Social networks and health information sharing in COVID-19 pandemic : Tetine Sentell

Background Understanding health information flow in social networks is important for designing effective health communications strategies and to achieve health literacy. Limited information is known about variation in social networks and health information sharing in the COVID-19 pandemic by demographic factors. Young people are of particular interest given their heavy exposure to digital media sources, which include considerable health misinformation. Methods Hawai'i (n = 324) residents between 18-35 completed a Spring 2021 online survey including questions on health information flow in social networks: (1) how many they talked to and (2) listened to about health. Two Poisson regression models were fit with gender, education, and race/ethnicity predicting social network size. Results Respondents were 67.6% female. Respondents discussed their own health with 2-3 people (M = 2.18, SD = 2.95) and listened to roughly the same number. Respondents who talked with a greater number of individuals about their own health were significantly more likely to have larger networks for listening to others (r (317) = .614;p< .001). In the model for discussing their own health, as education increased so did social network size. For the model predicting discussing others’ health, gender was significant (p = 0.003);women listened to 30.6% more individuals than men. Most (73%) respondents had conducted a recent digital health search for either themselves or someone else, including for parents, grandparents, and children. Facebook (63%) and Instagram (58%) were the most popular online sources for COVID-19 health information. Conclusions Understanding social networks and digital health sources in young people are important for designing effective health communications to reach all communities, especially those experiencing health inequities, given the amount of health misinformation circulating and the need to build trust in public health communication. Key messages • Social networks provide access to critical health information including information obtained from digital sources. • Gender and education were important predictors of social network size in COVID-19 health communications.

Ferritin and Neutrophil Lymphocyte Ratio in Assessingthe Severity of Disease in COVID 19 Positive Pregnancy

Introduction: The pandemic of coronavirus disease 2019 caused bythe SARS-CoV-2 is affecting many women during pregnancy and inthe postpartum period worldwide. A peculiar characteristic ofCOVID-19 is the release of a large amount of inflammatory cytokines. Some biomarkers have been considered as tools to monitor theevaluation of COVID-19, namely CRP, LDH, D-dimer and ferritin.Currently the neutrophil lymphocyte ratio constitutes a new stronginflammatory marker for the detection of inflammation. Neutrophillymphocyte ratio has also been used as a predictor of complication ofpregnancy, such as pre-eclampsia, gestational diabetes mellitus,hyperemesis gravidarum, premature labour and ectopic pregnancy.Aims &Objectives: To study the neutrophil lymphocyte ratio (NLR)and ferritin levels in COVID-19 positive pregnancy and correlate itwith the severity of the disease.Materials &Methods: This is an observational study conducted inthe obstetrics ward of a tertiary care center. The inclusion criteriawere all the pregnant females admitted in the obstetrics ward with adiagnosis of COVID-19 by RT PCR in the period of 3 months. Theexclusion criteria were patients with non reactive rapid test results.Clinical and demographic data were extracted from electronic medical records.Result: In our study, 32 out of 70 patients showed ferritin valuesabove 400 ng/ml. Lymphocytopenia, increased neutrophil lymphocyte ratio and increased ferritin had all been linked with diseaseseverity or mortality. Decreased lymphocyte value was associatedwith an increased likelihood of receiving oxygen supplementationduring hospitalization. These markers show abnormal values inobstetrics patients and reflects the course of the disease. It suggestedthat additional care should be reserved to patients presenting withdecreased value of these blood cells. Pregnancy is a physiologicanemic state and high levels of ferritin, especially in third trimesterare associated with negative outcomes like preterm delivery andgestational diabetes mellitus.Conclusions: Both neutrophil lymphocyte ratio and ferritin levels canact as independent markers in assessing the disease severity ofCOVID-19 in obstetrics patients.

Health Literate Hawai'i: A Blueprint to Empower Health and Wellbeing

Recent studies have identified high rates of chronic disease in Hawai'i's adults and youth. As the state responds to the COVID-19 pandemic and looks beyond it, the prevention and management of chronic diseases are critical for community health and wellbeing. Low health literacy is more common in rural populations, Filipinos, and Pacific Islanders in Hawai'I, older adults, and many other groups with high rates of chronic disease. Promoting health literacy can reduce chronic disease burdens for individuals, families, and communities. Using the framework of the social-ecological model, which is important for visioning effective chronic disease management and prevention, this article provides a blueprint of layers of influence for building a health literate Hawai'I generally and around chronic disease specifically. The article will close with a call to action informed by the National Action Plan to Improve Health Literacy for stakeholders and providers to address health literacy in the state of Hawai'I in organizations, systems, and policy. These actions should address root causes of disease and help build more equitable health outcomes across the state now and in the future. ©Copyright 2021 by University Health Partners of Hawai‘i (UHP Hawai‘i).

Short term neonatal outcomes of colocating and breastfeeding infants of mothers who tested positive for SARS-COV-2

Background: There is a paucity of data on the neonatal outcomes of maternal SARS-COV2 infection which has emerged as a pandemic spreading rapidly across the world. Further, conflicts in current guidelines exist on whether to routinely separate infants from infected mothers in the hospital, to utilize shared decision-making to regulate care or to encourage exclusive breastfeeding and standard feeding guidelines for these infants. At our hospital in New York City which has been the epicenter of the infection in the US, shared decision-making between the mother and clinical team was utilized. Mothers who elected to room-in were encouraged to initiate skin-to-skin care and follow routine breast-feeding practices while following strict hand washing and use of masks. Infected mothers who were restricted from NICU and mothers of isolated infants were encouraged to provide pumped breastmilk. We aimed to elucidate the outcomes of the infants born to mothers with COVID-19 infection following these practices. Methods: We identified all neonates born to mothers who were tested positive for SARS-CoV-2 from March 19 to April 22, 2020 at Elmhurst Hospital (Table Presented) Center. All infants were tested by nasopharyngeal PCR swabs. Data regarding demographic, epidemiologic, clinical features, breastfeeding practices and short-term outcomes including outpatient follow up through telemedicine or in-person visits were obtained by retrospective chart review of medical records. Results: Among 118 mothers tested during the study period, 45 (38%) of mothers tested positive of which 18(40%) were asymptomatic. All the infants were screened for SARS-CoV-2 and none were positive. 3 infants initially tested positive for SARS-CoV-2 on a screen at <24 hours of age, but tested negative on 2 repeated screens and were considered false positives. All the infants were asymptomatic for COVID-19 in the hospital. Demographic characteristics are described in Table 1. 33 babies were roomed with the mother while 7 required NICU admission. 5 newborns were isolated from the mother at birth due to maternal request. 31 infants were breastfed directly, 9 received expressed breastmilk and 5 did not receive any breastmilk. 41 babies were discharged to the same household as mother, one is still in the hospital and 3 were discharged to a different household (Table 2). During follow up, there was a 93% adherence to the initial in-person newborn visit while there was a 100 % compliance to the tele-medicine visit around 14 days. All infants were asymptomatic at follow up visits and none had COVID-19 related emergency department visits or subsequent hospital admissions. Conclusion: We report no short term adverse neonatal outcomes to skin-to-skin care, rooming-in or breastfeeding in infants of SARS-CoV-2 positive mothers in our population. Although this data is preliminary, it could help decide best practices for these infants.