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In response to the COVID?19 pandemic, Australia went into a nationwide lockdown that began on 22 March 2020 with stage one restrictions. These initial restrictions included closing non?essential businesses as [...], : Objective: Examine the changes in service delivery Australian public sexual health clinics made to remain open during lockdown. Methods: A cross?sectional survey designed and delivered on Qualtrics was emailed to 21 directors of public sexual health clinics across Australia from July?August 2020 and asked about a variety of changes to service delivery. Descriptive statistics were calculated. Results: Twenty clinics participated, all remained open and reported service changes, including suspension of walk?in services in eight clinics. Some clinics stopped offering asymptomatic screening for varying patient populations. Most clinics transitioned to a mix of telehealth and face?to?face consultations. Nineteen clinics reported delays in testing and 13 reported limitations in testing. Most clinics changed to phone consultations for HIV medication refills (n=15) and eleven clinics prescribed longer repeat prescriptions. Fourteen clinics had staff redeployed to assist the COVID?19 response. Conclusion: Public sexual health clinics pivoted service delivery to reduce risk of COVID?19 transmission in clinical settings, managed staffing reductions and delays in molecular testing, and maintained a focus on urgent and symptomatic STI presentations and those at higher risk of HIV/STI acquisition. Implications for public health: Further research is warranted to understand what impact reduced asymptomatic screening may have had on community STI transmission.

Approximately 39 million people living with HIV (PLWH) are at risk of infection with severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) that causes Coronavirus Disease 2019 (COVID 19). COVID 19 can lead to serious negative health outcomes for PLWH with a low CD4+ count and increased viral load (VL). The objective of this study was to determine the effect of herbal soup (formulated by mixing; dried ginger powder, dried garlic powder, roasted butternut squash powder, ground chia seeds, ground sunflower seeds, dried turmeric powder and chili pepper powder) on the immunological parameters of PLWH. This was a parallel single blind randomized control trial (RCT) conducted in Kakamega County Teaching and Referral Hospital (KCTRH) Comprehensive Care Centre (CCC). Block randomization and sequentially numbered opaque envelopes were used to assign respondents to either control group (received standard care including Nutrition counselling and anti-HIV drugs) or treatment group (received herbal soup in addition to the standard care). Participants in the treatment group prepared and consumed 1 serving (16.35g) of the soup daily for 3 months. A total of 60 respondents were selected for the control group (n=30) and treatment group (n=30), of whom, a small sample size of 41 completed the study limiting the study findings from drawing policy conclusions. Statistical Packages for Social Sciences was used for data organization and management. Paired t-test was used to determine the effect of herbal soup on CD4+ cell count and Viral Load (VL). The study findings indicated no significant effect on the mean CD4+ cell count (p=0.838), ([+ or -]277) and mean VL (p=0.051), ([+ or -]42) in the control group. There was a significant effect on mean CD4+ cell count (p=0.012), ([+ or -]199), however, no significant effect on the mean VL (p=0.102), ([+ or -]74) in the treatment group. The study concluded that the herbal soup had an effect on the CD4+ cell count and can be adopted for use at household and facility level to improve the immune defence of PLWH during emerging virus-related epidemics such as COVID 19. Key words: HIV/AIDS, SARS-CoV-2, COVID 19, CD4+ cell count, viral load, herbal soup, INTRODUCTION The estimated global burden of HIV/AIDS is approximately 39 million [1]. The HIV epidemic is disproportionately concentrated in sub-Saharan Africa (SSA) with an estimated 25.6 million PLWH [2]. Out [...]

Introduction In response to coronavirus disease 2019 (COVID?19), China issued comprehensive COVID?19 measures on 23 January, 2020. Shortly thereafter, the highest response level to the public health emergency was initiated [...], : Introduction: HIV self?testing (HIVST) is a useful strategy to promote HIV testing among key populations. This study aimed to understand HIV testing behaviours among men who have sex with men (MSM) and specifically how HIVST was used during the coronavirus disease 2019 (COVID?19) measures in China when access to facility?based testing was limited. Methods: An online cross?sectional study was conducted to recruit men who have sex with men (MSM) in China from May to June of 2020, a period when COVID?19 measures were easing. Data on socio?demographic characteristics, sexual behaviours and HIV testing in the three months before and during COVID?19 measures (23 January 2020) were collected. Chi?square test and logistic regression were used for analyses. Results: Overall, 685 MSM were recruited from 135 cities in 30 provinces of China, whose mean age was 28.8 (SD: 6.9) years old. The majority of participants self?identified as gay (81.9%) and had disclosed their sexual orientation (66.7%). In the last three months, 69.6% ever had sex with men, nearly half of whom had multiple sexual partners (47.2%). Although the overall HIV testing rates before and during COVID?19 measures were comparable, more MSM self?tested for HIV during COVID?19 measures (52.1%) compared to before COVID?19 measures (41.6%, p = 0.038). Fewer MSM used facility?based HIV testing during COVID?19 measures (42.9%) compared to before COVID?19 measures (54.1%, p = 0.038). Among 138 facility?based testers before COVID?19 measures, 59.4% stopped facility?based testing during COVID?19 measures. Among 136 self?testers during COVID?19 measures, 58.1% had no HIV self?testing before COVID?19 measures. Multivariable logistic regression showed that having sex with other men in the last three months (adjusted odds ratio, aOR = 2.04, 95% CI: 1.38 to 3.03), self?identifying as gay (aOR = 2.03, 95% CI: 1.31 to 3.13), ever disclosing their sexual orientation (aOR = 1.72, 95% CI: 1.19 to 2.50) and tested for HIV in three months before COVID?19 measures (aOR = 4.74, 95% CI: 3.35 to 6.70) were associated with HIV testing during COVID?19 measures. Conclusions: Facility?based HIV testing decreased and HIVST increased among MSM during COVID?19 measures in China. MSM successfully accessed HIVST as substitute for facility?based testing, with no overall decrease in HIV testing rates.

INTRODUCTION The first case of coronavirus disease 2019 (COVID?19), caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS?CoV?2) was reported in Wuhan, China in December 2019 [1]. Within months, the [...], : Introduction: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS?CoV?2) has infected >6 million people worldwide since December 2019. Global reports of HIV/SARS?CoV?2 coinfection are limited. To better understand the impact of the coronavirus disease 2019 (COVID?19) pandemic on persons with HIV and improve their care, we present an outpatient and inpatient clinical experience of HIV/SARS?CoV?2 coinfection from Rhode Island, US. Methods: We describe outpatient and inpatient preparedness for the COVID?19 pandemic, and present a case series of all known patients with HIV/SARS?CoV?2 coinfection at The Miriam Hospital and Rhode Island Hospital, and The Miriam Hospital Infectious Diseases and Immunology Center, in Providence, Rhode Island, US. Results and discussion: The Infectious Diseases and Immunology Center rapidly prepared for outpatient and inpatient care of persons with HIV and SARS?CoV?2. Between 30 March and 20 May 2020, 27 patients with HIV were diagnosed with SARS?CoV?2. Twenty were male, six female and one transgender female; average age was 49 years; 13/27 were Hispanic and 6/27 were African American. All had HIV viral load Conclusions: We highlight challenges of outpatient and inpatient HIV care in the setting of the COVID?19 pandemic and present the largest detailed case series to date from the United States on HIV/SARS?CoV?2 coinfection, adding to limited global reports. The aggregated clinical findings suggest that the clinical presentation and outcomes of COVID?19 appear consistent with those without HIV. Whether SARS?CoV?2 infection is more frequent among persons with HIV remains to be determined. More data are needed as we develop our understanding of how HIV and antiretroviral therapy are affected by or have an impact on this pandemic.

Author(s): Ritika Jindal (corresponding author) [1]; Mohit Gupta [2]; Fauzia R. Khan [3]; Gunjan Chaudhry [4] INTRODUCTION Ever since the coronavirus disease 2019 (COVID-19) outbreak started in Wuhan in late [...], Background and Aims: Coronavirus disease 2019 (COVID 19) has spread to every corner of the world and has led to significant health consequences, especially in patients with co morbidities. This study aimed to estimate the prevalence of co morbidities among COVID 19 patients in the Indian population and their association with mortality. Methods: PubMed, Google Scholar, and World Health Organization website were searched for Indian studies on COVID 19 published from February 2020 up to 20 May 2021. English language publications from India, studies reporting epidemiological characteristics, prevalence of co morbidities and in hospital mortality were included in the meta analysis. Results: 34 studies were identified with a total of 23,034 patients. The pooled prevalence for co morbidities in COVID 19 patients was 18.1 [95 confidence interval (CI), 13.3 to 24.3] for hypertension, 17.7 (95 CI, 12.2 to 25.1) for diabetes, 7.9 (95 CI, 4.6 to 13.4) for hypothyroidism and 7.7(95 CI, 4.8 to 12. 1) for cardiovascular diseases. For chronic kidney disease (CKD), chronic obstructive pulmonary disease (COPD), cerebrovascular diseases, asthma, chronic liver disease, tuberculosis and cancer, the pooled prevalence was less than 4. Additionally, the mortality risk was increased significantly in patients with CKD [odds ratio (OR) = 4.1], COPD (OR = 3.9), diabetes (OR = 3.7), cardiovascular diseases (OR = 4.07), tuberculosis (OR = 6.11), chronic liver disease (OR = 8.5), malignancy (OR = 1.89) and hypertension (OR = 2.9). Cerebrovascular diseases, hypothyroidism and asthma were not associated with increased mortality. Conclusion: Co-morbidities are more prevalent in COVID 19 hospitalised patients and the presence of co morbidities is associated with increased risk of mortality in Indian COVID 19 patients. Keywords: Co-morbidity, India, prevalence, SARS-CoV-2

Coronavirus disease 2019 (COVID?19), caused by a lipid?enveloped beta?coronavirus known as severe acute respiratory syndrome coronavirus?2 (SARS?CoV?2), was declared a global pandemic by the World Health Organization on 11 March [...], : Objective: To determine if non?pharmaceutical interventions (NPIs) impacted on respiratory virus detections in Queensland, Australia, during the COVID?19 pandemic year of 2020. Methods: We analysed weekly counts of influenza, human metapneumovirus, parainfluenza, respiratory syncytial virus, rhinovirus, and adenovirus available from a Queensland laboratory network for the year 2020. These were compared with averaged counts from 2015 to 2019. Results: Overall, 686,199 tests were performed. The timing of NPI implementation was associated with a sharp and sustained decline in influenza, where during the typical annual influenza season (weeks 23?40) no cases were detected from 163,296 tests compared with an average of 26.1% (11,844/45,396) of tests positive in 2015?2019. Similar results were observed for human metapneumovirus and parainfluenza. Respiratory syncytial virus detections also declined but increased in weeks 48?52 (5.6%; 562/10,078) to exceed the 2015?2019 average (2.9%; 150/5,018). Rhinovirus detections increased after schools reopened, peaking in weeks 23?27 (57.4%; 36,228/63,115), exceeding the 2017?2019 detections during that period (21.9%; 8,365/38,072). Conclusions: NPIs implemented to control COVID?19 were associated with altered frequency and proportions of respiratory virus detections. Implications for public health: NPIs derived from influenza pandemic plans were associated with profound decreases in influenza detections during 2020.

By 31 July 2020, 3,600 confirmed infections of severe acute respiratory syndrome?coronavirus?2 (SARS?CoV?2), the virus that causes coronavirus disease 2019 (COVID?19), had been recorded in New South Wales (NSW), Australia.[sup.1] [...], : Introduction: In May 2020, The Communicable Diseases Network of Australia (CDNA) case definition introduced serological criteria to support the diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS?CoV?2). We present findings that support the utility of SARS?CoV?2?specific serology for public health investigations. Methods: From 24 January to 31 July 2020, the following information was collected from individuals with positive SARS?CoV?2?specific immunofluorescence antibody tests: history of contact with COVID?19 cases; recent travel; symptoms consistent with COVID?19; and SARS?CoV?2 nucleic acid testing (NAT) results. Individuals were classified as confirmed or probable by CDNA criteria or additionally as possible (SARS?CoV?2?specific IgG positive with compatible symptoms or epidemiologic risk) or indeterminate (SARS?CoV?2?specific IgA/IgM positive only) cases. Results: A total of 10,595 individuals were tested in the six?month period. Of these, 9.8% (1,037) individuals had positive SARS?CoV?2?specific serology of which 566 (53.6%) were NAT?confirmed COVID?19 cases and 286 (27.6%) were part of a cruise ship outbreak sero?survey. The remaining 185 individuals (NAT negative) were individually classified as serologically confirmed (4, 0.4%), probable (72, 6.9%) possible (66, 6.4%) and indeterminate (38, 3.7%) cases. Maternal antibody transfer was inferred in one infant and four were unclassified. Conclusion: SARS?CoV?2?specific serology is a key diagnostic tool for retrospective identification of COVID?19 infection. Implications for public health: SARS?CoV?2 specific serology can enhance the ability to find cases, link missing cases in clusters of infection and identify the epidemiological extent of SARS?CoV?2 outbreaks. A combination of epidemiological criteria, clinical criteria and a quantitative serological test can be used as an adjunct to classify SARS?CoV?2 cases. Our study confirms the low level of community transmission in NSW during the first year of the COVID?19 pandemic

On 31 December 2019, a cluster of pneumonia cases of unknown aetiology, subsequently identified as coronavirus disease 2019 (COVID?19), was reported in Wuhan, China.[sup.1] By 13 January 2020, one of [...], : Objective: To investigate an outbreak of COVID?19 in Sydney, Australia. Methods: Epidemiological linking and analysis of cases of COVID?19 across multiple outbreak sites. Results: Fifteen cases of COVID?19 and 41 contacts were identified and linked in a cluster that included one workplace and five households. The mean incubation period in the cases ranged from 4.6 to 6.4 days, while the median incubation period was shorter, ranging from 3 to 5 days. The overall range of incubation periods was 2 to 12 days. Differential attack rates were found within households (86% adults vs. 9% children) and workplace (32%) settings. Conclusions and implications for public health: Our investigation links cases between multiple households and a workplace. When exploring these links using a rapid workplace assessment, real?time cluster data along with objective measurements of exposure, such as with the Australian Government COVIDSafe app, may have allowed these links to be identified more readily and potentially reduced further spread of COVID?19. We found age as a factor for infection, with children being less likely to both acquire SARS?CoV?2 infection and to develop symptoms. This finding aids in our understanding of how the virus affects children and cautiously supports face?to?face classroom teaching.

Outbreaks of Coronavirus Disease 2019 (COVID?19) in residential aged care facilities (RACF) have been responsible for approximately 75% of all COVID?19?related deaths in Australia, including 61 deaths in New South [...]

Introduction We are in the midst of an ongoing global pandemic caused by a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Coronavirus disease 2019 (COVID-19), the disease caused [...], Multiple studies have shown loss of severe acute respiratory syndrome coronavirus 2-specific (SARS-CoV-2-specific) antibodies over time after infection, raising concern that humoral immunity against the virus is not durable. If immunity wanes quickly, millions of people may be at risk for reinfection after recovery from coronavirus disease 2019 (COVID- 19). However, memory B cells (MBCs) could provide durable humoral immunity even if serum neutralizing antibody titers decline. We performed multidimensional flow cytometric analysis of S protein receptor binding domain-specific (S-RBD-specific) MBCs in cohorts of ambulatory patients with COVID-19 with mild disease (n = 7), and hospitalized patients with moderate to severe disease (n = 7), at a median of 54 days (range, 39-104 days) after symptom onset. We detected S-RBD-specific class-switched MBCs in 13 of 14 participants, failing only in the individual with the lowest plasma levels of anti-S- RBD IgG and neutralizing antibodies. Resting MBCs (rMBCs) made up the largest proportion of S-RBD-specific MBCs in both cohorts. FCRL5, a marker of functional memory on rMBCs, was more dramatically upregulated on S-RBD-specific rMBCs after mild infection than after severe infection. These data indicate that most SARS-CoV-2-infected individuals develop S-RBD- specific, class-switched rMBCs that resemble germinal center-derived B cells induced by effective vaccination against other pathogens, providing evidence for durable B cell-mediated immunity against SARS-CoV-2 after mild or severe disease.

Eighteen months on from the declaration of a pandemic, coronavirus disease 2019 (COVID?19) continues to restrict freedom of movement and inflict severe social and economic disruption.[sup.1] Worldwide, governments are promoting [...]

Author(s): Derya Evgin [sup.1] , Yagmur Sezer Efe [sup.2] , Fatma Özdemir [sup.3] Author Affiliations: (1) https://ror.org/005zfy155, 0000 0004 8351 8285, Department of Child Development, Kayseri University Health Science Faculty, [...], Objectives This study was conducted to examine the experiences and perceived challenges of nurses who are also mothers having a child during the coronavirus disease (COVID-19) pandemic. Methods A descriptive phenomenological design. The study was conducted with 18 nurse mothers working at COVID-19 clinics in Turkey. Results Nurse mothers missed their children and are worried about infecting their children. Based on content analysis, the themes of the study were determined as follows: (1) Nursing Care Process, (2) Disruption of Family Processes, (3) Nurse Mother's Perspective: Being a Child in a Pandemic, and (4) Coping with Challenges-"Searching for a solution." Conclusions Necessary conditions should be provided for nurses with children or family members in need of care and protocols should be made with relevant institutions.