Parental access to hospitalised children during infectious disease pandemics such as COVID-19.

The COVID-19 pandemic has resulted in many hospitals severely limiting or denying parents access to their hospitalised children. This article provides guidance for hospital managers, healthcare staff, district-level managers and provincial managers on parental access to hospitalised children during a pandemic such as COVID-19. It: (i) summarises legal and ethical issues around parental visitation rights; (ii) highlights four guiding principles; (iii) provides 10 practical recommendations to facilitate safe parental access to hospitalised children; (iv) highlights additional considerations if the mother is COVID-19-positive; and (v) provides considerations for fathers. In summary, it is a child's right to have access to his or her parents during hospitalisation, and parents should have access to their hospitalised children; during an infectious disease pandemic such as COVID-19, there is a responsibility to ensure that parental visitation is implemented in a reasonable and safe manner. Separation should only occur in exceptional circumstances, e.g. if adequate in-hospital facilities do not exist to jointly accommodate the parent/caregiver and the newborn/infant/child. Both parents should be allowed access to hospitalised children, under strict infection prevention and control (IPC) measures and with implementation of non-pharmaceutical interventions (NPIs), including handwashing/sanitisation, face masks and physical distancing. Newborns/infants and their parents/caregivers have a reasonably high likelihood of having similar COVID-19 status, and should be managed as a dyad rather than as individuals. Every hospital should provide lodger/boarder facilities for mothers who are COVID-19-positive, COVID-19-negative or persons under investigation (PUI), separately, with stringent IPC measures and NPIs. If facilities are limited, breastfeeding mothers should be prioritised, in the following order: (i) COVID-19-negative; (ii) COVID-19 PUI; and (iii) COVID-19-positive. Breastfeeding, or breastmilk feeding, should be promoted, supported and protected, and skin-to-skin care of newborns with the mother/caregiver (with IPC measures) should be discussed and practised as far as possible. Surgical masks should be provided to all parents/caregivers and replaced daily throughout the hospital stay. Parents should be referred to social services and local community resources to ensure that multidisciplinary support is provided. Hospitals should develop individual-level policies and share these with staff and parents. Additionally, hospitals should ideally track the effect of parental visitation rights on hospital-based COVID-19 outbreaks, the mental health of hospitalised children, and their rate of recovery.

Identifying factors that influenced wellbeing and learning effectiveness during the sudden transition into eLearning due to the COVID-19 lockdown.

BACKGROUND: The sanitary emergency due to COVID-19 virus obliged people to face up several changes in their everyday life becauseWorld Health Organisation (WHO) guidelines and countries' Health Systems imposed lockdown of activities and social distancing to flatten the infection curve. One of these rapid changes involved students and professors that had to turn the traditional "in presence" classes into online courses facing several problems for educational delivery. OBJECTIVES: This work aimed to investigate the factors that affected both teaching/learning effectiveness and general human comfort and wellbeing after the sudden transition from classrooms to eLearning platforms due to COVID-19 in Italy. METHODS: A workshop, involving students and experts of Human Factors and Ergonomics, has been performed to identify aspects/factors that could influence online learning. Then, from workshop output and literature studies, a survey composed of two questionnaires (one for students and one for teachers) has been developed and spread out among Italian universities students and professors. RESULTS: 700 people answered the questionnaires. Data have been analysed and discussed to define the most important changes due to the new eLearning approach. Absence of interactions with colleagues and the necessity to use several devices were some of the aspects coming out from questionnaires. CONCLUSIONS: The study shows an overview of factors influencing both teaching/learning effectiveness and general human comfort and wellbeing. Results could be considered as a basis for future investigation and optimization about the dependencies and correlations among identified factors and the characteristics of the products/interaction/environment during eLearning courses.

Child health services during a COVID-19 outbreak in KwaZulu-Natal Province, South Africa.

BACKGROUND: Current evidence indicates that children are relatively spared from direct COVID-19-related morbidity and mortality, but that the indirect effects of the pandemic pose significant risks to their health and wellbeing. OBJECTIVES: To assess the impact of the local COVID-19 outbreak on routine child health services. METHODS: The District Health Information System data set for KwaZulu-Natal (KZN) provincial health services was accessed, and monthly child health-related data were extracted for the period January 2018 - June 2020. Chronological and geographical variations in sentinel indicators for service access, service delivery and the wellbeing of children were assessed. RESULTS: During April - June 2020, following the start of the COVID-19 outbreak in KZN, significant declines were seen for clinic attendance (36%; p=0.001) and hospital admissions (50%; p=0.005) of children aged <5 years, with a modest recovery in clinic attendance only. Among service delivery indicators, immunisation coverage recovered most rapidly, with vitamin A supplementation, deworming and food supplementation remaining low. Changes were less pronounced for in- and out-of-hospital births and uptake rates of infant polymerase chain reaction testing for HIV at birth, albeit with wide interdistrict variations, indicating inequalities in access to and provision of maternal and neonatal care. A temporary 47% increase in neonatal facility deaths was reported in May 2020 that could potentially be attributed to COVID-19-related disruption and diversion of health resources. CONCLUSIONS: Multiple indicators demonstrated disruption in service access, service delivery and child wellbeing. Further studies are needed to establish the intermediate- and long-term impact of the COVID-19 outbreak on child health, as well as strategies to mitigate these.

Factors Associated with Caregiver Preferences for Children's Return to School during the COVID-19 Pandemic.

BACKGROUND: Amid the COVID-19 pandemic, there is a need to understand caregiver preferences for their children's instructional format for the start of the 2020 to 2021 academic year. The purpose of the current study was to assess caregiver preferences for on-campus versus virtual learning at home during the fall and factors associated with these preferences. METHODS: Participants were caregivers of 4436 children and adolescents who were enrolled in pre-kindergarten through high school at a large, public school district in Texas. Caregivers were asked to complete an anonymous, online survey about their initial preferences for their student's back to the school learning environment. RESULTS: Caregivers of high- and middle-school students were more likely to endorse a preference for an on-campus/virtual hybrid instructional format and less likely to endorse a preference for a traditional, face-to-face instructional format compared to caregivers of elementary school students. Regardless of the school level, concerns about child health and safety were the factor most strongly associated with caregiver preferences for on-campus versus virtual learning at home during the fall. CONCLUSIONS: These data highlight the importance of school re-opening plans offering virtual options and addressing caregiver concerns about children's health and safety amid the COVID-19 pandemic.