The psychosocial experiences of healthcare workers (HCWs) during COVID-19 quarantine: a qualitative study.

Purpose: Healthcare workers (HCWs) are more than others likely to be exposed to a viral overload regardless of the protective equipment and systems. Recent studies have reported that quarantine time is stressful for healthcare workers. We explored the impact of quarantine time as an external stressor on distress, sleep, healthy lifestyle behaviors, and familial relations among HCWs during the COVID-19 pandemic. Methods: A surgery team (n = 12) were working on a patient with confirmed thyroid cancer. This team was quarantined for 14 days as per the criteria of the local health government after the patient tested positive for COVID-19. We included and interviewed this team through a purposive technique in this qualitative study in Iraqi Kurdistan in 2020. Using the Graneheim and Lundman method, we analyzed the data via thematic content analysis with a deductive approach. Results: The participants experienced distress with mental health burdens during these difficult times. Some of them had to stay away from their families and friends for the first time. The first and last days were stressful for them due to fear of infection. The HCWs attempted to maintain their healthy lifestyles, including getting sufficient sleep, reducing stress levels, and creating a positive relationship with their families. The HCWs used the following coping strategies to alleviate the effects of COVID-19: beliefs, habits, and familial support. Familial and social support were their main strategies for maintaining a healthy lifestyle. The intensity level of familial and social relations was found to be a positive experience for HCWs during this stressful period. Conclusions: This study showed that HCWs experienced psychological stress during the quarantine time of the COVID-19 outbreak. The HCWs' quality of sleep was affected adversely along with negative effects on their lifestyles. However, the level of support from familial and social relations increased during the COVID-19 outbreak. This was the major means for them to deal with stress during this difficult time of their lives.

Receiving COVID-19 vaccine, hospitalization, and outcomes of patients with COVID-19: A prospective study.

Despite Iraq having started the COVID-19 vaccine in January 2020, there is no official data on vaccination and hospitalization across the country. We aimed to explore the role of the COVID-19 vaccine on the hospitalization and outcomes of patients with COVID-19 in Iraqi Kurdistan. In this prospective study, patients who were admitted to two COVID-19 hospitals in Iraqi Kurdistan in 2021 were followed-up by the discharge time between August and November 2021. The mean age of the patients was 57.6 (27-98 years) of both genders. Most of the patients were illiterate (69.3%) or had a lower level of education (20.5%). A small percentage of patients had previous thrombotic disorders (4.7%) and close to half of the patients had chronic diseases (44.9%). The patients had mild to moderate (44.9%), moderate-severe (36.2%), and critical (18.9%) status. The median hospitalization day was 9 days (1-45 days). The study found that 91.3% of the COVID-19 hospitalized patients did not receive the vaccine and 26.8% of patients died. We did not find a significant association between receiving vaccination and patients' outcomes or disease severity. No patients with previous thrombotic disorders received the COVID-19 vaccine. The male patients were more likely to receive the COVID-19 vaccine compared to female patients; 14.55% vs. 4.17%, p=0.0394.  This study showed that most patients with COVID-19 who were admitted to the hospitals have not received the COVID-19 vaccine. A high percentage of the COVID-19 hospitalized patients died of the disease in this region.

The Impact of COVID-19 on Individuals and Communities Through the Lens of a Kurdish Artist: A Narrative Inquiry Study.

The COVID-19 pandemic affects individuals and society at different levels. For a brief period during the pandemic, the Kurdish government closed all governmental organizations and interconnected routes, except for medical and security settings, and announced a curfew. In this article, we portray the effects of the pandemic on individuals and communities from an artist's view through an art-based narrative inquiry. Narrative analysis is used for analyzing texts or visual data in story form. It describes the life experiences of individuals and the environment in which they reside. Data came from the observations and experiences of the first author during the time he conducted research regarding the impacts of COVID-19 on different aspects of the Kurdish community in the Kurdistan Region through our previous research. The images and stories show that individuals feared COVID-19 and struggled to protect themselves from infection. They faced prolonged social distancing, quarantine, and complete lockdown and lost their family members and loved ones-their relationships with family members and others were disrupted during the pandemic. Additionally, vulnerable groups, such as children and older adults, have been especially affected psychologically during the COVID-19 pandemic. We suggest that the pandemic has affected different groups of people and impacted the health security of Iraqi Kurdistan society. Our findings add a conceptual understanding of the health threat of the pandemic that can be used to implement health services and health policy for individuals and communities in Iraqi Kurdistan.

The lived experience of hospitalized and non-hospitalized health care providers of COVID-19 pandemic: A qualitative study.

This paper explores the lived experience and any mental health issues of COVID-19 survivors throughout the disease crisis using a qualitative method. The semi-structured interviewing method was conducted with COVID-19 patients who were admitted and non-admitted to hospitals in Kurdistan, Iraq. The patients had positive and negative perceptions of the COVID-19 pandemic and disease including beliefs and thoughts about COVID-19, conspiracy thinking, and concerns toward the family and their children. The patients were affected by the disease in different ways including physical consequences of COVID-19 infection, social isolation, life changes, and mental wellbeing. But they had some coping strategies to overcome the disease such as seeking help, preventive measures, and coping techniques. The patients had some concerns about health settings and therapeutic procedures including lack of sufficient care, receptiveness, hospital environment, and infection guidelines. This study showed that the COVID-19 disease had devastating effects on patients either physically or psychologically.

Role of biomedical measurements on severity and outcomes of patients with COVID-19 infection: A retrospective follow-up study

Background: The clinical manifestations and laboratory biomarkers in the 1st week of the disease course may impact the patient’s final clinical outcome. Aims and Objectives: In this study, we aimed whether biomedical measurements at the early stage can predict the severity and outcomes of patients with COVID-19. The patients aged 18 years and older who were diagnosed with COVID-19 by the internist met the initial eligibility criterion. The patients with medical records of the laboratory indicators and clinical outcomes were included in this study. Materials and Methods: In this retrospective follow-up study, 155 clinically ill patients with COVID-19 were followed up until recovery and death from the disease. Results: The average age of the COVID-19 patients was 49.7 (Sta. deviation: 16.6) aged between 18 and 90 years. The patients had mild severity of disease (67.10%) followed by moderate (19.36%), severe (7.74%), and critical (5.81%). The study found that 6.45% (n=10) of the patients died and 93.55% (n=145) were recovered from the disease. The concentrations of C-reactive protein (CRP), D-dimer, ferritin, lactate dehydrogenase (LDH), lymphocytes, and white blood cell were increased with increasing severities and in dead patients. D-dimer and CRP were the main contributing factors to the higher severity of disease and mortality among COVID-19 patients. The contributed symptoms to disease severity were diarrhea, epigastric pain, shortness of breath, headache, and fever. The higher LDH and being male were contributed to higher disease severity. Conclusion: This study showed that CRP and D-dimer are the main factors contributing to the severity and mortality among COVID-19 patients. [ FROM AUTHOR] Copyright of Asian Journal of Medical Sciences is the property of Manipal Colleges of Medical Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Clinical and epidemiological characteristics and outcomes of Coronavirus disease-19 patients in a large longitudinal study.

OBJECTIVE: This study aimed to determine the clinical and epidemiological characteristics and outcomes of Coronavirus disease (COVID)-19 patients. METHODS: In this large cohort study, 15,409 confirmed patients with the COVID-19 of different severities were followed-up from three specialized COVID-19 hospitals between March 18 and October 11, 2020 in Iraqi Kurdistan. The predictors of mortality and severity were examined in binary logistic regression analysis. RESULTS: The incidence rate of severe/critical status was 12.3% with a median age of 36.0 and case fatality rate (CFR) of 1.98%. The incidence rate of severe/critical conditions and CFR rose with increased age groups; except for 0-14 years (11.9%). The incidence rate of severe/critical patients and CFR was 8.3% and 0.5%, 21.1% and 4.0%, and 23.7% and 8.7% in 15-49 years, 50-64 years, and 65 and older age groups, respectively. The severity of the disease and CFR was associated with coexisting chronic diseases such as cardiovascular diseases (18.2% and 3.1%) and diabetes mellitus (19.8% and 3.4%). The asymptomatic patients (8400 and 54.5%) had statistically higher CFR; 2.3% versus 1.6% (P = 0.006). The most common symptoms on diagnosis were fever (31.9%), cough (23.5%), loss of smell/taste (16.3%), sore throat (15.7%), shortness of breath (9.8%), and headache (9.5%). The results showed that being older was the only predictor of mortality and severity in COVID-19 patients. CONCLUSIONS: This region has a low incidence of severe-critic status and CFR. The patients with coexisting medical conditions are more likely to have severe conditions and die of COVID-19. The older age predicts severe/critic status and higher CFR.

Response of the Public to Preventive Measures of COVID-19 in Iraqi Kurdistan.

OBJECTIVES: On March 1, 2020, the Kurdistan Region Government (KRG) announced 4 confirmed cases of coronavirus disease (COVID-19). We aimed to explore the response of the public toward the prevention principles against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. METHODS: The investigators invited individuals from different geographic areas of Duhok Governorate of Iraqi Kurdistan in March 2020. RESULTS: The mean age of the participants was 25.74 (16-95 years). The mean score and prevalence of fear toward SARS-CoV-2 infection was 4.40 of 10 and 81.9%, respectively. A small percentage of participants did not minimize their exposures by reducing close contacts and transmission of respiratory droplets (14.5%) and visited public areas during the epidemic (28.7%). The study revealed that 30.8% of the participants do not use face masks or tissues when they sneeze in public areas. Most of the participants wash their hands when they suspect a possible transmission of the SARS-CoV-2 pathogen (94.6%) and clean or disinfect pathogen contamination-suspected areas at home (84.6%). The study also revealed that some participants (11.2%), due to a lower education, did not visit a medical clinic when they experienced possible symptoms of SARS-CoV-2 infection. Participants agreed with the health policies of KRG against the COVID-19 outbreak (90.8%). CONCLUSIONS: Some individuals do not adhere to preventive measures against SARS-CoV-2 infection.

Prevalence and correlates of COVID-19 vaccine hesitancy in the general public in Iraqi Kurdistan: A cross-sectional study.

Low vaccine acceptance is a major barrier to vaccination coverage in every health system. This study aimed to explore the prevalence and associated factors of the COVID-19 vaccine hesitancy in a sample of the general population in Iraqi Kurdistan. The general population with both genders with different educational levels and sociodemographic characteristics from the Duhok governorate was eligible to participate in this cross-sectional study in 2021. Therefore, an online Google form was sent to main pages and social groups through two main social media platforms. To obtain a representative sample of individuals with different educational levels, the author visited the main shopping center in Duhok city to collect the information from illiterate and low-level education individuals. The study found that 83.5% (n = 773) of the participants have not received and 51.4% (n = 476) did not intend to receive the COVID-19 vaccine. A small percentage has not decided to receive a COVID-19 vaccine yet (n = 17, 1.8%). The intention to receive a COVID-19 vaccine was increased with increasing level of education; 25.9%, 26.7%, 39.8%, and 53.6% in illiterate, under high school, high school, and college and higher, respectively (p < 0.0001). Healthcare workers were more likely to intend to receive a COVID-19, 57.5% vs 40.1%, p < 0.0001. Individuals who had concerns about the side effects of a COVID-19 vaccine were more likely to not receive and not intend to receive the COVID-19 vaccine. Prevalence of COVID-19 vaccine hesitancy was high in this region and was correlated with lower education and concerns about side effects.

The Response of Medical Doctors and Hospital Administration to Infection Prevention and Control in the Health Care of Suspected/Confirmed COVID-19 Patients.

The outbreak of novel coronavirus infection emerged in and spread from China to other countries. Health care workers are at significant risk of infection from this virus in medical settings. We aimed to explore and evaluate the response of medical doctors and hospital administration to infection prevention and control of suspected or confirmed COVID-19 patients. METHODS: This cross-sectional study included 108 doctors who had exposure to suspected/confirmed COVID-19 patients in public hospitals. RESULTS: The doctors were aged 24 to 53 years, working in general hospitals (72.2%), primary health centers (23.1%), and a special coronavirus hospital (4.6%). One third (33.3%) reported that their hospitals had established a clinical triage station at the entrance to the facility. Suspected COVID-19 cases were immediately placed in an area separate from other patients (63.9%). The doctors ensured that patients covered their nose and mouth with a tissue to cough or sneeze (53.7%), and they performed hand hygiene after patient contact (98.1%). A medical team designated to care exclusively for suspected or confirmed COVID-19 cases was reported by 50.9%. The screening equipment was shared among patients (56.5%). The doctors avoided moving and transporting patients out of their room or designated area (83.3%). Many hospitals (76.9%) limited the number of medical staff and visitors who come in contact with suspected or confirmed patients. Most hospitals (72.2%) did not have a surveillance process for acute respiratory infections. Only 51.9% reported that staff collecting specimens used appropriate personal protective equipment. CONCLUSIONS: The doctors reported that we adhere to infection prevention in providing health care, in contrast with hospital administration.

Experiences of nurses amidst giving care to COVID-19 patients in clinical settings in Iraqi Kurdistan: A qualitative descriptive study.

AIM AND OBJECTIVE: We explored the experiences of nurses who cared for coronavirus disease 2019 patients in Iraqi Kurdistan. BACKGROUND: Nurses play a major role in response to pandemics and epidemics in delivering patient care. The experiences of nurses who provided care have significant short and long-term consequences for individuals, communities, and the nursing profession. METHODS: Descriptive qualitative research approach was adopted in this study. We interviewed 12 nurses (22-50 years) who cared for the coronavirus disease 2019 patients in one of the clinical units of two coronavirus disease 2019 hospitals in Iraqi Kurdistan in 2020. Interviews were conducted via phone calls and were analysed using the thematic analysis method. The Consolidated criteria for reporting qualitative research checklist was applied when constructing this paper. RESULTS: The nurses had to care for a number of situations during the outbreak of coronavirus disease 2019 in Kurdistan. As people in the public did not believe that there was such a virus, nurses often had to deal with this lack of knowledge and aggression from some patients and their family members. Most nurses changed their preventive behaviours since the coronavirus disease 2019 outbreak at hospital or in public. This was mainly to protect not only themselves but their patients, colleagues, family members and friends. They were cautious about the use of a mask at the hospital and in public. Most nurses experienced fear, stress, anxiety and isolation during this period. CONCLUSIONS: The patients had some concerns about their health and staying at hospitals, and some of them had aggressive behaviours towards nurses at corona hospitals. The public, close friends and relatives of the nurses had a fear of getting the infection by the virus through the nurses. However, the nurses attempted to protect themselves, colleagues and family members, and provide the best care to coronavirus disease 2019 patients. The nurses had a high obligation towards care giving at hospitals. RELEVANCE TO CLINICAL PRACTICE: The negative experiences of the nurses regarding the care of coronavirus disease 2019 patients must be considered in clinical settings. Sensitive policy programs must be established to protect nurses from the ostracization and stigmatization of the coronavirus disease 2019 pandemic and to allow them to be able to achieve their professional practices safely.

Relation of Dietary Factors with Infection and Mortality Rates of COVID-19 across the World

OBJECTIVE: Poor dietary habits are considered to be the second-leading risk factors for mortality and disability-adjusted life-years (DALYs) in the world. Dietary patterns are different based on cultural, environmental, technological, and economic factors. Nutritional deficiencies of energy, protein, and specific micronutrients have been shown to contribute to depressed immune function and increased susceptibility to infections. We aimed to explore the relation of dietary factors with global infection and mortality rates of COVID-19 in this study. DESIGN: In the current ecological study, the countries that had national dietary data from the Global Dietary Databases of the United Nations and Coronavirus disease statistics from the World Health Organization (WHO) were included. The countries that had Coronavirus disease statistics from the WHO were consecutively checked for the recent data of the dietary factors. SETTING: World. PARTICIPANTS: 158 countries across the world. MEASUREMENTS: infection and mortality rates of COVID-19;dietary factors. RESULTS: The median crude infection and mortality rates by COVID-19 were 87.78 (IQR: 468.03) and 0.0015 (IQR: 0.0059), respectively. The two highest percentage of the crude infection rate were between 0 and 500 (75.9%) and 500–1000 (8.9%) per one million persons. The regression analysis showed that the crude infection rate has been increased by raising consuming fruits (Beta: 0.237;P=0.006) and calcium (Beta: 0.286;P=0.007) and was decreased with rising consuming beans and legumes (Beta: −0.145;P=0.038). The analysis showed that the crude mortality rate was increased by raising consuming sugar-sweetened beverages (Beta: 0.340;P<0.001). Whereas, the crude mortality rate by COVID-19 has been decreased by increasing fruits consuming (Beta: −0.226;P=0.047) and beans and legumes (Beta: −0.176;P=0.046). CONCLUSION: The present study showed the higher intake of fruits and sugar-sweetened beverages had a positive effect on infection and mortally rates by COVID-19, respectively. In contrast, the higher intake of beans and legumes had a negative effect on both increasing infection and mortality rates.

Public Opinions and Conspiracy Thinking Toward the COVID-19 Outbreak in Iraqi Kurdistan.

OBJECTIVE: The public's perceptions toward the COVID-19 crisis and the government's attempts to handle the crisis are critically noteworthy. The public opinions toward the COVID-19 crisis were explored in this study. METHODS: In this report, 1102 participants were included from 2 popular social media platforms from the Duhok Governorate in Iraqi Kurdistan between June 2 and 22, 2020, through an online technique. RESULTS: The study revealed that 14.0% of the participants believed that there is no COVID-19 in this region, and 20.1% had no concerns about the disease spread. This study revealed that 27.4% had conspiracy thinking about the COVID-19 outbreak, including that the outbreak is a plot against/of the Kurdistan Region Government, 16.4% and 19.3%, respectively. The outbreak caused considerable changes in participants' lives (85.8%). The participants who had conspiracy thinking were younger (27.0 vs 30.0; P = 0.001) and had a higher level of education (37.50% high school and under, 26.0% college and above, 16.2% illiterate: P < 0.001). In addition, they had a private job (43.7%), and were unemployed (23.9%; P < 0.001), and had negative views on the TV information (38.9% vs 17.5%; P < 0.001). CONCLUSIONS: A considerable percentage of the public exhibits conspiracy thinking toward the COVID-19 crisis in Iraqi Kurdistan.

Exploration of Association Between Respiratory Vaccinations With Infection and Mortality Rates of COVID-19.

OBJECTIVE: Respiratory disease vaccines may affect coronavirus disease 2019 (COVID-19) - associated infection and mortality rates due to vaccine nonspecific effects against viral infections. We compared the infection and mortality rates in relation to COVID-19 between countries with and without universal respiratory disease vaccine policies. METHODS: In this ecological study, 186 countries with COVID-19 statistics from the World Health Organization (WHO) were included. RESULTS: The study found that countries with universal BCG (bacillus Calmette Guérin) vaccine had significantly lower total infection and mortality rates, 0.2979 and 0.0077 versus 3.7445, and 0.0957/1000 people and confirmed cases (P < 0.001). The countries with universal pneumococcal vaccine (PCV), including PCV1, PCV2, and PCV3 vaccines, had significantly higher total mortality, 0.0111 versus 0.0080, respectively (P = 0.032). Higher income was associated with increasing total infection and mortality rates. Whereas, BCG vaccination was associated with a lower total mortality rate only (P = 0.030). The high-income countries were more likely to not receive universal BCG and receive second dose of meningococcal conjugate vaccine (MCV2) and third dose of PCV3 vaccination coverage. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection rates increased with increasing years of the second dose of measles-containing vaccine (P = 0.026) and pneumococcal conjugate third dose (PCV3). CONCLUSIONS: This study suggests that BCG vaccination could reduce the infection caused by COVID-19, and MCV2 vaccine years increases the total infection rate. This study identified high economic characteristics and not having universal BCG coverage as the independent risk factors of mortality by multivariate analysis.

The consequences of the COVID-19 pandemic on perceived stress in clinical practice: experience of doctors in Iraqi Kurdistan.

Introduction. The healthcare workers are at high risk of developing stress-related problems during outbreaks. This study aimed to explore the perceived stress and its relation to the duration of dealing with COVID-19 patients in medical doctors.Methods. The doctors who work in different medical settings in Iraqi Kurdistan during coronavirus outbreak were invited into this cross-sectional study. The doctors were invited from one pediatric, one emergency, one special corona, and one maternity and gynecology hospital. The "Perceived Stress Scale-10 (PSS)" measured the perceived degree of a doctor who experienced stress. The information was collected through a web-based technique to avoid the disease spread.Results. Doctors' mean duration of dealing with suspected/confirmed cases of COVID-19 was 1.2 (Range: 0-16 days). The mean stress score was 18.81 out of 40. Most of the doctors had a moderate level of stress (69.4%), followed by a low (21.1%) and a high level of stress (9.6%). The general physicians and medical lab specialties had higher stress scores; 21.56 and 19.88, respectively. The high level of stress was among general physicians and community and family medicine doctors; 20.0% and 25.0%, respectively. Whether or not doctors dealt with suspected/confirmed cases of COVID-19, did not have a significant difference over the perceived stress score; 19.02 vs. 18.87; P = 0.786). The mean score of stress was raised with increasing duration of dealing with suspected/confirmed cases of COVID-19; r = 0.202; P = 0.004 and decreased with increasing age (r = -0.141; P = 0.045), and clinical experience (r = -0.139, P = 0.048).Conclusion. This study showed that medical doctors are at a moderate level of perceived stress during the COVID-19 outbreak in Iraqi Kurdistan.

Psychological response of children to home confinement during COVID-19: A qualitative arts-based research.

BACKGROUND: The evidence has shown that children are more susceptible to the emotional effects of traumatic events such as outbreaks with the possible disruption in their daily lives. AIM: In this paper, we discussed the psychological wellbeing of children during the COVID-19 outbreak through the art-based qualitative study using the drawing method among children in Iraqi Kurdistan. METHODS: In this qualitative arts-based research study, 15 children aged 6 to 13 years old who were confined at home during the COVID-19 outbreak for at least 1 month were included following obtaining the consent from their parents. The children were asked to draw his/her feelings, reflections, and responses during the COVID-19 on a paper. The children were guided to paint their reflections during the COVID-19 based on the following criteria: if they experienced loneliness, tiredness, insomnia, depression, worry or anxiety, or have behavior changes and their relationship with their parents and other siblings. RESULTS: This study showed that children have a high level of stress at home during the COVID-19 outbreak. The children had great fear about the coronavirus. They experienced loneliness and stress, and felt sad, depressed due to home confinement and social distancing. The possibility of infection by coronavirus has occupied their entire mind. Mental health care providers must take the experiences of children who are caught in this global pandemic seriously and ensure that appropriate care is offered to the children and their parents. CONCLUSIONS: The children exhibited a strong feeling of distress, loneliness, and fear during the COVID-19 outbreak. This has implications for mental health care.

Insomnia and stress of physicians during COVID-19 outbreak.

BACKGROUND: Healthcare workers are at high risk of developing sleep disorders during an outbreak. This study aimed to measure severity of sleep difficulty and its correlation with duration of deal with suspected/confirmed cases of novel coronavirus (COVID-19) in physicians. METHODS: In this cross-sectional study, 268 physicians from different medical settings were included during the COVID-19 outbreak. RESULTS: The mean age and experience of physicians were 35.06 (33-70 years) and 10.13 years. The median duration of dealing with suspected/confirmed cases of COVID-19 was 1.0 (0-30 days). The mean sleep score and stress of physicians were 8.43 of 24.0 and 4.20 of 10, respectively. More than two-thirds of the physicians were sleepless (68.3%) and majority had stress (93.7%). The study did not find a significant difference in sleep score of physicians with different specialties (P = 0.059). However, most physicians were sleepless; including anesthesia and intensive care (77.8%); general physicians (80.8%), and obstetrics and gynecology (80.0%). They were sleepless in morning (58.7%); evening (77.8%); night (100%); and multi-shift (70.9%). The physicians who dealt with suspected or confirmed cases of COVID-19 or with stress had more escalated sleep compared to those who did not deal with patients or without stress (9.39 vs. 7.17 and 8.78 vs. 2.69 P < 0.001). The sleep of physicians was escalated with increasing stress (r = 0.558; P < 0.001) and a number of days that physicians dealt with suspected/confirmed cases of COVID-19 (r = 0.210; P = 0.001), respectively. CONCLUSION: The study confirmed that working with COVID-19 patients has a negative effect on the sleep of physicians.

Response of the Public to Preventive Measures of COVID-19 in Iraqi Kurdistan.

OBJECTIVES: On March 1, 2020, the Kurdistan Region Government (KRG) announced 4 confirmed cases of coronavirus disease (COVID-19). We aimed to explore the response of the public toward the prevention principles against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. METHODS: The investigators invited individuals from different geographic areas of Duhok Governorate of Iraqi Kurdistan in March 2020. RESULTS: The mean age of the participants was 25.74 (16-95 years). The mean score and prevalence of fear toward SARS-CoV-2 infection was 4.40 of 10 and 81.9%, respectively. A small percentage of participants did not minimize their exposures by reducing close contacts and transmission of respiratory droplets (14.5%) and visited public areas during the epidemic (28.7%). The study revealed that 30.8% of the participants do not use face masks or tissues when they sneeze in public areas. Most of the participants wash their hands when they suspect a possible transmission of the SARS-CoV-2 pathogen (94.6%) and clean or disinfect pathogen contamination-suspected areas at home (84.6%). The study also revealed that some participants (11.2%), due to a lower education, did not visit a medical clinic when they experienced possible symptoms of SARS-CoV-2 infection. Participants agreed with the health policies of KRG against the COVID-19 outbreak (90.8%). CONCLUSIONS: Some individuals do not adhere to preventive measures against SARS-CoV-2 infection.