Risk Perception and Preventive Practice During the COVID-19 Pandemic in the General Population.

Background People's perceptions of the COVID-19 pandemic and its associated risk are very essential to prevent the spread of the infection. The awareness among individuals may contribute to preventing COVID-19 infections. Coronavirus disease is a serious public health issue. However, preventive practices toward COVID-19 are relatively unknown. The present study aims to survey the risk perception and preventive practice during the COVID-19 pandemic among the general population in Odisha. Method A cross-sectional online survey among 395 participants was conducted by adopting the convenience sampling technique. The tools used for the survey consist of three divisions: collection of sociodemographic data, assessment of risk perception toward COVID-19, and assessment of preventive practices during COVID-19 through an online survey method. Results The majority (83.29%) of the participants strongly agreed that social distancing is necessary to control the transmission of COVID-19, 65.82% strongly agreed that lockdown is relevant to control COVID-19 spread, 49.62% strongly agreed that wearing a mask protects from the infection, and 40.25% strongly agreed that they will be able to connect with healthcare professionals if they are infected with COVID-19 infection. The finding revealed that the highest number of participants are always practicing all the preventive measures such as maintaining hand hygiene (77.21%), wearing a mask (68.10%), avoiding shaking hands (87.59%), willingness to seek medical help (90.37%), avoiding going to the market or meeting friends (80.75%), discussing preventive measures related to COVID-19 with their family members (76.45%), and eating only homemade food (87.34%). Conclusion This study found that an average number of study participants who had the highest level of practice on preventive measures are those who had higher perceived risk among the general population. Expanding the knowledge regarding the infection and its ill effect on health through the proper channel can bring a drastic change in the attitude of the general public. As many people depend on television and social media for acquiring information about COVID-19, any information that reaches the public should be accurate and based on evidence. To avoid miscommunication and the further spread of COVID-19, health education and awareness have to be implemented to increase self-efficacy and risk identification among the general public, which eventually increases the practice of preventive measures.

Pandemic and Online Learning: Is it for protection from Covid-19 or Health destruction? Voice of Indian parents

Background: Globally, 1.2 billion children are out of the classroom due to schools shut across the world owing to the covid -19 pandemic. Besides children, parents too struggled to embrace this sudden change and adapt to online learning. The present study aimed to assess parental perception towards children's online learning during the covid-19 pandemic. Methods: A cross-sectional web-based survey was carried out among 550 parents of children attending classes online during the covid-19 pandemic. Data were collected after obtaining ethical approval using a self-report questionnaire on parental perception of children's online learning and online class characteristics. Collected data were analyzed using R software. Results: Out of 550 parents approached online, only 300 had responded to the survey with a response rate of 55%. More than half of the children attended online classes using an android mobile phone (71.1%), in the Zoom app (52.2%) with an average duration of online classes was 180±30 minutes/day. Mean parental perception towards online learning score was16±6.3. Parents (80.3%) were concerned about children's general health, including vision, due to continuous exposure to screen in online classes quandary, they agreed (93.3%) online learning protects children from covid infection. Parents were interested in traditional classroom teaching and only 26.1% perceived online learning was effective. Conclusion: Parents, students are eagerly waiting to get rid of home-schooling. The success of online learning relies upon the cooperation of the school authority, teachers, parents, and students. The school education department has a great scope to understand and attend to parental concerns, also maintaining healthy schooling once shut down get relaxed. Also, it should focus on strengthening and supporting home-schooling and helping children balance physical and psychological health.

Telemedicine - a Boon to Parents of Children with Health Care Needs During COVID-19 Pandemic: A Qualitative Study from India.

OBJECTIVE: The coronavirus disease 2019 pandemic had greatly impacted health worldwide. The nationwide lockdown was imposed to contain the virus transmission, which indirectly affected health care utilization. Pediatric patients', as they are considered as a vulnerable group, parents faced a significant challenge to manage their children's surgical and medical care needs during the coronavirus disease 2019 pandemic. The study aims to explore the parental approach to health care facilities to meet children's surgical care needs during the coronavirus disease 2019 pandemic. MATERIALS AND METHODS: A qualitative approach was adopted to fulfill the objective by conducting an in-depth interview using a semi-structured interview schedule among 26 parents of children with perioperative surgical care needs at a tertiary care hospital, eastern India. The digitally recorded interviews were transcribed verbatim. Thematic analysis was employed to understand the parent's experience toward meeting children's surgical care needs during the coronavirus disease 2019 pandemic lockdown. QSR NVIVO software version 12 was used for data management. RESULTS: The study found 3 themes related to parent's experience which include state of desperation (sub-themes: lockdown effect, ignorant to the health facility, phobic to coronavirus disease infection, and testing), state of assurance (sub-themes: telemedicine: accessibility, approachability, and applicability), and state of serenity (sub-themes: refrained from somatic symptoms and shouldering the responsibility). CONCLUSION: Despite various hurdles parents faced during the pandemic, telemedicine helped parents meet their children's surgical care needs. Framing guidance, protocols to deal with emergency and primary care delivery, and disseminating information on telemedicine facilities to grassroot level to the community can protect this vulnerable population in the upcoming surge of coronavirus disease 2019 waves.

Detection of Covid-19 from chest X-ray scans using machine learning

Machine Learning (ML) can be used to track the disease and predict the growth of the epidemic. Several detection models for COVID-19 are developed. Due to the uncertainty and lack of essential data, many existing models have shown low accuracy in detection. In several technology domains, ML models have been used to define and prioritize adverse threat variables. This study proposes an improved model to analyses and detect the amount of COVID-19-affected patients. In this study, we propose a classification model that detect the infected condition through the chest X-ray images. A dataset containing chest x-ray images of normal people, people with pneumonia such as SARS and pneumococcus and other patients with COVID-19 were collected. Histogram of oriented gradients (HOG) is used for image features extraction. The images are then classified using Support Vector Machines (SVM), random forests and K-nearest neighbors (KNN). These results may contribute well in detecting COVID-19 disease. © 2022 Author(s).

The perceived social stigma, self-esteem, and its determinants among the health care professionals working in India during COVID 19 pandemic.

BACKGROUND: Health conditions perceived as contagious, dangerous, or incurable are associated with some facets of social stigma. METHODS: A cross-sectional survey was conducted from May 9, 2020 to June 9, 2020, among frontline healthcare workers (HCWs) in India to understand their perceived stigmatizing experiences (SE) and self-esteem during the COVID-19 pandemic. Google forms, an online forms tool, was used to create the survey, and samples were recruited through snowball sampling. Data comprised baseline characteristics of HCWs and their responses to the modified version of the Inventory of Stigmatizing Experiences and the Rosenberg Self-Esteem Scale. RESULTS: Of the 600 participants (mean age: 30.9 ± 6.7 years), 76% comprised of nurses. Most participants were residing in urban areas and working in government sectors in clinical areas. Approximately 66.3% HCWs had at least 1 SE, and 51.7% reported a high impact of stigma (SI) across their various life domains, viz. quality of life, social contacts, self-esteem, and family relations, but 73% had normal self-esteem. The SI was more at the family level than at the individual level. The prevalence of SE (69.5% vs. 56.6%) and psychosocial SI (54.5% vs. 44.1%) was higher among nurses than among doctors. Being a nurse and working in clinical areas were statistically significant (P < 0.05 and < 0.01, respectively) for predicting SE likelihood. CONCLUSION: Although HCWs have their own apprehensions, they do have high self-esteem and continue to deliver professional duties despite their SE. The government should frame guidelines to stop such discrimination and hail the saviors.

The burden & contributing factors of psychological distress across India during the COVID pandemic.

The unprecedented COVID-19 pandemic spread rapidly and engulfing the entire world, forcing people to stay home, muting the hustle and bustle of modern world with tide of fear for contracting disease and death. This brutal disease has infected millions of people worldwide, many lost their job, world economies have ravaged and many more uncountable consequences. OBJECTIVE: To assess the psychological distress due to COVID-19 outbreak and to determine contributing factors towards psychological distress. METHOD: A cross-sectional survey was conducted between 12th May to 20th June 2020 & 1537 valid responses were received. Modified K10 scale was used to assess psychological distress. Binary logistic regression analysis was used to determine extent of relationship between the contributing factors and psychological distress scale by estimating the odds of having significant stress with P ≤ 0.05. RESULT: A total of 1537 valid responses were obtained. The overall psychological distress score was 19.79 ± .75 which implies mild psychological distress. Analysis of degree of psychological distress revealed 815 (53.0%) with no psychological distress, 385 (25.0%) mild, 194 (12.6%) moderate and 143 respondents (9.3%) had severe degree of psychological distress. Females psychological distress was 1.448 times as compared to male (CI 0.191-10.986). The odds of having significant psychological distress for above 60 years as compared to 16-30 years. Shop owner & business man had more stress in compared to professionals (OR 1.176, CI 0.058-2.362). As compared to married, the psychological distress was 13.203 times higher among divorcee/separated (0.786-221.787) and 3.629 times higher among unmarried (0.376-35.054). CONCLUSION: This study showed 39.2% of the subject had psychological distress which is quite high. So, government and other policy makers have to develop strategy to relieve psychological distress among Indian population.

Collateral Impact of the COVID-19 Pandemic on Acute Care of Non-COVID Patients: An Internet-based Survey of Critical Care and Emergency Personnel.

PURPOSE: The impact of disruption to the care of non-coronavirus disease (COVID) patients (COVID collateral damage syndrome-CCDS) is largely unknown in resource-limited settings. We investigated CCDS as perceived by healthcare workers (HCWs) providing acute and critical care services in India. MATERIALS AND METHODS: A clinician and nurse codesigned and validated an internet-based survey, which was disseminated to HCWs using a multiple frame sampling technique. RESULTS: Responses were received from 468 HCWs (completion rate 84%); at the time of the survey, 48% were working in critical care, 41% aged 30-40 years, and 53% represented public institutions. Respondents perceived a decrease in service utilization and disruption to time-sensitive acute interventions (60.1% and 40.8%, respectively), with fear of infection (score, 63.0; standard deviation (SD), 31.8) and restrictions due to lockdown (61.4; SD 32.5) being cited as the causes of service disruption. Being overwhelmed or lack of protective equipment was perceived to contribute less to CCDS. Insistence on COVID test results X 2 (p = 0.02) and duty-avoidance (p < 0.01) was perceived as significant causes for CCDS by HCWs from private hospitals and those in leadership roles, respectively. CONCLUSIONS: Fear of infection and the effect of lockdown were perceived as important contributors to CCDS resulting in disruption to services and decreased service utilization. Perceptions were influenced by HCWs' role and hospital organizational structure. HOW TO CITE THIS ARTICLE: Tripathy S, Vijayaraghavan BKT, Panigrahi MK, Shetty AP, Haniffa R, Mishra RC, et al. Collateral Impact of the COVID-19 Pandemic on Acute Care of Non-COVID Patients: An Internet-based Survey of Critical Care and Emergency Personnel. Indian J Crit Care Med 2021;25(4):374-381.

Successful conduct of an acute stroke clinical trial during COVID.

Most clinical research stopped during COVID due to possible impact on data quality and personnel safety. We aimed to assess the impact of COVID on acute stroke clinical trial conduct at sites that continued to enroll patients during the pandemic. BEST-MSU is an ongoing study of Mobile Stroke Units (MSU) vs standard management of tPA-eligible acute stroke patients in the pre-hospital setting. MSU personnel include a vascular neurologist via telemedicine, and a nurse, CT technologist, paramedics and emergency medicine technicians on-board. During COVID, consent, 90-day modified Rankin Scale (mRS) and EQ5D were obtained by phone instead of in-person, but other aspects of management were similar to the pre-COVID period. We compared patient demographics, study metrics, and infection of study personnel during intra- vs pre-COVID eras. Five of 6 BEST-MSU sites continued to enroll during COVID. There were no differences in intra- (n = 57) vs pre- (n = 869) COVID enrolled tPA eligible patients' age, sex, race (38.6% vs 38.0% Black), ethnicity (15.8% vs 18.6% Hispanic), or NIHSS (median 11 vs 9). The percent of screened patients enrolled and adjudicated tPA eligible declined from 13.6% to 6.6% (p < .001); study enrollment correlated with local stay-at-home and reopening orders. There were no differences in alert to MSU arrival or arrival to tPA times, but MSU on-scene time was 5 min longer (p = .01). There were no differences in ED door to CT, tPA treatment or thrombectomy puncture times, hospital length of stay, discharge disposition, or remote vs in-person 90-day mRS or EQ5D. One MSU nurse tested positive but did not require hospitalization. Clinical research in the pre-hospital setting can be carried out accurately and safely during a pandemic. tPA eligibility rates declined, but otherwise there were no differences in patient demographics, deterioration of study processes, or serious infection of study staff. Trial registration: NCT02190500.