Green Institute

Would everyone wearing face masks help us slow the pandemic?

Science

Servick, Kelly.

Introduction

As cases of coronavirus disease 2019 (COVID-19) ballooned last month, people in Europe and North America scrambled to get their hands on surgical masks to protect themselves. Health officials jumped in to discourage them, worried about the limited supply of masks for health care personnel. “Seriously people-STOP BUYING MASKS!” began a 29 February tweet from U.S. Surgeon General Jerome Adams. The World Health Organization and U.S. Centers for Disease Control and Prevention (CDC) have both said that only people with COVID-19 symptoms and those caring for them should wear masks. But some health experts, including the director of the Chinese Center for Disease Control and Prevention, think that’s a mistake. Health authorities in parts of Asia have encouraged all citizens to wear masks in public to prevent the spread of the virus, regardless of whether they have symptoms. And the Czech Republic took the uncommon step last week of making nose and mouth coverings mandatory in public spaces, prompting a grassroots drive to hand-make masks.

Keywords

COVID-19, SARS-CoV-2, Treatment

Spotlight on Jails: COVID-19 Mitigation Policies Needed Now

Clinical Infectious Diseases

Wurcel, Alysse G.; Dauria, Emily; Zaller, Nicholas; Nijhawan, Ank; Beckwith, Curt; Nowotny, Kathryn; Brinkley-Rubinstein, Lauren 

Dear Editor,

In response to the COVID-19 pandemic, healthcare institutions and public health experts are mobilizing to develop mitigation protocols based on the experiences of other countries, including China, South Korea, and Italy. Compared to these countries, the US has a higher incarceration rate, with 10.6 million people booked into jails each year.2 Jails pose a unique set of challenges to COVID-19 prevention, detection, and management mitigation that deserves immediate attention.

In Other Covid-19 News

The Veterinary Record
Volume 186, Issue 12, Pages 370-370

Introduction

Vet practices are putting aside human-compatible ventilators, oxygen supplies and personal protective equipment such as surgical masks, as well as anaesthetic machines and monitors, for use in saving human lives. The scheme has been promoted by the RCVS, the BVA and several other veterinary associations and businesses.

Keywords

Epidemiology

Papa Giovanni XXIII Bergamo Hospital At The Time Of The COVID-19 Outbreak: Letter From The Warfront

International journal of laboratory hematology

Buoro, Sabrina; Di Marco, Fabiano; Rizzi, Marco; Fabretti, Fabrizio; Lorini, Ferdinando Luca; Cesa, Simonetta; Fagiuoli, Stefano

Abstract

In early December 2019, the 2019 novel coronavirus (COVID-19) was identified as the agent responsible for the first pneumonia cases of unknown origin in Wuhan, the capital of the Hubei region in China. The virus has been identified as a novel enveloped RNA betacoronavirus2 , that has been promptly named SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2). The World Health Organization (WHO), on January 12, 2020 declared the COVID-19 a public health emergency of international concern. On March 11, the WHO made the assessment that COVID-19 can be characterized as a pandemic.

Keywords

Clinical aspects, diagnosis, treatment; Epidemiology

Clinical Analysis Of Pregnant Women With 2019 Novel Coronavirus Pneumonia

Journal of Medical Virology

Chen, Siyu; Liao, E.; Shao, Yong

Abstract

The aim is to evaluate pregnant women infected with coronavirus disease 2019 (COVID‐19) and provide help for clinical prevention and treatment. All five cases of pregnant women confirmed COVID‐19 were collected among patients who admitted to the Maternal and Child Hospital of Hubei Province between January 20 and February 10, 2020. All patients, aging from 25 to 31 years old, had the gestational week from 38th weeks to 41st weeks. All pregnant women did not have an antepartum fever but developed a low‐grade fever (37.5℃‐38.5℃) within 24 hours after delivery. All patients had normal liver and renal function, two patients had elevated plasma levels of the myocardial enzyme. Unusual chest imaging manifestations, featured with ground‐grass opacity, were frequently observed in bilateral (three cases) or unilateral lobe (two cases) by computed tomography (CT) scan. All labors smoothly processed, the Apgar scores were 10 points 1 and 5 minutes after delivery, no complications were observed in the newborn. Pregnancy and perinatal outcomes of patients with COVID‐19 should receive more attention. It is probable that pregnant women diagnosed with COVID‐19 have no fever before delivery. Their primary initial manifestations were merely low‐grade postpartum fever or mild respiratory symptoms. Therefore, the protective measures are necessary on admission; the instant CT scan and real‐time reverse‐transcriptase polymerase‐chain‐reaction assay should be helpful in early diagnosis and avoid cross‐infection on the occasion that patients have fever and other respiratory signs.

Keywords

Clinical aspects, diagnosis, treatment; Epidemiology

Therapeutic opportunities to manage COVID-19/SARS-CoV-2 infection: Present and future

Indian Journal Of Ophthalmology

Shetty, Rohit; Ghosh, Arkasubhra; Honavar, Santosh G.; Khamar, Pooja; Sethu, Swaminathan.

Abstract

A severe form of respiratory disease - COVID-19, caused by SARS-CoV-2 infection, has evolved into a pandemic resulting in significant morbidity and mortality. The unabated spread of the disease is due to lack of vaccine and effective therapeutic agents against this novel virus. Hence, the situation demands an immediate need to explore all the plausible therapeutic and prophylactic strategies that can be made available to stem the spread of the disease. Towards this effort, the current review outlines the key aspects of the pathobiology associated with the morbidity and mortality in COVID-19 patients, which includes a viral response phase and an exaggerated host response phase. The review also summarizes therapeutic agents that are currently being explored along with those with potential for consideration. The broad groups of therapeutic agents discussed include those that: (i) block viral entry to host cells, (ii) block viral replication and survival in host cells, and (iii) dampen exaggerated host immune response. The various kinds of pharmaceutical prophylactic options that may be followed to prevent COVID-19 have also been discussed.

Keywords

COVID‑19, prophylaxis, SARS‑CoV‑2, therapy

A Strange New World

New Scientist
Volume 245, Issue 3275, 28 March 2020, Page 5

Introduction

The new coronavirus may be upending our lives, but we aren't helpless against it.

HARD times lie ahead. Not only do we all have to contend with the threat of covid-19 itself, and its economic fallout, but as nations lock down movement outside our homes, there are extra mental pressures to cope with too. Fortunately, there are constructive things we can do.

Keywords

Epidemiology

Possible Method for the Production of a Covid-19 Vaccine

The Veterinary Record
Volume 186, Issue 12, Pages 388-388

Myint, Aung; Jones, Trevor

Introduction

OVER a number of years we worked on genetically transformed Pasteurella multocida vaccines, experimenting on whether they could provide protection against a variety of animal and avian virus diseases. We think the methodology has potential for a Covid19 vaccine.

Keywords

Clinical aspects, diagnosis, treatment

Sourcing Personal Protective Equipment During the COVID-19 Pandemic

JAMA

Livingston, Edward; Desai, Angel; Berkwits, Michael

Introduction

As the coronavirus disease 2019 (COVID-19) pandemic accelerates, global health care systems have become overwhelmed with potentially infectious patients seeking testing and care. Preventing spread of infection to and from health care workers (HCWs) and patients relies on effective use of personal protective equipment (PPE)—gloves, face masks, air-purifying respirators, goggles, face shields, respirators, and gowns. A critical shortage of all of these is projected to develop or has already developed in areas of high demand. PPE, formerly ubiquitous and disposable in the hospital environment, is now a scarce and precious commodity in many locations when it is needed most to care for highly infectious patients. An increase in PPE supply in response to this new demand will require a large increase in PPE manufacturing, a process that will take time many health care systems do not have, given the rapid increase in ill COVID-19 patients.

Keywords

Clinical aspects, diagnosis, treatment

Spinal Anaesthesia For Patients With Coronavirus Disease 2019 And Possible Transmission Rates In Anaesthetists: Retrospective, Single-Centre, Observational Cohort Study

British Journal of Anaesthesia

Zhong, Qi; Liu, Yin Y.; Luo, Qiong; Zou, Yu F.; Jiang, Hai X.; Li, Hui; Zhang, Jing J.; Li, Zhen; Yang, Xin; Ma, Min; Tang, Li J.; Chen, Ying Y.; Zheng, Feng; Ke, Jian J.; Zhang, Zong Z.

 

Abstract

Background: The safety of performing spinal anaesthesia for both patients and anaesthetists alike in the presence of active infection with the novel coronavirus disease 2019 (COVID-19) is unclear. Here, we report the clinical characteristics and outcomes for both patients with COVID-19 and the anaesthetists who provided their spinal anaesthesia.

Methods: Forty-nine patients with radiologically confirmed COVID-19 for Caesarean section or lower-limb surgery undergoing spinal anaesthesia in Zhongnan Hospital, Wuhan, China participated in this retrospective study. Clinical characteristics and perioperative outcomes were recorded. For anaesthesiologists exposed to patients with COVID-19 by providing spinal anaesthesia, the level of personal protective equipment (PPE) used, clinical outcomes (pulmonary CT scans), and confirmed COVID-19 transmission rates (polymerase chain reaction [PCR]) were reviewed.

Results: Forty-nine patients with COVID-19 requiring supplementary oxygen before surgery had spinal anaesthesia (ropivacaine 0.75%), chiefly for Caesarean section (45/49 [91%]). Spinal anaesthesia was not associated with cardiorespiratory compromise intraoperatively. No patients subsequently developed severe pneumonia. Of 44 anaesthetists, 37 (84.1%) provided spinal anaesthesia using Level 3 PPE. Coronavirus disease 2019 infection was subsequently confirmed by PCR in 5/44 (11.4%) anaesthetists. One (2.7%) of 37 anaesthetists who wore Level 3 PPE developed PCR-confirmed COVID-19 compared with 4/7 (57.1%) anaesthetists who had Level 1 protection in the operating theatre (relative risk reduction: 95.3% [95% confidence intervals: 63.7–99.4]; P<0.01).

Conclusions: Spinal anaesthesia was delivered safely in patients with active COVID-19 infection, the majority of whom had Caesarean sections. Level 3 PPE appears to reduce the risk of transmission to anaesthetists who are exposed to mildly symptomatic surgical patients.

Keywords

Epidemiology

Reply to “Does hand hygiene reduce SARS-CoV-2 transmission?”

Graefe's Archive for Clinical and Experimental Ophthalmology

Lai, Tracy H. T.; Tang, Emily W. H.; Fung, Kitty S. C.; Li, Kenneth K. W.

Dear Editor,

We would like to thank Dr. Chao Yang’s comments to our article. We would like to emphasize that both face masking and hand hygiene are important in preventing the transmission of coronavirus disease 2019 (COVID-19) and are not mutually exclusive. According to the report of the WHO-China joint mission on COVID-19, COVID-19 is transmitted via droplets and fomites during close unprotected contact between an infector and infectee. Airborne spread has not been reported for COVID-19, and it is not believed to be a major driver based on currently available evidence. A recent study by Ong et al. obtained air and surface environmental samples from isolation wards of COVID-19 patients and found the air samples to be negative of SARS-CoV-2, but positive samples were found on multiple environmental surfaces. These sites included the table, bed rail, locker, chair, light switches, door, window, and surfaces in the toilet including the toilet bowl, sink, and door handle. Stool samples were also positive for SARS-CoV-2. Otter and his colleagues found that SARS-CoV and other coronaviruses can survive on environmental surfaces up to 6 days. Furthermore, it is not uncommon that healthcare workers, including ophthalmologists, may overlook the importance of hand hygiene, as frequent face touching is notoriously common that even medical students touched their faces 23 times per hour and 44% of those touches involved contact with mucous membranes.

Keywords

Infection prevention and control

The Role of Emergency Radiology in COVID-19: From Preparedness to Diagnosis

Canadian Association of Radiologists Journal

Nasir, Muhammad Umer; Roberts, James; Muller, Nestor L.; Macri, Francesco; Mohammed, Mohammed F.; Akhlaghpoor, Shahram; Parker, William; Eftekhari, Arash; Rezaei, Susan; Mayo, John; Nicolaou, Savvas.

Abstract

Emergency trauma radiology, although a relatively new subspecialty of radiology, plays a critical role in both the diagnosis/triage of acutely ill patients, but even more important in providing leadership and taking the lead in the preparedness of imaging departments in dealing with novel highly infectious communicable diseases and mass casualties. This has become even more apparent in dealing with COVID-19, the disease caused by the novel coronavirus SARS-CoV-2, first emerged in late 2019. We review the symptoms, epidemiology, and testing for this disease. We discuss characteristic imaging findings of COVID-19 in relation to other modern coronavirus diseases including SARS and MERS. We discuss roles that community radiology clinics, outpatient radiology departments, and emergency radiology departments can play in the diagnosis of this disease. We review practical methods to reduce spread of infections within radiology departments.

Keywords

COVID-19, emergency and trauma radiology, MERS, SARS, CT, preparedness

Prevalence And Impact Of Diabetes Among People Infected With SARS-Cov-2

Journal of Endocrinological Investigation

Fadini, G. P.; Morieri, M. L.; Longato, E.; Avogaro, A.

To the Editor,

In December 2019, a new coronavirus causing severe acute respiratory syndrome (SARS-CoV-2) emerged in Wuhan, China. The virus spread rapidly to more than 150 countries and, by the time we are writing (March 19th 2020), it affected > 230,000 individuals causing almost 10,000 deaths.
…

Keywords

Clinical aspects, diagnosis, treatment

Biological Treatment During COVID-19 Outbreak

Journal of Dermatological Treatment

Sriwijitalai, Won; Wiwanitkit, Viroj

Dear Editor,

We read the publication on ‘Should patients stop their biologic treatment during the COVID-19 pandemic’ and found that it is very interesting. Bashyam and Feldman raised an interesting issue for discussion regarding using biological treatment during COVID-19 outbreak. In fact, although there are infected patients worldwide, there has never any reports on biological treatment associated COVID-19. Whether, there is any problem relating to corticosteroid and TNF-α inhibitors in coronavirus infection is an interesting question. In a previous animal model study on coronavirus infection, TNF-α inhibitors did not deteriorate the disease course. Atanasova et al. found that blocking of TNF-α alone was not sufficient to ameliorate the disease. The immunopathology of the new disease is still largely unknown. It might be too early to conclude whether biological treatment should be ceased during COVID-19 outbreak.

Keywords

Clinical aspects, diagnosis, treatment; Epidemiology

COVID-19 Is A Disease Of Older People

The Journals of Gerontology: Series A

Le Couteur, David G.; Anderson, Rozalyn M.; Newman, Anne B.

Introduction

The case-fatality rate for COVID-19 increases dramatically with age from 3% to 5% between 65 and 74 years, 4% to 11% between 75 and 84 years, and 10% to 27% above 85 years and people aged 65 years and older account for 45% of hospitalizations, 53% of intensive care unit (ICU) admissions, and 80% of deaths (1). The first infections with the coronavirus, SARS-CoV-2, were recognized in December 2019 in Wuhan, China and since then, over 80,000 people in China contracted COVID-19, with more than 3,000 deaths (2). The United States has seen an exponential increase in the number of cases with the vast majority of deaths also occurring in people aged 65 years or older. Older people in residential aged care facilities and nursing homes have even greater risk of death given their age and comorbidities, confounded by the lack of capacity for social distancing from staff and other residents.

Keywords

Epidemiology

COVID-19 Outbreak And Inflammatory Bowel Disease Management: A Questionnaire Survey From Realistic Practice

Journal of Crohn's & Colitis

Bai, Xiaoyin; Yang, Hong; Qian, Jiaming

Introduction

Coronavirus disease 2019 [COVID-19] has swept Wuhan and other cities in China since January 2020.1 Despite the preliminary victory of containing the infection following 2 months of effort in China, the pandemic has posed a challenge regarding the routine clinical attention to patients with chronic disease. Inflammatory bowel disease [IBD] is a chronic disease which requires elaborate management. Due to the relative low incidence and prevalence of IBD,2 the limited number of specialists, and the individualised therapeutic approaches in our country, treatment recommendations still depend on the collaborative effort of experts in the high-volume hospitals. Nevertheless, given the severity of COVID-19, patients are adviseded to follow local primary physicians, which may result in unmet medical needs. In addition, most patients with IBD require glucocorticoids, immunomodulators, or biologic agents for a long time, which increases the likelihood of experiencing side effects and compromises the treatment outcome..

Keywords

Clinical aspects, diagnosis, treatment

Antibody Responses To SARS-CoV-2 In Patients Of Novel Coronavirus Disease 2019

Clinical Infectious Diseases

Zhao, Juanjuan; Yuan, Quan; Wang, Haiyan; Liu, Wei; Liao, Xuejiao; Su, Yingying; Wang, Xin; Yuan, Jing; Li, Tingdong; Li, Jinxiu; Qian, Shen; Hong, Congming; Wang, Fuxiang; Liu, Yingxia; Wang, Zhaoqin; He, Qing; Li, Zhiyong; He, Bin; Zhang, Tianying; Fu, Yang; Ge, Shengxiang; Liu, Lei; Zhang, Jun; Xia, Ningshao; Zhang, Zheng.

Abstract

Background

The novel coronavirus SARS-CoV-2 is a newly emerging virus. The antibody response in infected patient remains largely unknown, and the clinical values of antibody testing have not been fully demonstrated.

Methods

A total of 173 patients with SARS-CoV-2 infection were enrolled. Their serial plasma samples (n=535) collected during the hospitalization were tested for total antibodies (Ab), IgM and IgG against SARS-CoV-2. The dynamics of antibodies with the disease progress was analyzed.

Results

Among 173 patients, the seroconversion rate for Ab, IgM and IgG was 93.1%, 82.7% and 64.7%, respectively. The reason for the negative antibody findings in 12 patients might due to the lack of blood samples at the later stage of illness. The median seroconversion time for Ab, IgM and then IgG were day-11, day-12 and day-14, separately. The presence of antibodies was <40% among patients within 1-week since onset, and rapidly increased to 100.0% (Ab), 94.3% (IgM) and 79.8% (IgG) since day-15 after onset. In contrast, RNA detectability decreased from 66.7% (58/87) in samples collected before day-7 to 45.5% (25/55) during day 15-39. Combining RNA and antibody detections significantly improved the sensitivity of pathogenic diagnosis for COVID-19 (p<0.001), even in early phase of 1-week since onset (p=0.007). Moreover, a higher titer of Ab was independently associated with a worse clinical classification (p=0.006).

Conclusions

The antibody detection offers vital clinical information during the course of SARS-CoV-2 infection. The findings provide strong empirical support for the routine application of serological testing in the diagnosis and management of COVID-19 patients.

Keywords

Epidemiology, antibody, SARS-CoV-2, COVID-19.

Base Protocol For Real Time Active Random Surveillance Of Coronavirus Disease (COVID-19) – Adapting Veterinary Methodology To Public Health

One Health

Foddai, Alessandro; Lubroth, Juan; Ellis-Iversen, Johanne

Abstract

The pandemic of new coronavirus disease COVID-19 is threatening our health, economy and life style. Collaborations across countries and sectors as a One Health World could be a milestone.

We propose a general protocol, for setting timely active random surveillance of COVID-19, at the human community level, with systematic repeated detection efforts. Strengths and limitations are discussed.

If considered applicable by public health, the protocol could evaluate the status of COVID-19 epidemics consistently and objectively.

Keywords

Keywords

Pandemic, New coronavirus, COVID-19, Active random surveillance

Syndromic Panels or the Panels' Syndrome? A Perspective Through the Lens of Respiratory Tract Infections

Clinical Microbiology and Infection

Zanella, Marie-Céline; Meylan, Pascal; Kaiser, Laurent 

To the Editor,

We thank Brendish et al for their interest in our commentary and they rightly point out that it was not a systematic review. Our main intention was to provide food for thought and discussion regarding the use of panel assays in the light of some relevant publications. In particular, we aimed at discussing the limitations of their analytical aspects and clinical validation. We respectfully disagree with the statement that “The authors suggest that the increasing use of rapid, automated, syndromic molecular panels for respiratory viruses (RVs) should be abandoned in favor of more limited PCR testing for RVs”. As microbiologists and clinicians, we rather suggest that we have the responsibility to promote diagnostic stewardship in order to integrate these new technologies in clinical management, while considering their strengths and limitations. We also highlight the value of a multiple-step approach of testing that does not necessarily preclude their use.

Keywords

Epidemiology