Caregivers' experiences and perspectives on caring for the elderly during the COVID-19 pandemic: A qualitative systematic review.

AIMS: The goal of this study was to explore caregivers' experiences, perspectives, emotions, knowledge and needs in caring for older people during the COVID-19 pandemic. These included, but were not limited to, experiences in hospital care, home care and nursing home care. BACKGROUND: Because of the high mortality rate associated with the COVID-19 pandemic, senior care is critical. During the COVID-19 pandemic, caregivers caring for older people have had unique experiences potentially affecting the quality of care provided. This topic has received substantial attention since the start of the pandemic and has been studied by numerous researchers. However, experiences may differ among countries and time periods. In addition, no qualitative systematic reviews on this topic appear to have been published. EVALUATION: In this systematic review of qualitative studies, data were collected from the following electronic databases: PubMed, Web of Science, Scopus, CINAHL (Cumulative Index to Nursing and Allied Health Literature), Science Direct and PsycINFO. Titles and abstracts were screened according to the inclusion and exclusion criteria, full texts were screened and the methodological quality of included studies was assessed with the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research by two independent reviewers. KEY ISSUE(S): A total of 141 findings were extracted and aggregated into 20 categories; 6 synthesized findings were identified. CONCLUSION: This review indicates caregivers' experiences and perceptions regarding caring for older people during the COVID-19 pandemic. The results of a qualitative systematic review show that caregivers' emotions, cognitions and knowledge have affected the quality of caregivers' senior care services during the pandemic. Caregivers caring for older adults should practise self-awareness, understanding their knowledge and attitudes to improve the quality of senior care. Moreover, health care administrators and policymakers should make concerted efforts to cultivate a better working environment. IMPLICATIONS FOR NURSING MANAGEMENT: Managers should formulate timely and effective management strategies. During the COVID-19 pandemic, the workload of caregivers has increased, thus requiring better scheduling by managers. Furthermore, managers should consider the negative emotions of caregivers and prevent negative emotions from affecting their work. Besides, virtual technology should be applied to senior care and psychological support be provided for caregivers in this special care setting.

Psychological impacts of the COVID-19 pandemic on medical students in the United States of America.

This study aimed to assess the early psychological impacts of the COVID-19 pandemic on United States medical students when compared to graduate students in fields unrelated to healthcare using the perceived stress scale (PSS-10) and the perceived COVID-19-related risk scale (PCRS). This was a cross-sectional study between May and June 2020. We created an anonymous, online questionnaire that was administered to medical students nationwide and local graduate students. We used Student's t-test, Chi-square test, and regression models. We received 425 completed responses. Contrary to similar stress levels in graduate students, medical students on average experienced significantly more stress after coursework suspension than before (20.6 vs 14.7). Female gender and a mental illness diagnosis were associated with statistically significantly elevated PSS-10 scores before and after suspension in medical students. Medical students reported a low PCRS score. Most medical students were confident in their department's infection control measures and willing to report to work. Female gender and a mental illness diagnosis remain two important risk factors for medical students' stress levels during the pandemic. This study highlights the need to foster students' public health competency and safely involve students as non-frontline workers in public health emergency responses for their mental wellbeing.

A year of living distantly: global trends in the use of stay-at-home orders over the first 12 months of the COVID-19 pandemic.

During the first year of the COVID-19 pandemic, non-pharmaceutical interventions (NPIs) were the main pillar of defence to protect human society against the virus. While a variety of modelling studies try to quantify the effects of NPIs, this paper investigates when and how national and subnational governments have taken actions. We observe longitudinal changes in the global pattern of policymaking to combat the COVID-19 pandemic, with a particular focus on stay-at-home orders. Drawing on data from the Oxford COVID-19 Government Response Tracker, we show several important trends. First, while national governments exhibited a strong alignment in policy settings initially in March and April 2020, their cross-country policy heterogeneity has grown since May 2020, although countries within global regions continue to display similarities in their approaches. Second, most governments that have implemented multiple stay-at-home orders over the course of the pandemic have become less sensitive to case levels (insofar as they implement subsequent restrictions at progressively higher case levels), apart from a small number of contrast cases which have mostly eliminated domestic community transmission. Third, pandemic policies are increasingly specific to subnational levels, and there is often significant heterogeneity with regard to policy approaches even within the same country.

Government responses and COVID-19 deaths: Global evidence across multiple pandemic waves.

We provide an assessment of the impact of government closure and containment measures on deaths from COVID-19 across sequential waves of the COVID-19 pandemic globally. Daily data was collected on a range of containment and closure policies for 186 countries from January 1, 2020 until March 11th, 2021. These data were combined into an aggregate stringency index (SI) score for each country on each day (range: 0-100). Countries were divided into successive waves via a mathematical algorithm to identify peaks and troughs of disease. Within our period of analysis, 63 countries experienced at least one wave, 40 countries experienced two waves, and 10 countries saw three waves, as defined by our approach. Within each wave, regression was used to assess the relationship between the strength of government stringency and subsequent deaths related to COVID-19 with a number of controls for time and country-specific demographic, health system, and economic characteristics. Across the full period of our analysis and 113 countries, an increase of 10 points on the SI was linked to 6 percentage points (P < 0.001, 95% CI = [5%, 7%]) lower average daily deaths. In the first wave, in countries that ultimately experiences 3 waves of the pandemic to date, ten additional points on the SI resulted in lower average daily deaths by 21 percentage points (P < .001, 95% CI = [8%, 16%]). This effect was sustained in the third wave with reductions in deaths of 28 percentage points (P < .001, 95% CI = [13%, 21%]). Moreover, interaction effects show that government policies were effective in reducing deaths in all waves in all groups of countries. These findings highlight the enduring importance of non-pharmaceutical responses to COVID-19 over time.

Determining available strategies for prevention and therapy: Exploring COVID­19 from the perspective of ACE2 (Review).

Coronavirus disease 2019 (COVID­19) is an acute infectious pneumonia caused by a novel type of coronavirus infection. There are currently no clinically available specific drugs for the treatment of this virus. The process of host invasion is the key to viral infection, and it is a mechanism that needs to be considered when exploring antiviral drugs. At present, studies have confirmed that angiotensin­converting enzyme II (ACE2) is the main functional receptor through which severe acute respiratory syndrome coronavirus (SARS­CoV­2) invades host cells. Therefore, a number of studies have focused on this field. However, as ACE2 may play a dual role in mediating susceptibility and immunity to SARS­CoV­2 infection, the role of ACE2 in viral infection is controversial. Beginning with the physiological function of ACE2, the present review article summarizes the influence of the ACE2 content on the susceptibility to the virus and acute lung injury. Drug mechanisms were taken as the starting point, combined with the results of clinical trials, specifically elaborating upon and analyzing the efficacy of several ACE2­centered therapeutic drugs and their potential effects. In addition, the current status of ACE2 as a targeted therapy for COVID­19 is discussed in order to provide new insight into the clinical prevention and treatment of COVID­19.