Background India has experienced the second largest outbreak of COVID-19 globally, yet there is a paucity of studies analysing contact tracing data in the region which can optimise public health interventions (PHI’s). Methods We analysed contact tracing data from Karnataka, India between 9 March and 21 July 2020. We estimated metrics of transmission including the reproduction number (R), overdispersion (k), secondary attack rate (SAR), and serial interval. R and k were jointly estimated using a Bayesian Markov Chain Monte Carlo approach. We studied determinants of risk of further transmission and risk of being symptomatic using Poisson regression models. Findings Up to 21 July 2020, we found 111 index cases that crossed the super-spreading threshold of ≥8 secondary cases. Among 956 confirmed traced cases, 8.7% of index cases had 14.4% of contacts but caused 80% of all secondary cases. Among 16715 contacts, overall SAR was 3.6% [95% CI, 3.4–3.9] and symptomatic cases were more infectious than asymptomatic cases (SAR 7.7% vs 2.0%; aRR 3.63 [3.04–4.34]). As compared to infectors aged 19–44 years, children were less infectious (aRR 0.21 [0.07–0.66] for 0–5 years and 0.47 [0.32–0.68] for 6–18 years). Infectors who were confirmed ≥4 days after symptom onset were associated with higher infectiousness (aRR 3.01 [2.11–4.31]). As compared to asymptomatic cases, symptomatic cases were 8.16 [3.29–20.24] times more likely to cause symptomatic infection in their secondary cases. Serial interval had a mean of 5.4 [4.4–6.4] days, and case fatality rate was 2.5% [2.4–2.7] which increased with age. Conclusion We found significant heterogeneity in the individual-level transmissibility of SARS-CoV-2 which could not be explained by the degree of heterogeneity in the underlying number of contacts. To strengthen contact tracing in over-dispersed outbreaks, testing and tracing delays should be minimised and retrospective contact tracing should be implemented. Targeted measures to reduce potential superspreading events should be implemented. Interventions aimed at children might have a relatively small impact on reducing transmission owing to their low symptomaticity and infectivity. We propose that symptomatic cases could cause a snowballing effect on clinical severity and infectiousness across transmission generations; further studies are needed to confirm this finding.

Background and ObjectivesThe involvement of medical students in strategies to control COVID-19 might be considered to cope with the shortage of healthcare workers. This study aims at assessing the level of knowledge about COVID-19, willingness to volunteer, potential areas of involvement and reasons for deterrence towards volunteering among medical students.MethodsA cross-sectional study was conducted among undergraduate medical students of a tertiary care teaching hospital in New Delhi. A web-based questionnaire was used to elicit demographic information, knowledge of COVID-19, willingness to volunteer and reasons for deterrence for working during COVID-19 pandemic and self-declared knowledge in six domains.ResultsA total of 292 students participated in the study with a mean age of 19.9±3.1 years. The mean (S.D.) knowledge score of COVID-19 was 6.9 (1.1) (maximum score 10). Knowledge score was significantly different among preclinical (6.5), paraclinical (7.18), and clinical groups (7.03). Almost three fourth (75.3%) participants were willing to volunteer in COVID-19 pandemic, though 67.8% had not received any training in emergency medicine or public health crisis management. Willingness to work was maximum in areas of social work and indirect patient care (62.3% each). Lack of personal protective equipment was cited as a highly deterrent factor for volunteering (62.7%) followed by fear of transmitting the infection to family (45.9%), fear of causing harm to the patient (34.2%), and absence of treatment (22.2%).Interpretation & conclusionsMajority of the students were willing to volunteer even though they had not received adequate training. Students may serve as an auxiliary force during the pandemic, especially in the non-clinical setting.

Introduction: COVID-19 has emerged as a global health crisis. It has been established that people with obesity are prone to develop severe manifestations of COVID-19. Since there is no established treatment of the disease, yet, it is essential to increase public awareness toward prevention of infection. This study was aimed to assess the awareness, perception, and practices of obese subjects toward COVID-19 infection. Methods: This cross-sectional study was conducted among 260 obese patients between August 2020 and November 2020 who were enrolled in obesity and metabolic disorders clinic at our institute. A structured questionnaire consisting of 23 questions (15 of knowledge, four of perception, and four of practices) was administered by telephonic interview with the patients. Multiple regression analyses were conducted to identify factors associated with poor knowledge and practice toward COVID-19. Results: The mean age of the participants was 41.7 ± 10.2 years, with 166 (64%) females. Mean awareness score obtained by subjects was 9.1 ± 2.2 out of 15. The scores were categorized into good, moderate, and poor. Subjects with poor awareness constituted 36% of study population. Mean perception score of participants was 14.0 ± 2 out of 20. Majority of patients (69.2%) had moderate perception score. Mean score obtained in practices was 18.5 ± 2.1 out of 20 and 92% of subjects reported good practices. Age was negatively associated with awareness score. Gender and educational qualification had a significant impact on awareness score with males having better awareness then females. Graduates and above had higher awareness score. Increase in awareness score was found to be associated with improved practices but not with perception. Conclusion: The prevalence of good practices toward COVID-19 among obese patients was high (92%) although poor awareness was also highly prevalent (36%). Increasing the awareness through various means should be considered.

In this study, we aimed to assess the impact of the COVID-19 pandemic on the amount and pattern of screen time among college students. The relationship between increased screen time and quality of life (QoL), COVID-related stress, and personality traits were also explored. A cross-sectional online survey-based study was conducted among Indian college students who were recruited by purposive sampling. Details regarding socio-demographics, amount and pattern of screen time usage, change in screen time patterns during the COVID-19 pandemic, and COVID-related stress were collected. In addition, personality traits and QoL were assessed with validated questionnaires. A total of 731 responses (51% female, mean age 20.7 years) were analysed. Of the participants, 93.2% self-reported an increase in daily screen time during COVID-19. The predominant reasons for the increased screen time were educational screen time (89.6%), streaming or watching videos for entertainment (82.8%), use of social media for non-communication purposes (78.1%), communication with friends and/or family members (76.2%), reading or watching news (65.9%), and interactive recreational screen time (44.7%). A small but significant negative correlation between increased screen time and QoL (rs = -0.154, p < .001) was found. Increased screen time due to the use of social media for non-communication purposes was associated with poorer QoL (U = 32947.50; p = .02) and greater COVID stress (U = 32381.50; p = .01). Educational screen time was the most common cause for increased screen time among college students and was not associated with negative effects on QoL. The context and purpose of screen time appears to be important in ascertaining the impact of screen time on QoL.

Background The involvement of medical students in strategies to control Covid-19 might be considered to cope with the shortage of healthcare workers. We assessed the knowledge about Covid-19, willingness to volunteer, potential areas of involvement and reasons for hesitation among medical students towards volunteering. Methods We did this cross-sectional study among undergraduate students at a tertiary care teaching hospital in New Delhi. We used a web-based questionnaire to elicit demographic information, knowledge of Covid-19, willingness to volunteer and reasons deterring them from working during the Covid-19 pandemic, and self-declared knowledge in six domains. Results A total of 292 students participated in the study with a mean (SD) age of 19.9 (3.1) years. The mean (SD) knowledge score of Covid-19 was 6.9 (1.1) (maximum score 10). Knowledge score was significantly different among preclinical (6.5), paraclinical (7.18) and clinical groups (7.03). Almost three-fourth (75.3%) participants were willing to volunteer in the Covid-19 pandemic, though 67.8% had not received any training in emergency medicine or public health crisis management. Willingness to work was maximum in areas of social work and indirect patient care (62.3% each). Lack of personal protective equipment was cited as a highly deterring factor for volunteering (62.7%) followed by fear of transmitting the infection to family members (45.9%), fear of causing harm to the patient (34.2%) and the absence of available treatment (22.2%). Conclusions A majority of the students were willing to volunteer even though they had not received adequate training. Students may serve as an auxiliary force during the pandemic, especially in non-clinical settings.