Seroprevalence of SARS-COV2 Antibodies among the Serving Personnel of South Western Command: A Multi-Centric Study

Background: Serological diagnosis has become an important tool to understand the extent of COVID-19 in the community. Thus, this study was conducted to estimate the prevalence of SARS-CoV-2 antibodies and to analyze various characteristics (risk factors) associated with SARS-CoV-2 infection among serving personnel in a large geographical area straddling four North Indian states. Materials and Methods: This multicentric, cross-sectional analytical study was conducted among serving personnel in eight stations spread over Punjab, UP, Haryana, and Rajasthan in October-November 2020. A total of 3680 (410 x 8 = 3280 general participants and 50 x 8 = 400 purposive samples) individuals were enrolled and tested using IgG ELISA kit (in four stations) and RAPID CARD-based tests (in the rest four stations). Results: While the overall seroprevalence was found to be 16.57% (610/3680 participants being positive), the seropositivity was found to be 12.01% (10.92%-13.70%) and 54% (52.35%-56.45%) among the study participant's and purposive sampling groups, respectively. While statistically significant association was found between seronegativity and attending any lecture on COVID-19 before the survey (P < 0.001) or following recommended protocols for the prevention of COVID-19 (P < 0.001), a similar association was found between seropositivity and occupation with high exposure to serving personnel or civilians (P < 0.001), having close contact (less than one meter) with COVID-19 confirmed cases in the past (P < 0.001) and being tested positive for COVID-19 in the past (P < 0.05). Conclusion: Our study found a moderate overall seroprevalence with low seroprevalence in few stations and high in the rest.

Automated Contact Tracing using Person Tracking and Re-Identification

This paper presents an implementation of contact tracing (a protocol followed to curtail the spread of viruses like Covid-19) using CCTV video footage from multiple cameras. The proposed system gives immediate insights about all the possible people at risk when a person under surveillance is clinically tested positive. This system automates the process of manual contact tracing by detecting contact between people under surveillance by estimating the distance between them, identifying them, and tracking their interactions. This data is then stored, filtered, and analyzed. A confusion matrix was derived from the videos that took into account true contacts, false contacts between people in the input video and whether the contacts in the video were considered as true contacts or false contacts according to the algorithm. This gave us insights about the algorithm's accuracy, precision and recall which were found to be 91%, 94% and 71% respectively. © 2021 IEEE.

Perception and acceptance of coronavirus disease-2019 vaccines among doctors

Introduction: Numerous vaccine candidates are in the race of successful clinical trials in response to the ongoing coronavirus disease-2019 (COVID-19) pandemic. This study was conducted to assess the perception and hesitancy among the physicians of major cities of India toward the upcoming COVID-19 vaccine. Methodology: A cross-sectional online survey was conducted between November 25, and December 25, 2020, among the frontline physicians, and they were asked if they would get vaccinated as soon as the vaccine is available in the market. Associations between sociodemographic characteristics and acceptance and hesitancy of an upcoming COVID-19 vaccine were analyzed. Results: Among 139 respondents who gave consent, the majority was male (121, 83.4%). Seventy-six (54.7%) respondents would like to get vaccinated as soon as the vaccine is available. Fifty-six (40.28%) participants had shown fear against the new vaccines, and self-perceived knowledge about the vaccine was found low (79, 56.83%). The majority of the physicians agreed to get vaccinated once reverse transcription-polymerase chain reaction positive or recovered in the past. Self-perceived protection of the new COVID-19 vaccine was high (102, 73.4%), and most physicians thought it safe for humans (89, 64%). Conclusion: The acceptance among the physicians positively influences the approval of a COVID-19 vaccine in the general population. Failure to address physicians' hesitancy leaves immunization programs at significant risk of any country. © 2021 Wolters Kluwer Medknow Publications. All rights reserved.

Biothreat & one health: Current scenario & way forward

There is an increased connectedness among humans, animals, and the environment and the current pandemic has taught the interlinking of the health of humans, animals and the planet. This inter-connectedness and factors like population growth, migration, urbanization, and climate change contribute significantly to the enhanced probability of emergence of previously unknown wildlife source pathogens at any place, any time, and without warning. Lurking in the background is the massive potential for the deliberate use of biological agents as weapons by State or non-State entities. Biological weapons have been used in wars since antiquity, however, newer research and techniques have led to these being real threats with a vast potential of harm to humans, animals, and crops. Over a period, it has become increasingly difficult to differentiate between deliberate and natural biothreat incidents. The response to both types is alike to safeguard lives, livestock, crops and the environment and reduce the consequent socio-economic ramifications. Biothreat may be targeted towards humans, animals, or crops, or all these concurrently. Every country including India is at risk of biothreat. The concept of one health is thus essential for responding to emerging infectious diseases or biothreats. Comprehensive surveillance for early detection, reporting and early concerted action is needed for prevention and blunting the effect of biothreats, which require close coordination and collaboration among various stakeholders within each country as well as globally.

'There's a whole world, and i ain't in it': older adults' experiences with technology during the covid-19 shelterin-place orders

Background: Concerns have been raised regarding older adults' access to and comfort with technologies to overcome physical distancing restrictions during the COVID-19 pandemic. Our objective was to better characterize the 'digital divide' older adults may have experienced during shelter-in-place. Methods: Semi-structured in-depth interviews were conducted with a purposive sample of 13 community-dwelling older adults with diverse experiences with technology, recruited from two community sites and a geriatrics practice in San Francisco. Concurrent data analysis using a grounded theory approach was completed by two independent coders to identify salient themes. Results: Participants were 77 years on average (range 64-93), 69% female, 23% Black, 69% lived alone, and 54% reported at least one ADL impairment. Two themes emerged in how participants positively adapted to COVID-19 restrictions and emotionally coped through the use of technology. First, many reported discovery of new technologies to maintain or develop new connections, including Zoom-based community groups and telehealth services ('there's all kinds of virtual programs where you can exercise'). Second, older adults were resourceful in identifying community resources and enlisting family members to learn ('I had to ask one of my granddaughters how to make the chat thing work'). Two themes emerged regarding barriers to technology use. First, older adults identified internal barriers such as stigma and shame and concerns about privacy or overuse of technology ('my daughters have said that I overshare, so I don't want to set myself up'). Second, identified external barriers included lack of support for sudden breakdowns (from family and/or community), difficulty navigating technical details (passwords, upgrades, security protocols), and perceived structural ageism ('we act as if seniors can't hold that information'). Overall, participants described virtual interaction as inferior to in-person, but noted that video interaction was preferable to phone and 'better than nothing.' Conclusions: While technology was central to many older adults' ability to adapt to COVID-19 restrictions, barriers and frustrations were common. Identified facilitators and barriers can inform technology-based interventions that bridge the digital divide among older adults to improve health, social well-being, and quality of life.

Older adults with anxiety have higher avoidance of in-person medical visits during the covid-19 pandemic

Background: The COVID-19 pandemic continues to have detrimental effects on older adults' mental health while rapidly transforming access to medical care. Our objective was to determine if anxiety surrounding the pandemic may be associated with increased avoidance of in-person medical visits, even when visits were perceived as needed. Methods: We conducted phone-based surveys from April 7th, 2020 to October 27th, 2020 with 155 older adults age ≥60 from two community sites and an academic geriatrics outpatient clinical practice. Healthcare system access was assessed with questions on telehealth use, the number of delayed in-person medical appointments or procedures, and avoidance due to fear of the coronavirus of in-person medical visits participants perceived as 'needed'. Anxiety was measured with the Generalized Anxiety Disorder 2-item (GAD-2) scale. We used bivariate statistics to determine the association between the rate of healthcare utilization and anxiety. We also assessed freetext comments for expression of anxiety or concerns about access to medical care. Results: Participants were on average 75 years old (SD=10), 50% of whom had hearing or vision impairment, 26% had difficulty bathing, 64% lived alone, and 92% had accessed telehealth clinical services. Approximately 52% reported worries about delayed medical care and 41% reported avoiding an in-person medical visit that they felt was needed due to fear of COVID-19;55% of avoided visits were routine or preventive, 43% specialist appointments, and 8% urgent care/ED visits. Individuals screening positive for anxiety were more likely to avoid in-person medical visits (60% versus 47%, p=0.006). Open-ended responses revealed worries about delays in routine medical care (e.g. injections, vaccines, dental visits), fears that non-COVID health needs were deemed non-essential, and difficulty accessing the health system due to restrictions. Conclusion: Older adults who screened positive for anxiety were more likely to avoid needed in-person medical visits, and had a broad range of visit types they felt were needed. Clinicians should work with older patients, particularly those who are anxious, to provide safe and accessible options for seeking in-person care and reassure patients that non-COVID related health concerns are still a priority.

Knowledge, attitude, practices and behaviour study regarding COVID-19 amongst health care workers of armed forces in North-Western part of India

Background: A concerted effort has been made by the Government of India and the Armed Forces to train all health-care workers (HCWs) in various aspects of the prevention and management of COVID-19. This study was conducted to evaluate the efforts by assessing their knowledge, attitudes, practice, and behavior regarding COVID-19. Materials and Methods: A quick online survey, using a web portal and social media platform with a pretested questionnaire, was conducted. Responses were collected for 3 days and analyzed. Results: A total of 988 HCWs participated, including 61 (6.17%) specialist officers, 98 (9.91%) medical officers, 17 (1.72%) dental officers, 135 (13.66%) nursing officers, 518 (52.4%) paramedical staff, and 159 (16.09%) supporting staff. There was a high prevalence (>90%) of knowledge related to symptoms and transmission of the disease with no statistically significant difference in knowledge based on the category of HCW except for bleaching powder requirement (0.001) and chemoprophylaxis (0.001). The majority of the participants (>95%) agreed that lockdown, infection control programs, and repeated training of HCWs are good measures to control COVID-19 spread. Observing full precaution while handling personal protective equipment was the only practice which demonstrated a significant association with increasing qualification of the participant (P < 0.001). Conclusions: Levels of knowledge, positive attitude, and good practices are high among HCWs in the Armed Forces, however, feeling of anxiousness and worry prevail being frontline workers with maximum proximity toward patients. Aggressive, continuous, relevant target population-oriented information, education, and communication is the need of the hour, with structured and programmed interventions for positive mental health during course of the pandemic.