large decrease in clinical notifications and epidemiological investigation questionnaires for laboratory-confirmed cases after the 2nd epidemic wave, Portugal March 2020–July 2021

Funding Information: The present publication was funded by Fundação Ciência e Tecnologia, IP national support through CHRC (UIDP/04923/2020). Publisher Copyright: Copyright © 2023 Ricoca Peixoto, Vieira, Aguiar, Sentis, Carvalho, Rhys Thomas, Abrantes and Nunes.Introduction: In Portugal, COVID-19 laboratory notifications, clinical notifications (CNs), and epidemiological investigation questionnaires (EI) were electronically submitted by laboratories, clinicians, and public health professionals, respectively, to the Portuguese National Epidemiological Surveillance System (SINAVE), as mandated by law. We described CN and EI completeness in SINAVE to inform pandemic surveillance efforts. Methods: We calculated the proportion of COVID-19 laboratory-notified cases without CN nor EI, and without EI by region and age group, in each month, from March 2020 to July 2021. We tested the correlation between those proportions and monthly case counts in two epidemic periods and used Poisson regression to identify factors associated with the outcomes. Results: The analysis included 909,720 laboratory-notified cases. After October 2020, an increase in the number of COVID-19 cases was associated with a decrease in the submissions of CN and EI. By July 2021, 68.57% of cases had no associated CN nor EI, and 96.26% had no EI. Until January 2021, there was a positive correlation between monthly case counts and the monthly proportion of cases without CN nor EI and without EI, but not afterward. Cases aged 75 years or older had a lower proportion without CN nor EI (aRR: 0.842 CI95% 0.839–0.845). When compared to the Norte region, cases from Alentejo, Algarve, and Madeira had a lower probability of having no EI (aRR;0.659 CI 95%0.654–0.664; aRR 0.705 CI 95% 0.7–0.711; and aRR 0.363 CI 95% 0.354–0.373, respectively). Discussion: After January 2021, CN and EI were submitted in a small proportion of laboratory-confirmed cases, varying by age and region. Facing the large number of COVID-19 cases, public health services may have adopted other registry strategies including new surveillance and management tools to respond to operational needs. This may have contributed to the abandonment of official CN and EI submission. Useful knowledge on the context of infection, symptom profile, and other knowledge gaps was no longer adequately supported by SINAVE. Regular evaluation of pandemic surveillance systems' completeness is necessary to inform surveillance improvements and procedures considering dynamic objectives, usefulness, acceptability, and simplicity.publishersversionpublishe

Developing a population data science approach to assess increased risk of COVID-19 associated with attending large sporting events.

Objectives To design and test a method to assess whether test events were associated with an increase in risk of confirmed COVID-19, in order to inform policy on the safe re-introduction of spectator events following decreasing incidence of COVID-19 and relaxing of restrictions. Approach We designed a cohort study to measure relative risk of confirmed COVID-19 in those attending two large sporting events in South Wales during May-June 2021. First, we linked ticketing information to records on the Welsh Demographic Service (WDS) and identified NHS numbers for attendees. We then linked attendees to routine SARS-CoV-2 test data to calculate incidence rates in people attending each event for a fourteen days period following the event.  We selected a comparison cohort from WDS for each event, individually matched by age band, gender and locality of residence. Risk ratios were then computed for the two events. Results We successfully assigned NHS numbers to 91% and 84% of people attending the two events, respectively. Other identifiers were available for the remainder. Only a small number of attendees (1) than event 2 (<1), which did include pre-event testing. Conclusions We demonstrate the potential for data linkage to inform COVID-19 policy regarding sporting events. At that point in the epidemic, there was no evidence that attending large sporting events increased risk of COVID-19. However, these events took place between epidemic waves when background incidence and testing rate was low

Defining causality in COVID-19 and neurological disorders.

When faced with acute neurological presentations in a patient with COVID-19, how confident can one be that SARS-CoV2 is causal

100 years of STIs in the UK: a review of national surveillance data.

OBJECTIVES: The 1916 Royal Commission on Venereal Diseases was established in response to epidemics of syphilis and gonorrhoea in the UK. In the 100 years since the Venereal Diseases Act (1917), the UK has experienced substantial scientific, economic and demographic changes. We describe historical and recent trends in STIs in the UK. METHODS: We analysed surveillance data derived from STI clinics' statistical returns from 1917 to 2016. RESULTS: Since 1918, gonorrhoea and syphilis diagnoses have fluctuated, reflecting social, economic and technological trends. Following spikes after World Wars I and II, rates declined before re-emerging during the 1960s. At that time, syphilis was more common in men, suggestive of transmission within the men who have sex with men (MSM) population. Behaviour change following the emergence of HIV/AIDS in the 1980s is thought to have facilitated a precipitous decline in diagnoses of both STIs in the mid-1980s. Since the early 2000s, gonorrhoea and syphilis have re-emerged as major public health concerns due to increased transmission among MSM and the spread of antimicrobial-resistant gonorrhoea. Chlamydia and genital warts are now the most commonly diagnosed STIs in the UK and have been the focus of public health interventions, including the national human papillomavirus vaccination programme, which has led to substantial declines in genital warts in young people, and the National Chlamydia Screening Programme in England. Since the 1980s, MSM, black ethnic minorities and young people have experienced the highest STI rates. CONCLUSION: Although diagnoses have fluctuated over the last century, STIs continue to be an important public health concern, often affecting more marginalised groups in society. Prevention must remain a public health priority and, as we enter a new era of sexual healthcare provision including online services, priority must be placed on maintaining prompt access for those at greatest risk of STIs

A tale of two 'opens': intersections between Free and Open Source Software and Open Scholarship

There is no clear-cut boundary between Free and Open Source Software and Open Scholarship, and the histories, practices, and fundamental principles between the two remain complex. In this study, we critically appraise the intersections and differences between the two movements. Based on our thematic comparison here, we conclude several key things. First, there is substantial scope for new communities of practice to form within scholarly communities that place sharing and collaboration/open participation at their focus. Second, Both the principles and practices of FOSS can be more deeply ingrained within scholarship, asserting a balance between pragmatism and social ideology. Third, at the present, Open Scholarship risks being subverted and compromised by commercial players. Fourth, the shift and acceleration towards a system of Open Scholarship will be greatly enhanced by a concurrent shift in recognising a broader range of practices and outputs beyond traditional peer review and research articles. In order to achieve this, we propose the formulation of a new type of institutional mandate. We believe that there is substantial need for research funders to invest in sustainable open scholarly infrastructure, and the communities that support them, to avoid the capture and enclosure of key research services that would prevent optimal researcher behaviours. Such a shift could ultimately lead to a healthier scientific culture, and a system where competition is replaced by collaboration, resources (including time and people) are shared and acknowledged more efficiently, and the research becomes inherently more rigorous, verified, and reproducible

COVID-19 Encephalitis with SARS-CoV-2 Detected in Cerebrospinal Fluid Presenting as a Stroke Mimic

We report the case of a 35-year-old male with COVID-19 encephalitis presenting as a stroke mimic with sudden-onset expressive and receptive dysphasia, mild confusion and right arm incoordination. The patient received thrombolysis for a suspected ischaemic stroke, but later became febrile and SARS-CoV-2 was detected in cerebrospinal fluid. Electroencephalography demonstrated excess in slow waves, but neuroimaging was reported as normal. Respiratory symptoms were absent throughout and nasopharyngeal swab was negative for SARS-CoV-2. At the most recent follow-up, the patient had made a full neurological recovery. Clinicians should therefore consider testing for SARS-CoV-2 in CSF in patients who present with acute focal neurology, confusion and fever during the pandemic, even when there is no evidence of respiratory infection