Managing the risk of a COVID-19 outbreak from border arrivals

In an attempt to maintain the elimination of COVID-19 in New Zealand, all international arrivals are required to spend 14 days in government-managed quarantine and to return a negative test result before being released. We model the testing, isolation and transmission of COVID-19 within quarantine facilities to estimate the risk of community outbreaks being seeded at the border. We use a simple branching process model for COVID-19 transmission that includes a time-dependent probability of a false-negative test result. We show that the combination of 14-day quarantine with two tests is highly effective in preventing an infectious case entering the community, provided there is no transmission within quarantine facilities. Shorter quarantine periods, or reliance on testing only with no quarantine, substantially increases the risk of an infectious case being released. We calculate the fraction of cases detected in the second week of their two-week stay and show that this may be a useful indicator of the likelihood of transmission occurring within quarantine facilities. Frontline staff working at the border risk exposure to infected individuals and this has the potential to lead to a community outbreak. We use the model to test surveillance strategies and evaluate the likely size of the outbreak at the time it is first detected. We conclude with some recommendations for managing the risk of potential future outbreaks originating from the border.

Managing the risk of a COVID-19 outbreak from border arrivals

In an attempt to maintain elimination of COVID-19 in New Zealand, all international arrivals are required to spend 14 days in government-managed quarantine and to return a negative test result before being released. We model the testing, isolation and transmission of COVID-19 within quarantine facilities to estimate the risk of community outbreaks being seeded at the border. We use a simple branching process model for COVID-19 transmission that includes a time-dependent probability of a false negative test result. We show that the combination of 14-day quarantine with two tests reduces the risk of releasing an infectious case to around 0.1% per infected arrival. Shorter quarantine periods, or reliance on testing only with no quarantine, substantially increases this risk. We calculate the fraction of cases detected in the second week of their two week stay and show that this may be a useful indicator of the likelihood of transmission occurring within quarantine facilities. Frontline staff working at the border risk exposure to infected individuals and this has the potential to lead to a community outbreak. We use the model to test surveillance strategies and evaluate the likely size of the outbreak at the time it is first detected. We conclude with some recommendations for managing the risk of potential future outbreaks originating from the border.

Visual Binary Testing Of Hydrogen Sulfide Dissolved In Return Underground Local-Water Of Oil And Gas Condensate Fields

In order to screen samples of return underground local-water of oil and gas condensate fields for the presence of dissolved hydrogen sulfide, it was proposed to use single comparison sample for visual binary testing of H2S. Two indicator reactions occurring in solutions were selected — the formation of a stabilized suspension of MnS and CdS. Suspensions prepared in the presence of borate buffer (pH 9.18) and gelatin (stabilizer) are stable during the twenty four hours; a difference in the turbidity of suspensions can be observed near the normalized concentration of hydrogen sulfide (сlim = 15 mg L-1). When establishing the concentration of H2S in the comparison samples, a statistical approach was applied; the estimated values of the threshold concentration of H2S (ccomp.) are less than the normalized level on the value which providing the risk of a false-negative test result not more than 5% - 11.6 mg L-1 for MnS and 13.4 mg L-1 for CdS. Preference was given to a test system based on a stabilized suspension of CdS, because for this reaction, a narrower interval of unreliability and the value of ccomp. is nearer to the value of the сlim. The correctness of the visual binary testing of H2S in the samples of the analyzed water was confirmed by spectrophotometric method with p-phenylenediamine.

Performance of Alpine Touring Boots When Used in Alpine Ski Bindings

Alpine touring (AT) equipment is designed for ascending mountains and snow skiing down backcountry terrain. Skiers have been observed using AT boots in alpine (not made for Alpine Touring) ski bindings. We tested the effect on the retention-release characteristics of AT boots used in alpine bindings. Ten AT ski boots and 5 alpine ski boots were tested in 8 models of alpine ski bindings using an ASTM F504-05 (2012) apparatus. Thirty-one percent of the AT boots released appropriately when used in alpine ski bindings. One alpine binding released appropriately for all alpine and AT boots tested; 2 alpine ski bindings did not release appropriately for any AT boots. Altering the visual indicator settings on the bindings (that control the release torque of an alpine system) had little or no effect on the release torque when using AT boots in alpine ski bindings. Many combinations released appropriately in ski shop tests, but did not release appropriately in the more complex loading cases that simulated forward and backward falls; the simple tests performed by ski shops could produce a “false-negative” test result. These results indicate that using AT boots with alpine ski bindings could increase the likelihood of lower leg injuries.

Prospective testing for drug-dependent antibodies reduces the incidence of thrombocytopenia observed with the small molecule glycoprotein IIb/IIIa antagonist roxifiban: implications for the etiology of thrombocytopenia

Thrombocytopenia is a relatively common side effect observed during glycoprotein (GP) IIb/IIIa antagonist therapy. With the oral antagonist roxifiban, we observed thrombocytopenia, defined as 50% reduction of platelets over predose values or below 90 000/μL (9 × 1010/L), with a frequency of 2% (8 of 386). Thrombocytopenia occurred either early (days 2 to 4) or delayed (days 11 to 16). No additional cases were observed with up to 6 months of treatment. Retrospective analysis provided evidence for drug-dependent antibodies (DDABs) to GP IIb/IIIa in 5 of 6 subjects, suggestive of an immune etiology of thrombocytopenia. The hypothesis that excluding patients based on positive DDAB reaction would reduce the frequency of thrombocytopenia was tested. Patients were screened for DDABs during the study qualification period and, overall, 3.9% of the patients were excluded based on pre-existing DDAB concentrations above a statistically defined medical decision limit. An additional 2.6% were excluded based on therapy-related antibody production during the first 2 weeks. With antibody testing, 0.2% of patients (2 of 1044) developed immune-mediated thrombocytopenia. One case developed a rapidly increasing antibody concentration and presented with thrombocytopenia despite discontinuation of roxifiban therapy. The second case was related to a false-negative test result. The frequency of thrombocytopenia was statistically significantly reduced from 2% to 0.2% (P = .0007) comparing nonscreened and screened patients. Testing for DDABs can reduce the frequency of thrombocytopenia in patients treated with roxifiban and, by analogy, other GP IIb/IIIa antagonists. Thus, DDAB testing may be employed to increase the safety of GP IIb/IIIa antagonists.