scholarly journals Effectiveness of Epidemic Preventive Policies and Hospital Strategies in Combating COVID-19 Outbreak in Taiwan

Author(s):  
Ting Wan Tan ◽  
Han Ling Tan ◽  
Man Na Chang ◽  
Wen Shu Lin ◽  
Chih Ming Chang

(1) Background: The implementation of effective control measures in a timely fashion is crucial to control the epidemic outbreak of COVID-19. In this study, we aimed to analyze the control measures implemented during the COVID-19 outbreak, as well as evaluating the responses and outcomes at different phases for epidemic control in Taiwan. (2) Methods: This case study reviewed responses to COVID-19 and the effectiveness of a range of control measures implemented for epidemic control in Taiwan and assessed all laboratory-confirmed cases between 11 January until 20 December 2020, inclusive of these dates. The confirmation of COVID-19 infection was defined as the positive result of a reverse-transcriptase–polymerase-chain-reaction test taken from a nasopharyngeal swab. Test results were reported by the Taiwan Centers for Disease Control. The incidence rate, mortality rate, and testing rate were compiled, and the risk ratio was provided to gain insights into the effectiveness of prevention measures. (3) Results and Discussion: This study presents retrospective data on the COVID-19 incidence rate in Taiwan, combined with the vital preventive control measures, in a timeline of the early stage of the epidemic that occurred in Taiwan. The implementation of multiple strategy control measures and the assistance of technologies to control the COVID-19 epidemic in Taiwan led to a relatively slower trend in the outbreak compared to the neighboring countries. In Taiwan, 766 confirmed patients were included, comprised of 88.1% imported cases and 7.2% local transmission cases, within the studied period. The incidence rate of COVID-19 in Taiwan during the studied period was 32 per million people, with a mortality rate of 0.3 per million people. Our analysis showed a significantly raised incidence risk ratio in the countries of interest in comparison to Taiwan during the study period; in the range of 1.9 to 947.5. The outbreak was brought under control through epidemic policies and hospital strategies implemented by the Taiwan Government. (4) Conclusion: Taiwan’s preventive strategies resulted in a drastically lower risk for Taiwan nationals of contracting COVID-19 when new pharmaceutical drug or vaccines were not yet available. The preventive strategies employed by Taiwan could serve as a guide and reference for future epidemic control strategies.

2021 ◽  
Author(s):  
Abu Shadat M Noman ◽  
Mohammed Rezaul Karim ◽  
ASM Zahed ◽  
ATM Rezaul Karim ◽  
Syed S Islam

Abstract Background: Transmission risk of coronavirus disease 2019 (COVID-19) to close contacts and at different exposure settings are yet to be fully understood for the evaluation of effective control measures. Methods: We traced 1171 close contact cases who were linked to 291 index cases between July 3, 2020 and September 3, 2020. Clinical and epidemiological characteristics of all index cases, close contacts, and secondary contact cases were collected and analyzed the secondary attack rate and risk of transmission at different exposure settings. Results: Median age of 291 index cases were 43.0 years (range 18.5-82.3) including 213 male and 78 females. Among all 1171 close contact cases, 39(3.3%) cases were identified as secondary infected cases. Among 39 secondary cases, 33(84.62%) cases were symptomatic and 3 (7.69%) cases were asymptomatic. Of the 33 symptomatic cases, 31(86.1%) male and 5(13.9%) female. Of these 36 symptomatic cases, 24(66.7%) cases between age 20-59 and remaining 12(33.3%) cases were age 60 and over. Of the 36 symptomatic cases, 11(30.6%) cases were identified as severe, 19(52.8%) as moderate and 6(16.7%) as mild. The overall secondary clinical attack rate was 3.07% (95% CI 2.49-3.64). The attack rate was higher among those aged between 50 to 69 years and shows higher risk of transmission than age below 50 years. The attack rate was higher among household contact (6.17%(95%CI 4.7-7.6; risk ratio 2.44[95%CI1.5-3.4]), and lower in hospital facility (2.29%,95%CI0.58-3.40; [risk ratio 0.91,95%CI 0.17-1.9]), funeral ceremony (2.53%,95%CI 0.32-4.73), work places (3.95%,95% CI2.5-5.42 [risk ratio 1.56,95%CI 0.63-2.5]), family contacts (3.87%,95%CI 2.4-5.3; risk ratio 1.53,95%CI 0.61-2.45]). Conclusions: Among all exposure settings analyzed, household contact exposure setting remained the highest transmission probability and risk of transmission of COVID-19 with the increase of age and disease severity.


2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Xue-Mei Wu ◽  
Xin Yang ◽  
Xian-Cheng Fan ◽  
Xi Chen ◽  
Yu-Xin Wang ◽  
...  

Abstract Background Cryptosporidium baileyi is an economically important zoonotic pathogen that causes serious respiratory symptoms in chickens for which no effective control measures are currently available. An accumulating body of evidence indicates the potential and usefulness of metabolomics to further our understanding of the interaction between pathogens and hosts, and to search for new diagnostic or pharmacological biomarkers of complex microorganisms. The aim of this study was to identify the impact of C. baileyi infection on the serum metabolism of chickens and to assess several metabolites as potential diagnostic biomarkers for C. baileyi infection. Methods Ultraperformance liquid chromatography-mass spectrometry (UPLC-MS) and subsequent multivariate statistical analysis were applied to investigate metabolomics profiles in the serum samples of chickens infected with C. baileyi, and to identify potential metabolites that can be used to distinguish chickens infected with C. baileyi from non-infected birds. Results Multivariate statistical analysis identified 138 differential serum metabolites between mock- and C. baileyi-infected chickens at 5 days post-infection (dpi), including 115 upregulated and 23 downregulated compounds. These metabolites were significantly enriched into six pathways, of which two pathways associated with energy and lipid metabolism, namely glycerophospholipid metabolism and sphingolipid metabolism, respectively, were the most enriched. Interestingly, some important immune-related pathways were also significantly enriched, including the intestinal immune network for IgA production, autophagy and cellular senescence. Nine potential C. baileyi-responsive metabolites were identified, including choline, sirolimus, all-trans retinoic acid, PC(14:0/22:1(13Z)), PC(15:0/22:6(4Z,7Z,10Z,13Z,16Z,19Z)), PE(16:1(9Z)/24:1(15Z)), phosphocholine, SM(d18:0/16:1(9Z)(OH)) and sphinganine. Conclusions This is the first report on serum metabolic profiling of chickens with early-stage C. baileyi infection. The results provide novel insights into the pathophysiological mechanisms of C. baileyi in chickens. Graphic abstract


Author(s):  
Jianjun Bai ◽  
Fang Shi ◽  
Jinhong Cao ◽  
Haoyu Wen ◽  
Fang Wang ◽  
...  

Abstract Objectives To analyze the epidemiological characteristics of COVID-19 related deaths in Wuhan, China and comprehend the changing trends of this epidemic along with analyzing the prevention and control measures in Wuhan. Methods Through the China’s Infectious Disease Information System, we collected information about COVID-19 associated deaths from December 15, 2019 to February 24, 2020 in Wuhan. We analyzed the patient’s demographic characteristics, drew epidemiological curve and made geographic distribution maps of the death toll in each district over time, etc. ArcGIS was used to plot the numbers of daily deaths on maps. Statistical analyses were performed using SPSS and @Risk software. Results As of February 24, 2020, a total of 1833 deaths were included. Among the deaths with COVID-19, mild type accounted for the most (37.2%), followed by severe type (30.1%). The median age was 70.0 (inter quartile range: 63.0–79.0) years. Most of the deaths were distributed in 50–89 age group, whereas no deaths occurred in 0–9 age group. Additionally, the male to female ratio was 1.95:1. A total of 65.7% of the deaths in Wuhan combined with underlying diseases, and was more pronounced among males. Most of the underlying diseases included hypertension, diabetes and cardiovascular diseases. The peak of daily deaths appeared on February 14 and then declined. The median interval from symptom onset to diagnosis was 10.0 (6.0–14.0) days; the interval from onset to diagnosis gradually shortened. The median intervals from diagnosis to death and symptom onset to deaths were 6.0 (2.0–11.0), 17.0 (12.0–22.0) days, respectively. Most of the disease was centralized in central urban area with highest death rate in Jianghan District. Conclusion COVID-19 poses a greater threat to the elderly people and men with more devastating effects, particularly in the presence of underlying diseases. The geographical distributions show that the epidemic in the central area of Wuhan is more serious than that in the surrounding areas. Analysis of deaths as of February 24 indicates that a tremendous improvement of COVID-19 epidemic in Wuhan has achieved by effective control measures taken by Wuhan Government.


2020 ◽  
Vol 14 (07) ◽  
pp. 696-698
Author(s):  
Xiaoyan Zhang ◽  
Yuxuan Wang

Different countries have employed various strategies for controlling the coronavirus disease (COVID-19) pandemic because there is no consensus regarding effective control measures in the literature. Epidemic control strategies can be classified into two types based on their characteristics. The first type is the “severe acute respiratory syndrome (SARS)-like epidemic control strategy,” i.e., containment. The second type is the “influenza pandemic-like epidemic control strategy” (flu pandemic-like strategy), i.e., mitigation. This paper presents a comparative analysis on the prevention and control strategies for COVID-19 in different countries to provide a reference to control the further spread of the pandemic.


2021 ◽  
Author(s):  
Chonawee Supatgiat

Abstract For more than a year, governments around the world have attempted to control the COVID-19 pandemic. Control measures such as social distancing, face mask wearing, business/school closure, city or transportation lockdown, ban of mass gathering, population education and engagement, contact tracing, and improved mass testing protocols are being used to contain the pandemic. Currently, there are no studies to date that rank the importance of these measures so that the governments may allocate and target their resources towards the most effective control measures. In this paper, we propose a Discrete Time Markov Chain model that captures the above control measures and ranks them. We also show that the importance of the measures change overtime and depends on the stage of the transmission dynamics, as well as the environment. For example, contract tracing is known to be a powerful measure to effectively control the pandemic, however its influence is dynamic in nature. Our results show that contact tracing is indeed helpful during the early stage of the pandemic, but becomes less important after a vaccination program takes effect. If implemented, our novel and unique model may assist many countries in their crucial pandemic control decisions.


Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 1-1
Author(s):  
Carlos Plaza ◽  
Brener Sabando ◽  
Yaira Loor Morán ◽  
Maria Alejandra Posligua ◽  
Luis Layedra ◽  
...  

Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was identified in Hubei province, China in December 2019; pneumonia caused by the SARS-CoV-2 is named coronavirus disease 2019 (COVID-19).1 Several antiviral and anti-inflammatory therapies have been proposed such as hydroxychloroquine, remdesivir, interferon, IL-6 inhibitors, and convalescent plasma. Convalescent plasma has been used during outbreaks of Ebola, Middle East respiratory syndrome coronavirus, H5N1 avian influenza, and H1N1 influenza with mixed results. It has demonstrated reduce respiratory tract viral load, serum cytokine response, hospital stay, and mortality2. There is no specific treatment for COVID-19, however, evidence shows the use of convalescent plasma transfusion could be beneficial in patients infected with SARS-CoV-2, especially at the early stage of the disease3,4. Objectives The objective of this study was to describe the overall survival in patients treated with convalescent plasma transfusion versus the standard treatment at the time of the admission. Materials and Methods This study was performed in 3 hospitals from Guayaquil, Ecuador from April 1st until August 1st. We implemented a protocol using convalescent plasma in patients that had clinical features of severe COVID-19 infection. Convalescent plasma came from donors who had recovered from SARS-CoV-2 infection confirmed by a RT-PCR in the nasopharyngeal swab, being asymptomatic at least 15 days before the donation. We included in this cohort 78 patients who received 300mL of convalescent plasma, all patients were receiving standard treatment at the time of administration. We matched the experimental group with 65 controls selected randomly from the same day of admission. Results The median age was 58 and 62 years old in the case and control group, respectively. The median hospitalization stay was 15 days. The survival rate of patients who received convalescent plasma was higher than those who received standard treatment (64.1% vs 46.2%; p= 0.001). We analyzed mortality rate in patients who required mechanical ventilation at the time of plasma transfusion, the mortality rate was lower in CP transfused COVID-19 patients than the control group (53.8% vs 85.3%, p= 0.001). All patients who were not mechanical ventilation when administrated convalescent plasma transfusion have successfully recovered. None of the patients had no adverse reactions related to the transfusion. Conclusions The administration of convalescent plasma is an encouraging therapeutic option, in a developing country like ours, despite many adversities we are currently using this modality as an option in selected patients, specially in those that are in the early stages of the disease. In which many studies are demonstrating a higher benefit. Our results show the reduction of mortality rate in patients with SARS-CoV-2 infection treated with convalescent plasma, there are cofound factors that may underpower our study. But the adverse effect profile make these treatment a valid option in early stage severe life threading disease. we are encouraged by the initial reports to continue investigations of convalescent plasma and its benefits, while specific antiviral drugs or the vaccine against SARS-CoV-2 are being developed. Disclosures No relevant conflicts of interest to declare. OffLabel Disclosure: Convalescent Plasma Treatment in COVID 19


2014 ◽  
Vol 8 (03) ◽  
pp. 372-378 ◽  
Author(s):  
Archana Iyer ◽  
Taha Kumosani ◽  
Esam Azhar ◽  
Elie Barbour ◽  
Steve Harakeh

Introduction: Nosocomial infections are normally hospital acquired. Nasal carriage of Staphylococcus aureus (S. aureus) is very common and may be transmitted via a hand-to-nose route. The objective of the present study was to screen healthcare workers for the colonization of their nasal cavities with MRSA. Methodology: The study group included hospital staff such as nurses, doctors, and technicians. The control group included university students. For isolation, nasal swabs were taken from the volunteers and cultured on mannitol salt agar media selective for S. aureus. Suspected colonies were confirmed by PCR using specific primers for the coagulase and mecA gene. Typing of the coagulase-positive strains was done using restriction fragment length polymorphism (RFLP). Results: The results indicated an incidence rate of 76% among healthcare workers. This is in comparison with students who served as control and were negative for MRSA. Using RFLP, four different types of MRSA were confirmed. Conclusions: The results of this study are alarming. Effective control measures must be formulated and implemented to avoid indiscriminate use of antimicrobials and the spread of these infectious agents in the region.


2020 ◽  
Vol 19 (2) ◽  
pp. 56-62
Author(s):  
M. I. Gritsay ◽  
M. A. Koroleva ◽  
N. N. Fomkina ◽  
I. S. Koroleva

Aims. The purpose of this study was to identify current epidemiological features of meningococcal infection in Moscow.Materials and methods. Cases of invasive meningococcal disease in Moscow from 2014 to 2018 and the biomaterial from patients with an invasive meningococcal disease were analyzed.Results. The features of the epidemic process of meningococcal disease in Moscow were revealed: increasing in the incidence rate involving teenagers and young adults into the epidemic process; meningococcal strains of serogroups W and A increased in the etiology of the invasive meningococcal disease; high mortality rate.Conclusions. It seems reasonable to recommend vaccination against meningococcal disease by including adolescents, young adults and persons over 65 years old.


2020 ◽  
Author(s):  
Lukman Olagoke ◽  
Ahmet E. Topcu

BACKGROUND COVID-19 represents a serious threat to both national health and economic systems. To curb this pandemic, the World Health Organization (WHO) issued a series of COVID-19 public safety guidelines. Different countries around the world initiated different measures in line with the WHO guidelines to mitigate and investigate the spread of COVID-19 in their territories. OBJECTIVE The aim of this paper is to quantitatively evaluate the effectiveness of these control measures using a data-centric approach. METHODS We begin with a simple text analysis of coronavirus-related articles and show that reports on similar outbreaks in the past strongly proposed similar control measures. This reaffirms the fact that these control measures are in order. Subsequently, we propose a simple performance statistic that quantifies general performance and performance under the different measures that were initiated. A density based clustering of based on performance statistic was carried out to group countries based on performance. RESULTS The performance statistic helps evaluate quantitatively the impact of COVID-19 control measures. Countries tend show variability in performance under different control measures. The performance statistic has negative correlation with cases of death which is a useful characteristics for COVID-19 control measure performance analysis. A web-based time-line visualization that enables comparison of performances and cases across continents and subregions is presented. CONCLUSIONS The performance metric is relevant for the analysis of the impact of COVID-19 control measures. This can help caregivers and policymakers identify effective control measures and reduce cases of death due to COVID-19. The interactive web visualizer provides easily digested and quick feedback to augment decision-making processes in the COVID-19 response measures evaluation. CLINICALTRIAL Not Applicable


2021 ◽  
pp. 112067212110065
Author(s):  
Satria Audi Hutama ◽  
Firas Farisi Alkaff ◽  
Ryan Enast Intan ◽  
Citra Dewi Maharani ◽  
Luki Indriaswati ◽  
...  

Introduction: Ocular symptoms are uncommon manifestations of coronavirus disease 2019 (COVID-19) infection. Earlier study reported that dry eye, blurred vision, foreign body sensation, tearing, itching, conjunctival secretion, conjunctival congestion, ocular pain, and photophobia are among the ocular symptoms that could be found in COVID-19 patients. However, there are only a few reports available regarding corneal involvement in this disease. Here we report a case of keratoconjunctivitis as the only symptom of COVID-19 infection. Case description: A 27-year-old man who worked as an obstetrics and gynecology resident came to the outpatient clinic with the chief complaints of eye discomfort, foreign body sensation, conjunctival hyperemia, lacrimation, and photophobia in his right eye for the past 3 weeks. Fluorescence test showed a small corneal lesion. The patient was then diagnosed with keratoconjunctivitis. A week after the treatment, all symptoms were resolved. A month later, the patient came to the emergency room with the same eye complaints but with a more severe pain. The fluorescence test showed wider corneal lesion compared to last month. The result from the corneal swab is negative for bacterial or fungal infection, indicating a viral infection. Afterwards, reverse transcriptase polymerase chain reaction test from nasopharyngeal swab was performed and revealed that the patient was positive for COVID-19. Conclusions: This case report showed that keratoconjunctivitis may occur as the only manifestation of COVID-19 infection. Thus, patient presented with unexplainable eye symptoms should be evaluated for COVID-19 infection.


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