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Since the end of 2019, the whole world has been seized by the COVID-19 pandemic caused by the SARS-CoV2 virus. To date, the infection has led to more than 4 million deaths worldwide, and to more than 140 thousand deaths in Russia. COVID-19 (abbreviation for COronaVIrus Disease 2019) is a potentially severe acute respiratory infection caused by the SARS-CoV-2 coronavirus (2019-nCoV). Vaccination against COVID-19 plays a key role in stopping the pandemic. According to existing experience in infections prevention, mass vaccination will reduce the virus’s expansion and the risk of vaccine-resistant strains’ development. In the context of the COVID-19 the question of the feasibility and safety of vaccination of patients with Primary Immunodeficiency and Hereditary Angioedema arises. The Russian Association of Allergists and Clinical Immunologists and the National Association of Experts in Primary Immunodeficiencies have developed and approved a position paper on vaccination of patients with Primary Immunodeficiency and Hereditary Angioedema against COVID-19. This position paper provides answers to key questions regarding the vaccination of patients with these diseases.

One of the key tasks of the previous year is to stop the spread of coronavirus disease (COVID-19), which became a pandemic that led to the deaths of more than 4 million people worldwide and more than 140 thousand deaths in Russia. COVID-19 is caused by the severe acute respiratory syndrome coronavirus 2 (2019-nCoV) virus of the coronavirus family. Vaccination plays a leading role in ending the pandemic. Currently, five vaccines against COVID-19 have been registered in Russia, namely, Sputnik V, Sputnik light, EpiVacCorona, EpiVacCorona-Н, and СoviVak. The short follow-up period and absence of randomized placebo-controlled trials of COVID-19 vaccines in certain patients with chronic diseases lead to several questions about the effectiveness/safety of vaccination in these patients. Given the wide spread of allergic diseases and the heterogeneity of patients with allergopathology, experts of the Russian Association of Allergology and Clinical Immunology have developed and approved a position paper on vaccination of patients with allergopathology.

The evolution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has highlighted the need for versatile diagnostic assays that can discriminate among emerging variants of the virus. Here we report the development and performance benchmarking of an inexpensive (approximately US$0.30 per test) assay for the rapid (sample-to-answer time within 30 min) colorimetric detection of SARS-CoV-2 variants. The assay, which we integrated into foldable paper strips, leverages nucleic acid strand-displacement reactions, the thermodynamic energy penalty associated with single-base-pair mismatches and the metal-ion-controlled enzymatic cleavage of urea to amplify the recognition of viral RNAs for the colorimetric readout of changes in pH via a smartphone. For 50 throat swab samples, the assay simultaneously detected the presence of SARS-CoV-2 and mutations specific to the SARS-CoV-2 variants Alpha, Beta and Gamma, with 100% concordance with real-time quantitative polymerase chain reaction and RNA sequencing. Customizable and inexpensive paper-based assays for the detection of viruses and their variants may facilitate viral surveillance.

The essence of this paper is eminent to advance the study of Human Resource Management (HRM) in the profound new directions that has been introduced due to the covid-19 pandemic. This particular review elaborates on the following such as: Challenges Caused by Covid-19 to HRM Principles and Practice, HRM Outlook within Continents in this Coronavirus Pandemic, How Information Technology can still grow HRM in new Practices, The Case of HRM Practice in Developing World with Covid-19, How Both National and International HRM Practice is portrayed with Covid-19, Moving Forward with HRM Practice and Covid-19, and Organisational and Institutional Challenges and Demands in HRM Policies and Law. The general conclusion with this new Human Resource Management is associated with massive application of technology that Human Resource Management practices in various organisational operations and ways of doing things in the traditional HRM way has changed. Many of the roles are been performed remotely using internet and relevant HRM laws, applications and policies to deliver in managing work and the people. This is eminent for HRM practitioners and professionals to further educate and train themselves in this covid-19 era to avert themselves with the new principles instituted by organisations and governments in the area of HRM of activities and people. In this review the HRM is been twisted and thereby its efficacies are challenged which is why this new study is important to the practitioners and professionals to adapt and/or adopt.

Wuhan, Peter Daszak, Shi Zheng Li, Ralph Baric e Anthony Fauci: sono questi i nuovi protagonisti del presente articolo, il secondo della serie "The Coronavirus Papers", un'ulteriore e più approfondita investigazione sulle possibili origini della pandemia virale che ha recentemente cambiato il mondo. La parola-chiave di questa nuova indagine è «weaponised virus»: la modificazione artificiale dei genomi virali al fine di aumentarne contagiosità e patogenicità a fini bellici, così come delineato dallo scienziato statunitense Ralph Baric già nel 2006. E ritroveremo quello stesso Ralph Baric a collaborare, solamente pochi anni fa, con Shi Zheng Li, la responsabile del laboratorio cinese a massimo biocontenimento situato proprio a Wuhan, la città presso la quale la pandemia ha avuto inizio. Una storia di pericolosissime ricerche "dual-use" (civili e militari) allo stesso tempo) inizialmente consentite e poi temporaneamente bloccate dall'Amministrazione Obama: la "resurrezione" del virus dell'influenza spagnola, la modificazione del virus dell'influenza aviaria al fine di renderla contagiosa nei confronti degli esseri umani, le rischiose ricerche condotte da Peter Daszak e Ralph Baric sui coronavirus dei pipistrelli cinesi assieme a Shi Zheng Li; e il ruolo fondamentale occupato in queste vicende da Anthony Fauci, no dei massimi dirigenti del Nationa Institutes of Health statunitense, nel finanziare e poi nel tentare di mantenere in ombra quelle stesse ricerche. In tale contesto, sarà possibile osservare in una luce del tutto nuova le peculiari misure adottate dagli Stati occidentali per il contrasto alla pandemia. Lockdown, vaccinazioni di massa effettuata con i soli vaccini statunitensi, controllo ferreo del fronte interno, delegittimazione di ogni opposizione, esclusione di ogni altra terapia o trattamento: tutte soluzioni da assumersi in caso di attacco batteriologico, in un contesto tipicamente bellico, marcato dalla diffusione sul territorio di un «weaponised virus». La presente ricerca, effettuata consultando fonti ufficiali e certificate, tra le quali pubblicazioni scientifiche e organi di informazione internazionali, costituisce il secondo articolo della serie "The Coronavirus Papers", che comprende approfondimenti e analisi di scenario relativi all'emergenza pandemica SARS-Cov-2.

The 2019 outbreak of coronavirus disease (COVID-19) in Wuhan (Hubei province of China) has given rise to a pandemic spread of virus, more than 240 million incidences and a death toll larger than 5 million people. COVID-19 has set off large efforts in research, therapy and patient care, as well as public and private debates in every imaginable form. A number of scientists used the publication platforms provided by the Federation of the European Biochemical Societies (FEBS) to present their research data, reviews, opinions and other contributions relating to COVID-19 and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Here, I highlight the recent COVID-19 papers which have been published and collected in a Virtual Issue in FEBS Letters, and discuss their implications towards understanding the molecular, biochemical and cellular mechanisms of SARS-CoV-2 infections, vaccine development and antiviral discovery strategies.

Wuhan, Peter Daszak, Shi Zheng Li: sono questi i protagonisti del presente articolo, un'approfondita investigazione sulle possibili origini della pandemia virale che ha recentemente cambiato il mondo. Un laboratorio a massimo livello di biocontenimento situato proprio nella città cinese in cui tutto ha avuto inizio; uno scienziato britannico, a capo di un'organizzazione privata statunitense, che effettua ricerche il cui oggetto è la modificazione artificiale di genomi di coronavirus; una ricercatrice cinese che raccoglie campioni di coronavirus dai pipistrelli e pubblica articoli a firma congiunta con quello stesso studioso occidentale; un assoluto silenzio mantenuto su queste ricerche dopo lo scoppio dell'emergenza pandemica, benché esse siano state condotte solamente pochi anni fa; e un ruolo fondamentale assunto da Peter Daszak nella promozione dell'idea che il COVID-19 abbia avuto un'origine naturale. Un'indagine che intende andare oltre il livello informativo correntemente reso disponibile in Italia, basato sul mero conteggio di contagi, tamponi e vaccinati, muovendo invece alla ricerca di quelle tracce e quegli indizi, usualmente non evidenziati dai mass media, che sembrano indicare una direzione ben precisa: quella di Wuhan e dell'origine artficiale del COVID-19, un'ipotesi che è stata oggetto di sconcertanti censure preventive e delegittimazioni aprioristicamente sostenute, malgrado le palesi evidenze in contrario. La presente ricerca, effettuata consultando fonti ufficiali e certificate, tra le quali pubblicazioni scientifiche e organi di informazione internazionali, costituisce il primo articolo della serie "The Coronavirus Papers", che comprende approfondimenti e analisi di scenario relativi all'emergenza pandemica SARS-Cov-2.

Natural disasters and pandemics present as external shocks to Caribbean economies and affect provision of education and learning outcomes through multiple channels. This paper analyzes resilience in the education sector to climate, disaster and health shocks in Caribbean countries through the lenses of continuity of learning during emergency situations, infrastructure and skills.

Natural hazards, including hurricanes, floods and landslides, are a common phenomenon in the Caribbean, affecting both residents and private companies. Researchers estimate probability of Caribbean country to be hit by a natural hazard as 14% in any given year, making it one of the most vulnerable regions in the world. In recent years, several super storms have devastated the region, including Hurricane Maria, Hurricane Irma, Hurricane Matthew and Tropical Storm Dorian causing immense damages. The World Travel and Tourism Council ranks the Caribbean as the most tourism-dependent region relative to the contribution of travel and tourism to gross domestic product (GDP). The sector has grown continuously since the 1970s. Between 2080 and 1995 average annual growth in tourist arrivals was 5 percent. The growth continued for the following 15 years, but average annual growth slowed to 2.4 percent. Before the COVID-19 crisis, arrivals were expected to continue to grow but slower than international average. COVID-19 has completely changed the outlook for tourism, and it is still early to tell what recovery will look like as the crisis is still unfolding.

The Caribbean region is highly exposed to different types of shocks, some with devastating effects, ranging from climate change and disasters to external economic stresses and epidemics like the ongoing COVID-19 pandemic. Most Caribbean economies are small and open, and reliant on tourism and foreign investments, combined with high levels of poverty, which makes countries in the region vulnerable to such shocks. Shocks disproportionally affect the poor because they are often not only more exposed to them (e.g. due to their geographical location), but they are also more vulnerable to their effects. The sources of resilience available to the poor are more limited, and therefore they are often less equipped to anticipate, absorb, and recover from shocks. The social protection (SP), health, and education sectors play key roles in helping people to build human capital for resilience. These sectors contribute to strengthening the capacities of households and individuals, and in particular the poor, to anticipate, absorb, and recover from shocks. In this regard, ensuring business continuity for these services during shock events is crucial, alongside developing the capacity to rapidly adapt and deploy adequate support to people affected by shocks. Adaptive Social Protection (ASP) is concerned with how SP programs, services and systems can contribute to addressing covariate shocks through preventive, preparedness, and response actions: that is, adapting and using the capacity of the SP sector, typically developed for addressing idiosyncratic shocks, to enhance the resilience of households – and of the poor in particular

Objectives: To conduct a systematic survey of published techniques for automated diagnosis and prognosis of COVID-19 diseases using medical imaging, assessing the validity of reported performance and investigating the proposed clinical use-case. To conduct a scoping review into the authors publishing such work. Methods: The Scopus database was queried and studies were screened for article type, and minimum source normalized impact per paper and citations, before manual relevance assessment and a bias assessment derived from a subset of the Checklist for Artificial Intelligence in Medical Imaging (CLAIM). The number of failures of the full CLAIM was adopted as a surrogate for risk-of-bias. Methodological and performance measurements were collected from each technique. Each study was assessed by one author. Comparisons were evaluated for significance with a two-sided independent t-test. Findings: Of 1002 studies identified, 390 remained after screening and 81 after relevance and bias exclusion. The ratio of exclusion for bias was 71%, indicative of a high level of bias in the field. The mean number of CLAIM failures per study was 8.3 ± 3.9 [1,17] (mean ± standard deviation [min,max]). 58% of methods performed diagnosis versus 31% prognosis. Of the diagnostic methods, 38% differentiated COVID-19 from healthy controls. For diagnostic techniques, area under the receiver operating curve (AUC) = 0.924 ± 0.074 [0.810,0.991] and accuracy = 91.7% ± 6.4 [79.0,99.0]. For prognostic techniques, AUC = 0.836 ± 0.126 [0.605,0.980] and accuracy = 78.4% ± 9.4 [62.5,98.0]. CLAIM failures did not correlate with performance, providing confidence that the highest results were not driven by biased papers. Deep learning techniques reported higher AUC (p

OBJECTIVE: To identify barriers to, describe the development of and evaluate the implementation of a behavioural theory informed strategy to improve staff personal protective equipment (PPE) compliance during COVID-19 in a regional Australian Emergency Department. METHODS: Barriers to PPE use were identified through staff consultation then categorised using the Theoretical Domains Framework. The Behaviour Change Wheel was used to develop a strategy to address the barriers to PPE compliance. The strategy was refined and endorsed by the site COVID taskforce. Data were collected through direct observation. Descriptive statistics were used to summarise PPE compliance and inductive content analysis for free text data of staff behaviours. RESULTS: 73 barriers were identified, mapped to 9 intervention functions and 42 behaviour change techniques. The predominant mechanisms were: (1) Executive communication reinforcing policy and consequences; (2) implementation of a PPE Marshal; (3) face to face reinforcement / modeling; (4) environmental restructuring including electronic medical record modifications. The PPE Marshal observed 281 PPE activities. PPE compliance varied between 47.9% (Buddy check) and 91.8% (Bare below elbow). The PPE Marshal intervened on 121 occasions, predominantly through buddying, explaining and demonstrating correct PPE use, most frequently with medical staff (72%). CONCLUSION: We describe an evidence-based process to overcome barriers to PPE compliance that maximize safe work practice in a time critical situation. Staff require enabling, access to equipment and reinforcement to use PPE correctly.

Many countries around the world have been influenced by Covid-19 which is a serious virus as it gets transmitted by human communication. Although, its syndrome is quite similar to the ordinary flu. The critical step involved in Covid-19 is the initial screening or testing of the infected patients. As there are no special detection tools, the demand for such diagnostic tools has been increasing continuously. So, it is eminently admissible to find out positive cases of this disease at the earliest so that the spreading of this dangerous virus can be controlled. Although, some methods for the detection of Covid-19 patients are available, which are performed upon respiratory based samples and among them, a critical approach for treatment is radiologic imaging or X-ray imaging. The latest conclusions obtained from X-ray digital imaging based algorithms and techniques recommend that such type of digital images may consist of significant facts regarding the SARS-CoV-2 virus. The utilization of Deep Neural Networks based methodologies clubbed with digital radiological imaging has been proved useful for accurately identifying this disease. This could also be adjuvant in conquering the problem of dearth of competent physicians in far-flung areas. In this paper, a CheXImageNet model has been introduced for detecting Covid-19 disease by using digital images of Chest X-ray with the help of an openly accessible dataset. Experiments for both binary class and multi-class have been performed in this work for benchmarking the effectiveness of the proposed work. An accuracy of 100\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\%$$\end{document}% is reported for both binary classification (having cases of Covid-19 and Normal X-Ray) and classification for three classes (including cases of Covid-19, Normal X-Ray and, cases of Pneumonia disease) respectively.

Background Clinical guidelines on infection control strategies in healthcare workers (HCWs) play an important role in protecting them during the severe acute respiratory syndrome coronavirus 2 pandemic. Poorly constructed guidelines that are incomprehensive and/or ambiguous may compromise HCWs’ safety. Objective The objective of this study was to develop and validate a tool to appraise guidelines on infection control strategies in HCWs based on the guidelines published early in the coronavirus disease 2019 pandemic. Design, setting, and outcomes A three-stage, web-based, Delphi consensus-building process among a panel of diverse HCWs and healthcare managers was performed. The tool was validated by appraising 40 international, specialty-specific, and procedure-specific guidelines along with national guidelines from countries with a wide range of gross national income. Results Overall consensus (≥75%) was reached at the end of three rounds for all six domains included in the tool. The Delphi panel recommended an ideal infection control guideline should encompass six domains: general characteristics (domain 1), engineering recommendations (domain 2), personal protective equipment (PPE) use (domain 3), and administrative aspects (domain 4-6) of infection control. The appraisal tool performed well across the six domains, and the inter-rater agreement was excellent for the 40 guidelines. All included guidelines performed relatively better in domains 1–3 than in domains 4–6, and this was more evident in guidelines originating from lower income countries. Conclusion The guideline appraisal tool was robust and easy to use. Engineering recommendations aspects of infection control, administrative measures that promote optimal PPE use, and HCW wellbeing were generally lacking in assessed guidelines. This tool may enable health systems to adopt high-quality HCW infection control guidelines during the severe acute respiratory syndrome coronavirus 2 pandemic and may also provide a framework for future guideline development.

Background Patients presenting to Emergency Department (ED) with non-specific low back pain can receive more unnecessary, intensive and costly care than is recommended. The COVID-19 pandemic has provided an unprecedented opportunity to examine how health systems prioritise necessary care that provides clear benefits to patients. The purpose of this study was to examine the impact of COVID-19 on care of low back pain in the ED. Methods We performed a retrospective analysis of electronic medical record data on care for low back pain from three public hospitals in Sydney. We included patients diagnosed with spinal conditions who presented between March and May in 2019 and in 2020. Outcomes were the total number of patients presenting with spinal conditions to ED, the proportion diagnosed with non-specific low back pain, and the proportion receiving potentially unnecessary aspects of care (ambulance use, imaging, opioids, hospital admissions). We calculated relative risk with 95% CIs and examined plots with locally weighted smoothed curves. Results Presentations for spinal conditions over a three-month period to three EDs reduced from 694 in 2019 to 475 in 2020 (31% reduction, 95% CI = 26%–37%). The proportion of patients diagnosed with non-specific low back pain (83% in 2019 vs 86% in 2020), or receiving potentially unnecessary care were similar in 2019 and 2020 (Imaging = 25% vs 25%; Opioids = 54% vs 56%; Admitted = 18% vs 20%; pathology test = 24% vs 23%). The proportion of patients arriving by ambulance was higher during the pandemic; 29% in 2019 vs 41% in 2020 (RR = 1.39, 95% CI = 1.19–1.63). Conclusions ED presentations for low back pain associated with spinal conditions decreased substantially during the COVID-19 pandemic. Use of potentially unnecessary aspects of care did not change or increased during the pandemic.

Background COVID-19 is a global health crisis. Close contact with the mucous membranes and respiratory secretions of patients and aerosol-generating procedures renders dentists and other oral health professionals at high risk of exposure to SARS-CoV-2. We examined dentists’ knowledge, preparedness, and experiences of managing COVID-19 in Australia. Methods A cross-sectional online survey of dentists with a current membership with The Australian Dental Association (ADA) was conducted between March and April 2021. Results Of the 368 survey responses, most dentists (72.3%) reported having a good level of knowledge about COVID-19, with most visiting the ADA Federal COVID-19 (74.7%) and state/territory department of health websites (62.8%), respectively to source up-to-date information. Most dentists (87.6%) felt prepared to manage COVID-19 into the future, although 66% reported not receiving training or certification in the use of PPE. Over half (58.7%) reported not being concerned about contracting SARS-CoV-2 at work, with some (28.9%, n=98/339) feeling more stressed than usual and having heavier workloads. Conclusions COVID-19 had significant impact in oral healthcare in Australia. Dentistry has adapted to the varied challenges raised by the pandemic. Comprehensive training and detailed guidelines were fundamental for successful patient management during the COVID-19 outbreak.

Key summary points Aim To identify the impact of COVID-19 on case-mix, care standards and outcomes of hip fracture patients in Ireland for the first 6 months of the COVID-19 pandemic. Findings There was a 15% reduction in admissions per month during the first 6 months of the COVID-19 pandemic. There was a reduction in compliance with many of the Irish Hip Fracture Standards following the COVID-19 pandemic. Message Every attempt should be made to preserve the multidisciplinary team involved in the care pathway for hip fracture patients throughout any subsequent waves of the COVID-19 pandemic., Purpose To describe the impact of COVID-19 on hip fracture care during the first 6 months of the pandemic. Methods A secondary analysis of 4385 cases in the Irish Hip Fracture Database from 1st June 2019 to 31st August 2020 was conducted. Results Hip fracture admissions decreased by 15% during the study period (p

Globally, coronavirus disease (COVID-19) has badly affected the medical system and economy. Sometimes, the deadly COVID-19 has the same symptoms as other chest diseases such as pneumonia and lungs cancer and can mislead the doctors in diagnosing coronavirus. Frontline doctors and researchers are working assiduously in finding the rapid and automatic process for the detection of COVID-19 at the initial stage, to save human lives. However, the clinical diagnosis of COVID-19 is highly subjective and variable. The objective of this study is to implement a multi-classification algorithm based on deep learning (DL) model for identifying the COVID-19, pneumonia, and lung cancer diseases from chest radiographs. In the present study, we have proposed a model with the combination of Vgg-19 and convolutional neural networks (CNN) named BDCNet and applied it on different publically available benchmark databases to diagnose the COVID-19 and other chest tract diseases. To the best of our knowledge, this is the first study to diagnose the three chest diseases in a single deep learning model. We also computed and compared the classification accuracy of our proposed model with four well-known pre-trained models such as ResNet-50, Vgg-16, Vgg-19, and inception v3. Our proposed model achieved an AUC of 0.9833 (with an accuracy of 99.10%, a recall of 98.31%, a precision of 99.9%, and an f1-score of 99.09%) in classifying the different chest diseases. Moreover, CNN-based pre-trained models VGG-16, VGG-19, ResNet-50, and Inception-v3 achieved an accuracy of classifying multi-diseases are 97.35%, 97.14%, 97.15%, and 95.10%, respectively. The results revealed that our proposed model produced a remarkable performance as compared to its competitor approaches, thus providing significant assistance to diagnostic radiographers and health experts.

Purpose To evaluate the usefulness of compressive ultrasound (CUS) for the diagnosis of deep vein thrombosis (DVT) in patients with SARS-CoV-2-related infection. Methods 112 hospitalized patients with confirmed SARS-CoV-2 infection were retrospectively enrolled. CUS was performed within 2 days of admission and consisted in the assessment of the proximal and distal deep venous systems. Lack of compressibility, or direct identification of an endoluminal thrombus, were the criteria used for the diagnosis of DVT. Pulmonary embolism (PE) events were investigated at computed tomography pulmonary angiography (CTPA) within 5 days of follow-up. Logistic binary regression was computed to determine which clinical and radiological parameters were independently associated with PE onset. Results Overall, the incidence of DVT in our cohort was about 43%. The most common district involved was the left lower limb (68.7%) in comparison with the right one (58.3%) while the upper limbs were less frequently involved (4.2% the right one and 2.1% the left one, respectively). On both sides, the distal tract of the popliteal vein was the most common involved (50% right side and 45.8% left side). The presence of DVT in the distal tract of the right popliteal vein (OR = 2.444 95%CIs 1.084–16.624, p = 0.038), in the distal tract of the left popliteal vein (OR = 4.201 95%CIs 1.484–11.885, p = 0.007), and D-dimer values (OR = 2.122 95%CIs 1.030–5.495, p = 0.003) were independently associated with the onset on PE within 5 days. Conclusions CUS should be considered a useful tool to discriminate which category of patients can develop PE within 5 days from admission.

Background Personal-protective equipment (PPE)-preparedness, defined as adherence to guidelines, healthcare worker (HCW) training, procuring PPE stocks and responding appropriately to suspected cases, is crucial to prevent HCW-infections. Objective To perform a follow-up survey to assess changes in PPE-preparedness across six Asia-Pacific countries during the COVID-19 pandemic. Design Prospective follow-up cross-sectional, web-based survey between 10/08/2020 to 01/09/2020, five months after the initial Phase 1 survey. Setting The same six Asia-Pacific countries (Australia, Hong Kong, India, New Zealand, Philippines, and Singapore) that participated in Phase 1. Participants Intensivists from 231 ICUs across these six countries. Main outcome measures Changes in PPE-preparedness between Phases 1 and 2. Results Phase 2 had responses from 132 ICUs (57%). Compared to Phase 1 respondents reported increased use of PPE-based practices such as powered air-purifying respirator (40.2% vs. 6.1%), N95-masks at all times (86.4% vs. 53.7%) and double-gloving (87.9% vs. 42.9%). The reported awareness of PPE stocks (85.6% vs. 51.9%), mandatory showering policies following PPE-breach (31.1% vs. 6.9%) and safety perception amongst HCWs (60.6% vs. 28.4%) improved significantly during Phase 2. Despite reported statistically similar adoption rate of the buddy system in both phases (42.4% vs. 37.2%), there was a reported reduction in donning/doffing training in Phase 2 (44.3% vs. 60.2%). There were no reported differences HCW training in other areas, such as tracheal intubation, intra-hospital transport and safe waste disposal, between the 2 phases. Conclusions Overall reported PPE-preparedness improved between the two survey periods, particularly in PPE use, PPE inventory and HCW perceptions of safety. However, the uptake of HCW training and implementation of low-cost safety measures continued to be low and the awareness of PPE breach management policies were suboptimal. Therefore, the key areas for improvement should focus on regular HCW training, implementing low-cost buddy-system and increasing awareness of PPE-breach management protocols.

Purpose Chloroquine and hydroxychloroquine are effective against respiratory viruses in vitro. However, they lack antiviral efficacy upon oral administration. Translation of in vitro to in vivo exposure is necessary for understanding the disconnect between the two to develop effective therapeutic strategies. Methods We employed an in vitro ion-trapping kinetic model to predict the changes in the cytosolic and lysosomal concentrations of chloroquine and hydroxychloroquine in cell lines and primary human airway cultures. A physiologically based pharmacokinetic model with detailed respiratory physiology was used to predict regional airway exposure and optimize dosing regimens. Results At their reported in vitro effective concentrations in cell lines, chloroquine and hydroxychloroquine cause a significant increase in their cytosolic and lysosomal concentrations by altering the lysosomal pH. Higher concentrations of the compounds are required to achieve similar levels of cytosolic and lysosomal changes in primary human airway cells in vitro. The predicted cellular and lysosomal concentrations in the respiratory tract for in vivo oral doses are lower than the in vitro effective levels. Pulmonary administration of aerosolized chloroquine or hydroxychloroquine is predicted to achieve high bound in vitro-effective concentrations in the respiratory tract, with low systemic exposure. Achieving effective cytosolic concentrations for activating immunomodulatory effects and adequate lysosomal levels for inhibiting viral replication could be key drivers for treating viral respiratory infections. Conclusion Our analysis provides a framework for extrapolating in vitro effective concentrations of chloroquine and hydroxychloroquine to in vivo dosing regimens for treating viral respiratory infections. Graphical abstract

Objective:The COVID-19 pandemic initially doubled the rates of food insecurity across the USA and tripled rates among households with children. Despite the association among food insecurity, chronic disease and psychological distress, narratives depicting the experiences of already food insecure populations are notably underrepresented in the literature. The current study assessed the impact of COVID-19 on clients of a food pantry who were also enrolled in the Supplemental Nutrition Assistance Program (SNAP).Design:A qualitative study probing the effects of the pandemic on daily living, food needs, food buying and food insecurity. Interview transcripts were analysed using a combined deductive and inductive approach.Setting:Interviews were conducted via telephone between May and June of 2020.Participants:Equal numbers of English- and Spanish-speaking clients (n 40 total).Results:Three main findings emerged: (1) the pandemic increased economic distress, such as from job loss or increased utility bills due to sustained home occupancy and (2) the pandemic increased food needs, food prices and food shortages. In combination with economic stressors, this led to greater food insecurity; (3) increased economic stress and food insecurity contributed to increased psychological stress, such as from fear of infection, isolation and children being confined at home.Conclusions:Despite federal legislation and state and local programmes to alleviate food insecurity, COVID-19 exacerbated economic hardship, food insecurity and psychological distress among urban SNAP and food pantry clients. Additional research is needed to identify the most effective policies and programmes to ameliorate the short- and long-term health and economic inequities exacerbated by the pandemic.

The COVID-19 pandemic caused by the coronavirus SARS-CoV-2 is continuing to spread globally. SARS-CoV-2 infections of feline and canine species have also been reported. However, it is not entirely clear to what extent natural SARS-CoV-2 infection of pet dogs and cats is in households. We have developed enzyme-linked immunosorbent assays (ELISAs) using recombinant SARS-CoV-2 nucleocapsid (N) protein and the receptor-binding-domain (RBD) of the spike protein, and the SARS-CoV-2 spike-pseudotyped vesicular stomatitis virus (VSV)-based neutralization assay to screen serum samples of 239 pet cats and 510 pet dogs in Minnesota in the early phase of the COVID-19 pandemic from mid-April to early June 2020 for evidence of SARS-CoV-2 exposures. A cutoff value was used to identify the seropositive samples in each experiment. The average seroprevalence of N- and RBD-specific antibodies in pet cats were 8% and 3%, respectively. Among nineteen (19) N-seropositive cat sera, fifteen (15) exhibited neutralizing activity and seven (7) were also RBD-seropositive. The N-based ELISA is also specific and does not cross react with antigens of common feline coronaviruses. In contrast, SARS-CoV-2 antibodies were detected at a very low percentage in pet dogs (~ 1%) and were limited to IgG antibodies against SARS-CoV-2 N protein with no neutralizing activities. Our results demonstrate that SARS-CoV-2 seropositive rates are higher in pet cats than in pet dogs in MN early in the pandemic and that SARS-CoV-2 N-specific IgG antibodies can detect SARS-CoV-2 infections in companion animals with higher levels of specificity and sensitivity than RBD-specific IgG antibodies in ELISA-based assays.

Coronavirus 2019 (COVID-19) is an emerging contagious disease that has led to the global epidemic and is caused by severe acute respiratory syndrome, Coronavirus-2 (SARS-CoV-2). Zoonotic is an infection that is transmitted from animals to humans. Significantly changing animal infection is the best amplifying mask of pathogens. The power of animal infection is a contagious virus that usually spreads from vertebrate animals to humans and vice versa. The physical health of an animal depends on the normal vulnerability of its population and the change in actual animal health against infection over time, and is assessed based on previous circumstances in the population. After compiling the effect of virulence of the animal infection on the size of the susceptible, exposed and infected subjects, an investigation was made using MAPLE 18 with RK Fehlberg technique. This study discusses the stimulation of animal influences on the novel coronavirus infection that is reliable to be infectious. It analyzes all incoming and outgoing air passengers worldwide and in the country is keen on spreading the abnormally degenerate coronavirus. The zoonotic strength was applied to coronavirus infection and the rates of SEIR individuals terminated by secondary coronavirus infection were estimated. The transmission ability of coronavirus infection is associated with a lack of the perceived respiratory system in conservative people and global warming.

Wuhan has informed an outbreak of a typical lungs infection created by the 2019 novel coronavirus (2019-nCoV) in December 2019. Infections have been consigned to other cities, along with internationally which aggressing to trigger a global epidemic. In the past four years, coronavirus infections have become the most dangerous infections since of the event of some fresh deaths caused by corona infections in Saudi Arabia. Coronavirus infections may be planted in and spread out of Saudi Arabia by inbound and outbound Umrah visitors and non-Umrah visitors. The impact of fundamental reproductive number and zoonotic strength of infectivity on susceptible, exposed and infected peoples rate was assessed using Runge–Kutta–Felhberg strategy with shooting method. In this investigation, the vulnerable people's rate is significantly climbing in the brief interval of period owing to overwhelming and mean inactive period. Our examination shows the transmissibility of coronavirus is more grounded as contrasted and the Asia continent countries respiratory confusion. Middle East Respiratory Syndrome coronavirus is already spread in creature and human pools in Ethiopia. The Severe Acute Respiratory Syndrome coronavirus-2 growth in the Saudi Arabia may have a solemn crash on genetic assortment, interspecies circulation of these infections mostly with the reference to the alteration and recombination expectation of coronaviruses. Researches of the molecular mechanisms and genetics of this infection are provided in the component can act an important part of this project to follow tactics to prevent subsequent coronavirus outbreak.

BACKGROUND: Despite health anxiety (HA) is associated with higher incidence of anxiety disorders, no studies have examined the association between this variable and the increased levels of Post-Traumatic Stress Symptoms (PTSS) reported during COVID pandemic. METHODS: This study was conducted online between April and May 2020. Data were collected from 468 men and women from the Spanish general population. Sociodemographic and COVID-19-related data, health anxiety, PTSS, fear of becoming infected, social support, sleep problems and past/current psychological/psychiatric history were assessed. The mediating effect of HA when predicting PTSS was explored with mediational analyses. Moderated mediational analyses were also performed to test if receiving psychological treatment during pandemic changes the mediating effect of HA. RESULTS: Prevalence of PTSS was higher in high-scorers in HA (p

Although the functional parameters of microRNAs (miRNAs) have been explored to some extent, the roles of these molecules in coronavirus infection and the regulatory mechanism of miRNAs in virus infection are still unclear. Transmissible gastroenteritis virus (TGEV) is an enteropathgenic coronavirus and causes high morbidity and mortality in suckling piglets. Here, we demonstrated that microRNA-27b-3p (miR-27b-3p) suppressed TGEV replication by directly targeting porcine suppressor of cytokine signaling 6 (SOCS6), while TGEV infection downregulated miR-27b-3p expression in swine testicular (ST) cells and in piglets. Mechanistically, the decrease of miR-27b-3p expression during TGEV infection was mediated by the activated inositol-requiring enzyme 1 (IRE1) pathway of the endoplasmic reticulum (ER) stress. Further studies showed that when ER stress was induced by TGEV, IRE1 acted as an RNase activated by autophosphorylation and unconventionally spliced mRNA encoding a potent transcription factor, X-box-binding protein 1 (Xbp1s). Xbp1s inhibited the transcription of miR-27 and ultimately reduced the production of miR-27b-3p. Therefore, our findings indicate that TGEV inhibits the expression of an anti-coronavirus microRNA through the IRE1 pathway and suggest a novel way in which coronavirus regulates the host cell response to infection. Supporting Information The supporting information is available online at 10.1007/s11427-021-1967-x. The supporting materials are published as submitted, without typesetting or editing. The responsibility for scientific accuracy and content remains entirely with the authors.

The current pandemic of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is a global, unanticipated public health crisis. Another emerging challenge is the prevalence of "black fungus", or mucormycosis, among patients who recovered from COVID-19 infection. A retrospective study was conducted on 12 patients in a post-COVID recovery phase who developed mucormycosis. The study parameters evaluated lymphocyte count, CD4+ T cell status, and associated systemic co-morbidities for the patient, namely diabetes. The interventions during the treatment for COVID were also recorded to include administration of oxygen, ventilator assistance (invasive and non-invasive)/oxygen support, and steroid use. The possible relationship between low lymphocyte and CD4+ counts with diabetes and fungal growth was evaluated. It was observed that the majority of the patients who had a positive history for diabetes with low lymphocyte and CD4+ counts were more susceptible to opportunistic fungal infections. Most of the patients, but not all, had a history of receiving oxygen or assisted ventilation, as well as steroids, during the treatment for COVID infection. These interventions may be considered as accessory contributing factors for fungal infection. Post-exposure to SARS-CoV-2, therapies should be targeted at prevention of functional exhaustion of lymphocytes and maintaining optimal lymphocyte and subset counts in susceptible hosts for the prevention of opportunistic fungal infections. The relationship between functional exhaustion of the lymphocyte, diabetes, and COVID mandates further research.