Healthcare Resource Utilization and Direct Medical Costs Associated with Post COVID-19 Condition in Colombia, 2020-2021

Objectives: This study aimed to estimate the direct medical costs of patients with post COVID-19 condition in a Colombian insurance company with more than 2.5 million affiliates. Method(s): We conducted a bottom-up cost-of-illness study of adults with persistent symptoms after at least three months of hospital discharge due to COVID-19. We surveyed patients that were hospitalized between March 2020 and August 2021. We asked about healthcare resource utilization (HCRU), which included laboratories and images, medications, consults, rehospitalizations, and others, associated with post COVID-19 condition. The answers were verified using the company's outpatient and inpatient service authorization records. Costs were estimated from the third payer perspective and expressed in American dollars using an exchange rate of 1USD$=3,743COP. Result(s): We included 202 participants, 51.5% were male, mean age of 55.6 years old, 49% had a comorbidity (41.9% hypertension), and 46 patients (22.8%) required an intensive care unit. A total of 159 (78.7%) patients reported at least one symptom after discharge. Of these, 132 (65.3%) persisted with at least one symptom during the telephone survey. Seventy-five (47.2%) of the 159 patients with persistent symptoms reported HCRU. Of these, 93.3% consulted a physician (mean consultations: 2.1 SD 1.1;mean consultations with specialists: 2.4 SD 2.0), and 9.3% were re-hospitalized. The average direct medical costs of post COVID-19 condition were US$824 (95%CI 195-1,454). Costs in outpatient were US$373 (95%CI 158-588), and in inpatient, US$3,285 (95%CI -167-6,738). Conclusion(s): It is crucial to follow up and identify patients discharged from the hospital who persist with symptoms after three months since we observed a greater HCRU, including prolonged recovery therapiesCopyright © 2023

Effects of COVID-19 on health services in Santiago de Cuba, 2020

Introduction: In Santiago de Cuba province, the actions applied to control the epidemic in 2020 caused changes and negative effects on many of the health services that are usually provided in the territory.

The New Normal In Virtual Education: A View From Teaching Practice

The health emergency determined that classes were suspended in person, implementing virtual education, this measure required actions to adapt to the new normality. The objective was to explore the repercussions of virtual education from the perspective of teaching practice through the qualitative approach of systematic bibliographic review;Consulting academic literature, it was concluded that there were coincidences that teachers faced in the context of the health emergency, such as self-training initiatives, lack of digital skills, and emotional conditions.

CHANGES IN THE DIGITAL MARKETING STRATEGY OF EXPORTING SMES IN COSTA RICA AS A RESULT OF THE COVID-19 PANDEMIC

Exporting smes are essential in economies;however, some barriers can hinder their export performance due to their particularities. The crisis caused by the covid-19 pandemic has become one of those obstacles since it has affected businesses worldwide, leading to new ways of con-ducting business, such as adopting virtual tools and using digital media as part of the business strategy. This reality shows the importance of digital marketing. Therefore, this paper seeks to evaluate the changes in smes’ strategy as a result of the pandemic and their relation to the export performance by these firms. The study employed qualitative research through a case study design, in which we conducted in-depth interviews with five Costa Rican exporting smes. The main limitations were the difficulties for contacting enterprises and their lack of marketing knowledge. The data were analyzed through the atlas.ti 9 software, finding that changes in the activities and digital marketing strategies have been essential due to the information they provided, thus allowing smes to maintain their marketing actions during the pandemic. These insights may have a bearing on export performance. © 2022, Universidad Nacional de Colombia. All rights reserved.

Factors Associated with the Adoption of Drones for Product Delivery in the Context of the COVID-19 Pandemic in Medellin, Colombia

This study aims to identify the factors associated with the adoption of drone delivery in Medellin, Colombia, in the context of the COVID-19 pandemic. For that purpose, it implemented the Diffusion of Innovation (DOI) theory and the Technology Acceptance Model (TAM), which have constructs that complement each other to determine the decision to accept a given technology. A survey was administered to 121 participants in order to validate the model proposed here, which is based on variables that reflect the perceived attributes and risks of this innovation and individuals' characteristics. The results indicate that the factors Performance Risk, Compatibility, Personal Innovativeness, and Relative Advantage of Environmental Friendliness have the greatest influence on Intention to Use Drone Delivery (mediated by Attitude Towards Drone Delivery). This paper offers relevant information for the academic community and delivery companies because few other studies have investigated this topic. Additionally, the proposed technology adoption model can be a benchmark for other emerging economies in similar social, economic, and technological conditions.

Effects of COVID-19 on health services in Santiago de Cuba, 2020

Introduction: In Santiago de Cuba province, the actions applied to control the epidemic in 2020 caused changes and negative effects on many of the health services that are usually provided in the territory. Objective: To identify the effect of the COVID-19 epidemic on health services in Santiago de Cuba province during 2020. Methods: A retrospective ecological study was conducted with time series as units of comparative analysis in Santiago de Cuba province as the only geographical territory to evaluate the effects of COVID-19 on the provision of health services during 2020. Some health service indicators from the time series from 2015 to 2019 were selected. The data source was official statistics. The percentage of change was estimated and a classification of the effects of COVID-19 according to its magnitude and meaning was proposed. Results: There were changes in the number and types of health services in terms of outpatient and emergency medical consultations, hospital admissions and average stay of cardiology activities related to admissions, coronary angiographies performed, pacemakers implanted and operations performed, elective surgical activities and emergency operations, as well as outpatient and minimal access ones, rehabilitative treatments, studies for diagnosis through the use of clinical and microbiology laboratories, imaging studies in general, and the most affected were those related to Stomatology, and kidney and corneal transplants. Conclusions: The COVID-19 epidemic had a negative effect on the functioning of health services as there were unfavorable changes in the number of services provided at the primary and secondary care levels, which can impact on the health of vulnerable people if alternative strategies are not established.

Pandemic, Criminal Governance and Mechanisms of Social and Economic Regulation in Three Latin American Contexts

The Covid-19 pandemic has caused a series of adversities not only in people's lives but also in cities and their forms of territorial organization. How has it interfered with the mechanisms of social and economic regulation of crime in Latin America? This article compares three urban contexts where the regulation of armed actors has become important and criminal governance has reached a certain degree of stability or sophistication. Taking the pandemic as a turning point, we compare possible transformations related to mechanisms of regulation used by illegal armed groups in the peripheries of large cities or centers of power in Colombia and Brazil. © 2022 Universidade Federal do Rio de Janeiro. All rights reserved.

Cetylpyridinium Chloride Mouthwash to Reduce Shedding of Infectious SARS-CoV-2: A Double-Blind Randomized Clinical Trial.

The airborne transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) via respiratory fluids and droplets suggests that mouthwashes containing substances with virucidal activity can help reduce viral spread. We conducted a multicenter, double-blind, placebo-controlled, randomized trial to assess the virucidal activity of cetylpyridinium chloride (CPC) mouthwashes. Outpatients who tested positive for SARS-CoV-2 infection with or without symptoms were randomized to perform washes and gargles for 1 min with 15 mL of either colored distilled water or 0.07% CPC (Vitis CPC Protect) mouthwash. The study outcomes were the SARS-CoV-2 log10 viral RNA load and the nucleocapsid protein levels, both in saliva at 1 and 3 h after the intervention. In total, 118 patients were enrolled and randomized (mean [SD], age 46 [14] y). Thirteen of 118 participants (11%) did not complete follow-up or had insufficient sample volume for testing and were excluded from the analysis. The assessment of the viral load showed no significant differences between groups at any of the investigated points. However, the levels of SARS-CoV-2 nucleocapsid protein of lysed viruses were significantly higher in the CPC group compared with the control group at 1 h (adjusted difference 269.3 pg/mL; 95% confidence interval [CI], 97.1-441.5) and at 3 h postintervention (561.1 pg/mL; 95% CI, 380.0-742.2). In nonhospitalized patients with asymptomatic or mild symptomatic SARS-CoV-2 infection, a 0.07% CPC mouthwash, compared to placebo, was associated with a significant increase of nucleocapsid protein levels in saliva, indicating enhanced disruption of viral particles.

DIGIT ANALYSIS FOR COVID-19 DATA IN NORTH AMERICA

Benford's Law is an important probability distribution that describes the proportion of digits in databases formed by a large number of random numbers that usually include data of different orders of magnitude. This law is especially relevant, because a wide variety of data has shown to be consistent with it and therefore it has been applied in very diverse areas of knowledge. The main goal of this work was to analyze the conformity to the Benford's Law of the COVID-19 data of the three North American countries.

COVID-19 and risk assessment room for public health in four Colombian cross-border territories

Introduction: Public health risk management in Colombia is led by the National Institute of Health. In the face of the COVID-19 emergency, response actions were carried out through the implementation of Risk Analysis Rooms, strengthening surveillance at points of entry into the country. Objective: To carry out an analysis of the implementation and maintenance phases of the COVID-19 Risk Analysis Rooms in four border departments of Colombia. Materials and methods: A qualitative study was carried of Risk Analysis Rooms in public health for COVID-19. The documentation and data generated in the period from March to June 2020 in Amazonas, Vichada, Guainia and Putumayo were reviewed. Semi-structured interviews were conducted with key actors. The analysis was performed with the NVivo plus version 11 application, in three cycles: open coding;identification of emerging categories and modeling by analyzing the identified strengths and weaknesses. Results: The components of the incident command structure and the relationships between the public health areas were identified. Strengths were found in the integration of the areas;management of information in real time, border surveillance and strengthening of immediate response teams. The weaknesses identified were established in the planning, community surveillance and risk communication processes. Conclusions: The Risk Analysis Rooms constitute a joint effort of the national and local level where the articulated participation of the actors is promoted to analyze information and optimize the organized response during the COVID-19 pandemic.

IMPACT (IMpact on PostpArtum Care by Telehealth) Study: a retrospective cohort study

Objective: During the COVID-19 pandemic, institutions turned to telehealth as the primary method of postpartum care delivery. We aimed to determine the impact of telehealth on the completion of postpartum care goals. Study Design: We compared a 14-week period, March-June 2019, before implementation of telehealth to the same calendar months post-implementation during 2020. Patients with a postpartum visit (PPV) scheduled at our institution during the study period were included. Our primary outcome was attendance to the PPV. Secondary outcomes included completion of postpartum depression (PPD) screening, contraception selection, breastfeeding status at PPV, completion of postpartum 2-hour glucose tolerance test (GTT) for women with gestational diabetes, and cardiology follow-up when recommended. Multivariable logistic regression with backward elimination was used to control for confounders. Results: Of the 1,579 patients meeting inclusion criteria, 780 were in the pre-telehealth group and 799 were in the post-telehealth group. Subjects in the post-telehealth group were 90% more likely to attend a PPV compared to those in the pre-telehealth group, even when controlling for race, prenatal care provider, parity, gestational age at delivery, and insurance status (82.9% vs. 72.4%, p < 0.001;aOR 1.90, 95% CI [1.47-2.46]). Patients in the post-telehealth group were also more likely to get screened for PPD (86.3% vs. 65.1%, p < 0.001). While subjects were as likely to choose a contraceptive method at the PPV, those in the post-telehealth group were less likely to choose long-acting reversible contraception (LARC) or permanent sterilization (26.2% vs. 33.2%, p=0.03). There was no difference in breastfeeding status at the PPV, completion rate of postpartum 2-hour GTT, or attendance to cardiology follow-up appointments between groups. Conclusion: Availability of telehealth during the COVID-19 pandemic is associated with increased PPV attendance and PPD screening. However, the availability of telehealth was also associated with a decrease in the utilization of LARC or permanent sterilization. [Formula presented]

IMPACT (IMpact on PostpArtum Care by Telehealth) Study: a qualitative evaluation of the patient perspective

Objective: During the COVID-19 pandemic, institutions turned to telehealth as the primary method of postpartum care delivery. We aimed to understand the patient experience around telehealth for delivery of postpartum care using a qualitative approach. Study Design: We performed individual, semi-structured patient interviews (n=25) within two weeks of a scheduled telehealth postpartum visit (PPV) at our institution. Interviews were performed by phone from 10/1/2020-1/1/2021, more than 6 months into the COVID-19 pandemic. Transcriptions were analyzed using grounded theory and coded with a systematic approach. Results: Overall, participants reported mixed preferences for the modality of the postpartum visit (in-person vs. telehealth). Those in favor of telehealth focused on its convenience and flexibility. When performed via video and audio rather than audio alone, participants felt telehealth well-simulated in-person engagement. Participants also reported similar experiences by modality regarding contraceptive planning. On the other hand, several participants raised concerns about the limitations of telehealth for physical examination, such as providing patient reassurance regarding healing after delivery. Reported facilitators to telehealth were lack of need for childcare or transportation to an in-person encounter, minimized disruption to maternal-newborn routine, and prioritizing safety during the COVID-19 pandemic. Reported barriers also included the need for childcare during the telehealth encounter, as well as difficulty finding a private space for the visit, scheduling and logistic challenges, privacy concerns, and technological difficulties. Conclusion: Telehealth is becoming an increasingly utilized modality of PPVs in the United States. In this qualitative analysis, we characterize patients’ experiences with telehealth postpartum care, and identify areas of patient concern. Future work should determine how best to provide reassurance regarding postpartum healing to further optimize telehealth for postpartum care. [Formula presented]

Outreaching Optics during the COVID-19 Pandemic: From Face-to-Face to Social Networks

In this contribution we show how, in times of pandemic, outreach activities driven by social networks can be a successful alternative to face-to-face events. Designing each activity to properly suit the host platform ensures success. © 2021 The Author(s).

PRODUCTIVITY AND PRICES OF HARD CORN PRE AND POST COVID-19 IN ECUADOR

The hard yellow corn in Ecuador is one of the most significant products of the economy that has not been immune to the pandemic, so the objective of the research is to evaluate the effect on productivity and prices of hard corn of COVID 19. The The research is based on data from the Ministry of Agriculture and Livestock as well as the Central Bank of Ecuador. A causal model was built between productivity, prices and time before COVID-19;With this, a projection of post-COVID 19 production and prices was made. Among the results, it stands out that during the period of the pandemic, the productivity of hard corn per hectare decreases 4.2% and the same behavior was observed in corn prices hard at the producer level. The productivity of hard corn of 7 tons per hectare under an optimistic scenario is what would be expected for the country in the next five years due to the slight incidence of COVID 19. The prices of hard corn grain per quintal are presented under a pessimistic scenario. The multiple linear regression model for the corn crop is in accordance with economic theory

“Saving Lives, Protecting Livelihoods, and Safeguarding Nature”: Risk-Based Wildlife Trade Policy for Sustainable Development Outcomes Post-COVID-19

The COVID-19 pandemic has caused huge loss of life, and immense social and economic harm. Wildlife trade has become central to discourse on COVID-19, zoonotic pandemics, and related policy responses, which must focus on “saving lives, protecting livelihoods, and safeguarding nature.” Proposed policy responses have included extreme measures such as banning all use and trade of wildlife, or blanket measures for entire Classes. However, different trades pose varying degrees of risk for zoonotic pandemics, while some trades also play critical roles in delivering other key aspects of sustainable development, particularly related to poverty and hunger alleviation, decent work, responsible consumption and production, and life on land and below water. Here we describe how wildlife trade contributes to the UN Sustainable Development Goals (SDGs) in diverse ways, with synergies and trade-offs within and between the SDGs. In doing so, we show that prohibitions could result in severe trade-offs against some SDGs, with limited benefits for public health via pandemic prevention. This complexity necessitates context-specific policies, with multi-sector decision-making that goes beyond simple top-down solutions. We encourage decision-makers to adopt a risk-based approach to wildlife trade policy post-COVID-19, with policies formulated via participatory, evidence-based approaches, which explicitly acknowledge uncertainty, complexity, and conflicting values across different components of the SDGs. This should help to ensure that future use and trade of wildlife is safe, environmentally sustainable and socially just. © Copyright © 2021 Booth, Arias, Brittain, Challender, Khanyari, Kuiper, Li, Olmedo, Oyanedel, Pienkowski and Milner-Gulland.