Pandemia de la COVID-19 y las Políticas de Salud Pública en el Perú: marzo-mayo 2020/COVID-19 pandemic and Public Health Policies in Peru: March-May 2020

Objetivo El trabajo tiene como objetivo analizar la dinámica del comportamiento de la COVID-19 en el Perú, estimar y evaluar el impacto de la política pública de supresión (cuarentena). Métodos El modelo epidemiológico SIR y la estimación con el método de Mínimos Cuadrados Ordinarios (MCO). Resultados Se encontró que el número básico de propagación (Ro) cayó de 6,0 a 3,2 habiéndose reducido en 54% por efecto de la estrategia de supresión, y dos meses después cayó a 1,7. Sin embargo, sigue siendo alto y evidencia que aún continúa en expansión el nivel de infectados, con los efectos sociales y económicos adversos que esta medida implica. Conclusión La COVID-19 es una enfermedad que crece exponencialmente, por lo cual, la política de salud basada en la estrategia de supresión ha permitido aplanar la curva de contagio, evitando el colapso del Sistema de Salud. Objective The objective of the study is to analyze the behavior dynamics of COVID-19 in Peru, estimate and evaluate the impact of the suppression public policy (quarantine). Methods The SIR epidemiological model and the estimation with the ordinary Least Squares (OLS) method. Results It was found that the basic number of propagation (Ro) fell from 6,0 to 3,2 having been reduced by 54% due to the suppression strategy;and two months later it falls to 1,7. However, it remains high and evidence that the level of those infected continues to expand with its adverse social and economic effects. Conclusion COVID-19 is a disease that grows exponentially, and that the health policy based on the suppression strategy has allowed to flatten the contagion curve, thus avoiding the collapse of the Health System.

[COVID-19 pandemic and Public Health Policies in Peru: March-May 2020]. / Pandemia de la COVID-19 y las Políticas de Salud Pública en el Perú: marzo-mayo 2020.

OBJECTIVE: The objective of the study is to analyze the behavior dynamics of COVID-19 in Peru, estimate and evaluate the impact of the suppression public policy (quarantine). METHODS: The SIR epidemiological model and the estimation with the ordinary Least Squares (OLS) method. RESULTS: It was found that the basic number of propagation (Ro) fell from 6,0 to 3,2 having been reduced by 54% due to the suppression strategy; and two months later it falls to 1,7. However, it remains high and evidence that the level of those infected continues to expand with its adverse social and economic effects. CONCLUSION: COVID-19 is a disease that grows exponentially, and that the health policy based on the suppression strategy has allowed to flatten the contagion curve, thus avoiding the collapse of the Health System.

Mental Health Disorders and Coping Strategies in Healthcare Workers during the COVID-19 Pandemic: An Analytical Cross-Sectional Study in Southeastern Mexico

Mental health disorders are relatively common in the general population and were already an important issue for the healthcare sector before COVID-19. COVID-19, being a worldwide crucial event and evidently a great stressor has increased both the prevalence and incidence of these. Therefore, it is evident that COVID-19 and mental health disorders are closely related. Moreover, several coping strategies exist to endure said disorders such as depression and anxiety, which are used by the population to confront stressors, and healthcare workers are not the exception. This was an analytical cross-sectional study, conducted from August to November 2022, via an online survey. Prevalence and severity of depression, anxiety, and stress were assessed via the DASS-21 test, and coping strategies were assessed via the CSSHW test. The sample consisted of 256 healthcare workers and of those, 133 (52%) were males with a mean age of 40.4 ± 10.35, and 123 (48%) were females with a mean age of 37.28 ± 9.33. Depression was prevalent in 43%, anxiety in 48%, and stress in 29.7%. Comorbidities were a significant risk factor for both depression and anxiety with an OR of 10.9 and 4.18, respectively. The psychiatric background was a risk factor for depression with an OR of 2.17, anxiety with an OR of 2.43, and stress with an OR of 3.58. The age difference was an important factor in the development of depression and anxiety. The maladaptive coping mechanism was prevalent in 90 subjects and was a risk factor for depression (OR of 2.94), anxiety (OR of 4.46) and stress (OR of 3.68). The resolution coping mechanism was a protective factor for depression (OR of 0.35), anxiety (OR of 0.22), and stress (OR of 0.52). This study shows that mental health disorders are highly prevalent among healthcare workers in Mexico and that coping strategies are associated with their prevalence. It also implies that not only occupations, age, and comorbidities might affect mental health, but also the way patients confront reality and the behavior and decisions they take towards stressors.

Mental Health Disorders and Coping Strategies in Healthcare Workers during the COVID-19 Pandemic: An Analytical Cross-Sectional Study in Southeastern Mexico.

Mental health disorders are relatively common in the general population and were already an important issue for the healthcare sector before COVID-19. COVID-19, being a worldwide crucial event and evidently a great stressor has increased both the prevalence and incidence of these. Therefore, it is evident that COVID-19 and mental health disorders are closely related. Moreover, several coping strategies exist to endure said disorders such as depression and anxiety, which are used by the population to confront stressors, and healthcare workers are not the exception. This was an analytical cross-sectional study, conducted from August to November 2022, via an online survey. Prevalence and severity of depression, anxiety, and stress were assessed via the DASS-21 test, and coping strategies were assessed via the CSSHW test. The sample consisted of 256 healthcare workers and of those, 133 (52%) were males with a mean age of 40.4 ± 10.35, and 123 (48%) were females with a mean age of 37.28 ± 9.33. Depression was prevalent in 43%, anxiety in 48%, and stress in 29.7%. Comorbidities were a significant risk factor for both depression and anxiety with an OR of 10.9 and 4.18, respectively. The psychiatric background was a risk factor for depression with an OR of 2.17, anxiety with an OR of 2.43, and stress with an OR of 3.58. The age difference was an important factor in the development of depression and anxiety. The maladaptive coping mechanism was prevalent in 90 subjects and was a risk factor for depression (OR of 2.94), anxiety (OR of 4.46) and stress (OR of 3.68). The resolution coping mechanism was a protective factor for depression (OR of 0.35), anxiety (OR of 0.22), and stress (OR of 0.52). This study shows that mental health disorders are highly prevalent among healthcare workers in Mexico and that coping strategies are associated with their prevalence. It also implies that not only occupations, age, and comorbidities might affect mental health, but also the way patients confront reality and the behavior and decisions they take towards stressors.

COVID-19 pandemic and public health policies in Peru: March-May 2020 / Pandemia de la COVID-19 y las políticas de salud pública en el Perú: Marzo-Mayo 2020

Objective The objective of the study is to analyze the behavior dynamics of COVID-19 in Peru, estimate and evaluate the impact of the suppression public policy (quarantine). Methods The SIR epidemiological model and the estimation with the ordinary Least Squares (OLS) method. Results It was found that the basic number of propagation (Ro) fell from 6,0 to 3,2 having been reduced by 54% due to the suppression strategy; and two months later it falls to 1,7. However, it remains high and evidence that the level of those infected con-tinues to expand with its adverse social and economic effects. Conclusion: COVID-19 is a disease that grows exponentially, and that the health policy based on the suppression strategy has allowed to flatten the contagion curve, thus avoiding the collapse of the Health System.

Prevalence and Risk Factors of Adverse Effects and Allergic Reactions after COVID-19 Vaccines in a Mexican Population: An Analytical Cross-Sectional Study.

Vaccinations have helped to control the COVID-19 pandemic; however, few studies focus on the adverse effects and allergic reactions of these vaccines and fewer have a scope in the Latin American population. The objective of this study was to assess the associations between vaccinations, sex, age, allergic reactions, and adverse effects. This was an analytical cross-sectional study conducted between 1 July and 1 October 2022. The sample consisted of 443 surveyed participants, with a total of 1272 COVID-19 vaccine doses. Seven vaccines (Pfizer BioNTech, Oxford-AstraZeneca, CanSino, Moderna, Johnson and Johnson, Sinovac, and Sputnik V) were evaluated. A total of 12.6% of those surveyed had at least one allergic reaction posterior to vaccination, and females had a greater chance of developing one (p < 0.001, OR 3.1). The most common allergic reaction was chest pain, and Pfizer-BioNTech and Oxford-AstraZeneca were associated with the onset of allergic reactions (p < 0.005). A total of 54.6% of those surveyed developed adverse effects, the most common of which were myalgia, fever, cephalea, asthenia or adynamia, and arthralgia; moreover, older age was associated with the onset of adverse effects (p < 0.5). This study concludes that the BNT162b2 (Pfizer BioNTech) and ChAdOX1 nCOV-19 (Oxford-AstraZeneca) vaccines are strongly associated with the onset of allergic reactions, with ORs of 1.6 (CI 95%, 1.18 to 2.3) and 1.87 (CI 95%, 1.35 to 2.6), respectively. In addition, females have a greater chance of developing allergic reactions associated with COVID-19 vaccinations, and there was a relation found between older age and a greater prevalence of comorbidities, adverse effects after vaccination, and COVID-19 infection after vaccination.

COVID-19, Long COVID Syndrome, and Mental Health Sequelae in a Mexican Population.

The COVID-19 pandemic is currently a worldwide threat and concern, not only because of COVID-19 itself but its sequelae. The aim of this study was to evaluate whether a relation between COVID-19, Long COVID, and the prevalence of mental health disorders exist. A total of 203 people from Tabasco were included in this study, answering a survey integrated by three dominions: General and epidemiological data, the DASS-21 test (to determine the presence of signs or symptoms suggestive of depression, anxiety, and/or stress) and an exploratory questionnaire about Long COVID syndrome. A descriptive and inferential statistical analysis was made via Microsoft Excel and Graphpad Prism software, evaluating differences through the Mann-Whitney U test and considering p < 0.05 as statistically significant. Of the 203 people surveyed, 96 (47.29%) had had COVID-19 and 107 (52.71%) had not; from the ones that had COVID-19, 29 (30.21%) presented mental health disorders and 88 (91.66%) presented at least one symptom or sign of Long COVID syndrome; meanwhile, 31 (32.29%) presented 10 or more symptoms or signs. From the comparison between the population with previous mental health disorders and COVID-19 and those without background disorders or COVID-19, the results were the following: 27.58% vs. 16.82% presented severe depression, 48.27% vs. 17.75% presented severe anxiety, and 27.58% vs. 20.56% presented severe stress. A high prevalence of mental health effects was observed in patients without COVID-19 and increased in the population with Long COVID syndrome and previous mental health disorders.

Consensus Statement on the Management of Waldenström Macroglobulinemia Patients During the COVID-19 Pandemic.

In the light of the COVID-19 pandemic, the International Workshop on Waldenström Macroglobulinemia (IWWM) Treatment Recommendations Panel felt the need to provide a consensus statement for the management of Waldenström Macroglobulinemia (WM) patients during this challenging time. We followed the current recommendations by the American Society of Hematology, which have been modified accordingly to fit the specific realities associated with the management of WM. In this Consensus Statement, the Panel addresses questions related to treatment initiation, preferred therapies, minimizing visit to clinics and infusions centers, supportive care and guidance for WM patients in clinical trials. Finally, we also provide information on timing and appropriateness of testing and management of COVID-19 infected patients, as well as ways to get physicians and patients involved in registry studies that could help others.

Perceived Preparedness of Dental Academic Institutions to Cope with the COVID-19 Pandemic: A Multi-Country Survey.

Dental academic institutions are affected by COVID-19. We assessed the perceived COVID-19 preparedness of these institutions and the characteristics of institutions with greater perceived preparedness. An international cross-sectional survey of dental academics was conducted from March to August 2020 to assess academics' and institutional attributes, perceived preparedness, and availability of infection prevention and control (IPC) equipment. Principal component analysis (PCA) identified perceived preparedness components. Multilevel linear regression analysis assessed the association between perceived preparedness and fixed effect factors (academics' and institutions' attributes) with countries as random effect variable. Of the 1820 dental academics from 28 countries, 78.4% worked in public institutions and 75.2% reported temporary closure. PCA showed five components: clinic apparel, measures before and after patient care, institutional policies, and availability of IPC equipment. Significantly less perceived preparedness was reported in lower-middle income (LMICs) (B = -1.31, p = 0.006) and upper-middle income (UMICs) (B = -0.98, p = 0.02) countries than in high-income countries (HICs), in teaching only (B = -0.55, p < 0.0001) and in research only (B = -1.22, p = 0.003) than teaching and research institutions and in institutions receiving ≤100 patients daily than those receiving >100 patients (B = -0.38, p < 0.0001). More perceived preparedness was reported by academics with administrative roles (B = 0.59, p < 0.0001). Academics from low-income countries (LICs) and LMICs reported less availability of clinic apparel, IPC equipment, measures before patient care, and institutional policies but more measures during patient care. There was greater perceived preparedness in HICs and institutions with greater involvement in teaching, research, and patient care.

COVID-19 mortality risk factors in older people in a long-term care center.

PURPOSE: Despite high rates of COVID-19 infection and increased related mortality have been reported among older adults admitted in long-term care facilities, a limited amount of information is available about the natural course of this pandemic and prognostic factors in such population. In the current study, we aimed to investigate the epidemiologic, demographics, clinical, or therapeutic factors that may predict the prognosis in a cohort of COVID-19 infected institutionalized older in a nursing home. METHODS: We conducted a retrospective analysis of all COVID-19 confirmed institutionalized older in a nursing home from March 15 to June 5, 2020. Epidemiological, demographic, and frailty status before infection, and clinical, laboratory, treatment, and outcome data during infection were collected. We used bivariate analysis and multivariate logistic regression to identify risk factors for mortality. RESULTS: The analysis comprised all 100 COVID-19 confirmed cases during the study period. The median age was 85 years; 62% were female. The case fatality rate was 20%. In the bivariate analysis, male gender, fever, respiratory symptoms, severe cognitive decline, a low Barthel index, and lymphocytopenia were significantly associated with mortality. Patients treated with hydroxychloroquine plus azithromycin were related to a higher chance of survival than those without pharmacological treatment. Multivariate logistic regression analysis identified male gender, low Barthel index, no pharmacological treatment, and lymphocytopenia as independent risk factors associated with mortality. CONCLUSIONS: Male gender, low Barthel index, and lymphocytopenia are independent risk factors for COVID-19 mortality in institutionalized older patients in long-term care nursing homes. Treatment with hydroxychloroquine and azithromycin was associated with lower mortality in these patients.

Mitigating Global Oral Health Inequalities: Research Training Programs in Low- and Middle-Income Countries.

Although oral diseases are largely preventable, they are among the most non-communicable diseases globally, and they disproportionately burden disadvantaged communities, specially within low- and middle-income nations. The COVID-19 pandemic has highlighted the social, economic, and health inequalities in our society, including the existing global oral health inequalities. There is a shortage of dentist-scientist all around the world, especially in developing countries, such as Thailand. The National Institute of Dental and Craniofacial Research (NIDCR) and Fogarty International Center (FIC), joined efforts on creating research capacity in oral health in South East Asia through the Fogarty International Center Training Program in Clinical, Public Health and Behavioral Oral Health Research for Thailand (2006-2016). The University of Washington (USA), Thammasat University (Thailand) and Khon Kaen University (Thailand) partnered to conduct short-, medium- and long-term training programs to build regional oral health research capabilities. Investing in research has not only impacted trainees' career development but enhanced advancement of oral health research of South East Asia. The success of partnership calls for expanding oral health research training in other low-income countries.

Knowledge of dental academics about the COVID-19 pandemic: a multi-country online survey.

BACKGROUND: COVID-19 is a global pandemic affecting all aspects of life in all countries. We assessed COVID-19 knowledge and associated factors among dental academics in 26 countries. METHODS: We invited dental academics to participate in a cross-sectional, multi-country, online survey from March to April 2020. The survey collected data on knowledge of COVID-19 regarding the mode of transmission, symptoms, diagnosis, treatment, protection, and dental treatment precautions as well as participants' background variables. Multilevel linear models were used to assess the association between dental academics' knowledge of COVID-19 and individual level (personal and professional) and country-level (number of COVID-19 cases/ million population) factors accounting for random variation among countries. RESULTS: Two thousand forty-five academics participated in the survey (response rate 14.3%, with 54.7% female and 67% younger than 46 years of age). The mean (SD) knowledge percent score was 73.2 (11.2) %, and the score of knowledge of symptoms was significantly lower than the score of knowledge of diagnostic methods (53.1 and 85.4%, P <  0.0001). Knowledge score was significantly higher among those living with a partner/spouse than among those living alone (regression coefficient (B) = 0.48); higher among those with PhD degrees than among those with Bachelor of Dental Science degrees (B = 0.48); higher among those seeing 21 to 30 patients daily than among those seeing no patients (B = 0.65); and higher among those from countries with a higher number of COVID-19 cases/million population (B = 0.0007). CONCLUSIONS: Dental academics had poorer knowledge of COVID-19 symptoms than of COVID-19 diagnostic methods. Living arrangements, academic degrees, patient load, and magnitude of the epidemic in the country were associated with COVD-19 knowledge among dental academics. Training of dental academics on COVID-19 can be designed using these findings to recruit those with the greatest need.

Pandemia de la coviD-19 y las Políticas de Salud Pública en el Perú: marzo-mayo 2020

RESUMEN Objetivo El trabajo tiene como objetivo analizar la dinámica del comportamiento de la COVID-19 en el Perú, estimar y evaluar el impacto de la política pública de supresión (cuarentena). Métodos El modelo epidemiológico SIR y la estimación con el método de Mínimos Cuadrados Ordinarios (MCO). Resultados Se encontró que el número básico de propagación (Ro) cayó de 6,0 a 3,2 habiéndose reducido en 54% por efecto de la estrategia de supresión, y dos meses después cayó a 1,7. Sin embargo, sigue siendo alto y evidencia que aún continúa en expansión el nivel de infectados, con los efectos sociales y económicos adversos que esta medida implica. Conclusión La COVID-19 es una enfermedad que crece exponencialmente, por lo cual, la política de salud basada en la estrategia de supresión ha permitido aplanar la curva de contagio, evitando el colapso del Sistema de Salud.(AU) ABSTRACT Objective The objective of the study is to analyze the behavior dynamics of COVID-19 in Peru, estimate and evaluate the impact of the suppression public policy (quarantine). Methods The SIR epidemiological model and the estimation with the ordinary Least Squares (OLS) method. Results It was found that the basic number of propagation (Ro) fell from 6,0 to 3,2 having been reduced by 54% due to the suppression strategy;and two months later it falls to 1,7. However, it remains high and evidence that the level of those infected continues to expand with its adverse social and economic effects. Conclusion: COVID-19 is a disease that grows exponentially, and that the health policy based on the suppression strategy has allowed to flatten the contagion curve, thus avoiding the collapse of the Health System.(AU)

Behavior change due to COVID-19 among dental academics-The theory of planned behavior: Stresses, worries, training, and pandemic severity.

OBJECTIVE: COVID-19 pandemic led to major life changes. We assessed the psychological impact of COVID-19 on dental academics globally and on changes in their behaviors. METHODS: We invited dental academics to complete a cross-sectional, online survey from March to May 2020. The survey was based on the Theory of Planned Behavior (TPB). The survey collected data on participants' stress levels (using the Impact of Event Scale), attitude (fears, and worries because of COVID-19 extracted by Principal Component Analysis (PCA), perceived control (resulting from training on public health emergencies), norms (country-level COVID-19 fatality rate), and personal and professional backgrounds. We used multilevel regression models to assess the association between the study outcome variables (frequent handwashing and avoidance of crowded places) and explanatory variables (stress, attitude, perceived control and norms). RESULTS: 1862 academics from 28 countries participated in the survey (response rate = 11.3%). Of those, 53.4% were female, 32.9% were <46 years old and 9.9% had severe stress. PCA extracted three main factors: fear of infection, worries because of professional responsibilities, and worries because of restricted mobility. These factors had significant dose-dependent association with stress and were significantly associated with more frequent handwashing by dental academics (B = 0.56, 0.33, and 0.34) and avoiding crowded places (B = 0.55, 0.30, and 0.28). Low country fatality rates were significantly associated with more handwashing (B = -2.82) and avoiding crowded places (B = -6.61). Training on public health emergencies was not significantly associated with behavior change (B = -0.01 and -0.11). CONCLUSIONS: COVID-19 had a considerable psychological impact on dental academics. There was a direct, dose-dependent association between change in behaviors and worries but no association between these changes and training on public health emergencies. More change in behaviors was associated with lower country COVID-19 fatality rates. Fears and stresses were associated with greater adoption of preventive measures against the pandemic.

COVID-19 pandemic and Public Health Policies in Peru: March-May 2020

ABSTRACT Objective The objective of the study is to analyze the behavior dynamics of COVID-19 in Peru, estimate and evaluate the impact of the suppression public policy (quarantine). Methods The SIR epidemiological model and the estimation with the ordinary Least Squares (OLS) method. Results It was found that the basic number of propagation (Ro) fell from 6,0 to 3,2 having been reduced by 54% due to the suppression strategy;and two months later it falls to 1,7. However, it remains high and evidence that the level of those infected continues to expand with its adverse social and economic effects. Conclusion: COVID-19 is a disease that grows exponentially, and that the health policy based on the suppression strategy has allowed to flatten the contagion curve, thus avoiding the collapse of the Health System.