The Role of Communications in the Resilience of Risk Group in Kuching, Sarawak, During The Dispersal of COVID-19 Virus

The Covid-19 Pandemic has significantly interfered with all aspects of human life. Notably, this dangerous epidemic has a more significant impact on the risk group. It has caused them to feel stress, fear, and suffering from the ripple effect of Covid-19. Hence, this disruption occurred instantaneously, requiring people to demonstrate noteworthy adaptability and resiliency through communication. Therefore, this study examined the two dimensions of communication, namely self-centred communication (knowledge and optimistic thinking) and external communication (family support and media exposure), in predicting the resilience among the risk group in Kuching, Sarawak. The data collection was during the movement control order, so the distribution of the online questionnaire used voluntary response sampling to the target respondents through WhatsApp and social media accounts. Data collected was analysed using Partial Least Squares analyses. The results show that knowledge, optimistic thinking, and family support significantly correlate with the resilience of the risk group. Moreover, the self-centred communication constructs were the best predictor for resilience. However, media exposure was insignificant because they were in survival mode when it threatened the risk group's lives. So, this makes them prone to rely more on their knowledge, optimistic thinking, and their own family to help their resilience. Hence this has made them think the role of media is less important in resilience. This study has managed to contribute some useful suggestions for helping risk groups protect themselves during a pandemic. Critically, these findings can update relevant authorities in designing effective interventions to support risk groups by strengthening communication factors associated with resilience. © 2023, Penerbit Universiti Kebangsaan Malaysia. All rights reserved.

One year after the COVID-19 outbreak in Germany: long-term changes in depression, anxiety, loneliness, distress and life satisfaction.

Several studies have linked the COVID-19 pandemic to unfavorable mental health outcomes. However, we know little about long-term changes in mental health due to the pandemic so far. Here, we used longitudinal data from a general population sample of 1388 adults from Germany, who were initially assessed between April and May 2020 (i.e., at the beginning of the COVID-19 pandemic in Germany) and prospectively followed up after 6 (n = 1082) and 12 months (n = 945). Depressive and anxiety symptoms as well as loneliness did not change from baseline to 6-month follow-up. While anxiety symptoms did not change in the long run, depressive symptoms and loneliness increased and life satisfaction decreased from baseline to 12-month follow-up. Moreover, vulnerable groups such as younger individuals or those with a history of mental disorders exhibited an overall higher level of psychopathological symptoms across all assessment waves. Our findings suggest a deterioration in mental health during the course of the COVID-19 pandemic, which emphasizes the importance to implement targeted health promotions to prevent a further symptom escalation especially in vulnerable groups.

[The situation of people with intellectual and developmental disabilities in the COVID-19 pandemic-risk factors, problem areas, and measures]. / Die Situation von Menschen mit geistiger Behinderung in der COVID-19-Pandemie ­ Risikofaktoren, Problembereiche, Maßnahmen.

Many people with intellectual and developmental disabilities (IDD) were much more affected by COVID-19 than the average population. The morbidity in this population group was significantly higher due to the form of their housing and care as well as disability-associated health factors (such as Down's syndrome). This led, among other things, to a higher incidence of inpatient settings, a higher mortality rate among hospitalized patients, and a higher case fatality rate among certain subgroups. Risk factors were co-diseases such as dysphagia, epilepsy, or mental disorders. In addition, there were health consequences from restrictive exposure prophylaxis measures at the beginning of the COVID-19 pandemic.This overview article describes the main developments in the care of people with IDD since the beginning of the pandemic. New mental problems or an increase in existing mental problems occurred more frequently in people with IDD who were cared for on an outpatient basis or by relatives. People with IDD in inpatient residential facilities were less frequently affected. The main reasons for psychological problems were lack of social contacts, lost work and employment opportunities, the frightening pandemic situation, and the major structural and personnel changes in the facilities at the beginning of the pandemic. During the pandemic, there were also problems with the implementation of therapeutic and preventive measures. On the other hand, especially in the inpatient area, the "slowing down of life" associated with the restrictions at the beginning of the pandemic also had a stress-reducing effect on some of the people with IDD and was perceived by them as something positive. Caregivers had more time for the genuine (i.e., pedagogical) work. Overall, it was shown that health-promoting measures must also take into account the great heterogeneity of the people with IDD and their living conditions during the pandemic.

A large sample cross-sectional study on mental health challenges among adolescents and young adults during the COVID-19 pandemic at-risk group for loneliness and hopelessness during the COVID-19 pandemic.

BACKGROUND: The COVID-19 pandemic has posed unprecedented challenges for societies. Emerging data have indicated that the younger population are the most vulnerable group to the development of mental health problems during this pandemic. The present study aimed to examine the effects of the changes in health behaviors on mental health problems to identify an at-risk group among adolescents and young adults. METHODS: In the present cross-sectional study, secondary school students (N = 2556) ages 15-21 years participated in Hungary. A self-report questionnaire was developed to measure the changes in health behaviors. Mental health problems were measured by the Beck Hopelessness Scale and the 20-item UCLA Loneliness Scale. RESULTS: A significant proportion of the students showed moderate/severe hopelessness or high loneliness which were more pronounced among adolescent females. An at-risk group was identified among adolescents and young adults. Students who have a lower number of friends, spend less time in front of a screen, and feel lonely often/very often are more likely to have moderate/severe hopelessness with high loneliness. LIMITATIONS: All data were collected online, and students completed the questionnaires voluntarily. Cross-sectional, non-preregistered study. CONCLUSIONS: Loneliness and hopelessness were prevalent in the young population during the COVID-19 pandemic. The at-risk group of adolescents characterized by moderate/severe hopelessness with high loneliness highlights the need for follow-up mental health to avoid future poor mental and physical health. It is also recommended to develop effective interventions targeted to gender and age, with the promotion of resiliencies and buffers against vulnerabilities of negative life events.

[Doing vulnerability : The social construction of age(ing) during the COVID-19 pandemic]. / Doing Vulnerability : Soziale Konstruktionen des Alter(n)s während der COVID-19 Pandemie.

BACKGROUND: Since the beginning of the COVID-19 pandemic old age has been "vulnerablilized" in the media by characterizing old age as a vulnerable and risky phase of life. Gerontologists have criticized the age-based definition of risk groups for their underlying agism. OBJECTIVE: From a practice-theoretical perspective the article asks through which social practices a vulnerable age is realized during the COVID-19 pandemic. MATERIAL AND METHODS: The article refers to data from six qualitative interviews with people aged 65 and older. The data was analyzed using fine structure analysis followed by a topic analysis. RESULTS: The results show that during the COVID-19 pandemic doing age was characterized by a not doing or the disappearance of routinized everyday practices. For the respondents this not doing age was connected to experiencing vulnerable ageing, in which they felt physically and temporally vulnerable. DISCUSSION: Practices of aging during the COVID-19 pandemic have developed against the backdrop of a societal discourse that has positioned activity as an indicator of good and positive aging. At the same time few opportunities have been created to maintain activity under the conditions of the COVID-19 pandemic.

The Return to in-Person Classes and the Feelings Experienced by Academics during the Covid-19 Pandemic

Considering the global pandemic caused by Covid-19, the world has been affected in various social and educational spheres, changing the formats of classroom classes for online teaching. With that, the return to in-person classes is being studied through the advance of vaccination. In this sense, this work aimed to describe the students' perceptions and feelings most experienced by them through eleven structured questions. A form was created using the Google forms application and made available through WhatsApp to a population sample of 152 students from two institutions, one public and the other private, in the city of Altamira-Para-Brasil. The results characterized the occurrence of feelings such as worry, anxiety, fear, stress, and sadness. Furthermore, it was observed that the pandemic affected the emotional aspect of the participants.

The role of pre-pandemic depression for changes in depression, anxiety, and loneliness during the COVID-19 pandemic: Results from a longitudinal probability sample of adults from Germany.

BACKGROUND: The present study aims to delineate the role of preexisting depression for changes in common mental health problems during the COVID-19 pandemic. METHODS: Using mixed-effects linear regression models, we analyzed data on the course of depressive (Patient Health Questionnaire-2) and anxiety (Generalized Anxiety Disorder-2) symptoms as well as loneliness (three-item UCLA Loneliness Scale) in a subset of the Socio-Economic Panel Study, a large and nationally representative household panel study from Germany. Participants were assessed during the first COVID-19 wave in Germany (March 31 to July 4, 2020; n = 6,694) and prospectively followed up at the peak of the second COVID-19 wave (January 18 to February 15, 2021; n = 6,038). RESULTS: Overall, anxiety and depressive symptoms decreased, whereas loneliness increased from the first to the second COVID-19 wave. However, depressive symptoms increased and the surge in loneliness was steeper in those with versus without clinically relevant depressive symptoms in 2019 or a history of a depressive disorder before the COVID-19 pandemic. Anxiety symptoms remained stable throughout the pandemic in individuals with versus without clinically relevant depressive symptoms in 2019. Pre-pandemic depression was associated with overall higher depressive and anxiety symptoms and loneliness across both assessments. The stringency of lockdown measures did not affect the results. CONCLUSIONS: Our findings suggest that individuals with a history of depressive symptoms before the COVID-19 pandemic are at increased risk to experience an escalation of mental health problems due to the COVID-19 pandemic. Therefore, they might particularly profit from targeted prevention and early intervention programs.

Efficacy of Early Treatment With Favipiravir on Disease Progression Among High-Risk Patients With Coronavirus Disease 2019 (COVID-19): A Randomized, Open-Label Clinical Trial.

BACKGROUND: The role of favipiravir in preventing disease progression in coronavirus disease 2019 (COVID-19) remains uncertain. We aimed to determine its effect in preventing disease progression from nonhypoxia to hypoxia among high-risk COVID-19 patients. METHODS: This was an open-label, randomized clinical trial conducted at 14 public hospitals across Malaysia (February-July 2021) among 500 symptomatic, RT-PCR-confirmed COVID-19 patients, aged ≥50 years with ≥1 comorbidity, and hospitalized within first 7 days of illness. Patients were randomized 1:1 to favipiravir plus standard care or standard care alone. Favipiravir was administered at 1800 mg 2×/day on day 1 followed by 800 mg 2×/day until day 5. The primary endpoint was rate of clinical progression from nonhypoxia to hypoxia. Secondary outcomes included rates of mechanical ventilation, intensive care unit (ICU) admission, and in-hospital mortality. RESULTS: Of 500 patients randomized (mean [SD] age, 62.5 [8.0] years; 258 women [51.6%]; 251 [50.2%] had COVID-19 pneumonia), 487 (97.4%) patients completed the trial. Clinical progression to hypoxia occurred in 46 (18.4%) patients on favipiravir plus standard care and 37 (14.8%) on standard care alone (OR, 1.30; 95% CI: .81-2.09; P = .28). All 3 prespecified secondary endpoints were similar between both groups. Mechanical ventilation occurred in 6 (2.4%) vs 5 (2.0%) (OR, 1.20; 95% CI: .36-4.23; P = .76), ICU admission in 13 (5.2%) vs 12 (4.8%) (OR, 1.09; 95% CI: .48-2.47; P = .84), and in-hospital mortality in 5 (2.0%) vs 0 (OR, 12.54; 95% CI: .76-207.84; P = .08) patients. CONCLUSIONS: Among COVID-19 patients at high risk of disease progression, early treatment with oral favipiravir did not prevent their disease progression from nonhypoxia to hypoxia. CLINICAL TRIALS REGISTRATION: ClinicalTrials.gov (NCT04818320).

A Moderated Mediation Model Explaining the Relationship Between Risk-Group Membership, Threat Perception, Knowledge, and Adherence to COVID-19 Behavioral Measures.

Background: COVID-19 is a threat to individual and global health, thus, reducing the disease's spread is of significant importance. However, adherence to behavioral measures against the spread of COVID-19 is not universal, even within vulnerable populations who are at higher risk of exposure to the virus or severe COVID-19 infection. Therefore, this study investigates how risk-group membership relates to adherence to COVID-19 behavioral measures, whether perceived threat of COVID-19 is a mechanism explaining this relationship, and whether knowledge about COVID-19 moderates these effects. Methods: We conducted a web-based survey (N = 4,096) representative of the adult population in Germany with regard to gender, age (18 to 74), and province. Therein, we assessed risk group membership with two indicators (risk of exposure to COVID-19 and risk of severe COVID-19 infection), perceived COVID-19 threat with the Perceived Coronavirus Threat Questionnaire, knowledge about COVID-19 with a knowledge test; and adherence to six behavioral measures to protect against the spread of COVID-19 (e.g., keeping distance, using mouth-nose protection, and following contact restrictions). We used moderated mediation models to test whether perceived threat mediates the relationship between risk-group membership and adherence and whether knowledge about COVID-19 moderates this relationship. Results: We found that risk group members had more perceived COVID-19 threat and that knowledge about COVID-19 increased perceived threat. Moreover, risk group membership had a positive direct effect on adherence to most behavioral measures and risk group members with less knowledge about COVID-19 violated measures more frequently. Risk-group membership also had positive indirect effects on adherence via perceived COVID-19 threat. The moderated indirect effects of threat indicate that threat led to more adherence when knowledge was low, but lost relevance as knowledge increased. Conclusion: The results may help to evaluate disease-regulation measures and to combat the pandemic more effectively. For example, increasing COVID-19 knowledge in the general population could increase adherence to COVID-19 behavioral measures. However, policy makers should be mindful that this could also have negative mental health implications as knowledge increases perceived COVID-19 threat.

Living with the aftermaths of a stroke in the era of the COVID-19 pandemic; the significance of home and close surroundings.

Stay-at-home recommendations to reduce the spread of the COVID-19 virus have had a major impact on people's everyday lives. However, while the evidence indicates that such recommendations have caused distress, anxiety, and fear among the public, little is known about how persons living with complex health conditions, e.g., disability after stroke, have experienced and handled the situation. We interviewed fourteen participants (7 women, 7 men) aged 61-91 years living in ordinary housing during summer 2020 to explore how people who recovered after a stroke experienced their everyday lives in their homes and close surroundings during the COVID-19 pandemic recommendations. Three intertwined themes were constructed from the narrative data and the iterative thematic analysis: (1) Places within and out of reach, (2) Upholding activities-strategies and structures, and (3) Adapting to new circumstances. The findings suggest that places within reach were important to maintain activities and provide structure in daily life. The participants seemed to make use of their previous experiences of adjusting to new circumstances after stroke when adapting to living under the stay-at-home recommendations. In addition, feeling that they now shared the restrictions with all other people in society seemed to ease their situations. Access to nature and spaces in the close surroundings was essential for staying socially connected and receiving support in daily life. The significance of the home and the neighbourhood for health experiences among people who recently have had a stroke should inform rehabilitation interventions both during and after pandemics and environmental planning.

Mental health of Covid-19 risk groups during the first Covid-19 lockdown in Germany: a cross-sectional study.

BACKGROUND: The ongoing Covid-19 pandemic not only threatens physical health, but also affects the mental health of people. Yet, health consequences of the pandemic do not affect all members of society equally. We therefore assessed the mental health burden of individuals who are at increased risk of severe illness from Covid-19 compared to individuals who are at low risk of severe illness during the first lockdown (March, 2020) in Germany. Furthermore, we investigated variables mediating the effect of being an individual at increased risk of serve illness on depression. METHODS: Adult German residents (n = 2.369) provided responses to a cross-sectional online survey about risk factors for of severe illness from Covid-19 and various aspects of mental health during the first lockdown in Germany. For data collection, standardized and validated self-report measures were used and for data analysis Mann-Whitney U-tests as well as regression and mediation analyses were performed. RESULTS: The results clearly show that the mental health burden is higher among individuals at increased risk of severe illness from Covid-19 compared to individuals at low risk of severe illness from Covid-19. Moreover, our findings indicate that the association between Covid-19 risk status and depressive symptoms is mediated by concerns about mental health, anxiety and loneliness in a causal effect chain. CONCLUSIONS: Individuals at increased risk of severe illness from Covid-19 have an increased need for psychosocial support during times of lockdown. Future public health policies should pay special attention to these individuals and support them by targeted offers. More research, however, is needed on possible long-term consequences of social distancing on mental health.

Vaccination of Patients at Risk Against COVID-19: Pros and Cons

To date, the wave-like development of coronavirus infection continues, and each new round of morbidity takes human lives with it. In this regard, WHO calls on all citizens of the world to be vaccinated in order to avoid the negative consequences of a new coronavirus infection. Vaccination against COVID-19 is not mandatory, but the priorities that vaccinated people receive largely separate them from those who oppose vaccination. Among the reasons why people refuse vaccination is the presence of chronic diseases that, in their opinion, may worsen after the introduction of the vaccine or even lead to death. In addition, patients aged 60+ believe that against the background of vaccination, they may develop other diseases that will result from a decrease in immunity due to age. Accordingly, the debate about whether there is a need to vaccinate people from the risk group is quite hot, so this problem appears as relevant in modern conditions. The purpose of the work is to consider the priorities that vaccination gives to patients at risk, as well as to investigate the risks that may reduce the benefits of vaccination for such citizens.

Preventing COVID-19 Spread at Home of Thai University Students through appropriate Psycho-Behavioral Model

The core focus in this study were predictors from three models, namely, Knowledge-Attitude-Practice model (KAP), Theory of Planned Behavior model (TPB), and Psycho-Moral Strength model (PMS) on health preventive behavior concerning COVID-19 in family context of undergraduate students, which also formed the research objectives of the study. The purpose of this experimental, quantitative study was to investigate important antecedent variables from these three psychological models. The sample of the study comprised 672 undergraduate students. The research design was non-experimental where multiple regression methods were used to derive statistical results. The findings showed that PMS model accounted for more variance of health preventive behavior than TPB model or KAP model. In addition, hierarchical MRA showed that PMS model with four components could explain the behavior significantly beyond KAP with TPB models together with 6 components. Furthermore, stepwise regression findings revealed that variables from these three models were found as important predictors which were needed for achievement concerning COVID-19 prevention, locus of control concerning COVID-19 prevention, cognitive attitude component, perceived behavioral control concerning COVID-19 prevention, and behavioral intention concerning COVID-19 prevention with 36.50% in total sample. At-risk group of this behavior were male students with high GPA. This study recommends integrating predictors from the three models for future research and interventions. Model integration should also be encouraged to heighten the precision of predictions of important behaviors required for disease prevention and pro-social behaviors. © 2022 JESTP.

Explorative study regarding influenza vaccine hesitancy among HIV-infected patients.

There are scarce data regarding influenza vaccination among people with HIV infection (PWHIV). The goal of this explorative study is to assess hesitancy toward influenza vaccination in a group of PWHIV during the COVID-19 pandemic. A questionnaire was administered to 219 patients vaccinated at our clinic during the 2020-2021 campaign. It evaluated subjects' adherence to influenza vaccine over the last three seasonal vaccination campaigns, vaccine confidence, complacency and convenience, and the effect of the pandemic on the choice to become vaccinated. The population was divided into two groups: fully adherent to influenza vaccine (all three campaigns, 117 patients) and non-fully adherent (one or two campaigns, 102 patients). Adherence increased in the non-fully adherent group in 2020-2021, but the pandemic did not affect the choice. Misbeliefs emerged: the influenza vaccine was considered protective against SARS-CoV-2 (22.8% of the total population); almost half of all patients thought the influenza vaccine could improve their CD4 T cell level (57.3% in fully adherent, 40.2% in non-fully adherent, p < .05). In 2020-2021 campaign, three quarters of the non-fully adherent group would not have been vaccinated in a location other than our clinic (75.5% vs. 88.9% in the fully adherent group, p < .05). Conclusively, offering a secure and private space for vaccination against influenza seems to encourage vaccination; healthcare professionals should improve counseling to increase adherence and correct misbeliefs.

Perceived risk of COVID-19 exposure and poor COVID-19 prognosis impair sleep: The mediating and moderating roles of COVID-19-related anxiety and knowledge.

The ongoing COVID-19 pandemic has been linked to increased levels of stress, depression, and anxiety in many people around the world. Therefore, identifying individuals at risk of psychosocial burden during this unprecedented crisis is essential for developing prevention measures and treatment options for mental health issues. To this aim, we investigated two risk groups: individuals at higher risk of exposure to the virus and individuals at higher risk of poor prognosis if they contract the virus. We conducted a survey (N = 4167) with a representative sample of the German population and assessed perceived risk of COVID-19 exposure and poor prognosis if infected, COVID-19-related anxiety, problems with sleep and daytime functioning, as well as self-reported knowledge about the disease. Results showed that perceived risk group membership was linked to increased problems with sleep and daytime functioning via elevated levels of COVID-19-related anxiety. This mediated effect was further moderated by self-reported COVID-19 knowledge, but only for individuals who rated themselves at higher risk of COVID-19 exposure. Thus, knowledge buffered the negative effect of exposure risk on anxiety and ultimately on sleep in this risk group. Reaching individuals at increased risk of exposure with clear information about the disease, how to prevent infection, and treatment options could be an effective strategy to contain anxiety levels and promote good sleep, which is important for general well-being.

Active exercise outcome on health and disease of senior citizens in a bangkok district during covid-19 pandemic

The research objective was to study the outcome of regular and active exercise on the health and disease of senior citizens who were the high-risk group during the coronavirus 2019 (COVID-19) pandemic. The target population was the retired seniors who lived in the Bangkok district. The samples were purposely selected from the members of the public and private recreation centers. They were divided into two groups, an active exercise group (AEG) with those who exercised at least 5 days or 150 minutes each week and a lesser exercise group (LEG). The research instruments were questionnaires and interviews. The data were analyzed by descriptive statistics and the independent sample t-test. The study revealed that AEG’s top exercises were walking, running, and dancing, while that for LEG were walking, cycling, and housework. Both groups’ usage and skills of the social networks were at a high level. AEG had an overall better health record with 43% without chronic disease, while LEG had 39%. AEG had non-communicable diseases;Hypertension, Diabetes, Heart disease & Stroke, and Cancer at 22, 10, 7, and 7 % respectively, whilst the LEG had a similar rate. As a result of exercise, AEG attributed to better physical health, mental health, and disease prevention with a higher score than LEG. Statistically, there was significant difference (p<0.05) in physical health and socialization between the two groups i.e. AEG had significantly better physical health and socialization than LEG . Some of the participants believed that active exercise provided them relief from allergy, diabetes, bone & muscle pain, and prevented the return of the chronic diseases. © 2021, Mahidol University - ASEAN Institute for Health Development. All rights reserved.

Changes in daily life and wellbeing in adults, 70 years and older, in the beginning of the COVID-19 pandemic.

BACKGROUND: In the beginning of the COVID-19 pandemic, Swedish authorities enforced specific recommendations on social distancing for adults 70 years and older (70+). Day-to-day life changed for 15% of the Swedish population. The aim of the study was to explore how adults 70+ experienced and managed changes in everyday life due to the COVID-19 pandemic and how those changes affected wellbeing at the beginning of the virus outbreak. METHODS: Eleven women and six men, (mean age 76 years), living in ordinary housing, participated in remote semi-structured interviews in April 2020. The interviews were analysed with qualitative content analysis. FINDINGS: The theme Suddenly at risk - '…but it could have been worse' included four categories My world closed down; Negotiations, adaptations and prioritizations to manage staying at home; Barriers and facilitators to sustain occupational participation; and Considerations of my own and other's health and wellbeing emerged from the data analysis. CONCLUSION: Everyday life changes had implications for health and well-being. The participants questioned previous conceptions of meaning in relation to habitual activities, likely leading to consistent occupational changes. However, these long-term effects remain to be explored, and considered to enable older adult's health during the pandemic and beyond.

[Experiences and perspectives of nursing home residents with depressive symptoms during the COVID-19 pandemic: a qualitative study]. / Erfahrungen und Sichtweisen von Pflegeheimbewohnenden mit depressiver Symptomatik während der COVID-19-Pandemie: eine qualitative Studie.

BACKGROUND: The COVID-19 pandemic requires extensive health protection interventions in order to prevent infections in the long-term care setting. These interventions impact residents' lives, including an increase in depressive symptoms and other negative concomitants. OBJECTIVE: The study aimed to explore the experiences and perspectives of nursing home residents with depressive symptoms during the pandemic. METHODS: In this study nine guideline-based interviews were conducted with residents. These were analyzed using the content-structured content analysis according to Kuckartz. RESULTS: Three main themes were identified: perceptions and emotions related to the pandemic, changes and limitations due to the interventions and wishes in terms of the pandemic. The residents reported both emotional distress and not being afraid of infection and its consequences. In addition, some respondents reported unpleasant restrictions, such as wearing masks. In some cases their usefulness was critically questioned. Furthermore, various wishes of the residents in relation to the pandemic, such as leaving the nursing home, were identified. CONCLUSION: The study showed complex perceptions, changes, and wishes due to the pandemic and its interventions. Therefore, an individual approach to residents with depressive symptoms is necessary to avoid an increase in mental health problems. Against this background, there is a need for participatory implementation of health protection measures for the particularly vulnerable group of nursing home residents.

Laboratory biosafety measures involving SARS-CoV-2 and the classification as a Risk Group 3 biological agent.

The current public health emergency surrounding the COVID-19 pandemic, that is the illness caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has resulted in thousands of cases in Australia since 25 January 2020 when the first case was diagnosed. This emerging virus presents particular hazards to researchers and laboratory staff in a clinical setting, highlighted by rapid and widespread global transmission. Based on the epidemiological and clinical data that have become available in mid-2020, we propose the interim classification of SARS-CoV-2 as a Risk Group 3 organism is reasonable, and discuss establishing Biosafety Level 3 (BSL-3) regulations accordingly. Despite its global spread, the reported mortality rate of SARS-CoV-2 ranging from 0.13% to 6.22% is considerably less than that of other Risk Group 4 agents including Ebola and Marburg viruses with fatality rates as high as 90%. In addition, studies have demonstrated that approximately 86% of patients presenting with severe courses of the disease are aged 70 years or above, with the presence of comorbid conditions such as cardiovascular and respiratory system diseases in the majority of all fatal cases. In contrary to recent discussions surrounding the protective and administrative measures needed in a laboratory, the emerging evidence surrounding mortality rate, distinct demographics of severe infections, and the presence of underlying diseases does not justify the categorisation of SARS-CoV-2 as a Risk Group 4 organism. This article summarises biosafety precautions, control measures and appropriate physical containment facilities required to minimise the risk of laboratory-acquired infections with SARS-CoV-2.

COVID-19 and Slums: A Pandemic Highlights Gaps in Knowledge About Urban Poverty.

According to the United Nations, about 1 billion persons live in so-called slums. Numerous studies have shown that this population is particularly vulnerable to infectious diseases. The current COVID-19 pandemic, caused by the novel coronavirus SARS-CoV-2, emphatically underlines this problem. The often high-density living quarters coupled with a large number of persons per dwelling and the lack of adequate sanitation are reasons why measures to contain the pandemic only work to a limited extent in slums. Furthermore, assignment to risk groups for severe courses of COVID-19 caused by noncommunicable diseases (eg, cardiovascular diseases) is not possible due to inadequate data availability. Information on people living in slums and their health status is either unavailable or only exists for specific regions (eg, Nairobi). We argue that one of the greatest problems with regard to the COVID-19 pandemic in the context of slums in the Global South is the lack of data on the number of people, their living conditions, and their health status.