Living the life of floods: place-based learning in an Anthropocene harmscape

This article explores how place-based learning and the development of landscape literacies unfold in a place suffused with a complex set of risks resulting from inter-operating and intersecting sociohistorical, political and environmental factors. By analysing assemblages of images and accompanying texts produced through a photovoice process undertaken by co-researchers in an informal settlement in South Africa’s Cape Flats, we show that residents are embedded in an ongoing process of embodied place-connectedness that has extensive pedagogical impact. We suggest that the learning that takes place in this harmscape may enable residents’ survival at the cost of allowing for either hope or the possibility of transformative change

Understanding resilience capitals, agency and habitus in household experiences of water scarcity, floods and fire in marginalized settlements in the Cape Flats, South Africa

A significant percentage of the urban population in most low- and middle-income countries live in informal settlements. Due to poor quality housing, dense settlement patterns and lack of risk reducing infrastructure, informal settlements are least prepared and at higher risk for climate change issues. Marginalized communities in settlements in the Cape Flats region of South Africa face a range of environmental hazards and risks including recurrent large-scale fires, localised flooding and inconsistent access to water. This paper presents findings from a household survey with 600 participants from three economically marginalised settlements in this region. The paper explores how different forms of capital come into play in the shaping of these experiences and responses and uses these to consider power structures and the creation of particular types of habitus amongst settlement residents. Results show that cultural (knowledge) capital is one of the most important capitals enabling resilience and adaptive capacities across all three sites. Findings show the complex interplay of forms of capital and the importance of recognizing ownership, control and power structures. Our findings also illustrate how repeated exposure to risk can shape a habitus of risk acceptance and a focus on coping rather than change. Insights from this study further enhance knowledge of community resilience that could potentially inform policy development and institutional disaster risk reduction strategies for climate change resilience of cities in low- and middle-income countries

‘It Means We are Not Safe’: Understanding and Learning from Household Experiences of Water Scarcity, Flood and Fire in Marginalized Settlements in the Cape Flats, South Africa

As climate change-related extreme weather events such as flooding and droughts increase in frequency and severity in most cities worldwide, there is a need to deepen understanding of disaster risks and adaptive capacities. A significant percentage of the urban population in most low- and middle-income countries live in informal settlements. Due to poor quality housing, dense settlement patterns and lack of risk reducing infrastructure e.g., drainage systems, informal settlements have been identified as being least prepared and at higher risk for climate change issues and therefore serve as important sites for understanding these risks and capacities. Marginalized communities in settlements in the Cape Flats region of South Africa face a range of environmental hazards including recurrent large-scale fires, localised flooding and water supply shortages. This paper presents findings from a household survey with 600 participants from three economically marginalised township settlements in this region. The aim of the survey was to understand the lived experiences, coping mechanisms and resilience attributes of the residents faced with localised flooding, fires and water shortages – locally salient environmental risks and hazards. The paper explores how different forms of capital come into play in the shaping of these experiences and responses and uses these to consider power structures and the creation of particular types of habitus amongst settlement residents. Insights from this study further enhance knowledge of community resilience that could potentially inform policy development and institutional disaster risk reduction strategies for climate change resilience of cities in low- and middle-income countries

Hospital admission and emergency care attendance risk for SARS-CoV-2 delta (B.1.617.2) compared with alpha (B.1.1.7) variants of concern: a cohort study

Background: The SARS-CoV-2 delta (B.1.617.2) variant was first detected in England in March, 2021. It has since rapidly become the predominant lineage, owing to high transmissibility. It is suspected that the delta variant is associated with more severe disease than the previously dominant alpha (B.1.1.7) variant. We aimed to characterise the severity of the delta variant compared with the alpha variant by determining the relative risk of hospital attendance outcomes. Methods: This cohort study was done among all patients with COVID-19 in England between March 29 and May 23, 2021, who were identified as being infected with either the alpha or delta SARS-CoV-2 variant through whole-genome sequencing. Individual-level data on these patients were linked to routine health-care datasets on vaccination, emergency care attendance, hospital admission, and mortality (data from Public Health England's Second Generation Surveillance System and COVID-19-associated deaths dataset; the National Immunisation Management System; and NHS Digital Secondary Uses Services and Emergency Care Data Set). The risk for hospital admission and emergency care attendance were compared between patients with sequencing-confirmed delta and alpha variants for the whole cohort and by vaccination status subgroups. Stratified Cox regression was used to adjust for age, sex, ethnicity, deprivation, recent international travel, area of residence, calendar week, and vaccination status. Findings: Individual-level data on 43 338 COVID-19-positive patients (8682 with the delta variant, 34 656 with the alpha variant; median age 31 years [IQR 17–43]) were included in our analysis. 196 (2·3%) patients with the delta variant versus 764 (2·2%) patients with the alpha variant were admitted to hospital within 14 days after the specimen was taken (adjusted hazard ratio [HR] 2·26 [95% CI 1·32–3·89]). 498 (5·7%) patients with the delta variant versus 1448 (4·2%) patients with the alpha variant were admitted to hospital or attended emergency care within 14 days (adjusted HR 1·45 [1·08–1·95]). Most patients were unvaccinated (32 078 [74·0%] across both groups). The HRs for vaccinated patients with the delta variant versus the alpha variant (adjusted HR for hospital admission 1·94 [95% CI 0·47–8·05] and for hospital admission or emergency care attendance 1·58 [0·69–3·61]) were similar to the HRs for unvaccinated patients (2·32 [1·29–4·16] and 1·43 [1·04–1·97]; p=0·82 for both) but the precision for the vaccinated subgroup was low. Interpretation: This large national study found a higher hospital admission or emergency care attendance risk for patients with COVID-19 infected with the delta variant compared with the alpha variant. Results suggest that outbreaks of the delta variant in unvaccinated populations might lead to a greater burden on health-care services than the alpha variant. Funding: Medical Research Council; UK Research and Innovation; Department of Health and Social Care; and National Institute for Health Research

Changes in symptomatology, reinfection, and transmissibility associated with the SARS-CoV-2 variant B.1.1.7: an ecological study

Background The SARS-CoV-2 variant B.1.1.7 was first identified in December, 2020, in England. We aimed to investigate whether increases in the proportion of infections with this variant are associated with differences in symptoms or disease course, reinfection rates, or transmissibility. Methods We did an ecological study to examine the association between the regional proportion of infections with the SARS-CoV-2 B.1.1.7 variant and reported symptoms, disease course, rates of reinfection, and transmissibility. Data on types and duration of symptoms were obtained from longitudinal reports from users of the COVID Symptom Study app who reported a positive test for COVID-19 between Sept 28 and Dec 27, 2020 (during which the prevalence of B.1.1.7 increased most notably in parts of the UK). From this dataset, we also estimated the frequency of possible reinfection, defined as the presence of two reported positive tests separated by more than 90 days with a period of reporting no symptoms for more than 7 days before the second positive test. The proportion of SARS-CoV-2 infections with the B.1.1.7 variant across the UK was estimated with use of genomic data from the COVID-19 Genomics UK Consortium and data from Public Health England on spike-gene target failure (a non-specific indicator of the B.1.1.7 variant) in community cases in England. We used linear regression to examine the association between reported symptoms and proportion of B.1.1.7. We assessed the Spearman correlation between the proportion of B.1.1.7 cases and number of reinfections over time, and between the number of positive tests and reinfections. We estimated incidence for B.1.1.7 and previous variants, and compared the effective reproduction number, Rt, for the two incidence estimates. Findings From Sept 28 to Dec 27, 2020, positive COVID-19 tests were reported by 36 920 COVID Symptom Study app users whose region was known and who reported as healthy on app sign-up. We found no changes in reported symptoms or disease duration associated with B.1.1.7. For the same period, possible reinfections were identified in 249 (0·7% [95% CI 0·6–0·8]) of 36 509 app users who reported a positive swab test before Oct 1, 2020, but there was no evidence that the frequency of reinfections was higher for the B.1.1.7 variant than for pre-existing variants. Reinfection occurrences were more positively correlated with the overall regional rise in cases (Spearman correlation 0·56–0·69 for South East, London, and East of England) than with the regional increase in the proportion of infections with the B.1.1.7 variant (Spearman correlation 0·38–0·56 in the same regions), suggesting B.1.1.7 does not substantially alter the risk of reinfection. We found a multiplicative increase in the Rt of B.1.1.7 by a factor of 1·35 (95% CI 1·02–1·69) relative to pre-existing variants. However, Rt fell below 1 during regional and national lockdowns, even in regions with high proportions of infections with the B.1.1.7 variant. Interpretation The lack of change in symptoms identified in this study indicates that existing testing and surveillance infrastructure do not need to change specifically for the B.1.1.7 variant. In addition, given that there was no apparent increase in the reinfection rate, vaccines are likely to remain effective against the B.1.1.7 variant. Funding Zoe Global, Department of Health (UK), Wellcome Trust, Engineering and Physical Sciences Research Council (UK), National Institute for Health Research (UK), Medical Research Council (UK), Alzheimer's Society

Genomic assessment of quarantine measures to prevent SARS-CoV-2 importation and transmission

Mitigation of SARS-CoV-2 transmission from international travel is a priority. We evaluated the effectiveness of travellers being required to quarantine for 14-days on return to England in Summer 2020. We identified 4,207 travel-related SARS-CoV-2 cases and their contacts, and identified 827 associated SARS-CoV-2 genomes. Overall, quarantine was associated with a lower rate of contacts, and the impact of quarantine was greatest in the 16–20 age-group. 186 SARS-CoV-2 genomes were sufficiently unique to identify travel-related clusters. Fewer genomically-linked cases were observed for index cases who returned from countries with quarantine requirement compared to countries with no quarantine requirement. This difference was explained by fewer importation events per identified genome for these cases, as opposed to fewer onward contacts per case. Overall, our study demonstrates that a 14-day quarantine period reduces, but does not completely eliminate, the onward transmission of imported cases, mainly by dissuading travel to countries with a quarantine requirement

Genomic epidemiology of SARS-CoV-2 in a UK university identifies dynamics of transmission

AbstractUnderstanding SARS-CoV-2 transmission in higher education settings is important to limit spread between students, and into at-risk populations. In this study, we sequenced 482 SARS-CoV-2 isolates from the University of Cambridge from 5 October to 6 December 2020. We perform a detailed phylogenetic comparison with 972 isolates from the surrounding community, complemented with epidemiological and contact tracing data, to determine transmission dynamics. We observe limited viral introductions into the university; the majority of student cases were linked to a single genetic cluster, likely following social gatherings at a venue outside the university. We identify considerable onward transmission associated with student accommodation and courses; this was effectively contained using local infection control measures and following a national lockdown. Transmission clusters were largely segregated within the university or the community. Our study highlights key determinants of SARS-CoV-2 transmission and effective interventions in a higher education setting that will inform public health policy during pandemics.</jats:p

STAMP goes EAST: Integrating systems ergonomics methods for the analysis of railway level crossing safety management

Naweed, A ORCiD: 0000-0002-5534-4295Various systems ergonomics methods are available to support the design and analysis of rail systems. Whilst the utility of these methods is accepted, the increasing complexity of modern day systems is stretching their capabilities. The integration of distinct systems ergonomics methods provides a means of redressing this. This article presents a study in which the underpinning principles of the STAMP control structure method were added to the EAST framework, and subsequently used to examine railway level crossing safety management. Task, social and information networks for a railway level crossing system lifecycle were developed along with an additional control network showing safety controls and their interrelations. Analysis of the networks points to a need to (1) strengthen activities and controls around proactive risk management and performance monitoring, (2) tighten the coupling between organisations responsible for safety management, and (3) to increase the flexibility of design standards. The implications for future railway level crossing safety management and rail safety research and practice are discussed