ABSTRACT
The COVID-19 pandemic has highlighted the vulnerability of countries worldwide and their abilities to cope with the fast-paced demands of the research and medical community. A key to promoting ethical decision-making frameworks is by calibrating the sustainability at regional, national, and global levels to incorporate coordinated reforms. We performed a sustained ethical analysis and critically reviewed evidence addressing country-level responses to practices during the COVID-19 pandemic using PubMed (MEDLINE), Scopus, and CINAHL. The World Health Organization's ethical framework proposed for the entire population during the pandemic was applied to thematically delineate findings under equality, best outcomes (utility), prioritizing the worst off, and prioritizing those tasked with helping others. The findings demarcate ethical concerns about the validity of drug and vaccine trials in developing and developed countries, hints of unjust healthcare organizational policies, lack of equal allocation of pertinent resources, miscalculated allocation of resources to essential workers and stratified populations.
ABSTRACT
Introduction: Worsening air quality and pollution lead to numerous environmental health and sustainability issues in the South Asia region. This study analyzes India, Nepal, Bangladesh, Pakistan, Sri Lanka, and Nepal for air quality data trends and sustainability indicators. Methodology: By using a population-based study design, six South Asian countries were analyzed using a step-wise approach. Data were obtained from government websites and publicly available repositories for region dynamics and key variables. Results: Between 1990 and 2020, air quality data indicated the highest rise in CO2 emissions in India (578.5 to 2441.8 million tons) (MT), Bangladesh, Nepal, and Pakistan. Greenhouse gas emissions, from 1990 to 2018, nearly tripled in India (1990.4 to 3346.6 MT of CO2-equivalents), Nepal (20.6 to 54.6 MT of CO2-equivalents), and Pakistan, and doubled in Bangladesh. Methane emissions rose the highest in Pakistan (70.4 to 151 MT of CO2-equivalents), followed by Nepal (17 to 31 MT of CO2-equivalents) and India (524.8 to 669.3 MT of CO2-equivalents). Nitrous oxide nearly doubled in Bangladesh (16.5 to 29.3 MT of CO2-equivalents), India (141.6 to 256.9 MT of CO2-equivalents), Nepal (17 to 31 MT of CO2-equivalents), and more than doubled in Pakistan (27 to 61 MT of CO2-equivalents). On noting particulate matter 2,5 annual exposure, India saw the highest rise from 81.3 µg/m3 (in 1990) to 90.9 µg/m3 (2017), whereas trends were steady in Pakistan (60.34 to 58.3 µg/m3). The highest rise was noted in Nepal (87.6 to 99.7 µg/m3) until 2017. During the coronavirus disease 19 pandemic, the pre-and post-pandemic changes between 2018 and 2021 indicated the highest PM2.5 concentration in Bangladesh (76.9 µg/m3), followed by Pakistan (66.8 µg/m3), India (58.1 µg/m3), Nepal (46 µg/m3) and Sri Lanka (17.4 µg/m3). Overall, South Asian countries contribute to the worst air quality and sustainability trends regions worldwide. Conclusions: Air pollution is prevalent across a majority of South Asia countries. Owing to unsustainable industrial practices, pollution trends have risen to hazardous levels. Economic, environmental, and human health impacts have manifested and require urgent, concerted efforts by governing bodies in the region.
ABSTRACT
Background: South Asia has performed relatively better than initially during the COVID-19 pandemic. The overall burden and response have remained dynamic in the region with certain countries outperforming others despite limitations in health resources. Methodology: Using a population-based observational design, all 8 South Asian countries were analyzed using a step-wise approach. Data were obtained from government websites and publicly available data for population dynamics and other facilities. Results: South Asian countries have a younger average age of their population. Our findings demonstrate the inequitable distribution of resources centered in urban metropolitan cities within South Asian countries. Certain densely populated regions in these countries have better testing facilities and healthcare facilities that correlate with lower COVID-19 incidence per million populations. Trends of urban-rural disparities are not clear given the lack of clear reporting of the gap within these regions. COVID-19 vaccination lag has become apparent in South Asian countries with the expected time to complete the campaign being unfeasible as the COVID-19 pandemic progresses.Conclusion: The focus on response in the South Asia countries has been on controlling peaks rather than curbing them. With a redesign of governance policies on preventing the rise of COVID-19 promptly, the relief on the healthcare system and healthcare workers (HCWs) will allow for adequate time to roll out vaccination campaigns with equitable distribution.
Subject(s)
COVID-19ABSTRACT
Objective: To investigate social, economic, and environmental contributors to quit or continue smoking and vaping during the COVID-19 pandemic. Methods: A qualitative study design was adopted to identify smokers’ beliefs in a LMIC, using a small community sample. Results: 276 participants were primarily surveyed. Motivation to continue smoking included temporary pleasurable effects, working remotely, stress or anxiety, whereas a motivator to quit smoking was the overlap with COVID-19 symptomatology. There was a rise in social awareness regarding the potential harm of smoking and vaping during the pandemic yet those participants who were younger felt they were immune from its morbid complications. Conclusions: With paradoxical associations of COVID-19 with cigarette and vape usage, it is important to pay attention to biases in data in favor of educating its users of the increased risk of severe disease.
Subject(s)
COVID-19ABSTRACT
ABSTRACT The coronavirus disease 2019 (COVID-19) pandemic may further promote the development of Industry 4.0 leading to the fifth industrial revolution (Society 5.0). Industry 4.0 technology such as Big Data (BD) and Artificial Intelligence (AI) may lead to a personalized system of healthcare in Pakistan. The final bridge between humans and machines is Society 5.0, also known as the super-smart society that employs AI in healthcare manufacturing and logistics. In this communication, we review various Industry 4.0 and Society 5.0 technologies including robotics and AI being inspected to control the rate of transmission of COVID-19 globally. We demonstrate the applicability of advanced information technologies including AI, BD, and Information of Technology (IoT) to healthcare. Lastly, we discuss the evolution of Industry 4.0 to Society 5.0 given the impact of the COVID-19 pandemic in accordance with the technological strategies being considered and employed.
ABSTRACT
Background: The first cases of the coronavirus disease 2019 (COVID-19) were reported in Wuhan, China. No antiviral treatment options are currently available with proven clinical efficacy. However, preliminary findings from phase III trials suggest that remdesivir is an effective and safe treatment option for COVID-19 patients with severe disease. Objective: The aim of the present meta-analysis is to investigate whether remdesivir is effective for treating COVID-19 including reduced in-hospital adverse events, oxygen support, and mortality rates. Methods: Using PRISMA reporting guidelines, a review was conducted from January 1 2020 until 6 August 2020 with MeSH terms including COVID-19, coronavirus, SARS-CoV-2, COVID, remdesivir, adenosine nucleoside triphosphate analog, Veklury using Medline, Scopus, and CINAHL Plus. A modified Delphi process was used to include the studies and ensure that the objectives were addressed (Appendix A). Using dichotomous data for select values, the unadjusted odds ratios (ORs) were calculated applying Mantel Haenszel (M-H) random-effects method in Review Manager 5.4. Results: Randomized controlled trials pooled in 2,429 participants with 41.6% (n=1011) in the remdesivir group and 58.4% (n=1,418) in the placebo group. The placebo group had a higher risk of mortality as compared to the intervention group with significant odds ratio (OR=0.61) (95% confidence interval of 0.45-0.83; P=0.001). There was moderate heterogeneity among the studies. Conclusions: Our findings suggest that remdesivir extends clinical benefits by reducing mortality, adverse events and oxygen support in moderate to severely ill COVID-19 patients. Concerted efforts and further randomized placebo-controlled trials are warranted to examine the potency of anti-viral drugs and immune-pathological host responses contributing to severity of COVID-19.