3D Printing During the Covid-19 Pandemic in Lebanon: Strategic Cooperative Behavior to Reduce the Global Shortage of Personal and Protective Equipment (PPEs)

The COVID 19 pandemic has caused an unprecedented health and economic crisis which was characterized by a rapid shortage of Personal Protective Equipment (PPEs). Over the last few decades, academics and practitioners have argued that ‘public health’ should be considered as a Global Public Good (GPG), with a particular emphasis on the control of infectious diseases. The provision of GPGs today—nationally and internationally—involves multiple authorities and actors of varying power at different jurisdictional levels. Strategic behavior and noncooperative and cooperative game theory plays a major role in the success or failure of GPG provision. During the Covid-19 pandemic, the PPEs shortage was alleviated by the involvement of the 3D Printing community which implemented several initiatives. Indeed, health care providers, 3D printing organisations, designers and engineers cooperated to supply PPEs. Software designers released their PPEs digital files, and by choosing freeware, they contributed to the production of the GPG. In this paper, we argue that the success of the 3D printing community in establishing a culture of shared knowledge and data to increase the supply of medical PPEs was made possible thanks to the availability of technology (including 3D Printing and scanning, Artificial Intelligence, and nanomedicine). A game theory model will be used to illustrate the cooperative strategic behaviour of various players involved in this process, and the lessons learned are instrumental for public health policies as well as for intellectual property laws. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

The Association of Knowledge, Perception and Attitude of COVID-19 with the Psychological Status of the Public in Saudi Arabia

OBJECTIVE: To determine the association of knowledge, perception, and attitude of COVID-19 with the psychological distress status of the public in Saudi Arabia. METHODOLOGY: A cross-sectional study was performed among 429 participants using an online survey after approval from Umm Al-Qura University in March 2020. Data collection took three months during COVID-19 outbreak (May-July 2020). An online survey was composed of items related to knowledge, perception, attitude, and the population's psychological status during COVID-19 in Saudi Arabia. Association tests were used at a significance level of < 0.05 and a 95% confidence interval. RESULT(S): Nearly 80% of the participants had variable degrees of psychological distress. There were significant associations of perception (fear of being infected with COVID-19, (p < 0.05), fear of being in contact with patients with COVID-19 (p < 0.05), and fear of inability to continue their usual activities/work (p < 0.05), changes in social habits (p < 0.05), and following the precautional measures to prevent acquiring COVID-19 infection (p < 0.05) with psychological status. At the same time, the association of Knowledge regarding COVID-19 with psychological level was not statistically significant (p = 0.221). CONCLUSION(S): Most of the participants had variable degrees of psychological distress. There were significant associations of most of the elements of perception and attitudes of the public regarding COVID-19 with their psychological distress. The public should implement psychological support programs during the pandemic to help them overcome COVID-19-related psychological distress. Copyright © 2022, J Liaquat Uni Med Health Sci. All rights reserved.

Young Adult's Health-Preventive Behaviors toward Coronavirus Disease 2019

OBJECTIVE: To explore the young adult's coronavirus disease 2019 (COVID-19) health-preventive behaviors in Saudi Arabia. METHODOLOGY: Semi-structured virtual interviews regarding health-preventive behaviors were conducted with 35 participants during the lockdown because of the pandemic. The Health Belief Model was used in the analysis and data presentation. RESULTS: Young adults had feelings of fear, loneliness, anxiety, irritability, easy distraction, loss of concentration, and depression during the outbreak of the COVID-19 pandemic. Participants in this study were aware of the benefits of applying the health-preventive actions. The reported barriers hinder some of them from using some of the COVID-19 health-preventive steps are mainly related to social distancing and the curfew on some people. The participants reported their confidence in their COVID-19 health preventive knowledge and stated that they could protect themselves and others from getting infected with COVID-19. CONCLUSION: According to HBM, they strongly believe in health actions efficacy in their country and followed the COVID-19 health-preventive actions. Participants had a positive perception regarding the threat and severity of COVID-19 infection. Financial consequences of the curfew, noncompliance with the preventive actions' and lack of awareness of the importance of the health-preventive activities of some people are among the barriers to applying the COVID-19 health-preventive measures.

Transition to Tertiary Education and eLearning in Lebanon Against the Backdrop of Economic Collapse and Covid-19 Pandemic

This paper aims at describing academic trajectories of young students transitioning to tertiary education and online education, in the shadow of economic, security and health crises. Based on a survey conducted in 2020, among a population of 361 newly enrolled students in one of the biggest universities in Lebanon, it provides an overview of the academic challenges of online teaching and studying in time of Covid-19, in order to study its impact on their lived experience (uneasiness) and academic performances. The mental uneasiness refers to a state of being uneasy, apprehensive, or worried about what may happen. Despite the high levels of mental uneasiness and connectivity problems, Lebanese students seem to be highly motivated to study and succeed in a context of extreme adversity, since university degrees are perceived as a major passport for economic immigration. © 2021, Springer Nature Switzerland AG.

Online Education in Lebanon During the Covid-19 Crisis: An Ongoing Coping Phase

The Lebanese educational system muddles through the Covid-19 pandemic with limitations to effective application of Online Teaching/Learning, and official indecisiveness towards going back to face-to-face instruction. A national survey on 7095 respondents from the different educational stakeholders in Lebanon was launched to by the Center for Educational Research and Development in order to identify the online learning experience of the Lebanese educational community. This paper analyzes the needs and the gaps of Online teaching in a country where approximately 70% of the schools had their first experience in online learning during the COVID 19 pandemic and where approximately 60% of the students attend online classes using their cell phones. The paper compares the perception of 3 groups: students, parents, and teachers. © 2021, Springer Nature Switzerland AG.

Impact of covid-19 on sickle cell disease in lebanon;Mild disease and one case of deep vein thrombosis

Background: Novel coronavirus SARS-CoV-2, COVID-19, infection was first reported in December 2019, and then spread dramatically around the world. Sickle cell disease is caused by a mutation in the beta globin gene resulting in the production of sickled hemoglobin that alters its shape upon deoxygenation to form an elongated rigid sickled erythrocyte that leads to vaso-occlusion. To date, there have been limited published data on how COVID-19 may affect morbidity and mortality in SCD patients. A review of the literature showed that SARS-CoV-2 infection should be considered to be an important triggering factor of sickle cell crisis. Most investigators report mild disease in children and moderate disease in many SCD adults. Aims: The aim of this report is to describe the clinical features of 11 confirmed cases of COVID-19 in patients with SCD in Lebanon. Methods: 11 SCD patients, were infected with COVID-19. Data concerning the age, gender, weight, and genotype were collected. In addition to medications received and chronic transfusion. Information about the course of COVID-19 is reported regarding: complications, type and duration of symptoms as well as therapy. Results: In this series median age was 22.2 years (range 14-40 years), only 2 are females and 8 patients had HbSS, 2 HbS beta + thalassemia, and 1 HbSC. 3 patients weighed >70kg the others were all below 70 kg. Ten patients were on long term hydroxyurea (HU) and in one it was initiated for only 1 week before infection. 1 patient was receiving Voxelotor and 1 Crizanlizumab in addition to HU. None were on chronic transfusion. Two patients had previously been started on Aspirin. One was on acencoumarolum, for a previous pulmonary embolism. One patient had asthma and was a smoker. Nine patients had moderate to severe symptoms and 2 had mild symptoms. 2 patients underwent PRBC transfusion for pain and anemia and one had erythrocytopherisis to control severe pain. Three patients required oxygen but none were admitted to a critical care unit. The mean number of days with symptoms was 14.1 days. Of the 11 patients 7 experienced pain crisis. None developed acute chest syndrome. 3 patients received corticosteroids and 5 patients received low molecular weight heparin (LMWH) 2 received therapeutic dose and 3 prophylactic dose. A 16 years old male with HbSS genotype developed multi system inflammatory syndrome and was admitted to regular floor for 26 days. He had prolonged high grade fever, epigastric pain, sore throat in addition to maculopapular rash. He had elevated D-Dimers >3000 ng/ml. He received PRBC transfusion, IVIG, corticosteroids, LMWH and antibiotics. Another 18 year old male with HbSS, developed extensive right lower limb deep vein thrombosis (DVT) 20 days after recovering from very mild COVID-19 infection. This patient had been on aspirin for 6 years after recovering from a catheter provoked DVT. Summary/Conclusion: This is one of the first reports on COVID-19 in patients who are not of African descent. In our patients COVID-19 was manifested mainly as fever and pain crises. Most patients required transfusions. Overall the symptoms were mild or moderate, similar to what was reported by others. Of concern were the development of multi system inflammatory syndrome in one patient and the development of delayed extensive DVT in another.

Gestion d’une épidémie active de COVID-19 sur un camp de Roms étendu et séroprévalence élevée en post-épidémie

Introduction Les consultations dédiées aux personnes en situation de précarité ont été arrêtés au début de la vague épidémique. Plusieurs résidents d’un grand camp de Roms originaires de Moldavie (composé de plus de 600 habitants) ont été hospitalisés pour des formes sévères de COVID-19. L’objectif de ce travail est de dresser le bilan de l’intervention mise en place et de décrire la séroprévalence du Covid-19 sur le camp en post-épidémie. Matériels et méthodes Fin mars, une « équipe mobile précarité Covid » hospitalière multidisciplinaire a été créée pour intervenir quotidiennement directement sur les camps et détecter et prendre en charge les cas probables de COVID-19. En post-épidémie, une action de dépistage sérologique du COVID-19, de la varicelle (chez les 11–40 ans sans antécédents) et du VIH-VHB-VHC a été réalisée. Une analyse descriptive des données cliniques et biologiques recueillies est présentée. Résultats L’équipe mobile est intervenue quotidiennement sur le camp du 31/03 au 27/05 (43 interventions) et a effectué un total de 841 consultations dont 128 (15,2 %) pour Covid probable et 106 (12,6 %) pour Covid possible (toux sans fièvre, rhinite). Vingt-deux patients (2,6 %) ont été évacués sur les urgences et 7 ont été secondairement hospitalisés. Seuls 4 cas de Covid probables ou prouvés ont accepté un hébergement en centre Covid, tous les autres ayant refusé. Sur la période, 42 cas ont été confirmés par PCR lorsqu’ils étaient hospitalisés ou quand les PCR ont pu être réalisées par l’équipe mobile à partir de mi-avril. La majorité des consultations sollicitées par les habitants du camp concernait des pathologies variées autres (diabète, HTA, grossesse, ectoparasitose, viroses infantiles, etc.). Suite à l’hospitalisation d’un cas de varicelle, à l’incertitude sur le niveau d’immunité varicelle et Covid et à la disponibilité des tests sérologiques sur l’hôpital, il a été décidé de réaliser une action de dépistage et de vaccination large sur une durée de 10jours (25/5–5/6). Parmi les 211 personnes prélevées (65 % de femmes, âge médian 42 ans [26–51], 26≤18 ans), la séroprévalence du contact avec le SARS-CoV2 est de 75,6 % (152/211), du VIH de 3,5 % (6/170 dont 2 femmes enceinte), du VHC de 10,6 % (17/160), de l’AgHBs de 1,8 % (3/164) et de la varicelle de 92,21 % (71/77). Conclusion Ce large camps de Roms a fait face à une épidémie massive de SARS-CoV-2 qui n’a pas pu être prévenue mais a pu être gérée directement sur le camp par une équipe d’aller vers. Le diagnostic récent de 4 cas PCR+ questionne le seuil d’immunité de groupe. L’intégration à l’action du dépistage de viroses chroniques méconnues et des consultations de soins primaires a permis de répondre à la demande d’une population rencontrant des difficultés majeures d’accès aux soins exacerbé par le confinement.