Tsioutis, Constantinos

2021-12, Ilias Gountas, Annalisa Quattrocchi, Ioannis Mamais, Eirini Christaki, Konstantinos Fokianos, Georgios Nikolopoulos, Tsioutis, Constantinos

Background: Cyprus addressed the first wave of SARS CoV-2 (COVID-19) by implementing non-pharmaceutical interventions (NPIs). The aims of this study were: a) to estimate epidemiological parameters of this wave including infection attack ratio, infection fatality ratio, and case ascertainment ratio, b) to assess the impact of public health interventions and examine what would have happened if those interventions had not been implemented. Methods: A dynamic, stochastic, individual-based Susceptible-Exposed-Infected-Recovered (SEIR) model was developed to simulate COVID-19 transmission and progression in the population of the Republic of Cyprus. The model was fitted to the observed trends in COVID-19 deaths and intensive care unit (ICU) bed use. Results: By May 8th, 2020, the infection attack ratio was 0.31% (95% Credible Interval [CrI]: 0.15, 0.54%), the infection fatality ratio was 0.71% (95% CrI: 0.44, 1.61%), and the case ascertainment ratio was 33.2% (95% CrI: 19.7, 68.7%). If Cyprus had not implemented any public health measure, the healthcare system would have been overwhelmed by April 14th. The interventions averted 715 (95% CrI: 339, 1235) deaths. If Cyprus had only increased ICU beds, without any social distancing measure, the healthcare system would have been overwhelmed by April 19th. Conclusions: The decision of the Cypriot authorities to launch early NPIs limited the burden of the first wave of COVID-19. The findings of these analyses could help address the next waves of COVID-19 in Cyprus and other similar settings.

2020-11, Tsioutis, Constantinos, Annalisa Quattrocchi, Ioannis Mamais, Eirini Christaki, Costas Constantinou, Maria Koliou, Zoi-Dorothea Pana, Valentinos Silvestros, Fani Theophanous, Christos Haralambous, Androulla Stylianou, Sotiroula Sotiriou, Maria Athanasiadou, Theopisti Kyprianou, Anna Demetriou, Christiana A. Demetriou, Ourania Kolokotroni, Ioanna Gregoriou, Niki Paphitou, George Panos, Leontios Kostrikis, Peter Karayiannis, Georgios Petrikkos, Petros Agathangelou, George Mixides, Georgios Siakallis, Linos Hadjihannas, Lakis Palazis, Anna Vavlitou, Chrystalla Matsentidou-Timiliotou, Dimitris Koukios, Tonia Adamidi, Frangiskos Frangopoulos, Elizabeth Constantinou, Georgios Nikolopoulos

Coronavirus disease 2019 (COVID-19) has significantly affected the well-being of individuals worldwide. We herein describe the epidemiology of COVID-19 in the Republic of Cyprus during the first epidemic wave (9 March–3 May 2020). We analyzed surveillance data from laboratory-confirmed cases, including targeted testing and population screening. Statistical analyses included logistic regression. During the surveillance period, 64,136 tests (7322.3 per 100,000) were performed, 873 COVID-19 cases were diagnosed, and 20 deaths were reported (2.3%). Health-care workers (HCWs) represented 21.4% of cases. Overall, 19.1% of cases received hospital care and 3.7% required admission to Intensive Care Units. Male sex (adjusted Odds Ratio (aOR): 3.04; 95% Confidence Interval (CI): 1.97–4.69), increasing age (aOR: 1.56; 95%CI: 1.36–1.79), symptoms at diagnosis (aOR: 6.05; 95%CI: 3.18–11.50), and underlying health conditions (aOR: 2.08; 95%CI: 1.31–3.31) were associated with hospitalization. For recovered cases, the median time from first to last second negative test was 21 days. Overall, 119 primary cases reported 616 close contacts, yielding a pooled secondary attack rate of 12% (95%CI: 9.6–14.8%). Three population-based screening projects, and two projects targeting employees and HCWs, involving 25,496 people, revealed 60 positive individuals (0.2%). Early implementation of interventions with targeted and expanded testing facilitated prompt outbreak control on the island.