A Case Study Evaluating the Risk of Infection from Middle Eastern Respiratory Syndrome Coronavirus (MERS‐CoV) in a Hospital Setting Through Bioaerosols

Adhikari, Umesh; Chabrelie, Alexandre; Weir, Mark H.; Boehnke, Kevin F.; McKenzie, Erica R.; Ikner, Luisa A.; Wang, Meng; Wang, Qing; Young, Kyana; Haas, Charles N.; Rose, Joan B.; Mitchell, Jade

doi:10.1111/risa.13389

Cited by 102 publications

(97 citation statements)

References 59 publications

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“…As such, health care providers may become exposed to aerosols theoretically able to permeate N95 FFRs. Increasing air-exchange per hour (ACH) or HEPA filtration of room air represent potential supplemental mitigation measures (5). Air exchange rates varies between imaging suites, depending on ventilation, air circulation and room configuration.…”

Section: Protection Of Radiology Staffmentioning

confidence: 99%

Policies and Guidelines for COVID-19 Preparedness: Experiences from the University of Washington

et al. 2020

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The Coronavirus Disease 2019 pandemic initially presented in the United States in the greater Seattle area, and has rapidly progressed across the nation in the past 2 months, with the United States having the highest number of cases in the world. Radiology departments play a critical role in policy and guideline development both for the department and for the institutions, specifically in planning diagnostic screening, triage, and management of patients. In addition, radiology workflows, volumes and access must be optimized in preparation for the expected COVID-19 patient surges. This article discusses the processes that have been implemented at the University of Washington in managing the COVID-19 pandemic as well in preparing for patient surges, which may provide important guidance for other radiology departments who are in the early stages of preparation and management. Essentials Radiology policy goals are to reduce COVID-19-related morbidity and mortality through early diagnosis, appropriate treatment and prevention of disease dissemination.  Imaging currently is not routinely used to screen for COVID-19 unless access to RT-PCR results for COVID-19 is limited.  Postponing elective imaging and procedures will preserve resources and hospital beds, while also limiting patient population exposures.  Determination of time-sensitivity of procedures and imaging tests is by consensus with input from radiologists, patients, and/or ordering clinicians.  Radiology departments must prepare for patient surges through streamlined approaches to imaging that will limit exposures to healthcare workers and patients.

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Section: Protection Of Radiology Staffmentioning

confidence: 99%

Policies and Guidelines for COVID-19 Preparedness: Experiences from the University of Washington

et al. 2020

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“…The idea that saliva droplets could represent an important source of infection and a suitable sample for diagnosis was highlighted in 2003 during the SARS outbreak ( Wang et al 2004 ). Analogous considerations were made for the Middle Eastern respiratory syndrome coronavirus (MERS-CoV) outbreak ( Adhikari et al 2019 ). Similarly, the eruption of the new pandemic and its severe course have drawn the attention of researchers to these issues.…”

Section: The Detection Of Sars-cov-2 In Salivamentioning

confidence: 99%

Diagnostic Salivary Tests for SARS-CoV-2

et al. 2020

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The diagnosis of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection relies on the detection of viral RNA by real-time reverse transcription polymerase chain reaction (rRT-PCR) performed with respiratory specimens, especially nasopharyngeal swabs. However, this procedure requires specialized medical personnel, centralized laboratory facilities, and time to provide results (from several hours up to 1 d). In addition, there is a non-negligible risk of viral transmission for the operator who performs the procedure. For these reasons, several studies have suggested the use of other body fluids, including saliva, for the detection of SARS-CoV-2. The use of saliva as a diagnostic specimen has numerous advantages: it is easily self-collected by the patient with almost no discomfort, it does not require specialized health care personnel for its management, and it reduces the risks for the operator. In the past few months, several scientific papers, media, and companies have announced the development of new salivary tests to detect SARS-CoV-2 infection. Posterior oropharyngeal saliva should be distinguished from oral saliva, since the former is a part of respiratory secretions, while the latter is produced by the salivary glands, which are outside the respiratory tract. Saliva can be analyzed through standard (rRT-PCR) or rapid molecular biology tests (direct rRT-PCR without extraction), although, in a hospital setting, these procedures may be performed only in addition to nasopharyngeal swabs to minimize the incidence of false-negative results. Conversely, the promising role of saliva in the diagnosis of SARS-CoV-2 infection is highlighted by the emergence of point-of-care technologies and, most important, point-of-need devices. Indeed, these devices can be directly used in workplaces, airports, schools, cinemas, and shopping centers. An example is the recently described Rapid Salivary Test, an antigen test based on the lateral flow assay, which detects the presence of the virus by identifying the spike protein in the saliva within a few minutes.

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“…[2][3][4][5] Mounting and convincing evidence has shown that, in addition to the major route of transmission of COVID-19 of droplet transmission and contact with contaminated fomites, aerosols can be another route of transmission. [12][13][14][15] The SARS-CoV-2 virion, with a size of 0.07 to 0.09 mm, has the potential to be transmitted as an aerosol and might behave similar to its close relatives of SARS and Middle East respiratory syndrome. 16 van Doremalen et al 17 recently reported that viable SARS-CoV-2 virion could be detected in aerosols for 3 hours.…”

Section: Covid-19 Effects On Colorectal Practicementioning

confidence: 99%

COVID-19 and the Global Impact on Colorectal Practice and Surgery

Nunoo‐Mensah

Rizk

Caushaj

et al. 2020

Clinical Colorectal Cancer

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We have presented the results of a survey used to assess the global impact of coronavirus disease 2019 (COVID-19) on the delivery of colorectal surgery. Despite accessible guidance information, our results have demonstrated that COVID-19 has significantly affected the ability of colorectal surgeons to offer care to patients. We have also discussed practical adaptation strategies for use during the recovery phase. Background: The novel severe acute respiratory syndrome coronavirus 2 virus that emerged in December 2019 causing coronavirus disease 2019 (COVID-19) has led to the sudden national reorganization of health care systems and changes in the delivery of health care globally. The purpose of our study was to use a survey to assess the global effects of COVID-19 on colorectal practice and surgery. Materials and Methods: A panel of International Society of University Colon and Rectal Surgeons (ISUCRS) selected 22 questions, which were included in the questionnaire. The questionnaire was distributed electronically to ISUCRS fellows and other surgeons included in the ISUCRS database and was advertised on social media sites. The questionnaire remained open from April 16 to 28, 2020. Results: A total of 287 surgeons completed the survey. Of the 287 respondents, 90% were colorectal specialists or general surgeons with an interest in colorectal disease. COVID-19 had affected the practice of 96% of the surgeons, and 52% were now using telemedicine. Also, 66% reported that elective colorectal cancer surgery could proceed but with perioperative precautions. Of the 287 respondents, 19.5% reported that the use of personal protective equipment was the most important perioperative precaution. However, personal protective equipment was only provided by 9.1% of hospitals. In addition, 64% of surgeons were offering minimally invasive surgery. However, 44% reported that enough information was not available regarding the safety of the loss of intra-abdominal carbon dioxide gas during the COVID-19 pandemic. Finally, 61% of the surgeons were prepared to defer elective colorectal cancer surgery, with 29% willing to defer for 8 weeks. Conclusion: The results from our survey have demonstrated that, globally, COVID-19 has affected the ability of colorectal surgeons to offer care to their patients. We have also discussed suggestions for various practical adaptation strategies for use during the recovery period.

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A Case Study Evaluating the Risk of Infection from Middle Eastern Respiratory Syndrome Coronavirus (MERS‐CoV) in a Hospital Setting Through Bioaerosols

Cited by 102 publications

References 59 publications

Policies and Guidelines for COVID-19 Preparedness: Experiences from the University of Washington

Policies and Guidelines for COVID-19 Preparedness: Experiences from the University of Washington

Diagnostic Salivary Tests for SARS-CoV-2

COVID-19 and the Global Impact on Colorectal Practice and Surgery

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