Pandemic within a pandemic! Policy Implications of community-based Interventions to mitigate violence against women during COVID-19 in Urban Slums of Lucknow, India.

Background: The COVID-19 pandemic has brought an unprecedented adverse impact on women's health. Evidence from the literature suggests that violence against women has increased multifold. Gender-based violence in urban slums has worsened due to a lack of water and sanitation services, overcrowding, deteriorating conditions and a lack of institutional frameworks to address gender inequities. Methods: The SAMBHAV (Synchronized Action for Marginalized to Improve Behaviors and Vulnerabilities) initiative was launched between June 2020 to December 2020 by collaborating with the Uttar Pradesh state government, UNICEF and UNDP. The program intended to reach 6000 families in 30 UPS (Urban Poor settlements) of 13 city wards. These 30 UPS were divided into 5 clusters. The survey was conducted in 760 households, 397 taken from randomly selected 15 interventions and 363 households from 15 control UPS. This paper utilized data from a baseline assessment of gender and decision-making from a household survey conducted in the selected UPS during July 03-15, 2020. A sample size of 360 completed interviews was calculated for intervention and control areas to measure changes attributable to the SAMBHAV intervention in the behaviours and service utilization (pre- and post-intervention). Results: The data analysis showed a significant difference (p-value < 0.001) between respondents regarding women's freedom to move alone in the control and intervention area. It also reflected a significant difference between control and intervention areas as the respondents in the intervention area chose to work for the cause of gender-based violence. Conclusion: The SAMBHAV initiative brought an intersectional lens to gender issues. The community volunteers were trained to approach issues based on gender-based violence with the local public, and various conferences and meetings were organized to sensitize the community. The initiative's overall impact was that it built momentum around the issue of applying the concept of intersectionality for gender issues and building resilience in the community. There is still a need to bring multi-layered and more aggressive approaches to reduce the prevalence of gender-based violence in the community.

Engaging Employers in Apprentice Training: Focus Group Insights from Small-to-Medium-Sized Employers in Ontario, Canada.

Several factors have been identified to influence the registration and retention of apprentices in the construction trades. Employer engagement is a key factor to promote growth in apprenticeships in the construction trades as participation rates continue to be low among small-to-medium-sized employers. In this study, we evaluated the effectiveness of the Ontario Electrical League's (OEL) employer mentorship program through the perspectives of small-to-medium-sized employers using a qualitative approach. Two focus groups were conducted virtually with 11 employers. Focus group audio transcripts were recorded and transcribed for thematic analysis. Themes were generated using a data-driven approach to examine the relationships between mentorship program outcomes and perspectives on industry-related recruitment and retention barriers. Three themes were identified: (a) long-term apprentice recruitment and retention challenges; (b) equity and mental health in the workplace; and (c) industry challenges and mentorship program outcomes. Generally, this sample of employers appreciated the value of the OEL mentorship program through praise of the continued educational support, employer management expertise, hiring resources, and apprentice onboarding tools despite industry barriers in trade stigma, equity and mental health in the workplace, and recruitment and retention challenges. Industry partners should work with these small-to-medium-sized employers to develop workplace initiatives and engage external partners to provide ongoing apprenticeship mentorship support to address the recruitment and retention barriers identified in this study.

Global vaccine inequities and multilateralism amid COVID-19: Reconnaissance of Global Health Diplomacy as a panacea?

Background: The ongoing COVID-19 pandemic has shown a crystal-clear warning that nobody will be safe until everybody is safe against the pandemic. However, how everyone is safe when the pandemic's fat tail risks have broken every nerve of the global economy and healthcare facilities, including vaccine equity. Vaccine inequity has become one of the critical factors for millions of new infections and deaths during this pandemic. Against the backdrop of exponentially growing infected cases of COVID-19 along with vaccine in-equity, this paper will examine how multilateralism could play its role in mitigating vaccine equity through Global Health Diplomacy (GHD). Second, given the most affected developing countries' lack of participation in multilateralism, could GHD be left as an option in the worst-case scenario?. Methods: In this narrative review, a literature search was conducted in all the popular databases, such as Scopus, Web of Science, PubMed and Google search engines for the keywords in the context of developing countries and the findings are discussed in detail. Results: In this multilateral world, the global governance institutions in health have been monopolized by the global North, leading to COVID-19 vaccine inequities. GHD aids health protection and public health and improves international relations. Besides, GHD facilitates a broad range of stakeholders' commitment to collaborate in improving healthcare, achieving fair outcomes, achieving equity, and reducing poverty. Conclusion: Vaccine inequity is a major challenge of the present scenario, and GHD has been partly successful in being a panacea for many countries in the global south.

COVID-19 vaccine acceptance and associated factors in 13 African countries: A systematic review and meta-analysis.

Background: The COVID-19 pandemic has severely affected the entire world, especially sub-Saharan Africa. As a result, researchers and government agencies are working to create effective COVID-19 vaccinations. While vaccination campaigns are moving rapidly in high-income nations, COVID-19 is still ruthlessly affecting people in low-income nations. However, this difference in the spread of the disease is not because of a lack of a COVID-19 vaccine but mainly due to people's reluctance. As a result, this review summarized the data on COVID-19 vaccination adoption and factors related among nations in sub-Saharan Africa. Method: Comprehensive searches were conducted using PubMed, Embase, Medline, Web of Science, Google Scholar, and the Cochrane Library databases. The risk of bias and methodological quality of each published article that fit the selection criteria were evaluated using Critical Appraisal Checklist tools. All statistical analysis was done by STATA 16. Results: This review was based on 29 studies with 26,255 participants from sub-Saharan Africa. Using a random-effects model, the pooled prevalence of COVID-19 vaccine acceptance among study participants was 55.04% (95 % CI: 47.80-62.27 %), I2 = 99.55%. Being male [POR = 1.88 (95% CI: 1.45, 2.44)], having a positive attitude toward the COVID-19 vaccine [POR = 5.56 (95% CI: 3.63, 8.51)], having good knowledge in the COVID-19 vaccine [POR = 4.61 (95% CI: 1.24, 8.75)], having government trust [POR = 7.10 (95% CI: 2.37, 21.32)], and having undergone COVID-19 testing in the past [POR = 4.41 (95%CI: (2.51, 7.75)] were significant predictor variables. Conclusion: This analysis showed that respondents had a decreased pooled prevalence of COVID-19 vaccination acceptance. Sex, attitude, knowledge, government trust, and COVID-19 testing were statistically significantly correlated characteristics that affected the acceptability of the COVID-19 vaccine. All stakeholders should be actively involved in increasing the uptake of the COVID-19 vaccine and thereby reducing the consequences of COVID-19. The acceptance of the COVID-19 vaccination can be increased by using this conclusion as an indicator for governments, healthcare professionals, and health policymakers in their work on attitude, knowledge, government trust, and COVID-19 testing.

COVID-19 vaccine acceptance and associated factors in 13 African countries: A systematic review and meta-analysis

Background The COVID-19 pandemic has severely affected the entire world, especially sub-Saharan Africa. As a result, researchers and government agencies are working to create effective COVID-19 vaccinations. While vaccination campaigns are moving rapidly in high-income nations, COVID-19 is still ruthlessly affecting people in low-income nations. However, this difference in the spread of the disease is not because of a lack of a COVID-19 vaccine but mainly due to people's reluctance. As a result, this review summarized the data on COVID-19 vaccination adoption and factors related among nations in sub-Saharan Africa. Method Comprehensive searches were conducted using PubMed, Embase, Medline, Web of Science, Google Scholar, and the Cochrane Library databases. The risk of bias and methodological quality of each published article that fit the selection criteria were evaluated using Critical Appraisal Checklist tools. All statistical analysis was done by STATA 16. Results This review was based on 29 studies with 26,255 participants from sub-Saharan Africa. Using a random-effects model, the pooled prevalence of COVID-19 vaccine acceptance among study participants was 55.04% (95 % CI: 47.80–62.27 %), I2 = 99.55%. Being male [POR = 1.88 (95% CI: 1.45, 2.44)], having a positive attitude toward the COVID-19 vaccine [POR = 5.56 (95% CI: 3.63, 8.51)], having good knowledge in the COVID-19 vaccine [POR = 4.61 (95% CI: 1.24, 8.75)], having government trust [POR = 7.10 (95% CI: 2.37, 21.32)], and having undergone COVID-19 testing in the past [POR = 4.41 (95%CI: (2.51, 7.75)] were significant predictor variables. Conclusion This analysis showed that respondents had a decreased pooled prevalence of COVID-19 vaccination acceptance. Sex, attitude, knowledge, government trust, and COVID-19 testing were statistically significantly correlated characteristics that affected the acceptability of the COVID-19 vaccine. All stakeholders should be actively involved in increasing the uptake of the COVID-19 vaccine and thereby reducing the consequences of COVID-19. The acceptance of the COVID-19 vaccination can be increased by using this conclusion as an indicator for governments, healthcare professionals, and health policymakers in their work on attitude, knowledge, government trust, and COVID-19 testing.

Factors Associated with Job Satisfaction in Medical Laboratory Professionals during the COVID-19 Pandemic: An Exploratory Study in Ontario, Canada.

Job satisfaction has been widely studied across several healthcare disciplines and is correlated with important outcomes such as job performance and employee mental health. However, there is limited research on job satisfaction among medical laboratory professionals (MLPs), a key healthcare group that aids in diagnosis, treatment, and patient care. The objective of this study is to examine the demographic and psychosocial factors associated with job satisfaction for MLPs in Ontario, Canada during the COVID-19 pandemic. A survey was administered to medical laboratory technologists (MLTs) and medical laboratory technicians/assistants (MLT/As) in Ontario, Canada. The survey included demographic questions and items from the Copenhagen Psychosocial Questionnaire, third edition. Binary logistic regressions were used to examine the association between job satisfaction and demographic variables and psychosocial work factors. There were 688 MLPs included in the analytic sample (72.12% response rate). Having a higher sense of community at work was correlated with higher job satisfaction in both MLT (OR = 2.22, 95% CI: 1.07-4.77) and MLT/A (OR = 3.85, 95% CI: 1.12-14.06). In addition, having higher stress was correlated with lower job satisfaction in both MLT (OR = 0.32, 95% CI: 0.18-0.57) and MLT/A (OR = 0.26, 95% CI: 0.10-0.66). This study provides preliminary evidence on factors associated with job satisfaction in MLT and MLT/A. The findings can be used to support organizational practices and policies to improve psychosocial work factors.

Long COVID Syndrome and Cardiovascular Manifestations: A Systematic Review and Meta-Analysis.

(1) Background: Long COVID syndrome is a significant cause of morbidity in COVID-19 patients who remain symptomatic with varied clinical presentations beyond three weeks. Furthermore, the relevance of considering cardiovascular outcomes in post-COVID-19 syndrome is important in the current COVID-19 pandemic; (2) Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed for this systematic review and meta-analysis. Systematic searches were conducted from multiple databases without language restrictions until October 8, 2022, to find studies evaluating cardiovascular outcomes such as arrhythmias, myocardium and pericardium diseases, coronary vessel disease, and thromboembolic disorders in post-COVID cases. The pooled odds ratio (OR), and standard mean difference (SMD) with their corresponding 95% confidence intervals (CI) were computed to find the association; (3) Results: Altogether, seven studies with a total of 8,126,462 (cases: 1,321,305; controls: 6,805,157) participants were included in the meta-analysis. Pooled odds ratios of cardiovascular outcomes were significantly higher in post-COVID cases (OR > 1, p < 0.05) than in controls. However, the mortality (OR: 4.76, p = 0.13), and heart rate variability (SMD: -0.06, p = 0.91) between cases and controls were not statistically significant; (4) Conclusions: Significant cardiovascular sequelae in long COVID syndrome highlight the importance of careful cardiac monitoring of COVID-19 patients in the post-COVID phase to address cardiovascular complications as soon as possible; larger-scale prospective studies are required for accurate estimation.

"Digital global health diplomacy" for climate change and human security in the Anthropocene.

The COVID-19 pandemic has now affected everyone, threatening every aspect of our well-being with over 617597680 confirmed cases, including 6532705 deaths globally. The context of the Anthropocene is the backdrop for the novel, interlinked, systemic, and global threats. Anthropocene is a term proposed to designate the era in which human beings have become predominant drivers of planetary change, drastically altering the planet's biosphere. The concept of global health diplomacy (GHD), which connects the domains of health and international relations, has a critical role in advancing human security. Thus, there is a need for new forms of diplomacy, which is critically important in this complex intermestic and interdependent Anthropocene era, where globalization has inevitably linked nations and population health. This paper introduces, analyzes, and attempts to define "Digital Global Health Diplomacy" (DGHD), which has gained great momentum during this COVID-19 pandemic with concurrent health and human security threats. The application of digital formats to the existing traditional structures for dialogue has become a more popular tool recently. Furthermore, digital means are being used during the COVID-19 pandemic to share the health diplomacy discourse at subnational, supranational, international, regional, and global platforms. DGHD reminds us again of the criticality of this multidisciplinary concept involving the contributions of diplomats, global health specialists, digital technology experts, economists, trade specialists, international law, political scientists, etc., in the global policymaking process. If used effectively by trained global health diplomats through innovative digital platforms, DGHD has a great scope of delivering results faster and has more reach than the traditional approach.

Pandemic preparedness and response: exploring the role of universal health coverage within the global health security architecture.

In response to the COVID-19 pandemic, several international initiatives have been developed to strengthen and reform the global architecture for pandemic preparedness and response, including proposals for a pandemic treaty, a Pandemic Fund, and mechanisms for equitable access to medical countermeasures. These initiatives seek to make use of crucial lessons gleaned from the ongoing pandemic by addressing gaps in health security and traditional public health functions. However, there has been insufficient consideration of the vital role of universal health coverage in sustainably mitigating outbreaks, and the importance of robust primary health care in equitably and efficiently safeguarding communities from future health threats. The international community should not repeat the mistakes of past health security efforts that ultimately contributed to the rapid spread of the COVID-19 pandemic and disproportionately affected vulnerable and marginalised populations, especially by overlooking the importance of coherent, multisectoral health systems. This Health Policy paper outlines major (although often neglected) gaps in pandemic preparedness and response, which are applicable to broader health emergency preparedness and response efforts, and identifies opportunities to reconceptualise health security by scaling up universal health coverage. We then offer a comprehensive set of recommendations to help inform the development of key pandemic preparedness and response proposals across three themes-governance, financing, and supporting initiatives. By identifying approaches that simultaneously strengthen health systems through global health security and universal health coverage, we aim to provide tangible solutions that equitably meet the needs of all communities while ensuring resilience to future pandemic threats.

Pandemic preparedness and response: exploring the role of universal health coverage within the global health security architecture

In response to the COVID-19 pandemic, several international initiatives have been developed to strengthen and reform the global architecture for pandemic preparedness and response, including proposals for a pandemic treaty, a Pandemic Fund, and mechanisms for equitable access to medical countermeasures. These initiatives seek to make use of crucial lessons gleaned from the ongoing pandemic by addressing gaps in health security and traditional public health functions. However, there has been insufficient consideration of the vital role of universal health coverage in sustainably mitigating outbreaks, and the importance of robust primary health care in equitably and efficiently safeguarding communities from future health threats. The international community should not repeat the mistakes of past health security efforts that ultimately contributed to the rapid spread of the COVID-19 pandemic and disproportionately affected vulnerable and marginalised populations, especially by overlooking the importance of coherent, multisectoral health systems. This Health Policy paper outlines major (although often neglected) gaps in pandemic preparedness and response, which are applicable to broader health emergency preparedness and response efforts, and identifies opportunities to reconceptualise health security by scaling up universal health coverage. We then offer a comprehensive set of recommendations to help inform the development of key pandemic preparedness and response proposals across three themes—governance, financing, and supporting initiatives. By identifying approaches that simultaneously strengthen health systems through global health security and universal health coverage, we aim to provide tangible solutions that equitably meet the needs of all communities while ensuring resilience to future pandemic threats.

Healthcare workers’ compliance with COVID-19 preventive measures, and associated factors, in Ethiopia: A systematic review and meta-analysis

Objective Compliance with COVID-19 prevention measures limits infection occurrence and spread in healthcare settings. According to research conducted in Ethiopia, compliance with COVID-19 preventative strategies is inconsistent among healthcare providers. This systematic review and meta-analysis aimed to estimate the national pooled proportion of healthcare workers (HCWs) who adhere to COVID-19 preventive measures and associated factors with good compliance. Design A systematic review and meta-analysis of all identified studies with cross-sectional study design. Data sources A comprehensive search was conducted in PubMed/MEDLINE, POPLINE, HINARI, Science Direct, Cochrane Library databases and Google Scholar search engines from January 2020 to September 2021. Data extraction and synthesis This review included all observational studies conducted in Ethiopia that reported the proportion of compliance with COVID-19 preventive measures and associated factors among HCWs. Two independent authors assessed the methodological quality of studies using Joanna Briggs Institute’s meta-analysis of statistical assessment and review instrument. The effect estimates for pooled proportion and pooled OR (POR) were determined. Results From retrieved 611 original studies, 21 studies were included in the meta-analysis with a total of n=7933 HCWs. The pooled proportion of good compliance with COVID-19 preventive measures among HCWs was 49.7% (95% CI: 42.3% to 57.1%). Being male (POR=2.21, 95% CI: 1.52 to 3.21), service years (>3 years) (POR=2.65, 95% CI: 1.94 to 3.64), training (POR=2.30, 95% CI: 1.78 to 2.98), positive attitude (POR=3.14, 95% CI: 1.66 to 5.94) and good knowledge (POR=2.36, 95% CI: 1.92 to 2.89) were factors significantly associated with good compliance towards COVID-19 preventive measures. Conclusion Our study indicated that approximately one in every two HCWs had good compliance with COVID-19 preventive measures. There must be more emphasis on providing further training sessions for the HCWs to improve their compliance with COVID-19 preventative measures.

Standardizing Primary Health Care Referral Data Sets in Nigeria: Practitioners' Survey, Form Reviews, and Profiling of Fast Healthcare Interoperability Resources (FHIR).

BACKGROUND: Referral linkages are crucial for efficient functioning of primary health care (PHC) systems. Fast Healthcare Interoperability Resource (FHIR) is an open global standard that facilitates structuring of health information for coordinated exchange among stakeholders. OBJECTIVE: The objective of this study is to design FHIR profiles and present methodology and the profiled FHIR resource for Maternal and Child Health referral use cases in Ebonyi state, Nigeria-a typical low- and middle-income country (LMIC) setting. METHODS: Practicing doctors, midwives, and nurses were purposefully sampled and surveyed. Different referral forms were reviewed. The union of data sets from surveys and forms was aggregated and mapped to base patient FHIR resource elements, and extensions were created for data sets not in the core FHIR specification. This study also introduced FHIR and its relation to the World Health Organization's (WHO's) International Classification of Diseases. RESULTS: We found many different data elements from the referral forms and survey responses even in urban settings. The resulting FHIR standard profile is published on GitHub for adaptation or adoption as necessary to aid alignment with WHO recommendations. Understanding data sets used in health care and clinical practice for information sharing is crucial in properly standardizing information sharing, particularly during the management of COVID-19 and other infectious diseases. Development organizations and governments can use this methodology and profile to fast-track FHIR standards adoption for paper and electronic information sharing at PHC systems in LMICs. CONCLUSIONS: We presented our methodology for profiling the referral resource crucial for the standardized exchange of new and expectant moms' information. Using data from frontline providers and mapping to the FHIR profile helped contextualize the standardized profile.

Best practices for effective implementation of online teaching and learning in medical and health professions education: during COVID-19 and beyond

The COVID-19 pandemic has caused worldwide disruption to the entire educational system, including medical and health professions education. Considering the critical situation due to COVID-19, academic institutions shifted the entire pedagogical approach to the virtual learning mode. While delivering online teaching, educators experienced numerous challenges, including access to the internet, poor connectivity, and other technical issues. Some students did not have laptops and necessary devices to attend the Class. Besides, many educators were not confident enough to manage the online mode of delivery. In this perspective, we reviewed the evidence of best practices for the medical and health professions educators to deliver the curriculum through an online platform. Therefore, the current study aimed to review the best practices for effective online teaching and learning in medical and health professions education during COVID-19 and beyond. We reviewed the technical aspects of online teaching and educational strategies required for educators to provide quality training not just during the pandemic but beyond this crisis. The online literature search was performed on Medline, PubMed and google scholar databases for studies on online teaching in medical and health profession education and what are the best practices of teaching globally Online teaching and assessment must balance the requirements of technology, learning outcomes, delivery modes, learning resources, and learning resources. The study concludes that medical and health professions institutions strengthen technical infrastructure, promote continuous faculty development programs, and support indigent students to access digital technology.

Healthcare Workers' Knowledge and Perception of the SARS-CoV-2 Omicron Variant: A Multinational Cross-Sectional Study.

In late November 2021, a new SARS-CoV-2 Variant of Concern (VOC) named Omicron (initially named B.1.1.529) was first detected in South Africa. The rapid spread of the SARS-CoV-2 Omicron variant became globally dominant, and the currently available COVID-19 vaccines showed less protection against this variant. This study aimed to investigate healthcare workers' (HCWs) knowledge and perceptions about the novel SARS-CoV-2 Omicron variant. A cross-sectional anonymous electronic survey concerning the SARS-CoV-2 Omicron variant was conducted among HCWs during the second week of January 2022. The survey instrument was distributed through social media among HCWs to explore awareness (2 items), knowledge (10 items), source of information (1 item), and perceptions (10 items). Respondents who answered ≥80% of the items correctly were considered as having good knowledge and perception. A total of 940 of the 1054 HCW participants completed the survey (response rate: 89.1%); they had a mean age of 31.2 ± 11.2 years, most were doctors (45.7%), and most were from Asia (64.3%). All the participants were aware of the SARS-CoV-2 Omicron variant (100%). Only 36.3% attended lectures/discussions about Omicron and used news media to obtain information. Only a quarter of the HCWs demonstrated good knowledge (24.3%, n = 228) and perception (20.6%) about Omicron. However, while significant differences were observed in the knowledge and perception among HCWs, only a small proportion of doctors exhibited good knowledge (13%) and perception (10%) about the Omicron variant. HCWs who had participated in training/discussion related to the Omicron variant were more likely to have higher knowledge and perception scores (odds ratio: 1.80; 95% confidence interval: 1.04-3.11). As the SARS-CoV-2 Omicron variant spreads rapidly across the globe, ongoing educational interventions are warranted to improve knowledge and perceptions of HCWs.

India’s Neighbourhood Vaccine Diplomacy During COVID-19 Pandemic: Humanitarian and Geopolitical Perspectives

In recent years, India has established itself as the world?s ?pharmacy hub?, and this claim was proven once again when it delivered COVID-19 vaccines to its citizens, neighbouring nations and across the globe. Following the philosophy of humanitarianism through the principle of ?Vasudhaiva Kutumbakam?, India has decided to provide the COVID-19 health assistance to its immediate neighbouring countries. India?s immediate neighbourhood refers to the countries that are geographically adjacent to it. In addition, India?s vaccine diplomacy has exposed geopolitical fault lines in South Asia as China?s vaccine diplomacy aims to outpace India in the region. Against this background, the main objective of this paper is to explain and examine India?s vaccine diplomacy as an instrument of its ?Neighbourhood First? policy during the COVID-19 pandemic. It argues that India?s health-focused approach has proved effective and aligned with its national interests. This review demonstrates that India?s health diplomacy has had an impact on medical and humanitarian assistance reciprocation at the regional and international levels. As a result of this strategy, during the second wave of the pandemic, India received medical devices and vaccines from other countries in dealing with COVID-19.

Prevalence of depression and anxiety among general population in Pakistan during COVID-19 lockdown: An online-survey.

The present study's aim is to find the prevalence of two of the common indicators of mental health - depression and anxiety - and any correlation with socio-demographic indicators in the Pakistani population during the lockdown from 5 May to 25 July 2020. A cross-sectional survey was conducted using an online questionnaire sent to volunteer participants. A total of 1047 participants over 18 were recruited through convenience sampling. The survey targeted depression and anxiety levels, which were measured using a 14 item self-reporting Hospital Anxiety and Depression Scale (HADS). Out of the total sample population (N=354), 39.9% suffered from depression and 57.7% from anxiety. Binary logistical regressions indicated significant predictive associations of gender (OR=1.410), education (OR=9.311), residence (OR=0.370), household income (OR=0.579), previous psychiatric problems (OR=1.671), and previous psychiatric medication (OR=2.641). These were the key factors e associated with a significant increase in depression. Increases in anxiety levels were significantly linked to gender (OR=2.427), residence (OR=0.619), previous psychiatric problems (OR=1.166), and previous psychiatric medication (OR=7.330). These results suggest depression and anxiety were prevalent among the Pakistani population during the lockdown. Along with other measures to contain the spread of COVID-19, citizens' mental health needs the Pakistani government's urgent attention as well as that of mental health experts. Further large-scale, such as healthcare practitioners, should be undertaken to identify other mental health indicators that need to be monitored.

COVID-19 and Global Distributive Justice: ‘Health Diplomacy’ of India and South Africa for the TRIPS waiver

The second wave of the COVID-19 pandemic had left heart-wrenching impacts on all facets of life in general and the availability, accessibility, and affordability of medicines and vaccines in particular. Rather, the world has been divided into two groups regarding access to medicine and vaccines as haves and have-nots. The rich countries had pre-ordered the vaccines of COVID-19 along with the holding of the same. The pandemic situation was further worsened, given the Trade-Related Intellectual Property Rights (TRIPS) in practice and restrictions on sharing technology of vaccines, medicines, and life-saving equipment. In this context, India and South Africa have proposed the joint proposal and garnered support for waiving off TRIPS to ensure equity, accessibility, and affordability of vaccines and the same as public goods. In this review, we emphasize that global justice is one of the important elements of normative international theories, which focus on all the moral obligations from the world?s rich to the world?s poor. The paper also questions and argues that if the rich countries fail to go by the principles of global justice, can the Indian and South African (SA) patent diplomacy play a catalyst role in global justice? The review concludes with an emphasis on global solidarity, and the acceptance of joint India?South Africa?s ?patent diplomacy? for TRIPS waiver would result in mass production and fair distribution, making the COVID-19 medicines and technologies available to everyone regardless of their poor?rich status.

COVID-19 pandemic containment in the Caribbean Region: A review of case-management and public health strategies.

COVID-19 emerged initially from Wuhan, Hubei province, China, in late December 2019, and since then, it has spread globally to be declared a pandemic by the World Health Organization. The Caribbean region started reporting COVID-19 cases in early March 2020, triggering new regional public health crises. The initial suspects and confirmed cases across the Caribbean countries were mainly imported cases and from cruise ships. The clinical manifestations varied from fever, cough, and malaise in mild cases to acute respiratory distress syndrome (ARDS) and shock in severe cases. The Caribbean Public Health Agency has provided frequent updates on the preventive strategies and quarantine measures across the Caribbean member states. COVID-19 has had a serious impact on the Caribbean region's health system, economy, and psychology. This review presents the Caribbean perspective of COVID-19, detailing the epidemiology, clinical manifestations, diagnosis, management, and preventive and surveillance measures. Vaccine hesitancy was found to be a major challenge that needs appropriate health education strategies to address the public. Strong leadership and regional collaboration among the Caribbean member states are necessary to provide optimal real-time data to the public and implement appropriate and effective guidelines in the island states.