scholarly journals SARS-CoV-2 transmission and control in a hospital setting: an individual-based modelling study

2021 ◽  
Vol 8 (3) ◽  
Author(s):  
Qimin Huang ◽  
Anirban Mondal ◽  
Xiaobing Jiang ◽  
Mary Ann Horn ◽  
Fei Fan ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Hospital Setting ◽  
Credible Interval ◽  
Hospital Unit ◽  
Early Implementation ◽  
Using Data ◽  
And Control ◽  
The Impact ◽  
Pharmaceutical Interventions ◽  
Outbreak Size

Development of strategies for mitigating the severity of COVID-19 is now a top public health priority. We sought to assess strategies for mitigating the COVID-19 outbreak in a hospital setting via the use of non-pharmaceutical interventions. We developed an individual-based model for COVID-19 transmission in a hospital setting. We calibrated the model using data of a COVID-19 outbreak in a hospital unit in Wuhan. The calibrated model was used to simulate different intervention scenarios and estimate the impact of different interventions on outbreak size and workday loss. The use of high-efficacy facial masks was shown to be able to reduce infection cases and workday loss by 80% (90% credible interval (CrI): 73.1–85.7%) and 87% (CrI: 80.0–92.5%), respectively. The use of social distancing alone, through reduced contacts between healthcare workers, had a marginal impact on the outbreak. Our results also indicated that a quarantine policy should be coupled with other interventions to achieve its effect. The effectiveness of all these interventions was shown to increase with their early implementation. Our analysis shows that a COVID-19 outbreak in a hospital's non-COVID-19 unit can be controlled or mitigated by the use of existing non-pharmaceutical measures.

scholarly journals SARS-CoV-2 transmission and control in a hospital setting: an individual-based modelling study

2020 ◽  
Author(s):  
Qimin Huang ◽  
Anirban Mondal ◽  
Xiaobing Jiang ◽  
Mary Ann Horn ◽  
Fei Fan ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Hospital Setting ◽  
Credible Interval ◽  
Contact Tracing ◽  
Global Public Health ◽  
Minimal Impact ◽  
Social Distancing ◽  
Work Related ◽  
The Impact ◽  
Outbreak Size

Background: Development of strategies for mitigating the severity of COVID-19 is now a top global public health priority. We sought to assess strategies for mitigating the COVID-19 outbreak in a hospital setting via the use of non-pharmaceutical interventions such as social distancing, self-isolation, tracing and quarantine, wearing facial masks/ personal protective equipment. Methods: We developed an individual-based model for COVID-19 transmission among healthcare workers in a hospital setting. We calibrated the model using data of a COVID-19 outbreak in a hospital unit in Wuhan in a Bayesian framework. The calibrated model was used to simulate different intervention scenarios and estimate the impact of different interventions on outbreak size and workday loss. Results: We estimated that work-related stress increases susceptibility to COVID-19 infection among healthcare workers by 52% (90% Credible Interval (CrI): 16.4% - 93.0%). The use of high efficacy facial masks was shown to be able to reduce infection cases and workday loss by 80% (90% CrI: 73.1% - 85.7%) and 87% (CrI: 80.0% - 92.5%), respectively. The use of social distancing alone, through reduced contacts between healthcare workers, had a marginal impact on the outbreak. A strict quarantine policy with the isolation of symptomatic cases and a high fraction of pre-symptomatic/ asymptomatic cases (via contact tracing or high test rate), could only prolong outbreak duration with minimal impact on the outbreak size. Our results indicated that a quarantine policy should be coupled with other interventions to achieve its effect. The effectiveness of all these interventions was shown to increase with their early implementation. Conclusions: Our analysis shows that a COVID-19 outbreak in a hospital's non-COVID-19 unit can be controlled or mitigated by the use of existing non-pharmaceutical measures.

scholarly journals Evolving Epidemiology and Impact of Non-pharmaceutical Interventions on the Outbreak of Coronavirus Disease 2019 in Wuhan, China

2020 ◽  
Author(s):  
Chaolong Wang ◽  
Li Liu ◽  
Xingjie Hao ◽  
Huan Guo ◽  
Qi Wang ◽  
...  
Keyword(s):  
Attack Rate ◽  
Healthcare Workers ◽  
Age Groups ◽  
Credible Interval ◽  
Reproductive Number ◽  
Demographic Groups ◽  
Individual Level ◽  
Epidemiological Characteristics ◽  
The Impact ◽  
Pharmaceutical Interventions

ABSTRACTBACKGROUNDWe described the epidemiological features of the coronavirus disease 2019 (Covid-19) outbreak, and evaluated the impact of non-pharmaceutical interventions on the epidemic in Wuhan, China.METHODSIndividual-level data on 25,961 laboratory-confirmed Covid-19 cases reported through February 18, 2020 were extracted from the municipal Notifiable Disease Report System. Based on key events and interventions, we divided the epidemic into four periods: before January 11, January 11-22, January 23 - February 1, and February 2-18. We compared epidemiological characteristics across periods and different demographic groups. We developed a susceptible-exposed-infectious-recovered model to study the epidemic and evaluate the impact of interventions.RESULTSThe median age of the cases was 57 years and 50.3% were women. The attack rate peaked in the third period and substantially declined afterwards across geographic regions, sex and age groups, except for children (age <20) whose attack rate continued to increase. Healthcare workers and elderly people had higher attack rates and severity risk increased with age. The effective reproductive number dropped from 3.86 (95% credible interval 3.74 to 3.97) before interventions to 0.32 (0.28 to 0.37) post interventions. The interventions were estimated to prevent 94.5% (93.7 to 95.2%) infections till February 18. We found that at least 59% of infected cases were unascertained in Wuhan, potentially including asymptomatic and mild-symptomatic cases.CONCLUSIONSConsiderable countermeasures have effectively controlled the Covid-19 outbreak in Wuhan. Special efforts are needed to protect vulnerable populations, including healthcare workers, elderly and children. Estimation of unascertained cases has important implications on continuing surveillance and interventions.

SARS-CoV-2 Transmission and Control Among Healthcare Workers in a Hospital Setting: A Modelling Study

2020 ◽  
Author(s):  
Qimin Huang ◽  
Anirban Mondal ◽  
Xiaobing Jiang ◽  
Mary Ann Horn ◽  
Fei Fan ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Hospital Setting ◽  
And Control ◽  
Modelling Study

scholarly journals The impact of SARS‐CoV‐2 on the mental health of healthcare workers in a hospital setting—A Systematic Review

2020 ◽  
Vol 62 (1) ◽  
Author(s):  
Jaspinder Sanghera ◽  
Nikhil Pattani ◽  
Yousuf Hashmi ◽  
Kate F. Varley ◽  
Manikandar Srinivas Cheruvu ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Healthcare Workers ◽  
Hospital Setting ◽  
The Impact

Stopping Out and Going Back: The Impact of Educational Attainment on Criminal Desistance Among Stopped-Out Offenders

2019 ◽  
Vol 65 (4) ◽  
pp. 527-554 ◽  
Author(s):  
David Abeling-Judge
Keyword(s):  
Prevention And Control ◽  
Degree Attainment ◽  
Longitudinal Survey ◽  
Drop Out ◽  
Using Data ◽  
Desistance From Crime ◽  
And Control ◽  
The Impact ◽  
Educational Pursuits ◽  
Specific Degree

Education has been consistently studied as a source of crime prevention and control, but the relevance of returning and completing educational degrees among offenders who drop out, as an opportunity to further the process of desistance, has not received empirical attention. The current study addresses this gap in desistance research by examining the impact of educational return and specific degree attainment on desistance from crime using data from the National Longitudinal Survey of Youth 1997. Results indicate that reenrolling in educational pursuits can produce partial desistance effects as does specific degree attainment. The findings suggest a reconsideration of education as both a source of prevention and desistance and expands theoretical and practical discussion of desistance through educational pursuits.

scholarly journals Impact of non-pharmaceutical interventions for SARS-CoV-2 on norovirus outbreaks: an analysis of outbreaks reported by 9 US States

2020 ◽  
Author(s):  
Alicia N.M. Kraay ◽  
Peichun Han ◽  
Anita K. Kambhampati ◽  
Mary E. Wikswo ◽  
Sara A. Mirza ◽  
...  
Keyword(s):  
United States ◽  
South Carolina ◽  
The United States ◽  
Respiratory Pathogen ◽  
Secondary Outcome ◽  
Interrupted Time Series Analysis ◽  
Official Position ◽  
The Impact ◽  
Pharmaceutical Interventions ◽  
Outbreak Size

AbstractImportanceThe impact of non-pharmaceutical interventions (NPIs) in response to the SARS-CoV-2 pandemic on incidence of other infectious diseases is still being assessed.ObjectiveTo determine if the observed change in reported norovirus outbreaks in the United States was best explained by underreporting, seasonal trends, or reduced exposure due to NPIs. We also aimed to assess if the change in reported norovirus outbreaks varied by setting.DesignAn ecologic, interrupted time series analysis of norovirus outbreaks from nine states reported to the National Outbreak Reporting System (NORS) from July 2012–July 2020.SettingSurveillance data from Massachusetts, Michigan, Minnesota, Ohio, Oregon, South Carolina, Tennessee, Virginia, and Wisconsin were included in the analysis.Participants9,226 reports of acute gastroenteritis outbreaks with norovirus as an epidemiologically suspected or laboratory-confirmed etiology were included in the analysis, resulting in more than 8 years of follow up. Outbreak reports from states that participated in NoroSTAT for at least 4 years were included in the analysis (range: 4–8 years).ExposureThe main exposure of interest was time period: before (July 2012–February 2020) or after (April 2020–July 2020) the start of NPIs in the United StatesMain outcomeThe main outcome of interest was monthly rate of reported norovirus outbreaks. As a secondary outcome, we also examined the average outbreak size.ResultsWe found that the decline in norovirus outbreak reports was significant for all 9 states considered (pooled incidence rate ratio (IRR) comparing April 2020-July 2020 vs. all pre-COVID months for each state= 0.14, 95% CI: 0.098, 0.21; P=<0.0001), even after accounting for typical seasonal decline in incidence during the summer months. These patterns were similar across a variety of settings, including nursing homes, child daycares, healthcare settings, and schools. The average outbreak size was also reduced by 61% (95% CI: 56%, 42.7%; P=<0.0001), suggesting that the decline does not reflect a tendency to report only more severe outbreaks due to strained surveillance systems, but instead reflects a decline in incidence.Conclusions and relevanceWhile NPIs implemented during the spring and summer of 2020 were intended to reduce transmission of SARS-CoV-2, these changes also appear to have impacted the incidence of norovirus, a non-respiratory pathogen. These results suggest that NPIs may provide benefit for preventing transmission of other human pathogens, reducing strain to health systems during the continued SARS-CoV-2 pandemic.DisclaimerThe findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention (CDC).

scholarly journals Separation of ownership and control in South African-listed companies

2013 ◽  
Vol 16 (3) ◽  
pp. 316-345 ◽  
Author(s):  
Blanché Steyn ◽  
Lesley Stainbank
Keyword(s):  
South African ◽  
Stock Exchange ◽  
Listed Companies ◽  
South African Context ◽  
Valuable Contribution ◽  
Self Interest ◽  
African Context ◽  
Using Data ◽  
And Control ◽  
The Impact

This article tests the separation of ownership and control in South African-listed companies that leads to the divergence of interest between shareholders and directors. Where listed companies are owned by so many shareholders that their diffused shareholding results in negligible control over the directors who manage the assets of the company, it is likely that the directors will manage and direct the company to maximise their self-interest to the detriment of the interest of the shareholders. The separation of ownership and control and the maximisation of self-interest are central themes in the agency theory. Researching their validity in a South African context where the market is less liquid and the stock exchange is significantly smaller can add a valuable contribution to the continuing debate on corporate governance in the country. The article analyses 186 listed South African companies using data extracted over four years to test whether there is separation of ownership and control and whether such separation leads to the maximisation of self-interest. Data were extracted for the years 2005 and 2006, using the shareholding in 2006 to determine control, and for the years 2009 and 2010, using the shareholding in 2010 to determine control. Directors’ remuneration as a percentage of assets was used as a proxy for the maximisation of directors’ interest, and profit attributable to shareholders as a percentage of assets was used as a proxy for the maximisation of shareholders’ interest. These proxies were used to test the impact of control during the two controlling periods, namely 2006 and 2010.The article finds that the majority of listed companies in South Africa are controlled by a dominant shareholder. However, there are still a significant number of companies where the directors have de facto control. Contrary to the expectation that companies controlled by directors will aim to maximise directors’ remuneration, or companies controlled by shareholders will aim to maximise profit attributable to shareholders, this article finds the opposite to be true. This is possibly an indication that the controlling parties might consider factors other than their direct financial self-interest, or that there is an inherent cost associated with control.

scholarly journals Effect of public health interventions during the first epidemic wave of COVID-19 in Cyprus: a modelling study

2021 ◽  
Author(s):  
Ilias Gountas ◽  
Annalisa Quattrocchi ◽  
Ioannis Mamais ◽  
Constantinos Tsioutis ◽  
Eirini Christaki ◽  
...  
Keyword(s):  
Public Health ◽  
Healthcare System ◽  
Credible Interval ◽  
Health Interventions ◽  
Public Health Interventions ◽  
Case Ascertainment ◽  
Dynamic Stochastic ◽  
Republic Of Cyprus ◽  
The Impact ◽  
Pharmaceutical Interventions

AbstractBackgroundCyprus addressed the first wave of SARS CoV-2 (COVID-19) by implementing non-pharmaceutical interventions. The aims of this study were: a) to estimate epidemiological parameters of this wave including infection attack ratio, infection fatality ratio, and case ascertainment ratio, b) to assess the impact of public health interventions, and c) to examine what would have happened if those interventions had not been implemented.MethodsA dynamic, stochastic, individual-based Susceptible-Exposed-Infected-Recovered (SEIR) model was developed to simulate COVID-19 transmission and progression in the population of the Republic of Cyprus. The model was fitted to the observed trends in COVID-19 deaths and intensive care unit (ICU) bed use.ResultsBy May 8 2020th, the infection attack ratio was 0.31% (95% Credible Interval (CrI): 0.15%, 0.54%), the infection fatality ratio was 0.71% (95% CrI: 0.44%, 1.61%), and the case ascertainment ratio was 33.2% (95% CrI: 19.7%, 68.7%). If Cyprus had not implemented any public health measure, the healthcare system would have been overwhelmed by April 14th. The interventions averted 715 (95% CrI: 339, 1235) deaths. If Cyprus had only increased ICU beds, without any social distancing measure, the healthcare system would have been overwhelmed by April 19th.ConclusionsThe decision of the Cypriot authorities to launch early non-pharmaceutical interventions limited the burden of the first wave of COVID-19. The findings of these analyses could help address the next waves of COVID-19 in Cyprus and other similar settings.

scholarly journals Influence of observable and unobservable exposure on the patient's risk of acquiring influenza-like illness at hospital

2016 ◽  
Vol 144 (10) ◽  
pp. 2025-2030 ◽  
Author(s):  
C. PAYET ◽  
N. VOIRIN ◽  
R. ECOCHARD ◽  
P. VANHEMS
Keyword(s):  
Healthcare Workers ◽  
Credible Interval ◽  
Control Measures ◽  
Primary Case ◽  
Influenza Like Illness ◽  
Source Of Infection ◽  
Influenza Transmission ◽  
The Moment ◽  
Hospital Acquired ◽  
And Control

SUMMARYDuring outbreaks of hospital-acquired influenza-like illness (HA-ILI) healthcare workers (HCWs), patients, and visitors are each a source of infection for the other. Quantifying the effects of these various exposures will help improve prevention and control of HA-ILI outbreaks. We estimated the attributability of HA-ILI to: (1) exposure to recorded or unrecorded sources; (2) exposure to contagious patient or contagious HCW; (3) exposure during observable or unobservable contagious period of the recorded sources; and, (4) the moment of exposure. Among recorded sources, 59% [95% credible interval (CrI) 34–83] of HA-ILI of patients was associated with exposure to contagious patients and 41% (95% CrI 17–66) with exposure to contagious HCWs. Exposure during the unobservable contagiousness period of source patients accounted for 49% (95% CrI 19–75) of HA-ILI, while exposure during the unobservable contagiousness period of source HCWs accounted for 82% (95% CrI 51–99) of HA-ILI. About 80% of HA-ILIs were associated with exposure 1 day earlier. Secondary cases of HA-ILI might appear as soon as the day after the detection of a primary case highlighting the explosive nature of HA-ILI spread. Unobservable transmission was the main cause of HA-ILI transmission suggesting that symptom-based control measures alone might not prevent hospital outbreaks. The results support the rapid implementation of interventions to control influenza transmission.

scholarly journals The first wave of the COVID-19 pandemic in Spain: characterisation of cases and risk factors for severe outcomes, as at 27 April 2020

2020 ◽  
Vol 25 (50) ◽  
Author(s):  
Keyword(s):  
Risk Factors ◽  
Healthcare Workers ◽  
Chronic Renal Disease ◽  
Underlying Disease ◽  
Control Measures ◽  
Multivariable Regression ◽  
Underlying Diseases ◽  
And Control ◽  
The Impact ◽  
Case Characteristics

Background The first wave of the coronavirus disease (COVID-19) pandemic spread rapidly in Spain, one of Europe’s most affected countries. A national lockdown was implemented on 15 March 2020. Aim To describe reported cases and the impact of national lockdown, and to identify disease severity risk factors. Methods National surveillance data were used to describe PCR-confirmed cases as at 27 April 2020. We compared case characteristics by severity categories (hospitalisation, admission to intensive care unit (ICU), death) and identified severity risk factors using multivariable regression. Results The epidemic peaked on 20 March. Of 218,652 COVID-19 cases, 45.4% were hospitalised, 4.6% were admitted to ICU and 11.9% died. Among those who died, 94.8% had at least one underlying disease. Healthcare workers (HCWs) represented 22.9% of cases. Males were more likely to have severe outcomes than females. Cardiovascular disease was a consistent risk factor. Patients with pneumonia had higher odds of hospitalisation (odds ratio (OR): 26.63; 95% confidence interval (CI): 25.03–28.33). The strongest predictor of death was age ≥ 80 years (OR: 28.4; 95% CI: 19.85–40.78). Among underlying diseases, chronic renal disease had highest odds of death (OR: 1.47; 95% CI: 1.29–1.68). Conclusions COVID-19 case numbers began declining 6 days after the national lockdown. The first wave of the COVID-19 pandemic in Spain had a severe impact on elderly people. Patients with cardiovascular or renal conditions were at higher risk for severe outcomes. A high proportion of cases were HCWs. Enhanced surveillance and control measures in these subgroups are crucial during future COVID-19 waves.

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