atepeq/tico19 huggingface dataset:
Small numbers of COVID-19 patients aged &lt; 19 years were reported to be hospitalized (48) or admitted to an ICU (eight).
Pek m5 tst k` naath tin cv moc COVID-19 tin runkivn &lt; 19 cua kv lar 5 ca kv ts11c (48) kiv ca kv ts11c kv ICU (8).
In contrast, 335 patients aged &lt; 19 years were not hospitalized and 1,342 had missing data on hospitalization.
V gu1c kv nvmv, pek m5 k` 335 j5 ju1th t5 runkivn &lt; 19 t5 /k1n ts11c kvn pek m5 1,342 m5 ca ts11c cu l``r kv ku5cdivn thil.
Among all COVID-19 patients with complete information on underlying conditions or risk factors, 184 deaths occurred (all among patients aged ≥19 years); 173 deaths (94%) were reported among patients with at least one underlying condition.
Rvi j5 ju1th COVID-19 diaal tin ca l``r m5 thi`x jek kv ku5 cdivn kv ciaax ju1thn5 tin k]kivn tin te kv kv n5 wen, cu naath t5 184 l5w (94%) rvi j5 ju1th tin te raan kv juey d]divn n5 wen.
Among 122,653 U.S. COVID-19 cases reported to CDC as of March 28, 2020, 7,162 (5.8%) patients had data available pertaining to underlying health conditions or potential risk factors; among these patients, higher percentages of patients with underlying conditions were admitted to the hospital and to an ICU than patients without reported underlying conditions.
Rvi nath t5 122,653 k` U.S. Pek in ca l1r CDC k` j5 ju1th COVID-19 kv gu11th paay di]k 28, 2020, v naath t5 7,162 (5.8%) t5 te l``r kv ku5cdivn th5n kv ciaax ju1thn5 tin k]x n5 wen, rvi j5 ju1th titi, pek in d55t k` naath tin te kv ju1th k]kivn n5 wen cua kv ts11c kv ICU v b``l naath tin ca lar 5 thil ju1th k]kivn n5 wen .
These results are consistent with findings from China and Italy, which suggest that patients with underlying health conditions and risk factors, including, but not limited to, diabetes mellitus, hypertension, COPD, coronary artery disease, cerebrovascular disease, chronic renal disease, and smoking, might be at higher risk for severe disease or death from COVID-19.
Kvn titi we kv kvvl kv min ca jek b` k` China kvn Tiliaan, min nyooth f66 j5 ju1th tin raan kv jueydv k]divn n5 wen m5 x]]x jv rvi teek`dv cet kv juey thok22r mellituth, d5t rivm, CORD, ju1th r``l ksrsnvvr5, ju1th xith` thvr5bsrsbathkulsr, juey rokn5 m5 c5 j``ny, kv m1th tap` kv kvn naath tin la te kv rivk kiv b5 l5w kv juey COVID-19.
This analysis was limited by small numbers and missing data because of the burden placed on reporting health departments with rapidly rising case counts, and these findings might change as additional data become available.
Vn guec vmvm cuv p22k k` naath t5 tst kv f66 thilv l``r m5 r7x kvn f66 cv thiak w55 mukt`p` pusl` pu11ny vn f66 ba l``r malv n66x kv rvc kv ku2n kv pek in k``p jueyv, kv f66 ns kvn l``r5 titi d]x b5 kv rs gvr m5 ca l``r5 k]kivn nysk kv jek.
It is not yet known whether the severity or level of control of underlying health conditions affects the risk for severe disease associated with COVID-19.
Xotv /k1nv n5 x1c m5 b5 d5t kiv pek g1x ju1thn5 tin te pu1nyn5 nath n5 wen m5 bv ciaax rik` kv juey COVID-19 rep.
Many of these underlying health conditions are common in the United States: based on self-reported 2018 data, the prevalence of diagnosed diabetes among U.S. adults was 10.1%, and the U.S. age-adjusted prevalence of all types of heart disease (excluding hypertension without other heart disease) was 10.6% in 2017.
Ju1th t5 xuan k` kvn ti te pu1nyn5 nath n5 wen ti kvn xuan kv Yunaytet Y5tht22t: kv l``r 2 ca lar kv 2018, pek in ca jek kv juey thok22r kv dsx US v 10.1% k` ju1th lsaac k` U.S. tin la tussk d5t kv kvn d5t rivm v thil ju1th k]kivn (cua 10.6%) kv ru]]n 2017.
The age-adjusted prevalence of COPD among U.S. adults is 5.9%, and in 2018, the U.S. estimated prevalence of current asthma among persons of all ages was 7.9%.
R2p ju1th CORD kv rs xuan run5 k` dsx US v 5.9% kv ru]]n 2018, cu U.S. v diw 5 r2p ju1th adhuma nvmv kv rs k` run diaal k` naath cua 7.9%.
CDC continues to develop and update resources for persons with underlying health conditions to reduce the risk of acquiring COVID-19.
CDC ucv xot kv m5 l`tv kuak k` kapv kv nhial kv ku5c nath tin te kv ju1th k]kivn n5 wen kv f66 bv li11 nath kv COVID-19 xot.
The estimated higher prevalence of these conditions among those in this early group of U.S. COVID-19 patients and the potentially higher risk for more severe disease from COVID-19 associated with the presence of underlying conditions highlight the importance of COVID-19 prevention in persons with underlying conditions.
Pek in d55t in ca nvn kv ciaax ju1thn5 tin te th5n n5 wen k` j5 U.S. kv jvn bu]n vmv J5 ju1th COVID-19 kvn naath tin thi1k rivk kv pu]nydivn in we kvvl kv juey COVID-19 kvvl kvn ju1th tin te th5n n5 wen nyoothv bu]m kv ciaax in d22 gax naath tin te kv ju1th n5 wen.
The findings in this report are subject to at least six limitations.
Kvn tin ca jek k` l``r vmv te kvn kv diw kv dup b1kvl.
First, these data are preliminary, and the analysis was limited by missing data related to the health department reporting burden associated with rapidly rising case counts and delays in completion of information requiring medical chart review; these findings might change as additional data become available.
Kv nhiam, l``r5 titi kvn kuiy kv, k` guecdivn kuiyv kv f66 te l``r5 t5 xuan j]]r k` mukt`p pusl` pu11ny kv thiaak k` min ca l1th w55dv kv f66 b5 l``r5 mal dhil ben rvc kv p0th kvn j1ny kv thu]k l``r5 tin d22 we jek m5d5ksl cat; kvn titi tin ca jek d]x ba rs gvr m5 ca l``r5 k]kivn nysk kv jek.
Information on underlying conditions was only available for 7,162 (5.8%) of 122,653 cases reported to CDC.
L``r kv ku5c ju1thn5 tin te th5n n5 wen te kv th5n v la 7,162 (5.8%) k` 122,653 t5 tst k`] tin ca l1r CDC.
It cannot be assumed that those with missing information are similar to those with data on either hospitalizations or underlying health conditions.
/Ca jv dee met lar vn f66 naath tin te kv ju1th k]kivn n5 wen tin /k1n jek 5 kvn p``r kv kv tin ca l``r5kivn jek tin ca ts11c kiv tin te kv ju1th k]kivn.
Second, these data are subject to bias in outcome ascertainment because of short follow-up time.
Rvwdv, kvn l``r5 titi d22 rvidivn te kac kv ben raar x`th` kv f66 kuiy gu11th in gu]]r kv kv kv jv.
Some outcomes might be underestimated, and long-term outcomes cannot be assessed in this analysis.
Th11x ben`divn raar d]x ca kv guic v kuiy, k` tin b` raar kv gu11th m5 b``r thilv gu11th m5 d22 jrk kv rvi guec vmv.
Third, because of the limited availability of testing in many jurisdictions during this period, this analysis is likely biased toward more severe cases, and findings might change as testing becomes more widespread.
Di]]kdivn, kv f66 kuiy pek in th0m kv rvi gu1thn5 lu]]kn5 t5 xuan, vn guec vmv thi1k f66 derv te kv kac rvidv kv ku5c nath tin d5t jueydivn, k` min ca jek derv rs gvr m5 c5 th2m d5t k` naath.
Fourth, because of the descriptive nature of these data, attack rates among persons with and without underlying health conditions could not be compared, and thus the risk difference of severe disease with COVID-19 between these groups could not be estimated.
Xuaandivn, kv f66 t11 lar`divn kv l``r5 titi, ban kvn pek in ca lar k` naath tin thil kv ju1th k]kivn n5 wen v /ca kv dee p11r, k` 5ns d``k rik` ju1th in d55t k` COVID-19 kam bun5 tit /ca jv dee lu`x kv m1r.
Fifth, no conclusions could be drawn about underlying conditions that were not included in the case report form or about different conditions that were reported in a single, umbrella category.
Dhieecdivn, thilv guk m5 d22 lar kv ku5c nath tin tin te kv ju1th k]kivn tin /k1n mat rvi wargak` l``r5 titi kiv rik tin k]x t5 /k1n lar rvi k` kvl kv gu11th kuum` nvmv.
For example, asthma and COPD were included in a chronic lung disease category.
C``t, adhuma kvn CORD ca kv mat rvi ju1thn5 pu]]th tin ct5 j``ny.
Finally, for some underlying health conditions and risk factors, including neurologic disorders, chronic liver disease, being a current smoker, and pregnancy, few severe outcomes were reported; therefore, conclusions cannot be drawn about the risk for severe COVID-19 among persons in these groups.
Kv min jsak, k` th11x ju1thn5 tin te th5n n5 wen kvn ciaax rik`, derv la ram m`th kv tap kv jvn gu11th vmv, derv la ru2t, cua th11x rikn5 t5 d5t t5 c5 tussk lar, kv f66 ns, thilv guk m5 d22 met k1m raar kv ciaax rik` COVID-19 k` kvn naath tin te rvi bun` nvmv.
Persons in the United States with underlying health conditions appear to be at higher risk for more severe COVID-19, consistent with findings from other countries.
Naath tin te kv ju1th k]kivn n5 wen k` Yunaytet Y5tht22t jsc kv vn f66 thieek kvn kv rivk kv d5t COVID-19, v c``t kv min ca jek w55n5 tin k]x.
Persons with underlying health conditions who have symptoms of COVID-19, including fever, cough, or shortness of breath, should immediately contact their health care provider.
Naath tin te kv ju1th k]kivn n5 wen tin jssc nyuuthn5 COVID-19 k` kv cet kv l2th pu11ny, kivl, kiv civk yieek` v kv we gu11th in th6p kv ciaax pusl` pu11ny th5n kv p0th.
These persons should take steps to protect themselves from COVID-19, through washing their hands; cleaning and disinfecting high-touch surfaces; and social distancing, including staying at home, avoiding crowds, gatherings, and travel, and avoiding contact with persons who are ill.
Kvn naath titi v kvdhivl k11th titi gu]]r kv g1xdivn kv r] kv COVID-19, kv l1kdivn kv tetkivn, yi2cdivn kvn n`kdivn kv luex kv w5c kuakn5 tin ca thi22p; kv cu]x kiv nyuur kv kam, kvvl kvn f66 dee kv nyuur ci2xn5kivn; du]l nath kv rs kvn j`l gu`yn5, k` a kv /ca rs gueer kv naath.
Maintaining at least a 30-day supply of medication, a 2-week supply of food and other necessities, and knowledge of COVID-19 symptoms are recommended for those with underlying health conditions.
Rsm civvx` n77x` wal th5n kv n5n t5 30, n77x ku1n kv juskn5 2 kvn gsy tin k]x, kvn x`c kv nyuuthn5 COVID-19 gsw kvn diaal k` naath tin te kv ju1th k]kivn n5 wen.
All persons should take steps to protect themselves from COVID-19 and to protect others.
Naath diaal ba k11th titi dhil gu]]r kv f66 ba rs gax kv juey COVID019 kvvl kv naath tin k]x.
All persons who are ill should stay home, except to get medical care; should not go to work; and should stay away from others.
Naath diaal tin cv moc juey v kv nyur ci22xn5kivn, vn5 m5 wen5 raan dueelwal; v kv/c5 we l`t k` a kv n1n kv naath tin k]x.
This is especially important for those who work with persons with underlying conditions or who otherwise are at high risk for severe outcomes from COVID-19.
Nvmv gsaayv vl]x k` naath tin l`t kvvl kv naath tin te kv ju1th k]kivn n5 wen kiv tin d]x thi1k kv d5t rik` ku1th COVID-19.
Community mitigation strategies, which aim to slow the spread of COVID-19, are important to protect all persons from COVID-19, especially persons with underlying health conditions and other persons at risk for severe COVID-19–associated disease (https://www.cdc.gov/coronavirus/2019-ncov/downloads/community-mitigation-strategy.pdf).
C11p tin gax kv wec, l1t kv kv kv ku5c yuth` pivny COVID-19 kv f66 /cv fsw b5 thi`x, kvn gsy kv kv g1x nath diaal kv COVID-19 v civk naath tin te kv ju1th k]kivn n5 wen k` thi1k kv rivk ju1th in we kvvl kvn COVID-19 (https://www.cdc.gov/coronavirus/2019-ncov/downloads/community-mitigation-strategy.pdf).
What is already known about this topic?
Vxu x1c kv n5 wens kv jvn ruac vmv?
Published reports from China and Italy suggest that risk factors for severe COVID-19 disease include underlying health conditions, but data describing underlying health conditions among U.S. COVID-19 patients have not yet been reported.
L``r5 tin c5 ben raar kv wargak k` China kvn Tiliaan nyooth kvn f66 rik kv ku5c d5t` ju1th COVID-19 te rvidivn kv t11 ju1thn5 k]kivn th5n n5 wen k` naath, duxdv f66 l``r kv ku5c ju1thn5 tin te th5n n5 wen k` U.S. J5 ju1th COVID-19 xot kv /k1n kv n5 lar.
What is added by this report?
Vxu ca mat th5ns v l``r vmv?
Based on preliminary U.S. data, persons with underlying health conditions such as diabetes mellitus, chronic lung disease, and cardiovascular disease, appear to be at higher risk for severe COVID-19–associated disease than persons without these conditions.
K` min ca nvn k` l``r5 ti tst titi k` U.S., nnath tin te kv ju1th k]kivn n5 wen cet kv juey thok22r mellituth, jey pu]]th m5 c5 j``ny, kv juey lsaac m5 c5 j``ny la jsc kv 5 b5 rivkdivn d5t kv juey COVID-19 kvn ju1th tin ca rs mat v b``l min tussk k` naath tin thil ju1th k]kivn n5 wen.
What are the implications for public health practice?
Kv xun5 la rik tin k]x t] k` ciaax pusl` pu11ny nath diaal?
Strategies to protect all persons and especially those with underlying health conditions, including social distancing and handwashing, should be implemented by all communities and all persons to help slow the spread of COVID-19.
C11p tin gax kv naath diaal kvn f66 v civk naath tin te kv ju1th k]kivn n5 wen kv kvn f66 cu]x kiv nyuur kv kam kvn l1k tetn5, ba kv dhil l1th l`t v w55 diaal kvn naath diaal kv f66 ba thi1x COVID-19 kv fsw xok.
Emergence of a Novel Coronavirus (COVID-19): Protocol for Extending Surveillance Used by the Royal College of General Practitioners Research and Surveillance Centre and Public Health England
Ben ju1th ksrsnabayr`th in rvl rs (COVID-19): Xut kv rep g1x ju1th k` US v Royal Kslij nath diaal tin xi``c kv kv g6r x`c` kvn mukt`p g1x ju1th kvvl kv mukt`p pusl` pu11ny k` England
The Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) and Public Health England (PHE) have successfully worked together on the surveillance of influenza and other infectious diseases for over 50 years, including three previous pandemics.
Vn Royal Kslij nath diaal tin xi``c kv kv g6r x`c` (RCGP) Thvntvr g7r` x`c` kv g1x ju1th (RSC) kvvl kv mukt`p pusl` pu11ny England (PHE) c5 kv l`t kv gu11thdv kvvl kv ciaax g1x ju1th yinpiluvndha kvn luex ju1thn5 k]kivn kv gu11th m5 b``l run t5 5o am`n5 ju1th di]k t22 pay we.
With the emergence of the international outbreak of the coronavirus infection (COVID-19), a UK national approach to containment has been established to test people suspected of exposure to COVID-19.
Kv ben ju1th kv thi1xdv kv fsw w55 nu]]n kvvliw vn luex ksrsnabayr`th (COVID-19), c1p wec UK kv ts1w ju1th cua jv l1t kv th2m nath tin ca diw 5 cv moc juey COVID-19.
At the same time and separately, the RCGP RSC’s surveillance has been extended to monitor the temporal and geographical distribution of COVID-19 infection in the community as well as assess the effectiveness of the containment strategy.
Kvn diaal kv gu11th kvl kiv g66l5, g1x RCGP RSC’s cuv we nhiam kv g1x ju1th kv pek in cv k`p rvi wec kv juey COVID-19 rvi wec kvvl kvn guec gssy` t]w` ju1tham`n5 c11p tin nax jv.
The aims of this study are to surveil COVID-19 in both asymptomatic populations and ambulatory cases with respiratory infections, ascertain both the rate and pattern of COVID-19 spread, and assess the effectiveness of the containment policy.
Vn lust g7r` x`c` nvmv v f66 ba COVID-19 gax k` naath tin te kv nyutthn5 kvn f66 ba tin te kv nyuuthn5 luex` l55k` nax dueelwal kv thurbivvl5, ba pek kvn p1t`n COVID-19 guic kv thi`ydv fsaa, ba gss t]w`dv guic b`.
The RCGP RSC, a network of over 500 general practices in England, extract pseudonymized data weekly.
Vn RCG RSC, v nvtw`k g7r` l1t k` naath diaal k` England t5 b``l 500, m5 g77r du]]p pseudonymaadhed l``r5 kv jusk.
This extended surveillance comprises of five components: (1) Recording in medical records of anyone suspected to have or who has been exposed to COVID-19.
G1x in ca rep t22 kv gu1th dhieec: (1) G]r piny rvi g]r piny` dueelwal kv naath diaal rtin ca diw 5 cv moc juey COVID-19.
Computerized medical records suppliers have within a week of request created new codes to support this.
L`th k` tin ca gs1r piny k` ksmputvr kv rvi jok` kvl kv thiec in ca xun kv ksdn5 tin pay tussk kv lu`k k` nvmv.
(2) Extension of current virological surveillance and testing people with influenza-like illness or lower respiratory tract infections (LRTI)—with the caveat that people suspected to have or who have been exposed to COVID-19 should be referred to the national containment pathway and not seen in primary care.
T5c jsk g1x bayrslsj5ksl vmv kvn th2m kv yinpiluvndha in cet kv juey kiv luex pivn l55k` (LRTI) - kv yuth piny g66ny` k` naath tin ca diw 5 cv moc juey COVID-19 ba jv nax kv du]]p t]w` ju1th in ca lar v wec k` trhil gu11th yoop` min tst.
(3) Serology sample collection across all age groups.
Ba naath diaal thvm kv pek run5 diaal.
This will be an extra blood sample taken from people who are attending their general practice for a scheduled blood test.
Vns bv dhil v rivk d]divn m5 k1n kv k` naath tin guur x55cdivn kv ciaax th2m rivm kv gu11th in ca lar.
The 100 general practices currently undertaking annual influenza virology surveillance will be involved in the extended virological and serological surveillance.
Dup x55c` d1x w`l tin te th5n t`mv kv ru]]n kv ku5c yinpiluvndha kv g1x v bayrslj5 ba kv mat th5n kv rep g1x bayrslsj5ksl serslsj5ksl.
(4) Collecting convalescent serum samples.
Ba conbalvthvn serum kv th2m.
We have the opportunity to escalate the data extraction to twice weekly if needed.
Te kvn kv bax kv kap nhial l``r5 jv jekdivn k` rvvw kv jusk m5 g77rv jv.
Swabs and sera will be analyzed in PHE reference laboratories.
Ithwab kvn thvra ba kv guic rvi PHI lab.
General practice clinical system providers have introduced an emergency new set of clinical codes to support COVID-19 surveillance.
C1p x55c` dueelwal kvvliw k` naath tin th6p jv ca c1p m5 pay tussk kv ciaax in rup-rup nyoth kv l1t ksdn5 dueelwal kv lu`k g1x COVID-19.
Additionally, practices participating in current virology surveillance are now taking samples for COVID-19 surveillance from low-risk patients presenting with LRTIs.
Nysk, x55cn5 tin te th5n t`mv k` bayrslsj5 kv g1x ju1th tussk kvn t`mv COVID-19 k` naath tin dak rivkdivn tin be kv LRTI.
Within the first 2 weeks of setup of this surveillance, we have identified 3 cases: 1 through the new coding system, the other 2 through the extended virology sampling.
Kv rvi juskn5 d1x 2 tin nhiam kv tuk g1x vmv, c1ks nvvy 3 jek. Kv du]]p ksdix` min pay tussk, ca 2 k]kivn jek kv k`n th2m bayrslsj5.
We have rapidly converted the established national RCGP RSC influenza surveillance system into one that can test the effectiveness of the COVID-19 containment policy.
C1ks jv r5t kv p0th vn RCGP RSC wec in ca l1t kv g1x yinpiluvndha kv c1p kvl m5 nyooth gssy puslth5k` t]w` ju1th COVID-19.
The extended surveillance has already seen the use of new codes with 3 cases reported.
Vn g1x in ca tiec jsk cv cop k` l1t kv ksdn5 tin pay tussk n5 wen k` nath d1x 3 t5 ca lar.
Rapid sharing of this protocol should enable scientific critique and shared learning.
Nyuaak kv psrstok77l derv b0l thanyt5pik dhil kvn x55c in nyuakv.
The Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) is a network of general practices (GPs) with a nationally representative population that provides pseudonymized data for weekly surveillance of infectious diseases.
Vn Royal Kslij nath diaal tin xi``c kv kv g6r x`c` (RCGP) Thvntvr g7r` x`c` kv g1x ju1th (RSC) kvvl kv mukt`p pusl` pu11ny England (PHE) c5 kv l`t kv gu11thdv kvvl kv ciaax g1x ju1th yinpiluvndha kvn luex ju1thn5 k]kivn kv gu11th m5 b``l run t5 5o am`n5 ju1th di]k t22 pay we.
The disease surveillance program is commissioned by Public Health England (PHE) and covers 37 infectious diseases, including influenza.
Psrg5r11m kv ciaax g1x ju1th ca jv moc yi7u v mukt`p pusl` pu11ny England (PHE) k` k``pv gu1th luex` t5 35 kv yinpiluvndha kvvl.
The RCGP RSC and PHE have an established collaboration of over 50 years in influenza and respiratory disease surveillance and are now in their 53rd season of surveillance and analysis.
Vn RCGP RSC kvn PHE ca l1t k00l mat rvi w55n5 t5 b``l 50 kv ku5c yinpiluvndha kvn ju1th l55k` kv g1xdivn k` vn t``mv k` 53rd d``k` ruun`divn kvn v g1x kvn guec ju1thn5.
The RCGP RSC extracts pseudonymized data from a nationally representative sample of over 500 urban and nonurban GPs each week covering a population of over 4 million.
Vn RCGP RSCg77r l``r5 k` th22mn5 tin ca jak` nyin wec k` r0k t5 b``l 500 kvn tin /c5 ts a r0k kv GPs kv jusk kvl la copv pek m5 bathdssr 4.
Data from these practices are reported online in a weekly return, which includes monitoring weekly rates of influenza-like illness (ILI) and other communicable and respiratory diseases in England.
L``r m5 be k` kvn dup x55c` titi ca jv lar snlaany k` luny jsk jok`, m5 te rvidv kv g1x kv jusk n5 ciax kv pek yinpiluvndha kv ju1th tin cet kv jv (ILI) kvn ju1th k]kivn tin la dsap kv k` li``k k` England.
We also produce an annual report.
C1ks l``r ruun` k1m raar b`.
The RCGP RSC data set includes all coded data and all prescribed items including vaccine exposure.
Kvn l``r5 te rvidivn kv ksdn5 kvn kuak diaal tin ca g]r kvvl kv wal.
The RCGP RSC conducts virology surveillance each influenza season, with 100 GPs participating in the 2019-2020 season (Figure 1).
Vn RCGP RSC l`tv g1x bayrslsj5 kv gu11th in la k`p kv yinpiluvndha kv ru]]n, kv GPs n5 100 t5 l`t kv ru]]n 2019-2020.
These virology sampling practices are also recruited to be nationally representative (Figure 1).
Kvn th1mpsl5 bayrsdlsj5 titi kvn b` ca kv kuany v la f66 b5 kv a nyin wec (Thurv).
GPs take nasopharyngeal swabs from persons showing acute respiratory illness within 7 days of the onset of symptoms.
GPs la naxv nasopharyngeal swabs k` naath tin cv moc kuey l55k` m5 rup-rup kv rvi n5n5 d1x 7 kv tuk nyuuthn5.
Nasopharyngeal swabs are taken from children younger than 5 years showing symptoms of acute bronchitis or bronchiolitis.
nasopharyngeal swabs la k1n kv kv k` gaat tin /ken runkivn 5 cop kvn naath tin tin jsc cet te kv nyuuthn5 t5 ru]p-ru]]p k` bronchitis kvn bronchiolitis.
Additionally, nasopharyngeal samples are taken from anyone 5 years and older showing acute onset of ILI and respiratory synctial virus.
Nysk, tin th0m kv k` nasopharyngeal la k1n kv kv k` naath diaal tin te kv run 5 v we nhiam tin jsc cet te kv nyuuthn5 tin ru]p-ru]]p nyin ILI kvn bayr`th l55k`.
Swabs are tested at the PHE Respiratory Virus Unit for influenza to monitor positivity rates and circulating strains, as well as for measuring vaccine effectiveness.
Ithwab n5 la th0m kvkv k` PHE pek bayr`th` l55k` kv ku5c yinpiluvndha kv g1x pusthvtib` kvn ithtvrvvn in j`l, kvvl kv th2m gssy` wal.
The RCGP RSC successfully conducted a pilot collecting serological samples from adults and linking them to a patient’s medical records during the 2018-2019 influenza season.
Vn RCGP RSC cv we v gsaa kv ru]l serolojiksl5 tin waa thvm k` naath tin d5t k` cv kv r6m kv j5 ju1th ti ca gs11r piny kv n5n yinpiluvndha kv 2018-2019.
This pilot was in collaboration with the PHE Seroepidemiology Unit and added to the residual blood samples submitted to PHE by National Health Service (NHS) laboratories.
Vn paylst vm cuv l`t kvvl kv PHE min l`t kv Seroepidemiology k` rivm in c5 dusth piny m1t PHE 2 ca k1n kv th2mv mukt`p pusl` pu11ny wec (NHS).
Serology can provide important information about background population immunity, and sentinel networks can provide a mechanism for systematic data collection and linkage to medical records and health outcomes.
Seroloj5 la xunvl``r b5 gsaa kv ciaax bum` pu11ny nath, kvn thvntinvl nvtw`k tin la xun c11p tin ciaax g7r` l``r5 kvn matdivn kv kv g]r piny kvn ben raar civvx` pusl` pu11ny.
The serology pilot has demonstrated the ability of the network to collect serology samples in adults.
Seroloj5 paylst cv jv nyoth vn lu1x nvtw`kn5 kv g6r l``r5 kv naath tin d5t.
With the COVID-19 outbreak, PHE and RCGP RSC have adapted existing influenza surveillance to monitor the spread of COVID-19 in the community, and this protocol sets out the basis for that collaboration.
Kn thi`y COVID-19 rvi fsaa, PHE kvn RCGP RSC ca ciaax g1x yinpiluvndha in wen dsp kv k`p cu]x thi`y`dv rvi fsaa vn COVID-19, k` psrstsk77l vmv cv gssy l1t k00l nyoth.
The primary national strategy for COVID-19 infection is containment, with patients who are at high risk managed via the telephone help system NHS111 and the PHE health protection teams, but the RCGP RSC surveillance is entirely separate.
C11p wec tin tsaatn5 tin nhiam kv ku5c t]w` ju1th COVID-19, k` j5 ju1th tin d5t rivkdivn tin yusp kv kv talvpoon kv ciaax c`p` lu1k NHS111 kvn PHE bun g1x pusl` pu11ny, duxdv f66 g1x RCGP RSC kvvliwdv v g6l.
The RCGP RSC, by extending its established work, will provide virological and serological surveillance to monitor the temporal and geographical distribution of COVID-19 infection in the community, and assess the effectiveness of the containment strategy.
Vn RCGP RSC, kv k1th in d]x, nvtw`kdv min cv l1t bv g1x virological kvn serological n66x kv k`p ju1th cu]x kv gu11th m6 tst k` fsw in cv thi`x vn COVID-19 rvi wec, k` guicv gssy t]w` ju1th kv c11p tin l1t jv.
We would not be working in isolation on this research.
C1ks b5 l`t g7l` kv jvn g6r x`c` nvmv.
We will share the protocol with UK colleagues and the I-MOVE consortium who have recently obtained EU Horizon 2020 funding from the stream “Advancing knowledge for the clinical and public health response to the novel coronavirus epidemic”.
B1ks psrstsk77l nyuak kv UK kvn I-MOVE ksnthsrtium min pay yi7u jek k` EU Horizon 2020 kv jvn itht5r55m‘ kv kap x`c` nhial kv ciaax dueelwal kvn pusl` pu11ny kv ri`t kv ku5c ksrsnabayr`th in c5 fsw thi`x.
It is anticipated that great efficiencies in project management will result through this collaboration than that obtained from countries acting alone.
Cv jssc vn gssy m6r5 d55t in b22 kv yu]p psrj0k` bv tussk kv jvn l1t k00l vmv v /c5 ms a f66 d22 jv jek k` w55 t5 l`t k`r].
The aim of this study is to identify whether there is undetected community transmission of COVID-19, estimate population susceptibility, and monitor the temporal and geographical distribution of COVID-19 infection in the community.
Min lot g6r x`c` nvmv jv v f66 bv jssc m5 t22 kv m5 /k1n nvn v wec kv ciaax in dsap kv juey COVID-19, ba thi1k wec kv d6p ju1th pekdv guic, k` ba pek in t22 th5n t``mv vn COVID-19 x1c rvi wec.
The objectives of this study are as follows:
L]tn5 g7r`` x`c` nvmv kvn tin:
To monitor the burden of suspected COVID-19 activity in the community through primary care surveillance and clinical coding of possible COVID-19 cases referred into the containment pathway
V f66 ba thiak f1c diw` COVID-19 rvi wec yu]th piny kv ciaax yoop` m5 tst kvn f66 ba ksdn5 dueelwal COVID-19 nax kv ciaax m5 ba kv t]w kv jv
To provide virological evidence on the presence and extent of undetected community transmission of COVID-19 and monitor positivity rates among individuals presenting ILI or acute respiratory tract infections to primary care
V f55 bathu]k bayrslsj5ksl5 kv kv ciaax d6p ju1th COVID-19 rvi wec kv pek in cv k`p rvi nath x`c kvn min /k1n jek k` naath tin te kv ILI kiv juey l55k` min rup-rup lu`x kv l1t gu11th yoop` min tst
To estimate baseline susceptibility to COVID-19 in the community and estimate both symptomatic and asymptomatic exposure rates in the population through seroprevalence monitoring
V f66 pek k22r` k` naath tin derv thi1k kv k1pdivn yu]th piny vn COVID-19 k` tin te kv nyuuthn5 kvn tin thil nyuuthn5 rvi nath kv ciaax g1x kv du]]p seroprevalence
To pilot implementation of a scheme for collection of convalescent sera with antibody profiles among recovered cases of COVID-19 discharged to the community
V f55 ba l1th l`t kv pek in ba l1t kv th2m convalescent sera kv antibod5n5 k` naath tin c5 x]]th kv juey luex` COVID-19 k` ca lomy dueelwal rvi wec ku2x piny
We intend to capture the following.
Min lust kv v f66 ba titi pekdivn jek.
Clinical workload related to reports of COVID-19 using the codes created to flag cases, those being assessed and where the infection is located are excluded (Figures 2-​-44)
Pek l1t dueelwal kv ciaax th7p` l``r` kv ku5c COVID-19 kv ksdn5 tin ca l1t kv b0r5, k` tin ca jek kvn gu11th te luex th5n in ca p1l (thurv 2--44)
Foreign countries visited in the last 28 days
W55 tin k]x tin ca gu5l kv n5n t5 28 t22 c5 we
Existing codes that may have utility (Tables 1-​-3).3).
Ksdn5 tin te th5n n5 wen d]x dee kv te kv c1p (tharbetn5 1--3).3).
Many GPs and primary care teams may not realize that important relevant data can be coded.
Gps n5 t5 xuan kvn ciaax yoop` min tst d]x /c5i kvnv ee x1c vn gssy l``r5 tin ca ksd.
There is also the potential during any pandemic to monitor the effectiveness of any transmission control measures.
T22 kv lu1x b` kv n5n thi`y` ju1th rvi fsaa kv g1x kvn gssydv m5 ca ciaax d6pdv kv naath gax.
Reliable coding of letters and test results that will show an infection has become either confirmed or excluded
Ksdix m5 gsaa kv b`n5 kvn ben th2m raar in b5 jv nyoth 5 ca luex t11dv th5n x`th kiv jv p1l raar
The methods will follow the approach used in the current influenza surveillance system and recent serology study, and includes five components: (1) primary care clinical surveillance; (2) virological surveillance; (3) population serological surveillance; (4) convalescent sera in cases; and (5) data curation.
Kvn c11p titi b5 kv gu]]rn5 du]]p in coth kv naath vn rvi g1x yinpiluvndhak` nvmv kvn g6r x`c` serology kv dup dhieec titi: (1) Ciaax yoop` min tst kv g1x ju1th; (2) g1x bayrslsj5ksl; (3) g1x pek nath kv serological; (4) v pek convalescent sera kvn (5) yoop l``r5.
The NHS uses the Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT) system of coding, which is normally only updated twice annually.
Vn NHS l`tv kv c1p Nomenclature Du22lwal kv Ri``t kv (SNOMED CT) kv c1p ksdix, min la l`t kv naath k` rvvw n5 wen kv ru]]n.
There was added complexity as some computerized medical record (CMR) suppliers use the Read coding systems (Read clinical terms version 3 – CTv3), which is no longer updated.
Cuv te kv mi xuan jidv m5 ca mat th5n kv f66 th11x l``r5 tin ca g]r kv ksmputvr (CMR) gu11th in b` xsaakn5 th5n la l`t kv c1p Kuen` Ksdix (kuen ri``tn5 dueelwal kv k1th in 3 – CTv3), in /k1n met nysk kv t5c nhial.
Additionally, there were no clinical codes to record COVID-19 in early February 2020.
Nysk, thilv kilin5ksl ksdix m5 ca gs1r piny kv ku5c COVID-19 kv tuk paay rvw 2020.
Therefore, the two main GP system suppliers added the five terms shown in Table 4 as system-wide local codes.
Kv f66 ns, kvn rvw tin nhiam k` c1p GP kv naath xun xsak ca dhieec mat k` tharbet in 4 kv f66 vn c1p cv d5t kv ksdn5.
A UK emergency release of SNOMED CT concepts for COVID-19 was also subsequently made available across all CMR systems (Table 4).
Uk kv ben raar civvx` min rup-rup SNCMED CT kv lu]]tn5 COVID-19 cuv jv jak` jsc b` v guurs k` CMR n5 diaal (Tharbet 4).
The intention is that these will eventually be mapped to the new SNOMED CT concepts as they become available, allowing recording of relevant data (Multimedia Appendix 1).
Min lust kv v f66 kvn titi ba kv mat kvvl kv rvi gu1th v la SNOMED CT m5 pay tussk, kv lu]]tn5 kv min c5 kvn jssc, bv g]r piny cu jak` we v gsaa (Multimedia Appendix 1).
The key requirements for this release were the ability to code (Table 4) a case of COVID-19, exposure to risk of infection (travel to an area where there may be a higher risk), contact with anyone infected with COVID-19, a report that a person had been tested for COVID-19, and that the disease had been excluded (likely a negative test).
Tin nhiam tin g77rv kv ben raar vmv v lu1x kv l1t ksdn5 (thatbet 4) kv ku5c COVID-19, jek kv naath vn rivk luex` (gu1th tin j1l kv v naath diaal tin cv moc juey COVID-19, lkv l``r m5 laar f66 ca raan thvm kv COVID-19, kvn f66 juey ca jv p1l raar) (kv theem m5 nsgvtib).
In addition, practices are now able to code any foreign travel undertaken, including the ability to record visits to multiple countries (implemented February 8, 2020).
V nyskb`, l`t tin l1tkv mooc kvn j1l m5 c5 raan we wec d]divn kvjv bivl, cuu am`n5 lu1x muc` gu`l w55n5 ti xuan bivl vnysk(l1th kvjv l`t kv pay rvw 8, 2020).
Figures 2-​-44 show the EMIS web implementation.
Thurv 2--44 nyoothv min caa l1th l`t k` wvp EMIS.
Currently, virology samples for influenza surveillance are accompanied by a standard request form.
Vn t`mv, Gu`c civx` xsaan5 tin laa j1kv k` b1yr]th inp5luvndha laa ka j1kv kvv wargak thiec` min x1ckv.
For COVID-19, we will create a new request form that will record:
Kvv COVID-19, b1kss wargak thiec` m5 mooc xsak bivl vnysk cak:
Date of onset of symptoms
C`x in p`l kv nyuuthn5
Diagnosis of any of the following:
Jek du]]r` kvl k` titi:
Acute bronchitis/bronchiolitis in those younger than five years
Juey m5 p0th m5 pu]t ciw-ciwn5 tin d5t/ciw-ciwn5 tin tsatn5 k` gaat tin /k`n run dhieec th5`x
Lower respiratory tract infection (LRTI)
Luex l55k` min tst (LRTI)
History of fever (Y/N); measured (Y/N); if yes, level
L0x leth` pu11ny (Y/N); m5 caa thvm (Y/N); m5 luscdv v h``, lar pekdv
Shortness of breath (Y/N), if measured: oxygen saturation and respiratory rate
Rooth y5eek`(Y/N); m5 caa thvm: lar pek skth5j55n` rvy rivm kvnv pek y5eek` kvv minit kvl
Recent travel (Y/N); if yes, countries visited in last 14 days
J1l kv n5n t5 th51k (Y/N); m5 luscdv v h``, w55 tin c5 raan kv gu5l rvy n5n5 d1x 14 tin c5 we
Contact with a named person with confirmed COVID-19 (Y/N) with a free text comment about the level of certainty
R6m kv ram caa c56tdv lat5 caa jek COVID-19 (Y/N) kvv wargak m5 caa pek x`th`dv g]1r th5n v lsr
These codes will be grouped ontologically into “definite”, “probable”, “possible”, and “not a case” using our standard approach to grouping codes (Table 5), which has been used previously across disease areas.
Kvn tin caa moc bivl tic caa kv d11k bu]n5 v luaayr7 5nv “juey m5 thu]k”, “juey m5 divwkv n5 jv”, “d]x dera juey”, kvnv “/ci juey” k` l0l kvkv kv du]]p mucda kv xsaan5 bivvl bun5 min x1ckv(tharb2t 5), min laa l`t kv naath n5 wen gu`thn5 ju1thn5.
The RCGP RSC definition for ILI is shown in Multimedia Appendix 2.
Lat lot` RCGP RSC kvv ILI caa jv nyoth k` Gu11th l``r5 apvndik 2.
Public Presentation of Data Using an Observatory and Dashboards
Nyu]th l``r5 v jsc k` j5 wec l`tjv m5 guvckv n1n kvnv candukn5 pu]t`l``r5
We will develop an observatory to present data nationally and a dashboard for feedback to practices about their data quality and collection of virology and serology samples.
B5 nvy m5 guvckv vn1n kvnv candukn5 pu]t`l``r5 t`th kvh66 baa l``r5 nyoth w5c kvv liw kv h66 bv tekv m5 lu]c kv nvy kv ku5c gssy` l``r5 kvnv ruul5 th2m b1yr]th` kvnv rivm in caa j1k.
This is based on coding described in Table 4.
Vn nvmv w22 kv t11 muc` xsaan5 bivvl in caa lat k` tharb2t 4.
Definite case will be presented on our dashboard as “cases” of COVID-19.
Juey m5 thu]k baa jv nyoth k` canduk pu]t` l``r5 vla “juey” COVID-19.
Possible cases will be presented as “Under investigation” (investigating).
M5 d]x dera juey baa jv nyoth5 “Te naath g6r`dv” (g6r kvjv).
“Not a case” will be presented as “Excluded”.
M5 /ci juey baa jv nyoth5 “caa t0m j]]r ”.
Online data has been established within the initial few weeks in the COVID-19 Observatory (Figure 5), indicating the overall number of patients and rate per 10,000 patients of cases confirmed or under investigation, as well as where the virus is excluded.
Caa l``r5 kvv intvrnvt yiathpiny rvy juskn5 t5 tst tin nhiam k` gu`c COVID-19 vn1n (thurv 5), m5 nyooth nsmbsr j5 tu1thn5 kvvliw kvnv pek in repvrs rvy j5 ju1thn5 t55 10,000 t5 caa jek juey kiv t5 g7r kv juey pu]]nydivn, cu am`n5 gu`th tin ca b1yr]th t0m j]]r th5n.
We have the option to move to twice weekly surveillance reports with a scope to change this to daily reporting.
Te nvy kv du]]p d]divn b` m5 de naath nax k` th7p l``r5 gu5c` civvx` ju1th k` rvvw kv jusk, m5 te rvydv kv th7p l``r5 kv c`x kv c`x.
We will continue virology sampling from our sentinel practices, rather than discontinuing as seasonal influenza declines.
B5 nvy xot kv m5 l`t nvy th2m b1yr]th` cetkv min te nvvks gu5c n5 wen, v /c5 msa h66 d2 k1p n5 jv cu]x cetkv min la inp5luvdha rssdv vxook kv gu11th rvy ruun`.
Additionally, we will recruit more surveillance practices.
Vnyskb`, b5 nvy l`t gu1c civx` ju1th t5 reepr7 mat th5n.
The RCGP RSC virology practices will aim to undertake 200-300 nasopharyngeal swabs per week across the RCGP RSC sentinel network, collecting specimens across all age bands.
L`t th2m b1yr]th` RCGP RSC lotvjv 5 bv k`k t5 200-300 t5 k1nkv wuum kvnv r7l kv jusk kv rvy nvtw`k` min te gu5c, k` ruulv tin caa j1k 5 baa we thvm k` bun r5cn5 diaal.
In addition to the inclusion criteria for influenza virology surveillance (ILI, acute bronchitis/bronchiolitis), participating practices will take nasopharyngeal swab samples from any people showing acute symptoms of LRTI if the onset of symptoms is within 7 days.
Min matkv k` tin g6rkv kv gu`c civx` b1yr]th inp5luvndha (ILI, juey mi p0th m5 pu]t ciw-ciwn5 tin d5t/ciw-ciwn5 tin tsatn5), v tin laa l1tkv kv k`n5 k``k tin waa thvm tin k1nkv wuum kvnv r7l nvvn5 t5 te kv nyuuthn5 LRTI t5 p0th, m5 p`l kvn nyuuthn5 titi rvy n5n5 d1x b1rsw.
RCGP RSC research officers and practice liaison staff will manage practices to achieve a total national sample of 200-300 swabs per week.
B5 l11t g7r` x`c` RCGP RSC kvnv l11t mukt`p` laythvn l`t tin l1tkv kvh66 baa pek k``k t5 200-300 t5 d22 thvm kv jusk w5c kvvliw lu`x kv cu]p yop.
This could be increased if PHE modelers require more samples.
Vn pek vmv d2 jv n5 rep m5 c5 naath tin rial kvv PHE 5k` pek in j1kv in waa thvm m5 lvm g7r.
Samples from each practice would be spread across the following age groups: &lt; 5 years, 5-17 years, 18-64 years, and 65 years and older
Tin caa j1k t5 waa thvm gu`th l`tn5 titi d2 kv d`k`piny rvy bun5 r5cn5 titi:&lt; run 5, run 5-17, run 18-64, am`n5run 65 v we nhiam
Samples (swabs or serum) collected will be sent via prepaid envelopes addressed to the appropriate PHE laboratory for analysis.
Tin caa ru]]l t5 waa thvm(k`k kiv rivm) baa kv j`k k` lab PHE in lotrs kvv yinbvl6p adurvvthk` m5 caa y57wkv yusrpiny n5 wen kvh66 baa rvydivn we guic.
All samples collected will be tested for the presence of influenza and COVID-19.
Tin caa ru]]l t5 waa thvm baa kv thvm m5 te rvydivn kv inp5luvndha kvnv COVID-19.
Additionally, PHE will retrospectively test any influenza virology samples collected between early and mid-February 2020 for COVID-19.
Vnysk b`, b5 PHE tin caa j1k kv th2m inp5luvndha b1yr]th` t5 ru]]lkv kv tuk vwe d``r pay rvw 2020 nysk kv th2m kvv COVID-19.
Practices will still follow the PHE protocol for COVID-19 with respect to people at risk of infection who should be signposted down the containment pathway, rather than physically attend their practice.
L`t titi b5 kv xot kv m5 guur kvn p5rst6k77l PHE kvv COVID-19 kv t11 nvvn5 tin de luex kv mal k`p, t5 d22 dhil moc thurv m5 caa pu1t dupn5 g1x d`k` ju1th piny, v /c5 msa h66 b5 ben n5 pu1nykivn kv guur5 l1tdivn.
Direct testing of those who attend surgery remains permitted, but we have also rolled out self-swabbing at home.
Th2m m5 lotn5 nvy tin waa rvt xotv nhsakjv, duxdv h66 c5 nvy th2m ran kvrs dhsrv lvp vlsr.
Summary of processes are detailed in Multimedia Appendix 3.
L``r m5 civk-civk kv ku5c dupn5 titi caa lat vjsc k` Gu11th l``r5 apvndik 3.
Everyone with an ILI or a respiratory illness who contacts a GP (eg, phones for an appointment) should be asked specifically about recent travel to China and other countries flagged in current PHE advice, or if they have had contact with other people with COVID-19.
N5 raan m5 te kv ILI kiv juey l55k` m5 c5 r6m kvv GP (cetkv, y]1t pussnk` kv lunydv duel w1l) baa jv dhil th5ec m5 cv we j1l k` Cvyna rvy n5n5 t5 th51k kvnv w55 tin k]x tin ca bil rvy ruac com` PHE vth51kv, kiv m5 cv te kvv r6m kv ram5d]x m5 te kvv COVID-19.
If these screening enquiries are positive, the patient would be advised to not come to the practice but instead to follow the PHE flow sheet.
M5 te th5ecn5 g7r` ju1th titi th5n k` jv,baa gu1n ju1th vms com kvk66 /cv b5 ben l`t duxdv h66bv gu]]r5 lu2y xsaan5 tinca g]r k` wargak PHE.
This can be by a reception or clinician staff, depending on individual practice protocol.
Derv l1t ram in te duel j11l5 kiv l``t du2l w1l, vwe kvvl kv t11 l1t pirst6k77l` nvvn5 t]t].
These calls should be coded into the GP CMR system and can be reported as part of the RCGP RSC weekly return.
Kvn y]1t pussn5 titi baa kv dhil muoc bivl rvy c`pk` GP CMR` baa kv we th6p vla l``r rvy l``r5 RCGP RSC tin laa n66xkv kv jusk.
We have developed training material to support this coding (Multimedia Appendix 4).
C5 nvy wargak x55c` m5 lu`k muc xsaan5 bivl vmv l1t (Gu11th l``r5 apvndik 4).
These include prompt cards for:
Vn nvmv matvv kat m5 th6pkv kv p0th th5n kv ku5c:
Practice reception or triage staff: for coding of any patients calling the practice with symptoms of acute respiratory infection with a history of travel to important areas based on PHE advice
Nvy tin l`t duel j11l5 kiv l11t tin la j5 ju1tn5 vlvvy: kv muc nvvn5 tin c5 y]1t gu11th l1t 5 te kvn kv nyuuthn5 luex` ju1th l55k` k` c5 we j1l gu`thn5 tin caa latv PHE kv bivl
Administrative staff or clinicians who code: to encourage consistent coding of results for any suspected cases, including coding of negative results for exclusion
L11t mukt`p` ruec` du2l w1l kiv k5mn5 tin mooc naath bivl: kvh66 baa jekn5 muc` nvvn5 tin divwkv 5 tekv juey bivl jak` we kv gu11thdv, v mat kvv muc jekn5 nvvn5 tin k1n jek juey bivl th5n kv tvmdivn j]]r
Practices participating in virology surveillance will opportunistically collect blood samples from patients coming into the practice for a routine blood test.
L11t tin l`t k` gu`c civvx` b1yr]th` b5 kvn k`n5 rivm m5 d2 thvm mat th5n k` j5 ju1thn5 tin be gu11th l1t kv th2m rivmdivn in wen.
Patients who attend their practice for a routine blood test will be asked to provide an additional sample for serology.
J5 ju1thn5 tin be gu11th l1t kv th2m rivmdivn in wen baa kv thiec kv th7pn5 rivm d]divn m5 d2 thvm.
We have conducted initial searches within the RCGP RSC database to look at the number of full blood count (FBC) results and overall rates in adults and children (Figures 6-​-9).9).
C5 nvy g6r l1t kvv nhiam rvy busk l``r5 RCGP RSC kv gu`c jekn5 kuen` nsmbsr5 th0l5 rivm diaal (FBC) kvnv r2pdivn kv r7 k` nvy tin d5t kvnv gaat tin tsatn5 (Thurv 6-​9).9).
An FBC is one of the most common tests performed, and we hope this will give an approximate indication of overall numbers of blood tests performed.
Vn FBC v kvl k` theemn5 tin laa malv l1tkv, guic nvyv 5 derv naath nyu]th nsmbsr m5 thieek kv pek rimn5 diaal tin caa thvm.
The sampling rate, per 100,000 patients was highest for children 15-17 years of age and 60 year or older in adults, with the lowest rates in children 0-4 years of age and 18-29 years of age in adults (Figures 6-​-99).
R2p xsaan5 tin waa thvm kvrs rvy j5 ju1thn5 t55 10,000d55tv vl7x k` gaat tin te kv run 15-17 kvnv run t5 60 vwe nhiam, k` pek in tst tusskv k` gaat tin te kv run 0-4 kvnv nvy tin d5t t5 te kv run 18-29 (Thurv 6-​-99).
We will provide 1000 serology baseline samples across all ages that reflect the varying rates of attendance by age.
B5 nvy xsaan5 tin d22 thvm k` rivm t5 1000 th6p vla tuk k` run diaal m5 nyooth pek t5 g66l kv run nvvn5 tin c5 ben.
Additionally, we will test if we can obtain these all from virology practices to enhance the yield.
Vnysk b`, b5 nvy kv thvm m5 jek nvy l`t th2m b1yr]th` r2p k` min d2 jek ` th2m.
A good geographical spread is important, so PHE can advise on areas where serology will most usefully be collected.
D`k piny ju1th m5 gsaa rvy k2thn5 v m5 bum-bum, kv ku5cv ms ku PHE naath com kv gu`th tin d22 rivm k1n th5n.
This will be followed by 800 samples monthly.
vn nvmv baa jv gu]]r kv j`kn5 tin th0mkv t5 800 kv pay.
The sample will be stratified with 200 specimens for prepandemic survey (100 for monthly) in the following age groups: &lt; 5 years, 5-17 years, 18-64 years, and 65 years or older.
K` ba tin caa j15 waa thvm d``k` gu`th t5 200 t5 guvckv v /ken juey fsw n5 thi`x(100 kv pay) k` bun run5 titi:&lt; run 5, run 5-17, run 18-64, kvnv run 65 vwe nhiam.
The younger patients, in many practices younger than 14 years, and in nearly all for children younger than 8 years will require pediatric serology surveillance.
J5 ju1th5 tin kuiy runkivn, rvy l`tn5 t5 xuan nvy tin daak run 14, am`n5 k` gaat t5 te piny run5 8 diaal m5 /ci jvn 5ns, g77rkvn gu`c ju1th kv rivm k` gaat.
We will develop a new request form for practices to capture recent travel and exposure to COVID-19.
B5 nvy wargak th5ec` l1t kv ku5c l`tn5 tin dee j1l rvy n5n5 t5 th51k kvnv jek ran kvv COVID-19 k`p.
We will pilot a scheme for collecting convalescent serology from people with confirmed cases and who have had an acute virology sample at the time of their infection.
B5 nvy thurv c`r5 l1t kv ruul5 rivm nvvn5 tin c5 x]]th tin caa jek juey kvnv tinte kvv b1yr]th m5 caa jek rvy k` min caa thvm vd5t kv gu11th 2 te kvkv kv luex.
This is to identify a carrier state in patients who have recovered from the virus but may continue shedding the virus.
Vn nvmv v ku5c x5`c ju1th k` nvy tin de juey rs t]w pu]]nydivn k` c5 x]]th duxdv h66 de kvn b1yr]th j`k` rar.
If there are a small number of cases, this may assist in developing a test kit for patients to take to their own GP and explore its acceptability to patients.
M5 kuiy nsmbsr ju1th, derv naath lu`k kv t1th yieth` th2m m5 de j5 ju1thn5 jv n6x GP k` bv jv we guic m5 derv rs lot kv j5 ju1thn5.
If there are a large number of COVID-19 cases nationally, convalescent samples could be collected from RCGP RSC practices where there are confirmed cases, with the ability to link to the full medical record.
K` m5 xuan nsmbsr ju1th COVID-19 rvy wec, d22 tin wa thvm k` nvy tin c5 x]]th k1n k` l`t RCGP RSC gu`thn5 tin ca juey jek th5n, k` te kv lu1x v n77xn5 nyin5 du2l w1l tin caa g]1rpiny.
This process may include checking pseudonymized NHS numbers for positive individuals at RCGP RSC practices, checking current PHE guidance regarding considerations of infectiousness for confirmed cases, and offering the patient an appointment following the previously mentioned process.
Vn nvmv lu`kv naath kvh66 ba c56t tin ca k1m nsmbsr5 NSH nyskv gu`c kv ku5c nvvn5 tin caa jek juey k` l`t RCGP RSC, m5 nysk tin b77th naath k` PHE vn t`mv kv gu`c k` t11 luex` ju1th k` nvy tin caa jek juey, k` moocv gu1n ju1th kv gu11th m5 bv weluny jsk kvjv cetkv min ca lat min daan.
This needs to be carefully coordinated nationally across the network and may require PHE to ensure individuals are not contacted by multiple agencies.
Vn nvmv g77rv h66 ba r6m rvy wec kvvliw tiit` k` nvtw`k, v d]x derv PHE g7r5 bvv x1c vgsaa 5 /ken raan r6m kv j5 mukt11p t5 xuan.
RCGP RSC could provide a useful structure to channel the initial contact once PHE has made a request.
Kv ksr k` min c5 PHE thiec, de RCGP RSC dup t5 caa nax vcux t5 gsw th6p.
The RCGP RSC practices participating in the annual influenza virology surveillance have started sampling from patients showing symptoms of a LRTI.
C5 l`t tin l1tkv vRCGP RSC k` gu`c civx` b1yr]th` inp5luvndha kv ru]]n jv tok5 b5 kvn j5 ju1thn5 tin te kv nyuuthn5 LRTI d11k.
All samples received are being tested for influenza and COVID-19.
Kvn xsaan5 diaal tin ca j1k kv th2m tin caa k1n, th0m kvkv kv inp5luvndha kvnv COVID-19.
The RCGP RSC will explore ways to collect convalescent samples from any patients tested positive for COVID-19 through the extension of the virological surveillance.
B5 RCGP RSC dup ruul5 xsaan5 tin caa j1k k` j5 ju1thn5 tin c5 x]]th, k` caa jek COVID-19 g7r kv r2pdv kv gu`c civx` b1yr]thk`.
From the start, we will be carefully curating data to ensure that it can be used for future studies.
V tvmv n5 vn t`mv b5 nvy l``r5ks jak` thu]kdivn kv x1th g7r` x`c` kv gu11th vb5 bens.
Our clinical data will be linked to virology.
K` b5 l``r5 du2l w1la r6m kv th2m b1yr]th`.
We will curate our data using the Findable, Accessible, Interoperable, Reusable principles.
B5 nvy l``r5ks jak` thu]kdivn kv xut k` h66 b5 nvykv jak` t5 d2 jek, t5 th51k jekdivn, t5 j2kv kamn5kivn, k` t5 de naath nyskv l`t kvkv.
To facilitate this our data set is listed with Health Data Research UK and the European Health Data Evidence Network.
Kvh66 b5 nvmv kulv wewe c5 nvy l``r5ks jak` luay kvvl kv l``r5 g7r` x`c` UK kvnv l``r5 nvtw`k` tin nyooth pualpu11ny k` j5 Yursp.
The statistical methodology is in support of a policy approach to widespread disease outbreak, where so-called nonpharmaceutical interventions (NPIs) are used to respond to an emerging pandemic to produce disease suppression.
Vn du]]p 5thtat5thik vmv lu`kv naath kv c1p in lotn5 kac raar d`k` ju1thpiny, gu11th in laa min csal5 tu]m ju1th vthivl w`l (NPIs) v l1tkv kvv lusc k` juey m5 th5``x hsw m5 b22, kv du`c ju1th piny.
This policy aims to reduce contact rates in the population and thereby reduce transmission of the virus.
Vn c1p vmv g77rv n5h66 bv pek in reep r6mrs kvjv xok rvy nath k` bv d6p b1yr]th` cu xok b`.