Ontarians' Perceptions of Public Health Communications and Misinformation During the COVID-19 Pandemic: Survey Study.

BACKGROUND: Clear, accurate, and transparent risk communication is critical to providing policy makers and the public with directions to effectively implement public health strategies during a health emergency. OBJECTIVE: We aimed to explore the public's preferred sources of obtaining COVID-19 information, perceptions on the prevalence and drivers of misinformation during the pandemic, and suggestions to optimize health communications during future public health emergencies. METHODS: We administered a web-based survey that included Likert scale, multiple choice and open-ended response questions to residents of Ontario, Canada. We aimed to recruit a sample that reflected population diversity with respect to age and gender. Data were collected between June 10, 2020, and December 31, 2020, and were analyzed using descriptive statistics; open-ended data were analyzed using content analysis. Subgroup analyses to explore perceptions by age and gender were conducted using ordinal regression. RESULTS: A total of 1823 individuals participated in the survey (n=990, 54% women; n=703, 39% men; n=982, 54% aged 18-40 years; n=518, 28% aged 41-60 years; and n=215, 12% aged ≥61 years). Participants most commonly obtained COVID-19 information from local television news (n=1118, 61%) followed by social media (n=938, 51%), national or international television news (n=888, 49%), and friends and family (n=835, 46%). Approximately 55% (n=1010) of the participants believed they had encountered COVID-19-related misinformation; 70% (n=1284) of the participants reported high levels of trust in health authority websites and health care providers; 66% (n=1211) reported high levels of trust in health ministers or public health organizations. Sources perceived to be less trustworthy included friends and family, talk radio, social media, as well as blogs and opinion websites. Men were more likely to report encountering misinformation and to trust friends or family (odds ratio [OR] 1.49, 95% CI 1.24-1.79) and blogs or opinion websites (OR 1.24, 95% CI 1.03-1.50), compared to women. Compared to those aged 18-40 years, participants aged ≥41years were more likely to trust all assessed information sources, with the exception of web-based media sources, and less likely to report encountering misinformation. Of those surveyed, 58% (n=1053) had challenges identifying or appraising COVID-19 information. CONCLUSIONS: Over half of our participants perceived that they had encountered COVID-19 misinformation, and 58% had challenges identifying or appraising COVID-19 information. Gender and age differences in perceptions of misinformation and trust in information sources were observed. Future research to confirm the validity of these perceptions and to explore information-seeking patterns by population subgroups may provide useful insights on how to optimize health communication during public health emergencies.

Exploring Canadian perceptions and experiences of stigma during the COVID-19 pandemic.

Background: The COVID-19 pandemic has led to stigmatization of individuals based on race/ethnicity, age, gender, and occupation, among other factors. We canvassed Canadian residents to explore perceptions of and experiences with stigma during the COVID-19 pandemic. Methods: We conducted an online survey between June 10 and December 31 2020. The survey was rooted in the Health Stigma and Discrimination Framework and included multiple choice, Likert and open-ended questions related to perceived and experienced stigma. Residents of Ontario, Canada were eligible to participate and we aimed to recruit a sample that was diverse by race/ethnicity and age. Results: A total of 1,823 individuals participated in the survey (54% women, 39% men; 54% 18-40 years old, 28% 41-60 years old, 12% 61+ years old; 33% White, 26% East/SouthEast Asian, 14% Black, 12% South Asian). Fifty-one percent of participants agreed/strongly agreed that racist views had increased toward certain racial/ethnic groups in Canada during the pandemic. Participants perceived that people in Canada were stigmatized during the pandemic because of race/ethnicity (37%), political beliefs (26%), older age (24%), being a healthcare worker (23%), younger age (22%), being an essential worker (21%), and gender (11%). Thirty-nine percent of respondents feared experiencing and 37% experienced stigmatization during the pandemic. Men, individuals aged 18-40, and racialized participants were more likely to fear or experience stigma. With respect to health behaviors, 74, 68, and 59% of respondents were comfortable masking in public, seeking medical care if they became ill, and getting tested for COVID-19, respectively. Men were less likely to indicate comfort with mask wearing or seeking medical care. Participants aged 18-40 and Black participants were less likely to indicate comfort with all three behaviors compared to those over age 41 and White participants, respectively. South Asian participants were less likely to be comfortable seeking medical care compared to White Participants. Discussion: Participants feared or experienced stigmatization towards various demographic characteristics during the COVID-19 pandemic. It is critical that the factors driving stigma during health emergencies in Canada be better understood in order to develop effective public health messaging and interventions.

Kinetics of Neutralizing Antibodies against Omicron Variant in Vietnamese Healthcare Workers after Primary Immunization with ChAdOx1-S and Booster Immunization with BNT162b2.

We studied the development and persistence of neutralizing antibodies against SARS-CoV-2 ancestral strain, and Delta and Omicron (BA.1 and BA.2) variants in Vietnamese healthcare workers (HCWs) up to 15 weeks after booster vaccination. We included 47 HCWs, including group 1 (G1, N = 21) and group 2 (G2; N = 26) without and with breakthrough Delta variant infection before booster immunization, respectively). The study participants had completed primary immunization with ChAdOx1-S and booster vaccination with BNT162b2. Neutralizing antibodies were measured using a surrogate virus neutralization assay. Of the 21 study participants in G1, neutralizing antibodies against ancestral strain, Delta variant, BA.1, and BA.2 were (almost) abolished at month 8 after the second dose, but all had detectable neutralizing antibodies to the study viruses at week 2 post booster dose. Of the 26 study participants in G2, neutralizing antibody levels to BA.1 and BA.2 were significantly higher than those to the corresponding viruses measured at week 2 post breakthrough infection and before the booster dose. At week 15 post booster vaccination, neutralizing antibodies to BA.1 and BA.2 dropped significantly, with more profound changes observed in those without breakthrough Delta variant infection. Booster vaccination enhanced neutralizing activities against ancestral strain and Delta variant compared with those induced by primary vaccination. These responses were maintained at high levels for at least 15 weeks. Our findings emphasize the importance of the first booster dose in producing cross-neutralizing antibodies against Omicron variant. A second booster to maintain long-term vaccine effectiveness against the currently circulating variants merits further research.

Comparative-effectiveness research of COVID-19 treatment: a rapid scoping review.

OBJECTIVES: The COVID-19 pandemic has stimulated growing research on treatment options. We aim to provide an overview of the characteristics of studies evaluating COVID-19 treatment. DESIGN: Rapid scoping review DATA SOURCES: Medline, Embase and biorxiv/medrxiv from inception to 15 May 2021. SETTING: Hospital and community care. PARTICIPANTS: COVID-19 patients of all ages. INTERVENTIONS: COVID-19 treatment. RESULTS: The literature search identified 616 relevant primary studies of which 188 were randomised controlled trials and 299 relevant evidence syntheses. The studies and evidence syntheses were conducted in 51 and 39 countries, respectively.Most studies enrolled patients admitted to acute care hospitals (84%), included on average 169 participants, with an average age of 60 years, study duration of 28 days, number of effect outcomes of four and number of harm outcomes of one. The most common primary outcome was death (32%).The included studies evaluated 214 treatment options. The most common treatments were tocilizumab (11%), hydroxychloroquine (9%) and convalescent plasma (7%). The most common therapeutic categories were non-steroidal immunosuppressants (18%), steroids (15%) and antivirals (14%). The most common therapeutic categories involving multiple drugs were antimalarials/antibiotics (16%), steroids/non-steroidal immunosuppressants (9%) and antimalarials/antivirals/antivirals (7%). The most common treatments evaluated in systematic reviews were hydroxychloroquine (11%), remdesivir (8%), tocilizumab (7%) and steroids (7%).The evaluated treatment was in favour 50% and 36% of the evaluations, according to the conclusion of the authors of primary studies and evidence syntheses, respectively. CONCLUSIONS: This rapid scoping review characterised a growing body of comparative-effectiveness primary studies and evidence syntheses. The results suggest future studies should focus on children, elderly ≥65 years of age, patients with mild symptoms, outpatient treatment, multimechanism therapies, harms and active comparators. The results also suggest that future living evidence synthesis and network meta-analysis would provide additional information for decision-makers on managing COVID-19.

Comparative-effectiveness research of COVID-19 treatment: a rapid scoping review

Objectives The COVID-19 pandemic has stimulated growing research on treatment options. We aim to provide an overview of the characteristics of studies evaluating COVID-19 treatment. Design Rapid scoping review Data sources Medline, Embase and biorxiv/medrxiv from inception to 15 May 2021. Setting Hospital and community care. Participants COVID-19 patients of all ages. Interventions COVID-19 treatment. Results The literature search identified 616 relevant primary studies of which 188 were randomised controlled trials and 299 relevant evidence syntheses. The studies and evidence syntheses were conducted in 51 and 39 countries, respectively. Most studies enrolled patients admitted to acute care hospitals (84%), included on average 169 participants, with an average age of 60 years, study duration of 28 days, number of effect outcomes of four and number of harm outcomes of one. The most common primary outcome was death (32%). The included studies evaluated 214 treatment options. The most common treatments were tocilizumab (11%), hydroxychloroquine (9%) and convalescent plasma (7%). The most common therapeutic categories were non-steroidal immunosuppressants (18%), steroids (15%) and antivirals (14%). The most common therapeutic categories involving multiple drugs were antimalarials/antibiotics (16%), steroids/non-steroidal immunosuppressants (9%) and antimalarials/antivirals/antivirals (7%). The most common treatments evaluated in systematic reviews were hydroxychloroquine (11%), remdesivir (8%), tocilizumab (7%) and steroids (7%). The evaluated treatment was in favour 50% and 36% of the evaluations, according to the conclusion of the authors of primary studies and evidence syntheses, respectively. Conclusions This rapid scoping review characterised a growing body of comparative-effectiveness primary studies and evidence syntheses. The results suggest future studies should focus on children, elderly ≥65 years of age, patients with mild symptoms, outpatient treatment, multimechanism therapies, harms and active comparators. The results also suggest that future living evidence synthesis and network meta-analysis would provide additional information for decision-makers on managing COVID-19.

Kinetics of neutralising antibodies against Omicron variant in Vietnamese healthcare workers after primary immunisation with ChAdOx1-S and booster with BNT162b2 (preprint)

We studied the development and persistence of neutralising antibodies against SARS-CoV-2 ancestral strain, and Delta and Omicron (BA.1 and BA.2) variants in Vietnamese healthcare workers (HCWs) up to 15 weeks after booster vaccination. We included 47 HCWs with different pre-existing immune statuses (group 1 (G1): n=21, and group 2 (G2): n=26 without and with prior breakthrough Delta variant infection, respectively). The study participants had completed primary immunisation with ChAdOx1-S and booster vaccination with BNT162b2. Neutralising antibodies were measured using a surrogate virus neutralisation assay. Of the 21 study participants in G1, neutralising antibodies against ancestral strain, Delta variant, BA.1 and BA.2 were (almost) abolished at month 8 after the second dose, but all had detectable neutralising antibodies to the study viruses at week two post booster dose. Of the 26 study participants in G2, neutralising antibody levels to BA.1 and BA.2 were significantly higher than those to the corresponding viruses measured at week 2 post breakthrough infection and before the booster dose. At week 15 post booster vaccination, neutralising antibodies to BA.1 and BA.2 dropped significantly, with more profound changes observed in those without breakthrough Delta variant infection. Booster vaccination enhanced neutralising activities against ancestral strain and Delta variant, as compared to those induced by primary vaccination. These responses were maintained at high levels for at least 15 weeks. Our findings emphasise the importance of the first booster dose in producing cross-neutralising antibodies against Omicron variant. A second booster dose might be needed to maintain long-term protection against Omicron variant.

Depression, Anxiety and Associated Factors among Frontline Hospital Healthcare Workers in the Fourth Wave of COVID-19: Empirical Findings from Vietnam.

(1) Background: This study aims to assess the magnitude of, and factors associated with, depression and anxiety among Vietnamese frontline hospital healthcare workers in the fourth wave of COVID-19; (2) Methods: A hospital based cross-sectional study was carried out within two weeks, October 2020, at a central COVID-19 treatment hospital. Depression and anxiety were measured with PHQ-9 and GAD-7, respectively. Bivariate and multivariate logistic regression analysis were applied to recognize variables related to depression and anxiety, respectively; (3) Results: Among 208 frontline hospital healthcare workers, overall prevalence of depressive symptoms, anxiety symptoms, and both symptoms of depression and anxiety was 38.94%, 25.48% and 24.04%, respectively, in healthcare workers. In a reduced model after using multivariate stepwise logistic regression, age (OR = 0.9, p = 0.001), marital status (OR = 7.84, p = 0.027), profession (OR = 0.39, p = 0.028), having experienced traumatic stress following a work event (OR = 46.24, p < 0.001), feeling at very high risk for COVID-19 (OR = 0.02, p < 0.04), and affected by workplace conditions (OR = 5.36, p < 0.001) were associated with the symptoms of depression. With regard to symptoms of anxiety, single status (OR: 12.18, p = 0.002), being medical technician (OR: 68.89, p < 0.001), alcohol use (OR: 6.83, p = 0.014), using pain relief medications (OR: 25.50, p = 0.047), having experienced traumatic stress following a family event (OR: 130.32, p = 0.001), having experienced traumatic stress following a work event (OR: 181.55, p = 0.002), reporting at very high risk for COVID-19 (OR: 29.64, p = 0.011), treating moderate (OR: 6.46, p = 0.038) and severe (OR: 18.96, p = 0.004) COVID-19 patients, and being significantly affected by the community (OR: 6.33, p = 0.003) were increased risk factors for the symptoms of anxiety. Meanwhile, those living with 4-5 people (OR: 0.15, p = 0.011), specializing in infectious disease (OR: 0.13, p = 0.044)/resuscitation and emergency medicine (OR: 0.04, p = 0.046), and having knowledge preparation before participating in COVID-19 (OR: 0.008, p = 0.014) were less associated with the symptoms of anxiety; (4) Conclusions: There was a relatively high prevalence among Vietnamese hospital healthcare workers exhibiting symptoms of depression and anxiety during the ongoing pandemic. Greater attention to training in psychological skills should be suggested for those belonging to a younger age group, being single/widowed/divorced, treating moderate and severe COVID-19 patients, feeling at very high risk for COVID-19, being significantly affected a lot the community or workplace conditions, or experiencing traumatic stress following a family/work event in the past week.

Associated Factors with Perceived Fear of COVID-19 among Vietnamese Hospital Healthcare Workers during Fourth Wave of the COVID-19 Pandemic: Policy Implications for Interconnected and Social- and Personal-Based Health Support.

(1) Background: The present study measures the fear of COVID-19 among hospital healthcare workers and identifies several factors associated with increasing fear of COVID-19. (2) Methods: A cross-sectional, hospital-based survey was conducted on healthcare workforce recruited from the National Hospital of Tropical Diseases from 1 October 2021 and 20 October 2021. We selected the participants who have been directly involved in diagnosing, treating, or providing nursing care to patients with COVID-19. The primary data was collected via sending the invitation directly to the participants, utilizing structured self-completed questionnaires. The seven-item fear of COVID-19 scale was used to measure the data. The responses of 208 hospital healthcare workers were included in the final analysis. (3) Results: Total score of COVID-19 fear was 19.62 (SD = 5.22). The COVID-19 fear score of 7 items ranged from 2.38 (SD = 0.83) to 3.21 (SD = 0.96). The lowest and highest scores were the item 'My hands become clammy when I think about Corona' and the item 'I am most afraid of corona' was the highest, respectively. Linear regression of the COVID-19 fear showed that the factors positively correlated with the fear of COVID-19 among hospital healthcare workers were: being influenced by the community (p = 0.001), feeling at very high risk of COVID-19 (p = 0.03), and experiencing traumatic stress with an academic event (p = 0.042). (4) Conclusions: Although these findings merit further elaboration, these preliminary findings suggest relatively great fear of the COVID-19 pandemic among Vietnamese hospital healthcare workers and that social and personal connections are necessary for maintaining the mental wellbeing.

Impact of Central Quarantine Inside a Lockdown Hospital Due to COVID-19 Pandemic on Psychological Disorders among Health Care Staffs in Central Hospitals of Hanoi, Vietnam, 2020.

This study aims to examine the impact of undergoing a central quarantine due to the lockdown of Bach Mai hospital on the psychological disorders and identify associated factors with depression among hospital employees in central hospitals of Hanoi, Vietnam. Employing a cross-sectional design, the study collected data from staff working in the lockdown hospital and other central hospitals during 1 week after the lockdown happened. The sample size included 373 staff from 3 hospitals, the study time was. Depression was tested using PH-Q9 scale. Multivariate logistics regression was employed to test for the impact of central quarantine on depression and identify other significant related factors. The study confirmed a high burden of psychological issues that hospital employees were facing. Staff working in the lockdown hospital had 2.3 times higher odds of being perceived depression than others. Those who contact directly about 21 to 20 patients/day had 3.19-times higher odds of being perceived depression than others. Staff who being stigmatization associated with COVID-19 had 2.63 times higher odds of perceived depression than others. Reducing these associated factors to depression may help to reduce the psychological burden HEs have to cope with during the pandemic.

Preventing the transmission of COVID-19 and other coronaviruses in older adults aged 60 years and above living in long-term care: a rapid review.

BACKGROUND: The objective of this review was to examine the current guidelines for infection prevention and control (IPAC) of coronavirus disease-19 (COVID-19) or other coronaviruses in adults 60 years or older living in long-term care facilities (LTCF). METHODS: EMBASE, MEDLINE, Cochrane library, pre-print servers, clinical trial registries, and relevant grey literature sources were searched until July 31, 2020, using database searching and an automated method called Continuous Active Learning® (CAL®). All search results were processed using CAL® to identify the most likely relevant citations that were then screened by a single human reviewer. Full-text screening, data abstraction, and quality appraisal were completed by a single reviewer and verified by a second. RESULTS: Nine clinical practice guidelines (CPGs) were included. The most common recommendation in the CPGs was establishing surveillance and monitoring systems followed by mandating the use of PPE; physically distancing or cohorting residents; environmental cleaning and disinfection; promoting hand and respiratory hygiene among residents, staff, and visitors; and providing sick leave compensation for staff. CONCLUSIONS: Current evidence suggests robust surveillance and monitoring along with support for IPAC initiatives are key to preventing the spread of COVID-19 in LTCF. However, there are significant gaps in the current recommendations especially with regard to the movement of staff between LTCF and their role as possible transmission vectors. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42020181993.