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LitCovid-PD-MONDO

LitCovid-PD-CLO

LitCovid-PD-CHEBI

{"project":"LitCovid-PD-CHEBI","denotations":[{"id":"T3","span":{"begin":6497,"end":6506},"obj":"Chemical"}],"attributes":[{"id":"A3","pred":"chebi_id","subj":"T3","obj":"http://purl.obolibrary.org/obo/CHEBI_47867"}],"text":"Potential scenarios for the progression of the COVID-19 epidemic\nBased on epidemiological factors, we characterised three sequential scenarios for the spread of SARS-CoV-2 in the EU/EEA (Figure). The third scenario is divided in two sub-scenarios based on the impact on the healthcare system. The scenarios are: (1) short, sporadic chains of transmission, (2) localised sustained transmission, (3a) widespread sustained transmission with increasing pressure on the healthcare system and (3b) widespread sustained transmission with overburdened healthcare system. These scenarios are presented together with suggested control measures to limit the impact of the epidemic. It should be noted that at different points in time, different countries may find themselves in different scenarios. Some countries may skip one scenario to progress directly the following one.\nFigure Scenarios for the potential spread and impact of COVID-19 in the EU/EEA, with suggested actions for containment and mitigation, March 2020\nCOVID-19: coronavirus disease 2019; EU/EEA: European Union/European Economic Area; SARS-CoV: severe acute respiratory syndrome coronavirus. Up until 23 February, the number of cases in the EU/EEA was low and cases in Europe were either imported or part of well-defined transmission chains in Germany and France. Since the beginning of the outbreak, the response of countries to SARS-CoV-2 has been to limit virus importation and to contain clusters of cases as swiftly as possible. Those response measures, with the support of the measures taken in China, were initially effective in limiting the introduction of the virus to the EU/EEA. Besides preventing incident cases, they have delayed a larger outbreak, allowing time to review and implement preparedness measures, and also avoiding the peak influenza season. However, by 27 February, 92% (424/463) of cases reported in the EU/EEA had been locally acquired. The majority of those locally acquired cases (93%) have been found in Italy and from there, seeding events occurred in other EU/EEA countries. Considering the high number of cases reported within the EU/EEA, the European Centre for Disease Prevention and Control (ECDC) has since 28 February stopped distinguishing imported from locally acquired cases. While some EU/EEA countries are under the first scenario ‘short, sporadic chains of transmission’, others have reached or are about to reach the third scenario ‘Widespread sustained transmission with increasing pressure on the healthcare system’. The situation in the EU/EEA may change rapidly and countries may rapidly move from one scenario to the next at any time.\nIn Scenario 1: Short, sporadic chains of transmission, learning about the epidemiology of the virus is paramount. While the number of cases remains small, active case finding, including contact tracing, should be conducted. Swabbing of asymptomatic individuals may be considered. It is of paramount importance that contacts of cases are properly managed [3]. Cases should be isolated to avoid further transmission. The potential adaptation of influenza surveillance systems should be evaluated. It is now also advisable for countries to review their pandemic preparedness plan, including healthcare system surge capacity and plans for business and essential service continuity. Alternative supply chains should be identified for personal protective equipment and other healthcare consumables; stockpiling should be considered as supply chains may later be disrupted. Risks should be communicated in a transparent and consistent way to stakeholders and to the general public, according to the unfolding epidemiological situation. Messages should include the actions being taken with acknowledgement of uncertainty.\nWith the continuous introduction of SARS-CoV-2 and the ability of the virus to rapidly spread, the EU/EEA is about to enter Scenario 2: Limited sustained transmission. Countries should consider activating their pandemic preparedness plan. With a rising number of cases, resources may become stretched but detailed case histories, lists of contacts and samples for diagnostic testing should still be obtained, where possible. These data will give valuable insight into the epidemiology of the virus and will be essential in planning for further progression of the outbreak. While cases are concentrated in clusters, measures could be taken to boost capacity by transferring healthcare resources and staff from other locations. In preparation for the following scenarios, contingency plans should be reviewed and updated. Risk assessments before mass gatherings should consider their potential role in amplifying transmission of the virus. In this phase, there may be increasing concern among the population, particularly if a high level of uncertainty persists regarding disease severity. Risk communication messages should include clear justifications for any changes to the public health measures being implemented, as well as the critical importance of adherence to any such measures that may restrict personal freedom, such as quarantine or self-isolation. In addition, public perception should be monitored, regarding the outbreak itself but also the response, so that concerns, misinformation and rumours can be addressed.\nAs the incidence of COVID-19 cases increases, it will at some point no longer be feasible, or efficient, to trace all contacts of confirmed cases, thus discontinuing active case finding. This will probably happen at different points in time in different countries. We characterise this as progression to Scenario 3a: Widespread sustained transmission with increasing pressure on the healthcare system. The objective would then shift from containment to mitigation, requiring substantial risk communication effort to ensure that the public knows how to respond in case of a suspected infection. Countries may consider the implementation of social distancing measures such as cancellation of conferences, cultural or sport events or the recommendation of teleworking or school closures in order to slow transmission of the virus. Such measures may reduce the acute burden on healthcare systems and possibly delay and/or reduce the peak of an outbreak. In this phase, it may be essential to simplify case reporting and test for SARS-CoV-2 in specimens from syndromic primary healthcare and hospital-based influenza surveillance systems. Detections of SARS-CoV-2 via influenza surveillance would initially be an indicator of transmission in the community and over time would allow the spread, intensity and severity of the virus to be described. Preparations should be made for efficient triage of cases requiring medical attention and for cohort isolation of cases requiring treatment. Citizens should be advised on what they can do to reduce pressure on the healthcare system.\nThe severity of COVID-19 remains unclear, but initial indications are that older adults and those with comorbidities are at higher risk [2]. If infection with SARS-CoV-2 becomes widespread, even a small proportion of severe cases could place healthcare systems under heavy pressure, resulting in Scenario 3b: Widespread sustained transmission with overburdened healthcare system. The burden will be compounded if the novel virus co-circulates with seasonal influenza, which stretches hospital capacity in many countries each winter. As at 28 February, seasonal influenza activity remains high in the majority of European countries but the peak of transmission seems to be past in several countries [4]. In the event that hospitals, emergency rooms, and intensive care units are unable to admit patients because of insufficient numbers of beds or staff, countries should be ready to implement contingency plans (e.g. adapt standard hospital beds for the treatment of severe cases). It may be necessary to reschedule non-essential operations and to evaluate whether alternative locations could be used to provide healthcare. Redistribution of resources throughout the EU/EEA could be considered."}

LitCovid-PD-GO-BP

{"project":"LitCovid-PD-GO-BP","denotations":[{"id":"T1","span":{"begin":2702,"end":2710},"obj":"http://purl.obolibrary.org/obo/GO_0007612"}],"text":"Potential scenarios for the progression of the COVID-19 epidemic\nBased on epidemiological factors, we characterised three sequential scenarios for the spread of SARS-CoV-2 in the EU/EEA (Figure). The third scenario is divided in two sub-scenarios based on the impact on the healthcare system. The scenarios are: (1) short, sporadic chains of transmission, (2) localised sustained transmission, (3a) widespread sustained transmission with increasing pressure on the healthcare system and (3b) widespread sustained transmission with overburdened healthcare system. These scenarios are presented together with suggested control measures to limit the impact of the epidemic. It should be noted that at different points in time, different countries may find themselves in different scenarios. Some countries may skip one scenario to progress directly the following one.\nFigure Scenarios for the potential spread and impact of COVID-19 in the EU/EEA, with suggested actions for containment and mitigation, March 2020\nCOVID-19: coronavirus disease 2019; EU/EEA: European Union/European Economic Area; SARS-CoV: severe acute respiratory syndrome coronavirus. Up until 23 February, the number of cases in the EU/EEA was low and cases in Europe were either imported or part of well-defined transmission chains in Germany and France. Since the beginning of the outbreak, the response of countries to SARS-CoV-2 has been to limit virus importation and to contain clusters of cases as swiftly as possible. Those response measures, with the support of the measures taken in China, were initially effective in limiting the introduction of the virus to the EU/EEA. Besides preventing incident cases, they have delayed a larger outbreak, allowing time to review and implement preparedness measures, and also avoiding the peak influenza season. However, by 27 February, 92% (424/463) of cases reported in the EU/EEA had been locally acquired. The majority of those locally acquired cases (93%) have been found in Italy and from there, seeding events occurred in other EU/EEA countries. Considering the high number of cases reported within the EU/EEA, the European Centre for Disease Prevention and Control (ECDC) has since 28 February stopped distinguishing imported from locally acquired cases. While some EU/EEA countries are under the first scenario ‘short, sporadic chains of transmission’, others have reached or are about to reach the third scenario ‘Widespread sustained transmission with increasing pressure on the healthcare system’. The situation in the EU/EEA may change rapidly and countries may rapidly move from one scenario to the next at any time.\nIn Scenario 1: Short, sporadic chains of transmission, learning about the epidemiology of the virus is paramount. While the number of cases remains small, active case finding, including contact tracing, should be conducted. Swabbing of asymptomatic individuals may be considered. It is of paramount importance that contacts of cases are properly managed [3]. Cases should be isolated to avoid further transmission. The potential adaptation of influenza surveillance systems should be evaluated. It is now also advisable for countries to review their pandemic preparedness plan, including healthcare system surge capacity and plans for business and essential service continuity. Alternative supply chains should be identified for personal protective equipment and other healthcare consumables; stockpiling should be considered as supply chains may later be disrupted. Risks should be communicated in a transparent and consistent way to stakeholders and to the general public, according to the unfolding epidemiological situation. Messages should include the actions being taken with acknowledgement of uncertainty.\nWith the continuous introduction of SARS-CoV-2 and the ability of the virus to rapidly spread, the EU/EEA is about to enter Scenario 2: Limited sustained transmission. Countries should consider activating their pandemic preparedness plan. With a rising number of cases, resources may become stretched but detailed case histories, lists of contacts and samples for diagnostic testing should still be obtained, where possible. These data will give valuable insight into the epidemiology of the virus and will be essential in planning for further progression of the outbreak. While cases are concentrated in clusters, measures could be taken to boost capacity by transferring healthcare resources and staff from other locations. In preparation for the following scenarios, contingency plans should be reviewed and updated. Risk assessments before mass gatherings should consider their potential role in amplifying transmission of the virus. In this phase, there may be increasing concern among the population, particularly if a high level of uncertainty persists regarding disease severity. Risk communication messages should include clear justifications for any changes to the public health measures being implemented, as well as the critical importance of adherence to any such measures that may restrict personal freedom, such as quarantine or self-isolation. In addition, public perception should be monitored, regarding the outbreak itself but also the response, so that concerns, misinformation and rumours can be addressed.\nAs the incidence of COVID-19 cases increases, it will at some point no longer be feasible, or efficient, to trace all contacts of confirmed cases, thus discontinuing active case finding. This will probably happen at different points in time in different countries. We characterise this as progression to Scenario 3a: Widespread sustained transmission with increasing pressure on the healthcare system. The objective would then shift from containment to mitigation, requiring substantial risk communication effort to ensure that the public knows how to respond in case of a suspected infection. Countries may consider the implementation of social distancing measures such as cancellation of conferences, cultural or sport events or the recommendation of teleworking or school closures in order to slow transmission of the virus. Such measures may reduce the acute burden on healthcare systems and possibly delay and/or reduce the peak of an outbreak. In this phase, it may be essential to simplify case reporting and test for SARS-CoV-2 in specimens from syndromic primary healthcare and hospital-based influenza surveillance systems. Detections of SARS-CoV-2 via influenza surveillance would initially be an indicator of transmission in the community and over time would allow the spread, intensity and severity of the virus to be described. Preparations should be made for efficient triage of cases requiring medical attention and for cohort isolation of cases requiring treatment. Citizens should be advised on what they can do to reduce pressure on the healthcare system.\nThe severity of COVID-19 remains unclear, but initial indications are that older adults and those with comorbidities are at higher risk [2]. If infection with SARS-CoV-2 becomes widespread, even a small proportion of severe cases could place healthcare systems under heavy pressure, resulting in Scenario 3b: Widespread sustained transmission with overburdened healthcare system. The burden will be compounded if the novel virus co-circulates with seasonal influenza, which stretches hospital capacity in many countries each winter. As at 28 February, seasonal influenza activity remains high in the majority of European countries but the peak of transmission seems to be past in several countries [4]. In the event that hospitals, emergency rooms, and intensive care units are unable to admit patients because of insufficient numbers of beds or staff, countries should be ready to implement contingency plans (e.g. adapt standard hospital beds for the treatment of severe cases). It may be necessary to reschedule non-essential operations and to evaluate whether alternative locations could be used to provide healthcare. Redistribution of resources throughout the EU/EEA could be considered."}

LitCovid-sentences

LitCovid-PubTator