Evidence of early community transmission of Omicron (B1.1.529) in Delhi- A city with very high seropositivity and past exposure!

Background: Since identification, infections by the new SARS-CoV-2 variant Omicron are rapidly increasing worldwide. There is a huge gap of knowledge regarding virus behavior in the population from low and middle-income countries. Delhi being a unique population with a high seropositivity and vaccination rate against COVID-19 infection. We aimed to study the epidemiological and clinical presentations of a few early cases of community spread of Omicron infection in the state. Methods: This is a prospective study where respiratory specimen from all RT-PCR confirmed positive cases between November 25th-December 23rd 2021 collected from five districts of Delhi were subjected to whole-genome sequencing. Complete demographic and clinical details were recorded. We also analyzed the formation of local and familial clusters and eventual community transmission. Findings: Out of the 264 cases included during the study period, 68.9% (n=182)were identified as Delta and its sub-lineages while 31.06% (n=82) were Omicron with BA.1 as the predominant sub-lineage (73.1%). Most of the Omicron cases were asymptomatic (n=50,61%) and did not require any hospitalizations. A total of 72 (87.8%) cases were fully vaccinated. 39.1% (n=32) had a history of travel and/or contacts while 60.9 (n=50) showed a community transmission. A steep increase in the daily progression of Omicron cases with its preponderance in the community was observed from 1.8% to 54%. Interpretation: This study is among the first from India to provide evidence of community transmission of Omicron with significantly increased breakthrough infections, decreased hospitalization rates, and a lower rate of symptomatic infections among individuals with high seropositivity against SARS-CoV-2 infections.

SARS-CoV-2 Omicron Outbreak in a Dormitory in Saint-Petersburg, Russia

The B.1.1.529 Omicron variant of SARS-CoV-2 is rapidly spreading, displacing the globally prevalent Delta variant. Before December 16, 2021, community transmission had already been observed in tens of countries globally. However, in Russia, all reported cases had been sporadic and associated with travel. Here, we report an Omicron outbreak at a students’ dormitory in Saint Petersburg, Russia. Out of the 462 sampled residents of the dormitory, 206 (44.6%) tested PCR positive, and 159 (77.1%) of these infections carried the S:ins214EPE insertion, indicating that they were of the Omicron strain. 104 (65%) of Omicron-positive patients have been vaccinated and/or reported previous covid-19. Whole genome sequencing confirmed that the outbreak is caused by the Omicron variant. Phylogenetic analysis showed that the outbreak has a single origin, and belongs to the S:346K sublineage of Omicron which may be characterized by an increased rate of spread, compared to other Omicron sublineages. The rapid spread of Omicron in a population with preexisting immunity to previous variants underlines its propensity for immune evasion.

Smart facemask for wireless CO2 monitoring

The use of facemasks by the general population is recommended worldwide to prevent the spread of SARS-CoV-2. Despite the evidence in favour of facemasks to reduce community transmission, there is also agreement on the potential adverse effects of their prolonged usage, mainly caused by CO2 rebreathing. Herein we report the development of a sensing platform for gaseous CO2 real-time determination inside FFP2 facemasks. The system consists of an opto-chemical sensor combined with a flexible, battery-less, near-field-enabled tag with resolution and limit of detection of 103 and 140 ppm respectively, and sensor lifetime of 8 h, which is comparable with recommended FFP2 facemask usage times. We include a custom smartphone application for wireless powering, data processing, alert management, results displaying and sharing. Through performance tests during daily activity and exercise monitoring, we demonstrate its utility for non-invasive, wearable health assessment and its potential applicability for preclinical research and diagnostics.

The impact of spatial and social structure on an SIR epidemic on a weighted multilayer network

A key factor in the transmission of infectious diseases is the structure of disease transmitting contacts. In the context of the current COVID-19 pandemic and with some data based on the Hungarian population we develop a theoretical epidemic model (susceptible-infected-removed, SIR) on a multilayer network. The layers include the Hungarian household structure, with population divided into children, adults and elderly, as well as schools and workplaces, some spatial embedding and community transmission due to sharing communal spaces, service and public spaces. We investigate the sensitivity of the model (via the time evolution and final size of the epidemic) to the different contact layers and we map out the relation between peak prevalence and final epidemic size. When compared to the classic compartmental model and for the same final epidemic size, we find that epidemics on multilayer network lead to higher peak prevalence meaning that the risk of overwhelming the health care system is higher. Based on our model we found that keeping cliques/bubbles in school as isolated as possible has a major effect while closing workplaces had a mild effect as long as workplaces are of relatively small size.

COVID-19 surveillance in the Flemish school system: development of systematic data collection within the Public Health School System and descriptive analysis of cases reported between October 2020 and June 2021

Background The age specific distribution of SARS-CoV-2 cases in schools is not well described. The numbers recorded reflect the intensity of community transmission while being shaped by biases from age-dependent testing regimes and effective age-specific interventions. A case-surveillance system was introduced within the Flemish school and health-prevention network during the 2020-2021 school year. We present epidemiological data of in-school reported cases in pre-, primary and secondary schools based on the surveillance system, in conjunction with test data and community cases from October 2020 to June 2021. Methods We describe the development of the surveillance system and provide the number of reported cases and standardized rates per grade over time. We calculate absolute and relative differences between incidence cases by grade of primary (grades 1-6) and secondary-school (grades 7-12) and compare these to grades 7-8, relating them to non-pharmaceutical infection prevention interventions. Cumulative population incidences (IP) stratified by age, province and social-economic status (SES) of the school population are presented with their 95% confidence intervals (CI). Results A total of 59,996 COVID-19 cases were reported in the school surveillance system, with the highest population adjusted IP in grade 11-12 of 7.39% (95%CI 7.24-7.53) and ranging from 2.23–6.25% from pre-school through grade 10. Age-specific reduction in in-person teaching and introduction of masks, are temporally associated with decreases in incident cases by grades. Lower pupil SES is associated with increased cumulative cases (excess 2,739/100,000 pupils compared to highest SES tertile). Community testing volumes varied more for children compared to adults, with overall higher child test-positivity. Holidays influence capturing of cases by the system, however efficiency increased to above 75% after further automation and integration in existing structures. Conclusion Integration of case surveillance within an electronic school health system is feasible, provides data to follow up the epidemic evolution in schoolchildren and should be part of public health surveillance and pandemic preparedness. The relationship towards community transmission needs careful evaluation because of age-different testing regimens. In the Flemish region, case incidence within schools follows an age gradient that is mitigated through grade specific interventions, while differences by SES remain.

SARS-CoV-2 Transmission Dynamics in Households With Children, Los Angeles, California

Objectives: Studies of household transmission of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) focused on households with children are limited. We investigated household secondary attack rate (SAR), transmission dynamics, and contributing factors in households with children.Materials and Methods: In this prospective case-ascertained study in Los Angeles County, California, all households members were enrolled if ≥1 member tested positive for SARS-CoV-2 by polymerase chain reaction (PCR). Nasopharyngeal PCRs, serology, and symptom data were obtained over multiple visits.Results: A total of 489 individuals in 105 households were enrolled from June to December 2020. The majority (77.3%) reported a household annual income of <$50,000, and most (92.9%) were of Hispanic/Latinx ethnicity. Children <18 years old accounted for 46.9% index cases, of whom 45.3% were asymptomatic. Household index cases were predominantly children during low community transmission and adults during the high community transmission period (χ2 = 7.647, p = 0.0036. The mean household SAR was 77.0% (95% CI: 69.4–84.6%). Child and adult index cases both efficiently transmitted SARS-CoV-2 within households [81.9%, (95% CI: 72.1–91.9%) vs. 72.4% (95% CI: 59.8–85.1%), p = 0.23]. Household income and pets were significantly associated with higher SAR in the multivariable analysis of household factors (p = 0.0013 and 0.004, respectively).Conclusions: The SAR in households with children in an urban setting with a large ethnic minority population is much higher than previously described. Children play important roles as index cases. SAR was disproportionately impacted by household income. Vaccination and public health efforts need special focus on children and vulnerable communities to help mitigate SARS-CoV-2 spread.

Protecting Public Health and Preserving the Financial Viability of North Carolina’s Critical Health Care Facilities during Infectious Disease Outbreaks

While hospitals’ primary emphasis during the COVID-19 pandemic has been on ensuring sufficient health-related resource capacity (e.g., ICU beds, ventilators) to serve admitted patients, the impacts of the pandemic on the financial viability of hospitals has also become a critical concern. Data from the period March 2020-Janaury 2021 suggest that the halt to elective and non-emergency inpatient procedures, combined with a reduction in emergency room procedures, led to losses equal to 6.5% of revenue from inpatient procedures, or about $825 million. This study finds that societal measures to reduce the community transmission rates have a larger impact on available healthcare capacity and hospital financial losses than hospital-level decisions. This study illustrates the tradeoffs between hospital capacity, quality of care, and financial risk faced by health care facilities throughout the U.S. as a result of COVID-19, providing potential insights for many hospitals seeking to navigate these uncertain scenarios through adaptive decision-making.

The Adoption and Utilization of Electronic Business in Response to Global Economy during COVID-19

The COVID-19 epidemic has triggered unmatched impairment to businesses globally. There are unmeasurable financial influences in the short-term and long-term and have causes intangible destruction within businesses. This study investigates the adoption and utilization of e-business during COVID-19 by both organizations and the general populaces. The study used a questionnaire-based survey to collect data from top managers of business organizations and their clients. SPSS was used to analyze the adoption factors. The outcomes presented that embracing e-business can assist to reduce the spread of COVID-19 and can reduce the physical ways of doing business. The findings of this study will help strategy makers, companies, and officials in making better decisions on the implementation of e-business. This will reduce the rapid spread of community transmission since ordering goods and services can easily be done virtually without physical contact, which goes in line with the social distance policy and in return boost the country’s economy

Temporal trends in hospitalizations and 30-day mortality in older patients during the COVID pandemic from March 2020 to July 2021

Importance: Previous reports have suggested reductions in mortality risk from COVID-19 throughout the first wave of the COVID-19 pandemic. Mortality changes later in the pandemic and pandemic effects on other types of geriatric hospitalizations are less studied. Objectives: To describe the changes in hospitalizations and 30-day mortality in Stockholm for patients 70+ receiving inpatient geriatric care for COVID-19 and other causes. Design: Observational study. For patients 70 or older, we present the incidence of 30-day mortality from COVID-19 in the Stockholm region, in relationship to geriatric hospitalizations and 30-day mortality after admission for COVID-19 and other causes. Setting: Hospitalizations for patients 70+ from geriatric clinics in Stockholm, Sweden hospitalized for COVID-19 or other causes between March 2020 and July 31, 2021, were included. Participants: The total number of geriatric hospitalizations for patients 70+ was 5,320 for COVID-19 and 32,243 for non-COVID-19 causes, corresponding to 4,565 individual COVID-19 patients and 19,308 non-COVID-19 patients. Exposure(s): The date of hospital admission to a geriatric clinic. Main Outcome(s) and Measure(s): 30-day mortality after admission. Results: In patients with COVID-19, the 30-day mortality rate was highest at the beginning of the first wave (29% in March-April 2020), decreased as the first wave subsided (7% July-August), increased again in the second wave (17% November-December), but failed to increase as much in the third wave (11-13% March-July 2021). In non-COVID-19 geriatric patients during the same period, the 30-day mortality presented a similar trend, but with a smaller magnitude of variation (5 to 10%). The number of persons 70 or older testing positive for COVID-19 in Stockholm reached two peaks in 2020 (April and December), fell in January 2021 and then increased again in March-April 2021. Conclusions and Relevance: During the first and second waves, hospital admissions and 30-day mortality after geriatric hospitalization for COVID-19 increased in periods of high community transmission, although the mortality peak was lower in wave 2 than in wave 1. The mortality for non-COVID geriatric cases was lower and more stable but also showed an increase with the pandemic peaks.