COVID-19 and financial institution stability: stress testing the Eastern Caribbean currency union

PurposeThis paper aims to simulate the potential impact of increasing non-performing loans (NPLs) on capital adequacy, interest income and firm value of banks and credit unions in the Eastern Caribbean Currency Union (ECCU) using stress tests. Design/methodology/approachA financial stress testing model was deployed at the levels of individual financial intermediary (FI), sectoral loan portfolio composition, individual member country, and the ECCU collectively, to investigate the impact of NPL shocks on FI stability. FindingsThe authors find that shocks impact the capital adequacy of banks less than that of credit unions, but that firm value of banks is more susceptible to increases in NPLs. Interest income responses to NPL shocks were linked to credit exposure from the tourism sector, which also reduced capital adequacy more than other economic sectors. Findings show that while the COVID-19 pandemic occasioned some increase in NPLs, the magnitude of impact was significantly mitigated by pro-stability policies including loan repayment moratoria and restructuring, guidance on the distribution of profits and deleveraging by financial institutions leading up to 2020. Originality/valueThe paper is among the first to use stress testing on the Caribbean in response to the COVID-19 pandemic. Past studies which have used stress test models in the region have not explicitly investigated the impact of credit shocks on risk-weighted assets or interest income as done herein, nor do they include credit unions in the modeling. The results offer novel evaluations as well as implications for FIs in other developing economies, especially those that share a comparable financial and economic architecture.

High Mortality in Hospitalised Virally Suppressed Adults with Hiv in South Africa

Background: Mortality in PWH has been markedly improved by antiretroviral therapy (ART) but there are few reports describing this in the ~5 million virally suppressed (VS) PWH in South Africa(SA). We describe cause of death(CoD) in adults admitted to hospital with suspected pneumonia in SA. Method(s): We enrolled patients from June 2019-October 2021 at four hospitals and then followed them up for >=1 year. Eligibility included: Age >18 years, >=2 signs/symptoms of pneumonia, < 48 hrs since admission. Medical records were reviewed. All had HIV status ascertained and sputum sent for Xpert Ultra and mycobacterial culture. In PWH CD4 count, viral load (VL) and urine lipoarabinomannan were assessed. For those who died, CoD were ed from medical charts and interview of family. We categorised deaths as early: while admitted or to < 30 days after discharge;or late: >=30 days after discharge. We report mortality and CoD in VSPWH (VL<=50 copies/ml), unsuppressed and HIV uninfected(HUI) adults. Result(s): Of 1999 adults, 54% were PWH;61.2% reported receiving ART of whom 43.1% were VS;55.5% were women. Overall median age of VS was 48 years (IQR: 40-55) at entry;34.3% had comorbidities: hypertension (70.1%, obesity 41.3%, diabetes 28.9%) . Only 11.3% were diagnosed with HIV in the past year, 35.0%, had prior TB. Median CD4 count of VS patients was 289 cells/ mm3 (IQR:133-490) and Hb, 12.5g/dL (IQR:10.5-14.0);53.0% had CRP >100mg/ dL and 69.6% had oxygen saturation < 93% on room air;14.8% had >=1 assay positive for TB;and 42.9% were SARS-CoV-2 positive. Overall 25.4% VSPWH died compared to 31.2% and 22.9% of unsuppressed and HUI, respectively;median ages at death were 49 (IQR:43-59), 38 (IQR: 32-47) and 62 (IQR: 53-69) years respectively. Overall median times to early and late death was 8 (IQR: 4-16) and 104 (IQR: 75-254) days, respectively. The leading CoD in VSPWH were: COVID-19 (22.9%), chronic lung disease(CLD) (17.1%),malignancy (12.9%),sepsis, (12.9%) and TB (8.7%);in HIV unsuppressed, CoD were: advanced HIV and opportunistic infections-(TB,PJP)(55.5%), sepsis(9.6%), COVID-19(8.6%);and in HUI: COVID- 19(43.0%), cardiovascular disease (9.0%), TB(9.0%), malignancy (8.5%). Conclusion(s): Mortality in VSPWH admitted with suspected pneumonia was higher than in HUI and occurred 12 years earlier. The challenge for clinicians is to screen for diseases that disproportionately affect VSPWH and to try to prevent recurrent lung infections thereby increasing their comorbidity-free years and reduce mortality gaps.

COVID-19 Vaccine Awareness among Dental Students: A Cross Sectional Study

Background: Dental professionals are frequently exposed to environments with high levels of occupational hazards by performing duties in close contact with the oral cavity prone for COVID 19 disease transmission. Further, as healthcare providers, dentists are assigned with providing health care support and encouraging their patients, and community in various activities to prevent the spread of diseases including vaccinations especially during this COVID19 pandemic. Aim(s): The present study was aimed to assess the awareness of an individual towards COVID19 vaccination. Methodology: A cross sectional online-survey was conducted using self-administered questionnaires, through Google forms among dental students of Thai Moogambigai dental college and Hospital, Chennai, Tamilnadu, India. Result(s): Majority of the dental students were aware of the COVID19 Vaccines currently available. Among which 78.85% considered COVID-19 vaccines should be made mandatory for all the health care professionals. 75% felt vaccination is not recommended immediately following covid-19 infection or recovered recently. About half of the participants were unaware of vaccination protocols for patients with diabetes, immuno-compromised disease or any bleeding disorder. Conclusion(s): Most of the dental students were aware of vaccines available for the COVID 19 infection however show very low vaccination rate. Thus immediate implementation of epidemiology education associated with infectious diseases and vaccination developments should be incorporated by organizing awareness programs. Copyright © 2022, Institute of Medico-legal Publication. All rights reserved.

Efficacy of Social Networking Sites in Library services at the Time of Social Distancing Due to Covid- 19 Lockdown: A Study Among the Library professionals and Students in India

The ongoing outbreak of Corona virus Disease (COVID-19) compelled the world to begin a new way of life. Social distancing is the best way to prevent the spread of it. Currently, the entire library system around the world is being closed, facing hard choices. Even at this drastic time, the library and its services cannot be completely closed. Libraries are to be reassigned and should reach out to users at the same time as respecting the rules and restrictions around social distancing. Social networking sites (SNSs) provide the library a new and exciting way to reach out to users. SNSs due to their popularity are globally used to exchange various kinds of information. This study was to assess and evaluate the use and awareness of library professionals and students to exchange and share library services during social distancing due to COVID-19 lockdown via SNSs in India. The outcome of the study suggested the necessity of SNSs in the library to exchange and share the services. © 2021. All rights reserved

Classical and molecular virology in the context of sars-cov-2

Diagnostic virology has evolved as a discipline from being confined to hospital laboratories to dedicated state-of-the art research facilities around the world, working on different aspects of diagnosis and research on viral diseases. As the world struggles with the ongoing pandemic of Coronavirus Disease-2019 (COVID-19) caused by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), the need for the development and upgradation of new and existing tools has resurfaced. Latest technological advances in the field of molecular diagnosis have paved the way for providing faster turn-around times for tests, leading to expedited treatment and quarantine decisions. The use of classical and molecular virology tools leads to a better understanding of the virus in the context of the host. The initial diagnosis of the SARS-CoV-2 was carried out by using Next Generation Sequencing (NGS) platforms. Currently, real-time RT-PCR is the gold standard for the laboratory diagnosis of SARS-CoV-2. Serological assays are being used for the detection of antibodies against SARS-CoV-2 for serodiagnosis and to understand the parameters like infection rate and seroprevalence in the community. The present article describes the advancements in the field of viral diagnostics and the role of classical and molecular virology in the context ofthe COVID-19 pandemic response and research.

Controversies in Tracheostomy for Patients With COVID-19: The When, Where, and How.

COVID-19 has impacted how we deliver care to patients, and much remains unknown regarding optimal management of respiratory failure in this patient population. There are significant controversies regarding tracheostomy in patients with COVID-19 related to timing, location of procedure, and technique. In this narrative review, we explore the recent literature, publicly available guidelines, protocols from different institutions, and clinical reports to provide critical insights on how to deliver the most benefit to our patients while safeguarding the health care force. Consensus can be reached that patients with COVID-19 should be managed in a negative-pressure environment with proper personal protective equipment, and that performing tracheostomy is a complex decision that should be made through multidisciplinary discussions considering patient prognosis, institutional resources, staff experience, and risks to essential health care workers. A broad range of practices exist because there is no conclusive guidance regarding the optimal timing or technique for tracheostomy.