ABSTRACT
INTRODUCTION: The unprecedented nature of the COVID-19 pandemic has led to contentious discourse around issues related to vaccines and unproven COVID-19 therapies (UCTs), such as ivermectin. Despite recommendations against its use, ivermectin remains heavily used, and in some areas, highly demanded. We explored perceptions of patients living in the rural South about UCTs and healthcare distrust. METHOD(S): This mixed methods study was conducted from 2021-2022 in Moultrie, Georgia. Adult patients with a history of COVID-19 were recruited from inpatient and outpatient settings of a healthcare system. Validated phone questionnaires assessing healthcare distrust and a 30-minute qualitative interview exploring healthcare trust, perceptions of UCTs, and evidence-based therapies (eg monoclonal antibodies and vaccines) were conducted. Thematic analysis was applied to transcripts. Nonparametric independent samples Mann-Whitney U tests used conducted to compare survey means (95% CI). RESULT(S): We recruited 26 patients (62% female, 85% white). Eight themes emerged: 1) Anecdotal stories and personal experiences influence decision-making about COVID-19;2) Use of a haphazard approach to ;research';3) Strong distrust of national government and healthcare organizations;4) Strong trust in local doctors and the local health system;5) Decision-making is viewed as weighing pros and cons;6) Lack of consistency in COVID-19 related medication decisions (eg ivermectin, monoclonal antibodies, remdesivir);and 7) Patients value autonomous decisions about their healthcare and feel they have a right to try medications (knowing possible risks). High survey means indicated high distrust;healthcare distrust mean scores of those who requested/used ivermectin versus those who did not had a mean difference of 7.1 points (p=0.027). CONCLUSION(S): Although trust of healthcare and government was low, trust in local physicians was high. Patients value the right to try ivermectin, this desire was fueled by distrust of government. If clinicians are perceived as aligned with the government, such alignment may void trust of clinicians. Health messages should invoke patient autonomy and be framed as presenting options (including pros/cons) and should balance patient autonomy with clinicians' ethical parameters around unproven medical treatments.
ABSTRACT
Background: In 2020, the severe acute respiratory syndrome coronavirus 2 pandemic caused serious concerns about the availability of face masks. This paper studies the technical feasibility of user-specific face mask production by 3D printing and the effectiveness of these masks. Material & methods: Six different face mask designs were produced by 3D printing and tested by subjective experimenter evaluation and using a respirator fit testing kit. Results were compared with the requirements as given for standard protective face masks. Results: None of the printed masks came anywhere near the required standards for personal protective gear. Conclusion: In spite of their euphoric presentation in the press, none of the currently advertised 3D printed mask designs are suitable as reliable personal protective equipment.