A network modelling approach to assess non-pharmaceutical disease controls in a worker population : an application to SARS-CoV-2

As part of a concerted pandemic response to protect public health, businesses can enact non-pharmaceutical controls to minimise exposure to pathogens in workplaces and premises open to the public. Amendments to working practices can lead to the amount, duration and/or proximity of interactions being changed, ultimately altering the dynamics of disease spread. These modifications could be specific to the type of business being operated. We use a data-driven approach to parameterise an individual-based network model for transmission of SARS-CoV-2 amongst the working population, stratified into work sectors. The network is comprised of layered contacts to consider the risk of spread in multiple encounter settings (workplaces, households, social and other). We analyse several interventions targeted towards working practices: mandating a fraction of the population to work from home; using temporally asynchronous work patterns; and introducing measures to create ‘COVID-secure’ workplaces. We also assess the general role of adherence to (or effectiveness of) isolation and test and trace measures and demonstrate the impact of all these interventions across a variety of relevant metrics. The progress of the epidemic can be significantly hindered by instructing a significant proportion of the workforce to work from home. Furthermore, if required to be present at the workplace, asynchronous work patterns can help to reduce infections when compared with scenarios where all workers work on the same days, particularly for longer working weeks. When assessing COVID-secure workplace measures, we found that smaller work teams and a greater reduction in transmission risk reduced the probability of large, prolonged outbreaks. Finally, following isolation guidance and engaging with contact tracing without other measures is an effective tool to curb transmission, but is highly sensitive to adherence levels. In the absence of sufficient adherence to non-pharmaceutical interventions, our results indicate a high likelihood of SARS-CoV-2 spreading widely throughout a worker population. Given the heterogeneity of demographic attributes across worker roles, in addition to the individual nature of controls such as contact tracing, we demonstrate the utility of a network model approach to investigate workplace-targeted intervention strategies and the role of test, trace and isolation in tackling disease spread

The impact of school reopening on the spread of COVID-19 in England

By mid-May, cases of COVID-19 in the UK had been declining for over a month; a multi-phase emergence from lockdown was planned, including a scheduled partial reopening of schools on 1st June. Although evidence suggests that children generally display mild symptoms, the size of the school-age population means the total impact of reopening schools is unclear. Here, we present work from mid-May that focused on the imminent opening of schools and consider what these results imply for future policy. We compared eight strategies for reopening primary and secondary schools in England. Modifying a transmission model fitted to UK SARS-CoV-2 data, we assessed how reopening schools affects contact patterns, anticipated secondary infections and the relative change in the reproductive number, R. We determined the associated public health impact and its sensitivity to changes in social-distancing within the wider community. We predicted reopening schools with half-sized classes or focused on younger children was unlikely to push R above one. Older children generally have more social contacts, so reopening secondary schools results in more cases than reopening primary schools, while reopening both could have pushed R above one in some regions. Reductions in community social-distancing were found to outweigh and exacerbate any impacts of reopening. In particular, opening schools when the reproductive number R is already above one generates the largest increase in cases. Our work indicates that while any school reopening will result in increased mixing and infection amongst children and the wider population, reopening schools alone in June was unlikely to push R above one. Ultimately, reopening decisions are a difficult trade-off between epidemiological consequences and the emotional, educational and developmental needs of children. Into the future, there are difficult questions about what controls can be instigated such that schools can remain open if cases increase

The Grizzly, March 25, 1983

New Editors Elected: Romer, Hong, Pasekoff Named • Superstars Tournament Needs Participants • DuPont Gives Third Consecutive Chemistry Grant • The A\u27s Come to UC • Third Annual Special Olympics This Weekend • Summer in Japan • Folk Singers at Bomberger • Letters to the Editor: An Epilogue to Zeta Chi • USGA Holds Election • USGA Notes • Voight at Bat • 13 Spend Break in Quebec • To Hell With the USFL • College Bowl Goes to Maryland • 1983 Room Selection Procedure • Bear\u27s Den Replaces Cafe International • Cycling Marathon: Ride for Your Life • Men\u27s Lacrosse Slow Getting Started • Men\u27s and Women\u27s Track Win Openershttps://digitalcommons.ursinus.edu/grizzlynews/1097/thumbnail.jp

The Grizzly, April 29, 1983

Three Administrators to Leave: Harris, Layne Retire • Ursinus Makes Inquirer Headlines • Housing Shortage is Imminent • J-Board Changes to be Made • Ursinus Students Win German Awards • Computer Genius is Honored at Myrin • Renninger to go to Scotland • Ursinus Professor Sees Work Published • President\u27s Corner • Letters to the Editor • Bike-A-Thon Proves Successful • Film Reveals Nuclear Horror • Zacharias Ursinus to be Honored in Fall • Award Time • College Choir Turns Comic • Holocaust Survivor Speaks at Commemoration • Women\u27s Tennis Overcomes Adversities; Wins MAC Play-off Berth • Bears\u27 Softball Team Reaches Goal • Women\u27s Lacrosse Turns in Another Strong Season • Ursinus Sluggers Gear Up for Home Stretch • Sports Profile: The Mile Relay Team • Track Teams Close Out Seasons • Men\u27s Tennis Concludes Successful Campaign • Men\u27s Lacrosse Suffers Two Defeatshttps://digitalcommons.ursinus.edu/grizzlynews/1100/thumbnail.jp

The Case for Dynamic Models of Learners' Ontologies in Physics

In a series of well-known papers, Chi and Slotta (Chi, 1992; Chi & Slotta, 1993; Chi, Slotta & de Leeuw, 1994; Slotta, Chi & Joram, 1995; Chi, 2005; Slotta & Chi, 2006) have contended that a reason for students' difficulties in learning physics is that they think about concepts as things rather than as processes, and that there is a significant barrier between these two ontological categories. We contest this view, arguing that expert and novice reasoning often and productively traverses ontological categories. We cite examples from everyday, classroom, and professional contexts to illustrate this. We agree with Chi and Slotta that instruction should attend to learners' ontologies; but we find these ontologies are better understood as dynamic and context-dependent, rather than as static constraints. To promote one ontological description in physics instruction, as suggested by Slotta and Chi, could undermine novices' access to productive cognitive resources they bring to their studies and inhibit their transition to the dynamic ontological flexibility required of experts.Comment: The Journal of the Learning Sciences (In Press

The Atacama Cosmology Telescope: Galactic Dust Structure and the Cosmic PAH Background in Cross-correlation with WISE

We present a cross-correlation analysis between $1'$ resolution total intensity and polarization observations from the Atacama Cosmology Telescope (ACT) at 150 and 220 GHz and 15$''$ mid-infrared photometry from the Wide-field Infrared Survey Explorer (WISE) over 107 12.5$^\circ\times$12.5$^\circ$ patches of sky. We detect a spatially isotropic signal in the WISE$\times$ACT $TT$ cross power spectrum at 30$\sigma$ significance that we interpret as the correlation between the cosmic infrared background at ACT frequencies and polycyclic aromatic hydrocarbon (PAH) emission from galaxies in WISE, i.e., the cosmic PAH background. Within the Milky Way, the Galactic dust $TT$ spectra are generally well-described by power laws in $\ell$ over the range 10$^3 < \ell <$10$^4$, but there is evidence both for variability in the power law index and for non-power law behavior in some regions. We measure a positive correlation between WISE total intensity and ACT $E$-mode polarization at 1000$< \ell \lesssim$6000 at $>$3$\sigma$ in each of 35 distinct $\sim$100 deg$^2$ regions of the sky, suggesting alignment between Galactic density structures and the local magnetic field persists to sub-parsec physical scales in these regions. The distribution of $TE$ amplitudes in this $\ell$ range across all 107 regions is biased to positive values, while there is no evidence for such a bias in the $TB$ spectra. This work constitutes the highest-$\ell$ measurements of the Galactic dust $TE$ spectrum to date and indicates that cross-correlation with high-resolution mid-infrared measurements of dust emission is a promising tool for constraining the spatial statistics of dust emission at millimeter wavelengths.Comment: 20 pages, 14 figures, submitted to Ap

An analysis of school absences in England during the COVID-19 pandemic

Background: The introduction of SARS-CoV-2, the virus that causes COVID-19 infection, in the UK in early 2020, resulted in the introduction of several control policies to reduce disease spread. As part of these restrictions, schools were closed to all pupils in March (except for vulnerable and key worker children), before re-opening to certain year groups in June. Finally, all school children returned to the classroom in September. Methods: Here, we analyse data on school absences in late 2020 as a result of COVID-19 infection and how that varied through time as other measures in the community were introduced. We utilise data from the Department for Education Educational Settings database and examine how pupil and teacher absences change in both primary and secondary schools. Results: Our results show that absences as a result of COVID-19 infection rose steadily following the re-opening of schools in September. Cases in teachers declined during the November lockdown, particularly in regions previously in tier 3, the highest level of control at the time. Cases in secondary school pupils increased for the first 2 weeks of the November lockdown, before decreasing. Since the introduction of the tier system, the number of absences with confirmed infection in primary schools was observed to be (markedly) lower than that in secondary schools. In December, we observed a large rise in the number of absences per school in secondary school settings in the South East and London, but such rises were not observed in other regions or in primary school settings. We conjecture that the increased transmissibility of the new variant in these regions may have contributed to this rise in secondary school cases. Finally, we observe a positive correlation between cases in the community and cases in schools in most regions, with weak evidence suggesting that cases in schools lag behind cases in the surrounding community. Conclusions: We conclude that there is no significant evidence to suggest that schools are playing a substantial role in driving spread in the community and that careful monitoring may be required as schools re-open to determine the effect associated with open schools upon community incidence

Optimal health and economic impact of non-pharmaceutical intervention measures prior and post vaccination in England: a mathematical modelling study

AbstractBackgroundEven with good progress on vaccination, SARS-CoV-2 infections in the UK may continue to impose a high burden of disease and therefore pose substantial challenges for health policy decision makers. Stringent government-mandated physical distancing measures (lockdown) have been demonstrated to be epidemiologically effective, but can have both positive and negative economic consequences. The duration and frequency of any intervention policy could, in theory, could be optimised to maximise economic benefits while achieving substantial reductions in disease.MethodsHere we use a pre-existing SARS-CoV-2 transmission model to assess the health and economic implications of different strengths of control through time in order to identify optimal approaches to non-pharmaceutical intervention stringency in the UK, considering the role of vaccination in reducing the need for future physical distancing measures. The model is calibrated to the COVID-19 epidemic in England and we carry out retrospective analysis of the optimal timing of precautionary breaks in 2020 and the optimal relaxation policy from the January 2021 lockdown, considering the willingness to pay for health improvement.ResultsWe find that the precise timing and intensity of interventions is highly dependent upon the objective of control. As intervention measures are relaxed, we predict a resurgence in cases, but the optimal intervention policy can be established dependent upon the willingness to pay (WTP) per QALY loss avoided. Our results show that establishing an optimal level of control can result in a reduction in net monetary loss of billions of pounds, dependent upon the precise WTP value.ConclusionsIt is vital, as the UK emerges from lockdown, but continues to face an on-going pandemic, to accurately establish the overall health and economic costs when making policy decisions. We demonstrate how some of these can be quantified, employing mechanistic infectious disease transmission models to establish optimal levels of control for the ongoing COVID-19 pandemic.</jats:sec

Long-Term Follow-Up of Cardiac Function and Quality of Life for Patients in NSABP Protocol B-31/NRG Oncology: A Randomized Trial Comparing the Safety and Efficacy of Doxorubicin and Cyclophosphamide (AC) Followed by Paclitaxel With AC Followed by Paclitaxel and Trastuzumab in Patients With Node-Positive Breast Cancer With Tumors Overexpressing Human Epidermal Growth Factor Receptor 2

Purpose Early cardiac toxicity is a risk associated with adjuvant chemotherapy plus trastuzumab. However, objective measures of cardiac function and health-related quality of life are lacking in long-term follow-up of patients who remain cancer free after completion of adjuvant treatment. Patients and Methods Patients in NSABP Protocol B-31 received anthracycline and taxane chemotherapy with or without trastuzumab for adjuvant treatment of node-positive, human epidermal growth factor receptor 2–positive early-stage breast cancer. A long-term follow-up assessment was undertaken for patients who were alive and disease free, which included measurement of left ventricular ejection fraction by multigated acquisition scan along with patient-reported outcomes using the Duke Activity Status Index (DASI), the Medical Outcomes Study questionnaire, and a review of current medications and comorbid conditions. Results At a median follow-up of 8.8 years among eligible participants, five (4.5%) of 110 in the control group and 10 (3.4%) of 297 in the trastuzumab group had a \u3e 10% decline in left ventricular ejection fraction from baseline to a value \u3c 50%. Lower DASI scores correlated with age and use of medications for hypertension, cardiac conditions, diabetes, and hyperlipidemia, but not with whether patients had received trastuzumab. Conclusion In patients without underlying cardiac disease at baseline, the addition of trastuzumab to adjuvant anthracycline and taxane-based chemotherapy does not result in long-term worsening of cardiac function, cardiac symptoms, or health-related quality of life. The DASI questionnaire may provide a simple and useful tool for monitoring patient-reported changes that reflect cardiac function