A COVID-19 superspreading event involving two variants during sociotherapy activities in a French mental health centre.

BACKGROUND/PURPOSE: Investigation of a COVID-19 super-spreading event involving both beta and delta variants of SARS-CoV-2, following a choir in a mental health centre. METHODS: An epidemiological and biological (RT-PCR, mutations screening and sequencing) investigation was carried out to identify the chains of transmission. A morbidity and mortality review was performed using ALARM root causes analysis to understand how this superspreading event could have taken place. RESULTS: On May 25 and 26, 2021, all 13 choir participants were screened. Of these, eight were positive. None of them was vaccinated. Biological results suggested seven cases of delta variants (three confirmed by sequencing) and one case of beta variant. The screening of 141 contact individuals identified 21 subsequent cases with a suspected delta variant and two cases of suspected beta variant. Since the two index cases had similar Ct during the choir, this suggests different spreading abilities. The contributing factors were multiple, including underestimation of infectious risks by the social therapy team in relation to low individual and collective perceived vulnerability CONCLUSION: HCPs involved in sociotherapy must be aware of, and trained to mitigate, the risk of superspreading event. Conventional distancing and good natural ventilation appear to not be enough to prevent spread of more transmissible variants of SARS-CoV-2.

Evaluation in usual practice of the bevacizumab-FOLFIRI combination for the first-line treatment of patients with unresectable metastatic colorectal cancer treated in 2006: focus on resected patients and oncogeriatrics: AVASTIN OUEST cohort of the Observatory of Cancer of the Brittany and Pays de la Loire Areas (Observatoire dédié au Cancer Bretagne / Pays de la Loire).

BACKGROUND: In 2006, bevacizumab, a targeted therapy agent was combined with FOLFIRI for the firstline treatment of patients with unresectable metastatic colorectal cancer. METHODS/RESULTS: A study on a homogenous series of 111 patients from the Brittany and Pays de la Loire areas who received bevacizumab-FOLFIRI as first-line treatment in 2006 showed the following results: 51 responses, 29 stabilisations, 21 progressions and 10 cases of toxicity prior to assessment. Median overall survival (OS) was 25.1 months and median progression-free survival was 10.2 months. Surgery secondary to treatment tripled median OS which reached 59.2 months in resected patients versus 18.8 months in unresected patients. Comparison of patients aged more or less than 70 years showed no differences in terms of benefits or risks. CONCLUSION: Bevacizumab-FOLFIRI could be administered as part of a routine care protocol to elderly patients previously evaluated by a geriatric assessment and validated by a multidisciplinary staff.

En 2006, bevacizumab-FOLFIRI représente la thérapie ciblée administrable dès la première ligne chez les patients porteurs d'un cancer colorectal métastatique non opérable. Une série homogène de 111 patients colligés en région Bretagne et Pays de la Loire ayant reçu du bevacizumab- FOLFIRI en première ligne en 2006 révèle les résultats suivants: 51 réponses, 29 stabilités, 21 progressions et 10 toxicités avant évaluation. La médiane de survie globale (OS) est de 25,1 mois et la médiane de survie sans progression (PFS) de 10,2 mois. Dans le cas d'une chirurgie secondaire, l'OS médian triple de 18,8 mois chez les patients non réséqués versus 59,2 mois ceux réséqués. En comparant les sujets âgés de plus et de moins de 70 ans, aucune différence n'a été mise en évidence en termes de bénéfice ou de risque. Bevacizumab-FOLFIRI pourrait être administré en pratique courante chez les personnes âgées sous couvert d'une évaluation gériatrique et d'une approche multidisciplinaire.