Students’ Experiences of E-learning Practices During COVID-19: A Qualitative Study

COVID-19 pandemic has disrupted schooling globally. Affecting millions of students, the conventional face-to-face (F2F) education system has been replaced by e-learning overnight. As the advantages, disadvantages, and technical challenges of this abrupt transformation were already well-documented, this study aimed to intensely scrutinize university students' experiences of e-learning practices in this new normal situation. Methods: Adopting the Interpretative Phenomenological Analysis (IPA), a smaller sample of respondents (N=25) was observed to gain deeper insights using semi-structured interviews. Data were analyzed and interpreted through thematic analysis. Findings revealed that most of the students have had unfavorable experiences with e-learning. The majority of students feel that e-learning has ruined their social relationships by isolating them from their peers and instructors. A significant number of students were observed to be anxious about their future due to unstable financial status, poor learning outcomes, and unfair evaluation processes. Moreover, poor self-esteem, anxiety, and depressive symptoms have been observed among a significant portion of the students. The overall findings of this study are meant to assist stakeholders in taking the necessary steps to address the aforementioned issues and ensure an improved learning experience, particularly in an e-learning environment.

Disparities in critical care resources across Pakistan – findings from a national survey (preprint)

Background: In response to the COVID-19 pandemic, concerted efforts were made by provincial and federal governments to invest in critical care infrastructure and medical equipment to bridge the gap of resource-limitation in Intensive Care Units (ICUs) across Pakistan. An initial step in creating a plan towards strengthening Pakistan’s baseline critical care capacity was to carry out a needs-assessment within the country to assess gaps and devise strategies for improving the quality of critical care facilities.  Methods: To assess the baseline critical care capacity of Pakistan, we conducted a series of cross-sectional surveys of hospitals providing COVID-19 care across the country. These hospitals were pre-identified by the Health Services Academy (HSA), Pakistan. Surveys were administered via telephonic and on-site interviews and based on a unique checklist for assessing critical care units which was adapted from the Partners in Health 4S Framework, which is: Space, Staff, Stuff, and Systems. These components were scored, weighted equally, and then ranked into quartiles.  Results: A total of 106 hospitals were surveyed, with the majority being in the public sector (71.7%) and in the metropolitan setting (56.6%).  We found infrastructure, staffing, and systems lacking as only 19.8% of hospitals had negative pressure rooms and 44.4% had quarantine facilities for staff. Merely 36.8% of hospitals employed accredited intensivists and 54.8% of hospitals maintained an ideal nurse-to-patient ratio. 31.1% of hospitals did not have a staffing model while 37.7% of hospitals did not have surge policies. On chi-square analysis, statistically significant differences (p<0.05) were noted between public and private sectors along with metropolitan versus rural settings in various elements. Almost all ranks showed significant disparity between public-private and metropolitan-rural settings, with private and metropolitan hospitals having a greater proportion in the 1st rank, while public and rural hospitals had a greater proportion in the lower ranks. Conclusion: Pakistan has an underdeveloped critical care network with significant inequity between   public-private and metropolitan-rural strata. We hope for future resource allocation and capacity development projects for critical care in order to reduce these disparities.

Comparative inhibition analysis of wild type and G671S catalytic site mutant of the SARS-CoV-2 RNA-dependent RNA polymerase (preprint)

Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) has wrecked a global havoc, after its emergence in Wuhan, Hubei province of China. It is known to have a distressing effect on the respiratory tract and has a high mortality rate. Till to date (25 Dec 2021), total number of cases (279,362,428) have been reported across the globe. Variable mutations have been reported on various geographical levels. In this study, we have analyzed G671S mutation of RdRp of the SARS-CoV-2, which has been reported in various strains globally, but importantly delta variant cases of Pakistan and has a serious impact on the protein structure. To study the conformational impact, we screened a Tibetan medicinal compound/Sowa Rigpa library against RdRp and compared the best docked compound (Kaempferol 3-O-gentiobioside) to the wild type and mutant RdRp against Remdesivir. A short simulation was used to validate the findings. Both remdesivir and our screened compound showed better inhibition for mutant, compared to the wild type RdRp.

Uncovering socioeconomic gaps in mobility reduction during the COVID-19 pandemic using location data (preprint)

Using smartphone location data from Colombia, Mexico, and Indonesia, we investigate how non-pharmaceutical policy interventions intended to mitigate the spread of the COVID-19 pandemic impact human mobility. In all three countries, we find that following the implementation of mobility restriction measures, human movement decreased substantially. Importantly, we also uncover large and persistent differences in mobility reduction between wealth groups: on average, users in the top decile of wealth reduced their mobility up to twice as much as users in the bottom decile. For decision-makers seeking to efficiently allocate resources to response efforts, these findings highlight that smartphone location data can be leveraged to tailor policies to the needs of specific socioeconomic groups, especially the most vulnerable.

Utility of FebriDx in early identification of possible COVID19 infection (preprint)

Background Reliable differentiation between uncomplicated and self-limiting acute respiratory tract infections (ARIs) and more severe bacterial respiratory tract infections remains challenging, due to the non-specific clinical manifestations in both systemic bacterial or viral infections. The current COVID-19 pandemic is putting extraordinary strain on healthcare resources. To date, molecular testing is available but has a long turnaround time and therefore cannot provide results at the point-of-care, leading to a delay in results thereby exposing patients to cross-infection and delay in diagnosis (1-3). Methods We prospectively evaluated the utility of FebriDx®, a point-of-care fingerstick blood test that can differentiate viral from bacterial ARIs through simultaneous detection of both Myxovirus-resistance protein A (MxA) and C-reactive protein (CRP), in rapidly determining viral cases requiring immediate isolation and confirmatory molecular testing, from non-infectious patients or bacterial infections that require antibacterial therapy.Results 75 consecutive patients were assessed and 48 eligible cases were tested with FebriDx®. Overall, 35 patients had FebriDx® test viral positive. All 35 patients had either positive rt-PCR (n=30) for COVID-19 or clinical picture highly suggestive of COVID-19 infection (PPV of 100% in a pandemic situation)[AB1] . In the 13 cases it was viral negative, rRT-PCR was also negative in all cases. In one case of LRTI, it was not possible to determine the exact cause of infection and a viral infection couldn’t be excluded. Including this patient, the NPV was 12/13 (92%) exceeding the NPV of rRt-PCR at 71% (12/17). Sensitivity was conservatively calculated at 97% (35/36) compared to 85.7% (30[RS2] /35) for rRt-PCR.  Similarly the specificity of both FebriDx®and rRt-PCR was 100% (12/12).Conclusions In the current COVID-19, FebriDx® shows potential as a reliable POC test and a proxy marker of COVID-19 infection amongst inpatients in a secondary care setting.  [AB1]35/35 equates to a sensitivity and specificity of 100% for COVID, would you be willing to say that instead of ‘near 100% ppv)? [RS2]I believe PCR was 85.7% (30/35), because PCR only detects the COVID cases