scholarly journals Asymptomatic carriage rates and case fatality of SARS-CoV-2 infection in residents and staff in Irish nursing homes

2020 ◽  
Author(s):  
Sean P Kennelly ◽  
Adam H Dyer ◽  
Claire Noonan ◽  
Ruth Martin ◽  
Siobhan M Kennelly ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Early Stage ◽  
Case Fatality ◽  
Point Prevalence ◽  
Infection Rates ◽  
Symptom Profile ◽  
Asymptomatic Carriage ◽  
First Case ◽  
Reduce Risk ◽  
Systematic Point

Abstract Background SARS-CoV-2 has disproportionately affected nursing homes (NH). In Ireland, the first NH case COVID-19 occurred on 16 March 2020. A national point-prevalence testing programme of all NH residents and staff took place (18 April 2020 to 5 May 2020). Aims to examine characteristics of NHs across three Irish Community Health Organisations, proportions with COVID-19 outbreaks, staff and resident infection rates symptom profile and resident case fatality. Methods in total, 45 NHs surveyed, requesting details on occupancy, size, COVID-19 outbreak, outbreak timing, total symptomatic/asymptomatic cases and outcomes for residents from 29 February 2020 to 22 May 2020. Results surveys were returned from 62.2% (28/45) of NHs (2,043 residents, 2,303 beds). Three-quarters (21/28) had COVID-19 outbreaks (1,741 residents, 1,972 beds). Median time from first COVID-19 case in Ireland to first case in these NHs was 27.0 days. Resident incidence was 43.9% (764/1,741)—40.8% (710/1,741) laboratory confirmed, with 27.2% (193/710) asymptomatic and 3.1% (54/1,741) clinically suspected. Resident case fatality was 27.6% (211/764) for combined laboratory-confirmed/clinically suspected COVID-19. Similar proportions of residents in NHs with ‘early-stage’ (<28 days) versus ‘later-stage’ outbreaks developed COVID-19. Lower proportions of residents in ‘early’ outbreak NHs had recovered compared with those with ‘late’ outbreaks (37.4 versus 61.7%; χ2 = 56.9, P < 0.001). Of 395 NH staff across 12 sites with confirmed COVID-19, 24.7% (99/398) were asymptomatic. There was a significant correlation between the proportion of staff with symptomatic COVID-19 and resident numbers with confirmed/suspected COVID-19 (Spearman’s rho = 0.81, P < 0.001). Conclusion this study demonstrates the significant impact of COVID-19 on the NH sector. Systematic point-prevalence testing is necessary to reduce risk of transmission from asymptomatic carriers and manage outbreaks in this setting.

scholarly journals Asymptomatic carriage rates and case-fatality of SARS-CoV-2 infection in residents and staff in Irish nursing homes

2020 ◽  
Author(s):  
SP Kennelly ◽  
AH Dyer ◽  
R Martin ◽  
SM Kennelly ◽  
A Martin ◽  
...  
Keyword(s):  
Nursing Home ◽  
Case Fatality ◽  
Lower Proportion ◽  
Care Provision ◽  
Infection Rates ◽  
Testing Program ◽  
Symptom Profile ◽  
Asymptomatic Carriage ◽  
First Case ◽  
High Infection

AbstractBackgroundSARS-CoV-2 has disproportionately affected nursing home (NH) residents. In Ireland, the first NH case of COVID-19 occurred on 16/03/2020. A national point-prevalence testing program of all NH residents and staff took place from 18/04/2020-05/05/2020.AimsTo examine characteristics of NHs across three Community Health Organisations (CHOs) in Ireland, proportions with COVID-19 outbreaks, staff and resident, symptom-profile and resident case-fatality.MethodsForty-five NHs surveyed across three CHOs requesting details on occupancy, size, COVID-19 outbreak, timing of outbreak, total symptomatic/asymptomatic cases, and outcomes for residents from 29/02/2020-22/05/2020.ResultsSurveys were returned from (62.2%, 28/45) of NHs (2043 residents, 2303 beds). Three-quarters (21/28) had COVID-19 outbreaks (1741 residents, 1972 beds). Median time from first case of COVID-19 in Ireland to first case in these NHs was 27.0 days. Resident COVID-19 incidence was (43.9%, 764/1741): laboratory-confirmed (40.1%, 710/1741) with (27.2%, 193/710 asymptomatic), and clinically-suspected (3.1%, 54/1741). Resident case-fatality was (27.6%, 211/764) for combined laboratory-confirmed/clinically-suspected COVID-19. Similar proportions of residents in NH with an “early” outbreak (<28days) versus a later outbreak developed confirmed/suspected COVID-19. A lower proportion of residents in NHs with “early” outbreaks had recovered compared to those with “late” outbreaks (37.4% vs 61.7%; χ2=56.9, p<0.001). Among 675 NH staff across twenty-four sites who had confirmed/suspected COVID-19 (23.6%, 159/675) were asymptomatic. There was a significant correlation between the proportion of staff with symptomatic COVID-19 and resident numbers with confirmed/suspected COVID-19 (Spearman’s rho=0.81, p<0.001).ConclusionThis study demonstrates COVID-19 impact on NH residents and staff. High infection rates lead to challenges in care provision.

scholarly journals Analytical Review of COVID-19 Outbreak in India During the Global Pandemic

2020 ◽  
Vol 14 (suppl 1) ◽  
pp. 903-910
Author(s):  
Parth Goel ◽  
Dweepna Garg ◽  
Amit Ganatra
Keyword(s):  
Early Stage ◽  
Case Fatality ◽  
Epidemiological Data ◽  
Vital Role ◽  
Data Repository ◽  
Contagious Diseases ◽  
First Case ◽  
The World ◽  
Analytical Review ◽  
And Gender

COVID-19 is one of the very contagious diseases from the family Coronaviridae and spreading at a faster rate in the community. In December 2019, the first case of COVID-19 was reported in Wuhan, China. An epidemic outbreak of COVID-19 was seen in India from March 2020. Epidemiological data of COVID-19 cases of the world and India have been analyzed in our study. We have utilized publicly available two databases from data repository by Johns Hopkins CSSE and covid19india.org. COVID-19 cases and case fatality rate (CFR) of the world have been summarized and compared with India from January 22, 2020 to April 15, 2020. Indian cases were analyzed among states of India and also compared with age and gender by performing statistical approaches such as central tendency, standard deviation and interquartile range. By April 15, 2020, Indian has reported 12,322 confirmed cases, 1,498 recovered cases and 405 death cases of COVID-19. In spite of India being a diverse country with the second-highest population, the deadly side of COVID-19 was comparatively far less as compared to the other countries. India has taken preemptive measures at an early stage to prevent transmission of COVID-19 outbreak and it is reviewed from our study by comparing India with other countries. Our study also summarizes that age also plays a vital role in the intervention of COVID-19 cases.

Impact of hydroxychloroquin/azithromycin protocol on COVID-19 case-fatality rate reduction in Algeria. (Preprint)

2020 ◽  
Author(s):  
Ahmed Youssef Kada
Keyword(s):  
Case Fatality Rate ◽  
Doubling Time ◽  
Case Fatality ◽  
World Health ◽  
Fatality Rate ◽  
Therapeutic Protocol ◽  
First Case ◽  
The World ◽  
The Impact ◽  
At Home

BACKGROUND Covid-19 is an emerging infectious disease like viral zoonosis caused by new coronavirus SARS CoV 2. On December 31, 2019, Wuhan Municipal Health Commission in Hubei province (China) reported cases of pneumonia, the origin of which is a new coronavirus. Rapidly extendable around the world, the World Health Organization (WHO) declares it pandemic on March 11, 2020. This pandemic reaches Algeria on February 25, 2020, date on which the Algerian minister of health, announced the first case of Covid-19, a foreign citizen. From March 1, a cluster is formed in Blida and becomes the epicentre of the coronavirus epidemic in Algeria, its total quarantine is established on March 24, 2020, it will be smoothly alleviated on April 24. A therapeutic protocol based on hydroxychloroquine and azithromycin was put in place on March 23, for complicated cases, it was extended to all the cases confirmed on April 06. OBJECTIVE This study aimed to demonstrate the effectiveness of hydroxychloroquin/azithromycin protocol in Algeria, in particular after its extension to all patients diagnosed COVID-19 positive on RT-PCR test. We were able to illustrate this fact graphically, but not to prove it statistically because the design of our study, indeed in the 7 days which followed generalization of therapeutic protocol, case fatality rate decrease and doubling time increase, thus confirming the impact of wide and early prescription of hydroxychloroquin/azithromycin protocol. METHODS We have analyzed the data collected from press releases and follow-ups published daily by the Ministry of Health, we have studied the possible correlations of these data with certain events or decisions having a possible impact on their development, such as confinement at home and its reduction, the prescription of hydroxychloroquine/azithromycin combination for serious patients and its extension to all positive COVID subjects. Results are presented in graphics, the data collection was closed on 31/05/2020. RESULTS Covid-19 pandemic spreads from February 25, 2020, when a foreign citizen is tested positive, on March 1 a cluster is formed in the city of Blida where sixteen members of the same family are infected during a wedding party. Wilaya of Blida becomes the epicentre of coronavirus epidemic in Algeria and lockdown measures taken, while the number of national cases diagnosed begins to increases In any event, the association of early containment measures combined with a generalized initial treatment for all positive cases, whatever their degree of severity, will have contributed to a reduction in the fatality rate of COVID 19 and a slowing down of its doubling time. CONCLUSIONS In Algeria, the rapid combination of rigorous containment measure at home and early generalized treatment with hydroxychloroquin have demonstrated their effectiveness in terms of morbidity and mortality, the classic measures of social distancing and hygiene will make it possible to perpetuate these results by reducing viral transmission, the only unknown, the reopening procedure which can only be started after being surrounded by precautions aimed at ensuring the understanding of the population. CLINICALTRIAL Algeria, Covid-19, pandemic, hydroxychloroquin, azithromycin, case fatality rate

Covid-19 Cases in India: A Visual Exploratory Data Analysis Model (Preprint)

2020 ◽  
Author(s):  
Jayesh S
Keyword(s):  
Data Analysis ◽  
Exploratory Data Analysis ◽  
Case Fatality ◽  
Public Health Emergency ◽  
Virus Spread ◽  
Analysis Model ◽  
Case Fatality Ratio ◽  
First Case ◽  
Exploratory Data ◽  
The Government

UNSTRUCTURED Covid-19 outbreak was first reported in Wuhan, China. The deadly virus spread not just the disease, but fear around the globe. On January 2020, WHO declared COVID-19 as a Public Health Emergency of International Concern (PHEIC). First case of Covid-19 in India was reported on January 30, 2020. By the time, India was prepared in fighting against the virus. India has taken various measures to tackle the situation. In this paper, an exploratory data analysis of Covid-19 cases in India is carried out. Data namely number of cases, testing done, Case Fatality ratio, Number of deaths, change in visits stringency index and measures taken by the government is used for modelling and visual exploratory data analysis.

scholarly journals COVID-19 in obstetrics 2020: the experience at a New York City medical center

2020 ◽  
Vol 48 (9) ◽  
pp. 892-899
Author(s):  
Ashlesha K. Dayal ◽  
Armin S. Razavi ◽  
Amir K. Jaffer ◽  
Nishant Prasad ◽  
Daniel W. Skupski
Keyword(s):  
New York ◽  
Medical Center ◽  
Severe Disease ◽  
Infection Rates ◽  
Health Crisis ◽  
The Public ◽  
Public Health Crisis ◽  
Asymptomatic Carriage ◽  
Global Spread ◽  
Workforce Flexibility

AbstractThe global spread of the SARS-CoV-2 virus during the early months of 2020 was rapid and exposed vulnerabilities in health systems throughout the world. Obstetric SARS-CoV-2 disease was discovered to be largely asymptomatic carriage but included a small rate of severe disease with rapid decompensation in otherwise healthy women. Higher rates of hospitalization, Intensive Care Unit (ICU) admission and intubation, along with higher infection rates in minority and disadvantaged populations have been documented across regions. The operational gymnastics that occurred daily during the Covid-19 emergency needed to be translated to the obstetrics realm, both inpatient and ambulatory. Resources for adaptation to the public health crisis included workforce flexibility, frequent communication of operational and protocol changes for evaluation and management, and application of innovative ideas to meet the demand.

scholarly journals COVID-19 Response in Thailand and Its Implications on Future Preparedness

2021 ◽  
Vol 18 (3) ◽  
pp. 1089
Author(s):  
Wijitbusaba Marome ◽  
Rajib Shaw
Keyword(s):  
Early Stage ◽  
Health Resources ◽  
Holistic Approach ◽  
Disaster Risk ◽  
Community Level ◽  
Multilateral Cooperation ◽  
First Case ◽  
Multiple Dimensions ◽  
Economic And Social Impacts

Thailand has been affected by COVID-19, like other countries in the Asian region at an early stage, and the first case was reported as early as mid-January 2020. Thailand’s response to the COVID-19 pandemic has been guided by the “Integrated Plan for Multilateral Cooperation for Safety and Mitigation of COVID-19”. This paper analyses the health resources in the country and focuses on the response through community-level public health system and legislative measures. The paper draws some lessons on future preparedness, especially with respect to the four priorities of Sendai Framework for Disaster Risk Reduction. At the end, the paper puts some key learning for future preparedness. While Thailand’s response to COVID-19 has been effective in limiting the spread of the disease, it falls short at being able to address the multiple dimensions of the crisis such as the economic and social impacts. The socioeconomic sectors have been hardest hit, with significant impact on tourism sectors. Sociopolitical system also plays an important role in governance and decision-making for pandemic responses. The analysis suggests that one opportunity for enhancing resilience in Thailand is to strive for more multilevel governance that engages with various stakeholders and to support grassroots and community-level networks. The COVID-19 pandemic recovery is a chance to recover better while leaving no one behind. An inclusive long-term recovery plan for the various impacted countries needs to take a holistic approach to address existing gaps and work towards a sustainable society. Furthering the Health Emergency Disaster Risk Management (HEDRM) Framework may support a coordinated response across various linked sectors rather than straining one particular sector.

scholarly journals Characteristics Associated With Invasive Staphylococcus aureus Infection Rates in Nursing Homes, Emerging Infections Program

2020 ◽  
Vol 41 (S1) ◽  
pp. s60-s61
Author(s):  
Runa Gokhale ◽  
Kelly Jackson ◽  
Kelly Hatfield ◽  
Susan Petit ◽  
Susan Ray ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Nursing Homes ◽  
Influenza Vaccination ◽  
Incidence Rates ◽  
Resistant Organism ◽  
Short Stay ◽  
Emerging Infections ◽  
Infection Rates ◽  
Targeted Interventions ◽  
Surveillance Area

Background: Most invasive methicillin-resistant Staphylococcus aureus (iMRSA) infections have onset in the community but are associated with healthcare exposures. More than 25% of cases with healthcare exposure occur in nursing homes (NHs) where facility-specific iMRSA rates vary widely. We assessed associations between nursing home characteristics and iMRSA incidence rates to help target prevention efforts in NHs. Methods: We used active, laboratory- and population-based surveillance data collected through the Emerging Infections Program during 2011–2015 from 25 counties in 7 states. NH-onset cases were defined as isolation of MRSA from a normally sterile site in a surveillance area resident who was in a NH within 3 days before the index culture. We calculated MRSA incidence (cases per NH resident day) using Centers for Medicare & Medicaid Services (CMS) skilled nursing facility cost reports and described variation in iMRSA incidence by NH. We used Poisson regression with backward selection, assessing variables for collinearity, to estimate adjusted rate ratios (aRRs) for NH characteristics (obtained from the CMS minimum dataset) associated with iMRSA rates. Results: Of 590 surveillance area NHs included in analysis, 89 (15%) had no NH-onset iMRSA infections. Rates ranged from 0 to 23.4 infections per 100,000 resident days. Increased rate of NH-onset iMRSA infection occurred with increased percentage of residents in short stay ≤30 days (aRR, 1.09), exhibiting wounds or infection (surgical wound [aRR, 1.08]; vascular ulcer/foot infection [aRR, 1.09]; multidrug-resistant organism infection [aRR, 1.13]; receipt of antibiotics [aRR, 1.06]), using medical devices or invasive support (ostomy [aRR, 1.07]; dialysis [aRR, 1.07]; ventilator support [aRR, 1.17]), carrying neurologic diagnoses (cerebral palsy [aRR, 1.14]; brain injury [aRR, 1.1]), and demonstrating debility (requiring considerable assistance with bed mobility [aRR, 1.05]) (Table). iMRSA rates decreased with increased percentage of residents receiving influenza vaccination (aRR, 0.96) and with the presence of any patients in isolation for any active infection (aRR, 0.83). Conclusions: iMRSA incidence varies greatly across nursing homes, with many NH patient and facility characteristics associated with NH-onset iMRSA rate differences. Some associations (short stay, wounds and infection, medical device use and invasive support) suggest that targeted interventions utilizing known strategies to decrease transmission may help to reduce infection rates, while others (neurologic diagnoses, influenza vaccination, presence of patients in isolation) require further exploration to determine their role. These findings can help identify NHs in other areas more likely to have higher rates of NH-onset iMRSA who could benefit from interventions to reduce infection rates.Funding: NoneDisclosures: None

scholarly journals Preparedness is Essential for Western Pacific Islands During the COVID-19 Pandemic

2020 ◽  
pp. 1-5
Author(s):  
Yujie Mei ◽  
Jijia Hu
Keyword(s):  
Pacific Islands ◽  
Case Fatality ◽  
Western Pacific ◽  
Western Pacific Region ◽  
Dense Population ◽  
First Report ◽  
First Case ◽  
Long Time ◽  
Almost All ◽  
The Western Pacific

ABSTRACT Objectives: To clarify the pandemic status in Western Pacific countries or territories. Methods: The WHO’s daily situation reports of COVID-19 were reviewed from January 20, 2020, to March 24, 2020. Changes in the infections, deaths, and the case fatality rate (CFR) in Western Pacific countries or territories were counted. Results: As of March 24, a total of 17 countries or territories had reported the presence of COVID-19 in the Western Pacific Region, 96,580 people have been infected and a total of 3502 deaths. Fifty-three percent (9/17) of these countries or territories had their first case within 2 wk since the WHO’s first report, most are China’s neighbors with a large and dense population. No other country or territory in this region reported a new infection from January 30 to February 28. However, 8 (47.0%) countries or territories have reported the first cases in 3 wk since February 28, almost all are islands. Many countries maintained a small number of infections for a long time after the first report, but a rapid increase occurred later. Deaths occurred in 8 countries with a total CFR of 3.63%, and the CFR varies widely, from 0.39% (Singapore) to 7.14% (Philippines). Conclusions: The regional spread of COVID-19 urgently requires an aggressive preparedness for the Western Pacific Islands.

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