scholarly journals Estimating the burden of SARS-CoV-2 in France

Science ◽  
2020 ◽  
Vol 369 (6500) ◽  
pp. 208-211 ◽  
Author(s):  
Henrik Salje ◽  
Cécile Tran Kiem ◽  
Noémie Lefrancq ◽  
Noémie Courtejoie ◽  
Paolo Bosetti ◽  
...  
Keyword(s):  
Intensive Care ◽  
Severe Acute Respiratory Syndrome ◽  
Credible Interval ◽  
Control Measures ◽  
Reproductive Number ◽  
Infected Population ◽  
Population Immunity ◽  
The Impact ◽  
Second Wave ◽  
Death Data

France has been heavily affected by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic and went into lockdown on 17 March 2020. Using models applied to hospital and death data, we estimate the impact of the lockdown and current population immunity. We find that 2.9% of infected individuals are hospitalized and 0.5% of those infected die (95% credible interval: 0.3 to 0.9%), ranging from 0.001% in those under 20 years of age to 8.3% in those 80 years of age or older. Across all ages, men are more likely to be hospitalized, enter intensive care, and die than women. The lockdown reduced the reproductive number from 2.90 to 0.67 (77% reduction). By 11 May 2020, when interventions are scheduled to be eased, we project that 3.5 million people (range: 2.1 million to 6.0 million), or 5.3% of the population (range: 3.3 to 9.3%), will have been infected. Population immunity appears to be insufficient to avoid a second wave if all control measures are released at the end of the lockdown.

scholarly journals Estimating the burden of SARS-CoV-2 in France

2020 ◽  
Author(s):  
Henrik Salje ◽  
Cécile Tran Kiem ◽  
Noémie Lefrancq ◽  
Noémie Courtejoie ◽  
Paolo Bosetti ◽  
...  
Keyword(s):  
Intensive Care ◽  
Control Measures ◽  
Reproductive Number ◽  
Infected Population ◽  
Population Immunity ◽  
Current Population ◽  
The Impact ◽  
Second Wave ◽  
Death Data

AbstractFrance has been heavily affected by the SARS-CoV-2 epidemic and went into lockdown on the 17th March 2020. Using models applied to hospital and death data, we estimate the impact of the lockdown and current population immunity. We find 2.6% of infected individuals are hospitalized and 0.53% die, ranging from 0.001% in those <20y to 8.3% in those >80y. Across all ages, men are more likely to be hospitalized, enter intensive care, and die than women. The lockdown reduced the reproductive number from 3.3 to 0.5 (84% reduction). By 11 May, when interventions are scheduled to be eased, we project 3.7 million (range: 2.3-6.7) people, 5.7% of the population, will have been infected. Population immunity appears insufficient to avoid a second wave if all control measures are released at the end of the lockdown.

scholarly journals Evaluating the Impact of Intervention Strategies on the First Wave and Predicting the Second Wave of COVID-19 in Thailand: A Mathematical Modeling Study

Biology ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 80
Author(s):  
Wiriya Mahikul ◽  
Palang Chotsiri ◽  
Kritchavat Ploddi ◽  
Wirichada Pan-ngum
Keyword(s):  
Credible Interval ◽  
Face Mask ◽  
Intervention Strategies ◽  
Reproductive Number ◽  
Model Parameters ◽  
Disease Propagation ◽  
Imported Cases ◽  
The Impact ◽  
Second Wave ◽  
Preparation And Evaluation

Coronavirus disease 2019 (COVID-19) has spread rapidly worldwide. This study aimed to assess and predict the incidence of COVID-19 in Thailand, including the preparation and evaluation of intervention strategies. An SEIR (susceptible, exposed, infected, recovered) model was implemented with model parameters estimated using the Bayesian approach. The model’s projections showed that the highest daily reported incidence of COVID-19 would be approximately 140 cases (95% credible interval, CrI: 83–170 cases) by the end of March 2020. After Thailand declared an emergency decree, the numbers of new cases and case fatalities decreased, with no new imported cases. According to the model’s predictions, the incidence would be zero at the end of June if non-pharmaceutical interventions (NPIs) were strictly and widely implemented. These stringent NPIs reduced the effective reproductive number (Rt) to 0.73 per day (95% CrI: 0.53–0.93) during April and May. Sensitivity analysis showed that contact rate, hand washing, and face mask wearing effectiveness were the parameters that most influenced the number of reported daily new cases. Our evaluation shows that Thailand’s intervention strategies have been highly effective in mitigating disease propagation. Continuing with these strict disease prevention behaviors could minimize the risk of a new COVID-19 outbreak in Thailand.

scholarly journals 375. COVID 19 infection in a Massachusetts community hospital

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S257-S258
Author(s):  
Raul Davaro ◽  
alwyn rapose
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Essential Hypertension ◽  
Severe Acute Respiratory Syndrome ◽  
High Mortality ◽  
Case Series ◽  
World Health ◽  
Minimal Risk ◽  
The Impact

Abstract Background The ongoing pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections has led to 105690 cases and 7647 deaths in Massachusetts as of June 16. Methods The study was conducted at Saint Vincent Hospital, an academic health medical center in Worcester, Massachusetts. The institutional review board approved this case series as minimal-risk research using data collected for routine clinical practice and waived the requirement for informed consent. All consecutive patients who were sufficiently medically ill to require hospital admission with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection by positive result on polymerase chain reaction testing of a nasopharyngeal sample were included. Results A total of 109 consecutive patients with COVID 19 were admitted between March 15 and May 31. Sixty one percent were men, the mean age of the cohort was 67. Forty one patients (37%) were transferred from nursing homes. Twenty seven patients died (24%) and the majority of the dead patients were men (62%). Fifty one patients (46%) required admission to the medical intensive care unit and 34 necessitated mechanical ventilation, twenty two patients on mechanical ventilation died (63%). The most common co-morbidities were essential hypertension (65%), obesity (60%), diabetes (33%), chronic kidney disease (22%), morbid obesity (11%), congestive heart failure (16%) and COPD (14%). Five patients required hemodialysis. Fifty five patients received hydroxychloroquine, 24 received tocilizumab, 20 received convalescent plasma and 16 received remdesivir. COVID 19 appeared in China in late 2019 and was declared a pandemic by the World Health Organization on March 11, 2020. Our study showed a high mortality in patients requiring mechanical ventilation (43%) as opposed to those who did not (5.7%). Hypertension, diabetes and obesity were highly prevalent in this aging population. Our cohort was too small to explore the impact of treatment with remdesivir, tocilizumab or convalescent plasma. Conclusion In this cohort obesity, diabetes and essential hypertension are risk factors associated with high mortality. Patients admitted to the intensive care unit who need mechanical ventilation have a mortality approaching 50 %. Disclosures All Authors: No reported disclosures

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.

scholarly journals Modelling the impact of lockdown easing measures on cumulative COVID-19 cases and deaths in England

2020 ◽  
Author(s):  
H Ziauddeen ◽  
N Subramaniam ◽  
D Gurdasani
Keyword(s):  
Bayesian Model ◽  
Added Value ◽  
Reproductive Number ◽  
Baseline Scenario ◽  
Community Transmission ◽  
Uk Government ◽  
The Uk ◽  
Incident Cases ◽  
The Impact ◽  
Death Data

AbstractBackgroundAs countries begin to ease the lockdown measures instituted to control the COVID-19 pandemic, there is a risk of a resurgence of the pandemic. The UK started easing lockdown in England when levels of community transmission remained high, which could have a major impact on case numbers and deaths. Using a Bayesian model we assessed the potential impacts of successive lockdown easing measures in England, focussing on scenarios where the reproductive number (R) remains ≤1 in line with the UK government’s stated aim.MethodsWe developed a Bayesian model to infer incident cases and R in England, from incident death data from the Office of National Statistics. We then used this to forecast excess cases and deaths in multiple plausible scenarios in which R increases at one or more time points, compared to a baseline scenario where R remains unchanged by the easing of lockdown.FindingsThe model inferred an R of 0.81 on the 13th May when England first started easing lockdown. In the most conservative scenario where R increases to 0.85 as lockdown was eased further on 1st June and then remained constant, the model predicts an excess 400 (95% CI 34-1988) deaths and 56,019 (95% CI 4768-278,083) cumulative cases over 90 days. In the scenario with maximal increases in R (but staying ≤1) with successive easing of lockdown, the model predicts 1,946 (95% CI 165-9,667) excess cumulative deaths and 351,460 (95% CI 29,894-1,747,026) excess cases.InterpretationWhen levels of transmission are high, even small changes in R with easing of lockdown can have significant impacts on expected cases and deaths, even if R remains ≤1. This will have a major impact on tracing systems and health care services in England. This model can be updated with incoming death data to refine predictions over time.FundingNone.Research in contextEvidence before this studyThe impact of social distancing and lockdown measures on controlling the COVID-19 pandemic has been studied extensively over the last few months. However there has been little examination of the likely impact of easing lockdown measures in a staged manner as is being currently carried out in England, UK. We searched PubMed, medRxiv, bioRxiv, arXiv, and Wellcome Open Research for peer-reviewed articles, preprints, and research reports using the terms “COVID-19”, “United Kingdom” and “lockdown” for research examining these impacts, but found no relevant research that could inform the impact of phased easing of lockdown within England, UK.Added value of this studyDecisions around timing of easing lockdown need to be informed by current scientific evidence. In this context, this study provides urgently needed information about the potential impact of lockdown easing at this point within the COVID-19 pandemic in England. Using an epidemiological approach with Bayesian inference, we specifically assess several plausible scenarios of increase in R from baseline as a result of easing lockdown measures at levels of current community transmission, even when the R is maintained ≤1, which is the stated aim of the UK government. We provide a comparison of these scenarios, with a baseline scenario where R remains constant, as well as against elimination strategies, where transmission is aggressively suppressed to the lowest level possible. As our code is publicly available, these methods can be easily applied to accruing data, and to any number of scenarios to better understand the implications for public health policy.Implications of all the available evidenceEasing lockdown at a point of relatively high community transmission within the UK would lead to substantial excesses of deaths, and cases, even if R is maintained at ≤1. As expected, these increases are more marked, when R rises above 1, which is a distinct possibility, given recent estimates of R by a UK government advisory group.1 Our findings suggest that an elimination strategy would be more appropriate at this point, to allow suppression of community transmission to a point where easing of lockdown would not have the same impact, as with current transmission, and would likely not overwhelm systems of test, trace and isolate, and health services within England.

scholarly journals The effect of the COVID-19 pandemic on the epidemiology of positive blood cultures in Swiss intensive care units: a nationwide surveillance study

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Lauro Damonti ◽  
Andreas Kronenberg ◽  
Jonas Marschall ◽  
Philipp Jent ◽  
Rami Sommerstein ◽  
...  
Keyword(s):  
Intensive Care ◽  
Blood Culture ◽  
Intensive Care Units ◽  
Bloodstream Infections ◽  
Incidence Rates ◽  
Blood Cultures ◽  
Nationwide Surveillance ◽  
The Impact ◽  
Second Wave ◽  
Interim Period

Abstract Background Evidence about the impact of the pandemic of COVID-19 on the incidence rates of blood cultures contaminations and bloodstream infections in intensive care units (ICUs) remains scant. The objective of this study was to investigate the nationwide epidemiology of positive blood cultures drawn in ICUs during the first two pandemic waves of COVID-19 in Switzerland. Methods We analyzed data on positive blood cultures among ICU patients, prospectively collected through a nationwide surveillance system (ANRESIS), from March 30, 2020, to May 31, 2021, a 14-month timeframe that included a first wave of COVID-19, which affected the French and Italian-speaking regions, an interim period (summer 2020) and a second wave that affected the entire country. We used the number of ICU patient-days provided by the Swiss Federal Office of Public Health as denominator to calculate incidence rates of blood culture contaminations and bloodstream infections (ICU-BSI). Incidence rate ratios comparing the interim period with the second wave were determined by segmented Poisson regression models. Results A total of 1099 blood culture contaminations and 1616 ICU-BSIs were identified in 52 ICUs during the study. Overall, more episodes of blood culture contaminations and ICU-BSI were observed during the pandemic waves, compared to the interim period. The proportions of blood culture contaminations and ICU-BSI were positively associated with the ICU occupancy rate, which was higher during the COVID-19 waves. During the more representative second wave (versus interim period), we observed an increased incidence of blood culture contaminations (IRR 1.57, 95% CI 1.16–2.12) and ICU-BSI (IRR 1.20, 95% CI 1.03–1.39). Conclusions An increase in blood culture contaminations and ICU-BSIs was observed during the second COVID-19 pandemic wave, especially in months when the ICU burden of COVID-19 patients was high.

scholarly journals The severe acute respiratory syndrome epidemic in mainland China dissected

2011 ◽  
Vol 3 (1) ◽  
pp. 2 ◽  
Author(s):  
Wuchun Cao ◽  
Sake J. De Vlas ◽  
Jan H. Richardus
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Mainland China ◽  
Emerging Infectious Diseases ◽  
Case Fatality ◽  
Epidemiological Data ◽  
Control Measures ◽  
Political Commitment ◽  
Younger Age ◽  
Surrounding Areas ◽  
The Impact

This paper provides a review of a recently published series of studies that give a detailed and comprehensive documentation of the severe acute respiratory syndrome (SARS) epidemic in mainland China, which severely struck the country in the spring of 2003. The epidemic spanned a large geographical extent but clustered in two areas: first in Guangdong Province, and about 3 months later in Beijing with its surrounding areas. Reanalysis of all available epidemiological data resulted in a total of 5327 probable cases of SARS, of whom 343 died. The resulting case fatality ratio (CFR) of 6.4% was less than half of that in other SARS-affected countries or areas, and this difference could only partly be explained by younger age of patients and higher number of community acquired infections. Analysis of the impact of interventions demonstrated that strong political commitment and a centrally coordinated response was the most important factor to control SARS in mainland China, whereas the most stringent control measures were all initiated when the epidemic was already dying down. The long-term economic consequence of the epidemic was limited, much consumption was merely postponed, but for Beijing irrecoverable losses to the tourist sector were considerable. An important finding from a cohort study was that many former SARS patients currently suffer from avascular osteo­necrosis, as a consequence of the treatment with corticosteroids during their infection. The SARS epidemic provided valuable information and lessons relevant in controlling outbreaks of newly emerging infectious diseases, and has led to fundamental reforms of the Chinese health system. In particular, a comprehensive nation-wide internet-based disease reporting system was established.

scholarly journals Initial Assessment of the Impact of the Emergency State Lockdown Measures on the 1st Wave of the COVID-19 Epidemic in Portugal

2020 ◽  
Vol 33 (11) ◽  
pp. 733
Author(s):  
Vasco Ricoca Peixoto ◽  
André Vieira ◽  
Pedro Aguiar ◽  
Carlos Carvalho ◽  
Daniel Rhys Thomas ◽  
...  
Keyword(s):  
Intensive Care ◽  
Arima Model ◽  
Control Measures ◽  
Contact Tracing ◽  
Initial Assessment ◽  
Early Action ◽  
Containment Measures ◽  
Prevention And Control Measures ◽  
Care Capacity ◽  
The Impact

Introduction: Portugal took early action to control the COVID-19 epidemic, initiating lockdown measures on March 16th when it recorded only 62 cases of COVID-19 per million inhabitants and reported no deaths. The Portuguese public complied quickly, reducing their overall mobility by 80%. The aim of this study was to estimate the initial impact of the lockdown in Portugal in terms of the reduction of the burden on the healthcare system.Material and Methods: We forecasted epidemic curves for: Cases, hospital inpatients (overall and in intensive care), and deaths without lockdown, assuming that the impact of containment measures would start 14 days after initial lockdown was implemented. We used exponential smoothing models for deaths, intensive care and hospitalizations and an ARIMA model for number of cases. Models were selected considering fitness to the observed data up to the 31st March 2020. We then compared observed (with intervention) and forecasted curves (without intervention).Results: Between April 1st and April 15th, there were 146 fewer deaths (-25%), 5568 fewer cases (-23%) and, as of April 15th, there were 519 fewer intensive care inpatients (-69%) than forecasted without the lockdown. On April 15th, the number of intensive care inpatients could have reached 748, three times higher than the observed value (229) if the intervention had been delayed.Discussion: If the lockdown had not been implemented in mid-March, Portugal intensive care capacity (528 beds) would have likely been breached during the first half of April. The lockdown seems to have been effective in reducing transmission of SARS-CoV-2, serious COVID-19 disease, and associated mortality, thus decreasing demand on health services.Conclusion: An early lockdown allowed time for the National Health Service to mobilize resources and acquire personal protective equipment, increase testing, contact tracing and hospital and intensive care capacity and to promote broad prevention and control measures. When lifting more stringent measures, strong surveillance and communication strategies that mobilize individual prevention efforts are necessary.

Control of Simultaneous Outbreaks of Carbapenemase-Producing Enterobacteriaceae and Extensively Drug-ResistantAcinetobacter baumanniiInfection in an Intensive Care Unit Using Interventions Promoted in the Centers for Disease Control and Prevention 2012 Carbapenemase-Resistant Enterobacteriaceae Toolkit

2014 ◽  
Vol 35 (7) ◽  
pp. 810-817 ◽  
Author(s):  
Kyle B. Enfield ◽  
Nujhat N. Huq ◽  
Megan F. Gosseling ◽  
Darla J. Low ◽  
Kevin C. Hazen ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Infection Control ◽  
Disease Control ◽  
Control Measures ◽  
Surgical Trauma ◽  
Infection Control Measures ◽  
Resistance Plasmids ◽  
Centers For Disease Control ◽  
The Impact

ObjectiveWe describe the efficacy of enhanced infection control measures, including those recommended in the Centers for Disease Control and Prevention’s 2012 carbapenem-resistant Enterobacteriaceae (CRE) toolkit, to control concurrent outbreaks of carbapenemase-producing Enterobacteriaceae (CPE) and extensively drug-resistantAcinetobacter baumannii(XDR-AB).DesignBefore-after intervention study.SettingFifteen-bed surgical trauma intensive care unit (ICU).MethodsWe investigated the impact of enhanced infection control measures in response to clusters of CPE and XDR-AB infections in an ICU from April 2009 to March 2010. Polymerase chain reaction was used to detect the presence ofblaKPCand resistance plasmids in CRE. Pulsed-field gel electrophoresis was performed to assess XDR-AB clonality. Enhanced infection-control measures were implemented in response to ongoing transmission of CPE and a new outbreak of XDR-AB. Efficacy was evaluated by comparing the incidence rate (IR) of CPE and XDR-AB before and after the implementation of these measures.ResultsThe IR of CPE for the 12 months before the implementation of enhanced measures was 7.77 cases per 1,000 patient-days, whereas the IR of XDR-AB for the 3 months before implementation was 6.79 cases per 1,000 patient-days. All examined CPE shared endemicblaKPCresistance plasmids, and 6 of the 7 XDR-AB isolates were clonal. Following institution of enhanced infection control measures, the CPE IR decreased to 1.22 cases per 1,000 patient-days (P= .001), and no more cases of XDR-AB were identified.ConclusionsUse of infection control measures described in the Centers for Disease Control and Prevention’s 2012 CRE toolkit was associated with a reduction in the IR of CPE and an interruption in XDR-AB transmission.

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