SUMMARY Two brothers presented with unusual facial features, microcephaly, developmental delay, and severe postnatal growth retardation. They both developed eczema in infancy and have had recurrent infections. Additional physical findings in both boys included hypogonadism, flexion contractures, hypoplastic patellae, and scoliosis. Their facial similarity was striking with sloping foreheads, beaked noses, large, protruding ears, and micrognathia. Low levels of serum gammaglobulins and defective chemotaxis were present in both boys in infancy. The hypogammaglobulinaemia was transient and improved, reaching normal levels by 31/2 years and 15 months, respectively. Defective chemotaxis and recurrent infections have persisted to the present. Both parents were normal. The mode of inheritance was not clear, as both X linked and autosomal recessive patterns were possible. Although patients with congenital malformations who also had immunodeficiency have previously been reported, immune system abnormalities, especially those of a transient nature, may frequently go unrecognised.Several patients with immune deficiency and congenital malformations have been reported.
he coronavirus disease 2019 (COVID-19) pandemic has required governments around the world to institute severe physical-distancing measures to reduce the spread of the virus in order to protect public health and ensure health care system capacity. Mitigation measures in many countries, including Canada, have incorporated the temporary closure of nonessential businesses, which has led to bleak employment and economic outlooks. 1 Essential businesses that were allowed to remain open have, in many cases, led to the ongoing spread of the pandemic. Factories with employees working in close proximity have been particularly affected, not only putting the health and safety of the workforce at risk, but also negatively affecting supply chains and downstream businesses. 2 A trade-off exists between protecting populations from direct effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the indirect yet real potential health effects of constraining business and economic activity. 3 As Canadian jurisdictions relax public health measures and allow nonessential businesses to reopen, 2 main challenges arise: to keep employees safe and to maintain profitable operations given the continued limitations imposed by public health authorities. Measures to prevent SARS-CoV-2 from infiltrating a workforce and a plan for rapid containment of potential cases to mitigate spread within a workforce, should infiltration occur, are essential components of any back-to-work strategy. We analyze strategies that have been proposed for protecting employees during relaxation of public health measures and for limiting the risk of company-wide outbreaks. We also discuss an approach that involves cohorting employees in time, space or both, with associated rules designed to prevent and quickly contain the spread of SARS-CoV-2 in workplaces. We illustrate the approach using an example of a Canadian company, Bombardier, which operates 7 factories across 2 countries and 4 provinces and states, and employs 25 000 individuals (10 000 in Canada).
Spread of SARS-CoV-2 in workplaces: What's the scale of the problem?A substantial proportion of the spread of SARS-CoV-2 has been driven by workplace contacts. 4 For example, in Alberta, as of May 11, 2020, there were 6183 total cases, with 5539 outside of long-term care. 5 Of these cases, published news reports 6 suggest that 1783 (32.1% of noninstitutional cases) were from an occupational-related exposure. When wider community spread from those outbreaks is included, the number is closer to 50% of all cases. The Cargill meat plant in the Calgary zone has been called the worst outbreak in Canada and was directly responsible for 941 cases and indirectly responsible for 600 more in the surrounding community. Similar observations have been made in 6 Asian countries, where an estimated 15% of 690 local transmissions were occupation related. 7 The "Office Building X" outbreak in South Korea required the isolation of more than 1200 workers in an office tower after 44% of employees in a call ...
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.