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1.
Can J Anaesth ; 67(10): 1424-1430, 2020 Oct.
Article in English | MEDLINE | ID: covidwho-1777852

ABSTRACT

PURPOSE: Risk to healthcare workers treating asymptomatic patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the operating room depends on multiple factors. This review examines the evidence for asymptomatic or pre-symptomatic carriage of SARS-CoV-2, the risk of transmission from asymptomatic patients, and the specific risks associated with aerosol-generating procedures. Protective measures, such as minimization of aerosols and use of personal protective equipment in the setting of treating asymptomatic patients, are also reviewed. SOURCE: We examined the published literature as well as Societal guidelines. PRINCIPAL FINDINGS: There is evidence that a proportion of those infected with SARS-CoV-2 have detectable viral loads prior to exhibiting symptoms, or without ever developing symptoms. The degree of risk of transmission from asymptomatic patients to healthcare providers will depend on the prevalence of disease in the population, which is difficult to assess without widespread population screening. Aerosol-generating procedures increase the odds of viral transmission from infected symptomatic patients to healthcare providers, but transmission from asymptomatic patients has not been reported. Techniques to minimize aerosolization and appropriate personal protective equipment may help reduce the risk to healthcare workers in the operating room. Some societal guidelines recommend the use of airborne precautions during aerosol-generating procedures on asymptomatic patients during the coronavirus disease pandemic, although evidence supporting this practice is limited. CONCLUSION: Viral transmission from patients exhibiting no symptoms in the operating room is plausible and efforts to reduce risk to healthcare providers include reducing aerosolization and wearing appropriate personal protective equipment, the feasibility of which will vary based on geographic risk and equipment availability.


RéSUMé: OBJECTIF: Le risque encouru par les travailleurs de la santé traitant des patients asymptomatiques infectés par le syndrome respiratoire aigu sévère du coronavirus 2 (SARS-CoV-2) en salle d'opération dépend de plusieurs facteurs. Ce compte rendu examine les données probantes concernant la présence asymptomatique ou pré-symptomatique du SARS-CoV-2, le risque de transmission des patients asymptomatiques, et les risques spécifiques associés aux interventions générant des aérosols. Nous passons également en revue différentes mesures de protection, telles que la minimisation des aérosols et l'utilisation d'équipements de protection individuelle, dans un contexte de traitement de patients asymptomatiques. SOURCE: Nous avons examiné la littérature publiée ainsi que les directives sociétales. CONSTATATIONS PRINCIPALES: Selon certaines données probantes, une proportion des personnes infectées par le SARS-CoV-2 possèdent des charges virales détectables avant la présence de symptômes, voire même sans manifestation de symptômes. Le degré de risque de transmission des patients asymptomatiques aux travailleurs de la santé dépendra de la prévalence de la maladie dans la population, une donnée difficile à évaluer sans dépistage généralisé. Les interventions générant des aérosols augmentent le risque de transmission virale des patients symptomatiques infectés aux travailleurs de la santé, mais la transmission de patients asymptomatiques n'a pas été rapportée. Les techniques visant à minimiser l'aérosolisation et les équipements de protection individuelle adaptés pourraient être utiles pour réduire le risque des travailleurs de la santé en salle d'opération. Certaines directives régionales et nationales recommandent le recours à des précautions contre la transmission par voie aérienne durant les interventions générant des aérosols pratiquées sur des patients asymptomatiques pendant la pandémie de coronavirus, bien que les données probantes appuyant cette pratique soient limitées. CONCLUSION: La transmission virale des patients asymptomatiques en salle d'opération est plausible et les efforts visant à réduire le risque pour les travailleurs de la santé comprennent la réduction de l'aérosolisation et le port d'équipements de protection individuelle adaptés, deux mesures dont la faisabilité variera en fonction du risque géographique et de la disponibilité des équipements.


Subject(s)
Asymptomatic Infections/epidemiology , Coronavirus Infections/transmission , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Pneumonia, Viral/transmission , Aerosols , Betacoronavirus/isolation & purification , COVID-19 , Carrier State/epidemiology , Carrier State/virology , Coronavirus Infections/epidemiology , Health Personnel , Humans , Pandemics , Personal Protective Equipment , Pneumonia, Viral/epidemiology , SARS-CoV-2
3.
J Med Virol ; 92(7): 863-867, 2020 07.
Article in English | MEDLINE | ID: covidwho-1763253

ABSTRACT

With multiple virus epicenters, COVID-19 has been declared a pandemic by the World Health Organization. Consequently, many countries have implemented different policies to manage this crisis including curfew and lockdown. However, the efficacy of individual policies remains unclear with respect to COVID-19 case development. We analyzed available data on COVID-19 cases of eight majorly affected countries, including China, Italy, Iran, Germany, France, Spain, South Korea, and Japan. Growth rates and doubling time of cases were calculated for the first 6 weeks after the initial cases were declared for each respective country and put into context with implemented policies. Although the growth rate of total confirmed COVID-19 cases in China has decreased, those for Japan have remained constant. For European countries, the growth rate of COVID-19 cases considerably increased during the second time interval. Interestingly, the rates for Germany, Spain, and France are the highest measured in the second interval and even surpass the numbers in Italy. Although the initial data in Asian countries are encouraging with respect to case development at the initial stage, the opposite is true for European countries. Based on our data, disease management in the 2 weeks following the first reported cases is of utmost importance.


Subject(s)
Betacoronavirus/pathogenicity , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Health Policy/legislation & jurisprudence , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Public Health/legislation & jurisprudence , Asia/epidemiology , COVID-19 , Communicable Disease Control , Coronavirus Infections/diagnosis , Coronavirus Infections/prevention & control , Europe/epidemiology , Humans , Pandemics/prevention & control , Pneumonia, Viral/diagnosis , Pneumonia, Viral/prevention & control , Quarantine/organization & administration , SARS-CoV-2 , Time Factors , World Health Organization
5.
Ciênc. Saúde Colet ; 25(supl.1): 2461-2468, Mar. 2020. graf
Article in Portuguese | WHO COVID, LILACS (Americas) | ID: covidwho-1725050

ABSTRACT

Resumo A distribuição geográfica da COVID-19 por meio de recursos de Sistemas de Informação Geográfica é pouco explorada. O objetivo foi analisar a distribuição de casos da COVID-19 e de leitos de terapia intensiva exclusivos para a doença no estado do Ceará, Brasil. Estudo ecológico, com distribuição geográfica do coeficiente de detecção de casos da doença em 184 municípios. Construíram-se mapas dos valores brutos e estimados (método bayesiano global e local), com cálculo do índice de Moran e utilização do "BoxMap" e "MoranMap" Os leitos foram distribuídos por meio de pontos geolocalizados. Estudaram-se 3.000 casos e 459 leitos. As maiores taxas encontram-se na capital Fortaleza, região metropolitana (RM) e ao sul dessa região. Há autocorrelação espacial positiva na taxa bayesiana local (I = 0,66). A distribuição dos leitos de terapia intensiva sobreposta ao "BoxMap" evidenciou aglomerados com padrão Alto-Alto apresentando número de leitos (capital, RM, porção noroeste); porém, há o mesmo padrão (extremo leste) e em áreas de transição com insuficiência de leito. O "MoranMap" evidenciou "clusters" estatisticamente significativos no estado. A interiorização da COVID-19 no Ceará demanda medidas de contingência voltadas à distribuição dos leitos de terapia intensiva específicos para casos de COVID19 para atender à demanda.


Abstract The geographical distribution of COVID-19 through Geographic Information Systems resources is hardly explored. We aimed to analyze the distribution of COVID-19 cases and the exclusive intensive care beds in the state of Ceará, Brazil. This is an ecological study with the geographic distribution of the case detection coefficient in 184 municipalities. Maps of crude and estimated values (global and local Bayesian method) were developed, calculating the Moran index and using BoxMap and MoranMap. Intensive care beds were distributed through geolocalized points. In total, 3,000 cases and 459 beds were studied. The highest rates were found in the capital Fortaleza, the Metropolitan Region (MR), and the south of this region. A positive spatial autocorrelation has been identified in the local Bayesian rate (I = 0.66). The distribution of beds superimposed on the BoxMap shows clusters with a High-High pattern of number of beds (capital, MR, northwestern part). However, a similar pattern is found in the far east or transition areas with insufficient beds. The MoranMap shows clusters statistically significant in the state. COVID-19 interiorization in Ceará requires contingency measures geared to the distribution of specific intensive care beds for COVID-19 cases in order to meet the demand.


Subject(s)
Humans , Pneumonia, Viral/epidemiology , Coronavirus Infections/epidemiology , Pandemics , Geographic Mapping , Betacoronavirus , Hospital Bed Capacity/statistics & numerical data , Intensive Care Units/supply & distribution , Pneumonia, Viral/transmission , Brazil/epidemiology , Bayes Theorem , Coronavirus Infections , Coronavirus Infections/transmission , Geographic Information Systems
6.
Ciênc. Saúde Colet ; 25(supl.1): 2395-2401, Mar. 2020. tab, graf
Article in Portuguese | WHO COVID, LILACS (Americas) | ID: covidwho-1725046

ABSTRACT

Resumo A COVID-19 é uma doença produzida pelo vírus SARS-CoV-2. Esse vírus se espalhou rapidamente pelo mundo, o que levou a Organização Mundial da Saúde a classificar a COVID-19 como uma emergência de saúde internacional e, posteriormente, a declará-la uma pandemia. O número de casos confirmados, no dia 11 de abril de 2020, já passa de 1.700.000, porém esses dados não refletem a real prevalência de COVID-19 na população, visto que, em muitos países, os testes são quase que exclusivamente realizados em pessoas com sintomas, especialmente os mais graves. Para definir políticas de enfrentamento, é essencial dispor de dados sobre a prevalência real de infecção na população. Este estudo tem por objetivos avaliar a proporção de indivíduos já infectados pelo SARS-CoV-2 no Rio Grande do Sul, Brasil, analisar a velocidade de expansão da infecção e estimar o percentual de infectados com e sem sintomas. Serão realizados quatro inquéritos sorológicos repetidos a cada 15 dias, com amostragem probabilística de nove cidades sentinela, em todas as sub-regiões do Estado. As entrevistas e testes ocorrerão no âmbito domiciliar. Serão utilizados testes rápidos para detecção de anticorpos, validados previamente ao início da coleta de dados.


Abstract COVID-19, the disease produced by the virus SARS-CoV-2, has spread quickly throughout the world, leading the World Health Organization to first classify it as an international health emergency and, subsequently, declaring it pandemic. The number of confirmed cases, as April 11, surpassed 1,700,000, but this figure does not reflect the prevalence of COVID-19 in the population as, in many countries, tests are almost exclusively performed in people with symptoms, particularly severe cases. To properly assess the magnitude of the problem and to contribute to the design of evidence-based policies for fighting COVID-19, one must accurately estimate the population prevalence of infection. Our study is aimed at estimating the prevalence of infected individuals in the state of Rio Grande do Sul, Brazil, to document how fast the infection spreads, and to estimate the proportion of infected persons who present or presented symptoms, as well as the proportion of asymptomatic infections. Four repeated serological surveys will be conducted in probability samples of nine sentinel cities every two weeks. Tests will be performed in 4,500 participants in each survey, totaling18,000 interviews. Interviews and tests will be conducted at the participants' household. A rapid test for the detection of antibodies will be used; the test was validated prior to the beginning of the fieldwork.


Subject(s)
Humans , Pneumonia, Viral/epidemiology , Coronavirus Infections/epidemiology , Sentinel Surveillance , Clinical Laboratory Techniques/statistics & numerical data , Asymptomatic Infections/epidemiology , Pandemics , Betacoronavirus/immunology , Pneumonia, Viral/transmission , Time Factors , Brazil/epidemiology , Prevalence , Coronavirus Infections , Coronavirus Infections/diagnosis , Coronavirus Infections/transmission , Clinical Laboratory Techniques/methods , Clinical Laboratory Techniques/ethics , Betacoronavirus , Antibodies, Viral/blood
7.
Int J Environ Res Public Health ; 17(12)2020 06 22.
Article in English | MEDLINE | ID: covidwho-1725662

ABSTRACT

Sars-cov-2 virus (Covid-19) is a member of the coronavirus family and is responsible for the pandemic recently declared by the World Health Organization. A positive correlation has been observed between the spread of the virus and air pollution, one of the greatest challenges of our millennium. Covid-19 could have an air transmission and atmospheric particulate matter (PM) could create a suitable environment for transporting the virus at greater distances than those considered for close contact. Moreover, PM induces inflammation in lung cells and exposure to PM could increase the susceptibility and severity of the Covid-19 patient symptoms. The new coronavirus has been shown to trigger an inflammatory storm that would be sustained in the case of pre-exposure to polluting agents. In this review, we highlight the potential role of PM in the spread of Covid-19, focusing on Italian cities whose PM daily concentrations were found to be higher than the annual average allowed during the months preceding the epidemic. Furthermore, we analyze the positive correlation between the virus spread, PM, and angiotensin-converting enzyme 2 (ACE2), a receptor involved in the entry of the virus into pulmonary cells and inflammation.


Subject(s)
Air Pollution/adverse effects , Betacoronavirus , Coronavirus Infections/transmission , Particulate Matter , Pneumonia, Viral/transmission , Aerosols , Angiotensin-Converting Enzyme 2 , COVID-19 , Cities , Coronavirus Infections/mortality , Coronavirus Infections/virology , Humans , Inflammation/etiology , Italy/epidemiology , Morbidity , Oxidative Stress , Pandemics , Peptidyl-Dipeptidase A/metabolism , Pneumonia, Viral/mortality , Pneumonia, Viral/virology , SARS-CoV-2
8.
Int J Environ Res Public Health ; 17(9)2020 05 09.
Article in English | MEDLINE | ID: covidwho-1725605

ABSTRACT

In the early stages of the 2019 novel coronavirus disease (COVID-19) pandemic, containment of disease importation from epidemic areas was essential for outbreak control. This study is based on publicly accessible data on confirmed COVID-19 cases in Taiwan extracted from the Taiwan Centers for Disease Control website. We analysed the characteristics, infection source, symptom presentation, and route of identification of the 321 imported cases that were identified from 21 January to 6 April 2020. They were mostly returned Taiwanese citizens who had travelled to one or more of 37 countries for tourism, business, work, or study. Half of these cases developed symptoms before arrival, most of the remainder developed symptoms 1-13 days (mean 4.0 days) after arrival, and 3.4% never developed symptoms. Three-quarters of the cases had respiratory symptoms, 44.9% had fever, 13.1% lost smell or taste, and 7.2% had diarrhoea. Body temperature and symptom screening at airports identified 32.7% of the cases. Of the remainder, 27.7% were identified during home quarantining, 16.2% were identified via contact tracing, and 23.4% were reported by hospitals. Under the strict enforcement of these measures, the incidence of locally acquired COVID-19 cases in Taiwan remains sporadic. In conclusion, proactive border control measures are effective for preventing community transmission of this disease.


Subject(s)
Contact Tracing , Coronavirus Infections , Coronavirus/isolation & purification , Disease Transmission, Infectious/prevention & control , Fever of Unknown Origin/diagnosis , Mass Screening/methods , Pneumonia, Viral , Travel , Airports , Asymptomatic Infections , Betacoronavirus , COVID-19 , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Disease Outbreaks/prevention & control , Humans , Incidence , Pandemics/prevention & control , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Population Surveillance , Quarantine , SARS-CoV-2 , Sentinel Surveillance , Social Isolation , Taiwan/epidemiology , Travel Medicine
9.
Int J Environ Res Public Health ; 17(9)2020 05 07.
Article in English | MEDLINE | ID: covidwho-1725602

ABSTRACT

COVID-19 is an infectious disease caused by a novel coronavirus, which first appeared in China in late 2019, and reached pandemic distribution in early 2020. The first major outbreak in Europe occurred in Northern Italy where it spread to neighboring countries, notably to Austria, where skiing resorts served as a main transmission hub. Soon, the Austrian government introduced strict measures to curb the spread of the virus. Using publicly available data, we assessed the efficiency of the governmental measures. We assumed an average incubation period of one week and an average duration of infectivity of 10 days. One week after the introduction of strict measures, the increase in daily new cases was reversed, and the reproduction number dropped. The crude estimates tended to overestimate the reproduction rate in the early phase. Publicly available data provide a first estimate about the effectiveness of public health measures. However, more data are needed for an unbiased assessment.


Subject(s)
Coronavirus Infections/diagnosis , Coronavirus , Disease Outbreaks/prevention & control , Pandemics/prevention & control , Pneumonia, Viral/diagnosis , Public Health , Austria/epidemiology , Betacoronavirus , COVID-19 , Coronavirus/isolation & purification , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Humans , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , SARS-CoV-2 , Time Factors
10.
Int J Environ Res Public Health ; 17(9)2020 04 30.
Article in English | MEDLINE | ID: covidwho-1725594

ABSTRACT

Recently, due to the coronavirus pandemic, many guidelines and anti-contagion strategies continue to report unclear information about the persistence of coronavirus disease 2019 (COVID-19) in the environment. This certainly generates insecurity and fear in people, with an important psychological component that is not to be underestimated at this stage of the pandemic. The purpose of this article is to highlight all the sources currently present in the literature concerning the persistence of the different coronaviruses in the environment as well as in medical and dental settings. As this was a current study, there are still not many sources in the literature, and scientific strategies are moving towards therapy and diagnosis, rather than knowing the characteristics of the virus. Such an article could be an aid to summarize virus features and formulate new guidelines and anti-spread strategies.


Subject(s)
Betacoronavirus/physiology , Coronavirus Infections/epidemiology , Coronavirus Infections/virology , Environmental Microbiology , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/virology , COVID-19 , Coronavirus Infections/transmission , Dental Offices , Humans , Medical Office Buildings , Pneumonia, Viral/transmission , Risk , SARS-CoV-2
11.
Biomolecules ; 10(2)2020 02 19.
Article in English | MEDLINE | ID: covidwho-1725503

ABSTRACT

The world is currently witnessing an outbreak of a new coronavirus spreading quickly across China and affecting at least 24 other countries. With almost 65,000 infected, a worldwide death toll of at least 1370 (as of 14 February 2020), and with the potential to affect up to two-thirds of the world population, COVID-19 is considered by the World Health Organization (WHO) to be a global health emergency. The speed of spread and infectivity of COVID-19 (also known as Wuhan-2019-nCoV) are dramatically exceeding those of the Middle East respiratory syndrome coronavirus (MERS-CoV) and severe acute respiratory syndrome coronavirus (SARS-CoV). In fact, since September 2012, the WHO has been notified of 2494 laboratory-confirmed cases of infection with MERS-CoV, whereas the 2002-2003 epidemic of SARS affected 26 countries and resulted in more than 8000 cases. Therefore, although SARS, MERS, and COVID-19 are all the result of coronaviral infections, the causes of the coronaviruses differ dramatically in their transmissibility. It is likely that these differences in infectivity of coronaviruses can be attributed to the differences in the rigidity of their shells which can be evaluated using computational tools for predicting intrinsic disorder predisposition of the corresponding viral proteins.


Subject(s)
Betacoronavirus/physiology , Coronavirus Infections/transmission , Pneumonia, Viral/transmission , Viral Proteins/metabolism , Animals , COVID-19 , Coronavirus Infections/epidemiology , Humans , Pandemics , Pneumonia, Viral/epidemiology , SARS-CoV-2 , Viral Proteins/genetics , Virus Internalization
12.
J Chin Med Assoc ; 83(3): 217-220, 2020 03.
Article in English | MEDLINE | ID: covidwho-1722664

ABSTRACT

In late December 2019, a previous unidentified coronavirus, currently named as the 2019 novel coronavirus#, emerged from Wuhan, China, and resulted in a formidable outbreak in many cities in China and expanded globally, including Thailand, Republic of Korea, Japan, United States, Philippines, Viet Nam, and our country (as of 2/6/2020 at least 25 countries). The disease is officially named as Coronavirus Disease-2019 (COVID-19, by WHO on February 11, 2020). It is also named as Severe Pneumonia with Novel Pathogens on January 15, 2019 by the Taiwan CDC, the Ministry of Health and is a notifiable communicable disease of the fifth category. COVID-19 is a potential zoonotic disease with low to moderate (estimated 2%-5%) mortality rate. Person-to-person transmission may occur through droplet or contact transmission and if there is a lack of stringent infection control or if no proper personal protective equipment available, it may jeopardize the first-line healthcare workers. Currently, there is no definite treatment for COVID-19 although some drugs are under investigation. To promptly identify patients and prevent further spreading, physicians should be aware of the travel or contact history of the patient with compatible symptoms.


Subject(s)
Betacoronavirus , Coronavirus Infections , Infection Control , Infectious Disease Transmission, Patient-to-Professional , Pneumonia, Viral , Asia/epidemiology , Betacoronavirus/pathogenicity , COVID-19 , China/epidemiology , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Global Health , Humans , Infection Control/methods , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , SARS-CoV-2 , United States/epidemiology
13.
Dtsch Med Wochenschr ; 145(10): 670-674, 2020 05.
Article in German | MEDLINE | ID: covidwho-1721670

ABSTRACT

The Coronavirus Disease Pandemic 2019 (COVID-19), caused by the Severe Acute Respiratory Syndrome-related Coronavirus 2 (SARS-CoV-2), started in December 2019 in China. SARS-CoV-2 is easily transmitted by droplet infection. After an incubation period of 1-14 days, COVID-19 shows a mild course in 80 % of observed cases and a severe course in 20 %, with a lethality rate of 0.3-5.8 %. Elderly people and people with underlying diseases have a higher risk of severe courses with mandatory ventilation. So far there are neither effective drugs nor vaccinations available, so only public health interventions such as physical distancing and hygiene measures on the one hand and targeted testing followed by isolation and quarantine measures on the other hand are available. China has shown that maximum use of these measures can control the epidemic. The further course and also the consequences for the global economy cannot be clearly predicted at present.


Subject(s)
Betacoronavirus , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Public Health , COVID-19 , Coronavirus Infections/transmission , Humans , Pneumonia, Viral/transmission , SARS-CoV-2
14.
Emerg Microbes Infect ; 11(1): 168-171, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-1623181

ABSTRACT

HCoV-OC43 is one of the mildly pathogenic coronaviruses with high infection rates in common population. Here, 43 HCoV-OC43 related cases with pneumonia were reported, corresponding genomes of HCoV-OC43 were obtained. Phylogenetic analyses based on complete genome, orf1ab and spike genes revealed that two novel genotypes of HCoV-OC43 have emerged in China. Obvious recombinant events also can be detected in the analysis of the evolutionary dynamics of novel HCoV-OC43 genotypes. Estimated divergence time analysis indicated that the two novel genotypes had apparently independent evolutionary routes. Efforts should be conducted for further investigation of genomic diversity and evolution analysis of mildly pathogenic coronaviruses.


Subject(s)
Common Cold/epidemiology , Coronavirus Infections/epidemiology , Coronavirus OC43, Human/genetics , Genome, Viral , Genotype , Pneumonia, Viral/epidemiology , Base Sequence , Bayes Theorem , Child , Child, Hospitalized , Child, Preschool , China/epidemiology , Common Cold/pathology , Common Cold/transmission , Common Cold/virology , Coronavirus Infections/pathology , Coronavirus Infections/transmission , Coronavirus Infections/virology , Coronavirus OC43, Human/classification , Coronavirus OC43, Human/pathogenicity , Epidemiological Monitoring , Female , Humans , Infant , Male , Monte Carlo Method , Mutation , Phylogeny , Pneumonia, Viral/pathology , Pneumonia, Viral/transmission , Pneumonia, Viral/virology , Recombination, Genetic
17.
Evid Based Dent ; 21(3): 79, 2020 09.
Article in English | MEDLINE | ID: covidwho-1526068

ABSTRACT

Data sources Medline via PubMed, Scopus, Science Direct, Scielo and Google Scholar were searched without language restriction until 28 May 2020.Study selection Publications on the topic of biosafety measures before, during and after dental practice from observational studies, systematic reviews and literature reviews were included, while letters to the editor, individual opinions and books were excluded.Data extraction and synthesis The authors used a narrative review to describe the findings and grouped them into two categories: those considerations before dental care and those during dental consultation.Results The review was based on 43 publications. Of those, 23 were recent reviews, guidelines, protocols and recommendations from national and international organisations; three were COVID-related original studies and the remainder were pre-COVID publications on handpieces, surface contamination, ventilation, aerosols and airborne spread, ultrasonics, hand washing and dental pain management.Conclusions Patients should conform to COVID-19 screening protocols in order to receive dental care and follow all the procedures in place to prevent transmission while in the dental office.


Subject(s)
Betacoronavirus , Coronavirus Infections , Dental Care , Infection Control , Pandemics , Pneumonia, Viral , COVID-19 , Coronavirus Infections/prevention & control , Coronavirus Infections/transmission , Humans , Infection Control/methods , Pneumonia, Viral/prevention & control , Pneumonia, Viral/transmission , SARS-CoV-2
18.
Curr Opin Ophthalmol ; 31(5): 374-379, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-1511065

ABSTRACT

PURPOSE OF REVIEW: The use of slit lamp shields has been recommended by the American Academy of Ophthalmology as an infection control measure during the coronavirus disease 2019 pandemic. However, there is limited evidence regarding its efficacy to reduce viral transmission risks. We aim to provide an evidence-based approach to optimize the use of slit lamp shields during clinical examination. RECENT FINDINGS: Respiratory droplets from coughing and sneezing can travel up to 50 m/s and over a distance of 2 m, with a potential area of spread of 616 cm. Slit lamp shields confer added protection against large droplets but are limited against smaller particles. A larger shield curved toward the ophthalmologist and positioned closer to the patient increases protection against large droplets. A potential improvement to the design of such shields is the use of hydrophilic materials with antiviral properties which may help to minimize splashing of infectious droplets, reducing transmission risks. These include gold or silver nanoparticles and graphene oxide. SUMMARY: Slit lamp shields serve as a barrier for large droplets, but its protection against smaller droplets is undetermined. It should be large, positioned close to the patient, and used in tandem with routine basic disinfection practices.


Subject(s)
Betacoronavirus , Coronavirus Infections/transmission , Infection Control/instrumentation , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Pneumonia, Viral/transmission , Protective Devices , Slit Lamp , COVID-19 , Humans , Infection Control/methods , Pandemics , SARS-CoV-2
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