Social work in difficult times: emerging value frame in India

The contemporary global milieu is ridden with multiple tensions and conflicts and India is no exception. India is witness to a number of challenges in its social, political and economic domains. While the tumultuous man–nature relationship has life-threatening ramifications, the social, economic and political contexts are also rife with diverse challenges characteristic of a globalised world order. The situation has been compounded by the daunting COVID pandemic, which has demonstrated the interconnectedness of global challenges and has wrought an unprecedented impact on the wellbeing of people. The social work profession in India must play a meaningful role in diffusing the crisis by promulgating values that extend and consolidate human solidarities and human environment symbiosis. Located within the context of India, and based on a reflective lifeworld approach, this article reflects on the nature and role of social work values in capacitating social workers to play a more resolute role in resolving present day predicaments. It articulates the need to look beyond generic values, glean a more context-specific value frame and herald the process of transferring these values to students through suitable means. [ FROM AUTHOR] Copyright of Social Work Education is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Effectiveness of social distancing interventions in containing COVID-19 incidence: International evidence using Kalman filter.

The epidemiological literature has widely documented the importance of social distancing interventions in containing the spread of the COVID-19 pandemic. However, the epidemiological measure of virus reproduction, R0, provides a myopic view of containment, especially when the absolute number of cases is still high. The paper investigates cross-country variations concerning the impact of social distancing interventions on COVID-19 incidence by employing a statistical measure of containment, which models the daily number of cases as a structural time-series, state-space vector. Countries that adopt strict lockdown policies and provide economic support in the form of income augmentations and debt relief improve the response towards the pandemic. Countries like China and South Korea have been most influential in containing the spread of infections. European nations of France, Italy, Spain and the UK are witnessing a second wave of the virus, indicating that re-opening the European economy perhaps has instigated an exponential spread.

"Authors' Reply: Emerging Evidence on Multisystem Inflammatory Syndrome in Children Associated with SARS-CoV-2 Infection".

With increased patients of severe acute respiratory syndrome coronavirus 2 infection, more children with multisystem inflammatory syndrome (MIS-C) are being reported worldwide. Our focus is to share the new evidence-based findings and experiences during the early stage of the pandemic with the researchers on a larger platform . We hope this review will help to frame appropriate strategies and guidelines for management of MIS-C.

The perfect storm: Disruptions to institutional delivery care arising from the COVID-19 pandemic in Nepal.

BACKGROUND: The COVID-19 pandemic has led to system-wide disruption of health services globally. We assessed the effect of the pandemic on the disruption of institutional delivery care in Nepal. METHODS: We conducted a prospective cohort study among 52 356 women in nine hospitals to assess the disruption of institutional delivery care during the pandemic (comparing March to August in 2019 with the same months in 2020). We also conducted a nested follow up cohort study with 2022 women during the pandemic to assess their provision and experience of respectful care. We used linear regression models to assess the association between provision and experience of care with volume of hospital births and women's residence in a COVID-19 hotspot area. RESULTS: The mean institutional births during the pandemic across the nine hospitals was 24 563, an average decrease of 11.6% (P < 0.0001) in comparison to the same time-period in 2019. The institutional birth in high-medium volume hospitals declined on average by 20.8% (P < 0.0001) during the pandemic, whereas in low-volume hospital institutional birth increased on average by 7.9% (P = 0.001). Maternity services halted for a mean of 4.3 days during the pandemic and there was a redeployment staff to COVID-19 dedicated care. Respectful provision of care was better in hospitals with low-volume birth (ß = 0.446, P < 0.0001) in comparison to high-medium-volume hospitals. There was a positive association between women's residence in a COVID-19 hotspot area and respectful experience of care (ß = 0.076, P = 0.001). CONCLUSIONS: The COVID-19 pandemic has had differential effects on maternity services with changes varying by the volume of births per hospital with smaller volume facilities doing better. More research is needed to investigate the effects of the pandemic on where women give birth and their provision and experience of respectful maternity care to inform a "building-back-better" approach in post-pandemic period.

Emerging Evidence on Multisystem Inflammatory Syndrome in Children Associated with SARS-CoV-2 Infection: a Systematic Review with Meta-analysis.

With the increased spread of severe acute respiratory syndrome coronavirus 2 infection, more patients with multisystem inflammatory syndrome in children (MIS-C) are being reported worldwide. This systematic review with meta-analysis aims to analyse the clinical features, proposed pathogenesis and current treatment options for effective management of children with this novel entity. Electronic databases (Medline, Google Scholar, WHO, CDC, UK National Health Service, LitCovid, and other databases with unpublished pre-prints) were extensively searched, and all articles on MIS-C published from January 1, 2020, to October 10, 2020, were retrieved. English language studies were included. This systematic review analysed 17 studies with 992 MIS-C patients from low-income and middle-income countries (LMICs) and developed countries (France, the UK, Italy, Spain, Chile and the US CDC data). Fever (95%) was the most common clinical manifestation followed by gastrointestinal (78%), cardiovascular (75.5%), and respiratory system (55.3%) involvement. Laboratory or epidemiologic evidence of inflammation and SARS-CoV-2 infection was present. Though the exact pathogenesis remains elusive, virus-induced post-infective immune dysregulation appears to play a predominant role. Features resembling Kawasaki disease, toxic shock syndrome or macrophage activation syndrome were present; 49% had shock; 32% had myocarditis; 18% had coronary vessel abnormalities and 9% had congestive cardiac failure. Sixty-three percent of the patients were admitted in paediatric intensive care unit (PICU); 63% received intravenous immunoglobulin, 58% received corticosteroids and 19% received alternate agents like tocilizumab; there were 22 (2.2%) deaths. Only 9/144 children in LMICs received tocilizumab that was significantly less than children in developed countries (p < 0.0001). This systematic review delineates and summarises recently published data on MIS-C from LMICs and developed countries. Although most needed PICU admission and received treatment with IVIG and steroids, most of the patients survived. Significantly fewer patients in developing countries received tocilizumab therapy than those in developed countries. It is crucial for clinician to recognise MIS-C, to differentiate it from other defined inflammatory conditions and initiate early treatment. Further studies are needed for long-term prognosis, especially relating to cardiac complications of MIS-C. Supplementary Information: The online version of this article (10.1007/s42399-020-00690-6) contains supplementary material, which is available to authorized users.

Effects of the COVID-19 pandemic in India: An analysis of policy and technological interventions.

OBJECTIVES: Following a surge in cases of coronavirus disease 2019 (COVID-19) in June 2020, India became the third-worst affected country worldwide. This study aims to analyse the underlying epidemiological situation in India and explain possible impacts of policy and technological changes. METHODS: Secondary data were utilized, including recently published literature from government sources, the COVID-19 India website and local media reports. These data were analysed, with a focus on the impact of policy and technological interventions. RESULTS: The spread of COVID-19 in India was initially characterized by fewer cases and lower case fatality rates compared with numbers in many developed countries, primarily due to a stringent lockdown and a demographic dividend. However, economic constraints forced a staggered lockdown exit strategy, resulting in a spike in COVID-19 cases. This factor, coupled with low spending on health as a percentage of gross domestic product (GDP), created mayhem because of inadequate numbers of hospital beds and ventilators and a lack of medical personnel, especially in the public health sector. Nevertheless, technological advances, supported by a strong research base, helped contain the damage resulting from the pandemic. CONCLUSIONS: Following nationwide lockdown, the Indian economy was hit hard by unemployment and a steep decline in growth. The early implementation of lockdown initially decreased the doubling rate of cases and allowed time to upscale critical medical infrastructure. Measures such as asymptomatic testing, public-private partnerships, and technological advances will be essential until a vaccine can be developed and deployed in India. PUBLIC INTEREST SUMMARY: The spread of COVID-19 in India was initially characterized by lower case numbers and fewer deaths compared with numbers in many developed countries. This was mainly due to a stringent lockdown and demographic factors. However, economic constraints forced a staggered lockdown exit strategy, resulting in a spike in COVID-19 cases in June 2020. Subsequently, India became the third-worst affected country worldwide. Low spending on health as a percentage of gross domestic product (GDP) meant there was a shortage of hospital beds and ventilators and a lack of medical personnel, especially in the public health sector. Nevertheless, technological advances, supported by a strong research base, helped contain the health and economic damage resulting from the pandemic. In the future, measures such as asymptomatic testing, public-private partnerships, and technological advances will be essential until a vaccine against COVID-19 can be developed and rolled-out in India.

Knowledge and Attitude about COVID 19 among Health Care Workers Working in Seti Provincial Hospital.

BACKGROUND: Health care workers are at greater risk of infection during COVID 19 pandemic.  This study was carried out to assess the knowledge and attitude toward COVID-19 among healthcare workers at working at Seti Zonal Hospital. METHODS: A cross-sectional study was performed between April and May 2020 at Seti Zonal Hospital with purposive sampling technique and self-administered questionnaire of the knowledge and attitude of healthcare workers regarding COVID-19. The demographic characteristics mean knowledge and attitude score of healthcare workers were identified and inferential statistics t-test, ANOVA and Spearman's correlation were used to show the relationship between variables. RESULTS: A total of 230 healthcare workers (92% response rate) had a mean score of knowledge and attitude of 8±0.88 and 7.88±1.32, respectively with good knowledge and a low positive attitude. Majority (94.7%) were familiar with the sign and symptoms, agreed that chronic diseases patients and HCWs are at a higher risk (97%) and (87.8%) respectively while knowledge related to COVID 19 vaccination, isolation period and treatment by antibiotics was poor with low positive attitude towards information availability about COVID 19 (41%), government ability to control the epidemic (49%), and the family members might get infection (60%). There was a positive correlation between knowledge scores and attitude scores (r=0.28, p<0.0001). CONCLUSIONS: We identified a significant gap in information source, sufficient knowledge and low positive attitude about COVID 19 among health care workers. Greater educational efforts about prevention should be directed to different level of health workers.

A Systematic Review of Multisystem Inflammatory Syndrome in Children Associated With SARS-CoV-2 Infection.

BACKGROUND: Recently, severe manifestations associated with coronavirus disease 2019 (COVID-19) called multisystem inflammatory syndrome in children (MIS-C) have been recognized. Analysis of studies for this novel syndrome is needed for a better understanding of effective management among affected children. METHODS: An extensive search strategy was conducted by combining the terms multisystem inflammatory syndrome in children and coronavirus infection or using the term multisystem inflammatory syndrome in children in bibliographic electronic databases (PubMed, EMBASE, and CINAHL) and in preprint servers (BioRxiv.org and MedRxiv.org) following the Preferred Reporting Items for Systematic Reviews and Metaanalyses guidelines to retrieve all articles published from January 1, 2020, to July 31, 2020. Observational cross-sectional, cohort, case series, and case reports were included. RESULTS: A total of 328 articles were identified. Sixteen studies with 655 participants (3 months-20 years of age) were included in the final analysis. Most of the children in reported studies presented with fever, gastrointestinal symptoms, and Kawasaki Disease-like symptoms. Sixty-eight percent of the patients required critical care; 40% needed inotropes; 34% received anticoagulation; and 15% required mechanical ventilation. More than two-thirds of the patients received intravenous immunoglobulin and 49% received corticosteroids. Remdesivir and convalescent plasma were the least commonly utilized therapies. Left ventricular dysfunction was reported in 32% of patients. Among patients presenting with KD-like symptoms, 23% developed coronary abnormalities and 26% had circulatory shock. The majority recovered; 11 (1.7%) children died. CONCLUSIONS: This systematic review delineates and summarizes clinical features, management, and outcomes of MIS-C associated with SARS-CoV-2 infection. Although most children required intensive care and immunomodulatory therapies, favorable outcomes were reported in the majority with low-mortality rates.

Clinical Profile of Cases of COVID-19 in Far Western Province of Nepal.

The novel coronavirus (COVID-19) cause various symptoms such as pneumonia, fever, breathing difficult and lung infection. Till now, total 9 cases are reported in Nepal and 4 cases from this province. This case series is to describe the initial clinical features of COVID-19 among the patients admitted in isolation ward of Seti Provincial Hospital. Oropharyngeal swab was taken from all four patients and sample was transfer to national reference laboratory. Three patients were coming from infected country and one is local transmission. Age of patients was range from 20 to 40 years of age with male preponderance. The patient coming from United Arab Emirate was presented with mild symptoms and others were asymptomatic. More tests, contact tracing and keeping them in quarantine are the necessitated action need to be taken by government of Nepal. Keywords: COVID-19; local transmission; oropharyngeal swab.