Public Health Responses to COVID-19 Outbreaks on Cruise Ships — Worldwide, February–March 2020

Moriarty, Leah F.; Pluciński, Mateusz M.; Marston, Barbara J.; Kurbatova, Ekaterina V.; Knust, Barbara; Murray, Erin; Pesik, Nicki; Rose, Dale A.; Fitter, David; Kobayashi, Miwako; Toda, Mitsuru; Canty, Paul T.; Scheuer, Tara; Halsey, Eric S.; Cohen, Nicole J.; Stockman, Lauren J.; Wadford, Debra A.; Medley, Alexandra; Green, Gary; Regan, Joanna J.; Tardivel, Kara; White, Stefanie; Brown, Clive; Morales, Christina; Yen, Cynthia; Wittry, Beth; Freeland, Amy; Naramore, Sara; Novak, Ryan T.; Daigle, David; Weinberg, Michelle; Acosta, Anna M.; Herzig, Carolyn; Kapella, Bryan K.; Jacobson, Kathleen; Lamba, Katherine; Ishizumi, Atsuyoshi; Sarisky, John; Svendsen, Erik; Blocher, Tricia; Wu, Christine A.; Charles, Julia; Wagner, Riley; Stewart, Andrea; Mead, Paul S.; Kurylo, Elizabeth; Campbell, Stefanie; Murray, Rachel; Weidle, Paul J.; Cetron, Martín S.; Friedman, Cindy R.; Behravesh, Casey Barton; Bjork, Adam; Bower, William A.; Bozio, Catherine H; Braden, Zachary; Bertulfo, Mary Catherine; Chatham‐Stephens, Kevin; Chu, Victoria; Cooper, Barbara M.; Dooling, Kathleen; Dubray, Christine; Curren, Emily J; Honein, Margaret A.; Ivey, Kathryn N.; Jones, Jefferson M.; Kadzik, Melissa; Knight, Nancy; Marlow, Mariel; McColloch, Audrey; McDonald, Robert H.; Klevos, Andrew; Poser, Sarah; Rinker, Robin A.; Ritter, Troy; Rodríguez, Luis López; Ryan, M. J.; Schneider, Zachary; Shockey, Caitlin; Shugart, Jill; Silver, Margaret; Smith, Paul W.; Tobolowsky, Farrell; Treffiletti, Aimee; Wallace, Megan; Yoder, Jonathan S.; Barry, Pennan; Berumen, Ricardo; Bregman, Brooke; Campos-Campos, Kevin; Chai, Shua J.; Glenn-Finer, Rosie; Guevara, Hugo; Hacker, Jill K.; Hsieh, Kristina; Morris, Mary Kate; Murphy, Ryan; Myers, Jennifer F.; Padilla, Tasha; Pan, Chao-Yang; Readhead, Adam; Saguar, Estela; Salas, María; Snyder, Robert E.; Vugia, Duc J.; Watt, James; Wong, Cindy; Acosta, Meileen; Davis, Shai; Kapuszinsky, Beatrix; Mátyás, Béla T.; Miller, Glen; Ntui, Asundep; Richards, Jayleen

doi:10.15585/mmwr.mm6912e3

Cited by 352 publications

(412 citation statements)

References 4 publications

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“…Exposure to the Huanan seafood market was common among the earliest cases contributing to the SARS-CoV2 epidemic in China suggesting that this was a zoonotic disease with an intermediate animal host (non-aquatic animals were sold in the market) (35) (38). In fact, the Japanese National Institute of Infectious Disease reported detection of SARS-CoV2 RNA on surfaces in the cabins of symptomatic and asymptomatic passengers on the Diamond Princess up to 17 days after they were vacated (39). Live virus has also been isolated and cultured from fecal specimens raising the possibility of oro-fecal transmission, though corroborating clinical evidence for this method of transmission is lacking (40).…”

Section: Transmissionmentioning

confidence: 99%

COVID-19 for the Cardiologist

Atri

Siddiqi

Lang

et al. 2020

JACC: Basic to Translational Science

270

137

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Highlights-Severe acute respiratory virus-2 (SARS-CoV2), the infection responsible for coronavirus disease-2019 (COVID-19), has spread globally leading to a devastating loss of life. In a few short months, the clinical and scientific communities have rallied to rapidly evolve our understanding of the mechanism(s) of disease and potential therapeutics. -This review discusses the current understanding of the basis virology of SARS-CoV2 and the epidemiology, clinical manifestations, including cardiovascular, and mortality of COVID-19. A detailed review of the viral life cycle and putative mechanism(s) of injury frames the discussion of possible preventative and therapeutic strategies. -The ongoing, unprecedented collective effort will, without a doubt, advance our ability to prevent the spread and optimally care for patients suffering from COVID-19. SummaryThe coronavirus disease-2019 (COVID-19), a contagious disease caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV2), has reached pandemic status. As it spreads across the world, it has overwhelmed healthcare systems, strangled the global economy and led to a devastating loss of life. Widespread efforts from regulators, clinicians and scientists are driving a rapid expansion of knowledge of the SARS-CoV2 virus and the COVID-19 disease.We review the most current data with a focus on our basic understanding of the mechanism(s) of disease and translation to the clinical syndrome and potential therapeutics. We discuss the basic virology, epidemiology, clinical manifestation, multi-organ consequences, and outcomes. With a focus on cardiovascular complications, we propose several mechanisms of injury. The virology and potential mechanism of injury form the basis for a discussion of potential disease-modifying therapies.

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Section: Transmissionmentioning

confidence: 99%

COVID-19 for the Cardiologist

Atri

Siddiqi

Lang

et al. 2020

JACC: Basic to Translational Science

270

137

View full text Add to dashboard Cite

show abstract

“…The importance of accounting for asymptomatic individuals has been confirmed by other studies ( [39], [21]). In their model-based assessment of case-fatality ratios, Verity et al [40] estimated that 40-50% of cases went unidentified in China, as of February 8, 2020, while in the case of the Princess Diamond cruise ship, 46.5% of individuals who tested positive for COVID-19 were asymptomatic [49]. Further, Calafiore et al [21], using a modified SIR-model, estimated that, on average, cases in Italy went underreported by a factor of 63, as of March 30, 2020. Several prior mathematical models, motivated by the potential for pandemic influenza, have examined the utility of mask wearing by the general public.…”

Section: Introductionmentioning

confidence: 99%

To mask or not to mask: Modeling the potential for face mask use by the general public to curtail the COVID-19 pandemic

Eikenberry

Mancuso

Iboi

et al. 2020

Preprint

202

238

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Face mask use by the general public for limiting the spread of the COVID-19 pandemic is controversial, though increasingly recommended, and the potential of this intervention is not well understood. We develop a compartmental model for assessing the communitywide impact of mask use by the general, asymptomatic public, a portion of which may be asymptomatically infectious. Model simulations, using data relevant to COVID-19 dynamics in the US states of New York and Washington, suggest that broad adoption of even relatively ineffective face masks may meaningfully reduce community transmission of COVID-19 and decrease peak hospitalizations and deaths. Moreover, mask use decreases the effective transmission rate in nearly linear proportion to the product of mask effectiveness (as a fraction of potentially infectious contacts blocked) and coverage rate (as a fraction of the general population), while the impact on epidemiologic outcomes (death, hospitalizations) is highly nonlinear, indicating masks could synergize with other non-pharmaceutical measures. Notably, masks are found to be useful with respect to both preventing illness in healthy persons and preventing asymptomatic transmission. Hypothetical mask adoption scenarios, for Washington and New York state, suggest that immediate near universal (80%) adoption of moderately (50%) effective masks could prevent on the order of 17-45% of projected deaths over two months in New York, while decreasing the peak daily death rate by 34-58%, absent other changes in epidemic dynamics. Even very weak masks (20% effective) can still be useful if the underlying transmission rate is relatively low or decreasing: In Washington, where baseline transmission is much less intense, 80% adoption of such masks could reduce mortality by 24-65% (and peak deaths 15-69%), compared to 2-9% mortality reduction in New York (peak death reduction 9-18%). Our results suggest use of face masks by the general public is potentially of high value in curtailing community transmission and the burden of the pandemic. The community-wide benefits are likely to be greatest when face masks are used in conjunction with other non-pharmaceutical practices (such as social-distancing), and when adoption is nearly universal (nation-wide) and compliance is high.

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“…SARS-CoV-2 is a respiratory pathogen that is spread predominately through large droplets and contact (i.e. fomites such as surfaces) transmission [3]. As such, respiratory and contact isolation precautions are paramount in limiting further exposure.…”

Section: Introductionmentioning

confidence: 99%

Isolation protocol for a COVID-2019 patient requiring emergent surgical intervention: case presentation

et al. 2020

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Background: The concerns of the highly contagious and morbid nature of Coronavirus Disease-2019 (COVID-2019 have prompted healthcare workers to implement strict droplet and contact isolation precautions. Unfortunately, some patients who may be or presumptively or confirmed as infected with COVID-2019 may also require emergent surgical procedures. As such, given the high-risk for exposure of many healthcare workers involved the complex requirements for appropriate isolation must be adhered to. Case presentation: We present our experience with a 77-year-old who required emergency cardiac surgery for a presumed acute aortic syndrome in the setting of a presumed, and eventually confirmed, COVID-2019 infection. We outline the necessary steps to maintain strict isolation precautions to limit potential exposure to the surgical Team. Conclusions: We hereby provide our algorithm for emergent surgical procedures in critically-ill patients with presumptive or confirmed infection with COVID-2019. The insights from this case report can potentially be templated to other facilities in order to uphold high standards of infection prevention and patient safety in surgery during the current COVID-19 pandemic.

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Public Health Responses to COVID-19 Outbreaks on Cruise Ships — Worldwide, February–March 2020

Cited by 352 publications

References 4 publications

COVID-19 for the Cardiologist

COVID-19 for the Cardiologist

To mask or not to mask: Modeling the potential for face mask use by the general public to curtail the COVID-19 pandemic

Isolation protocol for a COVID-2019 patient requiring emergent surgical intervention: case presentation

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