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Transmission Roles Of Symptomatic And Asymptomatic Covid-19 Cases: A Modelling Study, Jianbin Tan, Yang Ge, Leonardo Martinez, Jimin Sun, Changwei Li, Adrianna Westbrook, Enfu Chen, Jinren Pan, Yang Li, Wei Cheng, Feng Ling, Zhinping Chen, Ye Shen, Hui Huang Sep 2022

Transmission Roles Of Symptomatic And Asymptomatic Covid-19 Cases: A Modelling Study, Jianbin Tan, Yang Ge, Leonardo Martinez, Jimin Sun, Changwei Li, Adrianna Westbrook, Enfu Chen, Jinren Pan, Yang Li, Wei Cheng, Feng Ling, Zhinping Chen, Ye Shen, Hui Huang

Faculty Publications

Coronavirus disease 2019 (COVID-19) asymptomatic cases are hard to identify, impeding transmissibility estimation. The value of COVID-19 transmissibility is worth further elucidation for key assumptions in further modelling studies. Through a population-based surveillance network, we collected data on 1342 confirmed cases with a 90-days follow-up for all asymptomatic cases. An age-stratified compartmental model containing contact information was built to estimate the transmissibility of symptomatic and asymptomatic COVID-19 cases. The difference in transmissibility of a symptomatic and asymptomatic case depended on age and was most distinct for the middle-age groups. The asymptomatic cases had a 66.7% lower transmissibility rate than symptomatic …


Covid-19 Disrupted Provision And Utilization Of Health And Nutrition Services In Uttar Pradesh, India: Insights From Service Providers, Household Phone Surveys, And Administrative Data, Phuong H. Nguyen, Shivani Kachwaha, Anjali Pant, Lan M. Tran, Monika Walia, Sebanti Ghosh, Praveen K. Sharma, Jessica Escobar-Alegria, Edward A. Frongillo Jr., Purnima Menon, Rasmi Avula Aug 2021

Covid-19 Disrupted Provision And Utilization Of Health And Nutrition Services In Uttar Pradesh, India: Insights From Service Providers, Household Phone Surveys, And Administrative Data, Phuong H. Nguyen, Shivani Kachwaha, Anjali Pant, Lan M. Tran, Monika Walia, Sebanti Ghosh, Praveen K. Sharma, Jessica Escobar-Alegria, Edward A. Frongillo Jr., Purnima Menon, Rasmi Avula

Faculty Publications

BACKGROUND: The coronavirus (COVID-19) pandemic may substantially affect health systems, but little primary evidence is available on disruption of health and nutrition services. OBJECTIVES: This study aimed to 1) determine the extent of disruption in provision and utilization of health and nutrition services induced by the pandemic in Uttar Pradesh, India; and 2) identify how adaptations were made to restore service provision in response to the pandemic. METHODS: We conducted longitudinal surveys with frontline workers (FLWs, n = 313) and mothers of children < 2 y old (n = 659) in December 2019 (in-person) and July 2020 (by phone). We also interviewed block-level managers and obtained administrative data. We examined changes in service provision and utilization using Wilcoxon matched-pairs signed-rank tests. RESULTS: Compared with prepandemic, service provision reduced substantially during lockdown (83-98 percentage points, pp), except for home visits and take-home rations (∼ 30%). Most FLWs (68%-90%) restored service provision in July 2020, except for immunization and hot cooked meals (< 10%). Administrative data showed similar patterns of disruption and restoration. FLW fears, increased workload, inadequate personal protective equipment (PPE), and manpower shortages challenged service provision. Key adaptations made to provide services were delivering services to beneficiary homes (∼ 40%-90%), social distancing (80%), and using PPE (40%-50%) and telephones for communication (∼ 20%). On the demand side, service utilization reduced substantially (40-80 pp) during the lockdown, but about half of mothers received home visits and food supplementation. Utilization for most services did not improve after the lockdown, bearing the challenges of limited travel (30%), nonavailability of services (26%), and fear of catching the virus when leaving the house (22%) or meeting service providers (14%). CONCLUSIONS: COVID-19 disrupted the provision and use of health and nutrition services in Uttar Pradesh, India, despite adaptations to restore services. Strengthening logistical support, capacity enhancement, performance management, and demand creation are needed to improve service provision and utilization during and post-COVID-19.


A Letter To Reconsider The Conditions For Testing Decontaminated N95 Respirators For Emergency Reuse To Address Shortage, Eric P. Vejerano, Jeonghyeon Ahn Jul 2020

A Letter To Reconsider The Conditions For Testing Decontaminated N95 Respirators For Emergency Reuse To Address Shortage, Eric P. Vejerano, Jeonghyeon Ahn

Faculty Publications

The battle with COVID-19 pandemic has resulted in the shortage of personal protective equipment, particularly, N95 respirators. Healthcare workers who reused N95 respirators may resort to unproven methods of cleaning/sterilization that can severely compromise the respirators’ filtration efficiency. A recently issued guideline will test decontaminated N95 respirators against particles with a median diameter of 0.075 ± 0.020 µm at a flow rate of 85 L min–1. For emergency reuse, these conditions may be too stringent. N95 respirators tested at this flow rate had predicted efficiencies of < 69%, assuming complete degradation of their electrostatic coating. Experimental efficiencies were ~15% lower. For emergency reuse, we recommend to either adjust the flow rate closer to normal breathing, or the size of the test particle should reflect that of virus-laden respiratory aerosols (~> 0.5 µm). By reconsidering the test conditions, a substantial fraction of used/decontaminated respirators can …