scholarly journals Implementation and Evolution of Mitigation Measures, Testing, and Contact Tracing in the National Football League, August 9–November 21, 2020

2021 ◽  
Vol 70 (4) ◽  
pp. 130-135
Author(s):  
Christina D. Mack ◽  
Erin B. Wasserman ◽  
Cria G. Perrine ◽  
Adam MacNeil ◽  
Deverick J. Anderson ◽  
...  
2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Satyaki Roy ◽  
Preetom Biswas ◽  
Preetam Ghosh

AbstractCOVID-19, a global pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus 2 virus, has claimed millions of lives worldwide. Amid soaring contagion due to newer strains of the virus, it is imperative to design dynamic, spatiotemporal models to contain the spread of infection during future outbreaks of the same or variants of the virus. The reliance on existing prediction and contact tracing approaches on prior knowledge of inter- or intra-zone mobility renders them impracticable. We present a spatiotemporal approach that employs a network inference approach with sliding time windows solely on the date and number of daily infection numbers of zones within a geographical region to generate temporal networks capturing the influence of each zone on another. It helps analyze the spatial interaction among the hotspot or spreader zones and highly affected zones based on the flow of network contagion traffic. We apply the proposed approach to the daily infection counts of New York State as well as the states of USA to show that it effectively measures the phase shifts in the pandemic timeline. It identifies the spreaders and affected zones at different time points and helps infer the trajectory of the pandemic spread across the country. A small set of zones periodically exhibit a very high outflow of contagion traffic over time, suggesting that they act as the key spreaders of infection. Moreover, the strong influence between the majority of non-neighbor regions suggests that the overall spread of infection is a result of the unavoidable long-distance trips by a large number of people as opposed to the shorter trips at a county level, thereby informing future mitigation measures and public policies.


2021 ◽  
Author(s):  
Marcelo Eduardo Borges ◽  
Leonardo Souto Ferreira ◽  
Silas Poloni ◽  
Ângela Maria Bagattini ◽  
Caroline Franco ◽  
...  

Among the various non–pharmaceutical interventions implemented in response to the Covid–19 pandemic during 2020, school closures have been in place in several countries to reduce infection transmission. Nonetheless, the significant short and long–term impacts of prolonged suspension of in–person classes is a major concern. There is still considerable debate around the best timing for school closure and reopening, its impact on the dynamics of disease transmission, and its effectiveness when considered in association with other mitigation measures. Despite the erratic implementation of mitigation measures in Brazil, school closures were among the first measures taken early in the pandemic in most of the 27 states in the country. Further, Brazil delayed the reopening of schools and stands among the countries in which schools remained closed for the most prolonged period in 2020. To assess the impact of school reopening and the effect of contact tracing strategies in rates of Covid–19 cases and deaths, we model the epidemiological dynamics of disease transmission in 3 large urban centers in Brazil under different epidemiological contexts. We implement an extended SEIR model stratified by age and considering contact networks in different settings – school, home, work, and elsewhere, in which the infection transmission rate is affected by various intervention measures. After fitting epidemiological and demographic data, we simulate scenarios with increasing school transmission due to school reopening. Our model shows that reopening schools results in a non–linear increase of reported Covid-19 cases and deaths, which is highly dependent on infection and disease incidence at the time of reopening. While low rates of within[&ndash]school transmission resulted in small effects on disease incidence (cases/100,000 pop), intermediate or high rates can severely impact disease trends resulting in escalating rates of new cases even if other interventions remain unchanged. When contact tracing and quarantining are restricted to school and home settings, a large number of daily tests is required to produce significant effects of reducing the total number of hospitalizations and deaths. Our results suggest that policymakers should carefully consider the epidemiological context and timing regarding the implementation of school closure and return of in-person school activities. Also, although contact tracing strategies are essential to prevent new infections and outbreaks within school environments, our data suggest that they are alone not sufficient to avoid significant impacts on community transmission in the context of school reopening in settings with high and sustained transmission rates.


2020 ◽  
Author(s):  
Viktor von Wyl

BACKGROUND Several countries have released digital proximity tracing (DPT) apps in addition to manual contact tracing (MCT) to combat the Sars-CoV-2 pandemic. The goal of DPT is to notify app users about proximity exposures to persons infected with Sars-CoV-2 so that they can self-quarantine. However, early press reports from Switzerland suggest multiple challenges for non-technical DPT implementation. OBJECTIVE Using media articles published during the first three months after the DPT app launch to describe non-technical implementation challenges reported by different stakeholders and to map these reports to the four constructs of normalization process theory (NPT), a framework to develop and evaluate complex digital health interventions. METHODS A Swiss media database was searched for articles on the Swiss DPT app (SwissCovid) published in German or French between 04.07.2020 and 03.10.2020. Topics were extracted manually from articles that were deemed pertinent in a structured process. Extracted topics were mapped to NPT constructs. RESULTS Out of 94 articles deemed pertinent and selected for closer inspection, 38 provided unique information on implementation challenges. These challenges included unclear DPT benefits, which affected commitment and raised fears among different health system actors regarding resource competition with established pandemic mitigation measures. Moreover, media reports indicated process interface challenges such as delays or unclear responsibilities in the notification cascade, as well as misunderstandings and unmet communication needs from certain health system actors. Finally, some reports suggested misaligned incentives, not only for app usage by the public but also for process engagement by other actors in the app notification cascade. These challenges mapped well to the four constructs of NPT. CONCLUSIONS Early experiences from one of the first adopters of DPT indicate that non-technical implementation challenges warrant attention. The detected implementation challenges fit well into the framework of NPT, which seems well suited to guide the development and evaluation of complex DPT interventions.


2020 ◽  
Vol 1 (1) ◽  
pp. 15-25
Author(s):  
Amod K. Pokhrel ◽  
Yadav P. Joshi ◽  
Sopnil Bhattarai

There is limited information on the epidemiology and the effects of mitigation measures on the spread of COVID-19 in Nepal. Using publicly available databases, we analyzed the epidemiological trend, the people's movement trends at different intervals across different categories of places and evaluated implications of social mobility on COVID-19. We also estimated the epidemic peak. As of June 9, 2020, Provinces 2 and 5 have most of the cases. People between 15 and 54 years are vulnerable to becoming infected, and more males than females are affected. The cases are growing exponentially. The growth rate of 0.13 and >1 reproduction numbers (R0) over time (median: 1.48; minimum: 0.58, and maximum: 3.71) confirms this trend. The case doubling time is five days. Google's community mobility data suggest that people strictly followed social distancing measures for one month after the lockdown. By around the 4th week of April, the individual's movement started rising, and social contacts increased. The number of cases peaked on May 12, with 83 confirmed cases in one day. The Susceptible-Exposed-Infectious-Removed (SEIR) model suggests that the epidemic will peak approximately on day 41 (July 21, 2020), and start to plateau after day 80. To contain the spread of the virus, people should maintain social distancing. The Government needs to continue active surveillance, more PCR-based testing, case detection, contact tracing, isolation, and quarantine. The Government should also provide financial support and safety-nets to the citizen to limit the impact of COVID-19.


2021 ◽  
Author(s):  
Sandra B Nelson ◽  
Caitlin Dugdale ◽  
Alyssa Bilinski ◽  
Duru Cosar ◽  
Nira L Pollock ◽  
...  

Introduction The SARS-CoV-2 secondary attack rate (SAR) in schools is low when mitigation measures are adopted, Data on the relative impact of such strategies are limited. We evaluated the SARS-CoV-2 SAR in Massachusetts schools during 2020-21 and factors associated with transmission risk. Methods: In a convenience sample of 25 Massachusetts public K-12 school districts, de-identified information about SARS-CoV-2 cases and their school-based contacts was reported using a standardized contact-tracing tool. Index cases were included if they were in school while infectious. SAR was defined as the proportion of in-school contacts acquiring SARS-CoV-2 infection and designated as possible or probable in-school transmission by school-based teams. We compared exposure-specific SAR using unadjusted risk ratios (RR) with 95% confidence intervals (CI); p-values were calculated using Fishers exact tests. Results Eight districts (70 schools with >33,000 enrolled students) participated. There were 435 index cases and 1,771 school-based contacts (Table 1). Most contacts (1327/1771 [75%]) underwent SARS-CoV-2 testing and 39/1327 (2.9%) contacts tested positive. Of 39 positive contacts, 10 (25.6%) had clear out-of-school exposures and were deemed not in-school transmissions, so were excluded from further calculations. Twenty-nine (74.4%) contacts were deemed possible or probable in-school transmissions, resulting in an in-school SAR of 2.2%. Of the 29 in-school transmissions, 6 (20.7%) were staff-to-staff, 7 (24.1%) were staff-to-student, 3 (10.3%) were student-to-staff, and 13 (44.8%) were student-to-student; 6 (20.7%) occurred from index cases attending work/school while symptomatic. The unadjusted SAR (Table 2) was significantly higher if the index case was a staff member versus a student (RR 2.18, 95% CI 1.06-4.49; p=0.030), if the index case was identified via in-school contact tracing versus via school-based asymptomatic testing (RR 8.44, 95% CI 1.98-36.06; p=0.001), if the exposure occurred at lunch versus elsewhere (RR 5.74, 95% CI 2.11-15.63; p<0.001; all lunch transmissions were staff-to-staff), and if both parties were unmasked versus both masked (RR 6.98, 95% CI 3.09-15.77; p<0.001). For students, SAR did not differ by grade level. Conclusions Secondary attack rates for SARS-CoV-2 were low in public school settings with comprehensive mitigation measures in place before the emergence of the delta variant; lack of masking and staff-to-staff dining were associated with increased risk.


2021 ◽  
Vol 13 (11) ◽  
pp. 268
Author(s):  
Theodoros Oikonomidis ◽  
Konstantinos Fouskas ◽  
Maro Vlachopoulou

The spread of coronavirus disease (COVID-19) has triggered a series of responses worldwide ranging from traveling restrictions and shelter-in-place orders to lockdowns, contact tracing, social distancing, and other mitigation measures. To assist with contact tracing and ensure the safety of citizens, a significant number of mobile applications has been developed, utilizing geospatial information and proximity sensing. We perform a thorough research on seven digital databases (Appbrain, e-Health Hub, GDPRhub, “fs0c131y”, News Sites, Appstore, and Google Play), identifying a total of 160 apps regarding COVID-19 related to our research questions. The aim of this research is to identify the main categories of apps and analyze their functions based on a proposed framework of by mapping aspects that affect their functionalities regarding Services, Technology, Societal & Business, and Legal aspects. As the world comes to the new normal, the utilization of these apps might become more essential for more mobile users and developers. The new encryption protocols that are established are also in favor of this argument. Future work can utilize our framework to further examine the development, design, and adoption of such mobile applications.


10.2196/25345 ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. e25345
Author(s):  
Viktor von Wyl

Background Several countries have released digital proximity tracing (DPT) apps to complement manual contact tracing for combatting the SARS-CoV-2 pandemic. DPT aims to notify app users about proximity exposures to persons infected with SARS-CoV-2 so that they can self-quarantine. The success of DPT apps depends on user acceptance and the embedding of DPT into the pandemic mitigation strategy. Objective By searching for media articles published during the first 3 months after DPT launch, the implementation of DPT in Switzerland was evaluated to inform similar undertakings in other countries. The second aim of the study was to create a link between reported DPT implementation challenges and normalization process theory for planning and optimizing complex digital health interventions, which can provide useful guidance for decision-making in DPT design and implementation. Methods A Swiss media database was searched for articles on the Swiss DPT app (SwissCovid) published in German or French between July 4 and October 3, 2020. In a structured process, topics were extracted and clustered manually from articles that were deemed pertinent. Extracted topics were mapped to four NPT constructs, which reflected the flow of intervention development from planning, stakeholder onboarding, and execution to critical appraisal. Coherence constructs describe sense-making by stakeholders, cognitive participation constructs reflect participants’ efforts to create engagement with the intervention, collective actions refer to intervention execution and joint stakeholder efforts to make the intervention work, and reflexive monitoring refers to collective risk-benefit appraisals to create improvements. Results Out of 94 articles deemed pertinent and selected for closer inspection, 38 provided unique information on implementation challenges. Five challenge areas were identified: communication challenges, challenges for DPT to interface with other processes, fear of resource competition with established pandemic mitigation measures, unclear DPT effectiveness, and obstacles to greater user coverage and compliance. Specifically, several articles mentioned unclear DPT benefits to affect commitment and to raise fears among different health system actors regarding resource competition. Moreover, media reports indicated process interface challenges such as delays or unclear responsibilities in the notification cascade, as well as misunderstandings and unmet communication needs from health system actors. Finally, reports suggested misaligned incentives, not only for app usage by the public but also for process engagement by other actors in the app notification cascade. NPT provided a well-fitting framework to contextualize the different DPT implementation challenges and to highlight improvement strategies, namely a better alignment of stakeholder incentives, or stakeholder-specific communication to address their concerns about DPT. Conclusions Early experiences from one of the first adopters of DPT indicate that nontechnical implementation challenges may affect the effectiveness of DPT. The NPT analysis provides a novel perspective on DPT implementation and stresses the need for stakeholder inclusion in development and operationalization.


2020 ◽  
Author(s):  
Paul J Birrell ◽  
Joshua Blake ◽  
Edwin van Leeuwen ◽  
Nick Gent ◽  
Daniela De Angelis ◽  
...  

England has been heavily affected by the SARS-CoV-2 pandemic, with severe 'lock-down' mitigation measures now gradually being lifted. The real-time pandemic monitoring presented here has contributed to the evidence informing this pandemic management. Estimates on the 10th May showed lock-down had reduced transmission by 75%, the reproduction number falling from 2.6 to 0.61. This regionally-varying impact was largest in London of 81% (95% CrI: 77%-84%). Reproduction numbers have since slowly increased, and on 19th June the probability that the epidemic is growing was greater than 50% in two regions, South West and London. An estimated 8% of the population had been infected, with a higher proportion in London (17%). The infection-to-fatality ratio is 1.1% (0.9%-1.4%) overall but 17% (14%-22%) among the over-75s. This ongoing work will be key to quantifying any widespread resurgence should accrued immunity and effective contact tracing be insufficient to preclude a second wave.


2020 ◽  
Vol 117 (26) ◽  
pp. 14857-14863 ◽  
Author(s):  
Renyi Zhang ◽  
Yixin Li ◽  
Annie L. Zhang ◽  
Yuan Wang ◽  
Mario J. Molina

Various mitigation measures have been implemented to fight the coronavirus disease 2019 (COVID-19) pandemic, including widely adopted social distancing and mandated face covering. However, assessing the effectiveness of those intervention practices hinges on the understanding of virus transmission, which remains uncertain. Here we show that airborne transmission is highly virulent and represents the dominant route to spread the disease. By analyzing the trend and mitigation measures in Wuhan, China, Italy, and New York City, from January 23 to May 9, 2020, we illustrate that the impacts of mitigation measures are discernable from the trends of the pandemic. Our analysis reveals that the difference with and without mandated face covering represents the determinant in shaping the pandemic trends in the three epicenters. This protective measure alone significantly reduced the number of infections, that is, by over 75,000 in Italy from April 6 to May 9 and over 66,000 in New York City from April 17 to May 9. Other mitigation measures, such as social distancing implemented in the United States, are insufficient by themselves in protecting the public. We conclude that wearing of face masks in public corresponds to the most effective means to prevent interhuman transmission, and this inexpensive practice, in conjunction with simultaneous social distancing, quarantine, and contact tracing, represents the most likely fighting opportunity to stop the COVID-19 pandemic. Our work also highlights the fact that sound science is essential in decision-making for the current and future public health pandemics.


2020 ◽  
Vol 59 (1) ◽  
pp. e02563-20
Author(s):  
Audrey N. Schuetz ◽  
Peera Hemarajata ◽  
Ninad Mehta ◽  
Sheldon Campbell ◽  
Stephanie Mitchell ◽  
...  

ABSTRACTOn 24 August 2020, the Centers for Disease Control and Prevention (CDC) updated its website to highlight that asymptomatic individuals, even those with exposure to a COVID-19-positive contact, do not necessarily need to be tested unless they have medical conditions associated with increased risk of severe illness from COVID-19. The CDC subsequently updated its guidance on 19 September 2020 to support testing of asymptomatic persons, including close contacts of persons with documented SARS-CoV-2 infection. In this editorial, the American Society for Microbiology Clinical and Public Health Microbiology Committee’s Subcommittee on Laboratory Practices comments on testing of asymptomatic individuals relative to current medical knowledge of the virus and mitigation measures. Specific points are provided concerning such testing when undertaking contact tracing and routine surveillance. Limitations to consider when testing asymptomatic persons are covered, including the need to prioritize testing of contacts of positive COVID-19 cases. We urge the CDC to consult with primary stakeholders of COVID-19 testing when making such impactful changes in testing guidance.


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