[Management and impact of interventions to reduce COVID-19 cases in Costa RicaGestão e impacto das medidas de intervenção para reduzir os casos de COVID-19 na Costa Rica]. / Gestión e impacto de las medidas de intervención para la reducción de casos por COVID-19 en Costa Rica.

Objective: Assess the impact of interventions introduced in Costa Rica during 2020 and 2021 to control the COVID-19 pandemic. Methods: A Bayesian Poisson regression model was used, incorporating control or intervention measures as independent variables in the changes in reported case numbers per epidemiological week. Results: The results showed the relative and combined impact of containment policies and measures on the reduction of cases: mainly vehicular traffic restrictions, use of masks, and implementation of health guidelines and protocols. Evidence of impact was optimized and made available for decision-making by the country's health and emergency authorities. Several iterations were generated for constant monitoring of variations in impact at four different moments in the pandemic's spread. Conclusion: The simultaneous implementation of different mitigation measures in Costa Rica has been a driving force in reducing the number of COVID-19 cases.

Objetivo: Avaliar o impacto das intervenções realizadas na Costa Rica durante 2020 e 2021 para o controle da pandemia de COVID-19. Método: Foi utilizado um modelo Bayesiano de regressão de Poisson que incorporou as medidas de controle ou intervenção como variáveis independentes sobre a variação do número de casos por semana epidemiológica. Resultados: Os resultados evidenciaram o efeito relativo e conjunto que as políticas ou medidas de contenção tiveram na redução de casos, principalmente as restrições a veículos, o uso de máscaras e a implementação de diretrizes e protocolos de saúde. As evidências dos efeitos foram otimizadas e disponibilizadas às autoridades sanitárias e de emergência do país para auxiliar na tomada de decisão. Diversas iterações foram geradas para o monitoramento constante da variação nos efeitos em quatro momentos distintos do avanço da pandemia. Conclusão: A aplicação simultânea de diferentes medidas de mitigação na Costa Rica tem sido um agente promotor da diminuição de casos de COVID-19.

EPIVIGILA system and notifiable diseases: strength of data in epidemiological surveillance.

The epidemiological surveillance of communicable diseases, an essential function in public health, requires the management of clear, accurate and reliable information to achieve with a faster analysis of its results, early detection and its consequent timely response to events. In Chile, surveillance and control during the COVID-19 pandemic were successful to a large extent because the country had an integrated notification platform, the EPIVIGILA system, which was outstanding in proving its usefulness in this complex epidemiological context, among other efficient tools of new information technologies, due to the strength and diversity of the data it collects and thanks to the innovative essence of its conception. The objective of this study was to describe the architecture of the EPIVIGILA platform for notifiable diseases as a tool for public health surveillance and control in Chile.Copyright © 2023, Editorial Ciencias Medicas. All rights reserved.

US National Institutes of Health Prioritization of SARS-CoV-2 Variants.

Since late 2020, SARS-CoV-2 variants have regularly emerged with competitive and phenotypic differences from previously circulating strains, sometimes with the potential to escape from immunity produced by prior exposure and infection. The Early Detection group is one of the constituent groups of the US National Institutes of Health National Institute of Allergy and Infectious Diseases SARS-CoV-2 Assessment of Viral Evolution program. The group uses bioinformatic methods to monitor the emergence, spread, and potential phenotypic properties of emerging and circulating strains to identify the most relevant variants for experimental groups within the program to phenotypically characterize. Since April 2021, the group has prioritized variants monthly. Prioritization successes include rapidly identifying most major variants of SARS-CoV-2 and providing experimental groups within the National Institutes of Health program easy access to regularly updated information on the recent evolution and epidemiology of SARS-CoV-2 that can be used to guide phenotypic investigations.

Open data for monitoring COVID-19 in Spain: Descriptive study.

BACKGROUND: The indicators of the pandemic have been based on the total number of diagnosed cases of COVID-19, the number of people hospitalized or in intensive care units, and deaths from the infection. The aim of this study is to describe the available data on diagnostic tests, health service used for the diagnosis of COVID-19, case detection and monitoring. METHOD: Descriptive study with review of official data available on the websites of the Spanish health councils corresponding to 17 Autonomous Communities, 2 Autonomous cities and the Ministry of Health. The variables collected refer to contact tracing, technics for diagnosis, use of health services and follow-up. RESULTS: All regions of Spain show data on diagnosed cases of COVID-19 and deaths. Hospitalized cases and intensive care admissions are shown in all regions except the Balearic Islands. Diagnostic tests for COVID-19 have been registered in all regions except Madrid region and Extremadura, with scarcely information on what type of test has been performed (present in 7 CCAA), requesting service and study of contacts. CONCLUSIONS: The information available on the official websites of the Health Departments of the different regions of Spain are heterogeneous. Data from the use of health service or workload in Primary Care, Emergency department or Out of hours services are almost non-existent.

Salus Platform: A Digital Health Solution Tool for Managing Syphilis Cases in Brazil-A Comparative Analysis.

(1) Introduction: Syphilis is a sexually transmitted infection (STI) that constitutes a serious public health problem in Brazil and worldwide; (2) Methods: This was a descriptive and exploratory study that sought to analyze and compare the characteristics of Brazilian health systems with a new platform (Salus) developed by the Laboratory of Technological Innovation in Health in the scope of notification and management of disease data, including syphilis. In addition, this analysis aimed to assess whether Salus fully meets the necessary data management fields and can be indicated as a tool to improve health management in the context of syphilis in Brazil. (3) Results: In this study, the Salus functionalities were demonstrated and compared with the current Brazilian systems by discovering the existing gaps in the evaluated systems. The gaps found may explain the delay in meeting demands, the difficulty of making routine therapeutic follow-ups, in addition to interference with the vital purpose of follow-up in the epidemiological surveillance of diseases. As a result, Salus demonstrates functionalities that surpass all others and meet case management demands in a superior way to the systems currently used in the country. (4) Conclusions: The Brazilian health information systems related to the response to syphilis do not fulfill the purpose for which they were developed. Instead, they contribute to the fragmentation of health data and information, delays in diagnosis, incomplete case management, and loss of data due to inconsistencies and inadequate reporting. In addition, they are systems without interconnection, which do not articulate epidemiological surveillance actions with primary health care. All these factors may be obscuring accurate data on syphilis in Brazil, resulting in high and unnecessary public spending and late care for users of the Unified Health System (SUS).

Impact of the COVID-19 pandemic on the seasonality of respiratory syncytial viral infection.

The article presents an overview of current trends in the epidemiology of respiratory syncytial viral (RSV) infection, including its seasonality, under the impact of the COVID-19 pandemic, both according to world literature and taking into account monitoring epidemiological studies conducted in the Russian Federation. A detailed description of the dynamics of RSV detection in the period 2020-2021 and the beginning of 2022 in Russia according to the results of the all-Russian epidemiological monitoring is given. Epidemiological studies in different regions of the world, including Russia, have revealed the absence of seasonal rises in the incidence of RSV infection, characteristic of previous years, in 2020 and winter-spring in 2021 under the influence of the COVID-19 pandemic. In 2021-2022, a sharp increase in the incidence and hospitalization of children was noted against the backdrop of a decrease in cases of a new coronavirus infection in all countries of the world, while the start time and duration of respiratory syncytial virus infection, typical for the prepandemic period, changed. Our previous studies have shown that in different years and in different regions of Russia, the start and end times of the epidemiological season may also not coincide, which makes it difficult to predict seasonal peaks in incidence, their duration and severity only on the basis of previously obtained data. This makes it expedient to extend the terms of passive specific prophylaxis with palivizumab for a year if there are indications for its use, including taking into account the data of epidemiological monitoring conducted in the Russian Federation.Copyright © 2022 Authors. All rights reserved.

Impact of the COVID-19 pandemic on the seasonality of respiratory syncytial viral infection.

The article presents an overview of current trends in the epidemiology of respiratory syncytial viral (RSV) infection, including its seasonality, under the impact of the COVID-19 pandemic, both according to world literature and taking into account monitoring epidemiological studies conducted in the Russian Federation. A detailed description of the dynamics of RSV detection in the period 2020-2021 and the beginning of 2022 in Russia according to the results of the all-Russian epidemiological monitoring is given. Epidemiological studies in different regions of the world, including Russia, have revealed the absence of seasonal rises in the incidence of RSV infection, characteristic of previous years, in 2020 and winter-spring in 2021 under the influence of the COVID-19 pandemic. In 2021-2022, a sharp increase in the incidence and hospitalization of children was noted against the backdrop of a decrease in cases of a new coronavirus infection in all countries of the world, while the start time and duration of respiratory syncytial virus infection, typical for the prepandemic period, changed. Our previous studies have shown that in different years and in different regions of Russia, the start and end times of the epidemiological season may also not coincide, which makes it difficult to predict seasonal peaks in incidence, their duration and severity only on the basis of previously obtained data. This makes it expedient to extend the terms of passive specific prophylaxis with palivizumab for a year if there are indications for its use, including taking into account the data of epidemiological monitoring conducted in the Russian Federation.Copyright © 2022 Authors. All rights reserved.

An opinion on Wastewater-Based Epidemiological Monitoring (WBEM) with Clinical Diagnostic Test (CDT) for detecting high-prevalence areas of community COVID-19 Infections.

Wastewater-Based Epidemiological Monitoring (WBEM) is an efficient surveillance tool during the COVID-19 pandemic as it meets all requirements of a complete monitoring system including early warning, tracking the current trend, prevalence of the disease, detection of genetic diversity as well asthe up-surging SARS-CoV-2 new variants with mutations from the wastewater samples. Subsequently, Clinical Diagnostic Test is widely acknowledged as the global gold standard method for disease monitoring, despite several drawbacks such as high diagnosis cost, reporting bias, and the difficulty of tracking asymptomatic patients (silent spreaders of the COVID-19 infection who manifest nosymptoms of the disease). In this current reviewand opinion-based study, we first propose a combined approach) for detecting COVID-19 infection in communities using wastewater and clinical sample testing, which may be feasible and effective as an emerging public health tool for the long-term nationwide surveillance system. The viral concentrations in wastewater samples can be used as indicatorsto monitor ongoing SARS-CoV-2 trends, predict asymptomatic carriers, and detect COVID-19 hotspot areas, while clinical sampleshelp in detecting mostlysymptomaticindividuals for isolating positive cases in communities and validate WBEM protocol for mass vaccination including booster doses for COVID-19.

Awareness of the epidemiological investigation tasks of the nurse in charge of COVID-19 epidemiological investigations

Purpose: This qualitative study was to understand the awareness of epidemiological investigation tasks for nurses who were in charge of coronavirus disease 2019 (COVID-19) epidemiological investigations. Methods: Before data collection, written consent was obtained from 13 participants, and the data were then collected from September 1 to December 31, 2021. Individual interviews were conducted and recorded by video interview using Zoom, and data were transcribed verbatim. Four themes were derived by using the qualitative thematic analysis method. Results: The participants perceived that epidemiological investigations were burdensome but that the field work was important, and that expertise and collaboration were required. The participants started work without preparation due to the explosive increase in the number of confirmed COVID-19 cases, and they recognized work conflicts, unstable employment, and exhaustion as obstacles to their work performance. On the other hand, the participants took pride in contributing to the national epidemiological investigation and control and felt a sense of responsibility as nursing professionals. Finally, participants mentioned that the training of infectious disease practitioner was important for work improvement. Conclusion: Further research is needed on the development of standardized manuals for the training of nursing personnel as infectious disease specialists through the job analysis of epidemiological investigators. Copyright ©2022 The Korean Academic Society of Nursing Education.

The One Health concept for the threat of severe acute respiratory syndrome coronavirus-2 to marine ecosystems

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a global health threat. This virus is the causative agent for coronavirus disease 2019 (COVID-19). Pandemic prevention is best addressed through an integrated One Health (OH) approach. Understanding zoonotic pathogen fatality and spillover from wildlife to humans are effective for controlling and preventing zoonotic outbreaks. The OH concept depends on the interface of humans, animals, and their environment. Collaboration among veterinary medicine, public health workers and clinicians, and veterinary public health is necessary for rapid response to emerging zoonotic pathogens. SARS-CoV-2 affects aquatic environments, primarily through untreated sewage. Patients with COVID-19 discharge the virus in urine and feces into residential wastewater. Thus, marine organisms may be infected with SARS-CoV-2 by the subsequent discharge of partially treated or untreated wastewater to marine waters. Viral loads can be monitored in sewage and surface waters. Furthermore, shellfish are vulnerable to SARS-CoV-2 infection. Filter-feeding organisms might be monitored to protect consumers. Finally, the stability of SARS-CoV-2 to various environmental factors aids in viral studies. This article highlights the presence and survival of SARS-CoV-2 in the marine environment and its potential to enter marine ecosystems through wastewater. Furthermore, the OH approach is discussed for improving readiness for successive outbreaks. This review analyzes information from public health and epidemiological monitoring tools to control COVID-19 transmission. Copyright © Bukha, et al. This article is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

ANTI-NUCLEOCAPSIDE IgG ANTIBODIES: A POTENTIAL MARKER FOR A MORE ACCURATE EPIDEMIOLOGICAL MONITORING OF SARS-COV-2 INFECTION

On March 11th, 2020, the World Health Organization (WHO) declared the pandemic status of CoronaVirus Disease-19 (COVID-19) caused by SARS-CoV-2. Viral nucleic acid detection using molecular testing is the gold standard to diagnose SARS-CoV-2 infection. Asymptomatic subjects or with mild symptoms may not be subjected to molecular diagnostic tests with important repercussions on epidemiological estimate. The overall evolution especially of post-pandemic dynamics, will be probably obtained by the detection of immune response. Humoral immune response against the nucleocapsid (N) protein is related to SARS-CoV-2 infection. The detection of these antibodies could discriminate cases with from cases without history of COVID-19 for a more accurate evaluation of population exposed to SARSCoV-2. In this retrospective study, we evaluated four subclasses of SARS-CoV-2 IgG (anti-S1, anti-S2, anti-RBD, anti-N) in n.200 blood samples (February-March 2022) of health workers of Azienda Sanitaria Provinciale (ASP) di Ragusa, already vaccinated against Covid-19 in the period February-March 2022. A statistically significant association between SARS-CoV-2 infection and seropositivity to anti-N IgG (p-value <0.0001) was found. In order to evaluate the SARS-CoV-2 anti-N antibodies titer trend, the cases with a positive history for COVID-19 were classified as follows: cases with infection within three months and cases with infection after three months from serological test.No statistically association (p-value= 0.075) was found between seropositivity to anti-N IgG and SARS-CoV-2 infection within and after three months. We observed that approximately 30% of cases with a history for COVID-19 was seronegative for anti-N IgG within three months from infection.In post-pandemic period the evaluation of anti-N IgG in a time interval of less than three months could identify asymptomatic population exposed to SARS-CoV-2. Although our findings should be validated with a larger cohort, these results suggest that anti-N IgG might be used as a marker of early infection and assure a more accurate epidemiological estimate.

Burden of COVID-19 on primary care in Belgium: a prospective nationwide observational study from March to August 2020.

BACKGROUND: The COVID-19 outbreak had an important impact on general practice, for example the lack of personal protective equipment (PPE) and the switch to telephone consultations. We installed a monitoring instrument and reported the burden the COVID-19 pandemic placed on Belgian general practitioners (GPs) during the first wave of the pandemic. METHODS: We conducted an observational longitudinal prospective study from the 19th of March until the 17th of August 2020. Daily data were collected by using a structured electronic form integrated into the GPs' electronic medical records (EMRs). Data were collected on the GPs' need for support and workload, epidemiological indicators and the availability of PPE. Reports with graphical presentations were made for GP circles and primary care zones, and governments of different administrative levels had access to all data to guide their policy. RESULTS: A total of 3.769 different GP centres participated, which included more than 10.000 GPs. Throughout the first three weeks, 20% declared they had insufficient resources (personnel and material) for the following week. Approximately 10% continued to report this during the entire study. The majority reported being able to complete their daily tasks without loss of quality. During the first week, 30% indicated an increased workload. Afterwards, this number decreased and stabilized to an average of 10-20%. More than 70% of the consultations in March 2020 were conducted by telephone. This percentage declined in April and stabilized at approximately 30% in June 2020. Consultations due to respiratory symptoms peaked at 4000/100,000 inhabitants at the beginning of the outbreak, then decreased over time along with the COVID-19 incidence. We noticed a lack of disinfectant hand gel, surgical masks and FFP2 masks, the latter remaining problematic in the long term. CONCLUSION: We introduced an instrument in Belgian EMR systems to monitor the burden on GPs during the first wave of the COVID-19 pandemic. The lack of PPE and increased workload were considered to be the main obstacles. A large number of the GP offices switched to teleconsultations to provide healthcare. Our monitoring instrument provided information for policy makers to intervene on a local level.

Test, Trace, and Put on the Blockchain?: A Viewpoint Evaluating the Use of Decentralized Systems for Algorithmic Contact Tracing to Combat a Global Pandemic.

The enormous pressure of the increasing case numbers experienced during the COVID-19 pandemic has given rise to a variety of novel digital systems designed to provide solutions to unprecedented challenges in public health. The field of algorithmic contact tracing, in particular, an area of research that had previously received limited attention, has moved into the spotlight as a crucial factor in containing the pandemic. The use of digital tools to enable more robust and expedited contact tracing and notification, while maintaining privacy and trust in the data generated, is viewed as key to identifying chains of transmission and close contacts, and, consequently, to enabling effective case investigations. Scaling these tools has never been more critical, as global case numbers have exceeded 100 million, as many asymptomatic patients remain undetected, and as COVID-19 variants begin to emerge around the world. In this context, there is increasing attention on blockchain technology as a part of systems for enhanced digital algorithmic contact tracing and reporting. By analyzing the literature that has emerged from this trend, the common characteristics of the designs proposed become apparent. An archetypal system architecture can be derived, taking these characteristics into consideration. However, assessing the utility of this architecture using a recognized evaluation framework shows that the added benefits and features of blockchain technology do not provide significant advantages over conventional centralized systems for algorithmic contact tracing and reporting. From our study, it, therefore, seems that blockchain technology may provide a more significant benefit in other areas of public health beyond contact tracing.