Article

# WHO declares COVID-19 a pandemic

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## Abstract

The World Health Organization (WHO) on March 11, 2020, has declared the novel coronavirus (COVID-19) outbreak a global pandemic (1). At a news briefing , WHO Director-General, Dr. Tedros Adhanom Ghebreyesus, noted that over the past 2 weeks, the number of cases outside China increased 13-fold and the number of countries with cases increased threefold. Further increases are expected. He said that the WHO is "deeply concerned both by the alarming levels of spread and severity and by the alarming levels of inaction," and he called on countries to take action now to contain the virus. "We should double down," he said. "We should be more aggressive." [...].

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... COVID-19, a contagious disease, known as the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), was declared a pandemic by the world health organisation on 11th March 2020. 1 The Australian government introduced "social distancing" five days later and significant changes in the public health system were progressively implemented. 1 European counterparts recognised a reduction in emergency presentations between March and April 2020 ranging from 13.0% to 46.3%, compared to the previous year. 1 4 On 25th March 2020 following the National Cabinet announcement and acting on the advice of the Australian health protection principal committee, New South Wales (NSW) state public hospitals suspended all non-urgent elective surgery. 1 With scientific communities working to better understand the nature of the disease and to develop prevention protocols, the provision of acute surgery services inevitably had to continue to function including for potential life-threatening pathologies such as cancer with hospitals reorganising their infrastructure within a socially distance manner. ...
... COVID-19, a contagious disease, known as the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), was declared a pandemic by the world health organisation on 11th March 2020. 1 The Australian government introduced "social distancing" five days later and significant changes in the public health system were progressively implemented. 1 European counterparts recognised a reduction in emergency presentations between March and April 2020 ranging from 13.0% to 46.3%, compared to the previous year. 1 4 On 25th March 2020 following the National Cabinet announcement and acting on the advice of the Australian health protection principal committee, New South Wales (NSW) state public hospitals suspended all non-urgent elective surgery. 1 With scientific communities working to better understand the nature of the disease and to develop prevention protocols, the provision of acute surgery services inevitably had to continue to function including for potential life-threatening pathologies such as cancer with hospitals reorganising their infrastructure within a socially distance manner. ...
... COVID-19, a contagious disease, known as the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), was declared a pandemic by the world health organisation on 11th March 2020. 1 The Australian government introduced "social distancing" five days later and significant changes in the public health system were progressively implemented. 1 European counterparts recognised a reduction in emergency presentations between March and April 2020 ranging from 13.0% to 46.3%, compared to the previous year. 1 4 On 25th March 2020 following the National Cabinet announcement and acting on the advice of the Australian health protection principal committee, New South Wales (NSW) state public hospitals suspended all non-urgent elective surgery. 1 With scientific communities working to better understand the nature of the disease and to develop prevention protocols, the provision of acute surgery services inevitably had to continue to function including for potential life-threatening pathologies such as cancer with hospitals reorganising their infrastructure within a socially distance manner. [2][3] During the first wave of the pandemic, countries internationally reported patients were severely affected by the disease and these results directly influenced surgical outcomes. ...
Article
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Background: The impact of SARS-COV-2 virus (COVID-19) has been well documented in international settings with a reduction in overall emergency presentations both influenced by social distancing and lockdowns. This study focuses on several common acute general surgical pathologies exploring differences in presentations and clinical outcomes for appendicitis, cholecystitis, and incarcerated hernias during the first wave. Methods: A retrospective review of medical records of all patients was analysed in two groups: the non-COVID-19 group (combined 2017-2019) and the COVID-19 group (2020). Results: There were 3,316 acute emergency surgical presentations with an 8.2% decrease in total presentations in 2020. There were 477 appendicectomies, 224 cholecystectomies, and 121 repair of incarcerated hernias. All general surgical procedures demonstrated significant differences between non-COVID and COVID cohorts, including length of stay (LoS) (2.7 vs. 2.1, p=0.009) and onset of symptoms (1.6 vs. 2.2, p=0.018) for those aged less than 25 years. Patients with appendicitis aged less than 25 years had a significantly longer onset of symptoms before hospital presentation and shorter LoS in the COVID group (1.7 vs. 2.5, p=0.002; 2.9 vs. 2.3, p=0.016). Likewise, patients with cholecystitis had a significantly longer onset of symptoms in the COVID-19 cohort compared to their counterparts (2.0 vs. 3.0 days, p=0.025). There were no significant differences in biochemical, clinical or post-operative outcomes. Conclusions: The first wave of the COVID-19 pandemic significantly reduced acute general surgical presentations. For those less than 25 years in the COVID-19 cohort, overall LoS was shorter despite indicating significantly delayed presentations.
... The COVID-19 has been a popular issue nowadays. Since March 2020, WHO has stipulated the COVID-19 as a global pandemic as the number of people is infected (Cucinotta & Vanelli, 2020). The COVID-19 Pandemic situation has encouraged many countries to implement several health policies, such as physical distancing, work from home, and lockdown status to prevent the spread of the COVID-19 virus (Chu et al., 2020;Kramer & Kramer, 2020). ...
Article
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The COVID-19 Pandemic has resulted the change in every sector of life. Education institutions transform their learning methods from face-to-face learning to online-based distance learning to keep the learning process running during the pandemic era. The purpose of this study is to obtain the description and analysis results regarding learning profile and evaluation system used in the lecture at Biology Education Study Program during the Pandemic. This survey study was conducted in August 2020 until August 2021, even semester of 2019/2020, odd semester of 2019/2020, even semester of 2020/2021, and odd semester of 2021/2022. The population of this study was the students of Biology Education of UMM and the students of private universities in Malang City. Purposive sampling was employed for sample selection. The instruments used were survey and questionnaire forms. The data was analyzed descriptively and quantitatively. The results of the study show that online learning is apparently not optimal in Biology Education and other private universities in Malang due to limitations in discussions, assignments, and assessments. Therefore, it is necessary to conduct training session, planning, and implementation of innovative online learning to optimize learning process. To make the learning process more accurate and effective, evaluations are also needed.
... That is, conventional representation models do not consider text 40 publications as evolving streams of data. 41 The contextual evolution of a word plays a vital role in its contemporary ?? ...
Preprint
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Semantics in natural language processing is largely dependent on contextual relationships between words and entities in a document collection. The context of a word may evolve. For example, the word apple'' currently has two contexts -- a fruit and a technology company. The changes in the context of words or entities in text data such as scientific publications, and news articles can help us understand the evolution of innovation or events of interest. In this work, we present a new diffusion-based temporal word embedding model that can capture short and long-term changes in the semantics of entities in different domains. Our model captures how the context of each entity shifts over time. Existing temporal word embeddings capture semantic evolution at a discrete/granular level, aiming to study how a language developed over a long period. Unlike existing temporal embedding methods, our approach provides temporally smooth embeddings, facilitating prediction and trend analysis better than those of existing models. Extensive evaluations demonstrate that our proposed temporal embedding model performs better in sense-making and predicting relationships between entities in the future compared to other existing models.
... Çin'in Wuhan şehrinde 2019 yılı aralık ayında nedeni bilinmeyen bazı solunum yolu vakaları ortaya çıkmıştır (Huang vd., 2020). Hastalığın Çin'den çıkıp tüm dünyayı etkisi altına alması, ciddi klinik vakalar ve kayıplar doğurması sonucunda Dünya Sağlık Örgütü 11 Mart 2020'de yeni koronavirüs salgınını pandemi ilan etmiştir (Cucinotta & Vanelli, 2020). ...
Conference Paper
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Forecasting techniques are evaluated with past data before forecasting future figures. Error series of past periods are used to calculate error statistics to evaluate accuracy of forecasting technique or to compare different methods. Forecast accuracy measures of MSE, RMSE, MPE, MAPE, SMAPE and Theill’s U will be evaluated with Turkish gasoline cars sales data set. ARIMA, ANN and exponential smoothing forecasting techniques will be used to generate forecasts of past periods. These forecasts are evaluated with the given forecast accuracy measures. Selected forecast accuracy measures presented consistent results about selected forecasts.
... The Covid-19 pandemic has posed new challenges to medical education. 1 The first case of Covid-19 in India was detected on 30 January 2020. A nationwide lockdown was imposed in March 2020 to curtail the increasing number of Covid-19 cases and to prepare healthcare workers/institutes to deal with the pandemic. ...
Article
Background The Covid-19 pandemic has posed a challenge to organizing a safe clinical assessment for postgraduate degree candidates completing the residency programmes in various specialties. Although minimizing the risk of Covid-19 transmission is a priority, fulfilling the objectives of the assessment is equally important. Methods We conducted this study in the Department of Internal Medicine at our institute. Instead of physically examining patients, case scenarios that included history, clinical and investigational data of the cardiovascular system (CVS) were presented to the candidates. Performance was scored by both the conventional and the CVS objective-structured clinical examination (CVS-OSCE) method and compared. Results Clinical assessment examination of 27 candidates for the degree of Doctor of Medicine showed that the median cumulative score gained in narrating and analysing various differential diagnoses was lower compared to the mean cumulative score gained in arriving at a single correct diagnosis (50% [interquartile range—IQR 39%–64%] v . 79% [IQR 64%–100%], p<0.01). Most of the candidates agreed that case scenarios were good alternatives to the conventional physical examination amidst the pandemic. Conclusion CVS-OSCE-based assessment using structured case scenarios is a feasible and effective alternative for clinical skill assessment in high-stake examinations.
... was declared a global pandemic by the World Health Organization (WHO) on the 11 th of March 2020 [1,2]. Since then, globally, according to the World Health Organisation Researching the psychological wellbeing of camped refugees has the potential to inform policy and practice on addressing the challenges they face in times of pandemics. ...
Article
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Vulnerable populations such as camped refugees are often exposed to spread of infectious diseases because of their living conditions, limited resources available to them and exclusion from social services. This study examined the psychological state of camped refugees in Ghana during the COVID-19 pandemic and how their background characteristics predict the severity of the pandemic’s psychological impact. It covered 763 refugees aged 15 years and above resident in two (Krisan = 316 and Ampain = 447) camps. Nine COVID-19 Anxiety Scale indicators were used to examine the psychological state of camped refugees. A composite indicator was derived to examine the overall psychological impact. Logistic regression was used to examine the factors that were associated with severe psychological impact. The multivariate analysis revealed that sex of the respondent, marital status and age of head of household were the only socio-demographic factors associated with having a severe psychological impact of the pandemic. There was very strong evidence that respondents who had moderate (OR = 1.74, 95% CI = 1.12, 2.7) and high (OR = 1.66, 95% CI = 1.05, 2.63) knowledge of the disease had increased odds of severe psychological impact. Also, those with moderate (OR = 2.97, 95% CI = 1.78, 4.97) and high (OR = 12.98, 95% CI = 7.86, 21.42) adherence had increased odds of severe psychological impact. None of the pre-existing health conditions and challenges were not significantly associated with severe psychological impact. The limited number of significant socio-demographic covariates suggests that severe psychological impact of the pandemic was a problem in the general population, and thus interventions should target the general population of camped refugees. Also, health education should not only focus on enhancing knowledge and promoting preventive measures but also on managing psychological distress.
... Coronavirus disease 2019 (COVID-19) is a respiratory infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [1]. Until September 2022, about 599,071,265 confirmed worldwide cases of COVID-19, including 6,467,023 deaths worldwide, were reported by the World Health Organization (WHO) [2]. ...
Article
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There are limited data about neurological manifestations in pediatric COVID-19 patients from all over the world, including Saudi Arabia. This study was performed to identify characteristics of pediatric COVID-19 cases with neurologic involvement hospitalized at King Abdulaziz University Hospital (KAUH), Saudi Arabia. This retrospective cross-sectional study included hospitalized patients aged 0–19 years with confirmed SARS-CoV-2 from April 2020 to February 2022. The required data were retrieved from patients’ medical records. Ninety-four cases were included. The median ages of the studied group, those with neurological manifestations, and those without neurologic manifestations, were 6.5, 11.0, and 5.0 years, respectively. Neurological manifestations occurred in 29 COVID-19 patients (30.9%) with headache and decreased consciousness being the most common recorded manifestations in 8.5% and 6.4% of patients, respectively. Specific neurological manifestations were rare, as only two infants developed encephalopathy with fatal outcome. Most patients with and without neurological manifestations survived. Neuroimaging abnormalities were detected in 8 cases with neurological manifestations. Neurological manifestations were common in 31% of hospitalized pediatric COVID-19 cases. However, most of the neurological manifestations were mild and nonspecific, with headache being the most common one. Specific neurological manifestations were rare; however, pediatric COVID-19 patients, particularly young infants, were at risk of developing severe encephalopathy with fatal outcome.
... COVID-19 is caused by the novel severe acute respiratory syndrome coronavirus 2, which emerged in China in the city of Wuhan [1]. In the midst of March 2020, WHO declared the novel coronavirus (COVID-19) outbreak a global pandemic [2]. The pandemic troubled the healthcare systems all over the world, which placed a huge burden of cases with COVID-19 on medical facilities, highlighting the important role of effective patient prioritizing is to allow adequate clinical care for those more severely deteriorating to critical COVID-19. ...
... The WHO declared the COVID-19 pandemic, on 11 March 2020. 1 Because of the fast spread of the contagion, different preventive measures, including social distancing, wearing masks, wearing disposable gloves and frequent hand washing using soap or alcoholbased disinfectants, have been introduced to prevent the disease, particularly among frontline workers such as employees working in healthcare facilities. 2 While these precautions are advised to prevent COVID-19 transmission, they may potentially have detrimental effects on the skin. 3 Following the WHO's recommendations, frequent hand washing with soap and water for 40-60 s has emerged as the most important activity during the COVID-19 pandemic. ...
Article
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Objective This study was aimed to explore the prevalence and risk factors of work-related contact dermatitis (WRCD) symptoms among cleaners working in healthcare institutions in Gondar city, Northwest Ethiopia, during the COVID-19 pandemic. Design A multicentre cross-sectional study was conducted from September to October 2021. An interviewer-administered standardised Nordic Occupational Skin Questionnaire, V.2002 (NOSQ-2002) was used to assess WRCD. The collected data were entered into EpiData V.4.6 and analysed using Stata V.14 software. The association between dependent and independent variables was computed with a binary logistic regression. The association was determined using an adjusted OR (AOR) with a 95% CI at a p value of <0.05. Setting The study was conducted in Gondar city healthcare institutions, Northwestern Ethiopia. Participants A total of 409 cleaners participated in this study. Outcome measures The primary outcome is the prevalence of WRCD symptoms, which was measured using the NOSQ-2002. Results The response rate was 95.6%. The majority, 302 (73.8%), of the study participants were female. The mean age (±SD) was 31 (±7.87) years old. The overall prevalence of self-reported WRCD during the last 12 months was 213 (52.1%) (95% CI (47.1% to 57.0%)). The highest symptoms reported were skin redness, 51.6% (n=110), and the most affected skin body sites were hands (hand dermatitis), 74.2% (n=158). Hand washing frequency more than 20 times per day (AOR=1.73, 95% CI (1.03 to 2.92)), personal history of eczema (AOR=1.46, 95% CI (1.01 to 2.42)) and lack of training on skin hazards (AOR=2.06, 95% CI (1.16 to 3.63)) were factors influencing the occurrence of WRCD. Conclusions This study revealed the prevalence of WRCD is common during the COVID-19 pandemic. Adjusting hand washing frequency per day, educating people with atopy about the avoidance of exposure to skin irritants and providing training on skin hazards were recommended to minimise the condition.
... Furthermore, there is mounting evidence that some of the people who suffered from the COVID-19 disease experience prolonged adverse health effects with continued multisystemic symptoms weeks and months post infection with a substantial impact on health and wellbeing [6,7]. From March 11, 2020, the time COVID-19 was declared a global pandemic by the World Health Organization [8], different countries have experienced different waves of the pandemic. This in turn has led to implementation of a range of interventions to alleviate pressure on the healthcare systems as well as to control the pandemic [9,10]. ...
Preprint
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The SARS-CoV-2 transmission dynamics have been greatly modulated by human contact behaviour. To curb the spread of the virus, global efforts focused on implementing both Non-Pharmaceutical Interventions (NPIs) and pharmaceutical interventions such as vaccination. This study was conducted to explore the influence of COVID-19 vaccination status and risk perceptions related to SARS-CoV-2 on the number of social contacts of individuals in 16 European countries. This is important since insights derived from the study could be utilized in guiding the formulation of risk communication strategies. We used data from longitudinal surveys conducted in the 16 European countries to measure social contact behaviour in the course of the pandemic. The data consisted of representative panels of participants in terms of gender, age and region of residence in each country. The surveys were conducted in several rounds between December 2020 and September 2021. We employed a multilevel generalized linear mixed effects model to explore the influence of risk perceptions and COVID-19 vaccination status on the number of social contacts of individuals. The results indicated that perceived severity played a significant role in social contact behaviour during the pandemic after controlling for other variables. More specifically, participants who perceived COVID-19 to be a serious illness made fewer contacts compared to those who had low or neutral perceptions of the COVID-19 severity. Additionally, vaccinated individuals reported significantly higher number of contacts than the non-vaccinated. Furthermore, individual-level factors played a more substantial role in influencing contact behaviour than country-level factors. Our multi-country study yields significant insights on the importance of risk perceptions and vaccination in behavioural changes during a pandemic emergency. The apparent increase in social contact behaviour following vaccination would require urgent intervention in the event of emergence of an immune escaping variant. Hence, insights derived from this study could be taken into account when designing, implementing and communicating COVID-19 interventions.
... Emerging infectious diseases (EIDs) can rapidly spread worldwide and cause damage by increasing morbidity and mortality, creating a national security issue equivalent to terrorism [1,2]. EIDs have occurred frequently in Korea in the last decade. ...
Article
Purpose: As coronavirus disease 2019 (COVID-19) and other emerging infectious diseases continue to threaten health security, a strategy is required to increase nursing students’ care intention for patients with such diseases. This study aimed to identify factors influencing Korean nursing students’ care intentions in regard to patients with emerging infectious diseases.Methods: The care intention, COVID-19 knowledge level, ethical sensitivity, beliefs, attitudes toward the care intention, subjective norms, and perceived behavioral control were investigated using the theory of planned behavior. An online survey was completed from December 2020 to January 2021 by 227 nursing students who had complete a clinical practicum. Descriptive statistics, correlation, and hierarchical regression analyses were conducted on the data.Results: The care intention was higher in men than in women nursing students and in junior than in senior students. Behavioral and normative beliefs, attitude toward the behavior, and perceived behavioral control significantly predicted care intention. Ethical sensitivity increased the predictability of nursing students’ care intentions for emerging infectious disease patients.Conclusion: The theory of planned behavior predicted nursing students’ care intentions for emerging infectious diseases. Therefore, an experience-based response program on emerging infectious diseases is required for nursing students.
... Хоча, за даними ВООЗ, захворювання на COVID-19 у більшості пацієнтів протікає в легкій, у 40%, або середній формі відповідно, близько у 15% пацієнтів може розвиватися досить тяжке захворювання, яке може потребувати кисневої підтримки, а у 5% спостерігається вкрай тяжкий (критичний) перебіг з такими ускладненнями, як ГРДС, дихальна недостатність, сепсис та септичний шок, тромбоемболія та/або поліорганна недостатність, включаючи гостре ураження нирок і серця [6,7,8]. В усьому світі залишається досить висока смертність від пневмоній, спричинених COVID-19, яка, за даними ВООЗ, складає понад 9,6 %. ...
Article
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Having analyzed the latest recommendations of the World Health Organization, the new data from the scientific literature, and current treatment guidelines, the latest epidemiological data of identified different cases of this infection according to epidemiological and clinical criteria were presented. The main pathogenetic signs, risk factors, including inter-individual differences, which can be represented by the host's genetic profile, are highlighted. The main clinical signs and their distribution, classification according to the severity of the disease, features of the course and treatment of pneumonia in human coronavirus infections are shown, including indications for antibacterial therapy and the main criteria of oxygen support. The basic WHO laboratory recommendations for patients with acute respiratory infection who have been in contact with patients having a confirmed or probable case are defined. The main hardware methods of diagnosis, modern approaches in the therapy in the absence of specific antiviral agents are presented. The lack of definitive specific treatment for this disease and the future development of such a pandemic remains unpredictable that indicates the need for strict adherence to classic public health recommendations, the importance of vaccination. The outbreak of COVID-19 in this century once again had emphasized the constant threat of infectious diseases spread by pathogenic viruses among humanity and this requires effective global cooperation and a high level of preparedness.
... Coronavirus disease 2019 (COVID-19) is caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and was initially identified in December 2019. 1 The rapid global spread of SARS-CoV-2 resulted in the declaration of a pandemic by the World Health Organization in March 2020. 2 Some patients, such as older individuals or those with advanced renal disease, diabetes, cancer, chronic obstructive pulmonary disease or cardiovascular disease, are at higher risk of developing severe COVID-19, which may result in hospitalisation or death. 3,4 Moreover, data have suggested that immunocompromised individuals or transplant recipients, who are also considered at high risk of severe COVID-19, have blunted serological responses to vaccines. ...
Preprint
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Introduction: There is limited real-world evidence surrounding the effectiveness of early, mild-to-moderate COVID-19 treatments following the emergence and dominance of Omicron SARS-CoV-2 subvariants. Here, characteristics and acute clinical outcomes are described for patients with COVID-19 treated with sotrovimab, nirmatrelvir/ritonavir or molnupiravir, or patients at highest risk per NHS criteria but who were untreated. Methods: Retrospective cohort study of non-hospitalised patients who received early treatment for, or were diagnosed with, COVID-19 between 1 December 2021 and 31 May 2022, using data from the Discover dataset in north-west London. Patients were included if aged ≥12 years and treated with sotrovimab, nirmatrelvir/ritonavir or molnupiravir, or were untreated but expected to be eligible for early treatment per NHS highest-risk criteria at time of diagnosis. Outcomes were reported for 28 days from COVID-19 diagnosis (index). Subgroup analyses were conducted in patients with advanced renal disease, those aged 18-64 and ≥65 years and by period of Omicron BA.1, BA.2 and BA.5 (post-hoc exploratory analysis) predominance. Results: A total of 696 patients prescribed sotrovimab, 337 prescribed nirmatrelvir/ritonavir, 470 prescribed molnupiravir and 4,044 eligible high-risk untreated patients were included. A high proportion of patients on sotrovimab had advanced renal disease (29.3%), ≥3 high-risk comorbidities (47.6%) and were aged ≥65 years (36.9%). In total, 5/696 (0.7%) patients on sotrovimab, <5/337 (0.3-1.2%) patients on nirmatrelvir/ritonavir, 10/470 (2.1%) patients on molnupiravir and 114/4,044 (2.8%) untreated patients were hospitalised with COVID-19 as the primary diagnosis. Similar results were observed across all subgroups and during Omicron subvariant periods. Conclusion: Patients who received sotrovimab appeared to show evidence of multiple comorbidities that may increase risk of severe COVID-19. Low hospitalisation rates were observed for all treated cohorts across subgroups and periods of predominant variants of concern. These descriptive results require confirmation with comparative effectiveness analyses adjusting for differences in underlying patient characteristics.
... However, the administration rescinded this new guidance in response to various lawsuits filed by more than 20 states, the District of Columbia, and two dozen universities [13,14]. When COVID-19 was declared a global pandemic in March of 2020 [15], almost all post-secondary U.S. educational institutions closed in-person classes and switched them to remote learning [16]. International students had to adjust to the new learning environment, which is virtual learning, and experience a lack of support with the risk of deportation [16]. ...
Article
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Background Since the Immigration and Nationality Act of 1952, the number of international students in the United States had been gradually increasing. However, the total numbers have begun to decrease since 2019–2020 school year due to the Trump administration's policy and COVID-19. Still, little is known about how international students’ psychological adjustment and well-being have been affected by changing nonimmigrant visa policy and the COVID-19 pandemic. Methods We conducted a total of 34 online semi-structured in-depth interviews with international students from 18 countries of origin studying in the San Francisco Bay Area, California. More than 60% of the participants (21 out of 34) were aged 21 to 25. Among our 34 participants, gender and 18 were male and 16 were female, and 19 were undergraduate students and 15 were master’s students. The majority of the participants were first-generation college students (22/34, 64.71%). Verbatim transcription was done for all interviews. NVivo was used for both deductive and inductive approaches to the qualitative analysis. Results Overall, the recent political climate negatively impacted participants’ psychology of adjustment and well-being. July 6, 2020 Policy Directive for international students caused severe uncertainty about whether they can continue studying in the United States. There were many resources or services needed to overcome this period, such as extended mental and emotional support from the counseling services as well as financial and informational support from the international student office and university. Although international students had the benefit of the university's food assistance program, they were not eligible to receive any external support outside of the university and financial aid at the local and federal levels. Whether maintaining F-1 visa status was one of their major concerns. Due to COVID-19, job opportunities were limited, which made international students difficult to obtain Curricular Practical Training (CPT) and secure a job in the United States within the 90-day unemployment limit of Optical Practical Training (OPT). H-1B visa and permanent residency were other challenges to go through, but participants saw positive perspectives from the Biden administration. Conclusions Uncertain policy changes due to COVID-19 and presidential transitions impacted international students’ psychological well-being and adjustment. International students are important populations in the United States who have supported jobs that are high in demand and economically contributed to the United States. It is expected that future policies at various levels support international students’ life and improve their health equity and mental health.
... One of the defense lines between COVID-19 and society were healthcare workers [1][2][3]; however, their health [4] and social lives were particularly troubled [5]. Interminably, the COVID outbreak attained the status of pandemic [6]. Health workers and administrative authorities worldwide made persistent efforts to alleviate the continuous spread of the COVID-19 virus [7]. ...
Article
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Social distancing measures can create psychological issues, especially among hospital staff who constantly deal with emergency patients. To explore the mediating role of COVID-19 anxiety on the association between COVID-19 safety protocols and mental health, and to test the moderating role of resilience between COVID-19 safety protocols and COVID-19 anxiety, this work collected data on hospital staff in terms of COVID-19 safety protocols, psychological resilience, COVID-19 anxiety, and improving staff mental health. The effects of the use of COVID-19 safety protocols on COVID-19 anxiety and the mental health of hospital workers in China were also analyzed. The experimental results showed that resilience remarkably moderated COVID-19 safety protocols and COVID-19 anxiety among Chinese hospital staff.
... On March 11, 2020, COVID-19 has been globally declared a pandemic health issue by the World Health Organization (WHO) [4]. It had resulted in serious concern due to its vague characteristics and methods of transmission at that time. ...
Article
Background: Acute appendicitis is the leading cause of acute abdominal pain that requires immediate intervention. Nonetheless, during COVID-19, hospital visits decreased as a result of serious COVID-19 concerns at that time, resulting in a decreased number of diagnosed cases with acute appendicitis due to COVID-19 restriction issues. Objectives: To report the percentage numbers, characteristics, applied management, and outcomes of patients with acute appendicitis during the COVID-19 pandemic and compare them to pre-COVID-19 cases. Methods: A retrospective cohort study included all patients with acute appendicitis in the determined periods "pre-COVID-19" and "during COVID-19" at King Abdul-Aziz Medical City, Academic Tertiary Center, Jeddah, Saudi Arabia. Mean and standard deviation were used, while categorical data were reported as frequencies and percentages. Variables were analyzed by the Chi-squared test, Fisher's exact test, and Mann-Whitney test as appropriate. Results: A total of 298 patients were included. The period of the pre-COVID-19 pandemic had 161 (54%) patients, while 137 (46%) were identified during COVID-19. The number of laparoscopic appendectomies performed during COVID-19 was less than the pre-COVID-19 pandemic of 96 cases (70.1%) vs 133 cases (82.6%) (P=0.0106). Uncomplicated appendicitis was the most commonly reported type of appendicitis in both periods: 113 (82.5%) during COVID-19 vs 135 (83.9%) pre-COVID-19, (P=0.7526). Furthermore, the number of patients who presented to the ER between 24 and 48 hours after the onset of symptoms was similar before and during the pandemic: 111 (68.9%) vs 89 (65%). Conclusion: Overall, we conclude that during the COVID-19 period, there was a reduction in the number of patients presenting with acute appendicitis and a lower chance of undergoing laparoscopic appendectomy due to COVID-19 restrictions. There was also an increase in perforated appendicitis and a decrease in gangrenous appendicitis.
... Introduction COVID-19 spread rapidly around the world, and the outbreak was declared a global pandemic by the World Health Organization on March 11, 2020 [1][2][3]. As of November 29, 2021, Canada has documented 1,790,142 cases of COVID-19, resulting in 29670 deaths [4]. ...
Article
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Background The COVID-19 pandemic has led the Canadian provincial governments to take unprecedented measures, including restrictions to healthcare services and pharmacists. Limited evidence exists on changes in prescription trends in Canada during the pandemic period. Objectives To examine the trend of prescription medications’ utilization before and during COVID-19, among incident and prevalent users in the general population. We examined 18 major classes of medications. Methods We used the administrative health databases from the province of Manitoba, Canada, to conduct a province-wide cross-sectional study. Incident and prevalent use was compared between two time periods; pre-COVID-19: July 2016-March 2020 and during COVID-19: April 2020-March 2021. Interrupted time series analysis using autoregressive models was used to quantify the change in level and slope in quarterly medication use among incident and prevalent users. Results The quarterly study population ranged from 1,353,485 to 1,411,630 Manitobans. The most common comorbidities were asthma (26.67%), hypertension (20.64%), and diabetes (8.31%). On average, the pandemic restrictions resulted in a 45.55% and 12.17% relative decline in the aggregated utilization of all drugs among both incident and prevalent users, respectively. Subclass analysis showed a 46.83%, 23.05%, and 30.98% relative drop among incident users of antibiotics, cardiovascular drugs and opioids use, respectively. We observed a significant slope increase during COVID-19 among the quarterly cardiovascular, antidiabetics, alpha-1 blockers, and statins incident users compared to the pre-COVID-19 period. We noted a significant decrease in level among NSAIDs, opioids, and antibiotic prevalent users, however, no significant changes in slope were observed. Conclusion Our findings show a significant impact of COVID-19 measures on prescription trends in the general population. The observed decline among several medication classes was temporary. Further research is needed to monitor prescription trends and better understand if those changes were associated with increased health services and worsened outcomes.
... The coronavirus disease 2019 was recognized as a global pandemic on March 11 th , 2020, by the World Health Organization (WHO) (Cucinotta and Vanelli 2020). This resulted in many governments implementing lockdown and other public health measures, such as social distancing and mask wearing, that affected all modes of transportation around the world (Shortall et al. 2021). ...
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The COVID-19 pandemic has led governments to implement restrictive policies which have caused unprecedented effects on transportation systems. This paper assesses which measures had more impacts on subway daily ridership in Montreal (Quebec, Canada) and on the interactions between modes using time series approaches. Change point detection methods, based on regression structure and Bayesian posterior probabilities, are first applied to automatic fare collection (AFC) data available from January 2019 to December 2021. Nine breakpoints (or ten phases) are found and linked to the COVID-19 timeline of the city. The impacts are then quantified by phase, and their variability is analyzed by day type and period. The evolution of the daily and weekly patterns in subway usage is also examined using time-frequency wavelet analysis. Finally, changes in correlations between the subway ridership and the use of three other transportation modes (cycling, private car, and carsharing) are modeled using interrupted time series models with autoregressive errors. The results reveal that lockdown implementations had a negative, immediate but decreasing impact on subway use, while release measures combined with transit-specific policies (such as free distribution of masks) led to a gradual recovery. The impacts varied in time, but traditional 5-day-a-week peak hour travel declined the most. The use of the other modes, as well as their system-level interactions with the subway, were also affected. Potential modal shifts were highlighted. Such findings provide practitioners and planners with useful insights into the COVID-19 pandemic impacts on mobility.
... Two years ago, since WHO's global pandemic declaration in December 2019 [1], Indonesia has been struggling to coexist with the COVID- This sudden shift pushes immediate adjustment that extensively involves various technology tools and digital learning platforms [2]. The adoption of online learning continues to persist today, portraying the unceasing investment in online-based education, even during the post-pandemic era [3]. ...
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Introduction: The blended learning with flipped classrooms combination may propose a more effective and efficient way to share information in the course sessions. However, a scientific-based investigation is required to confirm its effect on knowledge and self-efficacy improvement during the BLS course learning sessions. Methods: This was a quasi-experimental study with a pre-post test design, enrolling nurses who were participating in BLS Courses. Participants were assigned into two groups: a control group with Blended learning (BL) or conventional learning approach (n=30) and an experimental group with Blended Learning with Flipped Classroom (BLFC) (n=30). A knowledge questionnaire from the American Heart Association (AHA) Guidelines and a Self-Efficacy questionnaire of Resuscitation Self-Efficacy Scale (RSES) were employed to gather the study data. Data were then analyzed using the SPSS with the mean, median, Wilcoxon, and Mann-Whitney tests. Results: Wilcoxon test revealed a significant mean difference in knowledge and self-efficacy in the BL group with a p-value of 0.000 and 0.000, respectively. Further, the Mann-Whitney test showed mean differences between groups, with p=0.084 in the knowledge and p=1.000 in the self-efficacy variable. Conclusion: Significant changes in knowledge and self-efficacy before and after the course sessions were observed in the BL and BLFC groups. However, findings yielded insignificant differences in the mean and median between groups.
... Up to 7 April 2022, COVID-19 has infected more than 492 million people worldwide, resulting in 6.15 million deaths [1]. The World Health Organization (WHO) has declared COVID-19 a global pandemic [2]. Vaccination, as a means of disease prevention, can effectively interrupt the epidemic of SARS-COV-2 [3]. ...
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AimsSevere acute respiratory syndrome coronavirus type 2 (SARS-COV-2) infection may increase the risk of developing dangerous symptoms among the elderly with underlying medical conditions. The aim of this study was to evaluate the safety and immunogenicity of the SARS-CoV-2 inactivated vaccine (Vero) in patients over 60 years of age with hypertension and/or diabetes.Methods An open-label, multi-center, prospective clinical trial was conducted at three medical sites in Fujian, China. Participants aged 60 years and above with hypertension, diabetes, and healthy controls were included in four groups: hypertension, diabetes, combined disease, and healthy controls. Volunteers received two doses of the inactivated SARS-COV-2 vaccine (BBIBP-CorV) on days 0 and 21. Adverse events were recorded for 21 days after each dose. Blood samples were taken before the first vaccination and 28 days after the second vaccination to detect the serum conversion rate and geometric mean titer (GMT) of neutralizing antibodies.ResultsA total of 480 participants (110 hypertension, 110 diabetes, 100 combined hypertension and diabetes, and 160 healthy controls) were recruited. The incidences of adverse events in the four groups were 10 (9.1%) in the hypertension group, 19 (17.3%) in the diabetes group, 11 (11.0%) in the combined disease group, and 11 (6.9%) in healthy controls, with no statistical significance (P > 0.05). At 28 days after the second vaccination, the positive conversion rates of serum neutralizing antibody in the four groups were 97.3%(107/110), 97.3% (107/110), 100.0% (99/99),and 98.7%(155/157), respectively, and the GMTs were 75.28 (95% CI 64.03–88.50), 69.4 (95% CI 59–81.63), 77.21 (95% CI 66.68–89.41), and 78.64 (95% CI 69.87–88.50), respectively. There was no significant difference in neutralizing antibody responses among the four groups (P > 0.05). Additionally, the GMT after immunization was higher in females than in males (OR = 2.59, 95% CI 1.31–5.12).Conclusions The BBIBP-CorV vaccine is safe and elicits an adequate antibody response in patients over 60 years of age with hypertension and/or diabetes.Trial RegistrationClinicalTrials.gov identifier, NCT05065879.
... COVID-19, caused by the severe acute respiratory syndrome coronavirus 2, was declared a global pandemic by the World Health Organization on March 11, 2020. 15 The Johns Hopkins Coronavirus Resource Center reported that as of June 19, 2021, almost 180,000,000 global cases had been confirmed, with more than 33,500,000 in the United States. 16 At that time, the global death toll had reached more than 3,850,000 lives lost, with the United States surpassing 601,000 deaths. ...
... In this study, we investigated the knowledge, attitude, practices, and preparedness for the COVID-19 pandemic of a randomly selected sample of private pharmacists in Baghdad. The pharmacists were questioned between March 20 and May 15, 2020, which was between two weeks and two months after the WHO declared the COVID-19 outbreak a worldwide pandemic (14). ...
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Background During the COVID-19 pandemic, community pharmacies have been expected to make extraordinary efforts to prevent client cross-infection and to sell masks and disinfectants. Additionally, in most countries, the government might be considered to be responsible for taking the lead in informing the public about the outbreak and associated public health measures. This study aimed to assess Iraqi pharmacists’ knowledge, attitudes, practices, and readiness in relation to COVID-19. Methods Seventy pharmacies in Baghdad were randomly visited (from March 20 to May 15, 2020) outside of lockdown hours (9:00 a.m to 12:00 p.m) and had to complete a survey using Google forms following each visit. Descriptive statistical analyses were performed. Numbers and percentages were used to summarize the results. Results The Iraqi pharmacists in Baghdad trusted the World Health Organization (WHO), the media, and websites, including Ministry of Health (MOH) websites for COVID-19 information. In terms of COVID-19 treatment, the pharmacists prescribed acetaminophen and corticosteroids. Zinc, vitamin C, and vitamin D were recommended to improve immunity, and these medicines were given orally. Most pharmacists suggested that the call center of the MOH was not answered. Conclusion The Iraqi MOH did not include pharmacists in its health emergency preparations, which resulted in a delay in pharmacies’ readiness. National governments and organizations may benefit from using pharmacists’ knowledge and skills to reduce or stop future COVID-19 waves and manage risk if these waves occur.
... Later, the novel pathogenic coronavirus was officially renamed SARS-CoV-2 by the International Committee on Taxonomy of Virus (ICTV), and the disease was named COVID-19 (coronavirus disease 2019) in the system of International Classification of Disease (ICD) by WHO on 11 February 2020 [2]. The rapid spread of SARS-CoV-2, and the sharp increase in COVID-19 cases since its onset, drew international attention and constituted a global pandemic that was announced by WHO on 11 March 2020 [3]. ...
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SARS-CoV-2 as a zoonotic virus has significantly affected daily life and social behavior since its outbreak in late 2019. The concerns over its transmission through different media directly or indirectly have evoked great attention about the survival of SARS-CoV-2 virions in the environment and its potential infection of other animals. To evaluate the risk of infection by SARS-CoV-2 and to counteract the COVID-19 disease, extensive studies have been performed to understand SARS-CoV-2 biogenesis and its pathogenesis. This review mainly focuses on the molecular architecture of SARS-CoV-2, its potential for infecting marine animals, and the prospect of drug discovery using marine natural products to combat SARS-CoV-2. The main purposes of this review are to piece together progress in SARS-CoV-2 functional genomic studies and antiviral drug development, and to raise our awareness of marine animal safety on exposure to SARS-CoV-2.
... In late 2019, a new virus, SARS-CoV-2 (also known as COVID-19) emerged. Within a few months of emerging, it created a havoc situation worldwide, and eventually, WHO declared it a pandemic in March 2020 (Cucinotta and Vanelli, 2020). Due to its highly transmissible nature, nearly all nations reported infection cases from COVID-19. ...
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In this research work, for the first time, we have developed and demonstrated a COVID-19 repellent coating on cotton cloth that not only repels the virus but also most of the human body fluids (superhemophobic). The coating was tested in the BSL3 lab. The controlled experiments revealed no significant increase in the log viral particles on coated fabric compared to the uncoated surface, evidence that the coated fabric resisted the SARS-CoV-2 inoculum. Further, the coated cloth exhibited excellent dust-free nature and stain resistance against body fluids (blood, urine, bovine serum, water, and saliva aerosol). It also shows sufficient robustness for repetitive usage. The fabrication process for the developed COVID-19 repellent cloth is simple and affordable and can be easily scaled up for mass production. Such coating could be applied on various surfaces, including daily clothes, masks, medical clothes, curtains, etc. The present finding could be a mammoth step towards controlling infection spread, including COVID-19.
... On February 11, 2020, an international committee on Taxonomy of viruses named the disease Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV-2). It was declared as a global pandemic on March 11, 2020 due to the high rate of global transmission of the virus [14]. Spread rate of the virus is currently decreasing in Nigeria through as at 5 th October 2022, 236 new confirmed case were recorded the new cases reported from 9 states in Nigeria Benue (182), Delta (21), Lagos (15), Bauchi (7), Plateau (4), Rivers (4), Bayelsa (1), Kaduna (1), and Kano (1) [12]. ...
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In this article, we studied numerical analysis of basic reproduction numbers of co-dynamics of COVID-19 and pertussis in Nigeria. The major qualitative analysis like the disease free equilibrium point, endemic equilibrium, basic reproduction number and stability analysis of equilibrium of the sub models were analyzed. We determined numerical value of the basic reproduction number and proved that the disease free equilibrium is globally asymptotically when 0 < 1 and unstable when 0 > 1. The numerical values of COVID-19 only model and pertussis only model are 0.046 and 0.0133 respectively. Since the numerical values are less than 1, it shows that the disease can be eradicated from the population
... After the World Health Organization (WHO) declared the novel coronavirus COVID-19 a global pandemic in March 2020 (Cucinotta and Vanelli 2020), people's lives changed extraordinarily around the world. One of the most significant changes, among others, occurred in the way in which individuals across the world access healthcare. ...
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This paper explores the characteristics of people aged 50 or older from eight CEE countries who reported forgoing healthcare due to fear of COVID-19. The sample of 13,033 individuals was based on data from the SHARE Corona Survey combined with data from previous waves. We performed a multivariate logistic regression model for healthcare avoidance. The results suggested that women, younger older adults, better educated individuals, those in poorer health, and those with more chronic health conditions were more likely to avoid healthcare after the outbreak. Our findings may help policymakers better understand populations with unmet healthcare needs.
... Hence over the years, and in various situations, decision makers in different countries have sought the help of reference scenarios and models to predict disease spread as a tool for effective ways to prevent it and for formulating tailored health policies (1)(2)(3). This was also the case when the magnitude of local infection with COVID-19 in the Chinese province of Wuhan came to light and morbidity spread to other countries until the WHO declared it a pandemic (4). ...
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Reference scenarios based on mathematical models are used by public health experts to study infectious diseases. To gain insight into modeling assumptions, we analyzed the three major models that served as the basis for policy making in Israel during the COVID-19 pandemic and compared them to independently collected data. The number of confirmed patients, the number of patients in critical condition and the number of COVID-19 deaths predicted by the models were compared to actual data collected and published in the Israeli Ministry of Health's dashboard. Our analysis showed that the models succeeded in predicting the number of COVID-19 cases but failed to deliver an appropriate prediction of the number of critically ill and deceased persons. Inherent uncertainty and a multiplicity of assumptions that were not based on reliable information have led to significant variability among models, and between the models and real-world data. Although models improve policy leaders' ability to act rationally despite great uncertainty, there is an inherent difficulty in relying on mathematical models as reliable tools for predicting and formulating a strategy for dealing with the spread of an unknown disease.
... World Health Organization (WHO) declared that the respiratory disease initiated in 2019 is Coronavirus Disease-2019 . In February 2020, after a month passed, WHO designated the worldwide extent of the disease as a pandemic [1]. ...
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Almost one-third of all infectious diseases are caused by viruses, and these diseases account for nearly 20% of all deaths globally. It is becoming increasingly clear that highly contagious viral infections pose a significant threat to global health and economy around the world. The need for innovative, affordable, and safe antiviral therapies is a must. Zinc oxide nanoparticles are novel materials of low toxicity and low cost and are known for their antiviral activity. The genus Pelargonium was previously reported for its antiviral and antimicrobial activity. In this work, Pelargonium zonale leaf extract chemical profile was studied via high-performance liquid chromatography (HPLC) and was used for the biosynthesis of zinc oxide nanoparticles. Furthermore, the antiviral activity of the combination of P. zonale extract and the biosynthesized nanoparticles of ZnO against the human corona 229E virus was investigated. Results revealed that ZnONPs had been biosynthesized with an average particle size of about 5.5 nm and characterized with UV, FTIR, TEM, XRD, and SEM. The antiviral activity showed significant activity and differences among the tested samples in favor of the combination of P. zonale extract and ZnONPs (ZnONPs/Ex). The lowest IC50, 2.028 µg/mL, and the highest SI, 68.4 of ZnONPs/Ex, assert the highest antiviral activity of the combination against human coronavirus (229E).
... Background WHO first declared COVID-19 a public health emergency of international concern on 30 January 2020; on 11 March, it announced that the viral outbreak was officially a pandemic, the highest level of health emergency [1]. The novel coronavirus virus is highly contagious and has rapidly spread worldwide. ...
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Background The coronavirus disease 2019 (COVID-19) pandemic has disrupted lives across all countries and communities. It significantly reduced the global economic output and dealt health systems across the world a serious blow. There is growing evidence showing the progression of the COVID-19 pandemic and the impact it has on health systems, which should help to draw lessons for further consolidating and realizing universal health coverage (UHC) in all countries, complemented by more substantial government commitment and good governance, and continued full implementation of crucial policies and plans to avert COVID-19 and similar pandemic threats in the future. Therefore, the objective of the study was to assess the impact of good governance, economic growth and UHC on the COVID-19 infection rate and case fatality rate (CFR) among African countries. Methods We employed an analytical ecological study design to assess the association between COVID-19 CFR and infection rate as dependent variables, and governance, economic development and UHC as independent variables. We extracted data from publicly available databases (i.e., Worldometer, Worldwide Governance Indicators, Our World in Data and WHO Global Health Observatory Repository). We employed a multivariable linear regression model to examine the association between the dependent variables and the set of explanatory variables. STATA version 14 software was used for data analysis. Results All 54 African countries were covered by this study. The median observed COVID-19 CFR and infection rate were 1.65% and 233.46%, respectively. Results of multiple regression analysis for predicting COVID-19 infection rate indicated that COVID-19 government response stringency index (β = 0.038; 95% CI 0.001, 0.076; P = 0.046), per capita gross domestic product (GDP) (β = 0.514; 95% CI 0.158, 0.87; P = 0.006) and infectious disease components of UHC (β = 0.025; 95% CI 0.005, 0.045; P = 0.016) were associated with COVID-19 infection rates, while noncommunicable disease components of UHC (β = −0.064; 95% CI −0.114; −0.015; P = 0.012), prevalence of obesity among adults (β = 0.112; 95% CI 0.044; 0.18; P = 0.002) and per capita GDP (β = −0.918; 95% CI −1.583; −0.254; P = 0.008) were associated with COVID-19 CFR. Conclusions The findings indicate that good governance practices, favourable economic indicators and UHC have a bearing on COVID-19 infection rate and CFR. Effective health system response through a primary healthcare approach and progressively taking measures to grow their economy and increase funding to the health sector to mitigate the risk of similar future pandemics would require African countries to move towards UHC, improve governance practices and ensure economic growth in order to reduce the impact of pandemics on populations.
... The origin of the viral disease was traced to a wet market in Wuhan, a Chinese City in Hubei province. The disease is caused by a novel virus called Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [1]. ...
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The number of confirmed cases of COVID-19 globally is well over 400 million, however, the number of cases is showing a downward trend especially in developed countries largely as a result of effective vaccination against COVID-19. In developing countries, vaccination coverage is still very low as a result of vaccine hesitancy, which could be attributed to misconceptions about COVID-19 itself and its newly developed vaccines. This study assessed COVID-19 vaccine acceptance and perception amongst the adult population in Sokoto state, Nigeria. A cross-sectional study was conducted in Sokoto state among 854 respondents selected via a multi-stage sampling technique. Data was collected electronically using a set of structured questionnaire and analysis was done using IBM SPSS version 25. Respondents’ perception was assessed using a 5-point Likert scale ranging from strongly disagree (1) to strongly agree (5). Respondents having a score of 3 and below were graded as having poor perception and those having scores above 3 were graded as having good perception. Respondents’ ages ranged from 17 to 76 years, with a mean of 34.8±12.07; more than half [474(53.7%)] of the respondents were males, 667(75.5%) were married and 539(61.0%) had formal education. The majority [839(95.0%)] of the respondents had a good perception of COVID -19 vaccine; 49.9% agreed enough research would be required on the safety of the vaccine. The majority, (72.4%) expressed their willingness to accept the COVID- 19 vaccine (male 38.4% vs. female 34.0%); 410(47.4%) said they can spend more than one hour to get the vaccine. Significant predictors of willingness to accept COVID 19 vaccine include age (p = 0.006; aOR = 0.223; 95% CI = 0.077–0.645), education (p<0.001; aOR = 1.720; 95% CI = 1.274–2.321) and perception of COVID 19 vaccine (p<0.001; aOR = 0.020; 95% CI = 0.009–0.044). The majority of the respondents had a good perception of COVID- 19 vaccine and more than two-thirds were willing to be vaccinated with the vaccine. Government should make the vaccine available for vaccination since a significant proportion of the respondents expressed their willingness to accept the vaccine
... The novel coronavirus 2019 (COVID-19) has been responsible of a new rapidly spreading viral infection classified as pandemic on March 11, 2020 by World Health Organization (WHO) [1]. ...
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China has been the first country to be affected by the COVID-19 outbreak. The pandemic resulted in significant disruption of Health Care Services worldwide, and this effect on treatments for urinary stones is currently unclear. This is the first retrospective study involving three tertiary referral centers for urolithiasis across China. We evaluated surgical volumes and peri-operative outcomes of procedures delivered for upper urinary tract stones. We compared trimester prior to restrictions for COVID-19 (October 1st, 2019 to December 31st, 2019, period A), during restrictions (February 1st, 2020 to March 31st, 2020, period B), and afterword (April 1st, 2020 to June 31st, 2020, period C). A total of 2,543 procedures have been carried out. We observed a loss of 743 cases during period B (−29.2%) and 201 during period C (−7.9%). Percutaneous surgery showed the worst reduction, with 507 mini-PCNLs delivered in period A, 168 in period B (−60.8%), and 389 (−18.3%) in period C (p = 0.001). A worst trend was shown for standard PCNLs with 84 procedures carried out in period A, 5 in period B (−95.2%), and 9 (−89.2%) in period C (p = 0.001). Retrograde surgery also decreased, from 420 cases in period A to 190 cases in period B (−54.8%). An increment was however seen in period C when 468 cases have been carried out (+ 11.4%, p = 0.008). In term of SFRs, a difference was noticed for RIRSs, being 69.2%, 80.5%, and 69.3% during three periods (p = 0.045) and semirigid ureteroscopies (90.3%, 97.1%, and 84.8%, p = 0.013). Charlson’s Comorbidity Score could not show any difference between groups as well as no differences in term of post-operative complications have been noticed.
... The global spread of the SARS-CoV-2 virus, which started in early 2020 [1] and which was declared pandemic by the WHO in March 2020 [2], has promoted the intensive research on human coronaviruses [3], which are a global public health thread [4]. A major tool in monitoring and controlling the spread of the viruses is a fast, accurate and sensitive detection of the virus or the infection [5]. ...
... March 2020, COVID-19 was declared a global pandemic due to the highly contagious disease caused by the Severe Acute Respiratory Coronavirus 2 (SAR-CoV-2) [1]. It can cause severe morbidity and mortality especially in older patients and patients with chronic preexisting medical diseases. ...
Article
This review includes data supporting thrombocytopenia as an emerging adverse event associated with SARS-CoV2 vaccination, analyzes the published case reports supporting an association with acquired Thrombotic Thrombocytopenic Purpura (aTTP), reviews the association of Thrombosis with Thrombocytopenia Syndrome (TTS) and Immune Thrombocytopenia Purpura (ITP), analyzes data from the U.S. Food and Drug Administration’s (FDA) Vaccine Adverse Event Reporting System (VAERS) database, provides guidance for clinicians caring for patients desiring vaccination but at potential risk of COVID-19 vaccination associated thrombocytopenia, and provides guidance for patients with a history of thrombocytopenia to better enable an informed decision regarding the choice of vaccination. Although the incidence of thrombocytopenia is sufficiently low to allow the continued use of SARS-CoV2 vaccines in patients with a history of thrombocytopenia, caution is advised. The burden of disease in reported patients was significant with death in 8.99% of patients developing thrombocytopenia after receiving the COVID-19 vaccine and 15.4% having a life-threatening event. The burden on the healthcare system includes 30.6% of reported patients developing thrombocytopenia after receiving the COVID-19 vaccine requiring an ED visit, 26.5% requiring an office visit, and 49.5% requiring hospitalization. Hospitalizations were significant with a median stay of 7.21 days. Patients desiring vaccination should be screened for prior thrombocytopenia and counseled on the risks/benefits of vaccination that are unique to their medical history. Patients with a history of thrombocytopenia may choose to receive vaccination but should be monitored for the development of thrombocytopenia during 0-90 days and possibly as long as nine months following their last dose of vaccination.
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Introduction The COVID-19 pandemic is still in force, causing global public health challenges and threats. Although vaccination and herd immunity have proven to be the most efficient way to control the pandemic, massive and early testing of patients using the RT-qPCR technique is crucial for constant genomic surveillance. The appearance of variants of SARS-CoV-2 with new mutations can reduce the efficiency of diagnostic detection. In this sense, several commercial RT-qPCR kits have been the target of extensive analysis because low assay performance could lead to false-negative diagnoses. Methods In this study, we evaluated the performance of three commercial RT-qPCR kits; Thermo Fisher (TaqMan 2019-nCoV Assay Kit v1), BGI and Roche (LightCycler ® Multiplex RNA Virus Master) used for the diagnosis of COVID-19 throughout the pandemic in Santiago de Chile. Results Under our best assay conditions, we found significant differences in Cq amplification values for control and viral probes, against the same nasopharyngeal swab samples (NPSs). In addition, in some cases, the sensitivity of the RT-qPCR kits decreased against viral variants. Conclusion Our study suggests evaluating the RT-qPCR kits used to detect SARS-CoV-2 because variants such as Omicron, which has several mutations, can compromise their detection and underestimate viral circulation.
Chapter
The field of consumer health informatics (CHI) is constantly evolving. The literature that supports CHI includes a broad scope of expertise and disciplines, which makes discovering relevant literature a challenge. Through a library and information science lens, we provide foundational familiarity with the structures of information discovery systems and considerations that impact the discovery of CHI literature. We outline the steps included in the design and execution phases of a CHI-related literature search. We also provide an example search using wearable technologies and a case in point that illustrates how terminologies differ across databases. We describe the importance of operationalizing elements of a research question and strategically combining search terms in a query to enhance the findability of CHI literature. The reader will gain a database-agnostic understanding of the structures and factors relevant to the retrieval of CHI literature, which should be particularly useful as the field of CHI and the tools for retrieving literature continuously change.
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Purpose This study was conducted to determine if postoperative nurse-driven telehealth visits for patients undergoing septorhinoplasty decreased patient anxiety while improving comfort and satisfaction levels. Design The present study was an intervention-control study completed with a total of 160 participants (n = 80, intervention group; n= 80, control group). The intervention post-septorhinoplasty training using the telenursing method was conducted at three time points in this study; preoperatively-postoperatively, on days 3, and 10. Methods Data were collected from a group of patients undergoing septorhinoplasty in the Ear, Nose, and Throat (ENT) department of a University Hospital in Turkey between October 2021 and February 2022. Before the study initiation, approval was obtained from the Institutional Ethics Committee. The data collected in the study were evaluated with the SPSS 23.00 program and were analyzed with the independent sample t-test for two independent groups and the F-test (ANOVA) for more than two groups. Correlation analysis was performed to examine the relationship between scales, and P< .05 was considered statistically significant. Findings In the postoperative period, the mean anxiety inventory score of the experimental group was found to be significantly lower than that of the control group (P<.01). It was determined that telenursing increased the satisfaction and comfort of the patients and shortened the discharge time. It was determined that there was a negative and statistically significant relationship between satisfaction and SAI and TAI (r=-0.715, r=-0.739, P<.01). Conclusions This study confirms the importance of postoperative telenursing for septorhinoplasty patients in promoting continuity of care, reducing anxiety and discharge time, improving comfort and satisfaction levels during the Covid-19 pandemic. Remote care was well received during the study and should be utilized more frequently. There is a need for further research regarding telehealth; and the international incentives and regulations which will be needed to make telenursing a standard of care should be pursued.
Article
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) affects other systems, including the digestive, circulatory, urogenital, and even the central nervous systems, as its receptor Angiotensin-Converting Enzyme-2 (ACE-2) is expressed in several organs, such as lungs, intestine, heart, esophagus, kidneys, bladder, testes, liver and brain. Different mechanisms, in particular, massive virus replication, extensive apoptosis and necrosis of lung-related epithelial and endothelial cells, vascular leakage, hyperinflammatory responses, overproduction of proinflammatory mediators, cytokine storm, oxidative stress, the downregulation of ACE2 and impairment of the renin-angiotensin system contribute to the pathogenesis of COVID-19. Currently, COVID-19 is a global pandemic with no specific antiviral treatment. The favorable abilities of ginger were indicated in patients suffering from osteoarthritis, neurodegenerative disorders, rheumatoid arthritis, type 2 diabetes, respiratory distress, liver diseases, and primary dysmenorrhea. Ginger or its compounds exhibited strong anti-inflammatory and antioxidant influences in numerous animal models. This review provides evidence regarding the potential effects of ginger against SARS-CoV-2 infection and highlights its antiviral, anti-inflammatory, antioxidant, and immunomodulatory impacts in an attempt to consider this plant as an alternative therapeutic agent for the treatment of COVID-19.
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This study focuses on the psychosocial impacts of COVID-19 restrictions on wellbeing and uses a mixed methods design to develop a more profound understanding about adaptive coping during stressful situations. The quantitative phase of this study examined the association between psychological capital, perceived stress, coping and wellbeing. The online survey was conducted in May 2020 and had 257 participants. The Structural Equation Modelling (SEM) results showed that the hypothesized model had an adequate fit [χ2(306, N = 257) = 547.185, p = 0.00]; and that both psychological capital and perceived stress were significant predictors of wellbeing. Significantly, young people reported a more negative impact on their wellbeing during the lockdowns. In the subsequent qualitative phase, in-depth interviews with 21 voluntary participants (14 females and 7 males) suggested that individuals could reappraise stressful situations and use coping strategies for psychosocial adaptation. From this research, it was identified that especially the younger age group is at risk, and that that psychosocial resources, such as psychological capital, could be developed to enhance coping and wellbeing with the ongoing impacts of the pandemic.
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Background: Shifting to online learning during the coronavirus pandemic has increased the number of individuals symptomatic of digital eye strain (DES). This study aimed to determine the frequency and potential risk factors of DES among university staff members and students in this pandemic era. Methods: A cross-sectional online survey was conducted during the pandemic, in May and June 2020. The online questionnaire was designed to collect data on DES-related ocular and extraocular manifestations. The survey was sent via social media to the previous year’s students and staff within the Faculty of Medicine, Tanta University, Tanta, Egypt. The responses were downloaded and analyzed. Results: Of the 412 participants completing the questionnaire, 34 (8.3%) were university staff members with a mean (standard deviation [SD]) age of 36.7 (6.6) years, and 378 (91.7%) were university students with a mean (SD) age of 20.8 (1.8) years. Participants with DES symptoms numbered 294 (71.4%) before the lockdown, increasing to 366 (88.8%) during the last month, with 84 developing new-onset DES. Most participants reported ocular symptoms associated with DES. After the lockdown, both students and staff had a significant prolongation of nighttime digital screen use and TV watching, an increase in the 4-item Patient Health Questionnaire (PHQ-4) severity scale scores, and anxiety and depression, with a reduced duration of daytime reading (all P < 0.05). Students had a significant prolongation of daytime digital screen use and TV watching and an increase in the frequency of eye lubricant use and mean Perceived Stress Scale (PSS)-4 scores (all P < 0.05). Multiple logistic regression analysis revealed that studenthood and increased nighttime screen use were independent risk factors for DES by odds ratios (95% confidence intervals) of 10.60 (2.12 – 53.00) and 3.99 (1.71 – 9.34), respectively (both P < 0.05). Conclusions: Lockdown and closure of the university, with a shift to online learning, increased the exposure of staff and students to digital screens and the number of individuals with DES. Studenthood and prolonged nighttime digital screen use were independent risk factors for DES. Further studies investigating the prevalence and risk factors of DES, comparing similar data during and after the pandemic, may reveal other aspects of DES caused by virtual reality-based training.
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Objectives: The coronavirus disease 2019 pandemic, which began in 2020, disrupted healthcare services. Reports of changes in surgical activities coincide with the outbreak period. We aimed to identify if changes could be determined in hospitalization rates of ovarian cancer patients from 2016 to 2020, comparing pre-pandemic and pandemic levels. Methods: Aggregated data were obtained from the State of São Paulo Secretary of Health regarding ovarian cancer clinical and surgical hospitalization, both Coronavirus disease-specific ICU and infirmary bed occupation rates, average social distancing rates, coronavirus disease 2019 incidence, mortality, and lethality rates. We performed the joinpoint analysis to verify if there were changes regarding hospitalization rates during this period. We also calculated hospitalization rate ratios and tested if they were correlated with pandemic-related variables. Results: Hospitalization rates in the state fell, coinciding with the pandemic. Surgical hospitalization rate ratios were inversely correlated with Coronavirus disease-specific ICU bed occupation rates during the third trimester of 2020, with a Pearson's correlation coefficient of -0.50 (95%CI -0.78 to -0.05, p=0.03). Conclusion: These results demonstrate the impact of the coronavirus disease 2019 pandemic on the treatment of conditions that compete for the same healthcare resources.
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The global spread of COVID-19 and the declaration of the pandemic status made by the World Health Organization (WHO) led to the establishment of mass vaccination campaigns. The challenges posed by the request to immunise the entire population necessitated the set-up of new vaccination sites, named Mass Vaccination Centres (MVCs), capable of handling large numbers of patients rapidly and safely. The present study focused on the evolution of MVC performances, in terms of the maximum number of vaccinated patients and primary resource utilisation ratio, while involving statistics belonging to the patient dimension. The research involved the creation of a digital model of the MVC, using the Discrete-Event Simulation (DES) software (FlexSim Healthcare), and consequent what-if analyses. The results were derived from the study of an existing facility, located within a sports centre in the province of Bergamo (Italy) and operating with an advanced MVC organisational model, in compliance with the national anti-SARS-CoV-2 legislation. The research provided additional evidence on innovative MVC organisational models, identifying an optimal MVC configuration. Besides, the obtained results remain relevant for countries where a significant portion of the population has not yet addressed the emergency, either for upcoming vaccination treatments. Furthermore, the methodology adopted in the present article proved to be a valuable resource in the analysis of the health care processes.
Conference Paper
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Genius hour is a movement that allows students to discover their interests and encourages creativity in the classroom environment. The roots of the genius hour are based on the fact that international technology companies leave 20 percent of their working time free to work in their areas of interest to increase the creativity of their employees. Employees develop various projects in their areas of interest and interests. Later, it was adapted to the classroom environment by Juliani as inquiry-based and project-based learning. Unlike project-based learning, students need to discover their inner world and interests rather than academic gain. Students who discover their interests also have the opportunity to discover their learning styles. It contributes to the development of many other skills as well as the ability to think scientifically and prepare projects. In the process, what students work, how they work, and what they produce or create as a result is controlled by the teacher. Teachers, who are in a guiding position, encourage the development of creativity and self-learning in the work that students will do within their interests. Here, the guidance of the teachers is mainly based on student interests, background information, and learning interests. When the implementation process is examined, teachers allocate one lesson or one hour per week. On the other hand, they teach with a distribution where 80 percent of the time is based on traditional standards and 20 percent is student-focused. In both forms of practice, students have the opportunity to research areas of interest and curiosity. In science education, students must learn by researching the topics that are of interest to them according to their learning style. Especially, each of the questions that occur in the minds of the students during the lesson can be a Genius hour project to improve the science education lessons. For example, considering a solar system and beyond unit, students can be expected to develop different interests and different projects.
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Disasters, pandemics, and their response measures can have secondary effects on the physical and psychological health of affected populations. Using health insurance receipt data from 2009 to 2020, we assessed changes in the prevalence of major non-communicable diseases (NCDs), including hypertension, hyperlipidemia, diabetes, and mental disorders, among affected populations before and after the Fukushima disaster and coronavirus disease (COVID-19) outbreak in Japan. Furthermore, age and sex groups with the largest increases in prevalence after these events were identified. The participants of this study were employees of large companies and their dependent family members who were insured by health insurance societies (HIS). The dataset was provided by JMDC Inc. The annual age-adjusted prevalence of each disease belonging to the HIS scheme was used to calculate the ratio of disease prevalence before and after the events. After the Fukushima disaster, hypertension, hyperlipidemia, and diabetes generally increased over a 9-year period in Fukushima Prefecture. The increase in the prevalence rate of these three NCDs and mental disorders was the highest among females aged 40–74 years compared to males and the other age groups. The prevalence of all four diseases increased after the COVID-19 outbreak in Japan, with a marked increase in males aged 0–39 years. Changes in prevalence ratios of NCDs after the COVID-19 outbreak among the areas affected by the Fukushima disaster were lower than in the whole of Japan. It is important to provide tailor-made public health support among populations in accordance with the type of disasters and pandemic.
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Public health efforts to control the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic rely on accurate information on the spread of the disease in the community. Acute and surveillance testing has been primarily used to characterize the extent of the disease. However, obtaining a representative sample of the human population is challenging because of limited testing capacity and incomplete testing compliance. Wastewater-based epidemiology is an agnostic alternative to surveillance testing that provides an average sample from the population served by the treatment facility. We compare the performance of reverse transcription quantitative PCR (RT-qPCR) and reverse transcription digital droplet PCR (RT-dPCR) for analysis of SARS-CoV-2 RNA in a regional wastewater treatment facility in northern Indiana, USA from the earliest stages of the pandemic. 1-L grab samples of wastewater were clarified and concentrated. Nucleic acids were extracted from aliquots and analyzed in parallel using the two methods. Synthetic viral nucleic acids were used for method development and generation of add-in standard-curves. Both methods were highly sensitive in detecting SARS-CoV-2 in wastewater, with detection limits as low as 1 copy per 500 mL wastewater. RT-qPCR and RT-dPCR provided essentially identical coefficients of variation (s/x¯\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\overline{\mathrm{x} }$$\end{document} = 0.15) for triplicate measurements made on wastewater samples taken on 16 days. We also observed a sevenfold decrease in viral load from a grab sample that was frozen at – 80 °C for 92 days compared to results obtained without freezing. Freezing samples before analysis should be discouraged. Finally, we found that treatment with a glycine release buffer resulted in a fourfold inhibition in RT-qPCR signal; treatment with a glycine release buffer also should be discouraged. Despite their prevalence and convenience in wastewater analysis, glycine release and freezing samples severely and additively (~ tenfold) degraded recovery and detection of SARS-CoV-2.
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The COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has led to a global health emergency. There are many similarities between SARS-CoV-2 and influenza A virus (IAV); both are single-stranded RNA viruses infecting airway epithelial cells and have similar modes of replication and transmission. Like IAVs, SARS-CoV-2 infections poses serious challenges due to the lack of effective therapeutic interventions, frequent appearances of new strains of the virus, and development of drug resistance. New approaches to control these infectious agents may stem from cellular factors or pathways that directly or indirectly interact with viral proteins to enhance or inhibit virus replication. One of the emerging concepts is that host cellular factors and pathways are required for maintaining viral genome integrity, which is essential for viral replication. Although IAVs have been studied for several years and many cellular proteins involved in their replication and pathogenesis have been identified, very little is known about how SARS-CoV-2 hijacks host cellular proteins to promote their replication. IAV induces apoptotic cell death, mediated by the B-cell lymphoma-2 (Bcl-2) family proteins in infected epithelia, and the pro-apoptotic members of this family promotes viral replication by activating host cell proteases. This review compares the life cycle and mode of replication of IAV and SARS-CoV-2 and examines the potential roles of host cellular proteins, belonging to the Bcl-2 family, in SARS-CoV-2 replication to provide future research directions.
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The Movement Control Order (MCO) enacted during the COVID-19 pandemic has profoundly altered the social life and behaviour of the Malaysian population. Because the society is facing huge social and economic challenges that need individuals to work together to solve, prosocial behaviour is regarded as one of the most important social determinants. Because it is related with individual and societal benefits, participating in prosocial activities may be a major protective factor during times of global crisis. Rather than focusing only on medical and psychiatric paradigms, perhaps all that is necessary to overcome the COVID-19 risks is for individuals to make personal sacrifices for the sake of others. In reality, a large number of initiatives proven to be beneficial in decreasing viral transmission include a trade-off between individual and collective interests. Given its crucial importance, the purpose of this concept paper is to provide some insight into prosocial behaviour during the COVID-19 period. Understanding prosocial behaviour during the COVID-19 pandemic is crucial because it may assist in the establishment of a post-COVID society and provide useful strategies for coping with future crises.
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The global economy has been hard hit by the COVID-19 pandemic. Many countries are experiencing a severe and destructive recession. A significant number of firms and businesses have gone bankrupt or been scaled down, and many individuals have lost their jobs. The main goal of this study is to support policy- and decision-makers with additional and real-time information about the labor market flow using Twitter data. We leverage the data to trace and nowcast the unemployment rate of South Africa during the COVID-19 pandemic. First, we create a dataset of unemployment-related tweets using certain keywords. Principal Component Regression (PCR) is then applied to nowcast the unemployment rate using the gathered tweets and their sentiment scores. Numerical results indicate that the volume of the tweets has a positive correlation, and the sentiments of the tweets have a negative correlation with the unemployment rate during and before the COVID-19 pandemic. Moreover, the now-casted unemployment rate using PCR has an outstanding evaluation result with a low Root Mean Square Error (RMSE), Mean Absolute Percentage Error (MAPE), Symmetric MAPE (SMAPE) of 0.921, 0.018, 0.018, respectively and a high R2-score of 0.929.
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Purpose The purpose of the current research was to identify the influence of university students' personality traits on their fear of COVID-19 and psychological resilience levels. Design and methods A cross-sectional trial was completed with 690 students. Descriptive statistics and correlations were calculated, and a path analysis was employed with the objective of assessing the model fit and investigating direct and indirect impacts. Findings Among personality traits, conscientiousness and neuroticism were observed to affect fear of COVID-19, and conscientiousness, neuroticism, and openness to experience had an effect on psychological resilience. The tested model has a good fit and explains the direct effects of the study variables. Practice implications Nurses should improve university students' psychological resilience by supporting them with protective and improving factors. The role of the psychiatric nurse is important in providing conscious and need-oriented support in extraordinary events such as pandemics.
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To provide an overview of the current situation, challenges, and trends in online medical services from the perspective of andrology and promote the development of online medical services. Users of the Learning Alliance of Urology, who mainly worked in central regions of China, were invited to complete the questionnaire that included information on the participants and their institutions and their involvement in and concerns for online medical services. We received 875 complete responses. The percentage of online andrology patients at most institutions was less than 30%. The most common services were online appointment registration (92.7%) and online payment (81.8%). Online chat consultation (77.7%) was the most common form of consultation. Only 1 in 5 of the institutions had constructed their Internet hospital. Factors related to the percentage of online andrology patients included specialized andrology clinics and wards, sufficient time for doctors to provide online services, more diversified services, and online clinic training. The biggest challenge for online medical services was diagnosis and treatment safety. It is essential to raise awareness of online medical services for hospitals and patients and strengthen standardized management and training of online medical services, especially applicable to central regions of China. However, online medical services cannot wholly replace offline services due to insufficient diagnosis and treatment.
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The geographic spread of 2019 novel coronavirus (COVID-19) infections from the epicenter of Wuhan, China, has provided an opportunity to study the natural history of the recently emerged virus. Using publicly available event-date data from the ongoing epidemic, the present study investigated the incubation period and other time intervals that govern the epidemiological dynamics of COVID-19 infections. Our results show that the incubation period falls within the range of 2-14 days with 95% confidence and has a mean of around 5 days when approximated using the best-fit lognormal distribution. The mean time from illness onset to hospital admission (for treatment and/or isolation) was estimated at 3-4 days without truncation and at 5-9 days when right truncated. Based on the 95th percentile estimate of the incubation period, we recommend that the length of quarantine should be at least 14 days. The median time delay of 13 days from illness onset to death (17 days with right truncation) should be considered when estimating the COVID-19 case fatality risk.
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Background: The initial cases of novel coronavirus (2019-nCoV)-infected pneumonia (NCIP) occurred in Wuhan, Hubei Province, China, in December 2019 and January 2020. We analyzed data on the first 425 confirmed cases in Wuhan to determine the epidemiologic characteristics of NCIP. Methods: We collected information on demographic characteristics, exposure history, and illness timelines of laboratory-confirmed cases of NCIP that had been reported by January 22, 2020. We described characteristics of the cases and estimated the key epidemiologic time-delay distributions. In the early period of exponential growth, we estimated the epidemic doubling time and the basic reproductive number. Results: Among the first 425 patients with confirmed NCIP, the median age was 59 years and 56% were male. The majority of cases (55%) with onset before January 1, 2020, were linked to the Huanan Seafood Wholesale Market, as compared with 8.6% of the subsequent cases. The mean incubation period was 5.2 days (95% confidence interval [CI], 4.1 to 7.0), with the 95th percentile of the distribution at 12.5 days. In its early stages, the epidemic doubled in size every 7.4 days. With a mean serial interval of 7.5 days (95% CI, 5.3 to 19), the basic reproductive number was estimated to be 2.2 (95% CI, 1.4 to 3.9). Conclusions: On the basis of this information, there is evidence that human-to-human transmission has occurred among close contacts since the middle of December 2019. Considerable efforts to reduce transmission will be required to control outbreaks if similar dynamics apply elsewhere. Measures to prevent or reduce transmission should be implemented in populations at risk. (Funded by the Ministry of Science and Technology of China and others.).
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In December 2019, a cluster of patients with pneumonia of unknown cause was linked to a seafood wholesale market in Wuhan, China. A previously unknown betacoronavirus was discovered through the use of unbiased sequencing in samples from patients with pneumonia. Human airway epithelial cells were used to isolate a novel coronavirus, named 2019-nCoV, which formed another clade within the subgenus sarbecovirus, Orthocoronavirinae subfamily. Different from both MERS-CoV and SARS-CoV, 2019-nCoV is the seventh member of the family of coronaviruses that infect humans. Enhanced surveillance and further investigation are ongoing. (Funded by the National Key Research and Development Program of China and the National Major Project for Control and Prevention of Infectious Disease in China.).
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Background: An ongoing outbreak of pneumonia associated with a novel coronavirus was reported in Wuhan city, Hubei province, China. Affected patients were geographically linked with a local wet market as a potential source. No data on person-to-person or nosocomial transmission have been published to date. Methods: In this study, we report the epidemiological, clinical, laboratory, radiological, and microbiological findings of five patients in a family cluster who presented with unexplained pneumonia after returning to Shenzhen, Guangdong province, China, after a visit to Wuhan, and an additional family member who did not travel to Wuhan. Phylogenetic analysis of genetic sequences from these patients were done. Findings: From Jan 10, 2020, we enrolled a family of six patients who travelled to Wuhan from Shenzhen between Dec 29, 2019 and Jan 4, 2020. Of six family members who travelled to Wuhan, five were identified as infected with the novel coronavirus. Additionally, one family member, who did not travel to Wuhan, became infected with the virus after several days of contact with four of the family members. None of the family members had contacts with Wuhan markets or animals, although two had visited a Wuhan hospital. Five family members (aged 36-66 years) presented with fever, upper or lower respiratory tract symptoms, or diarrhoea, or a combination of these 3-6 days after exposure. They presented to our hospital (The University of Hong Kong-Shenzhen Hospital, Shenzhen) 6-10 days after symptom onset. They and one asymptomatic child (aged 10 years) had radiological ground-glass lung opacities. Older patients (aged >60 years) had more systemic symptoms, extensive radiological ground-glass lung changes, lymphopenia, thrombocytopenia, and increased C-reactive protein and lactate dehydrogenase levels. The nasopharyngeal or throat swabs of these six patients were negative for known respiratory microbes by point-of-care multiplex RT-PCR, but five patients (four adults and the child) were RT-PCR positive for genes encoding the internal RNA-dependent RNA polymerase and surface Spike protein of this novel coronavirus, which were confirmed by Sanger sequencing. Phylogenetic analysis of these five patients' RT-PCR amplicons and two full genomes by next-generation sequencing showed that this is a novel coronavirus, which is closest to the bat severe acute respiatory syndrome (SARS)-related coronaviruses found in Chinese horseshoe bats. Interpretation: Our findings are consistent with person-to-person transmission of this novel coronavirus in hospital and family settings, and the reports of infected travellers in other geographical regions. Funding: The Shaw Foundation Hong Kong, Michael Seak-Kan Tong, Respiratory Viral Research Foundation Limited, Hui Ming, Hui Hoy and Chow Sin Lan Charity Fund Limited, Marina Man-Wai Lee, the Hong Kong Hainan Commercial Association South China Microbiology Research Fund, Sanming Project of Medicine (Shenzhen), and High Level-Hospital Program (Guangdong Health Commission).
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Background: A recent cluster of pneumonia cases in Wuhan, China, was caused by a novel betacoronavirus, the 2019 novel coronavirus (2019-nCoV). We report the epidemiological, clinical, laboratory, and radiological characteristics and treatment and clinical outcomes of these patients. Methods: All patients with suspected 2019-nCoV were admitted to a designated hospital in Wuhan. We prospectively collected and analysed data on patients with laboratory-confirmed 2019-nCoV infection by real-time RT-PCR and next-generation sequencing. Data were obtained with standardised data collection forms shared by the International Severe Acute Respiratory and Emerging Infection Consortium from electronic medical records. Researchers also directly communicated with patients or their families to ascertain epidemiological and symptom data. Outcomes were also compared between patients who had been admitted to the intensive care unit (ICU) and those who had not. Findings: By Jan 2, 2020, 41 admitted hospital patients had been identified as having laboratory-confirmed 2019-nCoV infection. Most of the infected patients were men (30 [73%] of 41); less than half had underlying diseases (13 [32%]), including diabetes (eight [20%]), hypertension (six [15%]), and cardiovascular disease (six [15%]). Median age was 49·0 years (IQR 41·0-58·0). 27 (66%) of 41 patients had been exposed to Huanan seafood market. One family cluster was found. Common symptoms at onset of illness were fever (40 [98%] of 41 patients), cough (31 [76%]), and myalgia or fatigue (18 [44%]); less common symptoms were sputum production (11 [28%] of 39), headache (three [8%] of 38), haemoptysis (two [5%] of 39), and diarrhoea (one [3%] of 38). Dyspnoea developed in 22 (55%) of 40 patients (median time from illness onset to dyspnoea 8·0 days [IQR 5·0-13·0]). 26 (63%) of 41 patients had lymphopenia. All 41 patients had pneumonia with abnormal findings on chest CT. Complications included acute respiratory distress syndrome (12 [29%]), RNAaemia (six [15%]), acute cardiac injury (five [12%]) and secondary infection (four [10%]). 13 (32%) patients were admitted to an ICU and six (15%) died. Compared with non-ICU patients, ICU patients had higher plasma levels of IL2, IL7, IL10, GSCF, IP10, MCP1, MIP1A, and TNFα. Interpretation: The 2019-nCoV infection caused clusters of severe respiratory illness similar to severe acute respiratory syndrome coronavirus and was associated with ICU admission and high mortality. Major gaps in our knowledge of the origin, epidemiology, duration of human transmission, and clinical spectrum of disease need fulfilment by future studies. Funding: Ministry of Science and Technology, Chinese Academy of Medical Sciences, National Natural Science Foundation of China, and Beijing Municipal Science and Technology Commission.
Article
Background: A novel human coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was identified in China in December 2019. There is limited support for many of its key epidemiologic features, including the incubation period for clinical disease (coronavirus disease 2019 [COVID-19]), which has important implications for surveillance and control activities. Objective: To estimate the length of the incubation period of COVID-19 and describe its public health implications. Design: Pooled analysis of confirmed COVID-19 cases reported between 4 January 2020 and 24 February 2020. Setting: News reports and press releases from 50 provinces, regions, and countries outside Wuhan, Hubei province, China. Participants: Persons with confirmed SARS-CoV-2 infection outside Hubei province, China. Measurements: Patient demographic characteristics and dates and times of possible exposure, symptom onset, fever onset, and hospitalization. Results: There were 181 confirmed cases with identifiable exposure and symptom onset windows to estimate the incubation period of COVID-19. The median incubation period was estimated to be 5.1 days (95% CI, 4.5 to 5.8 days), and 97.5% of those who develop symptoms will do so within 11.5 days (CI, 8.2 to 15.6 days) of infection. These estimates imply that, under conservative assumptions, 101 out of every 10 000 cases (99th percentile, 482) will develop symptoms after 14 days of active monitoring or quarantine. Limitation: Publicly reported cases may overrepresent severe cases, the incubation period for which may differ from that of mild cases. Conclusion: This work provides additional evidence for a median incubation period for COVID-19 of approximately 5 days, similar to SARS. Our results support current proposals for the length of quarantine or active monitoring of persons potentially exposed to SARS-CoV-2, although longer monitoring periods might be justified in extreme cases. Primary funding source: U.S. Centers for Disease Control and Prevention, National Institute of Allergy and Infectious Diseases, National Institute of General Medical Sciences, and Alexander von Humboldt Foundation.
Detection of Covid-19 in Children in Early
• Q Zhang
• J Chen
• R Xiang
Zhang Q, Chen J, Xiang R, et al. Detection of Covid-19 in Children in Early January 2020 in Wuhan, China. N Engl J Med, March 12, 2020 (letter) DOI: 10.1056/NE-JMc2003717
Clinical features of patients infected with 2019 novel coronavirus in Wuhan
• C Huang
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Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497-506. [PMID: 31986264] doi:10.1016/S0140-6736(20)30183
Clinical presentation and virological assessment of hospitalized cases of coronavirus disease 2019 in a travel-associated transmission cluster
• R Woelfel
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Woelfel R, Corman VM, Guggemos W, et al Clinical presentation and virological assessment of hospitalized cases of coronavirus disease 2019 in a travel-associated transmission cluster,. medRXiv March,8, 2020
China Novel Coronavirus Investigating and Research Team. A novel coronavirus from patients with pneumonia in China
• N Zhu
• D Zhang
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Zhu N, Zhang D, Wang W, et al. China Novel Coronavirus Investigating and Research Team. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020;382:727-733. doi:10.1056/NEJMoa2001017