PA during the COVID-19 outbreak in China: a cross-sectional study.

COVID-19 has undergone several mutations and is still spreading in most countries now. PA has positive benefits in the prevention of COVID-19 infection and counteracting the negative physical and mental effects caused by COVID-19. However, relevant evidence has indicated a high prevalence of physical inactivity among the general population, which has worsened due to the outbreak of the pandemic, and there is a severe lack of exercise guidance and mitigation strategies to advance the knowledge and role of PA to improve physical and mental health in most countries during the epidemic. This study surveyed the effects of COVID-19 on PA in Chinese residents during the pandemic and provided important reference and evidence to inform policymakers and formulate policies and planning for health promotion and strengthening residents' PA during periods of public health emergencies. ANOVA, Kolmogorov-Smirnov, the chi-square test and Spearman correlation analysis were used for statistical analysis. A total of 14,715 participants were included. The results show that nearly 70% of Chinese residents had inadequate PA (95%CI 58.0%-82.19%) during the COVID-19 outbreak, which was more than double the global level (27.5%, 95%CI 25.0%-32.2%). The content, intensity, duration, and frequency of PA were all affected during the period of home isolation, and the types of PA may vary among different ages. The lack of physical facilities and cultural environment is the main factor affecting PA. However, there was no significant correlation between insufficient PA and the infection rate. During the period of home isolation and social distance of epidemic prevention, it is necessary to strengthen the scientific remote network monitoring and guidance for the process of PA in China.

Are COVID-19 patients given adequate instructions about toothbrush hygiene? A cross-sectional study.

OBJECTIVE: The aim of this study was to evaluate toothbrush hygienic practices, whether subjects with a positive COVID-19 test received instructions about toothbrush hygiene, and to determine if carriers of SARS CoV-2 were assigned separate bathrooms during home isolation. METHODS: Data were collected by an anonymous online questionnaire. Variables of interest included toothbrush hygiene practices, receiving instructions on toothbrush handling if tested positive for COVID-19, and being assigned separate bathrooms during home isolation. RESULTS: From November 2020 through April 2021; 755 responded (472 [62.5%] females, 269 [35.6%] males, 14 [1.85%] did not specify their gender). 14 (4.1%) of 341 respondents who reported a positive result of a COVID-19 test received instructions about how to maintain their toothbrush during home isolation. The majority of subjects (74.4%) reported the use of water to wet their toothbrush before brushing, this practice was significantly more common among young subjects (p < 0.001). 58.6% wash all parts of the toothbrush after use while 38.8% wash the head of the toothbrush, and 1.6% place the toothbrush in an antiseptic. 53% used separate bathrooms during isolation, this was significantly associated with age group (p = 0.006) and higher monthly income (p = 0.02). CONCLUSIONS: The majority of participants with a positive result of the COVID-19 test were not given explicit instructions about toothbrush handling. Less than half reported good toothbrush hygienic practices. Higher monthly income was significantly associated with using a separate bathroom during home isolation. Providing explicit instructions about toothbrush hygiene is recommended to reduce the spread of contagious diseases such as COVID-19.

Stigma among COVID-19 patients in South India-A cross-sectional study

Background: COVID-19 has a significant biopsychosocial impact on the lives of people who are infected, with the stigma associated with the illness being one of the major issues. However, the level of stigma based on demographics, gender differences, hospital-based or home-based care is yet to be explored. Hence, this study aimed to infer the level of stigma between these groups in the urban district of south India. Materials and Methods: This cross-sectional study recruited 50 participants who were recently infected with COVID-19 and were receiving either hospital or home-based care. The stigma was assessed using a standardized questionnaire which has four domains. MannWhitney U test was conducted to analyze the data. Results: Median age is 54 years and the majority of the participants are male (74%). The mean score of enacted stigma subscale was 4.48, disclosure fear was 2.34, internalized stigma was 2.82, perceived externalized stigma was 7.32 and the total stigma mean score was 17. The perceived externalized stigma subscale was higher in males (7.57 ± 5.96) when compared to females 6.62 ± 5.53. Total stigma scores were higher for males 17.2 ± 10.1 when compared to females 16.2 ± 10.5. The total stigma score was more (17 ± 10.3) among home isolated COVID patients as compared to hospitalized patients (16.9 ± 10.2). Conclusion: Increased levels of stigma among COVID-19 patients have various important psychosocial implications. This study highlights the need for larger prospective cohort studies to further understand stigma in the context of COVID-19. © 2022 by the Author(s).

Depression and the risk factors for isolated infectious disease fever patients in the hospital during the COVID-19.

Objectives: To compare and analyze the incidence of anxiety and depression of infectious disease fever patients in hospitalized isolation and home isolation during the COVID-19 pandemic, as well as the risk factors for the negative emotions of hospitalized isolation patients. Methods: Forty isolated infectious disease fever patients in Baoding No.1 Hospital were randomly selected as the study group, and the other 40 isolated infectious disease fever patients at home were randomly selected as the control group from March 2020 to August 2020. The scores and prevalence of depression and anxiety between the two groups were compared and analyzed. The logistic regression analysis was used to judge and analyze the negative psychological factors of hospitalized isolation patients such as depression and anxiety. Result: The HAMA and HAMD-17 scores of study group are significantly higher than those of control group (HAMA, p=0.00; HAMD-17, p=0.01). The prevalence of anxiety and depression in the study group was significantly higher than that in the control group (p=0.03, p=0.04). The gender (p=0.002), economic status (p=0.004) and isolation attitude (p=0.023) are the related factors of anxiety, among which economic status is the protective factor, while women and resistant attitude are the risk factors. Economic status (p=0.003) and isolation attitude (p=0.001) are the related factors of depression, among which economic status is the protective factor, and resistant attitude is the risk factor. Conclusion: The prevalence and severity of anxiety and depression in hospitalized isolation patients due to infectious disease fever are significantly higher than those of home isolation patients. The focus groups are women, with bad economic status and poor isolation attitude. Necessary psychological counseling and social support should be provided to these groups to reduce negative emotions and increase the experience of isolated patients.

Health Status and Management Practices of Home Isolated COVID-19 Adult Patients.

BACKGROUND: The worldwide containment strategy for COVID-19 outbreak includes laboratory-confirmed cases, and their isolation and management in health care institutions or at home. The spread of the COVID-19 virus has mandated home isolation for mild cases, as recommended by the Government of Nepal. Isolation is a situation that can have a substantial influence on physical and mental health of isolated people. This study is aimed to assess physical and mental well-being of COVID-19 home isolated patients, and their home management practices. METHODS: A descriptive cross-sectional research using quantitative methods was carried out. Purposive sampling was used to select COVID-19 patients. Total 536 COVID-19 home isolated patients were included in this study. Telephonic interview was conducted to obtain the data. Descriptive analysis was done and interpreted. RESULTS: About 34 % of the participants were symptomatic. The most common symptoms experienced were fever (22.6%), followed by cough (19.4%) and cold (16.1%). About 20 % indicated having difficulties isolating at home due to lack of separate room. Furthermore, 4 percent of the participants didn't have anyone to take care of them at home. Also almost 2 percent of participants didn't get family support when infected. Moreover, majorities of individuals had normal stress, depression and anxiety level. CONCLUSIONS: Most of the participants' physical and mental health was found to be normal though some of them experienced difficulties for management during home isolation. Hence, Interventions should focus resilience building by improving communication to address fears and concerns, encouraging routines and physical activities, and taking measures to reduce loneliness.

Telepharmacy during home isolation: drug-related problems and pharmaceutical care in COVID-19 patients receiving antiviral therapy in Thailand.

BACKGROUND: Home isolation has been proposed for coronavirus disease 2019 (COVID-19) patients with mild symptoms to avoid hospital overcrowding. This study aimed to describe the drug-related problems (DRPs) and the pharmaceutical care of home-isolating COVID-19 patients in Thailand. METHODS: Our cross-sectional study was undertaken from July 1 to September 30, 2021, at the King Chulalongkorn Memorial Hospital, Thailand. Patients who were ≥ 18 years old, were diagnosed with mild COVID-19 by real-time polymerase chain reaction (RT-PCR), and were able to isolate at home while receiving an antiviral agent and standard symptomatic treatment were enrolled. Infectious disease pharmacists provided a telepharmacy service on days 1 and 3 after the COVID-19 diagnosis. RESULTS: A total of 197 patients met the study criteria. Their median age was 45 years, and their most common underlying disease was hypertension (44.29%). All patients exhibited excellent anti-COVID-19 drug adherence. We identified 125 DRPs, including adverse reactions (68%), and the unnecessary use of products (62.40%). Moreover, 91 patients (46.19%) reported the use of supplements or herbs, with vitamin C being the main supplement (37.36%). Pharmacists provided 36 recommendations and received 33 questions from COVID-19 patients. CONCLUSIONS: Our study demonstrates that telepharmacy is an essential service for detecting and preventing DRPs in home-isolating COVID-19 patients.

The association of self-control, self-efficacy, and demographic characteristics with home-based E-learning behavior in nursing and midwifery undergraduates: A cross-sectional study under the COVID-19 epidemic.

BACKGROUND: During the coronavirus disease 2019 (COVID-19) pandemic, nursing and midwifery undergraduate students' time spent in home isolation and being engaged in home-based e-learning was extended. Limited research has been conducted on home-based e-learning behavior during home isolation, and the relationships between individual factors, such as self-control, self-efficacy, and other demographic characteristics, and home-based e-learning behavior are unclear. OBJECTIVES: This study aimed to explore the associations between self-control, self-efficacy, and demographic information with home-based e-learning behavior among nursing and midwifery undergraduates during the COVID-19 pandemic. DESIGN AND METHODS: A cross-sectional study was employed, and an online survey was conducted with 3733 nursing and midwifery undergraduates across seven provinces and cities in mainland China. Data were collected using the Brief Self-control Scale, General Self-efficacy Scale, Undergraduate Home-based E-learning Behavior Questionnaire, and Demographic Information Questionnaire. A multiple linear regression analysis using the stepwise method was conducted to identify predictors of home-based e-learning behavior. RESULTS: Undergraduates achieved an overall mean score of 26.02 (SD = 4.20) for home-based e-learning behavior and an overall mean score of 42.54 (SD = 6.22) and 27.59 (SD = 3.89) for self-control and self-efficacy, respectively. Better self-control (ß = 0.250, P < 0.001), higher self-efficacy (ß = 0.169, P < 0.001), universities being located in non-Hainan provinces (ß = 0.249, P < 0.001), being a sophomore or freshman (ß = -0.255, P < 0.001), and good perceived health status (ß = -0.044, P = 0.003) were identified as the predictors of better home-based e-learning behavior among nursing and midwifery undergraduates. CONCLUSION: Self-control, self-efficacy, and demographic characteristics including the province of the university, grade level, and personal perceived health status were associated with home-based e-learning behavior. Universities should help nursing and midwifery undergraduates improve self-control and enhance self-efficacy while taking measures to decrease the impact caused by demographic characteristic differences.

Experiencing COVID-19, home isolation and primary health care: A mixed-methods study.

Objectives: Although the vast majority of COVID-19 cases are treated in primary care, patients' experiences during home isolation have been little studied. This study aimed to explore the experiences of patients with acute COVID-19 and to identify challenges after the initial adaptation of the German health system to the pandemic (after first infection wave from February to June 2020). Methods: A mixed-method convergent design was used to gain a holistic insight into patients experience. The study consisted of a cross-sectional survey, open survey answers and semi-structured telephone interviews. Descriptive analysis was performed on quantitative survey answers. Between group differences were calculated to explore changes after the first infection wave. Qualitative thematic analysis was conducted on open survey answers and interviews. The results were then compared within a triangulation protocol. Results: A total of 1100 participants from all German states were recruited by 145 general practitioners from August 2020 to April 2021, 42 additionally took part in qualitative interviews. Disease onset varied from February 2020 to April 2021. After the first infection wave, more participants were tested positive during the acute disease (88.8%; 95.2%; P < 0.001). Waiting times for tests (mean 4.5 days, SD 4.1; 2.7days, SD 2.6, P < 0.001) and test results (mean 2.4 days, SD 1.9; 1.8 days, SD 1.3, P < 0.001) decreased. Qualitative results indicated that the availability of repeated testing and antigen tests reduced insecurities, transmission and related guilt. Although personal consultations at general practices increased (6.8%; 15.5%, P < 0.001), telephone consultation remained the main mode of consultation (78.5%) and video remained insignificant (1.9%). The course of disease, the living situation and social surroundings during isolation, access to health care, personal resilience, spirituality and feelings of guilt and worries emerged as themes influencing the illness experience. Challenges were contact management and adequate provision of care during home isolation. A constant contact person within the health system helped against feelings of care deprivation, uncertainty and fear. Conclusions: Our study highlights that home isolation of individuals with COVID-19 requires a holistic approach that considers all aspects of patient care and effective coordination between different care providers.

Hospitality and COVID-19: a willingness to choose e-consultation owing to unemployment and home isolation

PurposeCoronavirus disease (COVID-19) was declared as a pandemic since COVID-19's widespread outbreak and the hospitality industry has been the hardest hit due to lockdown. Consequently, hospitality workers are suffering from the negative aspects of mental health. In the event of such a crisis, this study aims to explore the link between unemployment and home isolation to the willingness to choose electronic consultation (e-consultation) by exploiting psychological ill-being and behavioural intention (BI) with marital status as a moderator.Design/methodology/approachA quantitative methodology is applied to primary data collected from 310 workers from the hospitality industry through an online survey.FindingsFindings of this study suggest that the usage of the e-consultation service can be adopted using three levels. There are valid reasons to conclude unemployment and home isolation are linked to higher rates of psychological health behaviours, which can result in stigma, loss of self-worth and increased mortality. The adverse effect is higher for single individuals than for married people.Originality/valueThe study focussed on e-consultation, BI coupled with the Fishbein scale and a classification model for the prediction of willingness to choose e-consultation with the extension of Theory of Planned Behaviour (TPB).

Investigation on anxious psycology and cognition of COVID-19 prevention and control in college students during home isolation

Objective To investigate the anxious psychology and cognition of COVID-19 prevention and control in college students during home isolation.Methods The convenience sampling method was used to conduct a questionnaire survey by using the "questionnaire Star", the self-rating Anxiety Scale (SAS) was used to assess the anxiety status, and the self-designed questions were used to evaluate the scores of COVID- 19 prevention and control knowledge.Results The SAS standard score in the college students averaged (39.07±7.16) points, which was higher than (29.78±0.46) point in the adult norm, and the difference was statistically significant (P <0.05).By demarcating with the standard score 50 points, 7.8% of the college students showed the anxiety symptoms.The change of sleep time, perceived poor health status and graduation grade were their risk factors.The prevention and control knowledge in the medical students was (7.92±1.43) points in average, which in the non-medical students was (7.46±1.42) points, which in the grade 1 students were (7.37±1.55) points, which in the grade 2-4 students were (7.77±1.39) points, and which in the grade 5 students were (8.42±1.34) points, and the differences were statistically significant (P <0.001).The multiple linear regression showed that the prevention and control knowledge score of the college students was negatively correlation with the anxiety psychology standard scores (b=-0.96, t=-5.177, P <0.001).Conclusion The factors of sleep time change, perceived poor health and graduation grade are the risk factors of anxiety symptoms in the college students.The college students have a good score on the knowledge of prevention and control of this epidemic, and the higher the score of knowledge of prevention and control, the lower the standard score of anxiety (English) [ FROM AUTHOR]

Prevalence and factors associated with depression, anxiety, and stress symptoms among home isolated COVID-19 patients in Western Nepal.

Introduction: Globally, COVID-19 pandemic has a significant impact on mental health. In Nepal, COVID-19 positive cases have to self-isolate at home in multi-generational and multi-family households. This could be strongly associated with depression, anxiety, and stress-related health outcomes. Additionally, COVID-19 related stigma and fear of transmission may intensify depression, anxiety, and stress symptoms. This study determined the prevalence of depression, anxiety, and stress symptoms and their association with presence of COVID-19 symptoms and comorbid conditions among home isolated COVID-19 positives in the Karnali province, Nepal. Methods: We conducted a cross-sectional study to assess depression, anxiety, and stress symptoms among 402 home isolated COVID-19 patients of Karnali province from January to May 2021 using "Depression, Anxiety and Stress Scale-21 (DASS-21)". We interviewed patients to collect socio-demographic, DASS-21, COVID-19 symptoms, comorbid conditions, and self-treatment. We conducted a telephonic interview using a standardized questionnaire using Kobotoolbox. We calculated the prevalence of depression, anxiety, and stress symptoms. We utilized univariate and multivariate logistic regression to determine their association with the presence of COVID-19 symptoms and comorbid conditions. In multivariate logistic regression, we adjusted sociodemographic factors (age, gender, ethnicity, marital status, monthly family income, education level), smoking status and history of self-treatment. We reported adjusted odds ratios (aOR) with 95% confidence intervals. All analyses were conducted in R (version: 4.0.3). Results: The prevalence of depression, anxiety and stress symptoms among home isolated COVID-19 patients were 8.0% (95% CI: 5.5 to 11.1), 11.2% (95% CI: 8.3 to 14.7), and 4.0% (95% CI: 2.3 to 6.4) respectively. Higher odds of depression symptoms (aOR: 2.86; 95% CI: 1.10-7.44, p = 0.03), anxiety symptoms (aOR: 3.81; 95% CI: 1.62 to 8.93; p = <0.01) and stress symptoms (aOR: 7.78; 95% CI: 1.43 to 42.28; p = 0.02) were associated significantly with presence of COVID-19 symptoms in past week. Higher odds of anxiety symptoms were associated with the presence of comorbid conditions (aOR = 2.92; 95% CI: 1.09 to 7.80; p = 0.03). Conclusion: Depression, anxiety, and stress symptoms were present in a significant proportion of home isolated COVID-19 patients in western Nepal and positively associated with the presence of COVID-19 symptoms. In this global COVID-19 pandemic, it is important to provide timely counseling to high-risk groups like those with comorbidities and COVID-19 symptoms to maintain a high level of mental health among home isolated COVID-19 patients.

Public information needs during the COVID-19 outbreak: a qualitative study in mainland China

PurposeThe impact of COVID-19 has led to a surge in the public's reliance on the Internet for pandemic information, and the policy of home isolation has exacerbated this. This study aimed to investigate public information needs and ways of accessing and disseminating information during COVID-19 in mainland China.Design/methodology/approachThis study used a qualitative research approach to conduct semi-structured interviews with 15 participants from 9 cities in mainland China about information needs and access behaviors during the COVID-19 outbreak. All interview recordings were converted into text and proofread, then coded and summarised in correspondence with the research questions using the grounded theory.FindingsThis study summarized the dynamics of public information needs during the 2.5-year pandemic and identified the difficulties in accessing certain information.Originality/valueAlthough information needs of public health emergencies have been a hot topic during COVID-19, scant studies focus on information needs in specific countries in Asia, especially in mainland China, the first country with a major outbreak and stringent lockdown mandates. Therefore, the current study is well enriched by focusing on information demand behavior in the context of COVID-19. Possible measures for improvement were also given to existing and potential problems, taking into account the participants' views.

Child abuse during COVID-19 pandemic: what we can see

Introduction: COVID-19 caused an ongoing health emergency that rapidly spread worldwide, so all countries adopted exceptional health measures to reduce disease's transmission. The stress caused by pandemic presents increasing risks for family violence and for child abuses. Interinstitutional Equips of Abusive and Maltreatment (IEAM) deals with the management of abusive families in Palermo's territory. IEAM starts evaluations after the interventions of the court solicited by a complaint filed by teachers, law enforcements or members of the family. IEAM is formed by consultations in maternity ward, child welfare service and school educational psychologists. Objective(s): The purpose of this research was to evaluate the variations of child abuse and maltreatment reported during local and National lockdown due to pandemic. Reported cases were compared with the previous year. Method(s): The authors collected data of IEAM's advisory from January 2019 until August 2021. The number of cases was evaluated monthly. Result(s): We observed 124 cases in 2019, 145 in 2020 and 94 until August 2021. Advisory reductions coincided with the service activity reduction in August of every year and in March 2020 when Italy declared national lockdown. Social isolation represents a risk factor for child abuse. Although the increase of cases was quite stable, there are reasons to speculate that the reporting of child abuse and maltreatment decreased since home isolation hampered the access to responsible services. Conclusion(s): School closure together with the strong reduction of social care and monitoring during and after lockdown might have increased the domestic violence. Lastly, the child abuse may be underreported despite the effective increase.

Policy Brief - Logistics and Supply Chain Management Strategy to Support Patient Home Isolation During the COVID-19 Pandemic in Thailand

Recently, the pandemic of coronavirus 2019 (COVID-19) raised number of patients who needed hospitalization higher than the existing medical resources and personnel. An increase of hospital occupancy rate caused an inadequate availability of COVID-19 beds in sanatoriums, hospitals, or field hospitals. Inaccessible medical care caused patients to delay treatment. Thus, home isolation or self-quarantine was an option for reducing hospital workload for patients with mild symptoms. In addition, Pribta Clinic was established as a center for distributing drug to home isolation patients as fast and accurately as possible. Researchers had an opportunity to join as volunteers in the Pribta Clinic for care of home isolation patients and had seen some gaps in care. The exploration of workflow and gap analysis were planned and executed after the pandemic reduced in magnitude. The research team had conducted a logistics and supply chain management gap analysis of self-quarantine in Thailand in four perspectives that included Information management and information technology management, Material planning and inventory management, Distribution management, and Leadership and governance, reflected on the problems and barriers of home isolation services that required improvement for better administration. The research team would like to present a Strategic Policy Framework. It contains seven elements including supply allocation, supply network nodes, supply network links, inventory policy, IT infrastructure, logistics working group, and cost/budget plan for improving quality and effectiveness of home isolation services and satisfying the patient and medical personnel needs. Copyright © 2022 Medical Association of Thailand. All rights reserved.

COVID's collateral damage: likelihood of measles resurgence in the United States.

BACKGROUND: Lockdowns imposed throughout the US to control the COVID-19 pandemic led to a decline in all routine immunizations rates, including the MMR (measles, mumps, rubella) vaccine. It is feared that post-lockdown, these reduced MMR rates will lead to a resurgence of measles. METHODS: To measure the potential impact of reduced MMR vaccination rates on measles outbreak, this research examines several counterfactual scenarios in pre-COVID-19 and post-COVID-19 era. An agent-based modeling framework is used to simulate the spread of measles on a synthetic yet realistic social network of Virginia. The change in vulnerability of various communities to measles due to reduced MMR rate is analyzed. RESULTS: Results show that a decrease in vaccination rate [Formula: see text] has a highly non-linear effect on the number of measles cases and this effect grows exponentially beyond a threshold [Formula: see text]. At low vaccination rates, faster isolation of cases and higher compliance to home-isolation are not enough to control the outbreak. The overall impact on urban and rural counties is proportional to their population size but the younger children, African Americans and American Indians are disproportionately infected and hence are more vulnerable to the reduction in the vaccination rate. CONCLUSIONS: At low vaccination rates, broader interventions are needed to control the outbreak. Identifying the cause of the decline in vaccination rates (e.g., low income) can help design targeted interventions which can dampen the disproportional impact on more vulnerable populations and reduce disparities in health. Per capita burden of the potential measles resurgence is equivalent in the rural and the urban communities and hence proportionally equitable public health resources should be allocated to rural regions.

Effectiveness of a monitored home isolation program for COVID-19 infection during the second wave of the pandemic.

Background: The rapidity of spread of COVID-19 infection during the second wave of the pandemic placed tremendous stress on healthcare resources. This study evaluated the effectiveness of a monitored home isolation (HI) program. Methods: In this descriptive longitudinal study, symptomatic patients were screened in the HI clinic and eligible patients were followed up at home using tele-consultation, until recovery or hospitalization. HI failure was defined as need for hospitalization. Factors associated with HI failure were assessed using logistic regression analysis and expressed as odds ratio (OR) with 95% confidence interval (CI). Results: During April and May 2021, 1957 RT-PCR confirmed patients (984 male) with mean (SD) age 40 (13.5) years were enrolled; 93.3% (n = 1825) were successfully managed at home. Of the 132 patients (6.7%) who failed HI, 57 (43.2%) required oxygen therapy and 23 needed intensive care admissions. Overall mortality was 0.4% (7/1957). On adjusted analysis, factors associated with HI failure were age ≥60 years (OR 2.24; 95%CI 1.26-3.99), male gender (OR 2.26; 95%CI 1.44-3.57), subjective reporting of breathing difficulty (OR 3.64; 95%CI 2.08-6.37), history of cough (OR 2.08; 95%CI 1.37-3.17), and higher heart rate (OR 1.04; 95%CI 1.02-1.05). Although patient status (non-healthcare workers), no prior vaccination and ≥2 comorbidities were associated with HI failure on unadjusted analysis, these were non-significant on adjusted analysis. Conclusion: Monitored HI program can be used successfully during a pandemic wave to judicially use scare hospital resources. Older male patients presenting with breathlessness or cough may warrant closer monitoring.

Potential roles of community-based pharmacists in assisting home-quarantined patients with COVID-19 in a resource-challenged setting.

OBJECTIVES: To present the experiences of community-based drug information centre (DIC) pharmacists assisting home-quarantined patients with COVID-19 in Indonesia. METHODS: A prospective case study included home-quarantined patients with suspected/confirmed COVID-19 contacting pharmacists at a DIC in Indonesia in July 2021. Patient characteristics, pharmacist interventions and outcomes were reported. KEY FINDINGS: Fifteen home-quarantined patients were screened for COVID-19 and were provided with follow-up services (i.e. medication review and monitoring). Worsening symptoms and/or reduction in oxygen saturation were reported in seven patients where a referral to medical services was made for them. Most patients recovered at follow-up (4-14 days). CONCLUSIONS: Community-based DIC pharmacists potentially contributed to the frontline emergency response, as observed during the COVID-19 crisis in Indonesia.

Community-based response to the COVID-19 pandemic: case study of a home isolation centre using flexible surge capacity.

OBJECTIVES: Coronavirus disease 2019 (COVID-19) has consumed many available resources within contingency plans, necessitating new capacity surges and novel approaches. This study aimed to explore the possibility of implementing the concept of flexible surge capacity to reduce the burden on hospitals by focussing on community resources to develop home isolation centres in Bangkok, Thailand. STUDY DESIGN: A qualitative study consisted of observational and semi-structured interview data. METHODS: The development and activities of home isolation centres were observed, and interviews were conducted with leaders and operational workforces. Data were deductively analysed and categorised based on the practical elements necessary in disaster and emergency management. RESULTS: Data were categorised into the seven collaborative elements of the major incident medical management and support model. The command-and-control category demonstrated four subcategories: (1) coordination and collaboration; (2) staff engagement; (3) responsibility clarification; and (4) sustainability. Safety presented two subcategories: (1) patients' information privacy and treatment; and (2) personnel safety and privacy. Communication showed internal and external communications subcategories. Assessment, triage, treatment and transport followed the processes of the COVID-19 treatment protocols according to the World Health Organisation (WHO) guidelines and hospital operations. Several supply- and patient-related challenges were identified and managed during centre development. CONCLUSIONS: The use of community resources, based on the flexible surge capacity concept, is feasible under restricted circumstances and reduced the burden on hospitals during the COVID-19 pandemic. Continuous education among multidisciplinary volunteer teams facilitated their full participation and engagement. The concept of flexible surge capacity may promote an alternative community-based care opportunity, irrespective of emergencies' aetiology.

Post-implementation Review of the Himalaya Home Care Project for Home Isolated COVID-19 Patients in Nepal.

Background: The emergence of coronavirus disease 2019 (COVID-19) has resulted in a pandemic that has significantly impacted healthcare systems at a global level. Health care facilities in Nepal, as in other low- and middle-income countries, have limited resources for the treatment and management of COVID-19 patients. Only critical cases are admitted to the hospital resulting in most patients in home isolation. Methods: Himalaya Home Care (HHC) was initiated to monitor and provide counseling to home isolated COVID-19 patients for disease prevention, control, and treatment. Counselors included one physician and four nurses. Lists of patients were obtained from district and municipal health facilities. HHC counselors called patients to provide basic counseling services. A follow-up check-in phone call was conducted 10 days later. During this second call, patients were asked about their perceptions of the HHC program. Project objects were: (1) To support treatment of home isolated persons with mild to moderate COVID-19, decrease burden of hospitalizations, and decrease risks for disease transmission; and, (2) To improve the health status of marginalized, remote, and vulnerable populations in Nepal during the COVID-19 pandemic. Results: Data from 5823 and 3988 patients from May 2021-February 2022 were entered in initial and follow-up forms on a REDCap database. The majority of patients who received counseling were satisfied. At follow-up, 98.4% of respondents reported that HHC prevented hospitalization, 76.5% reported they could manage their symptoms at home, and 69.5% reported that counseling helped to limit the spread of COVID-19 in their household. Conclusions: Telehealth can be an essential strategy for providing services while keeping patients and health providers safe during the COVID-19 pandemic.

Concerns of Home Isolating COVID-19 Patients While Receiving Care via Telemedicine during the Pandemic in the Northern Thailand: A Qualitative Study on Text Messaging.

As there were strict limits on contact between health professionals and patients during the COVID-19 pandemic, telemedicine increased in importance with regard to improving the provision of health care and became the preferred method of care. This study aims to determine the topics of concern expressed by individuals with COVID-19 receiving care at home via teleconsultation. The qualitative study was conducted using secondary data of chat messages from 213 COVID-19 patients who had consented to online consultation with the health care team. The messages were sent during the home isolation period, which was between 29th October and 20th December 2021. Thematic analysis was used to analyze the data. All patients had consented to the use of their data. A small majority of the patients were female (58.69%). The average age was 32.26 ± 16.92 years. A total of 475 questions were generated by 150 patients during the isolation period. Nearly thirty percent (29.58%) never asked any questions. From the analysis, the questions could be divided into three themes including: (1) complex care system; (2) uncertainty about self-care and treatment plan with regard to lack of knowledges and skills; and (3) concern about recovery and returning to the community after COVID-19 infection. In conclusion, there were enquiries about many aspects of medical care during home isolation, detailed answers from professionals were useful for the self-care of patients and to provide guidance for their future health behavior. The importance of the service being user friendly and accessible to all became increasingly evident.