SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18–49, 50–69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population

Evaluation of Groundwater Sensitivity to Pollution Using GIS-Based Modified DRASTIC-LU Model for Sustainable Development in the Nile Delta Region

The groundwater resources in the Nile Delta region are an important resource for freshwater because of rising water demand due to anthropogenic activities. The goal of this study is to quantify groundwater sensitivity to pollution in the Nile Delta by a modified GIS-based DRASTIC-LU model. In this study, we utilized two types of modified DRASTIC-LU models, generic and pesticide, to determine the groundwater vulnerability rates to contamination. The results of the generic DRASTIC-LU model showed that the research region, except for the northwestern part with moderate vulnerability of 3.38%, is highly and very highly vulnerable to pollution with 42.69 and 53.91%, respectively. Results from the pesticide DRASTIC-LU model, on the other hand, also confirmed that, except for the northwestern and southern parts with a moderate vulnerability of 9.78%, most the Nile Delta is highly and very highly vulnerable with 50.68 and 39.53%, respectively. A validation of the model generated was conducted based on nitrate concentrations in the groundwater and a sensitivity analysis. Based on the nitrate analysis, the final output map showed a strong association with the pesticide vulnerability model. Examining the model sensitivity revealed that the influence of depth to water and net recharge were the most important factors to consider

Evaluation of Groundwater Sensitivity to Pollution Using GIS-Based Modified DRASTIC-LU Model for Sustainable Development in the Nile Delta Region

The groundwater resources in the Nile Delta region are an important resource for freshwater because of rising water demand due to anthropogenic activities. The goal of this study is to quantify groundwater sensitivity to pollution in the Nile Delta by a modified GIS-based DRASTIC-LU model. In this study, we utilized two types of modified DRASTIC-LU models, generic and pesticide, to determine the groundwater vulnerability rates to contamination. The results of the generic DRASTIC-LU model showed that the research region, except for the northwestern part with moderate vulnerability of 3.38%, is highly and very highly vulnerable to pollution with 42.69 and 53.91%, respectively. Results from the pesticide DRASTIC-LU model, on the other hand, also confirmed that, except for the northwestern and southern parts with a moderate vulnerability of 9.78%, most the Nile Delta is highly and very highly vulnerable with 50.68 and 39.53%, respectively. A validation of the model generated was conducted based on nitrate concentrations in the groundwater and a sensitivity analysis. Based on the nitrate analysis, the final output map showed a strong association with the pesticide vulnerability model. Examining the model sensitivity revealed that the influence of depth to water and net recharge were the most important factors to consider

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population.The aim of this study was to inform vaccination prioritization by modelling the impact of vaccination on elective inpatient surgery. The study found that patients aged at least 70 years needing elective surgery should be prioritized alongside other high-risk groups during early vaccination programmes. Once vaccines are rolled out to younger populations, prioritizing surgical patients is advantageous