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Coronavirus disease (COVID-19)
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The impact of unplanned school closure on children’s social contact: rapid evidence review
BackgroundEmergency school closures are often used as public health interventions during infectious disease outbreaks to minimise the spread of infection. However, if children continue mixing with others outside the home during closures, the effect of these measures may be limited.
AimThis review aimed to summarise existing literature on children’s activities and contacts made outside the home during unplanned school closures.
MethodsIn February 2020, we searched four databases, MEDLINE, PsycInfo, Embase and Web of Science, from inception to 5 February 2020 for papers published in English or Italian in peer-reviewed journals reporting on primary research exploring children’s social activities during unplanned school closures. Main findings were extracted.
ResultsA total of 3,343 citations were screened and 19 included in the review. Activities and social contacts appeared to decrease during closures, but contact remained common. All studies reported children leaving the home or being cared for by non-household members. There was some evidence that older child age (two studies) and parental disagreement (two studies) with closure were predictive of children leaving the home, and mixed evidence regarding the relationship between infection status and such. Parental agreement with closure was generally high, but some disagreed because of perceived low risk of infection and issues regarding childcare and financial impact.
ConclusionEvidence suggests that many children continue to leave home and mix with others during school closures despite public health recommendations to avoid social contact. This review of behaviour during unplanned school closures could be used to improve infectious disease modelling.
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Understanding coronavirus disease (COVID-19) risk perceptions among the public to enhance risk communication efforts: a practical approach for outbreaks, Finland, February 2020
More LessUnderstanding risk perceptions of the public is critical for risk communication. In February 2020, the Finnish Institute for Health and Welfare started collecting weekly qualitative data on coronavirus disease (COVID-19) risk perception that informs risk communication efforts. The process is based on thematic analysis of emails and social media messages from the public and identifies factors linked to appraisal of risk magnitude, which are developed into risk communication recommendations together with health and communication experts.
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Whole genome and phylogenetic analysis of two SARS-CoV-2 strains isolated in Italy in January and February 2020: additional clues on multiple introductions and further circulation in Europe
Paola Stefanelli , Giovanni Faggioni , Alessandra Lo Presti , Stefano Fiore , Antonella Marchi , Eleonora Benedetti , Concetta Fabiani , Anna Anselmo , Andrea Ciammaruconi , Antonella Fortunato , Riccardo De Santis , Silvia Fillo , Maria Rosaria Capobianchi , Maria Rita Gismondo , Alessandra Ciervo , Giovanni Rezza , Maria Rita Castrucci , Florigio Lista and on behalf of ISS COVID-19 study groupWhole genome sequences of SARS-CoV-2 obtained from two patients, a Chinese tourist visiting Rome and an Italian, were compared with sequences from Europe and elsewhere. In a phylogenetic tree, the Italian patient’s sequence clustered with sequences from Germany while the tourist’s sequence clustered with other European sequences. Some additional European sequences in the tree segregated outside the two clusters containing the patients’ sequences. This suggests multiple SARS-CoV-2 introductions in Europe or virus evolution during circulation.
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Coronavirus disease (COVID-19) Community Testing Team in Scotland: A 14-day review, 6 to 20 February 2020
In response to the outbreak of COVID-19, we set up a team to carry out sampling in the community. This enabled individuals to remain in self-isolation in their own homes and to prevent healthcare settings and services from being overwhelmed by admissions for sampling of suspected cases. There is evidence that this is a cost effective, safe and necessary service to complement COVID-19 testing in hospitals.
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Estimating the infection and case fatality ratio for coronavirus disease (COVID-19) using age-adjusted data from the outbreak on the Diamond Princess cruise ship, February 2020
Adjusting for delay from confirmation to death, we estimated case and infection fatality ratios (CFR, IFR) for coronavirus disease (COVID-19) on the Diamond Princess ship as 2.6% (95% confidence interval (CI): 0.89–6.7) and 1.3% (95% CI: 0.38–3.6), respectively. Comparing deaths on board with expected deaths based on naive CFR estimates from China, we estimated CFR and IFR in China to be 1.2% (95% CI: 0.3–2.7) and 0.6% (95% CI: 0.2–1.3), respectively.
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Potential short-term outcome of an uncontrolled COVID-19 epidemic in Lombardy, Italy, February to March 2020
Sustained coronavirus disease (COVID-19) transmission is ongoing in Italy, with 7,375 reported cases and 366 deaths by 8 March 2020. We provide a model-based evaluation of patient records from Lombardy, predicting the impact of an uncontrolled epidemic on the healthcare system. It has the potential to cause more than 250,039 (95% credible interval (CrI): 147,717–459,890) cases within 3 weeks, including 37,194 (95% CrI: 22,250–67,632) patients requiring intensive care. Aggressive containment strategies are required.
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Rapid assessment of regional SARS-CoV-2 community transmission through a convenience sample of healthcare workers, the Netherlands, March 2020
Chantal B Reusken , Anton Buiting , Chantal Bleeker-Rovers , Bram Diederen , Mariëtte Hooiveld , Ingrid Friesema , Marion Koopmans , Titia Kortbeek , Suzanne PM Lutgens , Adam Meijer , Jean-Luc Murk , Ilse Overdevest , Thera Trienekens , Aura Timen , Wouter Van den Bijllaardt , Jaap Van Dissel , Arianne Van Gageldonk-Lafeber , Dewi Van der Vegt , Peter C Wever , Wim Van der Hoek and Jan KluytmansTo rapidly assess possible community transmission in Noord-Brabant, the Netherlands, healthcare workers (HCW) with mild respiratory complaints and without epidemiological link (contact with confirmed case or visited areas with active circulation) were tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Within 2 days, 1,097 HCW in nine hospitals were tested; 45 (4.1%) were positive. Of six hospitals with positive HCW, two accounted for 38 positive HCW. The results informed local and national risk management.
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Coronavirus disease (COVID-19) in a paucisymptomatic patient: epidemiological and clinical challenge in settings with limited community transmission, Italy, February 2020
Emanuele Nicastri , Alessandra D’Abramo , Giovanni Faggioni , Riccardo De Santis , Andrea Mariano , Luciana Lepore , Filippo Molinari , Giancarlo Petralito , Silvia Fillo , Diego Munzi , Angela Corpolongo , Licia Bordi , Fabrizio Carletti , Concetta Castiletti , Francesca Colavita , Eleonora Lalle , Nazario Bevilacqua , Maria Letizia Giancola , Laura Scorzolini , Simone Lanini , Claudia Palazzolo , Angelo De Domenico , Maria Anna Spinelli , Paola Scognamiglio , Paolo Piredda , Raffaele Iacomino , Andrea Mone , Vincenzo Puro , Nicola Petrosillo , Antonio Battistini , Francesco Vairo , Florigio Lista , Giuseppe Ippolito and on behalf of INMI and the Italian Army COVID-19 study groupsData concerning the transmission of the novel severe acute respiratory syndrome coronavirus (SARS-CoV-2) in paucisymptomatic patients are lacking. We report an Italian paucisymptomatic case of coronavirus disease 2019 with multiple biological samples positive for SARS-CoV-2. This case was detected using the World Health Organization protocol on cases and contact investigation. Current discharge criteria and the impact of extra-pulmonary SARS-CoV-2 samples are discussed.
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Influenza-associated pneumonia as reference to assess seriousness of coronavirus disease (COVID-19)
More LessInformation on severity of coronavirus disease (COVID-19) (transmissibility, disease seriousness, impact) is crucial for preparation of healthcare sectors. We present a simple approach to assess disease seriousness, creating a reference cohort of pneumonia patients from sentinel hospitals. First comparisons exposed a higher rate of COVID-19 patients requiring ventilation. There were more case fatalities among COVID-19 patients without comorbidities than in the reference cohort. Hospitals should prepare for high utilisation of ventilation and intensive care resources.
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Rapidly increasing cumulative incidence of coronavirus disease (COVID-19) in the European Union/European Economic Area and the United Kingdom, 1 January to 15 March 2020
The cumulative incidence of coronavirus disease (COVID-19) cases is showing similar trends in European Union/European Economic Area countries and the United Kingdom confirming that, while at a different stage depending on the country, the COVID-19 pandemic is progressing rapidly in all countries. Based on the experience from Italy, countries, hospitals and intensive care units should increase their preparedness for a surge of patients with COVID-19 who will require healthcare, and in particular intensive care.
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Serological and molecular findings during SARS-CoV-2 infection: the first case study in Finland, January to February 2020
Anu Haveri , Teemu Smura , Suvi Kuivanen , Pamela Österlund , Jussi Hepojoki , Niina Ikonen , Marjaana Pitkäpaasi , Soile Blomqvist , Esa Rönkkö , Anu Kantele , Tomas Strandin , Hannimari Kallio-Kokko , Laura Mannonen , Maija Lappalainen , Markku Broas , Miao Jiang , Lotta Siira , Mika Salminen , Taneli Puumalainen , Jussi Sane , Merit Melin , Olli Vapalahti and Carita Savolainen-KopraThe first case of coronavirus disease (COVID-19) in Finland was confirmed on 29 January 2020. No secondary cases were detected. We describe the clinical picture and laboratory findings 3–23 days since the first symptoms. The SARS-CoV-2/Finland/1/2020 virus strain was isolated, the genome showing a single nucleotide substitution to the reference strain from Wuhan. Neutralising antibody response appeared within 9 days along with specific IgM and IgG response, targeting particularly nucleocapsid and spike proteins.
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Estimating the asymptomatic proportion of coronavirus disease 2019 (COVID-19) cases on board the Diamond Princess cruise ship, Yokohama, Japan, 2020
More LessOn 5 February 2020, in Yokohama, Japan, a cruise ship hosting 3,711 people underwent a 2-week quarantine after a former passenger was found with COVID-19 post-disembarking. As at 20 February, 634 persons on board tested positive for the causative virus. We conducted statistical modelling to derive the delay-adjusted asymptomatic proportion of infections, along with the infections’ timeline. The estimated asymptomatic proportion was 17.9% (95% credible interval (CrI): 15.5–20.2%). Most infections occurred before the quarantine start.
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Post-discharge surveillance and positive virus detection in two medical staff recovered from coronavirus disease 2019 (COVID-19), China, January to February 2020
Yuanyuan Xing , Pingzheng Mo , Yu Xiao , Oiu Zhao , Yongxi Zhang and Fan WangSince December 2019, 62 medical staff of Zhongnan Hospital in Wuhan, China have been hospitalised with coronavirus disease 2019. During the post-discharge surveillance after clinical recovery, swabs were positive in two asymptomatic cases (3.23%). Case 1 had presented typical clinical and radiological manifestations on admission, while manifestation in Case 2 was very mild. In conclusion, a small proportion of recovered patients may test positive after discharge, and post-discharge surveillance and isolation need to be strengthened.
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Retrospective analysis of the possibility of predicting the COVID-19 outbreak from Internet searches and social media data, China, 2020
Cuilian Li , Li Jia Chen , Xueyu Chen , Mingzhi Zhang , Chi Pui Pang and Haoyu ChenThe peak of Internet searches and social media data about the coronavirus disease 2019 (COVID-19) outbreak occurred 10–14 days earlier than the peak of daily incidences in China. Internet searches and social media data had high correlation with daily incidences, with the maximum r > 0.89 in all correlations. The lag correlations also showed a maximum correlation at 8–12 days for laboratory-confirmed cases and 6–8 days for suspected cases.
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Evaluation of a quantitative RT-PCR assay for the detection of the emerging coronavirus SARS-CoV-2 using a high throughput system
More LessFacing the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), high-volume respiratory testing is demanded in laboratories worldwide. We evaluated the performance of a molecular assay for the detection of SARS-CoV-2 on a high-throughput platform, the cobas 6800, using the ‘open channel’ for integration of a laboratory-developed assay. We observed good analytical performance in clinical specimens. The fully automated workflow enables high-throughput testing with minimal hands-on time, while offering fast and reliable results.
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First cases of coronavirus disease 2019 (COVID-19) in the WHO European Region, 24 January to 21 February 2020
Gianfranco Spiteri , James Fielding , Michaela Diercke , Christine Campese , Vincent Enouf , Alexandre Gaymard , Antonino Bella , Paola Sognamiglio , Maria José Sierra Moros , Antonio Nicolau Riutort , Yulia V. Demina , Romain Mahieu , Markku Broas , Malin Bengnér , Silke Buda , Julia Schilling , Laurent Filleul , Agnès Lepoutre , Christine Saura , Alexandra Mailles , Daniel Levy-Bruhl , Bruno Coignard , Sibylle Bernard-Stoecklin , Sylvie Behillil , Sylvie van der Werf , Martine Valette , Bruno Lina , Flavia Riccardo , Emanuele Nicastri , Inmaculada Casas , Amparo Larrauri , Magdalena Salom Castell , Francisco Pozo , Rinat A. Maksyutov , Charlotte Martin , Marc Van Ranst , Nathalie Bossuyt , Lotta Siira , Jussi Sane , Karin Tegmark-Wisell , Maria Palmérus , Eeva K. Broberg , Julien Beauté , Pernille Jorgensen , Nick Bundle , Dmitriy Pereyaslov , Cornelia Adlhoch , Jukka Pukkila , Richard Pebody , Sonja Olsen and Bruno Christian CiancioIn the WHO European Region, COVID-19 surveillance was implemented 27 January 2020. We detail the first European cases. As at 21 February, nine European countries reported 47 cases. Among 38 cases studied, 21 were linked to two clusters in Germany and France, 14 were infected in China. Median case age was 42 years; 25 were male. Late detection of the clusters’ index cases delayed isolation of further local cases. As at 5 March, there were 4,250 cases.
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Potential scenarios for the progression of a COVID-19 epidemic in the European Union and the European Economic Area, March 2020
Two months after the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the possibility of established and widespread community transmission in the European Union and European Economic Area (EU/EEA) is becoming more likely. We provide scenarios for use in preparedness for a possible widespread epidemic. The EU/EEA is moving towards the ‘limited sustained transmission’ phase. We propose actions to prepare for potential mitigation phases and coordinate efforts to protect the health of citizens.
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Rapid establishment of laboratory diagnostics for the novel coronavirus SARS-CoV-2 in Bavaria, Germany, February 2020
The need for timely establishment of diagnostic assays arose when Germany was confronted with the first travel-associated outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Europe. We describe our laboratory experiences during a large contact tracing investigation, comparing previously published real-time RT-PCR assays in different PCR systems and a commercial kit. We found that assay performance using the same primers and probes with different PCR systems varied and the commercial kit performed well.
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Differential diagnosis of illness in patients under investigation for the novel coronavirus (SARS-CoV-2), Italy, February 2020
A novel coronavirus (SARS-CoV-2) has been identified as the causative pathogen of an ongoing outbreak of respiratory disease, now named COVID-19. Most cases and sustained transmission occurred in China, but travel-associated cases have been reported in other countries, including Europe and Italy. Since the symptoms are similar to other respiratory infections, differential diagnosis in travellers arriving from countries with wide-spread COVID-19 must include other more common infections such as influenza and other respiratory tract diseases.
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