Multiple early introductions of SARS-CoV-2 into a global travel hub in the Middle East

International travel played a significant role in the early global spread of SARS-CoV-2. Understanding transmission patterns from different regions of the world will further inform global dynamics of the pandemic. Using data from Dubai in the United Arab Emirates (UAE), a major international travel hub in the Middle East, we establish SARS-CoV-2 full genome sequences from the index and early COVID-19 patients in the UAE. The genome sequences are analysed in the context of virus introductions, chain of transmissions, and possible links to earlier strains from other regions of the world. Phylogenetic analysis showed multiple spatiotemporal introductions of SARS-CoV-2 into the UAE from Asia, Europe, and the Middle East during the early phase of the pandemic. We also provide evidence for early community-based transmission and catalogue new mutations in SARS-CoV-2 strains in the UAE. Our findings contribute to the understanding of the global transmission network of SARS-CoV-2

Solutions to the sedimentation and maintenance of semi-enclosed channels "How to deal with sedimentations in Dubai Canal?"

Dubai Canal, a cornerstone of the city's infrastructure and tourism, is facing a pressing challenge of sedimentation. As the canal plays a vital role in navigation and tourism, addressing the sedimentation problem becomes crucial to ensure its continued significance and operational efficiency. The project aims to study the build-up of sediment in semi-enclosed channels linked to tidal basins and develop solutions to maintenance schemes. The objective was to develop a numerical modeling methodology to predict future sedimentation behaviors and occurrences in Dubai Canal taking in consideration the effects of currents on coastlines. Accordingly, develop mitigation strategies and propose sustainable maintenance schemes to reduce the impacts of sedimentations. The method of investigation was initiated by data collection and sourcing to be used for modelling and validation. Hence, MIKE 3 software was used for modelling the sedimentation occurrences in Dubai Canal based on the numerical solution of the three-dimensional incompressible Reynolds averaged Navier-Stokes equations to calculate both Bed Load Transport & Suspended Load Transport to predict the sediment behaviour in the canal. Based on the model’s findings identifying potential sedimentation in three different locations in Dubai Canal, the project’s outcome was to propose a comprehensive mitigation strategy is proposed, encompassing design changes like tidal flaps, gates, a pumping system, and fountains. Feasibility studies and modeling will validate these alterations. A preventive scheme, featuring real-time monitoring and regular surveys, ensures sustained canal functionality. In addition, future policy recommendations were driven, emphasizing a balance between technical feasibility and financial considerations to preserve Dubai Canal's significance amid evolving sedimentation challenges. The project undertakes a novel approach by using numerical modelling for the first time to solve the sedimentation problem in a man-made marine canal in the Gulf Region, identifying the problem causes and exploring sustainable and efficient maintenance and dredging methods that will result in improving the marine environment and ecotourism, and which are cost efficient

Coinfections in Patients Hospitalized with COVID-19: A Descriptive Study from the United Arab Emirates

Abiola Senok,1,* Mubarak Alfaresi,2,* Hamda Khansaheb,3 Rania Nassar,1,4 Mahmood Hachim,1 Hanan Al Suwaidi,1 Majed Almansoori,2 Fatma Alqaydi,2 Zuhair Afaneh,2 Aalya Mohamed,2 Shahab Qureshi,2 Ayman Ali,2 Abdulmajeed Alkhajeh,3 Alawi Alsheikh-Ali1,3 1College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates; 2Sheikh Khalifa General Hospital, Umm Al Quwain, United Arab Emirates; 3Dubai Health Authority, Dubai, United Arab Emirates; 4Oral and Biomedical Sciences, School of Dentistry, Cardiff University, Cardiff, UK*These authors contributed equally to this workCorrespondence: Abiola SenokCollege of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, PO Box 505055, Dubai, United Arab EmiratesTel +971-4-383-8717Email [email protected]: Microbial coinfections in COVID-19 patients carry a risk of poor outcomes. This study aimed to characterize the clinical and microbiological profiles of coinfections in patients with COVID-19.Methods: A retrospective review of the clinical and laboratory records of COVID-19 patients with laboratory-confirmed infections with bacteria, fungi, and viruses was conducted. Only adult COVID-19 patients hospitalized at participating health-care facilities between February 1 and July 31, 2020 were included. Data were collected from the centralized electronic system of Dubai Health Authority hospitals and Sheikh Khalifa General Hospital Umm Al Quwain.Results: Of 29,802 patients hospitalized with COVID-19, 392 (1.3%) had laboratory-confirmed coinfections. The mean age of patients with coinfections was 49.3± 12.5 years, and a majority were male (n=330 of 392, 84.2%). Mean interval to commencement of empirical antibiotics was 1.2± 3.6) days postadmission, with ceftriaxone, azithromycin, and piperacillin–tazobactam the most commonly used. Median interval between admission and first positive culture (mostly from blood, endotracheal aspirates, and urine specimens) was 15 (IQR 8– 25) days. Pseudomonas aeruginosa, Klebsiella pneumoniae, and Escherichia coli were predominant in first positive cultures, with increased occurrence of Stenotrophomonas maltophilia, methicillin-resistant Staphylococcus aureus, Acinetobacter baumannii, Candida auris, and Candida parapsilosis in subsequent cultures. The top three Gram-positive organisms were Staphylococcus epidermidis, Enterococcus faecalis, and Staphylococcus aureus. There was variability in levels of sensitivity to antibiotics and isolates harboring mecA, ESBL, AmpC, and carbapenemase-resistance genes were prevalent. A total of 130 (33.2%) patients died, predominantly those in the intensive-care unit undergoing mechanical ventilation or extracorporeal membrane oxygenation.Conclusion: Despite the low occurrence of coinfections among patients with COVID-19 in our setting, clinical outcomes remained poor. Predominance of Gram-negative pathogens, emergence of Candida species, and prevalence of isolates harboring drug-resistance genes are of concern.Keywords: SARS-CoV2, microbial coinfections, clinical outcomes, Pseudomonas, Candid

Variations in the financial impact of the COVID-19 pandemic across 5 continents: a cross-sectional, individual level analysis

Background COVID-19 has caused profound socio-economic changes worldwide. However, internationally comparative data regarding the financial impact on individuals is sparse. Therefore, we conducted a survey of the financial impact of the pandemic on individuals, using an international cohort that has been well-characterized prior to the pandemic. Methods Between August 2020 and September 2021, we surveyed 24,506 community-dwelling participants from the Prospective Urban-Rural Epidemiology (PURE) study across high (HIC), upper middle (UMIC)-and lower middle (LMIC)-income countries. We collected information regarding the impact of the pandemic on their self-reported personal finances and sources of income. Findings Overall, 32.4% of participants had suffered an adverse financial impact, defined as job loss, inability to meet financial obligations or essential needs, or using savings to meet financial obligations. 8.4% of participants had lost a job (temporarily or permanently); 14.6% of participants were unable to meet financial obligations or essential needs at the time of the survey and 16.3% were using their savings to meet financial obligations. Participants with a post-secondary education were least likely to be adversely impacted (19.6%), compared with 33.4% of those with secondary education and 33.5% of those with pre-secondary education. Similarly, those in the highest wealth tertile were least likely to be financially impacted (26.7%), compared with 32.5% in the middle tertile and 30.4% in the bottom tertile participants. Compared with HICs, financial impact was greater in UMIC [odds ratio of 2.09 (1.88–2.33)] and greatest in LMIC [odds ratio of 16.88 (14.69–19.39)]. HIC participants with the lowest educational attainment suffered less financial impact (15.1% of participants affected) than those with the highest education in UMIC (22.0% of participants affected). Similarly, participants with the lowest education in UMIC experienced less financial impact (28.3%) than those with the highest education in LMIC (45.9%). A similar gradient was seen across country income categories when compared by pre-pandemic wealth status. Interpretation The financial impact of the pandemic differs more between HIC, UMIC, and LMIC than between socio-economic categories within a country income level. The most disadvantaged socio-economic subgroups in HIC had a lower financial impact from the pandemic than the most advantaged subgroup in UMIC, with a similar disparity seen between UMIC and LMIC. Continued high levels of infection will exacerbate financial inequity between countries and hinder progress towards the sustainable development goals, emphasising the importance of effective measures to control COVID-19 and, especially, ensuring high vaccine coverage in all countries. Funding Funding for this study was provided by the Canadian Institutes of Health Research and the International Development Research Centre