Background Accurate seroprevalence estimates of SARS-CoV-2 in different populations could clarify the extent to which current testing strategies are identifying all active infection, and hence the true magnitude and spread of the infection. Our primary objective was to identify valid seroprevalence studies of SARS-CoV-2 infection and compare their estimates with the reported, and imputed, COVID-19 case rates within the same population at the same time point. Methods We searched PubMed, Embase, the Cochrane COVID-19 trials, and Europe-PMC for published studies and pre-prints that reported anti-SARS-CoV-2 IgG, IgM and/or IgA antibodies for serosurveys of the general community from 1 Jan to 12 Aug 2020. Results Of the 2199 studies identified, 170 were assessed for full text and 17 studies representing 15 regions and 118,297 subjects were includable. The seroprevalence proportions in 8 studies ranged between 1%-10%, with 5 studies under 1%, and 4 over 10%—from the notably hard-hit regions of Gangelt, Germany; Northwest Iran; Buenos Aires, Argentina; and Stockholm, Sweden. For seropositive cases who were not previously identified as COVID-19 cases, the majority had prior COVID-like symptoms. The estimated seroprevalences ranged from 0.56–717 times greater than the number of reported cumulative cases–half of the studies reported greater than 10 times more SARS-CoV-2 infections than the cumulative number of cases. Conclusions The findings show SARS-CoV-2 seroprevalence is well below “herd immunity” in all countries studied. The estimated number of infections, however, were much greater than the number of reported cases and deaths in almost all locations. The majority of seropositive people reported prior COVID-like symptoms, suggesting that undertesting of symptomatic people may be causing a substantial under-ascertainment of SARS-CoV-2 infections.

The Infectious Diseases Data Observatory (IDDO, https://www.iddo.org) has launched a clinical data platform for the collation, curation, standardisation and reuse of individual participant data (IPD) on treatments for two of the most globally important neglected tropical diseases (NTDs), schistosomiasis (SCH) and soiltransmitted helminthiases (STHs). This initiative aims to harness the power of data-sharing by facilitating collaborative joint analyses of pooled datasets to generate robust evidence on the efficacy and safety of anthelminthic treatment regimens. A crucial component of this endeavour has been the development of a Research Agenda to

Objective: To describe improvements in hand hygiene compliance after a statewide hand hygiene campaign conducted in New South Wales public hospitals. Design and setting: The campaign was conducted in all area health services in NSW (covering all 208 public hospitals). Alcohol‐based hand rub (AHR) was introduced into all hospitals between March and June 2006. In each hospital, five overt observation surveys of hand hygiene compliance by health care workers (HCWs) were conducted: one pre‐implementation survey and four post‐implementation surveys (in August 2006, November 2006, February 2007 and July 2008). Main outcome measures: Overtly observed hand hygiene compliance rates by HCWs, stratified by before‐ and after‐patient contact, Fulkerson's contact risk categories, and four health care professional groupings. Results: The overall hand hygiene compliance rate improved from 47% before the intervention to an average of 61% over the last three observation periods (P < 0.001). All professional groups sustained improved compliance rates except medical staff, whose practices reverted to pre‐intervention rates. Nursing staff maintained significantly improved compliance, with an average rate of 67% after the intervention. Overall hand hygiene compliance before patient contact improved from 39% (pre‐campaign) to 52% (July 2008) (P < 0.001). Overall compliance after patient contact improved from 57% to 64% (P < 0.001) over the same period. Compliance associated with medium‐risk contacts increased from an average of 51% in the first two observation periods to an average of 62% over the last three observation periods (P < 0.001). The corresponding compliance rates associated with low‐risk contacts were 35% and 56%, respectively (P < 0.001). Conclusion: An overall improvement in hand hygiene rates was achieved with the introduction of AHR. Increased adherence to before‐patient contact compliance, especially by nursing staff, contributed to the progress made, but an acceptable overall level of hand hygiene practice is yet to be achieved. It is now time to focus on a long‐term behavioural change program directed specifically at medical staff.

Objective: To examine whether improved hand hygiene compliance in health care workers after a statewide hand hygiene campaign in New South Wales hospitals was associated with a fall in rates of infection with multiresistant organisms. Design and setting: Data on rates of new methicillin‐resistant Staphylococcus aureus (MRSA) infections (expressed as four clinical indicators) are reported by some Australian hospitals to the Australian Council on Healthcare Standards (ACHS) for accreditation purposes and are mandatorily reported by all NSW hospitals to the NSW Department of Health. Infections are classified according to whether they are acquired in the intensive care unit (ICU) or other wards and whether they are from sterile sites (blood cultures) or non‐sterile sites. The clinical indicators reflect four different site categories (ICU sterile site, ICU non‐sterile site, non‐ICU sterile site and non‐ICU non‐sterile site) and are expressed as the number of new health care‐associated infections per 10 000 acute care bed‐days. Clinical indicator rates were examined for any decline between the pre‐campaign period (July–December 2005) and post‐campaign period (January–July 2007), and were compared with trends over a similar period in states without a hand hygiene campaign. Main outcome measures: Pre‐campaign and post‐campaign rates for four MRSA clinical indicators. Results: Between the pre‐ and post‐campaign periods, there was a 25% fall in MRSA non‐ICU sterile site infections, from 0.60/10 000 bed‐days to 0.45/10 000 bed‐days (P = 0.027), and a 16% fall in ICU non‐sterile site infections, from 36.36/10 000 bed‐days to 30.43/10 000 bed‐days (P = 0.037). The pre‐ and post‐campaign rates of MRSA infection from ICU sterile sites (5.28/10 000 bed‐days v 4.80/10 000 bed‐days; P = 0.664) and non‐ICU non‐sterile sites (5.92/10 000 bed‐days v 5.66/10 000 bed‐days; P = 0.207) remained stable. Australia‐wide MRSA data reported to the ACHS showed a 45% decline in infections from ICU non‐sterile sites, from 25.89/10 000 bed‐days to 14.30/10 000 bed‐days (P < 0.001), and a 46% decline in infections from non‐ICU non‐sterile sites, from 3.70/10 000 bed‐days to 1.99/10 000 bed‐days (P < 0.001) over the period 2005–2006. Conclusion: Two out of four clinical indicators of MRSA infection remained unchanged despite significant improvements in hand hygiene compliance in NSW hospitals. The reduction in MRSA infections from ICU non‐sterile sites in NSW hospitals was mirrored in ACHS data for other Australian states and cannot be assumed to be the result of improved hand hygiene compliance. Concurrent clinical and infection control practices possibly influence MRSA infection rates and may modify the effects of hand hygiene compliance. More sensitive measurements of hand hygiene compliance are needed.

Highlights Majority of Iranians touch their face at least once an hour. Iranians touch their face on average 10 times per hour. COVID-safe behavior includes mask use. Non-mask wearers were 1.5 more likely to touch their mucosal zone compared with mask wearers.