COVID‐19 environmental transmission and preventive public health measures

With new COVID‐19 cases decreased to very low levels in most parts of Australia, although persisting in a number of hotspots – mainly in the state of Victoria – and increasing in some other countries such as Brazil, it is time to reflect on the effectiveness and unintended consequences of public health measures taken so far at home and overseas to prevent transmission, and to identify challenges ahead. Extensive testing, contact tracing, and individual‐case and community containment, in addition to travel bans and social distancing, have largely succeeded in curbing COVID‐19 infections in Australia. Strict lockdowns prevented widespread community transmission, albeit at very high economic cost. The imposed restrictions changed daily activity patterns and behaviours that also brought improvements in other areas. Greenhouse gas emissions declined, and ambient air and potentially surface water quality improved in many cities, mainly because of reduced road traffic and industrial activity. Influenza cases were suppressed as a result of social distancing, better hand hygiene and home schooling. Some of these changes are likely to be transient, as economic and social activities are progressively increasing in most areas. However, we can draw some important public health learnings from the response to the pandemic that will help us reduce the risk of a resurgence of COVID‐19 and strengthen disease prevention against a whole range of other pathogens in the long term

Clinical and epidemiological predictors of transmission in Severe Acute Respiratory Syndrome (SARS).

BACKGROUND: Only a minority of probable SARS cases caused transmission. We assess if any epidemiological or clinical factors in SARS index patients were associated with increased probability of transmission. METHODS: We used epidemiological and clinical data on probable SARS patients admitted to Tan Tock Seng Hospital. Using a case-control approach, index patients who had probable SARS who subsequently transmitted the disease to at least one other patient were analysed as "cases" against patients with no transmission as "controls", using multivariate logistic regression analysis. RESULTS: 98 index patients were available for analysis (22 with transmission, 76 with no transmission). Covariates positively associated with transmission in univariate analysis at p 650 IU/L (OR 6.4, 23.8 and 4.7 respectively). CONCLUSION: Clinical and epidemiological factors can help us to explain why transmission was observed in some instances but not in others