COVID-19 and its impacts: The situation in Niger republic.

COVID-19 being a public health emergency of international concern has emerged in most African countries including Niger. Niger, a landlocked country, is tasked with controlling the pandemic. However, of the big challenges the country faced is the fragility of healthcare system which posed limitations to the fight against the virus. The virus overwhelmed the fragile healthcare system which led to inaccessibility of quality healthcare to the citizens coupled with issues of flooding and economic recession that happened during the pandemic. The healthcare sectored has further been crippled by exposure and infection of the already insufficient healthcare workers. In addition to this, there was the burden of NTDs and other communicable and non-communicable diseases that subverted the country in the depths of difficulties. As per the predictions of World Bank, the poverty curve is likely to escalate due to the outrageous impacts of COVID-19. Adding on to this, the occurrence of natural disasters such as flooding has further stretched the country. It's no coincidence that the country would confront plethora of challenges amidst the second wave. Therefore, timely decision and necessary interventions are needed to strengthen the country's fight against the pandemic. However, this is only feasible when Nigerien government, international allies and other wealthy nations work closely to ensure that the challenges faced by the healthcare system are tackled.

Sexual Behavior Change Among Gay and Bisexual Men During the First COVID-19 Pandemic Wave in the United States.

BACKGROUND: After decades of navigating HIV and other sexually transmitted infections, gay and bisexual men are responding to new and uncertain risks presented by the coronavirus (COVID-19) pandemic by adapting their sexual behavior. METHODS: This paper uses data from a national sample of 728 gay and bisexual men collected from April 10 to May 10, 2020, to examine changes to sexual behavior in response to the first wave of the pandemic in the USA. We also assess whether behavior modifications are associated with exposure to statewide public health measures, including Stay-at-Home orders. RESULTS: Sexual minority men report significant changes to their sexual behavior and partner selection during the first wave. Nine out of 10 men reported having either one sexual partner or no sexual partner in the last 30 days at the time of interview, a decrease compared to just before the pandemic for nearly half of men surveyed. Reporting no sexual partners in the last 30 days was significantly predicted by increased exposure to a Stay-at-Home order. Sexual minority men also reduced interactions with casual partners, increased no-contact sexual behaviors (e.g., masturbation and virtual sex), and engaged in new strategies to reduce their risks of infection from partners. HIV-positive men were particularly likely to adopt strategies including avoiding casual partners and avoiding public transportation to meet sexual partners. CONCLUSION: Sexual minority men's behavior changes during the first wave may have reduced the impact of the coronavirus pandemic on their communities. Despite substantial changes in sexual behavior for most men in our sample during the initial first wave, we identify some concerns around the sustainability of certain behavioral changes over time and nondisclosure of COVID-19 symptoms to partners.

Increase in Motor Vehicle Crash Severity: An Unforeseen Consequence of COVID-19.

INTRODUCTION: The 2019 coronavirus (COVID-19) pandemic led to stay-at-home (SAH) orders in Pennsylvania targeted at reducing viral transmission. Limitations in population mobility under SAH have been associated with decreased motor vehicle collisions (MVC) and related injuries, but the impact of these measures on severity of injury remains unknown. The goal of this study is to measure the incidence, severity, and outcomes of MVC-related injuries associated with SAH in Pennsylvania. MATERIALS & METHODS: We conducted a retrospective geospatial analysis of MVCs during the early COVID-19 pandemic using a state-wide trauma registry. We compared characteristics of patients with MVC-related injuries admitted to Pennsylvania trauma centers during SAH measures (March 21-July 31, 2020) with those from the corresponding periods in 2018 and 2019. We also compared incidence of MVCs for each zip code tabulation area (ZCTA) in Pennsylvania for the same time periods using geospatial mapping. RESULTS: Of 15,550 trauma patients treated during the SAH measures, 3486 (22.4%) resulted from MVCs. Compared to preceding years, MVC incidence decreased 10% under SAH measures with no change in mortality rate. However, in ZCTA where MVC incidence decreased, there was a 16% increase in MVC injury severity. CONCLUSIONS: Stay-at-home orders issued in response to the COVID-19 pandemic in Pennsylvania were associated with significant changes in MVC incidence and severity. Identifying such changes may inform resource allocation decisions during future pandemics or SAH events.

Work in health during the pandemic: Experiences of linking with the community related to the social production of care in Mar del Plata, Argentina / Trabajar en salud durante la pandemia: Experiencias de vinculación con la comunidad relativas a la producción social del cuidado en Mar del Plata, Argentina

Resumen En este artículo proponemos visibilizar las estrategias de vinculación comunitaria de trabajadores/as de salud pública relativas a la producción del cuidado en el contexto crítico de la pandemia de la covid-19, signado por la profundización de la pobreza, la restricción de los servicios de salud y las tensiones del sistema sanitario en Argentina. Con un diseño metodológico cualitativo y enfoque etnográfico, entrevistamos a trabajadoras/es de distintas disciplinas, ocupaciones y géneros que se desempeñan en centros de salud y hospitales públicos en Mar del Plata y zonas rurales circundantes, entre los meses de marzo y diciembre de 2021. A partir de sus narrativas, analizamos las dimensiones de acceso a la alimentación, medicación y terapias holísticas, las dificultades encontradas y su contribución a la producción social del cuidado en salud. Concluimos que las estrategias generadas conllevan el potencial instituyente para la reorientación de los servicios públicos de salud de acuerdo con los desafíos del derecho a la salud desde la perspectiva de género y derechos en el tránsito a la postpandemia.

Abstract In this article we propose to make visible the strategies of community engagement of public health workers related to the production of care in the critical context of the covid-19 pandemic, marked by the deepening of poverty, the restriction of health services and the tensions of the health system in Argentina. With a qualitative methodological design and ethnographic approach, we interviewed workers from different disciplines, occupations and genders, who work in health centers and public hospitals in Mar del Plata and surrounding rural areas, between the months of March and December 2021. Based on their narratives, we analyze the dimensions of access to food, medication and holistic therapies, the difficulties encountered and their contribution to the social production of health care. We conclude that the strategies generated carry the instituting potential for the reorientation of public health services in accordance with the challenges of the right to health from the perspective of gender and rights in the transition to the post-pandemic.

Barriers to the Engagement of Complementary and Integrative Health Providers in Public Health Responses to COVID-19: Recommendations From a Multidisciplinary Expert Panel.

OBJECTIVE: The purpose of this project was to explore barriers to the involvement of complementary and integrative health (CIH) providers in the public health response to COVID-19 and potential solutions for future involvement in public health crises. METHODS: An expert panel of 10 people, which included doctors of chiropractic, naturopathic doctors, public health practitioners, and researchers from the United States, was convened for a day-long online panel discussion. Facilitators asked panelists how CIH practitioners could contribute and be mobilized. We summarized themes and recommendations from the discussion. RESULTS: Despite their skills and resources, few CIH providers participated in public health efforts like testing and contact tracing during the COVID-19 pandemic. Panelists described that CIH professionals may not have participated in those efforts due to the CIH providers possibly not having sufficient public health training and limited contact with public health professionals, as well as policy and financial challenges during the pandemic. Panelists proposed solutions to these barriers, including more public health training, stronger formal relationships between CIH and public health organizations, and improved financial support for both CIH care and public health efforts. CONCLUSION: Through an expert panel discussion, we identified barriers that hindered the involvement of CIH providers in the public health response to the COVID-19 pandemic. During future pandemics in the United States, public health planners should recognize CIH providers as part of the existing labor resource, with clinical expertise and community-level connections that can be called upon in a crisis. During future events, CIH professional leaders should be more proactive in seeking out a supportive role and sharing their knowledge, skills, and expertise.

SARS-CoV-2 cross-sectional seroprevalence study among public school staff in Metro Vancouver after the first Omicron wave in British Columbia, Canada.

OBJECTIVE: To determine the SARS-CoV-2 seroprevalence among school workers within the Greater Vancouver area, British Columbia, Canada, after the first Omicron wave. DESIGN: Cross-sectional study by online questionnaire, with blood serology testing. SETTING: Three main school districts (Vancouver, Richmond and Delta) in the Vancouver metropolitan area. PARTICIPANTS: Active school staff enrolled from January to April 2022, with serology testing between 27 January and 8 April 2022. Seroprevalence estimates were compared with data obtained from Canadian blood donors weighted over the same sampling period, age, sex and postal code distribution. PRIMARY AND SECONDARY OUTCOMES: SARS-CoV-2 nucleocapsid antibody testing results adjusted for test sensitivity and specificity, and regional variation across school districts using Bayesian models. RESULTS: Of 1850 school staff enrolled, 65.8% (1214/1845) reported close contact with a COVID-19 case outside the household. Of those close contacts, 51.5% (625/1214) were a student and 54.9% (666/1214) were a coworker. Cumulative incidence of COVID-19 positive testing by self-reported nucleic acid or rapid antigen testing since the beginning of the pandemic was 15.8% (291/1845). In a representative sample of 1620 school staff who completed serology testing (87.6%), the adjusted seroprevalence was 26.5% (95% CrI 23.9% to 29.3%), compared with 32.4% (95% CrI 30.6% to 34.5%) among 7164 blood donors. CONCLUSION: Despite frequent COVID-19 exposures reported, SARS-CoV-2 seroprevalence among school staff in this setting remained no greater than the community reference group. Results are consistent with the premise that many infections were acquired outside the school setting, even with Omicron.

A case study of using natural language processing to extract consumer insights from tweets in American cities for public health crises.

BACKGROUND: The COVID-19 pandemic was a "wake up" call for public health agencies. Often, these agencies are ill-prepared to communicate with target audiences clearly and effectively for community-level activations and safety operations. The obstacle is a lack of data-driven approaches to obtaining insights from local community stakeholders. Thus, this study suggests a focus on listening at local levels given the abundance of geo-marked data and presents a methodological solution to extracting consumer insights from unstructured text data for health communication. METHODS: This study demonstrates how to combine human and Natural Language Processing (NLP) machine analyses to reliably extract meaningful consumer insights from tweets about COVID and the vaccine. This case study employed Latent Dirichlet Allocation (LDA) topic modeling, Bidirectional Encoder Representations from Transformers (BERT) emotion analysis, and human textual analysis and examined 180,128 tweets scraped by Twitter Application Programming Interface's (API) keyword function from January 2020 to June 2021. The samples came from four medium-sized American cities with larger populations of people of color. RESULTS: The NLP method discovered four topic trends: "COVID Vaccines," "Politics," "Mitigation Measures," and "Community/Local Issues," and emotion changes over time. The human textual analysis profiled the discussions in the selected four markets to add some depth to our understanding of the uniqueness of the different challenges experienced. CONCLUSIONS: This study ultimately demonstrates that our method used here could efficiently reduce a large amount of community feedback (e.g., tweets, social media data) by NLP and ensure contextualization and richness with human interpretation. Recommendations on communicating vaccination are offered based on the findings: (1) the strategic objective should be empowering the public; (2) the message should have local relevance; and, (3) communication needs to be timely.

Post-acute sequelae of COVID-19 in older persons: multi-organ complications and mortality.

INTRODUCTION: Evidence on long-term associations between COVID-19 and risks of multi-organ complications and mortality in older population is limited. This study evaluates these associations. RESEARCH DESIGN AND METHODS: The cohorts included patients aged ≥60 year diagnosed with COVID-19 infection (cases), between 16 March 2020 and 31 May 2021 from the UK Biobank (UKB cohort, n = 11 330); and between 01 April 2020 and 31 May 2022 from the electronic health records in Hong Kong (HK cohort, n = 213 618). Each patient was randomly matched with up to 10 individuals without COVID-19 infection based on age and sex (UKB, n = 325 812; HK, n = 1 411 206) and were followed for up to 18 months until 31 August 2021 for UKB, and up to 28 months until 15 August 2022 for HK cohort. Caracteristics between cohorts were further adjusted with propensity score-based marginal mean weighting through stratification. For evaluating long-term association of COVID-19 with multi-organ disease complications and mortality after 21-days of diagnosis, Cox regression was employed. RESULT: Older adults with COVID-19 were associated with a significantly higher risk of cardiovascular outcomes [major cardiovascular disease (stroke, heart failure and coronary heart disease): hazard ratio (UKB): 1.4 (95% Confidence interval: 1.2,1.7), HK:1.2 (95% CI: 1.1,1.3)]; myocardial infarction: HR (UKB): 1.8 (95% CI: 1.4,2.5), HK:1.2 (95% CI: 1.1,1.5)]; respiratory outcomes [interstitial lung disease: HR (UKB: 3.5 (95% CI: 2.6,4.7), HK:6.6 (95% CI: 2.1,21.2); chronic pulmonary disease: HR (UKB): 1.6 (95% CI: 1.2,2.1), HK:1.7 (95% CI: 1.4,2.1)]; neuropsychiatric outcomes [seizure: HR (UKB): 2.7 (95% CI: 1.7,4.2), HK:1.8 (95% CI: 1.4,2.3)]; and renal outcomes [acute kidney disease: HR (UKB): 1.4 (95% CI: 1.1,1.6), HK:1.7 (95% CI: 1.4,2.1)]; and all-cause mortality [HR (UKB): 4.8 (95% CI: 4.4,5.4), HK:2.7 (95% CI: 2.6,2.8)]. CONCLUSION: COVID-19 is associated with long-term risks of multi-organ complications in older adults (aged ≥60). Infected patients in this age-group may benefit from appropriate monitoring of signs/symptoms for developing these complications.

Impact of fatigue as the primary determinant of functional limitations among patients with post-COVID-19 syndrome: a cross-sectional observational study.

OBJECTIVES: To describe self-reported characteristics and symptoms of treatment-seeking patients with post-COVID-19 syndrome (PCS). To assess the impact of symptoms on health-related quality of life (HRQoL) and patients' ability to work and undertake activities of daily living. DESIGN: Cross-sectional single-arm service evaluation of real-time user data. SETTING: 31 post-COVID-19 clinics in the UK. PARTICIPANTS: 3754 adults diagnosed with PCS in primary or secondary care deemed suitable for rehabilitation. INTERVENTION: Patients using the Living With Covid Recovery digital health intervention registered between 30 November 2020 and 23 March 2022. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was the baseline Work and Social Adjustment Scale (WSAS). WSAS measures the functional limitations of the patient; scores of ≥20 indicate moderately severe limitations. Other symptoms explored included fatigue (Functional Assessment of Chronic Illness Therapy-Fatigue), depression (Patient Health Questionnaire-Eight Item Depression Scale), anxiety (Generalised Anxiety Disorder Scale, Seven-Item), breathlessness (Medical Research Council Dyspnoea Scale and Dyspnoea-12), cognitive impairment (Perceived Deficits Questionnaire, Five-Item Version) and HRQoL (EQ-5D). Symptoms and demographic characteristics associated with more severe functional limitations were identified using logistic regression analysis. RESULTS: 3541 (94%) patients were of working age (18-65); mean age (SD) 48 (12) years; 1282 (71%) were female and 89% were white. 51% reported losing ≥1 days from work in the previous 4 weeks; 20% reported being unable to work at all. Mean WSAS score at baseline was 21 (SD 10) with 53% scoring ≥20. Factors associated with WSAS scores of ≥20 were high levels of fatigue, depression and cognitive impairment. Fatigue was found to be the main symptom contributing to a high WSAS score. CONCLUSION: A high proportion of this PCS treatment-seeking population was of working age with over half reporting moderately severe or worse functional limitation. There were substantial impacts on ability to work and activities of daily living in people with PCS. Clinical care and rehabilitation should address the management of fatigue as the dominant symptom explaining variation in functionality.

How behavioral economics can inform the next mass vaccination campaign: A narrative review.

Designing the next mass vaccination campaign will require ideas and techniques from behavioral economics. History and current events have shown how failing to consider features of human behavior, from individual biases in information processing to the relationships between people and policymakers, frustrated public health efforts. Behavioral economics can inform how a vaccination campaign needs to deliver processes and information necessary to help people decide to vaccinate, especially when mandates to vaccinate are not possible. Such campaigns need to employ both "nudges" (i.e., promote action) and remove "sludge" (i.e., break down blockers) to influence decisions directly. Strategies must be both acute and systemic to the current approach to public health.

Unintended consequences of communicating rapid COVID-19 vaccine policy changes- a qualitative study of health policy communication in Ontario, Canada.

BACKGROUND: The success of the COVID-19 vaccination roll-out depended on clear policy communication and guidance to promote and facilitate vaccine uptake. The rapidly evolving pandemic circumstances led to many vaccine policy amendments. The impact of changing policy on effective vaccine communication and its influence in terms of societal response to vaccine promotion are underexplored; this qualitative research addresses that gap within the extant literature. METHODS: Policy communicators and community leaders from urban and rural Ontario participated in semi-structured interviews (N = 29) to explore their experiences of COVID-19 vaccine policy communication. Thematic analysis was used to produce representative themes. RESULTS: Analysis showed rapidly changing policy was a barrier to smooth communication and COVID-19 vaccine roll-out. Continual amendments had unintended consequences, stimulating confusion, disrupting community outreach efforts and interrupting vaccine implementation. Policy changes were most disruptive to logistical planning and community engagement work, including community outreach, communicating eligibility criteria, and providing translated vaccine information to diverse communities. CONCLUSIONS: Vaccine policy changes that allow for prioritized access can have the unintended consequence of limiting communities' access to information that supports decision making. Rapidly evolving circumstances require a balance between adjusting policy and maintaining simple, consistent public health messages that can readily be translated into action. Information access is a factor in health inequality that needs addressing alongside access to vaccines.

The Causal Role of Lockdowns in COVID-19: Conclusions From Daily Epidemiological, Psychological, and Sociological Data.

Much has been written about the COVID-19 pandemic's epidemiological, psychological, and sociological consequences. Yet, the question about the role of the lockdown policy from psychological and sociological points of view has not been sufficiently addressed. Using epidemiological, psychological, and sociological daily data, we examined the causal role of lockdown and variation in morbidity referring to emotional and behavioral aspects. Dynamics of support requests to the Sahar organization concerning loneliness, depression, anxiety, family difficulties, and sexual trauma were investigated alongside processes of emergency and domestic violence reports to the Ministry of Welfare and Social Affairs. By exploring the signals and predictive modeling for a situation with no lockdown implementation, the lockdown was found as a critical factor in distress rising among the general population, which could affect long after the improvement in pandemic case counts. Applications and implications are discussed in the context of decision-making in dealing with crises as well as the need to allocate resources for adaptive coping.

Novel emm4 lineage associated with an upsurge in invasive group A streptococcal disease in the Netherlands, 2022.

Invasive group A streptococcal (iGAS) disease cases increased in the first half of 2022 in the Netherlands, with a remarkably high proportion of emm4 isolates. Whole-genome sequence analysis of 66 emm4 isolates, 40 isolates from the pre-coronavirus disease 2019 (COVID-19) pandemic period 2009-2019 and 26 contemporary isolates from 2022, identified a novel Streptococcus pyogenes lineage (M4NL22), which accounted for 85 % of emm4 iGAS cases in 2022. Surprisingly, we detected few isolates of the emm4 hypervirulent clone, which has replaced nearly all other emm4 in the USA and the UK. M4NL22 displayed genetic differences compared to other emm4 strains, although these were of unclear biological significance. In publicly available data, we identified a single Norwegian isolate belonging to M4NL22, which was sampled after the isolates from this study, possibly suggesting export of M4NL22 to Norway. In conclusion, our study identified a novel S. pyogenes emm4 lineage underlying an increase of iGAS disease in early 2022 in the Netherlands and the results have been promptly communicated to public health officials.

Positive Correlation Between Heavy Alcoholic Drinking and SARS-Cov-2 Non-Infection Rate.

Introduction During the SARS-CoV-2 pandemic, rumors claimed that alcohol drinking could someway be useful in contrasting the contagion and even the disease. It appears opportune to bring some robust data to determine whether heavy alcohol drinkers and non-drinkers experienced different infection rates. Methods A cross-sectional study through a simple survey based on the social media software Weixin and the mini survey program Wenjuanxing was carried out in China after the zero-Covid policy ended, namely from 15:00 January 1, 2023, to 12:35 January 3, 2023. The evaluation was conducted among subjects belonging to the first author's Weixin community, mostly residents in the higher populated China area. Study participants received a questionary and were asked about their virus infection status, and were classified into two groups: (a) infected, meaning he/she has been infected at least once (whether recovered or not); (b) remain uninfected, meaning the virus has not infected him/her. A total of 211 subjects adhered to the survey. Alcoholic drinking behavior about liquors with no less than 40% alcohol content in volume was retrieved from the participants. In China, such beverages are almost uniquely referred to as the Chinese Spirits or BaiJiu. The frequency of drinking quantified the drinking behavior, and it is classified into three groups: never drink or drink occasionally (group A); drink one or two times per week (group B); drink three times per week or more often (group C). The hypothesis of an existing relationship between infection status and drinking behavior was advanced before data collection. The numbers of the uninfected people in each of the three drinking groups were counted, and the rates of not-infection were calculated. The rates are compared with each other to conclude whether significant differences exist, considering the size of the samples. The conclusion is drawn from standard hypothesis testing. Results The male/female ratio was 108/103 (51.2% and 48.8%), the mean age was 38.8 years (range 21-68), and the median age of 37.4 years. The total 211 participants fell into three groups with different drinking frequencies, with counts (percentages in total 211 participants) 139 (65.9%) in group A, 28 (13.3%) in group B, and 44 (20.8%) in group C. The number (percentage within the group) of uninfected members in groups A, B, and C are 29 (20.9%), 7 (25.0%), and 17 (38.6%), respectively. The statistical analysis through the Cochran-Armitage trend test gave a significative result: p=0.0209. Conclusions Within the methodology's limitations, this study shows the significant relationship between alcohol drinking habits and the chances of avoiding SARS-CoV-2 infection. A possible hypothesis explaining these findings is advanced. However, the authors warn about misleading conclusions and advocate research that could properly guide ethanol use in the present and other possible pandemics. Limitations This study is based on self-reported data from a specific community in China. There could be recall bias and social desirability bias, and the generalizability of the findings to other populations could be limited. Other factors that could influence infection rates, such as age, occupation, and health status, are not controlled in the present study. There could be other explanations for the observed relationship between alcohol drinking habits and infection rates.

Thematic analysis of national online narratives on regular asymptomatic testing for Covid-19 in schools in England.

OBJECTIVE: To understand the public perceptions of the schools Covid-19 testing programme in England. DESIGN: Qualitative social media analysis. SETTING: Online users of parenting forums (Mumsnet and Netmums), Facebook newspaper pages and Daily Mail online readers, who responded to posts or articles about the schools testing programme in England, between 1 and 31 March, 2021. RESULTS: Overall, seven main themes were identified, these were divided into barriers and facilitators to engaging in testing for Covid-19. Barriers were: uncertainty around testing in the absence of symptoms; concerns about testing; implications about testing positive; mistrust in the Government. Facilitators were: desire to protect others; desire to return to normality; and hearing others' positive experiences. CONCLUSIONS: Our analysis highlighted that alongside well-established barriers to engaging in asymptomatic testing, parents were having to negotiate additional complex decisions around balancing their child's anxiety over testing alongside acknowledgement of the implications of regular testing, such as return to normality and protecting others. Parents and children would benefit from additional practical and social support to facilitate engagement with the schools testing programme.