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Objectives: This study explores the factors influencing the construction duration of public health emergency medical facilities and the ways in which they can be enhanced. Methods: Combining 30 relevant emergency medical facility construction cases in different cities in China from 2020 to 2021, seven condition variables and an outcome variable were selected, and necessary and sufficient condition analyses of duration influence factors were conducted using the fsQCA method. Results: The consistency of seven condition variables was <0.9, which shows that the construction period of public health emergency medical facilities is not independently affected by a single condition variable but by multiple influencing factors. The solution consistency value of the path configurations was 0.905, indicating that four path configurations were sufficient for the outcome variables. The solution coverage of the four path configurations was 0.637, indicating that they covered ~63.7% of the public health emergency medical facility cases. Conclusion: To reduce the construction duration, the construction of emergency medical facilities should focus on planning and design, the selection of an appropriate form of construction, the reasonable deployment of resources, and the vigorous adoption of information technology.
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Health Facilities , Public Health , ChinaABSTRACT
The world has witnessed the largest single disruption to social wellbeing since the first known case of coronavirus disease 2019 (COVID-19) was reported in China in December 2019. In Malaysia, the government implemented the Movement Control Order (MCO) on 18 March 2020 in response to the COVID-19 pandemic. Thus, this paper highlights how the Malaysian government responded to COVID-19 in comparison with some Asian countries; and what has and has not worked for the MCO imposed by the government. The paper adopts a review approach that is supported by findings from both grey and academic literature. The findings reveal that the COVID-19 pandemic has significant impacts on the society's wellbeing in Malaysia, the most severe of which are negative mental health and job unemployment. On the other hand, COVID-19 has sparked a surge of volunteering in society. This paper presumably and hopefully represents a frontier review with more empirical research to be conducted to investigate the extent of the social impact of COVID-19, the outcomes of which are a call for re-envisioning of social policies in Malaysia. To the best knowledge of the authors, little empirical research has been conducted to explore the social-wellbeing implications of COVID-19 in Malaysia. By reflecting on the various scenarios-both detrimental and beneficial in the context of the COVID-19 pandemic, the paper identifies potential avenues for relevant research in the social wellbeing realm.
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The outbreak of COVID-19 has caused a major impact on productivity and life functioning, and also led to adverse emotional reactions. In the face of this public health event, increased anxiety is one of the most common emotional reactions. Previous studies have shown that anxiety sensitivity, rumination and anxiety are closely related. Various dimensions of anxiety sensitivity have different effects on anxiety. Also, rumination can be divided into brooding and reflection. To explore the relationships among anxiety sensitivity's cognitive concerns, anxiety and different types of rumination, we conducted an online survey during the outbreak of coronavirus (February 17-25, 2020), using the Anxiety Sensitivity Scale-3 (ASI-3), Ruminative Responses Scale (RSS), and Depression Anxiety Stress Scale-21 (DASS-21). The results showed significant positive correlations among anxiety sensitivity's cognitive concerns, anxiety, brooding and reflection. Furthermore, brooding and reflection had a chain mediation effect between cognitive concerns and anxiety, and the mediation effect of reflection was even stronger. Results suggest that anxiety sensitivity's cognitive concerns may not only affect anxiety directly, but also affect anxiety through rumination, especially reflection.
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The COVID-19 pandemic requires mass screening to identify those infected for isolation and quarantine. Individually screening large populations for the novel pathogen, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), is costly and requires a lot of resources. Sample pooling methods improve the efficiency of mass screening and consume less reagents by increasing the capacity of testing and reducing the number of experiments performed, and are therefore especially suitable for under-developed countries with limited resources. Here, we propose a simple, reliable pooling strategy for COVID-19 testing using clinical nasopharyngeal (NP) and/or oropharyngeal (OP) swabs. The strategy includes the pooling of 10 NP/OP swabs for extraction and subsequent testing via quantitative real-time reverse transcription polymerase chain reaction (RT-qPCR), and may also be applied to the screening of other pathogens.
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INTRODUCTION: Vaccine-induced thrombocytopenia and thrombosis (VITT) is a rare but devastating adverse event associated with the ChAdOx1 nCoV-19 (Oxford-AstraZeneca) adenoviral vaccine against the Severe Acute Respiratory Syndrome CoronaVirus-2 (SARS-CoV-2). METHODS: A 49-year-old man presented to the emergency department with acute right limb ischemia (Rutherford IIB) nine days after his ChAdOx1 nCoV-19 (Oxford-AstraZeneca) vaccination. CT angiography revealed significant aortic thrombosis and right femoral artery occlusion. Severe thrombocytopenia (platelet count of 23 × 103/µL), promptly elevated D-dimers (37937 ng/mL) and a reduced fibrinogen level (176 mg/dL) were remarkable. ELISA testing for anti-PF4 antibodies confirmed the diagnosis of VITT. RESULTS: An emergency revascularization of the right leg was provided via thrombectomy. High-dose intravenous immunoglobulins were administered whereafter the platelet count restored gradually. Therapeutic anticoagulation was progressively started. The postoperative course was uneventful and follow-up imaging after four weeks showed an almost complete resolution of the significant aortic thrombosis. CONCLUSION: Early recognition and appropriate counseling of VITT is advocated to pursue a good clinical outcome. Our patient presenting with severe aortic thrombosis and acute limb ischemia was successfully treated by a vascular thrombectomy along with intravenous immunoglobulins and anticoagulation therapy as the mainstay therapy.
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Vaccination is an important part of the fight against COVID-19 virus. A predictor of the proportion of people who will actually take a vaccination is the willingness to vaccinate among the population. Literature shows that vaccination willingness among people with lower socioeconomic status is lower than among other groups. In this contribution we describe to what extent this is also the case in the Netherlands and show how risk perception, trust in the effects and safety of the vaccine, and health literacy may be related to this. Finally, we highlight a number of intervention strategies that can make a positive contribution to vaccination willingness among lower educated groups.
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The COVID-19 crisis has drastically affected organizations worldwide, thereby influencing the employees' psychological wellbeing. Since it is a new pandemic, research is sparse in the domain of employees' psychological wellbeing in relation to the phenomenon. Drawing on social support and job demand-resource perspectives, this research adds to the factors affecting employees' wellbeing due to the coronavirus outbreak. Specifically, this study is an investigation of co-workers' instrumental support in predicting employees' emotional exhaustion via employees' perceived uncertainties experienced due to the COVID-19 pandemic. Further, we tested for the contextual specificity of family support on uncertainties and its link with employees' emotional exhaustion. With data drawn from two universities (n = 275), the findings reveal a negative association between co-worker task support and an employee's emotional exhaustion, and an employee's perceived uncertainties mediate this relationship. Moreover, the moderating analysis exhibits that family support mitigates the negative effect of uncertainty perception on emotional exhaustion. Our study reveals that coworker and family support are extremely important during the COVID-19 pandemic. These findings are equally valuable for organizations and society to mitigate the detrimental effects of the COVID-19 pandemic on employees' wellbeing.
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We conducted a cross-sectional study to compare the impact of social distancing and lifestyle changes that occurred during Corona Virus Disease 2019 (COVID-19) lockdown on children and adolescents with and without Neurodevelopmental Disorders (NDDs). An online questionnaire was administered in order to investigate the effects of NDD condition, socio-demographic status, familiar/home environment and COVID-19 exposure on their lives during a two months period of social isolation. We used logistic regression, focusing on five endpoints (remote learning, lifestyle, stress/anxiety, sociality, scolding) to define the extent of these effects. Most questions were paired up to parents and children, to verify the occurrence of agreement. 8305 questionnaires were analyzed, 1362 of which completed by NDDs and 6943 by controls. Results showed that the presence of a NDD, compared to controls, had a significant impact on: Remote Learning (i.e. subjects with NDDs experienced more difficulties in attending online classes and studying), Sociality (i.e. subjects with NDDs missed their schoolmates less), Scolding (i.e. subjects with NDDs were scolded more often) and Anxiety (i.e. subjects with NDDs were perceived by their parents as more anxious). Substantial agreement between parents and children arose from questions concerning Remote learning, Lifestyle and Scolding. The current study actually points out that having a NDD gives account for a stronger influence on school performance and on behavioral and psychological aspects, during a two months lockdown. Such results may provide useful information to governments and school authorities on how carrying through supportive strategies for youth affected by NDDs. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12144-021-02321-2.
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The COVID-19 pandemic has caused millions of cases and over half a million deaths in the United States. While health experts urge citizens to adopt preventative measures such as social distancing and wearing a mask, these recommended behaviors are not always followed by the public. To find a way to promote preventative measures, the present study examined the role of gain-loss framing of COVID-19 related messages on social distancing and mask wearing compliance. Moreover, the study also tested potential moderating effects on framing with three individual characteristics: political ideology, subjective numeracy, and risk attitude. A sample of 375 U.S. adult residents were recruited from Amazon Mechanical Turk. Each participant read either a gain or loss-framed message related to practicing protective behaviors during the COVID-19 pandemic. Participants also completed scales of preventative behaviors, risk attitude, subjective numeracy, political ideology, and other demographic variables. It was found that those who were more liberal, risk-averse and had greater subjective numeracy were more likely to wear a mask and/or follow social distancing. Furthermore, in the presence of demographic and psychological factors, the study found participants in the loss-framed condition than in the gain-framed condition were more likely to adopt both preventative measures, supporting the notion of loss aversion. Additionally, the framing effect was also moderated by political ideology on mask-wearing, with the effect being stronger in liberals than in conservatives. Collectively, the study implies message framing may be a useful means to promote preventative measures in the current pandemic.
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Coronavirus disease (COVID-19) has caused a global health crisis. It also leads to different types of psychosocial problems in society as a result of preventive health measures and the disease itself. Among others, psychopathological symptoms and suicide behaviors have increased. The PsicorecurSOS COVID-19 online protocol was designed. At baseline, 1020 Spanish adults were assessed, during confinement, for sociodemographics, fear of COVID-19, anxious-depressive symptoms, covitality, and suicidal ideation. Reliability, descriptive, and frequency analyses were carried out, and the computer tool SPSS PROCESS was used to carry out a conditional process analysis (model 59). A total of 595 participants were included (58.30% response rate from baseline; mean age = 37.18 [SD = 13.30]; 72.44% female). Regarding suicidal ideation, 12% responded differently to "never," 19.3% exceeded the cutoff point on the anxiety scale, and 24% on the depression scale. Moderate mediation analysis explained 27% of the variance in suicidal ideation. In addition, the indirect effect of moderate mediation was significant (b = -.004, SE = .002 with the presence of covitality; and b = .01, SE = .003 absence of covitality). Sex and age did not influence the overall outcome of the model. The data from this study can serve as a starting point for generating social and health treatment initiatives based on self-examination of anxiety-depressive symptoms and increasing socio-emotional skills in order to prevent and alleviate the psychosocial effects of the pandemic.
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Tracheostomy is a standard surgical procedure that is used in critically ill patients who require sustained mechanical ventilation. In this article, we review the outcomes of coronavirus disease 2019 (COVID-19) patients who underwent tracheostomy. We searched for relevant articles on PubMed, Scopus, and Google Scholar, up to April 20, 2021. This meta- analysis examines ventilation liberation, decannulation, and hospital mortality rates in COVID-19 patients who have undergone tracheostomy. Two investigators evaluated the articles, and the differences of opinion were settled by consensus with a third author. A total of 4366 patients were included in 47 related articles for this meta-analysis. After data pooling, the proportions of ventilation liberation, decannulation and mortality were found to be 48% (95% CI: 31-64), 42% (95% CI: 17-69) and 18% (95% CI: 9-28) respectively. The Luis Furuya-Kanamori (LFK) index values for ventilation liberation, decannulation and mortality were 4.28, 1.32 and 0.69. No transmission of the disease attributable to participating in tracheostomy procedures was reported in most of the included articles.
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COVID-19 , Critical Illness , Humans , Respiration, Artificial , SARS-CoV-2 , TracheostomyABSTRACT
The recombinant receptor-binding domain (RBD) of the viral spike protein from SARS-CoV-1 and 2 are reliable antigens for detecting viral-specific antibodies in humans. We and others have shown that the levels of RBD-binding antibodies and SARS-CoV-2 neutralizing antibodies in patients are correlated. Here, we report the expression and purification of properly folded RBD proteins from SARS and common-cold HCoVs in mammalian cells. RBD proteins were produced with cleavable tags for affinity purification from the cell culture medium and to support multiple immunoassay platforms and drug discovery efforts. Graphic abstract: High-Yield Production of Viral Spike RBDs for Diagnostics and Drug Discovery.
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The UK's National Health Service (NHS) COVID-19 contact tracing app was announced to the British public on 12th April 2020. The UK government endorsed the app as a public health intervention that would improve public health, protect the NHS and 'save lives'. On 5th May 2020 the technology was released for trial on the Isle of Wight. However, the trial was halted in June 2020, reportedly due to technological issues. The app was later remodelled and launched to the public in September 2020. The rapid development, trial and discontinuation of the app over a short period of a few months meant that the mobilisation and effect of the discourses associated with the app could be traced relatively easily. In this paper we aimed to explore how these discourses were constructed in the media, and their effect on actors - in particular, those who developed and those who trialled the app. Promissory discourses were prevalent, the trajectory of which aligned with theories developed in the sociology of expectations. We describe this trajectory, and then interpret its implications in terms of infectious disease public health practices and responsibilities.
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INTRODUCTION: We aimed to investigate the clinical features and mortality of critically ill patients treated with convalescent plasma for COVID-19 in the intensive care unit (ICU). MATERIAL AND METHODS: We retrospectively collected clinical and laboratory data of COVID-19 patients treated in the ICU. The patients were divided into two groups: those who received convalescent plasma and those who did not. We evaluated changes in the laboratory parameters and PaO2/FiO2 of the patients in the convalescent plasma group on days 0, 7, and 14. RESULTS: A total of 188 patients were included, 89 of whom received convalescent plasma. There were no significant differences in length of hospitalization [median: 17 vs. 16 days, P = 0.13] or 28-day mortality between the two groups (59% vs. 65%, P = 0.38). The ICU stay of patients who received convalescent plasma was longer (P = 0.001). The dynamics of the laboratory parameters of 44 patients in the convalescent plasma group, who were still in intensive care on the 14th day, were analysed. There was no differences in CRP or PaO2/FiO2 on day 0, 7 or 14 (P = 0.12; P = 0.10, respectively). CONCLUSIONS: Convalescent plasma treatment was not associated with shorter hospitalisation or lower mortality in patients diagnosed with COVID-19. However, the ICU stay was longer in patients who received convalescent plasma.
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COVID-19 , COVID-19/therapy , Humans , Immunization, Passive , Intensive Care Units , Length of Stay , Retrospective Studies , SARS-CoV-2 , COVID-19 SerotherapyABSTRACT
BACKGROUND: This study was conducted to systematically review the existing literature examining the prevalence of anxiety among hospital staff and identifying the contributing factors to address the complications of this disorder and develop effective programmes for reducing the complications of this mental health problem. METHODS: We searched the electronic databases including PubMed, EMBASE, Scopus, Web of Science and Google Scholar from January 2020 to February 2021. To perform meta-analysis, the random effects model was used. To assess the statistical heterogeneity of the included studies, the I2 index was used, and 95% CI was estimated. Data analysis was performed by R software. RESULTS: In the final analysis, 46 articles with the total sample size of 61 551 hospital staff members were included. Accordingly, anxiety prevalence among healthcare workers (HCWs) was 26.1% (95% CI 19% to 34.6%). The prevalence rates of anxiety in health technicians and medical students were 39% (95% CI 13% to 73%) and 36% (95% CI 15% to 65%), respectively, indicating a much higher prevalence than other hospital staff members. Furthermore, a positive significant relationship between prevalence of anxiety among HCWs and their age was approved (p<0.001). The prevalence rate of anxiety was higher among women 37.7% (95% CI 25.4% to 51.8%) than men 27.2% (95% CI 18.2% to 38.6%). CONCLUSION: The findings show a moderately high prevalence rate of anxiety in hospital staff. Due to the high prevalence of this mental health problem in health technicians, medical students and frontline health workers, it is highly suggested that healthcare institutions offer mental health programmes for these working groups in order to appropriately manage anxiety during the COVID-19 pandemic.
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COVID-19 patients have presented with a wide range of neurological disorders, among which stroke is the most devastating. We have reviewed current studies, case series, and case reports with a focus on COVID-19 patients complicated with stroke, and presented the current understanding of stroke in this patient population. As evidenced by increased D-dimer, fibrinogen, factor VIII and von Willebrand factor, SARS-CoV-2 infection induces coagulopathy, disrupts endothelial function, and promotes hypercoagulative state. Collectively, it predisposes patients to cerebrovascular events. Additionally, due to the unprecedented strain on the healthcare system, stroke care has been inevitably compromised. The underlying mechanism between COVID-19 and stroke warrants further study, so does the development of an effective therapeutic or preventive intervention.
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COVID-19-related burden has a significant impact on mental health and has led to an increase of depression, anxiety, and stress symptoms. Physical activity has been suggested to mitigate the negative effects of the pandemic and to foster mental health. The present study aimed to investigate, whether sense of control might mediate the supposed beneficial effects of physical activity on positive (PMH) and negative mental health (NMH) in unpredictable extraordinary situations. Data were assessed in a sample of 568 students (M age = 19.90, SD age = 4.52) from Germany via an online survey in fall 2020. Mediation analyses revealed that sense of control mediated the relation between physical activity and PMH as well as depression, anxiety, and stress symptoms, respectively. The findings indicate that physical activity may be a promising strategy for fostering sense of control and thus mental health. Due to its practical implications and practicability, engagement in physical activity could be an effective way to reduce the NMH consequences of the current COVID-19 situation, and therefore should be addressed in actions for long-term prevention and intervention.
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INTRODUCTION: The aim of this study was to examine whether telehealth is as safe and effective as traditional office visits in assessing and treating patients with symptoms consistent with COVID-19. METHODS: In this retrospective cross-sectional study, the primary outcome was any 14-day related healthcare follow-up event(s). Secondary outcomes were the type of 14-day related follow-up event including hospital admission, emergency department visit, office visit, telehealth visit and/or multiple follow-up visits. Individual visit types were identified due to the significant difference between a hospital admission and an office visit. Logistic regressions were done using the predictors of visit type, age, gender and comorbidities and the primary outcome variable of a related follow-up visit and then by follow-up type: hospital admission, emergency department visit or office visit. RESULTS: Of 1305 visits, median age was 42.3 years and 65.8% were female. Traditional office visits accounted for 741 (56.8%) of initial visits, while 564 (43.2%) visits occurred via telehealth. One hundred and forty-six (25.9%) of the telehealth visits resulted in a 14-day related healthcare follow-up visit versus 161 (21.7%) of the office visits (adjusted odds ratio (OR) 1.22, 95% CI 0.94-1.58). DISCUSSION: There was no significant difference in related follow-ups of initial telehealth visits compared to initial office visits including no significant difference in hospital admission or emergency department visits. These findings suggest that based on follow up healthcare utilization, telehealth may be a safe and effective option in assessing and treating patients with respiratory symptoms as the COVID-19 pandemic continues.
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INTRODUCTION: The multisystem COVID-19 can cause prolonged symptoms requiring rehabilitation. This study describes the creation of a remote COVID-19 rehabilitation assessment tool to allow timely triage, assessment and management. It hypotheses those with post-COVID-19 syndrome, potentially without laboratory confirmation and irrespective of initial disease severity, will have significant rehabilitation needs. METHODS: Cross-sectional study of consecutive patients referred by general practitioners (April-November 2020). Primary outcomes were presence/absence of anticipated sequelae. Binary logistic regression was used to test association between acute presentation and post-COVID-19 symptomatology. RESULTS: 155 patients (n=127 men, n=28 women, median age 39 years, median 13 weeks post-illness) were assessed using the tool. Acute symptoms were most commonly shortness of breath (SOB) (74.2%), fever (73.5%), fatigue (70.3%) and cough (64.5%); and post-acutely, SOB (76.7%), fatigue (70.3%), cough (57.4%) and anxiety/mood disturbance (39.4%). Individuals with a confirmed diagnosis of COVID-19 were 69% and 63% less likely to have anxiety/mood disturbance and pain, respectively, at 3 months. CONCLUSIONS: Rehabilitation assessment should be offered to all patients suffering post-COVID-19 symptoms, not only those with laboratory confirmation and considered independently from acute illness severity. This tool offers a structure for a remote assessment. Post-COVID-19 programmes should include SOB, fatigue and mood disturbance management.
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As the COVID-19 pandemic continues to affect communities worldwide, this novel disease is leaving many survivors with severe lung damage. Among older patients, advanced lung damage is more likely. Survivors of all ages who have extensive lung impacts are likely to be new to managing those issues. Supporting healthy aging for these patients will require both gathering data about their unique experiences and using the existing evidence basis about adapting to managing obstructive lung disease. This article outlines key priorities for research with COVID-19 survivors aging with permanent lung damage and highlights unique considerations for people older at age of onset. It also outlines the relevance of findings from this research for clinical care supporting people newly aging with advanced lung disease from COVID-19. In the process, it summarizes lessons from established patient populations aging with progressive lung disease-using cystic fibrosis as a prominent example from the author's lived experience-that may enhance the experiences of older COVID-19 survivors.