Case series in Indonesia: B.1.617.2 (delta) variant of SARS-CoV-2 infection after a second dose of vaccine.

BACKGROUND: The B.1.617.2 (delta) variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first discovered in Maharashtra in late 2020 and has rapidly expanded across India and worldwide. It took only 2 mo for this variant to spread in Indonesia, making the country the new epicenter of the delta variant as of July 2021. Despite efforts made by accelerating massive rollouts of current vaccines to protect against infection, cases of fully-vaccinated people infected with the delta variant have been reported. AIM: To describe the demographic statistics and clinical presentation of the delta variant infection after the second dose of vaccine in Indonesia. METHODS: A retrospective, single-centre case series of the general consecutive population that worked or studied at Faculty of Medicine, Universitas Indonesia with confirmed Delta Variant Infection after a second dose of vaccine from 24 June and 25 June 2021. Cases were collected retrospectively based on a combination of author recall, reverse transcription-polymerase chain reaction (RT-PCR), and whole genome sequencing results from the Clinical Microbiology Laboratory, Faculty of Medicine, Universitas Indonesia. RESULTS: Between 24 June and 25 June 2021, 15 subjects were confirmed with the B.1.617.2 (delta) variant infection after a second dose of the vaccine. Fourteen subjects were vaccinated with CoronaVac (Sinovac) and one subject with ChAdOx1 nCoV-19 (Oxford-AstraZeneca). All of the subjects remained in home isolation, with fever being the most common symptom at the onset of illness (n = 10, 66.67%). The mean duration of symptoms was 7.73 d (± 5.444). The mean time that elapsed from the first positive swab to a negative RT-PCR test for SARS-CoV-2 was 17.93 d (± 6.3464). The median time that elapsed from the second dose of vaccine to the first positive swab was 87 d (interquartile range: 86-128). CONCLUSION: Although this case shows that after two doses of vaccine, subjects are still susceptible to the delta variant infection, currently available vaccines remain the most effective protection. They reduce clinical manifestations of COVID-19, decrease recovery time from the first positive swab to negative swab, and lower the probability of hospitalization and mortality rate compared to unvaccinated individuals.

Factors associated with high compliance behaviour against COVID-19 in the early phase of pandemic: a cross-sectional study in 12 Asian countries

IntroductionRegardless of having effective vaccines against COVID-19, containment measures such as enhanced physical distancing and good practice of personal hygiene remain the mainstay of controlling the COVID-19 pandemic. Countries across Asia have imposed these containment measures to varying extents. However, residents in different countries would have a differing degree of compliance to these containment measures potentially due to differences in the level of awareness and motivation in the early phase of pandemic.ObjectivesIn our study, we aimed to describe and correlate the level of knowledge and attitude with the level of compliance with personal hygiene and physical distancing practices among Asian countries in the early phase of pandemic.MethodsA multinational cross-sectional study was carried out using electronic surveys between May and June 2020 across 14 geographical areas. Subjects aged 21 years and above were invited to participate through social media, word of mouth and electronic mail.ResultsAmong the 2574 responses obtained, 762 (29.6%) participants were from East Asia and 1812 (70.4%) were from Southeast Asia (SEA). A greater proportion of participants from SEA will practise physical distancing as long as it takes (72.8% vs 60.6%). Having safe distancing practices such as standing more than 1 or 2 m apart (AdjOR 5.09 95% CI (1.08 to 24.01)) or more than 3 or 4 m apart (AdjOR 7.05 95% CI (1.32 to 37.67)), wearing a mask when they had influenza-like symptoms before the COVID-19 pandemic, preferring online news channels such as online news websites/applications (AdjOR 1.73 95% CI (1.21 to 2.49)) and social media (AdjOR 1.68 95% CI (1.13 to 2.50) as sources of obtaining information about COVID-19 and high psychological well-being (AdjOR 1.39 95% CI (1.04 to 1.87)) were independent factors associated with high compliance.ConclusionsWe found factors associated with high compliance behaviour against COVID-19 in the early phase of pandemic and it will be useful to consider them in risk assessment, communication and pandemic preparedness.

Association between well-being and compliance with COVID-19 preventive measures by healthcare professionals: A cross-sectional study.

IMPORTANCE: Knowledge and attitude influence compliance and individuals' practices. The risk and protective factors associated with high compliance to these preventive measures are critical to enhancing pandemic preparedness. OBJECTIVE: This survey aims to assess differences in mental health, knowledge, attitudes, and practices (KAP) of preventive measures for COVID-19 amongst healthcare professionals (HCP) and non-healthcare professionals. DESIGN: Multi-national cross-sectional study was carried out using electronic surveys between May-June 2020. SETTING: Multi-national survey was distributed across 36 countries through social media, word-of-mouth, and electronic mail. PARTICIPANTS: Participants ≥21 years working in healthcare and non-healthcare related professions. MAIN OUTCOME: Risk factors determining the difference in KAP towards personal hygiene and social distancing measures during COVID-19 amongst HCP and non-HCP. RESULTS: HCP were significantly more knowledgeable on personal hygiene (AdjOR 1.45, 95% CI -1.14 to 1.83) and social distancing (AdjOR 1.31, 95% CI -1.06 to 1.61) compared to non-HCP. They were more likely to have a positive attitude towards personal hygiene and 1.5 times more willing to participate in the contact tracing app. There was high compliance towards personal hygiene and social distancing measures amongst HCP. HCP with high compliance were 1.8 times more likely to flourish and more likely to have a high sense of emotional (AdjOR 1.94, 95% CI (1.44 to 2.61), social (AdjOR 2.07, 95% CI -1.55 to 2.78), and psychological (AdjOR 2.13, 95% CI (1.59-2.85) well-being. CONCLUSION AND RELEVANCE: While healthcare professionals were more knowledgeable, had more positive attitudes, their higher sense of total well-being was seen to be more critical to enhance compliance. Therefore, focusing on the well-being of the general population would help to enhance their compliance towards the preventive measures for COVID-19.

Impact of the coronavirus disease 2019 pandemic on irritable bowel syndrome.

BACKGROUND AND AIM: Gastrointestinal manifestations of the coronavirus disease 2019 (COVID-19) pandemic may mimic irritable bowel syndrome (IBS), and social distancing measures may affect IBS patients negatively. We aimed to study the impact of COVID-19 on respondents with self-reported IBS. METHODS: We conducted an anonymized survey from May to June 2020 in 33 countries. Knowledge, attitudes, and practices on personal hygiene and social distancing as well as psychological impact of COVID-19 were assessed. Statistical analysis was performed to determine differences in well-being and compliance to social distancing measures between respondents with and without self-reported IBS. Factors associated with improvement or worsening of IBS symptoms were evaluated. RESULTS: Out of 2704 respondents, 2024 (74.9%) did not have IBS, 305 (11.3%) had self-reported IBS, and 374 (13.8%) did not know what IBS was. Self-reported IBS respondents reported significantly worse emotional, social, and psychological well-being compared with non-IBS respondents and were less compliant to social distancing measures (28.2% vs 35.3%, P = 0.029); 61.6% reported no change, 26.6% reported improvement, and 11.8% reported worsening IBS symptoms. Higher proportion of respondents with no change in IBS symptoms were willing to practice social distancing indefinitely versus those who deteriorated (74.9% vs 51.4%, P = 0.016). In multivariate analysis, willingness to continue social distancing for another 2-3 weeks (vs longer period) was significantly associated with higher odds of worsening IBS. CONCLUSION: Our study showed that self-reported IBS respondents had worse well-being and compliance to social distancing measures than non-IBS respondents. Future research will focus on occupational stress and dietary changes during COVID-19 that may influence IBS.

IDDF2020-ABS-0205 The impact of the COVID-19 pandemic on irritable bowel syndrome

IDDF2020-ABS-0205 Table 1Comparison of demographic variables between respondents with and without IBS Non-IBS (n = 2024) IBS (n = 305) p Age 39.7 ± 12.9 40.1 ± 13.0 1.0 Gender 0.6 Male 727 (35.9) 119 (39.0) Female 1297 (64.1) 186 (61.0) Race 0.2 Bengali 31 (1.5) 2 (0.7) Caucasian 24 (1.2) 6 (2.0) Chinese 1148 (56.7) 188 (61.6) Filipino 45 (2.2) 2 (0.7) Indian 154 (7.6) 20 (6.6) Japanese 5 (0.2) 0 (0.0) Korean 131 (6.5) 28 (9.2) Malay 328 (16.2) 39 (12.8) Others 158 (7.8) 20 (6.6) Economic region 0.3 High 1156 (57.1) 183 (60.0) Upper-middle 457 (22.6) 74 (24.3) Middle/Low 411 (20.3) 48 (15.7) What is your highest education level? 0.8 No formal education/Primary school 9 (0.4) 0 (0.0) Secondary school 164 (8.1) 29 (9.5) Pre-university 258 (12.7) 44 (14.4) Tertiary – undergraduate/postgraduate degree 1593 (78.7) 232 (76.1) Employment 0.4 Full-time 1497 (74.0) 213 (69.8) Part-time 125 (6.2) 18 (5.9) Not working 402 (19.9) 74 (24.3) Housing 1.0 Dormitory 61 (3.0) 13 (4.3) Government housing with 2 or 3 rooms 306 (15.1) 37 (12.1) Government housing with more than 3 rooms 376 (18.6) 62 (20.3) Private apartment or condominium 601 (29.7) 89 (29.2) Private landed property 680 (33.6) 104 (34.1) Annual household Income per capita in USD (total household income/number of people in the household) 1.0 Less than $1000 259 (12.8) 37 (12.1) $1000 - $2000 274 (13.5) 46 (15.1) $2000 - $4000 375 (18.5) 49 (16.1) $4000 - $6000 211 (10.4) 29 (9.5) $6000 - $8000 138 (6.8) 24 (7.9) $8000 - $10000 173 (8.5) 23 (7.5) More than $10000 594 (29.3) 97 (31.8) Have you been diagnosed with COVID-19? 1.0 Yes 32 (1.6) 4 (1.3) No 1992 (98.4) 301 (98.7) Compliance 0.029 Yes 715 (35.3) 86 (28.2) No 1309 (64.7) 219 (71.8) Not flourishing 1025 (50.6) 207 (67.9) <0.01 Flourishing 999 (49.4) 98 (32.1) Well-being total scores 45.8 ± 14.6 40.5 ± 14.8 <0.01 Emotional well-being 10.3 ± 3.5 9.4 ± 3.6 <0.01 Social well-being 15.0 ± 6.1 12.8 ± 6.1 <0.01 Psychological well-being 20.4 ± 6.6 18.3 ± 6.7 <0.01 Abstract IDDF2020-ABS-0205 Table 2Comparison of demographic variables between respondents who reported no change and worsening in severity of IBSQuestion No change (n = 183) Worsen (n = 35) p Age 38.8 ± 12.2 40.1 ± 14.3 1.0 Gender 1.0 Male 71 (38.8) 14 (40.0) Female 112 (61.2) 21 (60.0) Economic region 0.1 High 110 (60.1) 28 (80.0) Upper-middle 44 (24.0) 6 (17.1) Middle/Low 29 (15.8) 1 (2.9) What is your highest education level? 1.0 Secondary school 18 (9.8) 4 (11.4) Pre-university 22 (12.0) 5 (14.3) Tertiary – undergraduate/postgraduate degree 143 (78.1) 26 (74.3) Employment 0.2 Full-time 132 (72.1) 26 (74.3) Part-time 7 (3.8) 4 (11.4) Not working 44 (24.0) 5 (14.3) Work from home 1.0 Yes 45 (32.1) 8 (26.7) No 95 (67.9) 22 (73.3) Compliance 1.0 Yes 54 (29.5) 10 (28.6) No 129 (70.5) 25 (71.4) Which of the following would you consider as main reason for compliance with social distancing measures? 0.034 Fear of getting COVID 19 90 (49.2) 11 (31.4) Fear of family members getting COVID 19 86 (47.0) 19 (54.3) Fear of fines/punitive measures 7 (3.8) 5 (14.3) Would you willingly participate in the contact tracing app? 1.0 Yes 143 (78.1) 27 (77.1) No 40 (21.9) 8 (22.9) For how long are you willing to practice social distancing behaviour to keep yourself and others safe? 0.016 As long as it takes 137 (74.9) 18 (51.4) For another 2–3 weeks 4 (2.2) 4 (11.4) For another 1 month 12 (6.6) 6 (17.1) For another 3 months 14 (7.7) 5 (14.3) For another 6 months 13 (7.1) 1 (2.9) I want social distancing to stop now 3 (1.6) 1 (2.9) Flourishing <0.01 Yes 64 (35.0) 3 (8.6) No 119 (65.0) 32 (91.4) Well-being total scores 40.5 ± 15.0 35.4 ± 13.3 0.1 Emotional well-being 9.5 ± 3.5 7.7 ± 3.6 0.014 Social well-being 12.7 ± 6.3 11.7 ± 4.7 0.8 Psychological well-being 18.3 ± 6.9 15.9 ± 6.5 0.1 Abstract IDDF2020-ABS-0205 Table 3Univariable and multivariable regression of factors associated with worsening in severity of IBS (with no change in severity of IBS group as reference)Question OR (95% CI) p AdjOR(95%CI) p Do you wash your hands before and after handing food?* Never (ref) 1.00 - - Seldom 0.0 (0.0) 1.0 - - 50% of the time 0.0 (0.0) 1.0 - - Most of the time 0.0 (0.0) 1.0 - - Always 0.0 (0.0) 1.0 - - Do you cover your mouth when you sneeze or cough?* Never (ref) 1.00 - - Seldom 0.0 (0.0) 1.0 - - 50% of the time 0.0 (0.0) 1.0 - - Most of the time 0.0 (0.0) 1.0 - - Always 0.0 (0.0) 1.0 - - Which of the following would you consider as main reason for compliance with social distancing measures? Fear of getting COVID 19 (ref) 1.00 1.00 Fear of family members getting COVID 19 1.8 (0.8 – 4.0) 0.1 2.0 (0.9 – 4.7) 0.1 Fear of fines/punitive measures 5.8 (1.6 – 21.6) <0.01 5.9 (1.4 – 25.6) 0.017 For how long are you willing to practice social distancing behaviour to keep yourself and others safe? As long as it takes (ref) 1.00 1.00 For another 2–3 weeks 7.6 (1.7 – 33.1) <0.01 6.0 (1.2 – 28.8) 0.026 For another 1 month 3.8 (1.3 – 11.4) 0.017 2.9 (0.9 – 9.0) 0.1 For another 3 months 2.7 (0.9 – 8.4) 0.1 3.1 (0.9 – 10.2) 0.1 For another 6 months 0.6 (0.1 – 4.7) 0.6 0.6 (0.1 – 4.7) 0.6 I want social distancing to stop now 2.5 (0.3 – 25.7) 0.4 1.3 (0.1 – 22.3) 0.9 Emotional well-being 0.9 (0.8 – 1.0) <0.01 0.9 (0.8 – 1.0) 0.042 Flourishing was excluded from analysis due to overlap with emotional well-being.*Excluded from multivariable analysis due to 0 respondents in reference categories for respondents with no change in control IBSConclusionsOur study showed differences in well-being and compliance to social distancing between IBS and non-IBS respondents, and these factors influence the worsening in severity of IBS. Further research will focus on how occupational stress and dietary changes may influence IBS symptoms