To understand the transmission dynamics of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) in a hospital outbreak to inform infection control actions.

Retrospective cohort study.

General medical and elderly inpatient wards in a hospital in England.

Coronavirus disease 2019 (COVID-19) patients were classified as community or healthcare associated by time from admission to onset or positivity using European Centre for Disease Prevention and Control definitions. COVID-19 symptoms were classified as asymptomatic, nonrespiratory, or respiratory. Infectiousness was calculated from 2 days prior to 14 days after symptom onset or positive test. Cases were defined as healthcare-associated COVID-19 when infection was acquired from the wards under investigation. COVID-19 exposures were calculated based on symptoms and bed proximity to an infectious patient. Risk ratios and adjusted odds ratios (aORs) were calculated from univariable and multivariable logistic regression.

Of 153 patients, 65 were COVID-19 patients and 45 of these were healthcare-associated cases. Exposure to a COVID-19 patient with respiratory symptoms was associated with healthcare-associated infection irrespective of proximity (aOR, 3.81; 95% CI, 1.6.3–8.87). Nonrespiratory exposure was only significant within 2.5 m (aOR, 5.21; 95% CI, 1.15–23.48). A small increase in risk ratio was observed for exposure to a respiratory patient for >1 day compared to 1 day from 2.04 (95% CI, 0.99–4.22) to 2.36 (95% CI, 1.44–3.88).

Respiratory exposure anywhere within a 4-bed bay was a risk, whereas nonrespiratory exposure required bed distance ≤2.5 m. Standard infection control measures required beds to be >2 m apart. Our findings suggest that this may be insufficient to stop SARS-CoV-2 transmission. We recommend improving cohorting and further studies into bed distance and transmission factors.

Internet addiction disorder is excessive computer use that interferes with daily life. There is debate over whether or not to include it as a diagnosis in the next DSM edition.

We present a case of a 24-year-old woman who although not meeting criteria for addiction was referred to our clinic due to excessive use of social networks which severely interfered her daily life.

A woman presented to our clinic accompanied by her parents because she had been spending approximately 5 hours/day checking her facebook webpage. She had subscribed to facebook 8 months before her examination and already had over 400 webfriends. During the previous 7 months, she ceased several of her activities, remained home most of the day in order to check her facebook and lost her job as a waitress because she repeatedly left her post in order to go to the nearest internet café. Noteworthy, during her examination she took out her mobile phone and tried to establish an internet connection and check facebook. On clinical examination mild anxiety, sleep disturbances were present, but she refused any further psychotherapeutic or pharmacotherapeutic help.

According to the prevailing view regarding addiction, facebook addiction can be considered as an “urge-driven disorder” with a strong compulsive component. Although our patient had been using internet for the past 7 years she had never been previously addicted to internet use. We suggest that facebook addiction may be another subcategory of the internet spectrum addiction disorders.