúde pública e privada nos tempos da pandemia e suas respectivas interações, no âmbito dos cuidados especializados. Avança para os conteúdos relacionados à atuação da atenção especializada durante a pandemia, a abordagem clínica do paciente com a COVID-19, a atenção hospitalar em suas diferentes configurações: nas filantrópicas, nos hospitais universitários, nos hospitais de campanha e com a telemedicina. Os textos que seguem se preocupam com as comissões de controle de infecção e o cuidado seguro com os pacientes da COVID-19. Alcançam os cuidados paliativos e as diretivas antecipadas de vontade. Ultrapassados os conteúdos mais gerais, os textos passam a revelar sobre os cuidados com os pacientes com doença renal e oncológicos, até adentrarem na temática da assistência farmacêutica. Nesse campo, os debates comtemplam a escassez, o uso seguro, os casos do kit intubação e da Cloroquina/Hidroxicloroquina que ocuparam fortemente os noticiários brasileiros e que se revelaram problemas ímpares para a gestão em saúde. Por fim, o livro contempla os debates relacionados à pesquisa clínica, o registro sanitário de vacinas para a COVID-19 e a necessária sustentabilidade do SUS, pelo olhar de quem defende

Risk communication and community engagement for COVID-19 contact tracing: interim guidance

Contact tracing is a key element of WHO's recommended approach to control the spread of COVID-19 by breaking the chains of human-to-human transmission. By effectively embedding risk communication and community engagement ( RCCE) principles in contact-tracing efforts in the context of COVID-19, compliance with contact-tracing efforts is safeguarded and transmission of COVID-19 is slowed or halted, ultimately reducing death and disease due to COVID-19 and mitigating the negative impact on health-care systems and economies. This document provides guidance to health authorities at all levels to improve the success rate of contact tracing by informing efforts with RCCE principles, evidence and activities, and provides ready-to-use tools for professionals involved in contact-tracing efforts to inform their practices with RCCE principles and likewise improve their success rate.