An analysis of the policy participation of field response nurses in South Korea: COVID-19 response guidelines and the infectious disease act revision.

INTRODUCTION: The Republic of Korea's response to Coronavirus disease 2019 was divided before and after global vaccine development at the end of 2020. It also varied according to the size of confirmed patients in the non-pharmaceutical intervention. Therefore, this study aimed to analyze the contribution of frontline nurses to the policy and law revision on infectious diseases and suggest health and nursing policies for emerging infectious diseases in the future. DESIGN: This case evaluation study analyzed the significant policy decisions that nurses' roles brought on changes in the infectious disease response system in the Republic of Korea and applying the health system model and those capacities on resilience under emerging infectious diseases. METHODS: Objective data that contributed directly to the revision of infectious disease-related Acts and policies in 2020 were collected and analyzed through literature search and information disclosure claims from the first to third waves of Coronavirus disease 2019 in one city. RESULTS: With the rapid outbreak of COVID-19 confirmed cases at the end of February 2020, a pan-government support group was formed and dispatched to D City. In addition, central quarantine officials worked with local quarantine officials to share real-time situations and find out on-site difficulties and support requests. As a result, inquiry of opinions to working staff before changing the "response guidelines to Coronavirus disease 2019" was reflected in major contents on the revision of "policy on infectious disease response" and "Infectious Disease Prevention and Management Act." With the establishment of an epidemiological investigation team in September 2020, the number of new nurses in 17 cities and provinces increased by 19.1% compared to the previous year, the most significant increase compared to doctors (-2.3), dentists (-1.6), and health workers (3.7). CONCLUSION: The experience of responding to Coronavirus was a reminder that the curriculum needed to be improved so that nurses will be recognized to have leadership competencies and as field experts regarding social determinants of health for population groups in the decision-making process. In the initial COVID-19 response process, nurses showed excellence in analyzing patient interviews and various information as field epidemiological investigation response personnel, making comprehensive judgments, and solving problems in cooperation with related agencies and severe patients' bedside nursing care. Continuous primary care and management of infectious diseases for the vulnerable should be prepared on an ongoing basis to assure the quality of care. CLINICAL RELEVANCE: Action strategies for developing leadership to enable nurses to have participated in the social determinants of health and the nursing policy formation for health equity should be applied in nursing education and practice, and global monitoring efforts were accelerated.

Impact of COVID-19 on the social relationships and mental health of older adults living alone: A two-year prospective cohort study.

BACKGROUND: Owing to the COVID-19 outbreak, older adults living alone, who can only connect socially outside their homes, are at risk of social isolation and poor mental health. This study aimed to identify the changes, before and after COVID-19, by sex and age, in social relationships (social activity, social network, and social support) and mental health (depression and suicide ideation) among older adults living alone. METHODS: This is a prospective cohort study of community-dwelling older adults who were at least 65 years old and living alone in South Korea. The study was conducted during 2018-2020 with 2,291 participants (795, 771, and 725 for the 1st to 3rd waves, respectively). The data were collected via face-to-face interviews. A generalized linear mixed modeling framework was used to test for changes over three years. RESULTS: Social activity was reduced after the COVID-19, with an interaction effect of sex: older women (odds ratio [OR], 0.19; 95% confidence interval [CI], 0.15-0.23; p < .001) showed greater reduction than older men (OR, 0.50; 95% CI, 0.34-0.75; p < .001). Interaction with neighbors also reduced after the pandemic, but there was no significant evidence of interaction effects. Interaction with family members increased in both sexes during the pandemic, with the interaction effect of sex: older women (OR, 1.40; 95% CI, 1.11-1.76; p = .004) showed greater increase than men (OR, 1.55; 95% CI, 1.13-2.14; p = .007). Social support increased in both sexes during the pandemic, but there was no significant evidence of interaction effects. Depression and suicide ideation showed no significant differences before and after the pandemic. CONCLUSIONS: The findings provide health administrators and health providers with explorative insights into the impact of the COVID-19 on social relationships and mental health among older adults living alone and can guide further studies of interventions considering specific properties of social relationships.

Trends in gastrointestinal infections before and during non-pharmaceutical interventions in Korea in comparison with the United States.

OBJECTIVES: This study examined how trends in the weekly frequencies of gastrointestinal infectious diseases changed before and during the coronavirus disease 2019 (COVID-19) pandemic in Korea, and compared them with the trends in the United States. METHODS: We compared the weekly frequencies of gastrointestinal infectious diseases (16 bacterial and 6 viral diseases) in Korea during weeks 5-52 before and after COVID-19. In addition, the weekly frequencies of 5 gastrointestinal infectious diseases in the United States (data from the Centers for Disease Control and Prevention) that overlapped with those in Korea were compared. RESULTS: The mean weekly number of total cases of gastrointestinal infectious diseases in Korea showed a significant decrease (from 522 before COVID-19 to 245 after COVID-19, p<0.01). Only bacterial gastrointestinal infectious diseases caused by Campylobacter increased significantly; other bacterial gastrointestinal infectious diseases showed either a decrease or no change. The incidence of all other viral diseases decreased. In the United States, the weekly numbers of Salmonella, Campylobacter, typhoid, shigellosis, and hepatitis A virus cases sharply decreased after the COVID-19 outbreak. The weekly case numbers of all viral diseases markedly decreased in both countries; however, bacterial gastrointestinal infectious diseases showed a different pattern. CONCLUSIONS: The incidence of gastrointestinal infectious diseases decreased after the COVID-19 outbreak. In contrast, Campylobacter infections showed an increasing trend in Korea, but a decreasing trend in the United States. Further studies are needed to elucidate the different trends in bacterial and viral infectious diseases before and after non-pharmaceutical interventions and between different countries.