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1.
Pediatr Endocrinol Diabetes Metab ; 26(4): 167-175, 2020.
Article in English | MEDLINE | ID: covidwho-1112834

ABSTRACT

INTRODUCTION: On March 11, 2020 the WHO announced a coronavirus disease 2019 (COVID-19) pandemic. Lockdown restrictions, compromised access to medical care and fear of potential exposure to SARS-CoV-2 have forced patients with non-COVID-19 illnesses such as type 1 diabetes (T1D) to stay home. This situation can lead to delay in T1D diagnosis and insulin treatment resulting in rapid progression to diabetic ketoacidosis (DKA) and therefore increased risk of complications and death.  . AIM: The aim of this study was to evaluate the frequency and severity of DKA at the onset of T1D in children diagnosed in our department during COVID-19 pandemic lockdown from March 2020 till May 2020 in comparison to corresponding period of the previous year. . MATERIAL AND METHODS: We collected data of children with newly diagnosed T1D. DKA was defined according to ISPAD guidelines. . RESULTS: The study cohort comprised 34 children in group 2020 and 52 in group 2019 with an average age 9.90 ±4.9 vs. 9.59±4.7 years with mean HbA1c 12.9 ±2.4 vs. 11.5 ±2.2%, respectively. The incidence of DKA was higher by 12% in group 2020 vs. 2019 (52.94% vs 40.38%; p = 0.276).  Regarding the DKA severity (2020 vs. 2019) 32.35% vs. 11.54% were severe (p = 0.026), 17.65 vs. 13% were moderate (p = 0.759), and 2.94 vs. 15.38% were mild (p = 0.081). None of the analyzed patients were COVID-19 positive. CONCLUSIONS: During the COVID-19 pandemic lockdown changes in society and health care system, the DKA rate has increased by 12 percentage points with more severe cases noted in children with newly diagnosed T1D. Regular education of the whole society about the symptoms of diabetes could contribute to faster diagnosis of T1D and reduction of DKA prevalence. .


Subject(s)
/psychology , Diabetes Mellitus, Type 1/complications , Diabetes Mellitus, Type 1/drug therapy , Diabetic Ketoacidosis/diagnosis , Diabetic Ketoacidosis/etiology , Health Services Accessibility/statistics & numerical data , Quarantine/statistics & numerical data , Adolescent , Child , Child, Preschool , Cohort Studies , Diabetes Mellitus, Type 1/epidemiology , Diabetic Ketoacidosis/epidemiology , Female , Humans , Incidence , Male , Pandemics/statistics & numerical data , Poland/epidemiology , Prevalence , Quarantine/trends , Risk Factors
2.
Int J Environ Res Public Health ; 18(4)2021 02 10.
Article in English | MEDLINE | ID: covidwho-1112722

ABSTRACT

This study describes self-reported physical activity (PA), motivation to exercise, physical and mental health and feelings towards PA during the March-May 2020 COVID-19 lockdown in New Zealand. Adults over the age of 18 years (n = 238; 80.2% female) completed the International Physical Activity Questionnaire (IPAQ), the Behavioural Regulation in Exercise Questionnaire 3, the Short Form-36 and open-ended questions about PA through an anonymous online survey. Regular exercise was undertaken by 85% of respondents prior to lockdown, but only 49.8% were able to maintain their usual level of PA. Although respondents were considered sufficiently physically active from the IPAQ, 51.5% reported not being able to maintain their usual level of PA primarily due to the closure of their gym facilities. Sixty percent of respondents reported that PA had a positive effect on their overall wellbeing. When asked to specify which aspects of wellbeing were affected, the effect on mental health was reported the most while the effect on body image or fitness was reported the least. Strategies to increase or maintain engagement in physical activity during lockdowns should be encouraged to promote positive mental health during the COVID-19 pandemic.


Subject(s)
/psychology , Exercise , Mental Health , Pandemics , Adolescent , Adult , Aged , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , New Zealand/epidemiology , Self Report , Young Adult
3.
Int J Environ Res Public Health ; 18(4)2021 02 10.
Article in English | MEDLINE | ID: covidwho-1112717

ABSTRACT

The COVID-19 emergency has imposed distanced education and has interrupted most rehabilitation services. Adolescents with disabilities have been isolated, and the burden on their families has been exacerbated. A cross-sectional survey was administered to adolescents with disability and to parents of disabled children to describe their experience during lockdown and their concerns or expectations about rehabilitation. A sample of 53 adolescents and 239 parents completed the survey. Adolescents were ages 13-18 years old (45.3% female). Most parents were between 35 and 55 years old (84.9% female). While 53.6% of the parents reported no positive effects of the lockdown, 92.5% of the adolescents expressed favorable consequences. The increased time spent with family members was judged positively by 27.2% of parents and by 64.2% of adolescents. Concern for their child's disability was expressed by 47.3% of parents, while 73.6% of adolescents expressed concerns regarding the ban on meeting friends. In both groups, anxiety symptoms were correlated with the fear of contracting COVID-19 and with financial problems. Parents would have liked even more remote support from school and healthcare professionals, which was available for most participants. Thus, socioeconomic support, assistive technology and telerehabilitation strategies might help families with disabilities during a lockdown.


Subject(s)
Communicable Disease Control , Disabled Children/rehabilitation , Adolescent , Adult , Cross-Sectional Studies , Family , Female , Humans , Interpersonal Relations , Italy , Male , Middle Aged , Pandemics , Social Behavior , Surveys and Questionnaires
4.
Int J Environ Res Public Health ; 18(4)2021 02 09.
Article in English | MEDLINE | ID: covidwho-1112716

ABSTRACT

Globally, the capacity of healthcare systems across continents has been strained and put to the test with the emergence of the Coronavirus disease 2019 (COVID-19) pandemic. The timely need to ensure the availability of healthcare facilities to isolate and manage the surge in COVID-19 cases without overwhelming existing hospital capacity has posed challenges in many countries. In this paper, we discuss the conceptualisation, preparations and operationalisation of a community healthcare facility that was set up within a short time frame to attend to the convalescent needs of a large number of COVID-19 patients in the early phase of handling the pandemic. In the first month of operations, we monitored a total of 2129 clinical encounters, with the majority of patients between 17-35 years of age and between day 2 to day 6 of illness upon admission. Overall, there was a good outcome for the patients, with only 2.3% requiring transfer back to restructured hospitals. There was also no mortality. We hope that the sharing of our experiences of the challenges and learning lessons gleaned may be useful to guide individuals in planning for the future preparedness of healthcare systems in managing pandemics.


Subject(s)
/therapy , Community Health Centers , Delivery of Health Care , Adolescent , Adult , Humans , Pandemics , Singapore , Young Adult
5.
Int J Environ Res Public Health ; 18(4)2021 02 09.
Article in English | MEDLINE | ID: covidwho-1112710

ABSTRACT

The aim of the study was to examine whether, and to what extent, fear of contracting Covid-19 and compliance with the mandatory rules of isolation affected Polish adults' nutritional behaviors. The online study was carried out during the first wave of the pandemic on a sample of 926 adults. Through cluster analysis, three groups of respondents were isolated: 1. People who fear a Covid-19 infection and follow the isolation rules (FFR), 2. People moderately afraid of the disease and following the rules loosely (MFFR), 3. People who are not afraid of the infection and do not follow the rules of isolation. (NFFR). The clusters were profiled with consideration of different aspects of eating behaviors as well as socio-demographic and economic features. The results of the study show a close relationship between the level of fear of contracting Covid-19 and the degree to which isolation rules are followed. These two factors were found to have a significant impact on eating behaviors, such as food purchases, eating patterns, and levels of consumption. It was stated that the FFR group changed their eating behaviors the most in terms of food purchasing, eating habits (excluding diversity and quality of diet), and food product consumption. The greatest stability in the majority of the analyzed areas of nutritional behaviors was observed in the MFFR cluster. The NFFR group shown the greatest decrease both in regularity and quality of their meals. This group also exhibited a significant increase in the consumption of alcoholic beverages. The results of the study can be useful in the decision making process when introducing restrictions or managing information. They also point to the need for extensive nutritional education focused on explaining the relationship between nutrition and health during a pandemic.


Subject(s)
/psychology , Consumer Behavior , Fear , Feeding Behavior , Adolescent , Adult , Aged , Communicable Disease Control , Female , Humans , Male , Middle Aged , Pandemics , Poland , Young Adult
8.
Span J Psychol ; 24: e8, 2021 Feb 08.
Article in English | MEDLINE | ID: covidwho-1101609

ABSTRACT

In the midst of the COVID-19 epidemic, Spain was one of the countries with the highest number of infections and a high mortality rate. The threat of the virus and consequences of the pandemic have a discernible impact on the mental health of citizens. This study aims to (a) evaluate the levels of anxiety, depression and well-being in a large Spanish sample during the confinement, (b) identify potential predictor variables associated to experiencing both clinical levels of distress and well-being in a sample of 2,122 Spanish people. By using descriptive analyses and logistic regression results revealed high rates of depression, anxiety and well-being. Specifically, our findings revealed that high levels of anxiety about COVID-19, increased substance use and loneliness as the strongest predictors of distress, while gross annual incomes and loneliness were strongest predictors of well-being. Finding of the present study provide a better insight about psychological adjustment to a pandemic and allows us to identify which population groups are at risk of experiencing higher levels of distress and which factors contribute to greater well-being, which could help in the treatments and prevention in similar stressful and traumatic situations.


Subject(s)
Adaptation, Psychological , Anxiety Disorders/psychology , Depressive Disorder/psychology , Mental Health , Psychological Distress , Substance-Related Disorders/psychology , Adolescent , Adult , Aged , Anxiety Disorders/diagnosis , Anxiety Disorders/epidemiology , Cross-Sectional Studies , Depressive Disorder/diagnosis , Depressive Disorder/epidemiology , Female , Health Surveys , Humans , Income , Internet , Loneliness/psychology , Male , Middle Aged , Pregnancy , Quality of Life/psychology , Risk Factors , Spain/epidemiology , Substance-Related Disorders/diagnosis , Substance-Related Disorders/epidemiology , Young Adult
11.
BMJ Open ; 11(2): e044384, 2021 02 18.
Article in English | MEDLINE | ID: covidwho-1090929

ABSTRACT

OBJECTIVE: The aim of this paper is to describe evolution, epidemiology and clinical outcomes of COVID-19 in subjects tested at or admitted to hospitals in North West London. DESIGN: Observational cohort study. SETTING: London North West Healthcare NHS Trust (LNWH). PARTICIPANTS: Patients tested and/or admitted for COVID-19 at LNWH during March and April 2020 MAIN OUTCOME MEASURES: Descriptive and analytical epidemiology of demographic and clinical outcomes (intensive care unit (ICU) admission, mechanical ventilation and mortality) of those who tested positive for COVID-19. RESULTS: The outbreak began in the first week of March 2020 and reached a peak by the end of March and first week of April. In the study period, 6183 tests were performed in on 4981 people. Of the 2086 laboratory confirmed COVID-19 cases, 1901 were admitted to hospital. Older age group, men and those of black or Asian minority ethnic (BAME) group were predominantly affected (p<0.05). These groups also had more severe infection resulting in ICU admission and need for mechanical ventilation (p<0.05). However, in a multivariate analysis, only increasing age was independently associated with increased risk of death (p<0.05). Mortality rate was 26.9% in hospitalised patients. CONCLUSION: The findings confirm that men, BAME and older population were most commonly and severely affected groups. Only older age was independently associated with mortality.


Subject(s)
/epidemiology , Hospitalization , Adolescent , Adult , Aged , Aged, 80 and over , /mortality , Child , Child, Preschool , Cohort Studies , Cross-Sectional Studies , Female , Humans , Infant , Infant, Newborn , Intensive Care Units , London/epidemiology , Male , Middle Aged , Respiration, Artificial , Risk Factors , Young Adult
12.
Malar J ; 20(1): 88, 2021 Feb 12.
Article in English | MEDLINE | ID: covidwho-1090664

ABSTRACT

BACKGROUND: Malaria remains a serious health threat in the Amazonas Region of Peru and approximately 95% of the cases, mainly Plasmodium vivax, are found in native communities of The Rio Santiago District, Condorcanqui Province. In 2019, more than one thousand malaria cases were reported, with an unusual number of Plasmodium falciparum autochthonous cases. The present study aims to report this P. falciparum outbreak while describing the epidemiology of malaria and the risk factors associated in the native communities of Amazonas, Peru. METHODS: The DIRESA-Amazonas in collaboration with the Condorcanqui Health Network and the Institute of Tropical Diseases of the UNTRM carried out a malaria Active Case Detection (ACD III) between January 31st and February 10th of 2020. A total of 2718 (47.4%) individuals from 21 native communities grouped in eight sanitary districts, were screened for malaria infections. Each participant was screened for malaria using microscopy. Follow-up surveys were conducted for all malaria positive individuals to collect socio-demographic data. Spatial clustering of infection risk was calculated using a generalized linear model (GLM). Analysis of risk considered factors such as gender, age, type of infection, symptomatology, and parasitaemia. RESULTS: The study suggests that the P. falciparum index case was imported from Loreto and later spread to other communities of Rio Santiago during 2019. The ACD III reported 220 (8.1%) malaria cases, 46 P. falciparum, 168 P. vivax and 6 mixed infections. SaTScan analysis detected a cluster of high infection risk in Middle Rio Santiago and a particular high P. falciparum infection risk cluster in Upper Rio Santiago. Interestingly, the evaluation of different risk factors showed significant associations between low parasitaemia and P. falciparum asymptomatic cases. CONCLUSION: This is the first report of a P. falciparum outbreak in native communities of Condorcanqui, Amazonas. Timely identification and treatment of symptomatic and asymptomatic cases are critical to achieve malaria control and possible elimination in this area. However, the current malaria situation in Condorcanqui is uncertain, given that malaria ACD activities have been postponed due to COVID-19.


Subject(s)
Disease Outbreaks , Malaria, Falciparum/epidemiology , Adolescent , Adult , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Peru/epidemiology , Rural Population , Young Adult
13.
JSLS ; 24(4)2020.
Article in English | MEDLINE | ID: covidwho-1090243

ABSTRACT

Objective: To evaluate the use of social media platforms by medical students, surgical trainees, and practicing surgeons for surgical education during the Covid-19 pandemic. Methods: An online, 15-question survey was developed and posted on Facebook and WhatsApp closed surgeon groups. Results: The online survey was completed by 219 participants from South America (87%), North America (7%), Europe (5%), Central America, and Asia. Respondents included medical students (6.4%), surgical residents/fellows (24.2%), and practicing surgeons (69.4%). The most common age group was 35-44 years. When asked which social media platforms they preferred, the video sharing site YouTube (33.3%), the messaging app WhatsApp (21%), and "other" (including videoconferencing sites) (22.3%) were most popular. Respondents reported using social media for surgical education either daily (38.4%) or weekly (45.2%), for an average of 1-5 hours/week. Most (85%) opined that surgical conferences that were cancelled during the pandemic should be made available online, with live discussions. Conclusion: Social media use for surgical education during Covid-19 appears to be increasing and evolving.


Subject(s)
Education, Distance/methods , Education, Medical/methods , General Surgery/education , Social Media/trends , Adolescent , Adult , Aged , Americas/epidemiology , Asia/epidemiology , /prevention & control , Cross-Sectional Studies , Education, Distance/statistics & numerical data , Education, Medical/trends , Europe/epidemiology , Female , General Surgery/trends , Global Health , Humans , Male , Middle Aged , Pandemics , Surveys and Questionnaires , Young Adult
14.
MMWR Morb Mortal Wkly Rep ; 70(7): 250-253, 2021 Feb 19.
Article in English | MEDLINE | ID: covidwho-1089244

ABSTRACT

Certain hazard controls, including physical barriers, cloth face masks, and other personal protective equipment (PPE), are recommended to reduce coronavirus 2019 (COVID-19) transmission in the workplace (1). Evaluation of occupational hazard control use for COVID-19 prevention can identify inadequately protected workers and opportunities to improve use. CDC's National Institute for Occupational Safety and Health used data from the June 2020 SummerStyles survey to characterize required and voluntary use of COVID-19-related occupational hazard controls among U.S. non-health care workers. A survey-weighted regression model was used to estimate the association between employer provision of hazard controls and voluntary use, and stratum-specific adjusted risk differences (aRDs) among workers reporting household incomes <250% and ≥250% of national poverty thresholds were estimated to assess effect modification by income. Approximately one half (45.6%; 95% confidence interval [CI] = 41.0%-50.3%) of non-health care workers reported use of hazard controls in the workplace, 55.5% (95% CI = 48.8%-62.2%) of whom reported employer requirements to use them. After adjustment for occupational group and proximity to others at work, voluntary use was approximately double, or 22.3 absolute percentage points higher, among workers who were provided hazard controls than among those who were not. This effect was more apparent among lower-income (aRD = 31.0%) than among higher-income workers (aRD = 16.3%). Employers can help protect workers from COVID-19 by requiring and encouraging use of occupational hazard controls and providing hazard controls to employees (1).


Subject(s)
/prevention & control , Mandatory Programs/statistics & numerical data , Occupational Diseases/prevention & control , Occupational Health/statistics & numerical data , Voluntary Programs/statistics & numerical data , Adolescent , Adult , Architectural Accessibility/statistics & numerical data , Female , Humans , Male , Masks/statistics & numerical data , Middle Aged , Personal Protective Equipment/statistics & numerical data , Surveys and Questionnaires , United States/epidemiology , Workplace/statistics & numerical data , Young Adult
15.
MMWR Morb Mortal Wkly Rep ; 70(7): 229-235, 2021 Feb 19.
Article in English | MEDLINE | ID: covidwho-1089241

ABSTRACT

During 2018, Black or African American (Black) persons accounted for 43% of all diagnoses of human immunodeficiency virus (HIV) infection in the United States (1). Among Black persons with diagnosed HIV infection in 41 states and the District of Columbia for whom complete laboratory reporting* was available, the percentages of Black persons linked to care within 1 month of diagnosis (77.1%) and with viral suppression within 6 months of diagnosis (62.9%) during 2018 were lower than the Ending the HIV Epidemic initiative objectives of 95% for linkage to care and viral suppression goals (2). Access to HIV-related care and treatment services varies by residence area (3-5). Identifying urban-rural differences in HIV care outcomes is crucial for addressing HIV-related disparities among Black persons with HIV infection. CDC used National HIV Surveillance System† (NHSS) data to describe HIV care outcomes among Black persons with diagnosed HIV infection during 2018 by population area of residence§ (area). During 2018, Black persons in rural areas received a higher percentage of late-stage diagnoses (25.2%) than did those in urban (21.9%) and metropolitan (19.0%) areas. Linkage to care within 1 month of diagnosis was similar across all areas, whereas viral suppression within 6 months of diagnosis was highest in metropolitan areas (63.8%). The Ending the HIV Epidemic initiative supports scalable, coordinated, and innovative efforts to increase HIV diagnosis, treatment, and prevention among populations disproportionately affected by or who are at higher risk for HIV infection (6), especially during syndemics (e.g. with coronavirus disease 2019).


Subject(s)
African Americans/statistics & numerical data , HIV Infections/ethnology , HIV Infections/therapy , Healthcare Disparities/ethnology , Rural Population/statistics & numerical data , Urban Population/statistics & numerical data , Adolescent , Adult , Cities , Female , Humans , Male , Middle Aged , Treatment Outcome , United States , Young Adult
17.
CMAJ Open ; 9(1): E107-E114, 2021.
Article in English | MEDLINE | ID: covidwho-1089183

ABSTRACT

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic is thought to have increased use of virtual care, but population-based studies are lacking. We aimed to assess the uptake of virtual care during the COVID-19 pandemic using comprehensive population-based data from Ontario. METHODS: This was a repeated cross-sectional study design. We used administrative data to evaluate changes in in-person and virtual visits among all residents of Ontario before (2012-2019) and during (January-August 2020) the COVID-19 pandemic. We included all patients who had an ambulatory care visit in Ontario. We excluded claims for patients who were not Ontario residents or had an invalid or missing health card number. We compared monthly or quarterly virtual care use across age groups, neighbourhood income quintiles and chronic disease subgroups. We also examined physician characteristics that may have been associated with virtual care use. RESULTS: Among all residents of Ontario (population 14.6 million), virtual care increased from 1.6% of total ambulatory visits in the second quarter of 2019 to 70.6% in the second quarter of 2020. The proportion of physicians who provided 1 or more virtual visits per year increased from 7.0% in the second quarter of 2019 to 85.9% in the second quarter of 2020. The proportion of Ontarians who had a virtual visit increased from 1.3% in 2019 to 29.2% in 2020. Older patients were the highest users of virtual care. The proportion of total virtual visits that were provided to patients residing in rural areas (v. urban areas) declined significantly between 2012 and 2020, reflecting a shift in virtual care to a service increasingly used in urban centres. The rates of virtual care use increased similarly across all conditions and across all income quintiles. INTERPRETATION: Our findings show that Ontario's approach to virtual care led to broad adoption across all provider groups, patient age, types of chronic diseases and neighborhood income. These findings have policy implications, including use of virtual care billing codes, for the ongoing use of virtual care during the second wave of the pandemic and beyond.


Subject(s)
Ambulatory Care/trends , Telemedicine/trends , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Cross-Sectional Studies , Female , Humans , Income , Male , Middle Aged , Ontario , Residence Characteristics , Rural Population , Urban Population , Young Adult
18.
Mil Med Res ; 8(1): 13, 2021 02 16.
Article in English | MEDLINE | ID: covidwho-1088620

ABSTRACT

BACKGROUND: Until January 18, 2021, coronavirus disease-2019 (COVID-19) has infected more than 93 million individuals and has caused a certain degree of panic. Viral pneumonia caused by common viruses such as respiratory syncytial virus, rhinovirus, human metapneumovirus, human bocavirus, and parainfluenza viruses have been more common in children. However, the incidence of COVID-19 in children was significantly lower than that in adults. The purpose of this study was to describe the clinical manifestations, treatment and outcomes of COVID-19 in children compared with those of other sources of viral pneumonia diagnosed during the COVID-19 outbreak. METHODS: Children with COVID-19 and viral pneumonia admitted to 20 hospitals were enrolled in this retrospective multi-center cohort study. A total of 64 children with COVID-19 were defined as the COVID-19 cohort, of which 40 children who developed pneumonia were defined as the COVID-19 pneumonia cohort. Another 284 children with pneumonia caused by other viruses were defined as the viral pneumonia cohort. The epidemiologic, clinical, and laboratory findings were compared by Kolmogorov-Smirnov test, t-test, Mann-Whitney U test and Contingency table method. Drug usage, immunotherapy, blood transfusion, and need for oxygen support were collected as the treatment indexes. Mortality, intensive care needs and symptomatic duration were collected as the outcome indicators. RESULTS: Compared with the viral pneumonia cohort, children in the COVID-19 cohort were mostly exposed to family members confirmed to have COVID-19 (53/64 vs. 23/284), were of older median age (6.3 vs. 3.2 years), and had a higher proportion of ground-glass opacity (GGO) on computed tomography (18/40 vs. 0/38, P < 0.001). Children in the COVID-19 pneumonia cohort had a lower proportion of severe cases (1/40 vs. 38/284, P = 0.048), and lower cases with high fever (3/40 vs. 167/284, P < 0.001), requiring intensive care (1/40 vs. 32/284, P < 0.047) and with shorter symptomatic duration (median 5 vs. 8 d, P < 0.001). The proportion of cases with evaluated inflammatory indicators, biochemical indicators related to organ or tissue damage, D-dimer and secondary bacterial infection were lower in the COVID-19 pneumonia cohort than those in the viral pneumonia cohort (P < 0.05). No statistical differences were found in the duration of positive PCR results from pharyngeal swabs in 25 children with COVID-19 who received antiviral drugs (lopinavir-ritonavir, ribavirin, and arbidol) as compared with duration in 39 children without antiviral therapy [median 10 vs. 9 d, P = 0.885]. CONCLUSION: The symptoms and severity of COVID-19 pneumonia in children were no more severe than those in children with other viral pneumonia. Lopinavir-ritonavir, ribavirin and arbidol do not shorten the duration of positive PCR results from pharyngeal swabs in children with COVID-19. During the COVID-19 outbreak, attention also must be given to children with infection by other pathogens infection.


Subject(s)
/epidemiology , Severe Acute Respiratory Syndrome/epidemiology , Adolescent , /therapy , Child , Child, Preschool , China/epidemiology , Female , Humans , Infant , Male , Pandemics , Retrospective Studies , Severe Acute Respiratory Syndrome/physiopathology , Severe Acute Respiratory Syndrome/therapy , Severity of Illness Index
20.
BMC Public Health ; 21(1): 367, 2021 02 17.
Article in English | MEDLINE | ID: covidwho-1088589

ABSTRACT

BACKGROUND: The use of face masks remains contentious, with international variation in practice. Their prevalence in the UK, is likely to increase due to new legislation. Clear information regarding the appropriate use of masks is needed, to ensure compliance with policies to reduce transmission of COVID-19. We aimed to assess the impact of visual representations of guidance, or infographics, upon the knowledge of appropriate face mask usage in a representative UK cohort. METHODS: Adult patients were recruited to this randomised internet-based questionnaire study during the 12-14 May 2020 from across the UK. Respondents viewed one of five public health stimuli regarding the use of face masks, or no stimulus. The groups accessed aids by the European Centre for Disease Control (EUCDC), World Health Organisation (WHO), Singaporean Ministry of Health (SMOH), text from the UK government (UK Gov), or an infographic designed by the Behavioural Insights Team (BIT). The primary outcome was to evaluate the effect of each infographic upon participants' recall of face mask technique, sentiments and willingness to wear a face covering. Secondary outcomes included the effect of symptomology and socio-demographic factors. RESULTS: 4099 respondents were randomised (1009 control, 628 EUCDC, 526 WHO, 639 SMOH, 661 UKGOV and 606 BIT). Stimuli from the WHO, SMOH and BIT demonstrated significantly higher average recall scores compared to the controls (7.40 v. 7.38 v. 7.34 v. 6.97, P < 0.001). BIT's stimulus led to the highest confidence about mask-wearing (87%). Only 48.2% of the cohort felt stimuli reduced anxiety about COVID-19. However, willingness to use a mask was high, (range 84 to 88%). CONCLUSIONS: To ensure the appropriate use of masks, as mandated by UK law, guidance must provide sufficient information, yet remain understandable. Infographics can aid the recall of correct mask techniques by highlighting salient steps and reducing cognitive burden. They have also demonstrated greater trustworthiness than text-only guidance. The effect of infographics upon COVID-19-related anxiety was poor, and they should be further developed to address this sentiment. A willingness to wear face masks has, however, been demonstrated.


Subject(s)
Audiovisual Aids , Health Education/methods , Health Knowledge, Attitudes, Practice , Masks/statistics & numerical data , Adolescent , Adult , Cohort Studies , Female , Humans , Internet , Male , Middle Aged , Surveys and Questionnaires , United Kingdom/epidemiology , Young Adult
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