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5.
BMC Med ; 18(1): 316, 2020 10 05.
Artículo en Inglés | MEDLINE | ID: mdl-33012285

RESUMEN

BACKGROUND: Many low- and middle-income countries have implemented control measures against coronavirus disease 2019 (COVID-19). However, it is not clear to what extent these measures explain the low numbers of recorded COVID-19 cases and deaths in Africa. One of the main aims of control measures is to reduce respiratory pathogen transmission through direct contact with others. In this study, we collect contact data from residents of informal settlements around Nairobi, Kenya, to assess if control measures have changed contact patterns, and estimate the impact of changes on the basic reproduction number (R0). METHODS: We conducted a social contact survey with 213 residents of five informal settlements around Nairobi in early May 2020, 4 weeks after the Kenyan government introduced enhanced physical distancing measures and a curfew between 7 pm and 5 am. Respondents were asked to report all direct physical and non-physical contacts made the previous day, alongside a questionnaire asking about the social and economic impact of COVID-19 and control measures. We examined contact patterns by demographic factors, including socioeconomic status. We described the impact of COVID-19 and control measures on income and food security. We compared contact patterns during control measures to patterns from non-pandemic periods to estimate the change in R0. RESULTS: We estimate that control measures reduced physical contacts by 62% and non-physical contacts by either 63% or 67%, depending on the pre-COVID-19 comparison matrix used. Masks were worn by at least one person in 92% of contacts. Respondents in the poorest socioeconomic quintile reported 1.5 times more contacts than those in the richest. Eighty-six percent of respondents reported a total or partial loss of income due to COVID-19, and 74% reported eating less or skipping meals due to having too little money for food. CONCLUSION: COVID-19 control measures have had a large impact on direct contacts and therefore transmission, but have also caused considerable economic and food insecurity. Reductions in R0 are consistent with the comparatively low epidemic growth in Kenya and other sub-Saharan African countries that implemented similar, early control measures. However, negative and inequitable impacts on economic and food security may mean control measures are not sustainable in the longer term.


Asunto(s)
Control de Enfermedades Transmisibles , Infecciones por Coronavirus , Transmisión de Enfermedad Infecciosa/prevención & control , Relaciones Interpersonales , Pandemias , Neumonía Viral , Adulto , Betacoronavirus , Control de Enfermedades Transmisibles/métodos , Control de Enfermedades Transmisibles/organización & administración , Control de Enfermedades Transmisibles/estadística & datos numéricos , Infecciones por Coronavirus/economía , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Femenino , Humanos , Kenia/epidemiología , Masculino , Evaluación de Resultado en la Atención de Salud , Pandemias/economía , Pandemias/prevención & control , Neumonía Viral/economía , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Pobreza/estadística & datos numéricos , Aislamiento Social , Factores Socioeconómicos , Encuestas y Cuestionarios
7.
J Otolaryngol Head Neck Surg ; 49(1): 71, 2020 Oct 06.
Artículo en Inglés | MEDLINE | ID: mdl-33023663

RESUMEN

Within Neurotology, special draping systems have been devised for mastoid surgery recognizing that drilling of middle ear mucosa is an aerosol generating medical procedure (AGMP) which can place surgical teams at risk of COVID-19 infection. We provide a thorough description of a barrier system utilized in our practice, along with work completed by our group to better quantify its effectiveness. Utilization of a barrier system can provide near complete bone dust and droplet containment within the surgical field and prevent contamination of other healthcare workers. As this is an early system, further adaptations and national collaborations are required to ultimately arrive at a system that seamlessly integrates into the surgical suite. While these barrier systems are new, they are timely as we face a pandemic, and can play a crucial role in safely resuming surgery.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Transmisión de Enfermedad Infecciosa/prevención & control , Enfermedades del Oído/epidemiología , Apófisis Mastoides/cirugía , Procedimientos Quirúrgicos Otológicos/métodos , Neumonía Viral/epidemiología , Base del Cráneo/cirugía , Comorbilidad , Enfermedades del Oído/cirugía , Humanos , Pandemias , Equipo de Protección Personal
8.
Can Respir J ; 2020: 2045341, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33005276

RESUMEN

Objective: Coronavirus disease 2019 (COVID-19), caused by the novel coronavirus SARS-CoV-2, was first identified in December 2019 in Wuhan, China, and has since spread globally, resulting in an ongoing pandemic. However, the study of asymptomatic patients is still rare, and the understanding of its potential transmission risk is still insufficient. In this study, epidemiological investigations were conducted in the Zhejiang province to understand the epidemiology and clinical characteristics of asymptomatic patients with COVID-19. Methods: This retrospective study was carried out on 22 asymptomatic patients and 234 symptomatic patients with COVID-19 who were hospitalized in Zhejiang Duodi Hospital from January 21 to March 16, 2020. The characteristics of epidemiology, demography, clinical manifestations, and laboratory data of mild patients were compared and analyzed. Results: The median age was 28 years in asymptomatic patients and 48 years in symptomatic patients. The proportion who were female was 77.3% in asymptomatic patients and 36.3% in symptomatic patients (p < 0.001). The proportion of patients with coexisting diseases was 4.5% in asymptomatic patients and 38.0% in symptomatic patients (p=0.002). The proportion of patients with increased CRP was 13.6% in the asymptomatic group and 61.1% in the symptomatic group (p < 0.001). The proportion of patients received antiviral therapy was 45.5% in the asymptomatic group and 97.9% in the symptomatic group (p < 0.001). The proportion of patients received oxygen therapy was 22.7% in the asymptomatic group and 99.1% in symptomatic patients (p < 0.001). By March 16, 2020, all patients were discharged from the hospital, and no symptoms had appeared in the asymptomatic patients during hospitalization. The median course of infection to discharge was 21.5 days in asymptomatic patients and 22 days in symptomatic patients. Conclusions: Asymptomatic patients are also infectious; relying only on clinical symptoms, blood cell tests, and radiology examination will lead to misdiagnosis of most patients, leading to the spread of the virus. Investigation of medical history is the best strategy for screening asymptomatic patients, especially young people, women, and people without coexisting disease, who are more likely to be asymptomatic when infected. Although the prognosis is good, isolation is critical for asymptomatic patients, and it is important not to end isolation early before a nucleic acid test turns negative.


Asunto(s)
Enfermedades Asintomáticas , Infecciones por Coronavirus , Transmisión de Enfermedad Infecciosa/prevención & control , Pandemias , Neumonía Viral , Medición de Riesgo/métodos , Adulto , Factores de Edad , Enfermedades Asintomáticas/epidemiología , Enfermedades Asintomáticas/terapia , Betacoronavirus/aislamiento & purificación , China/epidemiología , Comorbilidad , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/tratamiento farmacológico , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/fisiopatología , Infecciones por Coronavirus/terapia , Errores Diagnósticos/prevención & control , Femenino , Hospitalización/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Terapia por Inhalación de Oxígeno/estadística & datos numéricos , Neumonía Viral/diagnóstico , Neumonía Viral/epidemiología , Neumonía Viral/fisiopatología , Neumonía Viral/terapia , Pronóstico , Factores Sexuales
11.
Ig Sanita Pubbl ; 76(2): 107-118, 2020.
Artículo en Italiano | MEDLINE | ID: mdl-32877395

RESUMEN

Knowledge about the new infectious disease COVID-19, which first spread in the city of Wuhan in China, in December 2019, is based on the evidence retrieved from coronaviruses previously known to humans. The main transmission ways of the new SARS-CoV-2 virus are respiratory droplets and direct and close contact with infected individuals and contaminated surfaces. To date, some scientific publications provide initial evidence that SARS-CoV-2 can be detected in the air, thus assuming a further route of infection, that airborne, although these results are to be considered preliminary and they need careful interpretation. In support of this hypothesis, ventilation systems, aimed to improve indoor air, could represent an easy way to spread and promote the virus infection especially in hospitals and in all health facilities where the presence of infected individuals is potentially high as well as the possibility of infection by air. Indeed, by generating jets of air at different speeds, they can interfere with the mission of respiratory particles and determine an environmental diffusion of the potentially contaminating droplet. Therefore, ventilation systems could provide a potential transmission channel for the viral load able to spread out in indoor air. Nonetheless, good management, technical and operational practices may lead to a low risk of contagion, both in community and health environments.


Asunto(s)
Contaminación del Aire Interior/prevención & control , Infecciones por Coronavirus , Pandemias , Neumonía Viral , Ventilación , Betacoronavirus , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/transmisión , Transmisión de Enfermedad Infecciosa/prevención & control , Humanos , Control de Infecciones/métodos , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Neumonía Viral/transmisión
12.
R I Med J (2013) ; 103(7): 15-20, 2020 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-32872685

RESUMEN

In December 2019 a respiratory illness known as Coronavirus 2 (SARS-CoV-2, COVID-19) broke out in a region in China and rapidly spread to become a pandemic affecting all sporting events worldwide. The Summer Olympics scheduled to be held in Tokyo were postponed until 2021, and all professional leagues in the United States postponed or canceled events. As the United States has begun to open up, there remains uncertainty of when sporting events can safely be held. Many professional leagues and the National Collegiate Athletic Association have established guidelines and recommendations for their athletes to compete safely. In this article, we review the protocols that have been established to allow athletes to return to play, and we review briefly the effects COVID-19 infection may have on athletes.


Asunto(s)
Control de Enfermedades Transmisibles , Infecciones por Coronavirus , Transmisión de Enfermedad Infecciosa/prevención & control , Pandemias , Neumonía Viral , Volver al Deporte , Deportes/tendencias , Atletas , Betacoronavirus , Control de Enfermedades Transmisibles/métodos , Control de Enfermedades Transmisibles/organización & administración , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Humanos , Pandemias/prevención & control , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Medición de Riesgo
15.
Tex Med ; 116(8): 20-25, 2020 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-32866271

RESUMEN

Ricardo Garza, MD, was still walking the tightrope: standing, but unable to withstand another gust of wind. COVID-19 swept away about 35% of the San Antonio solo cardiologist's practice revenue, and that was just what he could calculate as he waited for insurers to process straggling claims. But he had returned to in-office operations without any layoffs. While some practices are surviving - and trying their best to prepare for future threats - others weren't so lucky. On-the-ground experiences align with the Texas Medical Association's Practice Viability Survey in showing COVID-19 was, and still is, a disruptor unlike any other - challenging or torpedoing the viability of various practice types.


Asunto(s)
Control de Enfermedades Transmisibles/métodos , Infecciones por Coronavirus , Pandemias , Neumonía Viral , Práctica Profesional , Telemedicina , Betacoronavirus , Infecciones por Coronavirus/economía , Infecciones por Coronavirus/epidemiología , Toma de Decisiones en la Organización , Transmisión de Enfermedad Infecciosa/prevención & control , Humanos , Innovación Organizacional , Pandemias/economía , Neumonía Viral/economía , Neumonía Viral/epidemiología , Pautas de la Práctica en Medicina/organización & administración , Pautas de la Práctica en Medicina/tendencias , Práctica Profesional/economía , Práctica Profesional/tendencias , Texas/epidemiología
16.
Tex Med ; 116(8): 30-31, 2020 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-32866272

RESUMEN

IN TEXAS, COVID-19 outbreaks have been especially pronounced in three types of facilities: nursing homes, jails or prisons, and meatpacking plants. The Amarillo area has plenty of all three. But it was the meatpacking plants that drew national attention to Amarillo's COVID-19 problems. The city, which straddles Potter and Randall counties, has numerous plants that employ 12,000 to 15,000 people. In early April, Amarillo's two hospitals began filling up with COVID-19 patients who worked at a plant in neighboring Moore County. Two weeks later, workers from a plant in Potter County flooded in.


Asunto(s)
Infecciones por Coronavirus , Transmisión de Enfermedad Infecciosa/prevención & control , Embalaje de Alimentos , Control de Infecciones , Productos de la Carne/virología , Pandemias , Neumonía Viral , Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Embalaje de Alimentos/métodos , Embalaje de Alimentos/normas , Humanos , Control de Infecciones/métodos , Control de Infecciones/organización & administración , Industria para Empaquetado de Carne/organización & administración , Pandemias/prevención & control , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Texas/epidemiología
18.
Tex Med ; 116(8): 34, 2020 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-32866275

RESUMEN

Medical schools typically have predictable schedules. The timing of lectures, clerkships, exams, and even extracurricular activities tend to follow in the same grooves year after year. Students can reliably block out even minor events months ahead of time and be confident they'll take place. All that changed with COVID-19. Since March, when the pandemic began closing down schools, businesses, and other institutions across the state, figuring out what comes next in medical school has been anything but predictable.


Asunto(s)
Control de Enfermedades Transmisibles/organización & administración , Infecciones por Coronavirus , Pandemias , Neumonía Viral , Facultades de Medicina , Estrés Psicológico/etiología , Estudiantes de Medicina/psicología , Betacoronavirus , Agotamiento Psicológico/psicología , Competencia Clínica , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Transmisión de Enfermedad Infecciosa/prevención & control , Humanos , Innovación Organizacional , Pandemias/prevención & control , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Facultades de Medicina/ética , Facultades de Medicina/organización & administración , Facultades de Medicina/tendencias , Enseñanza/ética , Enseñanza/psicología , Texas/epidemiología , Incertidumbre
20.
Ann Glob Health ; 86(1): 104, 2020 08 19.
Artículo en Inglés | MEDLINE | ID: mdl-32874935

RESUMEN

Despite predictions that the number of deaths in Africa due to COVID-19 will reach 10 million, overall, the continent has reported relatively few cases compared to the rest of the world. Many African countries have been successful in containing initial outbreaks by rapidly using evidence-based interventions through implementation strategies adapted from other countries' COVID-19 response as well as from prior epidemics. However, it is unclear whether these interventions will lead to long-term and complete success in stopping COVID-19 spread. Implementation research is a tool that can be used by countries to learn how to identify and understand contextual factors impacting COVID-19 prevention and control and select evidence-based interventions and strategies known to reduce spread of the virus. We identify seven key contextual factors that are facilitators or barriers to implementation of these interventions, and several strategies that can be leveraged if the factor is present or ones to strengthen if weak to improve implementation. These factors are: a culture of accountability, national coordination, financial stability of the population, culture of innovation, culture and capacity for research, health systems strength, and cross-border economies. Implementation science methods can serve to develop knowledge at a country and regional level on how to identify, utilize, and address these and other contextual factors, and inform relevant evidence-based interventions and implementation strategies. This approach can support African countries' ability to address key challenges as they arise, both in fighting COVID-19 and future health systems challenges.


Asunto(s)
Control de Enfermedades Transmisibles , Infecciones por Coronavirus , Práctica Clínica Basada en la Evidencia , Pandemias , Neumonía Viral , Investigación/organización & administración , Organizaciones Responsables por la Atención , África/epidemiología , Betacoronavirus/aislamiento & purificación , Control de Enfermedades Transmisibles/métodos , Control de Enfermedades Transmisibles/organización & administración , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Difusión de Innovaciones , Transmisión de Enfermedad Infecciosa/prevención & control , Práctica Clínica Basada en la Evidencia/métodos , Práctica Clínica Basada en la Evidencia/normas , Humanos , Pandemias/prevención & control , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Factores Socioeconómicos
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