Behavioural changes during the COVID-19 pandemic: Results of a nationwide survey in Singapore

INTRODUCTION@#As part of infection control measures for COVID-19, individuals have been encouraged to adopt both preventive (such as handwashing) and avoidant behavioural changes (e.g. avoiding crowds). In this study, we examined whether demographics predicted the likelihood that a person would adopt these behaviours in Singapore.@*METHODS@#A total of 1,145 participants responded to an online survey conducted between 7 March and 21 April 2020. We collected demographic information and asked participants to report which of 17 behaviour changes they had undertaken because of the COVID-19 outbreak. Regression analyses were performed to predict the number of behavioural changes (preventive, avoidant, and total) as a function of demographics. Finally, we sought to identify predictors of persons who declared that they had not undertaken any of these measures following the outbreak.@*RESULTS@#Most participants (97%) reported at least one behavioural change on account of the pandemic, with changes increasing with the number of local COVID-19 cases (@*CONCLUSION@#Our characterisation of behavioural changes provides a baseline for public health advisories. Moving forward, health authorities can focus their efforts on encouraging segments of the population who do not readily adopt infection control measures against COVID-19.

Atualizações no tratamento de bronquiolite viral aguda / Updates on acute bronchiolitis treatment

Bronquiolite viral aguda consiste em uma afecção viral que acomete lactentes com idade inferior a dois anos, sendo o pico de incidência abaixo de seis meses de vida. O quadro clínico consiste em sintomas de infecção de vias aéreas superiores, que evolui após dois a quatro dias com cansaço, dispneia, taquipneia, além de esforço respiratório. Febre e redução da aceitação da dieta também podem ocorrer. Apneia tem sido relatada em casos graves ou em prematuros. O diagnóstico baseia-se na história clínica e no exame físico, sendo exames complementares reservados quando há suspeita de outros diagnósticos ou de complicações. O tratamento é suportivo, sendo a oxigenoterapia indicada para pacientes com saturação de oxigênio abaixo de 90%. Atualmente, o corticoide oral não tem indicação no tratamento. Broncodilatadores não são indicados de rotina e o uso da salina hipertônica é controverso. O antiviral, ribavirina, tem indicação em casos específicos, devido aos efeitos adversos e ao alto custo. A profilaxia da BVA é fundamental, sendo a lavagem das mãos e o uso de álcool, de máscaras e de luvas essenciais para prevenção da doença. Como medicação profilática, o palivizumabe é indicado apenas em casos selecionados.(AU)

Acute bronchiolitis consists of a viral infection that affects children younger than 2 years old, with the peak of incidence under 6 months. The clinical disease has symptoms of infection of the upper airway, which develops after 2-4 days with fatigue, dyspnea, tachypnea, and respiratory effort. Fever and reduction of dietary compliance, may also occur. Apnea has been reported in severe cases or premature. The diagnosis is based on clinical history and physical examination, reserved additional tests when there is a suspicion of other diagnoses or complications. Treatment is supportive, the oxygen therapy is indicated for patients with oxygen saturation under 90%. Currently, oral corticosteroids has no indication for the treatment. The use of bronchodilators is not routinely indicated and the use of hypertonic saline is controversial. The use of the antiviral ribavirin is indicated in specific cases because there are adverse effects and high costs. Prophylaxis of bronchiolitis is fundamental, and hand-washing, use of alcohol, use of masks and gloves are essential for disease prevention. The use of palivizumab is indicated in selected cases.(AU)

Hand-washing Practices in Health Care Workers.

The care provided to a patient in a hospital has to be curative as well as preventive. The curative aspect deals with the disease with which the patient was admitted to the hospital; while the preventive aspect deals mainly with prevention of nosocomial infections to the patient. Various bio-safety measures, which prevent disease transmission to health care workers and to the patients as well, are in vogue. The most widely used is the ‘Universal Safety Precautions’ (USP)1. Preventing the transmission of the diseases from Health Care Workers (HCWs) to patient or from patient-to-patient is one of the responsibilities of the Health Care Setup. To achieve this, adherence to universal safety precautions is necessary. The first and foremost principle of USP IS “HANDWASHING”. Even though hand-washing has been recognized as a single most effective measure to prevent the spread of infections since more than 150 years, the present scenario is very bleak. The compliance of hand washing is found to be quite variable and unsatisfactory, even in western countries. The experts in infection control coax, cajole, threaten and plead, but still their colleagues neglect to wash their hands. To assess and rectify, such pathetic attitudes and practices, the present study was conducted to assess the compliance and practice of hand washing in all health care personnel; as the saying “self analysis or introspection is the secret of success” holds good as much as for an institution or a system as for an individual.