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July 8 | Daily COVID-19 LST Report

CLIMATE:

· A cross-sectional survey of 812 Sudanese residents assessed their knowledge, attitude, and practices towards COVID-19. While 78.2% exhibited accurate comprehension, there was significant variance between demographics and only 34.1% report wearing masks in public, highlighting the need for increase education especially in vulnerable populations in order to improve public health outcomes.

· The Italian Ministry of Justice published measures implemented to limit the spread of COVID-19 in Italian prisons. These include widespread testing and rapid identification, isolation, and treatment of infected individuals. Legal and bioethics researchers argue that these initiatives fell short in effectively protecting the prisoners and urge legislators to decrease the prison population by providing alternative sentences, such as house arrest during the COVID-19 pandemic.




EPIDEMIOLOGY:

· Chinese researchers created a statistical model using COVID-19 transmission data from 367 Chinese cities to estimate the "COVID-19 spreading profile" (i.e. peak infection time, rate of infection, etc) for any given population. Applying their model to early case spread in South Korea, Italy, and Iran, the authors accurately predicted peak surges in mid-April, late March, and the end of May. The authors believe this model may be used by public health officials to predict COVID-19 surges after initial infection in cities.

· A cross-sectional study of COVID-19 patients in Italy (n=202) found 64% reported altered taste/smell, and of those, 89% had complete or partial recovery of taste/smell after 4 weeks. Higher degree of olfactory and gustatory impairment correlated with a lower likelihood of recovery after 4 weeks, suggesting these symptoms may be a useful prognostic factor in addition to screening tool.


UNDERSTANDING THE PATHOLOGY:

· Researchers from India hypothesize that early onset pulmonary edema in COVID-19 is due to a SARS-CoV-2 mediated insult to the nucleus tractus solitarius (NTS), leading to a loss of inhibition of sympathetic outflow. This increased sympathetic activity may result in neurogenic pulmonary edema by injuring lung vasculature and inducing a hypercoagulable state.


TRANSMISSION AND PREVENTION:

· A case series of 51 COVID-19 patients in India found the median duration of viral persistence in asymptomatic individuals was 8.87 days, with 10 of the 44 cases lasting beyond 2 weeks, leading authors to propose the quarantine duration should be extended from 17 to 21 days regardless of symptoms.

· Researchers from Harvard and Stanford University propose a feasible method for decontaminating N95 respirators. This strategy involves heating the masks in a convection oven at 85 degrees C with 60-85% humidity for 30 minutes. They found no significant decrease in filtration after five cycles of decontamination, offering a safe way to reuse these masks in resource-limited settings.

· Researchers from a 150-bed Skilled Nursing Facility (SNF) generated heat maps to track the spread of SARS-CoV-2 infection among residents and staff. They observed "rapid dissemination within 3 weeks of the first confirmed case despite adequate protection measures”, suggesting the need for increased testing and appropriate isolation precautions to prevent further transmission, and recommend increasing staff reserve to compensate for the predicted increase in employees requiring self-quarantine.


MANAGEMENT:

· A retrospective study from Italy (n=115) found that therapeutic anticoagulation was an independent predictor of survival (OR 0.055). Additional findings include age (OR 1.1), D-dimer (OR: 1.0), and albuminuria (OR: 11.6) were found to be independent predictors of death


R&D DIAGNOSIS AND TREATMENT:

· Research from the Institute of Virology in Germany suggests that utilizing IgG binding avidity may improve characterization of SARS-CoV-2 infection status. Current data shows IgM responses are highly variable with IgG status, making it difficult to distinguish past infection vs. early infections. However, understanding that low avidity = new infection and high avidity = past infection may improve contact tracing, vaccination programs, and epidemiological data.

· A retrospective cohort study conducted in Wuhan, China examined 64 COVID-19 patients with Influenza A/B co-infection alongside age and sex matched COVID-19 positive controls to understand the effect of co-infection on COVID-19 and the use of lopinavir/ritonavir. Resolution of lung involvement demonstrated a hazard ratio of 1.878 (p=0.020) for patients treated with lopinavir/ritonavir compared to those not treated with this regiment, and viral shedding time was significantly longer (17 days versus 12 days) for patients with Influenza co-infection than those without co-infection (p=0.001).


MENTAL HEALTH AND RESILIENCE:

· The COVID Trauma Response Group and the Institute of Mental Health at University College London offer guidance on providing psychological support to hospital staff during the COVID-19 pandemic. The authors suggest that implementing these recommendations may help maintain morale in the workplace while possibly avoiding the need for formal psychological interventions in the future. Interventions include:

· Meeting basic needs of access to personal protective equipment, nutrition, rest and sleep.

· Alternating high and low-stress jobs.

· Avoid psychological debriefing (PD), critical incident stress debriefing (CISD) or any other single session intervention which involves mandating staff to talk about their thoughts or feelings.

· Partnering less experienced staff with more experienced mentors.


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