The multifactorial aquaculture‐related COVID‐19 shock in Benin, West Africa: A socio‐economic perspective of mitigating the disruptive impacts on the small‐scale and subsistence producers

Aquaculture development in Benin depends heavily on small‐scale and subsistence aquaculture producers (SSAPs), who are sustaining production activities. The aquaculture sector is vulnerable to market shocks because of its dependence on inputs and equipment, which are mainly imported from overseas. The recent outbreaks of global aquaculture diseases have also proven the sensitivity of the sector. The vulnerability of SSAPs is expected to increase as a subsequent result of the coronavirus disease 2019 (COVID‐19) pandemic. This is the reason why COVID‐19‐related difficulties affecting aquaculture production deserve to be evaluated in the country's aquaculture sector. We conducted an online survey to assess the impact of COVID‐19 and the resulting restrictive measures on the functioning of SSAPs farms. Data were collected from 98 SSAPs informants spread over the geographic area with high aquaculture production potential in the country. The rate of increase in input prices, linear discriminant and factorial correspondence analyses projected severe constraints in almost all the value chain. The rates of increase in the unit price of inputs increased from 14% to 188%, thus weakening aqua‐farmers' purchasing capacity. COVID‐19 has led to a drop in the sales turnover of aqua‐farms, resulting in staff reductions and unemployment. Difficulties in accessing quality inputs have led to the disruption of fish growth and thus the production cycle. The sale of aquaculture products saw a 20%–30% drop in turnover in many farms. The critical challenges mentioned by both men and women SSAPs are mainly the high cost of fish feed, the rising input and transport costs, and the lack of financial resources. Therefore, short‐, medium‐, and long‐term mitigation measures are suggested and could help to alleviate these difficulties while sustaining the blue revolution already under way. This community of men and women SSAPs should adopt and strengthen their use of existing endogenous technologies as well as digital modern options for remote aquaculture sales, in order to cope with future disruptions. The scientific community should help to propose incentive‐based alternative options (e.g., affordable production systems, and efficient micro‐credit model) that can motivate SSAPs to continue with aquaculture, as a guarantee of the sustainability of their livelihoods.

Risk factors for COVID-19 associated pulmonary aspergillosis (CAPA) in severe COVID-19 and impact of airborne fungal contamination within negative pressure isolation room

Background. COVID-19 increase the risk of invasive pulmonary aspergillosis. However, the risk factors and fungal origin of COVID-19 associated pulmonary aspergillosis (CAPA) is not fully defined yet. We aim to identify the risk factors for CAPA in severe COVID-19 and evaluate association between fungal contamination within the air of negative pressure rooms and diagnosis of CAPAs. Methods. We performed a retrospective case-control study to identify risk factors for CAPA with 420 severe COVID-19 patients from March 2020 to January 2022 who admitted to a tertiary care hospital in South Korea. CAPA was defined with modified AspICU criteria. Control, matched by admission date and severity of COVID-19 at admission, was selected for each case. Air sampling and fungal culture was done on Jan 2022 with a microbial air sampler (MAS-100NT) at 11 spaces in the COVID-19 designated isolation ward including 9 negative pressure isolation rooms (IRs). A cross-sectional comparison between rooms with and without airborne fungal contamination was performed. Results. A total of 420 COVID-19 patients were hospitalized during the study period, and 51 patients were diagnosed with CAPA (prevalence 12.14%, incidence 6.26 per 1000 patient.day). Multivariate analysis showed that older age (odds ratio [OR] 1.051, 95% confidence intervals [CI] 1.006-1.009, p=0.025), mechanical ventilator use (OR 2.692, 95% CI 1.049-6.911, p=0.04), and lymphopenia (OR 4.353, 95% CI 1.727-10.975, p=0.02) were independent risk factors for CAPA. (Table 1, 2) Aspergillus spp. was identified within the air from 7 out of 11 spaces including 6 IRs and 1 doctors' room. (Figure 1). All 6 IRs with positive aspergillus culture were being occupied by patients at least 8 days. Among 6 patients, 3 had already been diagnosed with CAPA whereas the other 3 were not diagnosed with CAPA through the observation period. Among 4 patients in isolation rooms without airborne aspergillus contamination, one patient had been diagnosed as CAPA before air sampling. (Table 3). Conclusion. Association between CAPA and airborne aspergillus contamination within the negative pressure room could not be demonstrated in this study. Rather than environmental factors, patient factors such as older age, ventilator care, and lymphopenia were found to be associated with CAPA diagnosis.

Social Support and General Self-Efficacy: Predictors of Subjective Discomfort in Ecuadorian Teachers

The crisis caused by the COVID-19 pandemic has generated new challenges for regular basic education teachers, who, day by day, interact with students and constitute a significant part of the student's development. These new circumstances have affected teachers, raising their stress levels and affecting their skills. In this context, this study aims to determine the influence of social support and general self-efficacy on subjective discomfort in Ecuadorian regular basic education teachers. The methodology used was based on the predictive design in which 311 teachers participated, 230 women and 81 men. The selected instruments were the Duke-UNK-11 Functional Social Support Questionnaire, the General Self-Efficacy Scale (GAS) and the Kessler Subjective Discomfort Scale-10. The results showed that the Social support variable significantly influences subjective discomfort, showing that teachers who have high levels of social support show lower levels of subjective discomfort. It is concluded that social support is a predictor of subjective discomfort in Ecuadorian teachers of basic education. © 2022 Figueroa-Suárez et al.

Impact of SARS-CoV2 pandemic onto acute ST-elevation myocardial infarction care and patient outcomes in a large tertiary cardiac center

Background: SARS-CoV2 pandemic has caused major impact on patient care worldwide. We experienced a surge of cases beginning March 2020 leading to the government imposing a movement control order, more commonly known as 'lockdown' starting 18th March 2020. As such, various changes were implemented by our center to the clinical pathway for STEMI patients including using thrombolysis as the preferred initial treatment modality. Purpose: We aim to determine the impact of SARS-CoV2 pandemic on the clinical outcome of acute STEMI patients in our center which is a large regional tertiary hospital for cardiology. Methods and results: This is a single center retrospective cross-sectional study from 1st January 2020 until 31st May 2020. We compared clinical outcomes of patients admitted for acute STEMI before (group 1) and after (group 2) 15th March 2020 which is the date our center implemented changes to our STEMI care pathway. A total of 172 cases of acute STEMI was admitted to our center during this period. Admission for STEMI was noticeably lower after the lockdown implementation (group 1, n = 97 vs group 2, n = 75). The median time from symptom to presentation at our center did not differ between the two groups being 4.15h[2.78,7.28] vs 4.42h[2.97,8.01] p = 0.702, suggesting no outof- hospital delays in management. Majority of the patients in group 1 (n = 75, 77.2%) received primary percutaneous coronary intervention (PCI) vs only 17 (22.7%) in group 2. Most in group 2 (n = 54, 72%) received thrombolytic therapy and subsequently underwent coronary intervention within the same admission. This shows a shift in the preferred initial treatment modality for STEMI at our center during this period. The door to balloon time for patients undergoing primary PCI during this period was also numerically higher in group 2 but the difference was not statistically significant at 46min [38,63] vs 59min [45,72], p = 0.063, most likely due to the additional preparation needed in terms of SARS-CoV2 testing and personal protective equipment (PPE) prior to the procedure. The primary composite endpoint of in-hospital mortality and cardiogenic shock between the two groups (17.5% vs 24.3%, p = 0.275) did not show any significant difference. The incidence of inhospital mortality and cardiogenic shock were 4.1% vs 6.7% (p = 0.458) and 15.5% vs 21.9% (p = 0.281) respectively. Conclusions: This study suggests that thrombolysis as the preferred initial treatment modality for STEMI could be a reasonable temporary measure during the initial phase of a global pandemic to reduce infection risk of healthcare providers without compromising patient outcomes until adequate PPE and testing modalities are available for primary PCI to be performed safely. A follow-up study is needed to determine the long-term outcome of these patients.

Environmental contamination in the isolation rooms of COVID-19 patients with severe pneumonia requiring mechanical ventilation or high-flow oxygen therapy.

BACKGROUND: Identifying the extent of environmental contamination of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is essential for infection control and prevention. The extent of environmental contamination has not been fully investigated in the context of severe coronavirus disease (COVID-19) patients. AIM: To investigate environmental SARS-CoV-2 contamination in the isolation rooms of severe COVID-19 patients requiring mechanical ventilation or high-flow oxygen therapy. METHODS: Environmental swab samples and air samples were collected from the isolation rooms of three COVID-19 patients with severe pneumonia. Patients 1 and 2 received mechanical ventilation with a closed suction system, while patient 3 received high-flow oxygen therapy and non-invasive ventilation. Real-time reverse transcription-polymerase chain reaction (rRT-PCR) was used to detect SARS-CoV-2; viral cultures were performed for samples not negative on rRT-PCR. FINDINGS: Of the 48 swab samples collected in the rooms of patients 1 and 2, only samples from the outside surfaces of the endotracheal tubes tested positive for SARS-CoV-2 by rRT-PCR. However, in patient 3's room, 13 of the 28 environmental samples (fomites, fixed structures, and ventilation exit on the ceiling) showed positive results. Air samples were negative for SARS-CoV-2. Viable viruses were identified on the surface of the endotracheal tube of patient 1 and seven sites in patient 3's room. CONCLUSION: Environmental contamination of SARS-CoV-2 may be a route of viral transmission. However, it might be minimized when patients receive mechanical ventilation with a closed suction system. These findings can provide evidence for guidelines for the safe use of personal protective equipment.