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In December, 2019, an infection outbreak occurred in Wuhan of unknown cause, which attracts intense attention. Shortly after the virus was identified with the name of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2), the epidemic of coronavirus disease 2019 (COVID-19) broke out and an information storm occurred. At that time, two important aspects: the stage and the links of epidemic, were unclear. Answers to the questions, what are the sources, how do infections occur, and who will be affected should be clarified as the outbreak continues to evolve. Furthermore, the epidemic process and the stage of epidemic should be explored and discussed. Based on information of SARS, middle east respiratory syndrome(MERS) and COVID-19, the links of epidemic (the sources, the routes of infection, and the susceptible population) will be discussed as well as the role of the natural and the social factors. Epidemiology characteristics of patients will be traced based on current information.
In early 2020 the world as we knew it began to change dramatically and rapidly with the COVID-19 outbreak. Social distancing restrictions and lockdown measures have been the most effective course of action, and an inarguably imperative approach at this time. However, in trying to keep the global population safe, social distancing measures unwittingly placed children already experiencing maltreatment and disadvantage in harm’s way. This paper will consider the evidence base which attests to the importance of considering the accumulation of adversity when seeking to understand risk and impact of child maltreatment and disadvantage. Given these unique and unprecedented circumstances which have accompanied the COVID-19 outbreak, and the dearth of research pertaining to the impact of pandemics on child welfare, the paper draws on an emerging body of literature on the effect of natural disasters, conflict and significant global events on child maltreatment. The paper synthesises the research to date in order to call attention to the cumulative impact of the COVID-19 pandemic on children already experiencing abuse and neglect. The paper concludes with an outline of the implications for practice in the helping professions.
Italy has been one of the first countries to implement mitigation measures to curb the COVID-19 pandemic. There is currently a debate on when and how such measures should be loosened.
To forecast the demand for hospital ICU and non-ICU beds for COVID-19 patients from May-September, we developed two models, assuming a gradual easing of restrictions or an intermittent lockdown.
Methods:
We used a compartmental model to evaluate two scenarios: A) an intermittent lockdown; B) a gradual relaxation of the lockdown. Predicted intensive care unit (ICU) and non-ICU demand was compared with the peak in hospital bed utilization observed in April 2020.
Results:
Under scenario A, while ICU demand will remain below the peak, the number of non-ICU will substantially rise and will exceed it (133%; 95%CI: 94-171). Under scenario B, a rise in ICU and non-ICU demand will start in July and will progressively increase over the summer 2020, reaching 95% (95%CI: 71-121) and 237% (95%CI: 191-282) of the April peak.
Conclusions:
Italian hospital demand is likely to remain high in the next months. If restrictions are reduced, planning for the next several months should consider an increase in healthcare resources to maintain surge capacity across the country.
Coronavirus disease (Covid-19) is an infectious disease caused by a SARS-CoV-2 that emerged as a health problem worldwide. It seems that Covid-19 is more lethal for Iranian veterans with a history of exposure to mustard gas. There are some similarities in the pathogenesis of SARS-CoV-2 and mustard gas in immune system disruption and pulmonary infection. SARS-CoV-2 and mustard gas inducing oxidative stress, immune system dysregulation, cytokine storm, and overexpression of ACE2 receptor in lungs that act as functional entry receptors for SARS-CoV-2. Moreover, Iranian survivors exposed to mustard gas are more susceptible and vulnerable to Covid-19. It is suggested that the principles of infection prevention and control in Iranian survivors exposed to mustard gas considered more than others. Therefore, in this review, we discussed the different pathologic aspects of lung injury caused by mustard gas and also the relationship between these damages and the increased susceptibility of Iranian mustard gas exposed survivors to Covid-19.
The proximity required of a thorough biomicroscopic slit-lamp examination may put ophthalmologists at increased risk for respiratory-borne infection with SARS-CoV-2. Conjunctivitis has been described in a few patients with COVID-19 and other coronavirus syndromes. Although SARS-CoV-2 has been detected in the conjunctival secretions or tears of patients with COVID-19 and conjunctivitis, transmission of infection through respiratory droplets to ophthalmologists without eye protection or masks may be the bigger concern.
This letter examines healthcare worker deaths by category and medical speciality during the COVID-19 emergency in Italy, and underlines factors that may have contributed to the elevated number of fatalities among healthcare personnel. These data are now available because Italy was the first western country to be severely affected. These are matters for urgent discussion as development goes forward.
In the current absence of vaccine for COVID-19, public health response target breaking the chain of infection by focusing on the mode of transmission. This paper summarizes current evidence-base around the transmission dynamics, pathogenic, and clinical features of COVID-19, to critically identify if there are any gaps in the current IPC guidelines.
Methods
This study involved a review of global COVID-19 IPC guidelines such as WHO, the CDC, and European Centre for Disease Prevention and Control (ECDC). Guidelines from two high income countries (Australia and UK) and one middle income country (China) were also reviewed. We searched publications in English on ‘Pubmed’ and Google Scholars. We extracted information related to COVID-19 transmission dynamics, clinical presentations and exposures that may facilitate the transmission and compared and contrasted these findings with the recommended IPC measures.
Results
The review findings showed nosocomial transmission of SARS-CoV-2 in health settings through droplet, aerosol and by an oral-fecal or fecal-droplet route. However, the IPC guidelines fail to cover all transmission modes and the recommendations also conflict with each other. Most guidelines recommend surgical masks for healthcare providers during routine care and N95 respirators for aerosol generating procedures. However, recommendations around type of surgical masks varied. In addition, CDC recommends cloth masks when the surgical mask is totally unavailable.
Conclusion
IPC strategies should consider all the possible routes of transmission and target all patient care activities where there may be person to person transmission risk. This review may assist international health agencies to update their guidelines.
The current Covid-19 pandemic is not just a medical and social tragedy, but within the threat of the outbreak looms the potential for a significant and persistent negative mental health impact, based on previous experience with other pandemics such as SARS in 2003 and the earlier H1N1 outbreak of 1918. This piece will highlight the links between depression and viral illnesses and explore important overlaps with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome, potentially implicating inflammatory mechanisms in those exposed to a range of viral agents. While containment of psychological distress currently focuses on social anxiety and quarantine measures, a second wave of psychological morbidity due to viral illness may be imminent.