SG-APSIC1100: Healthcare-associated infections in COVID-19 patients in Vietnam: Are we able to respond better?

Objectives: Studies have revealed that a relatively high incidence of severe infection and mortality in COVID-19 patients is attributed to healthcare-associated infections (HAIs). We implemented a study in 2 field hospitals dedicated to COVID-19 treatment in Da Nang, Vietnam (July–August 2020), and Ho Chi Minh City, Vietnam (August–October 2021), to identify pathogens, risk factors, and outcomes associated with HAIs. Methods: We applied a prospective study tool to estimate HAI incidence among 1,454 patients. HAIs are diagnosed and ascertained using surveillance criteria established by the US Centers for Disease Control and Prevention. All patients hospitalized for COVID-19 for at least 2 days were enrolled in this assessment of HAI risks, pathogens, and outcomes. Results: Among 1,454 sampled patients, 391 patients had 423 HAIs (27.1%). The highest proportion occurred in ICUs, with 422 HAI patients (34.1%). Pneumonia (n = 331, 78.3%) and bloodstream infections (n = 55, 13.1%) were the most common HAIs. Multidrug-resistant (MDR) bacteria, such as Klebsiella pneumonia (27.9%) and Acinetobacter baumannii (25.3%), were the most commonly isolated organisms. Ventilators and central venous catheters were independently associated with HAIs. Regarding the mortality rates, 55% of deaths occurred in intensive care units. Patients with HAIs (70.3%) were twice as likely to die compared to patients without HAIs (38.8%). HAIs leading to septic shock caused almost triple mortality (n = 58, 90.6%) compared with non-HAI patients (n = 412, 38.8%). HAIs prolonged hospital stay: 24.7 days for patients with HAIs and 19.1 days for patients without HAIs (P < .001). Conclusions: Patients with COVID-19–related critical illnesses are at high risk of HAIs from multidrug-resistant (MDR) bacteria. HAIs prolong hospitalization, whereas HAIs with septic shock almost tripled mortality. Guidelines and procedures to prevent and control HAIs caused by MDR bacteria as well as training and monitoring on aseptic-compliant techniques during invasive clinical procedures are needed.

Digital health literacy and well-being among university students: Mediating roles of fear of COVID-19, information satisfaction, and internet information search.

Background: Digital health literacy (DHL) enables healthy decisions, improves protective behaviors and adherence to COVID-19 measures, especially during the era of the "infodemic", and enhances psychological well-being. Objective: We aimed to explore the mediating roles of fear of COVID-19, information satisfaction, and the importance of online information searching on the association between DHL and well-being. Methods: A cross-sectional web-based survey was conducted among 1631 Taiwanese university students, aged 18 years and above, from June 2021 to March 2022. The collected data include sociodemographic characteristics (sex, age, social status, and financial satisfaction), the importance of online information searching, information satisfaction, fear of COVID-19, DHL, and well-being. A linear regression model was utilized to investigate factors associated with well-being, followed by a pathway analysis to assess the direct and indirect relationship between DHL and well-being. Results: The scores of DHL and overall well-being were 3.1 ± 0.4 and 74.4 ± 19.7, respectively. Social status (B = 2.40, 95% confidence interval (CI) 1.73-3.07, p < 0.001), DHL (B 0.29, 95% CI 0.10-0.49, p < 0.001), importance of online information searching (B = 0.78, 95% CI 0.38-1.17, p < 0.001), and information satisfaction (B = 3.59, 95% CI 2.22-4.94, p < 0.001) were positively associated with well-being, whereas higher fear of COVID-19 scores (B = -0.38, 95% CI -0.55-(-0.21), p < 0.001) and female (B = -2.99, 95% CI -5.02-0.6, p = 0.004) were associated with lower well-being, when compared with lower fear scores and male, respectively. Fear of COVID-19 (B = 0.03, 95% CI 0.016-0.04, p < 0.001), importance of online information searching (B = 0.03, 95% CI 0.01-0.05, p = 0.005), and information satisfaction (B = 0.05, 95% CI 0.023-0.067, p < 0.001) were significantly mediated the relationship between DHL and well-being. Conclusion: Higher DHL scores show direct and indirect associations with higher well-being scores. Fear, importance of online information searching, and information satisfaction significantly contributed to the association.

Association of Digital Health Literacy with Future Anxiety as Mediated by Information Satisfaction and Fear of COVID-19: A Pathway Analysis among Taiwanese Students.

Digital Health Literacy (DHL) helps online users with navigating the infodemic and co-existing conspiracy beliefs to avoid mental distress and maintain well-being. We aimed to investigate the association between DHL and future anxiety (FA); and examine the potential mediation roles of information satisfaction and fear of COVID-19 (F-CoV). A web-based cross-sectional survey was carried out among 1631 Taiwanese university students aged 18 years and above from June 2021 to March 2022. Data collected were socio-demographic characteristics (sex, age, social status, university location), information satisfaction, F-CoV, DHL and FA (using Future Dark scale). The linear regression model was used to explore factors associated with FA. The pathway analysis was further used to evaluate the direct and indirect relationship between DHL and FA. A higher score of DHL (B = -0.21; 95% CI, -0.37, -0.06; p = 0.006), and information satisfaction (B = -0.16; 95% CI, -0.24, -0.08; p < 0.001) were associated with a lower FA score, whereas a higher F-CoV score was associated with a higher FA score (B = 0.43; 95% CI, 0.36, 0.50; p < 0.001). DHL showed the direct impact (B = -0.1; 95% CI, -0.17, -0.04; p = 0.002) and indirect impact on FA as mediated by information satisfaction (B = -0.04; 95% CI, -0.06, -0.01; p = 0.002) and F-CoV (B = -0.06, 95% CI, -0.08, -0.04; p < 0.001). Strategic approaches to promote DHL, information satisfaction, lower F-CoV are suggested to reduce FA among students.

Clinical Characteristics of Hospital Follow-up for Patients Hospitalized from SARS CoV-2 (COVID 19) in an Academic Outpatient Internal Medicine Clinic.

BACKGROUND: As of July 2022, there have been more than 91.3 million cases of COVID-19 and nearly 1.03 million deaths in the United States alone. In addition, many people who survived COVID-19 had long-term symptoms, such as fatigue, dyspnea, loss of smell and taste, depression, and anxiety. OBJECTIVES: The purpose of our study is to evaluate the status of COVID-19 patients who were previously hospitalized. METHODS: We conducted a single-center retrospective cohort study at Texas Tech University Health Sciences Center and its affiliated University Medical Center under IRB of L21-144. We included all patients hospitalized for COVID-19 and followed up in our Internal Medicine Clinic at any time between April 1, 2020, and April 1, 2021, and reviewed follow-up data for these patients after discharge. RESULTS: A total of 128 patients were included; 59 (46%) were men, and 69 (54%) were women with an average age of 59.7 ± 14.8 years. Most of the patients (n = 78, 60.9%) identified their race as Hispanic or Latino origin; the next largest group was Caucasian (n = 29, 22.65%). The average number of days until post-hospitalization follow-up was 36 ± 38 days. The 50% of the patients (n = 64) used telemedicine for follow-up visits. Important comorbidities in these patients included diabetes (n = 84, 65.6%) and hypertension (n = 94, 73.4%). Thirty-four patients (26.6%) reported respiratory symptoms at their follow-up appointments, 24 patients (18.8%) reported constitutional symptoms, 12 patients (9.4%) reported GI symptoms, and 25 patients (19.5%) reported other symptoms, such as paresthesia, lower extremity edema, or psychological symptoms. After hospital discharge, 54 patients had follow-up chest x-rays, and 41 (75.9%) still had abnormal findings consistent with COVID-19 imaging characteristics. Follow-up laboratory tests identified 44 patients (77.2%, 57 tested) with elevated D-dimer levels, 44 patients (78.6%, 56 tested) with high ferritin levels, and 21patients (35.6%, 59 tested) with elevated troponin T HS levels. CONCLUSION: Long-lasting COVID-19 symptoms in these patients included respiratory symptoms (26.6%), constitutional symptoms (18.8%), GI symptoms (9.4%), and other symptoms, such as paresthesia, lower extremity edema, or psychological symptoms (19.5%). The rate of telehealth follow-up was 50%. Many patients had elevated inflammatory markers that will need follow up to determine the clinical implications.

Comparison of COVID-19 Resilience Index and Its Associated Factors across 29 Countries during the Delta and Omicron Variant Periods.

Our study aims to compare the pandemic resilience index and explore the associated factors during the Delta and Omicron variant periods. In addition, the study aims to identify the characteristics of countries that had good performances. We analyzed observation data among 29 countries over the first eight weeks during the two periods of Delta and Omicron variant dominance. Data were extracted from open public databases. The Omicron variant caused a lowered mortality rate per 100,000 COVID-19 patients; however, it is still imposing a colossal burden on health care systems. We found the percentage of the population fully vaccinated and high government indices were significantly associated with a better resilience index in both the Delta and Omicron periods. In contrast, the higher death rate of cancers and greater years lived with disability (YLD) caused by low bone density were linked with poor resilience index in the Omicron periods. Over two periods of Delta and Omicron, countries with good performance had a lower death rate from chronic diseases and lower YLD caused by nutrition deficiency and PM2.5. Our findings suggest that governments need to keep enhancing the vaccine coverage rates, developing interventions for populations with chronic diseases and nutrition deficiency to mitigate COVID-19 impacts on these targeted vulnerable cohorts.

The Effects of Non-Pharmaceutical Interventions on COVID-19 Epidemic Growth Rate during Pre- and Post-Vaccination Period in Asian Countries.

There is little knowledge about how the influence of non-pharmaceutical interventions (NPIs) reduces the COVID-19 infection rate during the period of vaccine rollout. This study aimed to examine the effectiveness of NPIs on decreasing the epidemic growth of COVID-19 between before and after the vaccine rollout period among Asian countries. Our ecological study included observations from 30 Asian countries over the 20 weeks of the pre- and post-vaccination period. Data were extracted from the Oxford COVID-19 Government Response Tracker and other open databases. Longitudinal analysis was utilized to evaluate the impacts of public health responses and vaccines. The facial covering policy was the most effective intervention in the pre-vaccination period, followed by border control and testing policies. In the post-vaccination period, restrictions on gatherings and public transport closure both play a key role in reducing the epidemic growth rate. Vaccine coverage of 1-5%, 5-10%, 10-30%, and over 30% of the population was linked with an average reduction of 0.12%, 0.32%, 0.31%, and 0.59%, respectively. Our findings support the evidence that besides the vaccine increasingly contributing to pandemic control, the implementation of NPIs also plays a key role.

Technology Advances, High-Risk Research, and a Safe Way Forward.

The human and economic toll of the coronavirus disease 2019 (COVID-19) pandemic and the unknowns regarding the origins of the virus, with a backdrop of enormous advances in technologies and human understanding of molecular virology, have raised global concerns about the safety of the legitimate infectious disease research enterprise. We acknowledge the safety and security risks resulting from the broad availability of tools and knowledge, tools and knowledge that can be exploited equally for good or harm. The last 2 decades have shown us that the risks are real. They have also shown us that more traditional top-down regulations alone are not the answer. We encourage government to be thoughtful and nuanced in dealing with this significant challenge and to carefully consider human factors and the important role of organizational-level leadership before simply layering an additional bureaucratic burden on the enterprise without understanding value and cost.

Prevalence and Factors Associated with Psychological Problems of Healthcare Workforce in Vietnam: Findings from COVID-19 Hotspots in the National Second Wave.

Adopting a cross-sectional study design, we aimed to examine the prevalence of psychological problems in different healthcare workers during the COVID-19 pandemic in the hospitals in these COVID-19 hotspots (Da Nang city and Quang Nam province) and to explore the socioeconomic and COVID-19 control-related factors that are associated with various psychological problems. A total of 611 healthcare workers were included in the final analysis from 1 August 2020 to 31 August 2020. The prevalence of anxiety, depression, insomnia, and overall psychological problems was 26.84%, 34.70%, 34.53%, and 46.48%, respectively. The prevalence rates of anxiety were approximately equal amongst the groups of healthcare workers, and moderate-to-severe anxiety was the most common in physicians (11.11%). The prevalence of depression was the highest in nurses (38.65%) and moderate-to-severe depression was mainly found in physicians (11.81%). The prevalence rates of insomnia were 34.03% in physicians, 36.20% in nurses, and 31.21% in technicians; in particular, the rate of moderate-to-severe insomnia was higher in physicians and nurses compared to technicians. The prevalence of overall moderate-to-severe psychological problems was the highest among physicians (14.58%), followed by nurses (12.58%) and technicians (9.22%). Statistically significant associated factors of current psychological problems were the occupations of physicians or nurses, less than 1 year of experience, university education, living with 4-5 people, reporting 1000-5000 m distance between home and workplace, participating in the COVID-19 control for less than 1 week, being under social isolation at home, being affected a lot by the community, reporting inadequate equipment in current workplace conditions, frequently working in the department directly in contact with the COVID-19 patients, and feeling anxious, stressed, or sad about current works. Present findings can provide valuable evidence for the policymakers and managers to adopt supportive, encouraging, motivational, protective, training, and educational interventions into healthcare workforce in other parts of Vietnam.

Religious Engagement in the COVID-19 Pandemic (preprint)

The COVID-19 pandemic has presented a particularly urgent need for religions to take an active role in addressing the crisis. Although the pandemic is a time in which religious institutions are as much victims of the crisis as they are agents of addressing the problem, the conditions of the pandemic oftentimes disrupt the ability of religious leaders to engage with their followers and to communicate with one another. When we speak of religious engagement, we are really speaking of three fronts: (1) within the tradition; (2) with secular institutions; and (3) with other religious traditions. Within each individual set of engagement, there are specific issues to focus on. Here, I would like to focus on three matters that religious engagement can help address when it comes the coronavirus pandemic or other similar dilemmas: (1) communicating an interreligious message to religious adherents within and across traditions; (2) communicating truthful, scientifically sound information to the public; and (3) communicating examples of proper behavior to the people.

Social Media as Means of Mitigation of Marginalization for Vietnamese Migrant Workers in Thailand (preprint)

In this paper, I will discuss how social media has been essential in mitigating the ongoing experience of marginalization and coping with crisis, in particular the COVID-19 pandemic ravaging the world. I will demonstrate how mutual support is often sought and given via social media to compensate for the lack of official channels of support. In addition, I will also discuss some of the negative aspects of the role of social media in the lives of UVMWs that need to be addressed by religious and social leaders. Because of the prominent role – both positive and negative – of social media in the lives of UVMWs, those who consider spiritual and social support work with migrant workers must take advantage of social media in order to respond more fully to their needs. This discussion is presented from the perspective of someone who has been involved in support work for this community for 14 years, a large part of which takes place in the online arena. What is demonstrated in this study is that social media, when employed intentionally and prudently, can help compensate for significant social, legal, emotional, and material limitations faced by migrant communities due to their disadvantaged status. At the same time, measures must be taken in order to help young UVMWs better make use of social media to enhance their lives rather than suffering the consequences of misusing digital information technology.