Resilience Strategies of Tour Operators During the Uncertainty of COVID-19: Evidence from Bangladesh

Since the outbreak of COVID-19 pandemic, tour operators have been going through uncertain times as they depend directly on supply-side (e.g. airlines, hotels) and demand-side (e.g. tourists) of tourism as well as on destination management organizations. This study explores resilience strategies made by tour operators in Bangladesh that ultimately helped them survive through the COVID-19 pandemic. Drawing on qualitative semi-structured interviews with 25 tour operators, findings of the study show that resilience-building depends not only on strategies of tour operators but also on supports from external agencies. The study further shows that a multi-dimensional understanding of resilience strategies is essential in tourism research and proposes that the resilience-building of tour operators can be conceptualized as a three-dimensional mechanism including innate resilience, internally-induced resilience, and externally-induced resilience. The study would facilitate improved resilience strategy and informed policymaking to better address uncertainties during and after a major crisis for tour operators.

Sero-surveillance of SARS-CoV-2 specific antibody (IgG) among garment workers in Bangladesh (preprint)

Background Since the detection of first corona virus infection in Bangladesh on 8th March, 2020, it has been spread to the whole country quickly. Though there is lack of proper treatment facility, diagnostic facility, lack of awareness, unwillingness of people to follow the social distance guideline and lack of other containment strategies, the prevalence of COVID-19 infection especially severe and symptomatic infection among people of Bangladesh specially among working people like garment workers, people living in slum areas and rural areas are low.Objectives The purpose of this research was to determine the sero-prevalence of SARS-CoV-2-specific antibody (IgG) among Bangladeshi garment workers.Methods A cross-sectional and observational research was conducted on 402 garment workers. (69.4% female; mean age = 28.9 ± 6.9 years) in Dhaka city. A semi-structured questionnaire including informed consent as well as, socio-demographics and COVID-19 infection related information, was used to conduct the survey. Blood samples of all participants were also collected to measure the SARS-CoV-2 specific antibody (IgG). Serum level of SARS-CoV-2 specific antibody (IgG) was assessed by Chemiluminescent immunoassay technique as per instruction of manufacturer.Results The prevalence of sero-prevalence of SARS-CoV-2 specific antibody (IgG) was 80.8% which was slightly higher among females compared to male but not significant (82.1% vs. 78.0%, p > 0.05). It was notable that no significant differences were obtained in other socio-demographic information (e.g., age, education, marital status, residence, and economic status).Conclusions The findings reflect that the SARS-CoV-2 specific antibody (IgG) was prevalent among garment workers in Bangladesh. It may be due to the virus itself, genetic factor of virus, people and presence of preexisting immunity specially SARS-CoV-2 specific antibody due to previous cross infections with other corona viruses in Bangladesh.

A comprehensive design for prevention and management of COVID-19 in a tertiary medical institution in Bangladesh.

INTRODUCTION: Containment of the further spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and reducing fatality due to coronavirus disease 19 (COVID-19) represent a pressing challenge to global health services. Here, we present a management blueprint for both the containment of SARS-CoV-2 and treatment of COVID-19 through a comprehensive approach. METHODOLOGY: A cohort of 130 consecutive patients identified as positive for SARS-CoV-2 by testing of nasal swab by polymerase chain reaction were managed at a peripheral city of Bangladesh between 1 April and 31 May, 2020. Based on their clinical status, 64 of them were initially selected for isolation (Isolation Group) and 66 recommended for hospitalization (Hospital Group) as per the direction of the "Central COVID-19 Control" Center. Both groups of patients were allocated to receive standard of care management and oxygen inhalation, and intensive care unit management as and when necessary. Based on the conditions of the COVID-19 patients, there was an active system of patients being transferred from the "Isolation Group" to "Hospital Group" and vice versa. RESULTS: Twelve patients of the "Isolation Group" were transferred to the hospital, as they exhibited symptoms of deterioration. Four patients of the "Hospital Group" died during the observation period of two months in the intensive care unit. However, there has been no fatality among the patients of the "Isolation Group". CONCLUSIONS: The concept of "Isolation" and "Hospital Management" with the participation of the community seems to be an effective management strategy for COVID-19 in developing countries.

The psychometric properties of the Bangla Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5): preliminary reports from a large-scale validation study

Background The Posttraumatic Stress Disorder Checklist (PCL-5) is the most widely used screening tool in assessing posttraumatic stress disorder symptoms, based on the Diagnostic and Statistical Manual of Mental disorders (DSM-5) criteria. This study aimed to evaluate the psychometric properties of the newly translated Bangla PCL-5. Methods A cross-sectional survey was carried out among 10,605 individuals (61.0% male;mean age: 23.6 ± 5.5 [13–71 years]) during May and June 2020, several months after the onset of the COVID-19 outbreak in Bangladesh. The survey included the Bangla PCL-5 and the PHQ-9 depression scale. We used confirmatory factor analysis to test the four-factor DSM-5 model, the six-factor Anhedonia model, and the seven-factor hybrid model. Results The Bangla PCL-5 displayed adequate internal consistency (Cronbach’s alpha = 0.90). The Bangla PCL-5 score was significantly correlated with scores of the PHQ-9 depression scale, confirming strong convergent validity. Confirmatory factor analyses indicated the models had a good fit to the data, including the four-factor DSM-5 model, the six-factor Anhedonia model, and the seven-factor hybrid model. Overall, the seven-factor hybrid model exhibited the best fit to the data. Conclusions The Bangla PCL-5 appears to be a valid and reliable psychometric screening tool that may be employed in the prospective evaluation of posttraumatic stress disorder in Bangladesh.

Self-medication practices and associated factors among COVID-19 recovered patients to prevent future infections: A web-based survey in Bangladesh (preprint)

Background Human health is largely affected by self-medication in both ways, adversely and favorably, as evidenced by the COVID-19 pandemic. The fear of spreading COVID-19 among health workers and hospital environments has led many Bangladeshi people to practice self-medicate for as a preventive strategy against this disease. Consequently, this practice entails an improper and injudicious use of medicine to cure self-recognized symptoms. To date, the COVID-19 has no effective treatment. The lack of a cure for COVID-19 and the continual progression of the diseases in educational settings induce a substantial population to practice self-medication. Therefore a study of self-medication practices is necessary for the framework of the pandemic. This study aimed to estimate the prevalence and factors associated with self-medication to prevent or manage future COVID-19 infections among recovered COVID-19 patients. Methods This cross-sectional study was conducted from September 2020 to February 2021 using an e-survey along with 360 participants. Data were collected using a pre-tested self-reported questionnaire. Descriptive statistics and correlations analysis were performed in the study. Results Among 360 participants, males were 69.7%, and females 30.3%. The prevalence of self-medication is 11%, and monthly family income, residence, education, occupation, and previous history of SM are the associated factors. Among the participants, 29.7% use antibiotics, and 30% use herbal products or drugs as medication. Conclusion The present study found SMP is moderately prevalent among COVID-19 recovered patients. To minimize the rate of SMP, adequate health care access systems and public education should be introduced, and media & community should be engaged in rational use of medication.

Self-Isolation Negatively Impacts Self-Management of Diabetes During the Coronavirus (COVID-19) Pandemic (preprint)

Background/Aim: People with diabetes are at a greater risk of serious complications from Coronavirus disease (COVID-19). Self-management of diabetes is therefore of paramount importance. The purpose of this study is to compare self-management of diabetes pre-COVID-19 and during COVID-19 pandemic. Methods: 679 participants with diabetes completed an online structured questionnaire. Outcome variables that were analysed were: (i) fluctuation of blood glucose levels, (ii) access to diabetes medicine, (iii) access to healthy diet, and (iv) physical activity. Adjusted multiple regression analysis ascertained significant associations for each outcome variable against exposure variables such as demographics (age/gender), history of diabetes (duration, treatment, and complications) and the need for self-isolation. Results:  Multiple regression analysis showed that self-isolation was significantly associated with greater fluctuation in blood glucose levels (OR=1.8, 95% CI=1.2-2.6, p=0.005), worsened access to diabetes medicine (OR=1.9, 95% CI=1.1-3.1, p=0.02) and reduced access to healthy diet (OR=3.0, 95% CI= 2.0-4.6, p<0.001). Fluctuating blood glucose was also significantly associated with having at least one complication of diabetes (OR=2.2, 95 % CI=1.2-3.9, p=0.008) and worsened access to diabetes medicine was significantly higher in people who were on insulin (OR=2.1, 95% CI=1.3-3.3, p=0.001).   Conclusions: Self-isolation impacted various factors that influence self-management of diabetes. A targeted approach to improved access to diabetes medicine and healthy diet for people needing to self-isolate is vital in order to ensure that they are able to self-manage their diabetes effectively.  

Surging COVID-19 in Bangladesh driven by B.1.351 variant (preprint)

A dramatic resurgence of COVID-19 cases and deaths in Bangladesh in March 2021 coincided with the SARS-CoV-2 B.1.351 (501Y.V2) variant of concern rapidly becoming the dominant circulating variant. Concurrently, increasing numbers of reinfections have been detected and the effective Reproductive number, Rt, has doubled, despite high levels of prior infection in Dhaka city. These data support the prediction that acquired immunity from past infection provides reduced protection against B.1.351, and highlights the major public health concern posed by immune escape variants, especially in populations where vaccination coverage remains low.

Knowledge, attitudes and perceptions towards COVID-19 vaccinations: a cross-sectional community survey in Bangladesh (preprint)

BackgroundSeveral vaccines have been approved against coronavirus disease (COVID-19) and distributed globally in different regions. However, general community knowledge, attitudes and perceptions towards COVID-19 vaccinations are poorly understood. Thus, the study aimed to investigate community knowledge, attitudes and perceptions towards COVID-19 vaccinations in Bangladesh. MethodsAn exploratory and anonymous population-based e-survey was conducted among 1658 general individuals (55.6% male; mean age=23.17{+/-}6.05 years; age range=18-65 years). The survey was conducted using a semi-structured and self-reported questionnaire containing informed consent along with four sections (i.e., socio-demographics, knowledge, attitudes, and perceptions). Multiple linear regression was performed to determine the variables predicting knowledge, and attitudes towards COVID-19 vaccinations. ResultsThe mean scores of knowledge and attitudes were 2.83{+/-}1.48 (out of 5) and 9.34{+/-}2.39 (out of 12) respectively. About a quarter of participants thought that the COVID-19 vaccination available in Bangladesh is safe, only 60% will have the vaccination and about two-thirds will recommend it to family and friends. In the multiple regression model, higher SES, having university/ higher levels of education, holding nuclear families and having previous history of essential vaccines uptake were associated with knowledge; whilst attitudes were significantly associated with being female and having previous history of essential vaccines uptake. Just over half of the participants thought that everyone should be vaccinated and 61% responded that health workers should be vaccinated first on priority basis. 95% vaccine should be administered free of charge in Bangladesh and almost 90% believed that the COVID-19 vaccine used in Bangladesh may have side effects. ConclusionsThe findings reflect inadequate knowledge but more positive attitudes towards COVID-19 vaccine among the general population in Bangladesh. In order to improve knowledge, immediate health education programs need to be initiated before mass vaccination schedule.

The Psychometric Properties of the Bangla Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5): A Large-scale Validation Study (preprint)

Background: The Posttraumatic Stress Disorder Checklist (PCL-5) is the most widely used screening tool in assessing posttraumatic stress disorder symptoms, based on the Diagnostic and Statistical Manual of Mental disorders (DSM-5) criteria. This study aimed to evaluate the psychometric properties of the newly translated Bangla PCL-5. Methods: A cross-sectional survey was carried out among 10,605 individuals (61.0% male; mean age: 23.6±5.5 [13-71 years]) during May and June 2020, several months after the onset of the COVID-19 outbreak in Bangladesh. The survey included Bangla PCL-5 and PHQ-9 depression scale. We used confirmatory factor analysis to test the four-factor DSM-5 model, the six-factor Anhedonia model, and the seven-factor Hybrid model. Results: Bangla PCL-5 displayed adequate internal consistency (Cronbach’s alpha = 0.90). The Bangla PCL-5 score was significantly correlated with scores of the PHQ-9 depression scale. Confirmatory factor analyses indicated the models had a good fit to the data, including the four-factor DSM-5 model, the six-factor Anhedonia model, and the seven-factor Hybrid model.Conclusions: The Bangla PCL-5 appears to be a valid and reliable psychometric screening tool that may be employed in the prospective evaluation of posttraumatic stress disorder in Bangladesh.

A transformer based approach for fighting COVID-19 fake news (preprint)

The rapid outbreak of COVID-19 has caused humanity to come to a stand-still and brought with it a plethora of other problems. COVID-19 is the first pandemic in history when humanity is the most technologically advanced and relies heavily on social media platforms for connectivity and other benefits. Unfortunately, fake news and misinformation regarding this virus is also available to people and causing some massive problems. So, fighting this infodemic has become a significant challenge. We present our solution for the "Constraint@AAAI2021 - COVID19 Fake News Detection in English" challenge in this work. After extensive experimentation with numerous architectures and techniques, we use eight different transformer-based pre-trained models with additional layers to construct a stacking ensemble classifier and fine-tuned them for our purpose. We achieved 0.979906542 accuracy, 0.979913119 precision, 0.979906542 recall, and 0.979907901 f1-score on the test dataset of the competition.

Correlates of Financial Concerns and Symptoms of Depression and Posttraumatic Stress Disorder in Impoverished Urban-dwelling Individuals in Bangladesh During the COVID-19 Pandemic: Face-to-face Interview Findings (preprint)

Background: The COVID-19 pandemic has impacted the physical, mental and financial health of many individuals. How substantially marginalized groups like impoverished urban-dwelling individuals are specifically impacted amid this pandemic is poorly understood. The present study aimed to investigate correlates of financial concerns and symptoms of depression and posttraumatic stress disorder (PTSD) during the COVID-19 pandemic among impoverished urban-dwelling individuals residing in Dhaka, Bangladesh. Methods: A cross-sectional survey was conducted between August and September 2020 using face-to-face interviews in six disadvantaged neighborhoods (“slums”) in Dhaka. Individuals were interviewed using a structured questionnaire consisting of questions assessing socio-demographics, lifestyle, financial well-being relating to the COVID-19 pandemic, depression, and PTSD. Results: A total of 435 individuals (male=54.7%; mean age=45.0±12.0 years; age range=18-85 years) participated. Most (96.3%) reported that their household income decreased due to the COVID-19 pandemic. Associated factors included female gender, primary education, jobless, food scarcity, and depression. Depression symptoms were linked to female gender, being jobless, being divorced, living in a joint family, excessive sleep, and smoking. Low incomes, excessive sleep, joblessness, and food scarcity were positively associated with PTSD symptoms. In contrast, less sleep appeared protective against PTSD. Limitations: Potential limitations included cross-sectional study design and limited sample size. Conclusions: Public health initiatives, in particular mental health services, should be introduced to mitigate against psychological and financial effects of the pandemic on impoverished urban-dwelling individuals in Bangladesh.

Prevalence and correlates of anxiety and depression in frontline healthcare workers treating people with COVID-19 in Bangladesh (preprint)

Background: Healthcare workers (HCWs) who are in the frontline during the COVID-19 pandemic are often under significant pressures which may predispose them to mental ill-health. This study aimed to investigate the prevalence of anxiety and depression among HCWs and factors correlated with mental problems during the COVID-19 pandemic in Bangladesh. Methods: A cross-sectional survey was conducted between July and August 2020. A self-reported online questionnaire was utilized to collect data. The survey included questions concerning socio-demographic, lifestyle, and work setting and the Hospital Anxiety and Depression Scale (HADS). Results: Data from 803 HCWs (50.7% male; mean age: 27.3 [SD=6.9]; age range: 18-58 years) were included in analyses. Prevalence estimates of anxiety and depression were, respectively, 69.5% and 39.5% for at least borderline abnormal, 41.2% and 15.7% for at least abnormal symptoms. Regression analyses with HADS-score as dependent variable revealed significant (p<0.05) associations with female sex, moderate and poor health status, irregular physical exercising, smoking, having had regrets about their profession because of the pandemic and many unexpected experiences, not updating on the latest COVID-19-related research, experiencing discrimination in the workplace, and facing social problems due to working in a lab or hospital. Conclusions: Symptoms of mental ill-health are prevalent among HCWs during the COVID-19 pandemic in Bangladesh. The findings suggest a need for monitoring and early interventions to help these individuals.

Knowledge, attitudes and practices associated with the COVID-19 among slum dwellers resided in Dhaka City: A Bangladeshi interview-based survey (preprint)

Background: The emergent COVID-19 has impacted unprecedentedly to all classes of people. Slum-dwellers' knowledge, attitudes and practices (KAP) towards COVID-19 are currently poorly understood. To investigate the KAP towards COVID-19 among slum dwellers resided in Dhaka City, Bangladesh. Methods: A cross-sectional offline survey was carried out enrolling 406 slum dwellers (53.2% male; mean age=44.9 years [SD=12.1]; age range=18-85 years) between August and September, 2020. The face to face interview was conducted to collect data from 6 selected slum areas in Dhaka City using convenience sampling. The questionnaire consisted of informed consent along with questions concerning observational checklists, socio-demographics, and KAP. Results: A sizeable minority were observed without wearing face masks during the survey periods (18.2%) and a vast portion (97.5%) without any hand protection. The mean scores of KAP were 6.1plus-or-minus sign2.6 (out of 17), 12.3plus-or-minus sign1.7 (out of 14), and 9.8plus-or-minus sign1.6 (out of 12), respectively. Moreover, the KAP were strongly and positively correlated with each other. Conclusions: The findings revealed that the majority of slum dwellers in Bangladesh have limited knowledge of COVID-19. Poor practices (i.e., face mask and hand protection) were directly observed during the survey. The findings suggest the immediate implementation of health education programs and adequate interventions.

Scenario Planning: Systematic Handling of Organisational Crises during COVID-19 Economic Recession (preprint)

Scenario planning also well known as scenario thinking or scenario analysis is a strategic planning tool that some organizations use to create multiple long-term plans. The scenario planning is largely an adaptation and generalization of classic methods used by Military intelligence. The scenario planning method was that a group of analysts would generate imaginary simulation games for the decision makers. The scenarios contain known facts about the future such as demographics, geography, military, political, industrial information and mineral reserves with different alternatives social, technical, economic, environmental, educational, political and aesthetic trends which are the key driving forces. Scenario planning further may involvement of systems thinking, specifically the recognition of many factors which may combine in complex ways to create unprecedented future situation. The method also allows the inclusion of factors difficult to formalize like novel insights about the future, deep shifts in values, unexpected change in rules and regulations. Systems thinking used along with scenario planning leads to probable scenario story lines due to causal relationships can be demonstrated. When scenario planning is integrated with a system thinking approach to scenario development it is referred to as structural dynamics (Anon 2011a).Royal Dutch Shell company has been using the Scenario planning for formulating their enterprise strategies for the last 3 decades actively to predict a highly uncertain industry future and stay ahead of other industry players. In this Paper we will explore 3 different scenarios and strategic response for Royal Arcade Mall. The shopping mall industry has experienced vast expansion in UAE for the last one decade with at least 15 large scale shopping malls has been built from 2001 to 2011 and 5 malls still to come in the market within next 2 years period of time. UAE is a popular destination and preferred work place for expatriate professionals and with this trend UAE expatriate population is going to increase in the coming years (anon-2007).We will examine the Mall industry in Abu Dhabi in three different scenarios and will formulate strategic responses to these scenarios as follows: -1) No external environmental change2) Negative external change3) Positive external change In the later stage of this Paper we will explore different scenarios including current hot topic COVID-19 economic recession and how to take advantage of Scenario planning to formulate strategic responses for all those scenarios.

Effect of COVID-19 pandemic induced lockdown (general holiday) on air quality of Dhaka City (preprint)

A worldwide pandemic of COVID-19 has forced to implement a lockdown during April-May 2020 by restricting people's movement, the shutdown of industries and motor vehicles in Dhaka, Bangladesh, to contain the virus. This type of strict measures returned an outcome of the reduction of urban air pollution around the world. The present study aims to investigate the reduction of the concentration of pollutants in the air of Dhaka City and the reduction of the Air Quality Index (AQI). Necessary time-series data of the concentration of PM2.5, NO2, SO2, and CO have been collected from the archive of the U.S. Environmental Protection Agency (US EPA) and Sentinel-5P. The time-series data have been analyzed by descriptive statistics, and AQI is calculated following an appropriate formula suggested by US EPA based on the criteria pollutants. The study found that the concentrations of PM2.5, NO2, SO2, and CO have been reduced by 23, 30, 07, and 07% during April-May 2020, respectively, compared with the preceding year's concentration. Moreover, the AQI has also been reduced by up to 35% than the previous year in April-May 2020. However, the magnitude of pollution reduction in Dhaka is lower than other cities and countries globally, including Delhi, Sao Paulo, Wuhan, Spain, Italy, USA, etc. The main reason includes the poor implementation of lockdown, especially in the first week of April and the second fortnight of May. The findings will be useful for policymakers to find a way to control the pollution sources to enhance Dhaka's air quality.