COVID-19 pandemic: perception, attitude, and practices of university students from health sector faculties

Background: Adherence to preventive control measures is influenced by perception, attitudes, and practices toward the disease prevention. Aim: To assess the perceptions, attitude, and practices of university students in three health sector faculties (Medicine, Nursing, and Pharmacy) from six Egyptian universities towards COVID-19 pandemic prevention. Methods: An electronic online survey was distributed to students of 3 faculties (Medicine, Pharmacy, and Nursing) in six Egyptian universities from March to July 2021. The questionnaire consists of the following parts: socio-demographic data of participants, student perception and attitude towards the COVID-19 pandemic and its consequences, as well as practices of preventive measures in the community. Results: The study included 1990 participants. Most respondents perceived the seriousness of the COVID-19 pandemic (88.2%). The rates of practicing precautionary measures were mostly high (approximately 90% or above). Significantly high attitude scores toward the pandemic were detected in people with quite-to-extremely concerned, very good/excellent status, aware of infection risk, willing to report positive cases and avoiding contact with them, and seeking medical advice regarding infection. The attitude to protective measures followed a similar pattern along with average health status, female students, and avoidance of contact when experiencing flu symptoms. Significantly higher practice scores were observed in those with bad health status, rural areas, perceiving the risk of infection, willing to report positive cases, and avoiding contact with positive cases. Conclusion: The effectiveness of precautionary measures should be stressed to promote positive student practices.

Household Materials for Homemade Masks: How Effective Are They?

Introduction: With the fear of uncertain behaviours and mechanisms of the coronavirus in the rapidly evolving COVID-19 pandemic, people are required to cover their mouth and nose to prevent the spread of the virus. This has become a challenge as most countries struggle with the dwindling stocks of face masks. However, the Centers for Disease Control and Prevention suggested the use of cloth masks as a substitute. In an effort to find suitable materials that serve this purpose and ensure sufficient protection afforded, the masks need to be tested. Methods: In this study, the penetration and breathing resistance of 13 easily obtained household materials potentially used by the public as face masks, were randomly selected and tested by using TSI Model 8130 Automated Filter Tester, while the thickness was measured by S-Cal EVO Proximity caliper. Results: The level of thickness ranged between 0.25 mm (satin) and 4.83 mm (diaper). Double-layer denim material showed the lowest percentage of penetration (Median, IQR: 27.50%, 27.05-28.80) while the greatest was single-layer lycra (Median, IQR: 90.60%, 80.80-92.10). Single-layer chiffon fabric showed the best breathing resistance (Median, IQR in mmH2O: 1.30, 0.90, 1.45) while the worst was diaper (Median, IQR in mmH2O: 87.20, 86.95, 87.25). Conclusion: Double-layer dried wet tissue, single-layer tissue paper and double-layer non-woven fabric can be considered to be used as face masks due to their efficiency based on penetration and breathing resistance factors. © 2021 UPM Press. All rights reserved.

Emergency and response planning for healthcare workers to manage COVID-19 pandemic situation

The Coronavirus Disease 2019 (COVID-19) was first detected in December 2019 in Wuhan, China and despite drastic measures by the Chinese authority in enforcing a “lockdown” in Wuhan, the virus had since spread to a growing number of countries worldwide - including Malaysia. The World Health Organization (WHO) declared the outbreak of COVID-19 a pandemic on 11 March 2020. The Malaysian Government announced the restricted activities order known as the Movement Control Order (MCO) nationwide under the Prevention and Control of Infectious Diseases Act 1988 (Amendment) Regulation 2020 from 18 March 2020 to 31 March 2020. With the pandemic still spreading at an alarming rate, hospitals and healthcare workers were overburdened to cope with the sudden influx of large numbers of COVID-19 patients. It was reported that the healthcare workers were ill-equipped with personal protective equipment (PPE) and ventilators to treat the COVIC-19 patients, thus exposing and putting them at risk of infection or losing their lives. The purpose of this study is to provide an insight into the current situation of the ERP for Healthcare Workers. Fortifying a framework for addressing the six stages of ERP will prepare and protect the healthcare workers in performing their duties systematically and address issues and concerns faced by the healthcare workers on the lack of PPE and medical support for COVID-19 treatment. As there is a lack of studies on the improvement of ERP for hospitals, this proposed framework can lead to further research on strengthening the existing ERP for healthcare workers in public hospitals to counter future influenza outbreaks. © 2021 American Institute of Physics Inc.. All rights reserved.

The prediction of pulmonary embolism & CTPA findings in the covid-19 crisis

Objective To determine if the key features used to predict and diagnose pulmonary embolism (PE) in the hospital setting were affected by the COVID-19 crisis. Our hospital protocol utilises a two-tier Wells probability score with values of 4 or less requiring a positive D-dimer test to determine if imaging is necessary. The components of a Wells score and D-dimer levels may be affected by coincident coronavirus infection. Methods Observational data has been collected for patients presenting to acute services with a possible PE at our trust as part of ongoing pathway development. A representative month (April 2019) was used to provide a cohort for comparison with the COVID-19 patients who were investigated for PE during April 2020. Results During April 2020, 126 patients had a CTPA with 30 diagnosed PEs (23.8%) compared with 2019 when only seven PEs were diagnosed from 59 scans (11.8%). The calculated Wells score for the 2020 cohort had a mean of 4.5 and median of 4.5, in 2019 the mean Wells was 4.0 with a median of 4.5. The most common components of the Wells score seen in 2020 were: PE most likely diagnosis (n=89), heart rate >100bpm (n=88), immobile for >3 days (n=61). The available D-dimer results indicate they were significantly higher in the COVID cohort (12097 n=72) than the 2019 group (3367 n=28, p<0.05 t-test). During COVID D-dimer levels were significantly higher in patients with a PE (25207)) than those without PE (7000, p<0.01). From the 126 CTPAs 50 cases had CT features consistent with COVID-19 disease, ten of whom also had a PE. 75 cases had COVID proven on viral swab PCR or CT criteria. COVID proven patients had higher platelet count, ferritin and CRP with lower lymphocyte count (all p<0.05 t-test) compared with the rest of the 2020 cohort. The COVID proven patients with a PE also had a significantly higher D-dimer than without a PE (38156 vs 3855 p<0.01) and a trend towards a prolonged INR (1.52 vs 1.11 p=0.09). Conclusion The COVID-19 crisis was associated with an increase in PE diagnoses and diagnostic rates on imaging with higher D-dimer levels. Thresholds and predictionmodels may need to be re-evaluated.

S62 The prediction of pulmonary embolism & CTPA findings in the COVID-19 crisis

ObjectiveTo determine if the key features used to predict and diagnose pulmonary embolism (PE) in the hospital setting were affected by the COVID-19 crisis. Our hospital protocol utilises a two-tier Wells probability score with values of 4 or less requiring a positive D-dimer test to determine if imaging is necessary. The components of a Wells score and D-dimer levels may be affected by coincident coronavirus infection.MethodsObservational data has been collected for patients presenting to acute services with a possible PE at our trust as part of ongoing pathway development. A representative month (April 2019) was used to provide a cohort for comparison with the COVID-19 patients who were investigated for PE during April 2020.ResultsDuring April 2020, 126 patients had a CTPA with 30 diagnosed PEs (23.8%) compared with 2019 when only seven PEs were diagnosed from 59 scans (11.8%). The calculated Wells score for the 2020 cohort had a mean of 4.5 and median of 4.5, in 2019 the mean Wells was 4.0 with a median of 4.5. The most common components of the Wells score seen in 2020 were: PE most likely diagnosis (n=89), heart rate >100bpm (n=88), immobile for >3 days (n=61). The available D-dimer results indicate they were significantly higher in the COVID cohort (12097 n=72) than the 2019 group (3367 n=28, p<0.05 t-test). During COVID D-dimer levels were significantly higher in patients with a PE (25207)) than those without PE (7000, p<0.01). From the 126 CTPAs 50 cases had CT features consistent with COVID-19 disease, ten of whom also had a PE. 75 cases had COVID proven on viral swab PCR or CT criteria. COVID proven patients had higher platelet count, ferritin and CRP with lower lymphocyte count (all p<0.05 t-test) compared with the rest of the 2020 cohort. The COVID proven patients with a PE also had a significantly higher D-dimer than without a PE (38156 vs 3855 p<0.01) and a trend towards a prolonged INR (1.52 vs 1.11 p=0.09).ConclusionThe COVID-19 crisis was associated with an increase in PE diagnoses and diagnostic rates on imaging with higher D-dimer levels. Thresholds and predictionmodels may need to be re-evaluated.