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99.1% of close contacts of patients infected with Omicron diagnosed within 10 days

Last weekend at Emerging infectious diseasesSouth Korean researchers reported that the average time from exposure to diagnosis of COVID-19 was 3.7 days among quarantined close contacts of patients infected with the SARS-CoV-2 Omicron variant and that 99, 1% of diagnoses occurred on day 10, supporting a 10-day quarantine period.

The study assessed the time from exposure to diagnosis among 107 close contacts from two Omicron groups on November 24 and 25, 2021. In South Korea, close contacts of Omicron patients were mandated to self-quarantine for 14 days amid surges, regardless of symptoms and vaccination status. Contacts were tested for COVID-19 on days 1, 9 and 13.

The average time between exposure and diagnosis was 3.7 days. Of all contacts, 50% were diagnosed on day 3, while 70% were diagnosed on day 5 and 99.1% on day 10. One diagnosis occurred on day 13 in an unvaccinated child who had previously been tested negative.

Half of contacts in all age groups were diagnosed on day 3. Among contacts with symptoms of COVID-19, half of diagnoses occurred on day 3 and 70% on day 5. Diagnoses of COVID-19 19 among contacts without symptoms occurred in 50% on day 5 and 70% on day 8.

The results of the study led the South Korean government to shorten the quarantine from 14 to 10 days and to 7 days in times of limited capacity due to surge in quarantine facilities.

The researchers noted that unpublished data from a previous study suggested that Omicron’s incubation period may be shorter than that of the Delta variant. “Estimating the duration of infectivity is more difficult than measuring incubation periods; a study that measured viral load from Omicron suggested that viral load fell by 10-13 days, which is consistent with our findings.

While the most effective COVID-19 containment measures are isolation and quarantine, the authors noted that these strategies come with personal and socioeconomic costs. “A 10-day quarantine period can encompass most people exposed to Omicron; however, the duration of quarantine may become shorter after balancing the societal cost with the public health benefits,” they concluded.
March 11 Urgent disinfection search letter

Support tool related to better antibiotic prescribing for pneumonia patients

A real-time electronic decision support tool has helped community hospital clinicians provide best care practices to emergency department patients with pneumonia and has been associated with a decrease in intensive care unit admissions (ICU), more appropriate use of antibiotics and an overall 38% reduction in deaths according to a study last week in the American Journal of Respiratory and Critical Care Medicine.

For the study, researchers at Intermountain Healthcare in Salt Lake City, Utah, deployed the healthcare system’s electronic open-loop clinical decision support (ePNa) system in 16 of its community hospitals in December 2017 to June 2019. During this period, these hospitals had 6,848 cases of pneumonia and a treating clinician used ePNa in 67% of eligible patients.

The support tool brings together more than 50 key patient indicators, including age, fever, oxygen saturation, lab and chest imaging results, and vital signs to make care decisions, including appropriate antibiotic therapy, laboratory studies, and treatment setting recommendations, such as admission to intensive care. , hospital admission or discharge. The median patient age was 67, 48% were female, and 64.8% were admitted to hospital.

Using the tool, Intermountain researchers found a range of positive patient outcomes, including a 38% relative reduction in mortality 30 days after a pneumonia diagnosis, with the largest reduction in mortality rates in patients admitted directly from the emergency department to the ICU. Guideline-compliant antibiotic prescribing increased from 83.5% to 90.2% (P

Other results were a 61% increase in the number of patients treated on an outpatient basis (from 29.2% to 46.9%), a decrease in admissions to intensive care without safety problems and a reduction in the average time between admission to emergency and the start of the first antibiotic, going from 159.4 minutes to 150.9 minutes.

The researchers say the results are consistent with a previous study involving the use of the ePNa system in large Intermountain hospitals.

“Our study found that clinicians were able to make better treatment decisions with this resource,” first author Nathan Dean, MD, said in an Intermountain press release. “Some of our community hospitals have as few as 20 beds. We wanted to validate the effectiveness of ePNa in very different healthcare settings.”
March 9 Am J Respir Crit Care Med study
March 9 Intermountain Healthcare Press release

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Mary Cashion

The author Mary Cashion