scholarly journals COVID-19 Contact Tracing Solutions for Mass Gatherings

2020 ◽  
pp. 1-7 ◽  
Author(s):  
Benjamin J. Ryan ◽  
Damon Coppola ◽  
James Williams ◽  
Raymond Swienton
Keyword(s):  
High Risk ◽  
Contact Tracing ◽  
Management Approach ◽  
Limiting Factor ◽  
Sporting Events ◽  
Safety Measures ◽  
Mass Gatherings ◽  
Media Communications ◽  
Current Guidelines ◽  
Limited List

ABSTRACT Mass gatherings and high-density activities, such as sporting events, conventions, and theme parks, are consistently included among highest-risk activities given the increased potential for widespread coronavirus disease 2019 (COVID-19) transmission. A more balanced risk management approach is required because absolute suppression of risk is unrealistic in all facets of life. Contact tracing remains a limiting factor in achieving such a balance. The use of Bluetooth or pairing devices is proposed to address this challenge. This simple approach, when applied in a manner that satisfies privacy and trust concerns, would allow high-risk encounters to be quickly identified, namely those where participants have spent 15 minutes or more within 6 ft of each other per current guidelines. If an attendee later tests positive for COVID-19 and tracing is required, the event organizer can provide a limited list of potential close contacts rather than an exhaustive list of all attendees. Contact tracers can, therefore, limit efforts to this concise group rather than needing to contact thousands of people or conduct mass media communications. Such a system, if institutionalized, supports risk assurance and safety measures for businesses by demonstrating a commitment to staff, customer protection, and ensuring high-risk encounters are logged, reinforcing longer-term societal pandemic resilience.

scholarly journals Pilot evaluation of risk assessment and enhanced protocols regarding contacts at an international professional golf event

2021 ◽  
Vol 7 (3) ◽  
pp. e001127
Author(s):  
Patrick G Robinson ◽  
Andrew Murray ◽  
Volker Sheer ◽  
Graeme Close ◽  
Denis F Kinane
Keyword(s):  
Risk Assessment ◽  
Pilot Study ◽  
High Risk ◽  
Disease Transmission ◽  
Low Risk ◽  
Contact Tracing ◽  
Sporting Events ◽  
Medical Surveillance ◽  
Rt Pcr ◽  
Antigen Testing

ObjectivesThe aim of this study was to assess whether a risk assessment and managed risk approach to contact tracing was practical and feasible at the Gran Canaria Lopesan Open 2021 and could inform further pilot work regarding disease transmission during elite sporting events.MethodsThis prospective cohort study included all international attendees. All participants required a minimum of one negative reverse transcriptase PCR (RT-PCR) test prior to travelling to each tournament. High-risk contacts were isolated for 10 days. Moderate-risk contacts received education regarding enhanced medical surveillance, had daily rapid antigen testing for 5 days, with RT-PCR day 5, mandated mask use and access to outside space for work purposes only. Low-risk contacts received rapid antigen testing every 48 hours and PCR testing on day 5.ResultsA total of 550 persons were accredited and were required to undergo RT-PCR testing before the event. Two of these tests were positive (0.36%). Of these, case 1 had 1 high, 23 moderate and 48 low-risk contacts. Case 2 did not have any significant travel history within 2 days of positive test and had one high-risk contact. There were no further positive tests on site in the wider cohort of attendees, from a total of 872 RT-PCR and 198 rapid antigen tests.ConclusionsThis pilot study showed it is practical, feasible and well accepted to provide enhanced (daily) virus testing and risk-mitigating measures at a professional golf event. Further study is required to assess the efficacy of these interventions; however, no transmission was found in this pilot study.

scholarly journals TissueCypher Barrett’s esophagus assay impacts clinical decisions in the management of patients with Barrett’s esophagus

2021 ◽  
Vol 09 (03) ◽  
pp. E348-E355
Author(s):  
David L. Diehl ◽  
Harshit S. Khara ◽  
Nasir Akhtar ◽  
Rebecca J. Critchley-Thorne
Keyword(s):  
High Risk ◽  
Barrett’S Esophagus ◽  
Barrett's Esophagus ◽  
Clinical Decision Making ◽  
Eradication Therapy ◽  
Low Risk ◽  
Management Approach ◽  
Low Grade ◽  
Management Decisions ◽  
The Impact

Abstract Background and study aims The TissueCypher Barrett’s Esophagus Assay is a novel tissue biomarker test, and has been validated to predict progression to high-grade dysplasia (HGD) and esophageal adenocarcinoma (EAC) in patients with Barrett’s esophagus (BE). The aim of this study was to evaluate the impact of TissueCypher on clinical decision-making in the management of BE. Patients and methods TissueCypher was ordered for 60 patients with non-dysplastic (ND, n = 18) BE, indefinite for dysplasia (IND, n = 25), and low-grade dysplasia (LGD, n = 17). TissueCypher reports a risk class (low, intermediate or high) for progression to HGD or EAC within 5 years. The impact of the test results on BE management decisions was assessed. Results Fifty-two of 60 patients were male, mean age 65.2 ± 11.8, and 43 of 60 had long segment BE. TissueCypher results impacted 55.0 % of management decisions. In 21.7 % of patients, the test upstaged the management approach, resulting in endoscopic eradication therapy (EET) or shorter surveillance interval. The test downstaged the management approach in 33.4 % of patients, leading to surveillance rather than EET. In the subset of patients whose management plan was changed, upstaging was associated with a high-risk TissueCypher result, and downstaging was associated with a low-risk result (P < 0.0001). Conclusions TissueCypher was used as an adjunct to support a surveillance-only approach in 33.4 % of patients. Upstaging occurred in 21.7 % of patients, leading to therapeutic intervention or increased surveillance. These results indicate that the TissueCypher test may enable physicians to target EET for TissueCypher high-risk BE patients, while reducing unnecessary procedures in TissueCypher low-risk patients.

scholarly journals Investigation of Four Clusters of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in Rwanda, 2020

2021 ◽  
Vol 18 (13) ◽  
pp. 7018
Author(s):  
Olivier Nsekuye ◽  
Edson Rwagasore ◽  
Marie Aime Muhimpundu ◽  
Ziad El-Khatib ◽  
Daniel Ntabanganyimana ◽  
...  
Keyword(s):  
High Risk ◽  
Severe Acute Respiratory Syndrome ◽  
Symptom Onset ◽  
Attack Rate ◽  
Positive Sample ◽  
Contact Tracing ◽  
Face To Face ◽  
Laboratory Confirmation ◽  
Closed Environment ◽  
Index Cases

We reported the findings of the first Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) four clusters identified in Rwanda. Case-investigations included contact elicitation, testing, and isolation/quarantine of confirmed cases. Socio-demographic and clinical data on cases and contacts were collected. A confirmed case was a person with laboratory confirmation of SARS-CoV-2 infection (PCR) while a contact was any person who had contact with a SARS-CoV-2 confirmed case within 72 h prior, to 14 days after symptom onset; or 14 days before collection of the laboratory-positive sample for asymptomatic cases. High risk contacts were those who had come into unprotected face-to-face contact or had been in a closed environment with a SARS-CoV-2 case for >15 min. Forty cases were reported from four clusters by 22 April 2020, accounting for 61% of locally transmitted cases within six weeks. Clusters A, B, C and D were associated with two nightclubs, one house party, and different families or households living in the same compound (multi-family dwelling). Thirty-six of the 1035 contacts tested were positive (secondary attack rate: 3.5%). Positivity rates were highest among the high-risk contacts compared to low-risk contacts (10% vs. 2.2%). Index cases in three of the clusters were imported through international travelling. Fifteen of the 40 cases (38%) were asymptomatic while 13/25 (52%) and 8/25 (32%) of symptomatic cases had a cough and fever respectively. Gatherings in closed spaces were the main early drivers of transmission. Systematic case-investigations contact tracing and testing likely contributed to the early containment of SARS-CoV-2 in Rwanda.

scholarly journals Microcalcifications without a thyroid nodule as the sole sign of papillary thyroid carcinoma

2021 ◽  
Vol 2021 ◽  
Author(s):  
Stamatina Ioakim ◽  
Vasilis Constantinides ◽  
Meropi Toumba ◽  
Theodoros Lyssiotis ◽  
Angelos Kyriacou
Keyword(s):  
High Risk ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Gland ◽  
Thyroid Carcinoma ◽  
Histopathological Examination ◽  
Needle Aspiration ◽  
List Type ◽  
Papillary Thyroid ◽  
Resected Tissue ◽  
Current Guidelines

Summary Our objective is to demonstrate the importance of considering microcalcifications even without evidence of nodules as a potential sign of malignancy. Current guidelines, such as those of the British Thyroid Association, acknowledge the clinical significance of microcalcifications only when found within nodules. In this case, they are considered a suspicious feature, classifying the nodules as U5 (i.e. high risk) where fine-needle aspiration biopsy (FNAB) is warranted, following the high likelihood of cancer in these nodules. In addition, there is a dearth of evidence of ultrasound scan (USS) detection of microcalcifications in the thyroid gland outside of nodules, along with their associated clinical implications. Yet, this clinical manifestation is not so infrequent considering that we do encounter patients in the clinic showing these findings upon ultrasound examination. Three patients who presented to our clinic with thyroid-related symptoms were shown to have areas of microcalcifications without a nodule upon sonographic evaluation of their thyroid gland. These incidentally detected hyperechoic foci were later confirmed to correspond to areas of papillary thyroid carcinoma (PTC) on histopathological examination of resected tissue following thyroidectomy. Four more cases were identified with sonographic evidence of microcalcifications without nodules and given their clinical and other sonographic characteristics were managed with active surveillance instead. Learning points Echogenic foci known as microcalcifications may be visible without apparent association to nodular structures. Microcalcifications without nodules may not be an infrequent finding. Microcalcifications are frequently indicative of malignancy within the thyroid gland even without a clearly delineated nodule. Empirically, the usual guidelines for the management of thyroid nodules can be applied to the management of microcalcifications not confined to a nodule, but such a finding per se should be classified as a ‘high-risk’ sign.

scholarly journals Mortality at Music Festivals

2019 ◽  
Vol 34 (s1) ◽  
pp. s151-s151
Author(s):  
Tracie Jones
Keyword(s):  
Motor Vehicle ◽  
Grey Literature ◽  
Safety Measures ◽  
Music Festivals ◽  
Music Festival ◽  
Academic Literature ◽  
Mass Gatherings ◽  
Mortality Burden ◽  
Data Source ◽  
Media Reports

Introduction:Fatalities at music festivals are seldom reported in the academic literature, making it difficult to understand the full scope of the issue. This gap in our knowledge makes it challenging to develop strategies that might reduce the mortality burden. It is hypothesized that the number of fatalities is rising. Building on earlier research, two further years of data on mortality at music festivals was analyzed.Methods:Synthesis of grey/academic literature.Results:The grey literature for 2016-2017 documented a total of 201 deaths, including both traumatic (105; 52%) and non-traumatic (96; 48%) causes. Deaths resulted from acts of terror (n = 60), trampling (n = 13), motor-vehicle-related (n = 10), thermal injury (n = 6), shootings (n = 5), falls (n = 4), structural collapses (n = 3), miscellaneous trauma (n = 2), and assaults (n = 2). Non-traumatic deaths included overdoses/poisonings (n = 41), miscellaneous causes (n = 36), unknown/not reported (n = 18), and natural causes (n = 1). The majority of non-trauma-related deaths were related to overdose (44%). No academic literature documented fatalities that occurred while attending a music festival during 2016 or 2017.Discussion:Reports of fatalities at music festivals are increasingly common. However, the data for this manuscript were drawn primarily from media reports, a data source that is problematic. Currently no rigorous reporting system for fatalities exists. In the context of safety planning for mass gatherings, a standardized method of reporting fatalities would inform future planning and safety measures for festival attendees. The hypothesis that mortality rate reporting increased was substantiated. However, the proliferation of music festivals, the increase in attendance at these events, and the overall increase in internet usage may have influenced this outcome.

Implementation of the Canadian Contingency Plan for a Case of Suspected Viral Hemorrhagic Fever

2003 ◽  
Vol 24 (4) ◽  
pp. 280-283 ◽  
Author(s):  
Mark Loeb ◽  
Douglas MacPherson ◽  
Michele Barton ◽  
Jan Olde
Keyword(s):  
High Risk ◽  
Tertiary Care ◽  
Hemorrhagic Fever ◽  
Internal Communication ◽  
Contact Tracing ◽  
Suspected Case ◽  
Viral Hemorrhagic Fever ◽  
Laboratory Equipment ◽  
Contingency Plan ◽  
Close Contacts

AbstractObjective:To describe the implementation of the Canadian contingency plan for viral hemorrhagic fever (VHF) in response to a suspected case.Setting:A 300-bed, tertiary-care, university-affiliated hospital.Participants:A 32-year-old Congolese woman admitted to the hospital with suspected VHF in February 2001. Contact evaluation included hospital healthcare workers and laboratory staff.Intervention:Enhanced isolation precautions were implemented in the patient care setting to prevent nosocomial transmission. Contact tracing and evaluation of close and high-risk contacts with symptoms was conducted. Laboratory precautions included barrier precautions and diversion of specimens. Communication occurred to both hospital employees and the media.Results:Three high-risk contacts, 13 close contacts, and 60 casual contacts were identified. Two close contacts became symptomatic and required evaluation. Challenging process issues included tracing of laboratory specimens, decontamination of laboratory equipment, and internal and external communication. After 5 days, a transmissible VHF of public health consequence was ruled out in the index case.Conclusion:Contingency plans for VHF can be implemented in an efficient and feasible manner. Contact tracing, laboratory issues, internal communication, and media interest can be anticipated to be the key challenges.

scholarly journals Disaster Management in High Risk Regions

2020 ◽  
Vol 3 (1) ◽  
pp. 62-74
Author(s):  
Bright Chinemerem Amajuoyi ◽  
Oguguo C. Njoku ◽  
Joachim Kodjo Arthur ◽  
Dilshad Sarwar
Keyword(s):  
High Risk ◽  
Natural Disaster ◽  
Disaster Management ◽  
Global Perspective ◽  
Himalayan Region ◽  
Natural Phenomenon ◽  
Management Approach ◽  
Indian Himalayan Region ◽  
Research Article ◽  
Stakeholder Communication

The occurrence of several cases of natural disaster and its impact on high-risk regions remains an issue that continues to attract continued research, most especially from a global perspective. Despite the devastating impact of several known natural phenomenon such as flooding, tsunamis, earthquakes, glaciers and tornadoes, there seem not to be well-structured disaster management approach from stakeholders in high-risk disaster-prone regions to cope with eventual disaster cases. The Indian Himalayan region under review within this research article has been conducted investigated, and a review on how the build of poorly constructed residences have impacted the lives of people living within this region. This article addresses this problem in a line with well-structured thematic sections that examines community resilience, effective stakeholder communication and community preparedness can result in effective disaster management approach.

scholarly journals Witch’s Broom Disease of Lime (Candidatus Phytoplasma aurantifolia): Identifying High-Risk Areas by Climatic Mapping

2018 ◽  
Vol 111 (6) ◽  
pp. 2553-2561 ◽  
Author(s):  
Philip Donkersley ◽  
Justine M Blanford ◽  
Renan Batista Queiroz ◽  
Farley W S Silva ◽  
Claudine M Carvalho ◽  
...  
Keyword(s):  
High Risk ◽  
Middle East ◽  
Plant Pathogen ◽  
Limiting Factor ◽  
Bioclimatic Modeling ◽  
Monitoring Effort ◽  
Risk Areas ◽  
Broom Disease ◽  
Acid Lime ◽  
Lime Production

Abstract Biological invasions of vectorborne diseases can be devastating. Bioclimatic modeling provides an opportunity to assess and predict areas at risk from complex multitrophic interactions of pathogens, highlighting areas in need of increased monitoring effort. Here, we model the distribution of an economically critical vectorborne plant pathogen ‘Candidatus Phytoplasma aurantifolia’, the etiological agent of Witches’ Broom Disease of Lime. This disease is a significant limiting factor on acid lime production (Citrus aurantifolia, Swingle) in the Middle East and threatens its production globally. We found that temperature, humidity, and the vector populations significantly determine disease distribution. Following this, we used bioclimatic modeling to predict potential novel sites of infections. The model outputs identified potential novel sites of infection in the citrus producing regions of Brazil and China. We also used our model to explore sites in Oman where the pathogen may not be infectious, and suggest nurseries be established there. Recent major turbulence in the citrus agricultural economy has highlighted the importance of this work and the need for appropriate and targeted monitoring programs to safeguard lime production.

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