Orthodontists' use of remote monitoring platforms pre-, amid, and post-COVID-19: a survey study.

BACKGROUND: Did the COVID-19 pandemic affect orthodontists' use of remote monitoring platforms? The goal of this research was to examine orthodontists' experiences implementing remote monitoring platforms before, during, and after the initial COVID-19 lockdown. METHODS: In this descriptive cross-sectional survey study, an electronic, anonymous questionnaire consisting of a series of 31 short-answer and multiple-choice questions was administered to an international sampling of practicing orthodontists. The target population in the study included currently practicing orthodontists who were graduates of an accredited orthodontic residency program. Participants were recruited in 2021 through collaboration with the American Association of Orthodontists (AAO) Partners in Research Program and the Harvard School of Dental Medicine Orthodontic Alumni Association. Descriptive analysis was conducted, reporting frequency (N and %) distributions for each question. The questionnaire aimed to describe whether orthodontists incorporated remote monitoring platforms into their practices, their experiences doing so, and if the COVID-19 pandemic influenced their use of these resources. RESULTS: Orthodontists' use of remote monitoring platforms was negligible prior to the pandemic; however, a quarter of surveyed orthodontists began using a remote monitoring platform during COVID-19 and nearly all respondents plan to continue using remote monitoring for the foreseeable future. Approximately half of orthodontists believe most patients' treatment progress can be monitored to the standard of care between in-person orthodontic appointments using remote monitoring platforms. Half of the orthodontists who do not currently use a remote monitoring platform in their practice are interested in learning more about how to implement one. CONCLUSIONS: The COVID-19 pandemic led to an increase in the interest and adoption of remote monitoring platforms in orthodontic practices. Most orthodontists had not incorporated remote monitoring platforms into their practices prior to the COVID-19 pandemic. However, this study revealed that a subset of orthodontists utilized the pandemic as motivation to incorporate remote monitoring into their practices and an additional group of orthodontists were interested in incorporating one in the future. Remote monitoring platforms garnered interest and importance with the arrival of the COVID-19 pandemic and may only have an increasing role in the field in years to come.

Transmission dynamics of COVID-19 in household and community settings in the United Kingdom, January to March 2020.

BackgroundHouseholds appear to be the highest risk setting for COVID-19 transmission. Large household transmission studies in the early stages of the pandemic in Asia reported secondary attack rates ranging from 5 to 30%.AimWe aimed to investigate the transmission dynamics of COVID-19 in household and community settings in the UK.MethodsA prospective case-ascertained study design based on the World Health Organization FFX protocol was undertaken in the UK following the detection of the first case in late January 2020. Household contacts of cases were followed using enhanced surveillance forms to establish whether they developed symptoms of COVID-19, became confirmed cases and their outcomes. We estimated household secondary attack rates (SAR), serial intervals and individual and household basic reproduction numbers. The incubation period was estimated using known point source exposures that resulted in secondary cases.ResultsWe included 233 households with two or more people with 472 contacts. The overall household SAR was 37% (95% CI: 31-43%) with a mean serial interval of 4.67 days, an R0 of 1.85 and a household reproduction number of 2.33. SAR were lower in larger households and highest when the primary case was younger than 18 years. We estimated a mean incubation period of around 4.5 days.ConclusionsRates of COVID-19 household transmission were high in the UK for ages above and under 18 years, emphasising the need for preventative measures in this setting. This study highlights the importance of the FFX protocol in providing early insights on transmission dynamics.

Genomic assessment of quarantine measures to prevent SARS-CoV-2 importation and transmission.

Mitigation of SARS-CoV-2 transmission from international travel is a priority. We evaluated the effectiveness of travellers being required to quarantine for 14-days on return to England in Summer 2020. We identified 4,207 travel-related SARS-CoV-2 cases and their contacts, and identified 827 associated SARS-CoV-2 genomes. Overall, quarantine was associated with a lower rate of contacts, and the impact of quarantine was greatest in the 16-20 age-group. 186 SARS-CoV-2 genomes were sufficiently unique to identify travel-related clusters. Fewer genomically-linked cases were observed for index cases who returned from countries with quarantine requirement compared to countries with no quarantine requirement. This difference was explained by fewer importation events per identified genome for these cases, as opposed to fewer onward contacts per case. Overall, our study demonstrates that a 14-day quarantine period reduces, but does not completely eliminate, the onward transmission of imported cases, mainly by dissuading travel to countries with a quarantine requirement.