The Impact of Extended E-Learning on Emotional Well-Being of Students during the COVID-19 Pandemic in Saudi Arabia.

Educational institutions in Saudi Arabia extended e-learning until the third semester of the academic calendar to prevent the spread of COVID-19 infection and to achieve 70% inoculation for the Saudi population. This study assesses the impact of extended e-learning and other associated stressors on the emotional health of university students in Saudi Arabia. An online cross-sectional survey collected data between the months of January-March 2021. The emotional signs of stress were measured by using a subset of items from the COVID-19 Adolescent Symptom and Psychological Experience Questionnaire (CASPE). Data about demographic variables, educational characteristics and academic performance were also collected. A regression analysis was performed to determine predictors of emotional health. A total of 434 university students including females (63%) and males (37%) provided responses. One-third of students (33%) indicated that the COVID-19 pandemic and its resulting changes including online distance studies greatly influenced their daily lives in a negative way. The regression analysis demonstrated that female students and students with average academic performance had increased vulnerability to experience emotional signs of stress (p < 0.05). The factors 'Not going to university' and 'Not having a routine life' were significant predictors of stress responses (p < 0.01) and (p < 0.001) respectively. E-learning during the COVID-19 pandemic made it possible for students to complete their studies as per academic calendar; simultaneously, it increased the vulnerability to experience stress, particularly for female students and students with average academic performance. These findings imply that academic advising and counseling services should be more readily available during digital studies to support at risk students.

Types and Sources of Social Support Accessible to University Students with Disabilities in Saudi Arabia during the COVID-19 Pandemic.

University students with disabilities face an increased risk of experiencing negative implications in educational, psychological, and social spheres during the COVID-19 pandemic. This study aimed at assessing various dimensions of social support and its sources during the COVID-19 pandemic that availed university students with disabilities. This cross-sectional descriptive study collected data from 53 university students with disabilities. We administered the Social Support Scale (SSC) to assess five dimensions: informational, emotional, esteem, social integration and tangible support, and access to social support from four sources: family, friends, teachers, and colleagues. Multiple regression analysis showed that university students with disabilities mainly relied upon their friends for informational support (ß = 0.64; p < 0.001), emotional support (ß = 0.52; p < 0.001), and social integration support (ß = 0.57; p < 0.001). Family members (ß = 0.406; p < 0.01) and colleagues (ß = 0.36; p < 0.01) provided esteem support to students with disabilities. Support from teachers demonstrated an association with informational support (ß = 0.24; p < 0.05). The findings from the current study suggest that students with disabilities primarily sought informational, emotional, and social integration support from their peers. Although teachers were the primary source of informational support, emotional and esteem support were not found to be significantly associated with them. These findings necessitate exploring the underlying factors and how to enhance them during unusual circumstances such as online distance education and social distancing.

Adapting an integrated acute respiratory infections sentinel surveillance to the COVID-19 pandemic requirements, Egypt, 2020-2022.

Objectives: In Egypt, an integrated surveillance for acute respiratory infections (ARIs) was established in 2016 to identify the causes of ARIs. The surveillance system includes 19 governmental hospitals. In response to the coronavirus disease 2019 (COVID-19) pandemic, the World Health Organisation (WHO) requested surveillance adaptation to address the emerging challenges. This study aims to describe the experience in Egypt of adapting ARI surveillance to the COVID-19 pandemic. Methods: WHO case definitions were used to identify patients with ARIs. Nasopharyngeal/oropharyngeal swabs were collected for SARS-CoV-2 and influenza testing. Demographic and clinical information were obtained by interviewing patients at the hospitals. During the COVID-19 pandemic, the first two outpatients daily and every fifth admitted patient were enrolled in the study. To determine the status of ARIs in Egypt during the pandemic, patient demographic, clinical and laboratory data from 2020 to 2022 were obtained and descriptive analyses were performed. Results: Overall, 18,160 patients were enrolled in the study, including 7923 (43.6%) seen at outpatient clinics and 10,237 (56.4%) inpatients. Of the study participants, 6453 (35.5%) tested positive for ARIs, including 5620 (87.1%) for SARS-CoV-2, 781 (12.1%) for influenza and 52 (0.8%) for SARS-CoV-2/influenza coinfection. SARS-CoV-2 was the cause for 95.3% of admitted patients and 65.4% of outpatients. Influenza subtypes included A/H3 (55.7%), Influenza-B (29.1%) and H1/pdm09 (14.2%). Compared with influenza, SARS-CoV-2 tended to infect the elderly, in warm weather and in urban governorates, and resulted in more hospitalisations, longer hospital stays and higher case fatalities (16.3% vs 6.6%, p < 0.001). Conclusions: ARI surveillance in Egypt was successfully adapted to the COVID-19 pandemic and effectively described the clinical characteristics and severity of circulating viruses. Surveillance reported the re-emergence of influenza with a severe course and high fatality. Surveillance is essential for monitoring the activity of respiratory viruses with the aim of guiding clinical management, including preventative and control measures.

Epidemiology, Disease Severity and Outcome of Severe Acute Respiratory Syndrome Coronavirus 2 and Influenza Viruses Coinfection Seen at Egypt Integrated Acute Respiratory Infections Surveillance, 2020-2022.

Background: Cocirculation of influenza (Flu) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (SARS-CoV-2/Flu) represent a public health concern as it may worsen the severity and increase fatality from coronavirus disease 2019. An increase in the number of patients with coinfection was recently reported. We studied epidemiology, severity, and outcome of patients with SARS-CoV-2/Flu coinfection seen at Egypt's integrated acute respiratory infections surveillance to better describe disease impact and guide effective preventive measures. Methods: The first two outpatients were seen daily, and every fifth patient admitted to 19 sentinel hospitals with respiratory symptoms was enrolled. Patients were interviewed using a standardized questionnaire and provided nasopharyngeal swabs to be tested for SARS-CoV-2 and influenza by real-time polymerase chain reaction at the central laboratory. Data from all patients with coinfection were obtained, and descriptive data analysis was performed for patients' demographics, clinical course, and outcome. Results: The total number of patients enrolled between January 2020 and April 2022 was 18,160 and 6,453 (35.5%) tested positive for viruses, including 52 (0.8%) coinfection. Of them, 36 (69.2%) were coinfected with Flu A/H3, 9 (17.3%) Flu-B, and 7 (13.5%) Flu A/H1. Patients' mean age was 33.2 ± 21, 55.8% were males, and 20 (38.5%) were hospitalized, with mean hospital days 6.7 ± 6. At the hospital, 14 (70.0%) developed pneumonia, 6 (30.0%) ICU admitted, and 4 (20.0%) died. The hospitalization rate among patients coinfected with Flu-B and Flu A/H3 was 55.6 and 41.7%, with mean hospital days (8.0 ± 6 and 6.4 ± 6), pneumonia infection (40.0 and 80.0%), ICU admission (40.0 and 26.7%), and death (20.0% for both), while no patients hospitalized with A/H1. Conclusions: The recent increase in the number of SARS-CoV-2/Flu coinfections was identified in Egypt. The disease could have a severe course and high fatality, especially in those coinfected with Flu-B and Flu A/H3. Monitoring disease severity and impact is required to guide preventive strategy.

Using Spiritual Connections to Cope With Stress and Anxiety During the COVID-19 Pandemic

During the initial phases of the COVID-19 pandemic, stress and anxiety were pervasive among the masses due to high morbidity and mortality. Besides the fear of coronavirus was also particularly driven by social media. Many people started to look for faith and spiritual connections to gain comfort. The role of spiritual ties and religious beliefs in relation to coping with pandemic stress has acquired the attention of researchers in some parts of the world. This cross-sectional survey aimed at assessing the intensity of stress and anxiety symptoms experienced by people and how much they were alleviated by employing spiritual connections. The study sample comprises 795 respondents with 52% males and 48% females living in Saudi Arabia. The brief online study questionnaire collected data about background variables, anxiety and stress scale from DASS-21, and items from the WHOQOL (SRBP) instrument assessed the use of spiritual beliefs to cope. Multiple regression models were tested to determine the role of spiritual connections after adjusting demographic variables. Results illustrated that after adjusting for gender and age, participants’ anxiety symptoms decreased by (β = −0.27;p = 0.000) units with each unit increase in the use of spiritual connections, and participants’ stress symptoms reduce by (β = −0.36;p = 0.000) units with each unit increase in coping with spirituality. Additionally, females’ risk to experience anxiety and stress symptoms was more than males [(β = 0.88;p = 0.01) and (β = 0.92;p = 0.000)], respectively. An increase in age decreases the likelihood of experiencing anxiety symptoms and stress symptoms by (β = −0.75;p = 0.02) and (β = −0.11;p = 0.000) units, respectively. Findings support the protective role of spiritual connections despite small beta coefficients. The social and cultural context in Saudi Arabia favors deep-rooted connections with spirituality and faith. Our findings support the fact that the reliance on spiritual connections helped older people to deal with exaggerated fear during the initial phase of the COVID-19 pandemic and reduces the risk of experiencing anxiety and stress symptoms. Females and younger participants were relatively vulnerable to developing these symptoms. We discussed these findings considering some recent studies that reported similar relationships and made recommendations for future research.

The value of contact tracing and isolation in mitigation of COVID-19 epidemic: findings from outbreak investigation of COVID-19 onboard Nile Cruise Ship, Egypt, March 2020.

WHO informed Egypt health authorities of individuals of different nationalities who proved positive for COVID-19 after returning from Egypt. Patients were among touristic group who visited Cairo and spent 1-week onboard Nile cruise ship. Investigation performed to confirm outbreak, detect source, and implement containment measures. Active case finding and contact tracing performed among contacts of the index cases and their contacts. Contacts defined as anyone within 6 feet from confirmed or suspected COVID-19 case for ≥15 min. Overall, 331 contacts, including 201 ship boarders and 130 hotel guests, were listed and interviewed using semistructured questionnaire and tested for COVID-19 by PCR. Among them, 136 (41.1%) were close contacts of index cases and 195 (58.9%) contacted secondary cases. Their mean age was 34.6±11.5 years, 251 (75.8%) were males and 126 (38.1%) non-Egyptians. Of them, 67 (20.2%) tested positive for COVID-19, including 57 (28.4%) ship boarders and 10 (7.7%) hotel guests. Per cent positive was significantly higher in: contacts of index cases, Egyptians, ship boarders and in males than corresponding categories (35.3% vs 9.7%, 22.9% vs 15.9%, 27.4% vs 7.7%, 24.7% vs 6.3%), respectively. Of all positive cases, 40 (59.7%) were asymptomatic where ship boarders, non-Egyptians, >50 years old and females were more likely to be asymptomatic than corresponding categories (85.0 vs 48.9%, 72.7 vs 54.5%, 100.0 vs 56.5%), respectively. COVID-19 patients among group of tourists triggered an outbreak onboard Nile ship and hotel in Egypt. Outbreak quickly contained through lab testing, case isolation, strict infection control measures and contact tracing which proved effective in reducing COVID-19 transmission early in pandemic.

The Impact of Implementing the Egypt Pandemic Preparedness Plan for Acute Respiratory Infections in Combating the Early Stage of the COVID-19 Pandemic, February-July 2020: Viewpoint.

This article briefly describes Egypt's acute respiratory infection (ARI) epidemic preparedness and containment plan and illustrates the impact of implementation of the plan on combating the early stage of the COVID-19 epidemic in Egypt. Pillars of the plan include crisis management, enhancing surveillance systems and contact tracing, case and hospital management, raising community awareness, and quarantine and entry points. To identify the impact of the implementation of the plan on epidemic mitigation, a literature review was performed of studies published from Egypt in the early stage of the pandemic. In addition, data for patients with COVID-19 from February to July 2020 were obtained from the National Egyptian Surveillance system and studied to describe the situation in the early stage of the epidemic in Egypt. The lessons learned indicated that the single most important key to success in early-stage epidemic containment is the commitment of all partners to a predeveloped and agreed-upon preparedness plan. This information could be useful for other countries in the region and worldwide in mitigating future anticipated ARI epidemics and pandemics. Postepidemic evaluation is needed to better assess Egypt's national response to the COVID-19 epidemic.