Use of Telehealth During the COVID-19 Pandemic Among Practicing Maternal-Fetal Medicine Clinicians.

Background: Limited knowledge exists about the drivers of telehealth use among obstetricians during COVID-19 in the United States. We investigated the use of live video visits by Maternal-Fetal Medicine (MFM) clinicians, the factors associated with use and interest in future use. Methods: We drew survey data from 373 clinicians on two outcomes: (1) use of any (vs. no) live video visits during COVID-19 and (2) among users, the extent of live video use. Bivariate and multivariate logistic regressions quantified the association between predisposing (demographic and practice setting characteristics) and enabling factors (prepandemic telehealth use, structural and perceived patient barriers) and each outcome. Results: During the pandemic, 88% reported any use, a jump from 29% prepandemic utilization. Users (vs. nonusers) were younger (p = 0.02); tended to provide comprehensive prenatal care (p = 0.01) and/or inpatient care (p = 0.02), practice in university settings (p = 0.01), engage in various telehealth modalities prepandemic (p ≤ 0.01), and to perceive challenges with technical (p < 0.01), reimbursement (p = 0.05), and patient barriers to internet or data plan access (p ≤ 0.001). After adjusting for covariates, only prepandemic communication through patient portal (adjusted odds ratio [aOR] = 3.85; 95% confidence interval [CI] = 1.33-11.12), perceived patient access barriers (aOR = 5.27; 95% CI = 1.95-14.23), and practice in multiple versus university settings (aOR = 0.18; 95% CI = 0.06-0.56) remained significantly associated with use. Approximately 44% were high users. Prepandemic ultrasound use (aOR = 1.92; 95% CI = 1.17-3.16), perceived patient access barriers (aOR = 1.85; 95% CI = 1.12-3.06) and Midwest versus North practice location (aOR = 0.46; 95% CI = 0.21-0.98) predicted high use. Among high users, 99% wanted to continue offering video visits. Conclusions: We found widespread use of live video obstetric care by MFM clinicians and continued interest in use postpandemic.

Assessing the general health, increase in mental and physical workload among administrative staff of the University of Nigeria due to the COVID-19 pandemic.

The coronavirus disease 2019 (COVID-19) pandemic has changed the global workloads and general well-being of employees, especially in the university system. The object of this study is to evaluate the mental health and effect of increase in workload on the general well-being of the administrative staff of the University of Nigeria, Nsukka, on the resumption of academic activities after the lockdown due to COVID-19. A total of 73 randomly selected administrative staff were involved in the study. Three sets of instruments, the demographic questionnaire, National Aeronautics and Space Administration-Task Load Index, and General Health Questionnaire, were used to obtain information on the demographic characteristics, workload, and level of mental disorder among the respondents due to COVID-19. The generalized linear regression model, 1-way analysis of variance, independent samples t test, and contingency coefficient were used to analyze the data. The results revealed that high workload is significantly associated with high risk of mental and general health disorders among the respondents. The married, divorced, widowed, older, and females staff with >2 children are the most vulnerable to mental disorder, physical workload, frustration, and general health challenges. The younger staff, those with at most 2 children, and those who are still single experience lower mental and general health disorder and are more resilient. Significant and comprehensive health and administrative support should be provided for the overall well-being of the staff.

Political Affiliation and Race Associated With Parents’ Intentions to Have a COVID-19 Vaccination but Not With History of Refusing to Vaccinate a Child: A Cross-Sectional Study (preprint)

Background: Parental attitudes about vaccinating themselves against COVID-19 may offer insights into their attitudes about vaccinating their children when the time comes. The objective was to identify parents with high COVID-19 vaccine hesitancy to prioritize for vaccine education interventions.Methods. We conducted multiple logistic regression on data from a nationally representative sample to estimate the association between socio-demographic factors and COVID-19 vaccine intention and history of refusal to vaccinate a child.   Results. In the adjusted model, parents who were Black, female, Republican, and lower income had a significantly lower odds of COVID-19 vaccine intention (adjusted Odds Ratio [aOR]=0.47, 0.73, 2.59, 0.50, respectively). Only age was associated with previous vaccine refusal. Conclusions. The results highlight the politicization of the pandemic and the possibility of continued disparities in COVID-19 health outcomes among those unlikely to get COVID-19 vaccination. Overall, a high proportion of parents and children may ultimately go unvaccinated given that parents’ vaccine behavior is closely tied to that of their children. This is concerning given the role that younger adults and pediatric populations play in sustaining SARS-CoV-2 transmission. 

Covid-19 treatment options and vaccination in india: A perspect

The origin of Severe Acute Respiratory Syndrome Coronavirus-2 [SARS CoV-2] from Wuhan city, China advanced to the cata-strophic pandemic. There are attempts universally to gear up the potential therapeutic line in the treatment of COVID-19. The current management for COVID-19 is leaning towards the repurposing of drugs based on preceding outbreak data [SARS 2002-2003, MERS-2012] and structural organization and genomics of the coronavirus. Unfortunately, no specific therapy is available to treat coronavirus infection amidst this emergency. Antibody improvement is a key element for decreasing mortality related to viral diseases. Viral vaccines have to be immunogenic, safe, efficacious and suitable to induce long-lasting immunity. Studies are being expedited right now in the development of a vaccine for coronavirus globally. India with a dense population and enormous resources related to pharmaceuticals can be one of the bulk manufacturers of Coronavirus vaccines. This article focuses on the outline of therapeutic options, vaccine development strategy and highlights the current status of vaccines trials in India. ©@IJCRR.

Emergency department presentations in the Southern District of New Zealand during the 2020 COVID-19 pandemic lockdown.

OBJECTIVE: To assess changes in presentations to EDs during the COVID-19 pandemic lockdown in the Southern Region of New Zealand. METHODS: We conducted a retrospective audit of patients attending EDs in the Southern District Health Board (SDHB), from 1 March to 13 May 2020. We made comparisons with attendances during the same period in 2019. The 2020 study period included 'pre-lockdown' (1 March-25 March), 'level 4 (strict) lockdown' (26 March-27 April) and 'level 3 (eased) lockdown' (28 April-13 May). RESULTS: Patient volumes reduced in all SDHB EDs during levels 4 and 3, mostly representing a loss of low acuity patients (Australasian Triage Scale 3, 4 and 5), although high-acuity presentations also declined. Average patient age increased by 5 years; however, the proportions of sexes and ethnicities did not change. Presentations of cerebrovascular accidents and appendicitis did not change significantly. Trauma, mental health, acute coronary syndrome and infectious respiratory presentations decreased significantly during level 4, and infectious respiratory presentations decreased further in level 3. CONCLUSIONS: Within the SDHB, patient volumes reduced during levels 4 and 3 of our lockdown, with reduced low-acuity presentations. High-acuity patient numbers also declined. Trauma, mental health, alcohol-related, infectious respiratory and acute coronary syndrome presentations declined while cerebrovascular accident and appendicitis numbers showed little to no change.

Maternal transmission of SARS-COV-2 to the neonate, and possible routes for such transmission: a systematic review and critical analysis.

BACKGROUND: Early reports of COVID-19 in pregnancy described management by caesarean, strict isolation of the neonate and formula feeding. Is this practice justified? OBJECTIVE: To estimate the risk of the neonate becoming infected with SARS-CoV-2 by mode of delivery, type of infant feeding and mother-infant interaction. SEARCH STRATEGY: Two biomedical databases were searched between September 2019 and June 2020. SELECTION CRITERIA: Case reports or case series of pregnant women with confirmed COVID-19, where neonatal outcomes were reported. DATA COLLECTION AND ANALYSIS: Data were extracted on mode of delivery, infant infection status, infant feeding and mother-infant interaction. For reported infant infection, a critical analysis was performed to evaluate the likelihood of vertical transmission. MAIN RESULTS: Forty nine studies included information on mode of delivery and infant infection status for 655 women and 666 neonates. In all, 28/666 (4%) tested positive postnatally. Of babies born vaginally, 8/292 (2.7%) tested positivecompared with 20/374 (5.3%) born by Caesarean. Information on feeding and baby separation were often missing, but of reported breastfed babies 7/148 (4.7%) tested positive compared with 3/56 (5.3%) for reported formula fed ones. Of babies reported as nursed with their mother 4/107 (3.7%) tested positive, compared with 6/46 (13%) for those who were reported as isolated. CONCLUSIONS: Neonatal COVID-19 infection is uncommon, rarely symptomatic, and the rate of infection is no greater when the baby is born vaginally, breastfed or remains with the mother. TWEETABLE ABSTRACT: Risk of neonatal infection with COVID-19 by delivery route, infant feeding and mother-baby interaction.