The Impact of COVID-19 on Mortality in Spain: Monitoring Excess Mortality (MoMo) and the Surveillance of Confirmed COVID-19 Deaths

Measuring mortality has been a challenge during the COVID-19 pandemic. Here, we compared the results from the Spanish daily mortality surveillance system (MoMo) of excess mortality estimates, using a time series analysis, with those obtained for the confirmed COVID-19 deaths reported to the National Epidemiological Surveillance Network (RENAVE). The excess mortality estimated at the beginning of March 2020 was much greater than what has been observed in previous years, and clustered in a very short time. The cumulated excess mortality increased with age. In the first epidemic wave, the excess mortality estimated by MoMo was 1.5 times higher than the confirmed COVID-19 deaths reported to RENAVE, but both estimates were similar in the following pandemic waves. Estimated excess mortality and confirmed COVID-19 mortality rates were geographically distributed in a very heterogeneous way. The greatest increase in mortality that has taken place in Spain in recent years was detected early by MoMo, coinciding with the spread of the COVID-19 pandemic. MoMo is able to identify risk situations for public health in a timely manner, relying on mortality in general as an indirect indicator of various important public health problems.

Instruments and Perspectives of Coping with Pandemic COVID-19 in the Assessments of Medical Workers of the Kharkiv Region

Groups with special qualities in the eyes of the public can help to overcome barriers to vaccination and other anti-pandemic measures. Such groups can be opinion leaders to advance the pandemic response. One of these groups is specialized doctors. A research question: how ready are they today to act as a group opinion leader in promoting vaccinations and other responses to the pandemic? We present original data that allow us to draw the local (national) characteristics of attitudes towards measures to coping the pandemic of medical workers in Ukraine, and about their potential as an agent for informational promotion of vaccination. We used a questionnaire survey of medical workers (797 medical workers were interviewed in March-September 2021) in the Kharkiv region to collect empirical material. We focused on their assessment of the readiness to vaccinate their environment – as an indirect indicator of assessing the prospects for mass vaccination and their own ability to act as agents of promoting mass vaccination. According to the results of the survey, the social group potential of medical workers in promoting vaccination is relatively high. About half of doctors with higher education, who are included in the pandemic topics of the information space and are confident in the need for mass vaccination, can be the agent core of the information promotion of anti-pandemic tools, particularly vaccination.

Method for assessing the thermophysical properties of the contact pair ‘tool – steel workpiece’

To The analysis of methods for evaluating the properties of contact pairs “hard -alloy coated tool-steel billet” is carried out in order to use them to increase the reliability of the choice of turning modes in the generations of CNC systems equipped with technological intelligence. It is proposed to use the value of the thermo-emf of the test pass as an indirect indicator of the properties of contact pairs composed of a coated carbide tool and a processed steel billet. Models for calculating the cutting speed based on a given tool durability period of a coated carbide tool and predicting the actual cutting tool durability period for given processing conditions are proposed by introducing into their structure an additional informative value about the properties of each contact pair - the thermo-EMF of the test pass. The conducted resistance tests of various carbide plates during the processing of P-group steels showed sufficient reliability of the proposed dependences.

Fineness of Coal Fly Ash for Use in Cement and Concrete

Nowadays, coal is increasingly being used as an energy source in some countries. This coal-fired generation process, however, has the disadvantage that produces large quantities of coal fly ash. Its characteristics differ depending on the combustion conditions and the coal source. Fineness will influence early compressive strength in cement-based materials. The finer the binding material, the higher the early compressive strength. They can be used to produce high-volume fly ash (HVFA) concrete, self-compacting concrete (SCC), concrete for marine infrastructures, pervious concrete, roller compacted concrete (RCC) and so on.More than seven hundred samples of coal fly ash were collected from a coal-fired power plant for a period of ten years, and their fineness were characterized by sieving. The average fineness on 45 µm, 63 µm, 90 µm and 200 µm mesh sieves were 22.5%, 15.5%, 9.1% and 2.0%, respectively. Then, most of the coal fly ash particles were lower than 45 µm, i.e., from 15 to 30% were retained on the 45 µm sieve, and from 10 to 20% by mass of coal fly ash particles were retained on a 63 µm sieve. Fineness on a 45 µm sieve is a good indirect indicator of the residues on the 63 µm, 90 µm and 200 µm mesh sieves. Accordingly, it is suggested to broaden the range from ±5% to as high as ±7% regarding the fineness variation requirement. Finally, the tested coal fly ash can be applied as cement constituent.

Reduction in Pediatric Emergency Department Admissions during Lockdown: Just Fear of COVID-19?

Objective: Italy was the first European nation to undergo a general lockdown as a means of containing the COVID-19 pandemic. In that period, a significant reduction in pediatric accesses to emergency rooms (ERs) was reported. In this study, we evaluated whether, in addition to the fear of infection, the reduced ER visits were also an indirect indicator of reduced incidence of common seasonal viruses. Methods: Sales data for pediatric formulations of antipyretics and probiotics from 27 pharmacies were evaluated, during March-May 2020, and compared to sales during the same period in 2019. Pediatric accesses in the emergency department (ED) also were evaluated. Results: The median number of antipyretics and probiotics sold per pharmacy was respectively 152 (IQR = 144) and 55 (IQR = 52) in 2019; during the same period of 2020 it was 77.5 (IQR = 60) (p < .001) and 27 (IQR = 44) (p < .05). In the March-May period of 2019, the number of pediatric accesses was 1004, whereas in the same period of 2020 it was 143, a reduction of 85.76% (p < .001). Conclusions: We found a statistically significant reduction in pediatric admissions to the ED during the lockdown, but that this reduction could largely be due to a reduction in seasonal viral disease as an effect of social distancing, mask use, and frequent hand-washing, as mandated by healthcare dispositions.

1192. Correlation Between SARS CoV 2 Viral Load and Clinical Evolution of Patients Under 15 Years of Age with COVID 19 in a General Hospital in the Province of Buenos Aires, Argentina

Background SARS CoV2 infection produces clinical manifestations of different severity. The pediatric population represents less than 10% of cases, with a mortality of less than 1%. The severity of the condition and mortality are mainly associated with comorbidities. There is controversy about the correlation between the viral load of SARS CoV2 in respiratory samples and the evolution and severity of the clinical picture. The CT (cycle threshold) in the detection of the SARS CoV 2 genome in respiratory samples can be used as an indirect indicator of the viral load in the analyzed samples. Goals to determine the correlation between the SARS CoV 2 CT values in the detection of the viral genome with the severity of the clinical picture. Describe the clinical, epidemiological, and laboratory characteristics of patients with PCR-confirmed SARS CoV2 infection in respiratory samples. Methods A retrospective, observational and analytical study that included patients under 15 years of age with confirmed SARS CoV2 infection by PCR of respiratory samples treated at the Hospital Isidoro Iriarte in the city of Quilmes between March 1 2020 and April 30, 2021. Results 485 patients (n) were included. The distribution by severity of the clinical picture was mild (84%, n = 408), moderate (12%, n = 59) and severe (4%, n = 18). Comorbidities were more frequent among patients with moderate and severe symptoms. Viral load was associated with severity of clinical manifestations. Patients with moderate and severe COVID19 required hospital admission more frequently for a longer time, the use of supplemental oxygen and antibiotics were more frequent in patients with moderate and severe symptoms. Symptoms of lower respiratory tract infection such as cough and respiratory distress were more frequent in patients with moderate and severe symptoms. No patient required admission to the ICU or mechanical ventilation. No patient died. Conclusion In this study, patients with moderate and severe COVID19 infection had a higher viral load in respiratory samples, a higher frequency of comorbidities, a higher frequency of hospitalization and a longer hospital stay. Lower respiratory symptoms were associated with moderate and severe symptoms, while odynophagia, vomiting, and diarrhea were associated with mild clinical symptoms. Disclosures All Authors: No reported disclosures

Mean Platelet Volume and Platelet Volume Distribution Width in Canine Parvoviral Enteritis

Bacterial translocation from the damaged intestinal tract, reported in canine parvoviral (CPV) enteritis, is thought to be responsible for the systemic inflammatory response resulting from coliform septicemia, which could ultimately progress to septic shock and death. Alterations in platelet indices, specifically mean platelet volume (MPV), is a consistent finding in critically ill people and dogs with and without sepsis. Increased MPV has been reported to be an indirect indicator of platelet activation and of bone marrow response in people and dogs with sepsis. The study aim was to compare admission MPV and platelet volume distribution width (PVDW) in dogs with CPV enteritis to that of healthy aged-matched control dogs. Forty-eight dogs with CPV enteritis and 18 healthy age matched control dogs were included. CPV infection was confirmed with electron microscopy and concurrent blood-borne infections were excluded using PCR. EDTA whole blood samples were analyzed on an automated cell counter, ADVIA 2120, within 30-60 min from collection. There was no significant difference for platelet count between the groups. The MPV for CPV infected dogs (median: 14.0; IQR: 12.2–15.1) was significantly higher compared to controls (11.3; IQR: 10.3–13.1, P = 0.002). The PVDW for CPV infected dogs (66.9; IQR: 64.2–68.8) was significantly higher compared to controls (63.3; IQR: 60.2–65.1, P &lt; 0.001). These findings suggest that significant platelet activation is present in dogs with CPV enteritis which may play a role in the disease outcome, similar to people with sepsis. Further studies are required to investigate the prognosticating ability of MPV in dogs with CPV enteritis.

The effect of various modifiers on the course of periodontitis

The purpose of the work is to establish the degree of influence of various modifiers on the course of chronic generalized periodontitis. We examined 83 periodontal patients. During the examination, in addition to the obligatory volume, data on somatic burden and dependence on smoking were included with the determination of the number of cigarettes smoked per day. Bleeding of the gums was determined in the area of all teeth. To determine the rate of progression of periodontitis on the basis of orthopantomogram data, an indirect indicator was calculated — the decrease in the alveolar bone in relation to the patient's age. It was established by the research that the modeling of periodontitis, with an identical hygienic state of the oral cavity of patients, is affected by concomitant somatic pathology, especially diabetes mellitus, making the course of periodontitis worse; and also a bad habit — smoking, which contributes to more pronounced vascular changes in the periodontium in patients with clinical manifestations of periodontitis. Recommendations are given to take into account the concomitant pathology of internal organs and the degree of dependence of patients on tobacco smoking when planning periodontal treatment, in order to correct these risk factors and motivate the patient to cooperate with a doctor.

Algorithm of diagnosis and treatment of patients with distal occlusion in the period of replacement bite

The purpose of the work is to establish the degree of influence of various modifiers on the course of chronic generalized periodontitis. We examined 83 periodontal patients. During the examination, in addition to the obligatory volume, data on somatic burden and dependence on smoking were included with the determination of the number of cigarettes smoked per day. Bleeding of the gums was determined in the area of all teeth. To determine the rate of progression of periodontitis on the basis of orthopantomogram data, an indirect indicator was calculated — the decrease in the alveolar bone in relation to the patient's age. It was established by the research that the modeling of periodontitis, with an identical hygienic state of the oral cavity of patients, is affected by concomitant somatic pathology, especially diabetes mellitus, making the course of periodontitis worse; and also a bad habit — smoking, which contributes to more pronounced vascular changes in the periodontium in patients with clinical manifestations of periodontitis. Recommendations are given to take into account the concomitant pathology of internal organs and the degree of dependence of patients on tobacco smoking when planning periodontal treatment, in order to correct these risk factors and motivate the patient to cooperate with a doctor.

Applying mixture model methods to SARS-CoV-2 serosurvey data from the SEROCoV-POP study

Serosurveys are an important tool to estimate the true extent of the current SARS-CoV-2 pandemic. So far, most serosurvey data have been analysed with cut-off based methods, which dichotomize individual measurements into sero-positives or negatives based on a predefined cutoff. However, mixture model methods can gain additional information from the same serosurvey data. Such methods refrain from dichotomizing individual values and instead use the full distribution of the serological measurements from pre-pandemic and COVID-19 controls to estimate the cumulative incidence. This study presents an application of mixture model methods to SARS-CoV-2 serosurvey data from the SEROCoV-POP study from April and May 2020 (2766 individuals). Besides estimating the total cumulative incidence in these data (8.1% (95% CI: 6.8% - 9.8%)), we applied extended mixture model methods to estimate an indirect indicator of disease severity, which is the fraction of cases with a distribution of antibody levels similar to hospitalised COVID-19 patients. This fraction is 51.2% (95% CI: 15.2% - 79.5%) across the full serosurvey, but differs between three age classes: 21.4% (95% CI: 0% - 59.6%) for individuals between 5 and 40 years old, 60.2% (95% CI: 21.5% - 100%) for individuals between 41 and 65 years old and 100% (95% CI: 20.1% - 100%) for individuals between 66 and 90 years old. Additionally, we find a mismatch between the inferred negative distribution of the serosurvey and the validation data of pre-pandemic controls. Overall, this study illustrates that mixture model methods can provide additional insights from serosurvey data.