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Interrupting COVID-19 transmission by implementing enhanced traffic control bundling: Implications for global prevention and control efforts

Identifieur interne : 000205 ( Pmc/Checkpoint ); précédent : 000204; suivant : 000206

Interrupting COVID-19 transmission by implementing enhanced traffic control bundling: Implications for global prevention and control efforts

Auteurs : Muh-Yong Yen [Taïwan] ; Jonathan Schwartz [États-Unis] ; Shey-Ying Chen [Taïwan] ; Chwan-Chuen King [Taïwan] ; Guang-Yang Yang [Taïwan] ; Po-Ren Hsueh [Taïwan]

Source :

RBID : PMC:7156133

Abstract

We argue that enhanced Traffic Control Bundling (eTCB) can interrupt the community-hospital-community transmission cycle, thereby limiting COVID-19’s impact. Enhanced TCB is an expansion of the traditional TCB that proved highly effective during Taiwan’s 2003 SARS outbreak. TCB’s success derived from ensuring that Health Care Workers (HCWs) and patients were protected from fomite, contact and droplet transmission within hospitals.

Although TCB proved successful during SARS, achieving a similar level of success with the COVID-19 outbreak requires adapting TCB to the unique manifestations of this new disease. These manifestations include asymptomatic infection, a hyper-affinity to ACE2 receptors resulting in high transmissibility, false negatives, and an incubation period of up to 22 days. Enhanced TCB incorporates the necessary adaptations. In particular, eTCB includes expanding the TCB transition zone to incorporate a new sector – the quarantine ward. This ward houses patients exhibiting atypical manifestations or awaiting definitive diagnosis. A second adaptation involves enhancing the checkpoint hand disinfection and gowning up with Personal Protective Equipment deployed in traditional TCB. Under eTCB, checkpoint hand disinfection and donning of face masks are now required of all visitors who seek to enter hospitals.

These enhancements ensure that transmissions by droplets, fomites and contact are disrupted both within hospitals and between hospitals and the broader community. Evidencing eTCB effectiveness is Taiwan’s success to date in containing and controlling the community-hospital-community transmission cycle.


Url:
DOI: 10.1016/j.jmii.2020.03.011
PubMed: 32205090
PubMed Central: 7156133


Affiliations:


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PMC:7156133

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<p>We argue that enhanced Traffic Control Bundling (eTCB) can interrupt the community-hospital-community transmission cycle, thereby limiting COVID-19’s impact. Enhanced TCB is an expansion of the traditional TCB that proved highly effective during Taiwan’s 2003 SARS outbreak. TCB’s success derived from ensuring that Health Care Workers (HCWs) and patients were protected from fomite, contact and droplet transmission within hospitals.</p>
<p>Although TCB proved successful during SARS, achieving a similar level of success with the COVID-19 outbreak requires adapting TCB to the unique manifestations of this new disease. These manifestations include asymptomatic infection, a hyper-affinity to ACE2 receptors resulting in high transmissibility, false negatives, and an incubation period of up to 22 days. Enhanced TCB incorporates the necessary adaptations. In particular, eTCB includes expanding the TCB transition zone to incorporate a new sector – the quarantine ward. This ward houses patients exhibiting atypical manifestations or awaiting definitive diagnosis. A second adaptation involves enhancing the checkpoint hand disinfection and gowning up with Personal Protective Equipment deployed in traditional TCB. Under eTCB, checkpoint hand disinfection and donning of face masks are now required of all visitors who seek to enter hospitals.</p>
<p>These enhancements ensure that transmissions by droplets, fomites and contact are disrupted both within hospitals and between hospitals and the broader community. Evidencing eTCB effectiveness is Taiwan’s success to date in containing and controlling the community-hospital-community transmission cycle.</p>
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<name>
<surname>Yen</surname>
<given-names>Muh-Yong</given-names>
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<email>myyen1121@gmail.com</email>
<xref rid="aff1" ref-type="aff">a</xref>
<xref rid="cor1" ref-type="corresp"></xref>
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<surname>Schwartz</surname>
<given-names>Jonathan</given-names>
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<xref rid="aff2" ref-type="aff">b</xref>
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<contrib contrib-type="author" id="au3">
<name>
<surname>Chen</surname>
<given-names>Shey-Ying</given-names>
</name>
<xref rid="aff3" ref-type="aff">c</xref>
</contrib>
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<name>
<surname>King</surname>
<given-names>Chwan-Chuen</given-names>
</name>
<xref rid="aff4" ref-type="aff">d</xref>
</contrib>
<contrib contrib-type="author" id="au5">
<name>
<surname>Yang</surname>
<given-names>Guang-Yang</given-names>
</name>
<xref rid="aff5" ref-type="aff">e</xref>
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<contrib contrib-type="author" id="au6">
<name>
<surname>Hsueh</surname>
<given-names>Po-Ren</given-names>
</name>
<xref rid="aff6" ref-type="aff">f</xref>
<xref rid="aff7" ref-type="aff">g</xref>
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<aff id="aff1">
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Division of Infectious Diseases, Taipei City Hospital, School of Medicine, National Yang-Ming University, Taipei, Taiwan</aff>
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<label>b</label>
Department of Political Science, State University of New York, New Paltz, NY, USA</aff>
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Department of Emergency Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan</aff>
<aff id="aff4">
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Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, 10055, Taiwan</aff>
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Institute of Environmental and Occupational Health Sciences, School of Medicine, National Yang-Ming University, Taipei, 11221 Taiwan</aff>
<aff id="aff6">
<label>f</label>
Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan</aff>
<aff id="aff7">
<label>g</label>
Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan</aff>
<author-notes>
<corresp id="cor1">
<label></label>
Corresponding author. Division of Infectious Disease, Taipei City Hospital, Taipei, Taiwan. No. 100, Kunming St, Taipei, 10844, Taiwan.
<email>myyen1121@gmail.com</email>
</corresp>
</author-notes>
<pub-date pub-type="pmc-release">
<day>14</day>
<month>3</month>
<year>2020</year>
</pub-date>
<pmc-comment> PMC Release delay is 0 months and 0 days and was based on .</pmc-comment>
<pub-date pub-type="epub">
<day>14</day>
<month>3</month>
<year>2020</year>
</pub-date>
<history>
<date date-type="received">
<day>10</day>
<month>3</month>
<year>2020</year>
</date>
<date date-type="accepted">
<day>11</day>
<month>3</month>
<year>2020</year>
</date>
</history>
<permissions>
<copyright-statement>© 2020 Taiwan Society of Microbiology. Published by Elsevier Taiwan LLC.</copyright-statement>
<copyright-year>2020</copyright-year>
<copyright-holder></copyright-holder>
<license>
<license-p>Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.</license-p>
</license>
</permissions>
<abstract id="abs0010">
<p>We argue that enhanced Traffic Control Bundling (eTCB) can interrupt the community-hospital-community transmission cycle, thereby limiting COVID-19’s impact. Enhanced TCB is an expansion of the traditional TCB that proved highly effective during Taiwan’s 2003 SARS outbreak. TCB’s success derived from ensuring that Health Care Workers (HCWs) and patients were protected from fomite, contact and droplet transmission within hospitals.</p>
<p>Although TCB proved successful during SARS, achieving a similar level of success with the COVID-19 outbreak requires adapting TCB to the unique manifestations of this new disease. These manifestations include asymptomatic infection, a hyper-affinity to ACE2 receptors resulting in high transmissibility, false negatives, and an incubation period of up to 22 days. Enhanced TCB incorporates the necessary adaptations. In particular, eTCB includes expanding the TCB transition zone to incorporate a new sector – the quarantine ward. This ward houses patients exhibiting atypical manifestations or awaiting definitive diagnosis. A second adaptation involves enhancing the checkpoint hand disinfection and gowning up with Personal Protective Equipment deployed in traditional TCB. Under eTCB, checkpoint hand disinfection and donning of face masks are now required of all visitors who seek to enter hospitals.</p>
<p>These enhancements ensure that transmissions by droplets, fomites and contact are disrupted both within hospitals and between hospitals and the broader community. Evidencing eTCB effectiveness is Taiwan’s success to date in containing and controlling the community-hospital-community transmission cycle.</p>
</abstract>
<kwd-group id="kwrds0010">
<title>Keywords</title>
<kwd>COVID-19</kwd>
<kwd>SARS-CoV</kwd>
<kwd>Traffic control bundling</kwd>
<kwd>eTCB</kwd>
<kwd>Community-hospital-community transmission</kwd>
<kwd>Fomite transmission</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
<affiliations>
<list>
<country>
<li>Taïwan</li>
<li>États-Unis</li>
</country>
<region>
<li>État de New York</li>
</region>
</list>
<tree>
<country name="Taïwan">
<noRegion>
<name sortKey="Yen, Muh Yong" sort="Yen, Muh Yong" uniqKey="Yen M" first="Muh-Yong" last="Yen">Muh-Yong Yen</name>
</noRegion>
<name sortKey="Chen, Shey Ying" sort="Chen, Shey Ying" uniqKey="Chen S" first="Shey-Ying" last="Chen">Shey-Ying Chen</name>
<name sortKey="Hsueh, Po Ren" sort="Hsueh, Po Ren" uniqKey="Hsueh P" first="Po-Ren" last="Hsueh">Po-Ren Hsueh</name>
<name sortKey="Hsueh, Po Ren" sort="Hsueh, Po Ren" uniqKey="Hsueh P" first="Po-Ren" last="Hsueh">Po-Ren Hsueh</name>
<name sortKey="King, Chwan Chuen" sort="King, Chwan Chuen" uniqKey="King C" first="Chwan-Chuen" last="King">Chwan-Chuen King</name>
<name sortKey="Yang, Guang Yang" sort="Yang, Guang Yang" uniqKey="Yang G" first="Guang-Yang" last="Yang">Guang-Yang Yang</name>
</country>
<country name="États-Unis">
<region name="État de New York">
<name sortKey="Schwartz, Jonathan" sort="Schwartz, Jonathan" uniqKey="Schwartz J" first="Jonathan" last="Schwartz">Jonathan Schwartz</name>
</region>
</country>
</tree>
</affiliations>
</record>

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