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1.
Medicine (Baltimore) ; 100(5): e23925, 2021 Feb 05.
Artículo en Inglés | MEDLINE | ID: mdl-33592845

RESUMEN

ABSTRACT: The World Health Organization (WHO) classified the spread of COVID-19 (Coronavirus Disease 2019) as a global pandemic in March. Scholars predict that the pandemic will continue into the coming winter and will become a seasonal epidemic in the following year. Therefore, the identification of effective control measures becomes extremely important. Although many reports have been published since the COVID-19 outbreak, no studies have identified the relative effectiveness of a combination of control measures implemented in Wuhan and other areas in China. To this end, a retrospective analysis by the collection and modeling of an unprecedented number of epidemiology records in China of the early stage of the outbreaks can be valuable.In this study, we developed a new dynamic model to describe the spread of COVID-19 and to quantify the effectiveness of control measures. The transmission rate, daily close contacts, and the average time from onset to isolation were identified as crucial factors in viral spreading. Moreover, the capacity of a local health-care system is identified as a threshold to control an outbreak in its early stage. We took these factors as controlling parameters in our model. The parameters are estimated based on epidemiological reports from national and local Center for Disease Control (CDCs).A retrospective simulation showed the effectiveness of combinations of 4 major control measures implemented in Wuhan: hospital isolation, social distancing, self-protection by wearing masks, and extensive medical testing. Further analysis indicated critical intervention conditions and times required to control an outbreak in the early stage. Our simulations showed that South Korea has kept the spread of COVID-19 at a low level through extensive medical testing. Furthermore, a predictive simulation for Italy indicated that Italy would contain the outbreak in late May under strict social distancing.In our general analysis, no single measure could contain a COVID-19 outbreak once a health-care system is overloaded. Extensive medical testing could keep viral spreading at a low level. Wearing masks functions as favorably as social distancing but with much lower socioeconomic costs.


Asunto(s)
Control de Enfermedades Transmisibles , Hospitalización/estadística & datos numéricos , Evaluación de Resultado en la Atención de Salud/métodos , /aislamiento & purificación , /economía , /prevención & control , China/epidemiología , Control de Enfermedades Transmisibles/métodos , Control de Enfermedades Transmisibles/organización & administración , Control de Enfermedades Transmisibles/normas , Trazado de Contacto/estadística & datos numéricos , Transmisión de Enfermedad Infecciosa/prevención & control , Transmisión de Enfermedad Infecciosa/estadística & datos numéricos , Humanos , Modelos Teóricos , Mortalidad , Análisis de Sistemas , Tiempo de Tratamiento/estadística & datos numéricos
2.
Mo Med ; 118(1): 81-84, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33551491

RESUMEN

The public health community has used contact tracing to address pandemics since the eighteenth century. With the emergence of COVID-19, these classical skills are the primary defense for communities to limit morbidity and mortality during the pandemic. Here we describe the methods, strengths, and challenges of contact tracing.


Asunto(s)
/prevención & control , Trazado de Contacto/métodos , Pandemias/prevención & control , Concienciación , /epidemiología , Trazado de Contacto/estadística & datos numéricos , Brotes de Enfermedades/prevención & control , Desinfección de las Manos/métodos , Humanos , Missouri/epidemiología , Aislamiento de Pacientes/métodos , Salud Pública/métodos , Salud Pública/normas , Cuarentena/métodos , /aislamiento & purificación
3.
Public Health ; 190: 147-151, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33386140

RESUMEN

OBJECTIVES: The objective of this study was to inform public health practitioners who are designing, adapting and implementing testing and tracing strategies for Coronavirus disease (COVID-19) control. STUDY DESIGN: The study design is monitoring and evaluation of a national public health protection programme. METHODS: All close contacts of laboratory-confirmed cases of COVID-19 identified between the 19th May and 2nd August were included; secondary attack rates and numbers needed to test were estimated. RESULTS: Four thousand five hundred eighty six of 7272 (63%) close contacts of cases were tested with at least one test. The secondary attack rate in close contacts who were tested was 7% (95% Confidence Interval [CI]: 6.3 - 7.8%). At the 'day 0' test, 14.6% (95% CI: 11.6-17.6%) of symptomatic close contacts tested positive compared with 5.2% (95% CI: 4.4-5.9%) of asymptomatic close contacts. CONCLUSIONS: The application of additional symptom-based criteria for testing in this high-incidence population (close contacts) is of limited utility because of the low negative predictive value of absence of symptoms.


Asunto(s)
/estadística & datos numéricos , Trazado de Contacto/estadística & datos numéricos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Infecciones Asintomáticas , Portador Sano , Niño , Preescolar , Trazado de Contacto/métodos , Femenino , Humanos , Incidencia , Lactante , Recién Nacido , Irlanda/epidemiología , Masculino , Persona de Mediana Edad
4.
Sci Rep ; 11(1): 2145, 2021 01 25.
Artículo en Inglés | MEDLINE | ID: mdl-33495491

RESUMEN

The coronavirus disease (COVID-19) outbreak has killed over a million people since its emergence in late 2019. However, there has been substantial variability in the policies and intensity of diagnostic efforts between countries. In this paper, we quantitatively evaluate the association between national contact tracing policies and case fatality rates of COVID-19 in 138 countries. Our regression analyses indicate that countries that implement comprehensive contact tracing have significantly lower case fatality rates. This association of contact tracing policy and case fatality rates is robust in our longitudinal regression models, even after controlling for the number of tests conducted and non-pharmaceutical control measures adopted by governments. Our results suggest that comprehensive contact tracing is instrumental not only to curtailing transmission but also to reducing case fatality rates. Contact tracing achieves the early detection and isolation of secondary cases which are particularly important given that the peak in infectiousness occurs during the presymptomatic phase. The early detection achieved by contact tracing accelerates the rate at which infected individuals receive medical care they need to maximize their chance of recovery. In addition, the combination of reduced transmission and more rapid recovery diminishes the burden on the healthcare system which in turn ensures that the resources remain available for individuals who do become infected.


Asunto(s)
/mortalidad , Trazado de Contacto/estadística & datos numéricos , Salud Global/estadística & datos numéricos , Pandemias/prevención & control , Política Pública , /diagnóstico , /virología , Humanos , Pandemias/estadística & datos numéricos , /patogenicidad
5.
Nat Commun ; 12(1): 587, 2021 01 26.
Artículo en Inglés | MEDLINE | ID: mdl-33500407

RESUMEN

While Digital contact tracing (DCT) has been argued to be a valuable complement to manual tracing in the containment of COVID-19, no empirical evidence of its effectiveness is available to date. Here, we report the results of a 4-week population-based controlled experiment that took place in La Gomera (Canary Islands, Spain) between June and July 2020, where we assessed the epidemiological impact of the Spanish DCT app Radar Covid. After a substantial communication campaign, we estimate that at least 33% of the population adopted the technology and further showed relatively high adherence and compliance as well as a quick turnaround time. The app detects about 6.3 close-contacts per primary simulated infection, a significant percentage being contacts with strangers, although the spontaneous follow-up rate of these notified cases is low. Overall, these results provide experimental evidence of the potential usefulness of DCT during an epidemic outbreak in a real population.


Asunto(s)
/epidemiología , Trazado de Contacto/métodos , Aplicaciones Móviles/estadística & datos numéricos , Pandemias/prevención & control , Cooperación del Paciente/estadística & datos numéricos , Adolescente , Adulto , Distribución por Edad , /transmisión , Trazado de Contacto/estadística & datos numéricos , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Privacidad , Teléfono Inteligente , España/epidemiología , Encuestas y Cuestionarios/estadística & datos numéricos , Adulto Joven
6.
J Med Internet Res ; 23(2): e24730, 2021 02 03.
Artículo en Inglés | MEDLINE | ID: mdl-33465034

RESUMEN

BACKGROUND: During the COVID-19 pandemic, new digital solutions have been developed for infection control. In particular, contact tracing mobile apps provide a means for governments to manage both health and economic concerns. However, public reception of these apps is paramount to their success, and global uptake rates have been low. OBJECTIVE: In this study, we sought to identify the characteristics of individuals or factors potentially associated with voluntary downloads of a contact tracing mobile app in Singapore. METHODS: A cohort of 505 adults from the general community completed an online survey. As the primary outcome measure, participants were asked to indicate whether they had downloaded the contact tracing app TraceTogether introduced at the national level. The following were assessed as predictor variables: (1) participant demographics, (2) behavioral modifications on account of the pandemic, and (3) pandemic severity (the number of cases and lockdown status). RESULTS: Within our data set, the strongest predictor of the uptake of TraceTogether was the extent to which individuals had already adjusted their lifestyles because of the pandemic (z=13.56; P<.001). Network analyses revealed that uptake was most related to the following: using hand sanitizers, avoiding public transport, and preferring outdoor over indoor venues during the pandemic. However, demographic and situational characteristics were not significantly associated with app downloads. CONCLUSIONS: Efforts to introduce contact tracing apps could capitalize on pandemic-related behavioral adjustments among individuals. Given that a large number of individuals is required to download contact tracing apps for contact tracing to be effective, further studies are required to understand how citizens respond to contact tracing apps. TRIAL REGISTRATION: ClinicalTrials.gov NCT04468581, https://clinicaltrials.gov/ct2/show/NCT04468581.


Asunto(s)
/prevención & control , Trazado de Contacto/estadística & datos numéricos , Conductas Relacionadas con la Salud , Aplicaciones Móviles/estadística & datos numéricos , Adulto , Estudios de Cohortes , Control de Enfermedades Transmisibles/estadística & datos numéricos , Trazado de Contacto/métodos , Femenino , Desinfección de las Manos , Desinfectantes para las Manos/uso terapéutico , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Pandemias , Singapur , Encuestas y Cuestionarios , Transportes/estadística & datos numéricos
7.
Public Health Rep ; 136(1): 88-96, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33108976

RESUMEN

OBJECTIVES: Widespread global transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus causing coronavirus disease 2019 (COVID-19), continues. Many questions remain about asymptomatic or atypical infections and transmission dynamics. We used comprehensive contact tracing of the first 2 confirmed patients in Illinois with COVID-19 and serologic SARS-CoV-2 antibody testing to determine whether contacts had evidence of undetected COVID-19. METHODS: Contacts were eligible for serologic follow-up if previously tested for COVID-19 during an initial investigation or had greater-risk exposures. Contacts completed a standardized questionnaire during the initial investigation. We classified exposure risk as high, medium, or low based on interactions with 2 index patients and use of personal protective equipment (PPE). Serologic testing used a SARS-CoV-2 spike enzyme-linked immunosorbent assay on serum specimens collected from participants approximately 6 weeks after initial exposure to either index patient. The 2 index patients provided serum specimens throughout their illness. We collected data on demographic, exposure, and epidemiologic characteristics. RESULTS: Of 347 contacts, 110 were eligible for serologic follow-up; 59 (17% of all contacts) enrolled. Of these, 53 (90%) were health care personnel and 6 (10%) were community contacts. Seventeen (29%) reported high-risk exposures, 15 (25%) medium-risk, and 27 (46%) low-risk. No participant had evidence of SARS-CoV-2 antibodies. The 2 index patients had antibodies detected at dilutions >1:6400 within 4 weeks after symptom onset. CONCLUSIONS: In serologic follow-up of the first 2 known patients in Illinois with COVID-19, we found no secondary transmission among tested contacts. Lack of seroconversion among these contacts adds to our understanding of conditions (ie, use of PPE) under which SARS-CoV-2 infections might not result in transmission and demonstrates that SARS-CoV-2 antibody testing is a useful tool to verify epidemiologic findings.


Asunto(s)
/epidemiología , Trazado de Contacto/estadística & datos numéricos , Personal de Salud/estadística & datos numéricos , Exposición Profesional/estadística & datos numéricos , /inmunología , Ensayo de Inmunoadsorción Enzimática , Femenino , Humanos , Illinois/epidemiología , Masculino , Pandemias , Equipo de Protección Personal , Medición de Riesgo
8.
Radiología (Madr., Ed. impr.) ; 63: 0-0, 2021. ilus, tab, graf
Artículo en Español | IBECS | ID: ibc-196868

RESUMEN

INTRODUCCIÓN: A mediados de diciembre de 2019 se describió en China una enfermedad infecciosa causada por un nuevo tipo de coronavirus que provocaba infección respiratoria aguda y pronto se extendió por el país y por el resto del mundo. A pesar de que la radiografía de tórax es la prueba de elección inicial ante infecciones respiratorias bajas con o sin disnea, hay pocos artículos que describan los hallazgos radiológicos del niño con COVID-19. OBJETIVO: Describir las características clínicas, analíticas y los hallazgos en la radiografía de tórax de la población pediátrica atendida con clínica de infección respiratoria en nuestro hospital durante el mes de marzo. Analizar la frecuencia de COVID-19 frente a otras infecciones respiratorias y sus manifestaciones radiológicas. MATERIAL Y MÉTODOS: Estudio observacional transversal desde el 1 de marzo al 31 de marzo del 2020 de todos los niños con clínica de infección respiratoria (fiebre, rinorrea, tos y/o disnea) que han precisado radiografía de tórax en nuestro hospital. RESULTADOS: 231 niños precisaron radiografía de tórax por clínica de infección respiratoria, 90 (38,9%) niñas y 141 (61%) niños; rango de edad 1 mes-16 años, con una mediana de 4 años. La mayoría de los niños presentaron síntomas leves (88,4%). Un 29,9% de los niños presentaba ambiente epidémico familiar positivo con clínica respiratoria similar a la que presentaba el paciente. Se realizó test PCR SARS-CoV-2 a 47 de los niños que acudieron a la urgencia (20,3%), que fue positivo en 3 (6,3% de los testados). Se realizaron determinaciones microbiológicas al 36,8% (85/231), demostraron otros agentes infecciosos diferentes al SARS-CoV-2 en el 35,3% de los pacientes (30/85). Únicamente uno de los pacientes PCR positivo para SARS-CoV-2 presentó infección de orina por Escherichia coli y hemocultivo positivo para Streptococcus viridans. El 73,2% de los pacientes presentó algún tipo de alteración en la radiografía de tórax. Los engrosamientos peribronquiales fueron el hallazgo más común en el 57%. El 38,5% presentó consolidación parenquimatosa, que en un 29,2% fue bilateral y en un 3,3% asoció derrame pleural. Se demostró aumento de la trama intersticial en el 7,3%. El 7,3% se manifestó con opacidades en vidrio deslustrado. CONCLUSIÓN: Durante el mes de marzo coexistieron infecciones respiratorias sintomáticas COVID-19 y no COVID-19. El patrón radiológico de las infecciones respiratorias, incluida la COVID-19, no es específico y la radiografía en ningún caso fue suficiente para establecer el diagnóstico. Los niños con clínica respiratoria compatible con COVID-19, con o sin PCR confirmatoria, presentaron síntomas leves y en su mayoría no requirieron ingreso ni ventilación invasiva. En un entorno de transmisión comunitaria, la ausencia de antecedente epidemiológico conocido no debería ser una contraindicación para realizar estudio de PCR para SARS-CoV-2


BACKGROUND: An infectious disease caused by a new type of coronavirus that can manifest as an acute respiratory infection was discovered in China in mid-December 2019 and soon spread throughout the country and to the rest of the world. Although chest X-rays are the initial imaging technique of choice for low respiratory infections with or without dyspnea, few articles have reported the radiologic findings in children with COVID-19. OBJECTIVE: To describe the clinical, laboratory, and chest X-ray findings in pediatric patients with signs and symptoms of respiratory infection attended at our hospital in March 2020. To analyze the frequency of COVID-19 compared to other respiratory infections, and to describe the radiologic manifestations of COVID-19 in pediatric patients. MATERIAL AND METHODS: This cross-sectional observational study included all children with clinical manifestations of respiratory infection (fever, rhinorrhea, cough, and/or dyspnea) that required chest X-rays in our hospital between March 1 and March 31. RESULTS: A total of 231 pediatric patients (90 (39%) girls and 141 (61%) boys; mean age, 4 y, range 1 month - 16 years) underwent chest X-rays for suspected respiratory infections. Most (88.4%) had mild symptoms; 29.9% had a family member positive for COVID-19 with symptoms similar to those of the patient. Nasal and/or throat swabs were analyzed for SARS-CoV-2 with PCR in the 47 (20.3%) children who presented at the emergency department; 3 (6.3%) of these were positive. Microbiological analyses were done in 85 (36.8%) of all patients, finding infections due to pathogens other than SARS-CoV-2 in 30 (35.3%). One of the patients with a PCR positive for SARS-CoV-2 had urine infection due to E. coli and blood culture positive for S. viridans. Abnormalities were observed on X-rays in 73.2% of the patients. Peribronchial thickening was the most common abnormal finding, observed in 57% of patients. Parenchymal consolidations were observed in 38.5%, being bilateral in 29.2% and associated with pleural effusion in 3.3%. The interstitial lines were thickened in 7.3%, and 7.3% had ground-glass opacities. CONCLUSION: During March 2020, COVID-19 and other symptomatic respiratory infections were observed. The radiologic pattern of these infections is nonspecific, and chest X-rays alone are insufficient for the diagnosis. Children with clinical manifestations compatible with COVID-19 (with or without PCR confirmation of infection by SARS-CoV-2) had mild symptoms and most did not require admission or invasive mechanical ventilation. In a context of community transmission, the absence of a known epidemiological antecedent should not be a contraindication for PCR to detect SARS-CoV-2


Asunto(s)
Humanos , Masculino , Femenino , Lactante , Preescolar , Niño , Adolescente , Infecciones del Sistema Respiratorio/diagnóstico por imagen , Radiografía Torácica/métodos , Infecciones por Coronavirus/epidemiología , Síndrome Respiratorio Agudo Grave/diagnóstico por imagen , Estudios Transversales , Pandemias/estadística & datos numéricos , Reacción en Cadena de la Polimerasa/estadística & datos numéricos , Virus del SRAS/aislamiento & purificación , Trazado de Contacto/estadística & datos numéricos
9.
Artículo en Inglés | IBECS | ID: ibc-196939

RESUMEN

INTRODUCCIÓN: Ante la posible coexistencia de la infección por el virus SARS-CoV-2 con otras infecciones estacionales, se pretende identificar síntomas diferenciales. Se ha estudiado el papel de los niños en el contagio intrafamiliar y la sensibilidad de la reacción en cadena de la polimerasa con transcriptasa inversa (RT-PCR) en un área con baja transmisión comunitaria. MATERIAL Y MÉTODOS: Estudio observacional transversal. Pacientes entre 0-15 años estudiados por técnica RT-PCR por sospecha clínica de infección por virus SARS-CoV-2 en los meses de marzo-mayo del 2020. Encuesta sobre síntomas y contactos. Determinación de anticuerpos anti-SARS-CoV-2 al menos 21 días después del test RT- PCR. RESULTADOS: Se incluyó a 126 pacientes, 33 con infección confirmada y edad media 8,4 años (IC del 95%, 6,8-10,0) superior a los no infectados. La fiebre fue el síntoma más común y con mayor sensibilidad. Las diferencias encontradas fueron una mayor frecuencia de anosmia (p = 0,029) y cefalea (p = 0,009) entre los niños infectados con una especificidad del 96,7 y el 81,5% respectivamente. No hubo diferencias en la duración de los síntomas. Un 81,8% de los infectados fue probablemente contagiado en el núcleo familiar, en un 85,2% por un progenitor que trabajaba fuera del hogar. La sensibilidad de RT-PCR fue 70,9% y su valor predictivo negativo 91,1%. CONCLUSIONES: El cuadro clínico es inespecífico y los síntomas más específicos difíciles de detectar en niños más pequeños. Los niños tuvieron un papel reducido en la transmisión intrafamiliar. La sensibilidad de la RT-PCR podría estar relacionada con una menor contagiosidad infantil tras una semana de infección


INTRODUCTION: Given the possible coexistence of infection by the SARS-CoV-2 with other seasonal infections, the aim is to identify differential symptoms. I know has studied the role of children in intrafamily contagion and the sensitivity of reverse transcriptase polymerase chain reaction (RT-PCR) in an area with low community transmission. MATERIAL AND METHODS: Cross-sectional observational study. Patients between 0-15 years studied by RT-PCR technique due to clinical suspicion of infection by SARS-CoV-2 virus in the months of March-May 2020. Survey on symptoms and contacts. Determination of Anti-SARS-CoV-2 antibodies at least 21 days after the RT-PCR test. RESULTS: 126 patients were included, 33 with confirmed infection and age mean 8.4 years (95% CI 6.8-10,5) higher than not infected. Fever was the most common and with greater sensitivity. The differences found were a greater frequency of anosmia (P = 0.029) and headache (P = .009) among children infected with a specificity of 96.7% and 81.5% respectively. There were no differences in the duration of the symptoms. 81.8% of those infected were probably infected in the nucleus 85.2% by a parent who worked outside the home. The sensitivity of RT-PCR was 70.9% and its negative predictive value 91.1%. CONCLUSIONS: The clinical picture is nonspecific and the symptoms more specific difficult to detect in younger children. Children had a reduced role in the intrafamily transmission. The sensitivity of RT-PCR could be related to a less contagiousness in children after one week of infection


Asunto(s)
Humanos , Masculino , Femenino , Recién Nacido , Lactante , Preescolar , Trazado de Contacto/métodos , Trazado de Contacto/estadística & datos numéricos , Infecciones por Coronavirus/transmisión , Neumonía Viral/transmisión , Infecciones por Coronavirus/diagnóstico , Neumonía Viral/diagnóstico , Pandemias , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Sensibilidad y Especificidad , Diagnóstico Diferencial , Estudios Transversales
12.
PLoS One ; 15(10): e0241170, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33112895

RESUMEN

Estimating the percentages of undiagnosed and asymptomatic patients is essential for controlling the outbreak of SARS-CoV-2, and for assessing any strategy for controlling the disease. In this paper, we propose a novel analysis based on the birth-death process with recursive full tracing. We estimated the numbers of undiagnosed symptomatic patients and the lower bound of the number of total infected individuals per diagnosed patient before and after the declaration of the state of emergency in Hokkaido, Japan. The median of the estimated number of undiagnosed symptomatic patients per diagnosed patient decreased from 1.7 to 0.77 after the declaration, and the median of the estimated lower bound of the number of total infected individuals per diagnosed patient decreased from 4.2 to 2.4. We will discuss the limitations and possible expansions of the model.


Asunto(s)
Infecciones Asintomáticas/epidemiología , Betacoronavirus , Trazado de Contacto/estadística & datos numéricos , Infecciones por Coronavirus/epidemiología , Pandemias , Neumonía Viral/epidemiología , Técnicas de Laboratorio Clínico , Análisis por Conglomerados , Simulación por Computador , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/transmisión , Conjuntos de Datos como Asunto , Humanos , Islas , Japón/epidemiología , Modelos Teóricos , Neumonía Viral/diagnóstico , Neumonía Viral/transmisión , Cuarentena , Procesos Estocásticos
13.
Nat Hum Behav ; 4(10): 1080-1090, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-33024280

RESUMEN

Starting in mid-May 2020, many US states began relaxing social-distancing measures that were put in place to mitigate the spread of COVID-19. To evaluate the impact of relaxation of restrictions on COVID-19 dynamics and control, we developed a transmission dynamic model and calibrated it to US state-level COVID-19 cases and deaths. We used this model to evaluate the impact of social distancing, testing and contact tracing on the COVID-19 epidemic in each state. As of 22 July 2020, we found that only three states were on track to curtail their epidemic curve. Thirty-nine states and the District of Columbia may have to double their testing and/or tracing rates and/or rolling back reopening by 25%, while eight states require an even greater measure of combined testing, tracing and distancing. Increased testing and contact-tracing capacity is paramount for mitigating the recent large-scale increases in US cases and deaths.


Asunto(s)
Trazado de Contacto/estadística & datos numéricos , Infecciones por Coronavirus/prevención & control , Control de Infecciones/estadística & datos numéricos , Modelos Teóricos , Pandemias/prevención & control , Pandemias/estadística & datos numéricos , Neumonía Viral/prevención & control , Aislamiento Social , Humanos , Estados Unidos
14.
Ann Biol Clin (Paris) ; 78(5): 499-518, 2020 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-33026346

RESUMEN

The French society of clinical biology "Biochemical markers of COVID-19" has set up a working group with the primary aim of reviewing, analyzing and monitoring the evolution of biological prescriptions according to the patient's care path and to look for markers of progression and severity of the disease. This study covers all public and private sectors of medical biology located in metropolitan and overseas France and also extends to the French-speaking world. This article presents the testimonies and data obtained for the "Overseas and French-speaking countries" sub-working group made up of 45 volunteer correspondents, located in 20 regions of the world. In view of the delayed spread of the SARS-CoV-2 virus, the overseas regions and the French-speaking regions have benefited from feedback from the first territories confronted with COVID-19. Thus, the entry of the virus or its spread in epidemic form could be avoided, thanks to the rapid closure of borders. The overseas territories depend very strongly on air and/or sea links with the metropolis or with the neighboring continent. The isolation of these countries is responsible for reagent supply difficulties and has necessitated emergency orders and the establishment of stocks lasting several months, in order to avoid shortages and maintain adequate patient care. In addition, in countries located in tropical or intertropical zones, the diagnosis of COVID-19 is complicated by the presence of various zoonoses (dengue, Zika, malaria, leptospirosis, etc.).


Asunto(s)
Servicios de Laboratorio Clínico , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/terapia , Salud Global/estadística & datos numéricos , Neumonía Viral/diagnóstico , Neumonía Viral/epidemiología , Neumonía Viral/terapia , Medicina del Viajero/organización & administración , Adulto , África/epidemiología , Anciano , Anciano de 80 o más Años , Bélgica/epidemiología , Betacoronavirus/fisiología , Biomarcadores/análisis , Biomarcadores/sangre , Cambodia/epidemiología , Niño , Servicios de Laboratorio Clínico/organización & administración , Servicios de Laboratorio Clínico/estadística & datos numéricos , Trazado de Contacto/métodos , Trazado de Contacto/estadística & datos numéricos , Infecciones por Coronavirus/transmisión , Diagnóstico Diferencial , Femenino , Francia/epidemiología , Hospitalización/estadística & datos numéricos , Humanos , Recién Nacido , Islas/epidemiología , Lenguaje , Laos/epidemiología , Louisiana/epidemiología , Masculino , Personal de Laboratorio Clínico/organización & administración , Personal de Laboratorio Clínico/estadística & datos numéricos , Persona de Mediana Edad , Pandemias , Neumonía Viral/transmisión , Estudios Retrospectivos , Encuestas y Cuestionarios , Análisis de Supervivencia , Medicina del Viajero/métodos , Medicina del Viajero/estadística & datos numéricos , Enfermedad Relacionada con los Viajes , Clima Tropical , Medicina Tropical/métodos , Medicina Tropical/organización & administración , Medicina Tropical/estadística & datos numéricos , Vietnam/epidemiología
15.
PLoS One ; 15(10): e0239750, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33002013

RESUMEN

BACKGROUND: Swingers, heterosexuals who, as couples, practice mate swapping or group sex with other couples or heterosexual singles, are at risk for sexually transmitted infections (STIs). Therefore, the aim of this study was to assess changes in sexual behaviour and STI testing behaviour, as well as predictors of STI testing. METHODS: Two cross-sectional studies were performed, using the same internet survey in 2011 and 2018. For trend analysis, sexual behaviour and STI testing behaviour were used. Socio-demographics, swinger characteristics, sexual behaviour, and psycho-social variables were used to assess predictors of STI testing in the past year, using multivariable regression analysis. RESULTS: A total of 1173 participants completed the survey in 2011, and 1005 in 2018. Condom use decreased for vaginal (73% vs. 60%), oral (5% vs. 2%), and anal sex (85% vs. 75%). STI positivity was reported in 23% and 30% of the participants, respectively, although testing for STI was comparable between both years (~65%). The following predictors of STI testing were significant: being female (OR = 1.9, 95%CI: 1.2-2.9), having a high swinging frequency (>12 times a year, OR = 3.7, 95%CI: 1.9-7.3), swinging at home (OR = 1.6, 95%CI: 1.0-2.7), receiving a partner notification (OR = 1.7, 95%CI: 1.2-2.6), considering STI testing important (OR = 4.3, 95%CI: 2.2-8.5), experiencing no pressure from a partner to test (OR = 0.6, 95%CI: 0.3-0.9), partners test for STI regularly (OR = 10.0, 95%CI: 6.2-15.9), perceiving STI testing as an obligation (OR = 2.1, 95%CI: 1.3-3.5), experiencing no barriers such as being afraid of testing (OR = 1.9, 95%CI: 1.2-3.1), limited opening hours (OR = 1.6, 95%CI: 1.0-2.4), and forgetting to plan appointments (OR = 3.0, 95%CI: 2.0-4.6). CONCLUSIONS: Swingers exhibit self-selection for STI testing based on their sexual behaviour. However, STI prevention efforts are still important considering the increasing numbers of reported STIs, the decreased use of condom use, and the one-third of swingers who were not tested in the previous year.


Asunto(s)
Conducta Sexual/estadística & datos numéricos , Enfermedades de Transmisión Sexual/diagnóstico , Adolescente , Adulto , Trazado de Contacto/estadística & datos numéricos , Estudios Transversales , Escolaridad , Relaciones Extramatrimoniales/psicología , Femenino , Heterosexualidad/psicología , Heterosexualidad/estadística & datos numéricos , Humanos , Internet , Masculino , Persona de Mediana Edad , Países Bajos/epidemiología , Conducta Sexual/psicología , Minorías Sexuales y de Género/psicología , Minorías Sexuales y de Género/estadística & datos numéricos , Enfermedades de Transmisión Sexual/etiología , Enfermedades de Transmisión Sexual/prevención & control , Encuestas y Cuestionarios , Adulto Joven
16.
MMWR Morb Mortal Wkly Rep ; 69(38): 1360-1363, 2020 Sep 25.
Artículo en Inglés | MEDLINE | ID: mdl-32970654

RESUMEN

Contact tracing is a strategy implemented to minimize the spread of communicable diseases (1,2). Prompt contact tracing, testing, and self-quarantine can reduce the transmission of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19) (3,4). Community engagement is important to encourage participation in and cooperation with SARS-CoV-2 contact tracing (5). Substantial investments have been made to scale up contact tracing for COVID-19 in the United States. During June 1-July 12, 2020, the incidence of COVID-19 cases in North Carolina increased 183%, from seven to 19 per 100,000 persons per day* (6). To assess local COVID-19 contact tracing implementation, data from two counties in North Carolina were analyzed during a period of high incidence. Health department staff members investigated 5,514 (77%) persons with COVID-19 in Mecklenburg County and 584 (99%) in Randolph Counties. No contacts were reported for 48% of cases in Mecklenburg and for 35% in Randolph. Among contacts provided, 25% in Mecklenburg and 48% in Randolph could not be reached by telephone and were classified as nonresponsive after at least one attempt on 3 consecutive days of failed attempts. The median interval from specimen collection from the index patient to notification of identified contacts was 6 days in both counties. Despite aggressive efforts by health department staff members to perform case investigations and contact tracing, many persons with COVID-19 did not report contacts, and many contacts were not reached. These findings indicate that improved timeliness of contact tracing, community engagement, and increased use of community-wide mitigation are needed to interrupt SARS-CoV-2 transmission.


Asunto(s)
Trazado de Contacto/estadística & datos numéricos , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Pandemias/prevención & control , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Humanos , Incidencia , North Carolina/epidemiología
17.
Math Biosci Eng ; 17(4): 3052-3061, 2020 04 08.
Artículo en Inglés | MEDLINE | ID: mdl-32987516

RESUMEN

The novel coronavirus disease 2019 (COVID-19) infection broke out in December 2019 in Wuhan, and rapidly overspread 31 provinces in mainland China on 31 January 2020. In the face of the increasing number of daily confirmed infected cases, it has become a common concern and worthy of pondering when the infection will appear the turning points, what is the final size and when the infection would be ultimately controlled. Based on the current control measures, we proposed a dynamical transmission model with contact trace and quarantine and predicted the peak time and final size for daily confirmed infected cases by employing Markov Chain Monte Carlo algorithm. We estimate the basic reproductive number of COVID-19 is 5.78 (95%CI: 5.71-5.89). Under the current intervention before 31 January, the number of daily confirmed infected cases is expected to peak on around 11 February 2020 with the size of 4066 (95%CI: 3898-4472). The infection of COVID-19 might be controlled approximately after 18 May 2020. Reducing contact and increasing trace about the risk population are likely to be the present effective measures.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Modelos Biológicos , Pandemias/estadística & datos numéricos , Neumonía Viral/epidemiología , Algoritmos , Número Básico de Reproducción/estadística & datos numéricos , China/epidemiología , Simulación por Computador , Trazado de Contacto/estadística & datos numéricos , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/transmisión , Epidemias/prevención & control , Epidemias/estadística & datos numéricos , Mapeo Geográfico , Humanos , Cadenas de Markov , Conceptos Matemáticos , Método de Montecarlo , Pandemias/prevención & control , Neumonía Viral/prevención & control , Neumonía Viral/transmisión , Cuarentena/estadística & datos numéricos
18.
Emerg Infect Dis ; 26(11): 2617-2624, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-32946369

RESUMEN

To assess the role of in-flight transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), we investigated a cluster of cases among passengers on a 10-hour commercial flight. Affected persons were passengers, crew, and their close contacts. We traced 217 passengers and crew to their final destinations and interviewed, tested, and quarantined them. Among the 16 persons in whom SARS-CoV-2 infection was detected, 12 (75%) were passengers seated in business class along with the only symptomatic person (attack rate 62%). Seating proximity was strongly associated with increased infection risk (risk ratio 7.3, 95% CI 1.2-46.2). We found no strong evidence supporting alternative transmission scenarios. In-flight transmission that probably originated from 1 symptomatic passenger caused a large cluster of cases during a long flight. Guidelines for preventing SARS-CoV-2 infection among air passengers should consider individual passengers' risk for infection, the number of passengers traveling, and flight duration.


Asunto(s)
Viaje en Avión , Betacoronavirus , Infecciones por Coronavirus/transmisión , Transmisión de Enfermedad Infecciosa/estadística & datos numéricos , Neumonía Viral/transmisión , Cuarentena/estadística & datos numéricos , Adulto , Anciano , Aeronaves , Análisis por Conglomerados , Trazado de Contacto/estadística & datos numéricos , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Transmisión de Enfermedad Infecciosa/prevención & control , Femenino , Humanos , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Pandemias/prevención & control , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control
19.
BMC Med Res Methodol ; 20(1): 233, 2020 09 17.
Artículo en Inglés | MEDLINE | ID: mdl-32942988

RESUMEN

BACKGROUND: Contact tracing data of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic is used to estimate basic epidemiological parameters. Contact tracing data could also be potentially used for assessing the heterogeneity of transmission at the individual patient level. Characterization of individuals based on different levels of infectiousness could better inform the contact tracing interventions at field levels. METHODS: Standard social network analysis methods used for exploring infectious disease transmission dynamics was employed to analyze contact tracing data of 1959 diagnosed SARS-CoV-2 patients from a large state of India. Relational network data set with diagnosed patients as "nodes" and their epidemiological contact as "edges" was created. Directed network perspective was utilized in which directionality of infection emanated from a "source patient" towards a "target patient". Network measures of " degree centrality" and "betweenness centrality" were calculated to identify influential patients in the transmission of infection. Components analysis was conducted to identify patients connected as sub- groups. Descriptive statistics was used to summarise network measures and percentile ranks were used to categorize influencers. RESULTS: Out-degree centrality measures identified that of the total 1959 patients, 11.27% (221) patients have acted as a source of infection to 40.19% (787) other patients. Among these source patients, 0.65% (12) patients had a higher out-degree centrality (> = 10) and have collectively infected 37.61% (296 of 787), secondary patients. Betweenness centrality measures highlighted that 7.50% (93) patients had a non-zero betweenness (range 0.5 to 135) and thus have bridged the transmission between other patients. Network component analysis identified nineteen connected components comprising of influential patient's which have overall accounted for 26.95% of total patients (1959) and 68.74% of epidemiological contacts in the network. CONCLUSIONS: Social network analysis method for SARS-CoV-2 contact tracing data would be of use in measuring individual patient level variations in disease transmission. The network metrics identified individual patients and patient components who have disproportionately contributed to transmission. The network measures and graphical tools could complement the existing contact tracing indicators and could help improve the contact tracing activities.


Asunto(s)
Betacoronavirus/aislamiento & purificación , Trazado de Contacto/estadística & datos numéricos , Infecciones por Coronavirus/epidemiología , Pandemias , Neumonía Viral/epidemiología , Red Social , Adulto , Betacoronavirus/fisiología , Trazado de Contacto/métodos , Infecciones por Coronavirus/transmisión , Infecciones por Coronavirus/virología , Femenino , Humanos , India/epidemiología , Masculino , Modelos Teóricos , Neumonía Viral/transmisión , Neumonía Viral/virología , Adulto Joven
20.
NASN Sch Nurse ; 35(6): 327-331, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-32806994

RESUMEN

School nurses across Massachusetts and the nation rose to the challenges presented by the pandemic of the coronavirus disease 2019 (COVID-19). One of the many ways in which school nurses responded to the pandemic was to work in collaboration with their Local Boards of Health in a variety of capacities. The essential functions of a school nurse uniquely prepare them for the roles of case investigators and contact tracing monitors as a means to ensure population health. In addition to both individual and population health within the school setting, school nurses are effective partner in emergency planning and can help inform decision making and policy making within communities.


Asunto(s)
Trazado de Contacto/estadística & datos numéricos , Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Enfermería en Salud Pública/organización & administración , Betacoronavirus , Humanos , Massachusetts , Pandemias , Salud Pública , Servicios de Enfermería Escolar/normas
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