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2.
JAMA Netw Open ; 5(1): e2142210, 2022 01 04.
Article in English | MEDLINE | ID: covidwho-1611175

ABSTRACT

Importance: A surge of COVID-19 occurred from March to June 2021, in New Delhi, India, linked to the B.1.617.2 (Delta) variant of SARS-CoV-2. COVID-19 vaccines were rolled out for health care workers (HCWs) starting in January 2021. Objective: To assess the incidence density of reinfection among a cohort of HCWs and estimate the effectiveness of the inactivated whole virion vaccine BBV152 against reinfection. Design, Setting, and Participants: This was a retrospective cohort study among HCWs working at a tertiary care center in New Delhi, India. Exposures: Vaccination with 0, 1, or 2 doses of BBV152. Main Outcomes and Measures: The HCWs were categorized as fully vaccinated (with 2 doses and ≥15 days after the second dose), partially vaccinated (with 1 dose or 2 doses with <15 days after the second dose), or unvaccinated. The incidence density of COVID-19 reinfection per 100 person-years was computed, and events from March 3, 2020, to June 18, 2021, were included for analysis. Unadjusted and adjusted hazard ratios (HRs) were estimated using a Cox proportional hazards model. Estimated vaccine effectiveness (1 - adjusted HR) was reported. Results: Among 15 244 HCWs who participated in the study, 4978 (32.7%) were diagnosed with COVID-19. The mean (SD) age was 36.6 (10.3) years, and 55.0% were male. The reinfection incidence density was 7.26 (95% CI: 6.09-8.66) per 100 person-years (124 HCWs [2.5%], total person follow-up period of 1696 person-years as time at risk). Fully vaccinated HCWs had lower risk of reinfection (HR, 0.14 [95% CI, 0.08-0.23]), symptomatic reinfection (HR, 0.13 [95% CI, 0.07-0.24]), and asymptomatic reinfection (HR, 0.16 [95% CI, 0.05-0.53]) compared with unvaccinated HCWs. Accordingly, among the 3 vaccine categories, reinfection was observed in 60 of 472 (12.7%) of unvaccinated (incidence density, 18.05 per 100 person-years; 95% CI, 14.02-23.25), 39 of 356 (11.0%) of partially vaccinated (incidence density 15.62 per 100 person-years; 95% CI, 11.42-21.38), and 17 of 1089 (1.6%) fully vaccinated (incidence density 2.18 per 100 person-years; 95% CI, 1.35-3.51) HCWs. The estimated effectiveness of BBV152 against reinfection was 86% (95% CI, 77%-92%); symptomatic reinfection, 87% (95% CI, 76%-93%); and asymptomatic reinfection, 84% (95% CI, 47%-95%) among fully vaccinated HCWs. Partial vaccination was not associated with reduced risk of reinfection. Conclusions and Relevance: These findings suggest that BBV152 was associated with protection against both symptomatic and asymptomatic reinfection in HCWs after a complete vaccination schedule, when the predominant circulating variant was B.1.617.2.


Subject(s)
COVID-19/epidemiology , Health Personnel , Reinfection , SARS-CoV-2 , Adult , COVID-19/etiology , COVID-19/prevention & control , COVID-19 Vaccines/administration & dosage , Cohort Studies , Female , Humans , Immunogenicity, Vaccine , India/epidemiology , Male , Middle Aged , Surveys and Questionnaires , Tertiary Care Centers , Vaccines, Inactivated/administration & dosage , Virion/immunology , Young Adult
4.
Indian J Public Health ; 65(4): 384-386, 2021.
Article in English | MEDLINE | ID: covidwho-1607696

ABSTRACT

A nationwide lockdown was imposed from March 25, 2020, to curb the spread of the COVID-19 pandemic. The study aimed to analyze the trend, pattern of animal bite cases and to quantify the reduction in the incidence of animal bite cases due to diminution of exposure time with animals as a result of lockdown. The interrupted time series method was used to evaluate the effect of lockdown on the incidence of animal bite cases. Right after the lockdown, the mean number of reported animal bite cases decreased significantly (P = 0.04) by 8.3%. Furthermore, the month-to-month change of cases for the postlockdown period was in decreasing trend (ß3 = 0.872) and was significant (P < 0.05). Reduction in the exposure time with street animal surely reduce the incidence in animal bite cases and hence, the Government should take appropriate actions to control the intermixing of street dogs with marginal populations at the village and urban slums level.


Subject(s)
Bites and Stings , COVID-19 , Animals , Bites and Stings/epidemiology , Communicable Disease Control , Dogs , Humans , India/epidemiology , Pandemics , SARS-CoV-2 , Tertiary Care Centers
5.
Indian J Public Health ; 65(4): 410-413, 2021.
Article in English | MEDLINE | ID: covidwho-1607361

ABSTRACT

Generation Z has seen drastic changes in the medical sector with the health-care industry constantly updating itself with newer tools to provide quality treatment. The COVID-19 pandemic has greatly tested the services in every aspect of life and has led to an unprecedented increase in the online storage of patient data. Electronic health records (EHRs) are real-time records that make health information of any patient available securely to authorized users. EHRs in the Indian scenario are still in their budding stages, described as "islands of excellence in an ocean of inadequacy." The central institutes and corporate hospitals have implemented it, but the state medical colleges and peripheral health centers have miles to go. These patient data records become an essential tool in physician's decision-making, expertise, and management. One can review the data which is just a click away even after the patients have been discharged, especially in the follow-up period. The current scenario is such that health-care workers and nonhealth-care workers alike share the data of the patients in respect to their records, radiographs, and laboratory data using social media such as WhatsApp, Facebook, and Telegram. In the absence of adequate regulations, the reliability of the EHRs is questionable and doubt creates a preference for the traditional medical services among the health-care workers. To conclude, a clear and precise guideline that can enlighten the patient and health-care workers is the need of the hour. The concerns of online storage of data need to be alleviated and privacy regulations need to be addressed.


Subject(s)
COVID-19 , Humans , India/epidemiology , Pandemics , Reproducibility of Results , SARS-CoV-2
6.
PLoS One ; 16(12): e0261529, 2021.
Article in English | MEDLINE | ID: covidwho-1599654

ABSTRACT

BACKGROUND: Risk factors for the development of severe COVID-19 disease and death have been widely reported across several studies. Knowledge about the determinants of severe disease and mortality in the Indian context can guide early clinical management. METHODS: We conducted a hospital-based case control study across nine sites in India to identify the determinants of severe and critical COVID-19 disease. FINDINGS: We identified age above 60 years, duration before admission >5 days, chronic kidney disease, leucocytosis, prothrombin time > 14 sec, serum ferritin >250 ng/mL, d-dimer >0.5 ng/mL, pro-calcitonin >0.15 µg/L, fibrin degradation products >5 µg/mL, C-reactive protein >5 mg/L, lactate dehydrogenase >150 U/L, interleukin-6 >25 pg/mL, NLR ≥3, and deranged liver function, renal function and serum electrolytes as significant factors associated with severe COVID-19 disease. INTERPRETATION: We have identified a set of parameters that can help in characterising severe COVID-19 cases in India. These parameters are part of routinely available investigations within Indian hospital settings, both public and private. Study findings have the potential to inform clinical management protocols and identify patients at high risk of severe outcomes at an early stage.


Subject(s)
COVID-19/blood , COVID-19/epidemiology , Hospitalization , SARS-CoV-2 , Severity of Illness Index , Adolescent , Adult , Age Factors , C-Reactive Protein/analysis , Case-Control Studies , Female , Fibrin Fibrinogen Degradation Products/analysis , Hospitals , Humans , India/epidemiology , Interleukin-6/blood , L-Lactate Dehydrogenase/blood , Male , Middle Aged , Procalcitonin/blood , Risk Factors , Young Adult
7.
Prim Care Companion CNS Disord ; 24(1)2021 Dec 30.
Article in English | MEDLINE | ID: covidwho-1598165

ABSTRACT

Objective: To explore the impact of lockdown due to coronavirus disease 2019 (COVID-19) on the subjective well-being of migrant workers staying in a shelter home in India.Methods: A total of 54 residents of the shelter home participated in this exploratory survey study. Baseline assessments included sociodemographic profile, the Subjective Well-Being Inventory (SUBI), and the Perceived Stress Scale. The participants were reassessed with the SUBI after 2 weeks of staying in the shelter home. The survey was administered April 11 to May 10, 2020.Results: The mean ± SD age of the participants was 23.54 ± 11.68 years, and the majority were men and in the age group 21-30 years (45%). At baseline assessments, the mean ± SD stress level score was 17.39±4.62. The mean ± SD SUBI score was 81.44 ± 4.62 at baseline and increased to 100.65±5.95 after 2 weeks of staying in the shelter home.Conclusions: The survey findings demonstrate that the levels of subjective well-being among participants improved after their physical and mental health needs were met during their stay in the shelter home. The findings could help policy planners and senior public health administrators minimize gaps to better understand the multiple issues related to the subjective well-being of this population.


Subject(s)
COVID-19 , Transients and Migrants , Adolescent , Adult , Child , Communicable Disease Control , Cross-Sectional Studies , Female , Humans , India/epidemiology , Male , SARS-CoV-2 , Young Adult
9.
PLoS One ; 16(12): e0261700, 2021.
Article in English | MEDLINE | ID: covidwho-1597256

ABSTRACT

Dietary adequacy and diversity during the lactation period are necessary to ensure good health and nutrition among women and children. Behavioral interventions pertaining to health and nutrition counselling during pregnancy and lactation are critical for awareness about dietary diversity. The issue assumes salience for marginalized communities because of the Covid-19 pandemic and associated economic and societal disruptions. This paper assesses the dietary patterns among 400 lactating mothers in the tribal-dominated district of Palghar in Maharashtra, India in 2020. The study is based on primary data regarding consumption of 10 food groups among women across 10 food groups based on 24-hour recall period. The primary outcome variable was binary information regarding Minimum Dietary Diversity defined as consumption from at least 5 food groups. Econometric analysis based on multilevel models and item-response theory is applied to identify food groups that were most difficult to be received by mothers during the early and late lactation period. We find that the daily diet of lactating mothers in Palghar primarily consists of grains, white roots, tubers, and pulses. In contrast, the intake of dairy, eggs, and non-vegetarian food items is much lower. Only Half of the lactating women (56.5 percent; 95% CI: 37.4; 73.8) have a minimum diversified diet (MDD). The prevalence of lactating women with MDD was higher among households with higher income (73.1 percent; 95% CI: 45.2; 89.9) than those in lower income group (50.7 percent; 95% CI: 42.3; 58.9). Lactating Women (in early phase) who received health and nutrition counseling services are more likely (OR: 2.37; 95% CI: 0.90; 6.26) to consume a diversified diet. Food groups such as fruits, meat, poultry, fish, nuts, and seeds were among the rare food items in daily diet. The dietary pattern lacking in fruits, nuts, and heme (iron) sources indicates more significant risks of micronutrient deficiencies. The findings call for improving dietary diversity among lactating mothers, particularly from the marginalized communities, and are driven by low consumption of dairy products or various fruits and vegetables. Among the different food items, the consumption of micronutrient-rich seeds and nuts is most difficult to be accessed by lactating mothers. Also, diet-centric counseling and informing lactating mothers of its benefits are necessary to increase dietary diversity for improving maternal and child nutrition.


Subject(s)
Breast Feeding , COVID-19/epidemiology , Diet/methods , Lactation/physiology , Nutritional Status/physiology , Pandemics , SARS-CoV-2 , Adolescent , Adult , Cross-Sectional Studies , Dairy Products , Female , Fruit , Humans , Income , India/epidemiology , Infant , Infant, Newborn , Middle Aged , Pregnancy , Vegetables , Young Adult
10.
J Cancer Res Ther ; 17(6): 1540-1546, 2021.
Article in English | MEDLINE | ID: covidwho-1597096

ABSTRACT

Purpose: Coronavirus disease (COVID-19) pandemic has affected the entire health-care system and has led to a sense of fear and anxiety in the minds of patients. Patient's perceptions in this scenario of the pandemic are unknown. Providing continued care for cancer patients during the lockdown has been challenging. Measures are needed to improve patient safety and satisfaction during these challenging times and hence the importance of measuring the degree of satisfaction for the quality of care provided. The aim of the study was to evaluate the factors related to patients' satisfaction and also understand their apprehensions, fears, and anxieties they face as they receive radiotherapy treatment amid COVID-19 pandemic. The study's objective was to explore other aspects such as logistic issues, patient-staff communication, and also perceptions of the patients toward the outbreak. Materials and Methods: This study was conducted from April to September 2020. A questionnaire was created for which the patients were asked to provide answers. Parameters assessed included general information such as mode of transport used, frame of mind during treatment, awareness about pandemic, satisfaction toward care provided by health-care staff, and also documenting the suggestions to improve the quality of care. Results: During this period, we interviewed 108 patients: 56 males (51.9%) and 52 females (48.1%). 90.7% of the participants were satisfied with the condition and safety measures employed in waiting area and billing section. Majority (88.9%) were found to be aware about COVID-19. 74.1% of the participants were very satisfied with the services provided to them in the department of radiation oncology. Conclusion: The survey was useful in measuring the patient satisfaction, in understanding their fears and anxieties, and also in determining their awareness about the pandemic. The survey was also useful to get the patients' opinion and ideas for improvement in the health-care services.


Subject(s)
Neoplasms/radiotherapy , Patient Satisfaction/statistics & numerical data , Professional-Patient Relations , Tertiary Care Centers/statistics & numerical data , Adult , Aged , Anxiety/psychology , COVID-19/epidemiology , Communication , Fear/psychology , Female , Humans , India/epidemiology , Male , Middle Aged , Patient Safety , Quality of Health Care , SARS-CoV-2 , Surveys and Questionnaires
11.
Indian J Ophthalmol ; 70(1): 51-58, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1593811

ABSTRACT

Purpose: To evaluate the association of daily screen time and quality of sleep with the prevalence of dry eye among college-going women. Methods: This study was a cross-sectional, comparative questionnaire-based study of 547 college-going women in northern India. A 10-item Mini Sleep Questionnaire was used to check the quality of sleep, and the Standard Patient Evaluation of Eye Dryness (SPEED) scale was used to examine the prevalence of dry eye among college-going women. Results: Multinomial logistic regression showed a significant association between dry eye with daily screen time spent (P < 0.05) and the quality of sleep (P < 0.05) among college-going girls. Using Latent Class Analysis, two latent classes were selected based on the Bayesian Information Criteria. It was found that the majority population falls in class two and was having Severe Sleep-Wake difficulty. It was seen that the participants in class two belonged to the age bracket of 18-21 years, were from stream Humanities, education of father and mother equal to graduation, father working only, belonging to the nuclear family, having one sibling, hailing from the urban locality, spending more than 6 h daily on-screen, a majority of them using mobile phones, not using eye lubricants, and reported an increase in screen time during COVID-19. Conclusion: Dry eye and sleep quality are essential global health issues, and coupled with increased screen time, may pose a challenge in the present era. Preventive strategies need to be incorporated in school and college curriculums to promote physical, social, and psychological well-being and quality of life.


Subject(s)
COVID-19 , Dry Eye Syndromes , Adolescent , Adult , Bayes Theorem , Cross-Sectional Studies , Dry Eye Syndromes/diagnosis , Dry Eye Syndromes/epidemiology , Female , Humans , India/epidemiology , Quality of Life , SARS-CoV-2 , Screen Time , Sleep , Surveys and Questionnaires , Young Adult
12.
PLoS One ; 16(12): e0261776, 2021.
Article in English | MEDLINE | ID: covidwho-1581731

ABSTRACT

The Coronavirus Disease 2019 has resulted in a transition from physical education to online learning, leading to a collapse of the established educational order and a wisdom test for the education governance system. As a country seriously affected by the pandemic, the health of the Indian higher education system urgently requires assessment to achieve sustainable development and maximize educational externalities. This research systematically proposes a health assessment model from four perspectives, including educational volume, efficiency, equality, and sustainability, by employing the Technique for Order Preference by Similarity to an Ideal Solution Model, Principal Component Analysis, DEA-Tobit Model, and Augmented Solow Model. Empirical results demonstrate that India has high efficiency and an absolute health score in the higher education system through multiple comparisons between India and the other selected countries while having certain deficiencies in equality and sustainability. Additionally, single-target and multiple-target path are simultaneously proposed to enhance the Indian current education system. The multiple-target approach of the India-China-Japan-Europe-USA process is more feasible to achieve sustainable development, which would improve the overall health score from .351 to .716. This finding also reveals that the changes are relatively complex and would take 91.5 years considering the relationship between economic growth rates and crucial indicators. Four targeted policies are suggested for each catching-up period, including expanding and increasing the social funding sources, striving for government expenditure support to improve infrastructures, imposing gender equality in education, and accelerating the construction of high-quality teachers.


Subject(s)
COVID-19/epidemiology , Education, Distance/methods , Educational Status , Models, Theoretical , Pandemics , SARS-CoV-2 , Sustainable Development , COVID-19/virology , China/epidemiology , Europe/epidemiology , Humans , India/epidemiology , Japan/epidemiology , Principal Component Analysis/methods , United States/epidemiology
14.
Asia Pac J Public Health ; 33(8): 935-939, 2021 11.
Article in English | MEDLINE | ID: covidwho-1575368

ABSTRACT

Health care workers (HCW) are especially vulnerable to developing mental health problems in pandemic situations. The impact may be much devastating in developing countries due to fragmented health care system. Our study aims to explore the underlying burden of depression and its related factors among health care workers in South Asian countries. Data was collected through an online survey. A total of 476 health care workers including doctors, nurses, and paramedical staff participated from Pakistan, India, and Sri Lanka. A validated WHO Self Reporting Questionnaire (SRQ-20) was used to screen for Depression. A 25.7% prevalence of depression was reported among health care workers. Almost 70% of them were either not satisfied or partially satisfied with the provided personal protective equipment. On multivariable analysis, females gender (aOR=1.80, 95% CI: 1.11 - 2.90), fear of unprotection (aOR=1.80, 95% CI: 1.11 - 2.90), confirmed COVID-19 case in workplace (aOR=1.98, 95% CI= 1.18 - 3.33) and family (aOR=2.98, 95% CI: 1.02 - 8.70) were found to be independent predictors of depression among healthcare workers. Depression among HCW in South-Asian countries is quite alarming. This may jeopardize attention to other non-COVID health problems which are still on a priority in developing countries.


Subject(s)
COVID-19 , Pandemics , Anxiety , Depression/epidemiology , Female , Health Personnel , Humans , India/epidemiology , Pakistan/epidemiology , Prevalence , Risk Factors , SARS-CoV-2
15.
Glob Heart ; 16(1): 82, 2021.
Article in English | MEDLINE | ID: covidwho-1574806

ABSTRACT

Background: Hypertension is the leading risk factor for cardiovascular disease in India, but less than 10% of the estimated people with hypertension have blood pressure under control. The India Hypertension Control Initiative (IHCI) was implemented to strengthen hypertension management and control in public sector health facilities. Since late March 2020, lockdown due to the COVID-19 pandemic limited healthcare access and disrupted the provision of essential health services. IHCI quickly implemented adaptive interventions to improve access to medications. Objectives: To estimate the availability of antihypertensive drugs in peripheral public sector facilities during the lockdown and the proportion of patients who received drugs through community drug distribution, i.e., through Health and Wellness Centers (HWCs)/Sub-Centers (SCs), the most peripheral public sector health facilities for primary care, and home delivery. Methods: We collected data from 29 IHCI districts of 5 states (Kerala, Madhya Pradesh, Maharashtra, Punjab, and Telangana) during April-May 2020. The population included individuals diagnosed with hypertension and enrolled under IHCI in all public sector primary care health facilities. We contacted a convenience sample of more than one-third of the functional HWC/SC and analyzed the proportion of facilities and patients who received drugs. We also contacted a convenience sample of patients telephonically to estimate their self-reported availability of drugs. Conclusion: Of the 4245 HWC/SC, more than one-third were contacted telephonically, and 85-88% had received antihypertensive medications for community-level distribution. Among 721,675 patients registered until March 2020, 38.4% had received drug refills through HWC/SC or home delivery by frontline workers during the lockdown. We demonstrated the feasibility of community-level drug distribution for patients with hypertension during the COVID-19 lockdown in India. The adaptive strategy of community-based drug distribution through HWC/SC and home delivery appears feasible and may help improve access to hypertension care during the COVID-19 pandemic and beyond.


Subject(s)
COVID-19 , Hypertension , Communicable Disease Control , Continuity of Patient Care , Humans , Hypertension/drug therapy , Hypertension/epidemiology , India/epidemiology , Pandemics/prevention & control , SARS-CoV-2
16.
J Prev Med Hyg ; 62(3): E628-E634, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1575254

ABSTRACT

The number of outbreaks have progressively increased since many years in India. In this era of globalization and rapid international travel, any infectious disease in one country can become a potential threat to the entire globe. Outbreaks of Nipah, Zika, Crimean-Congo Haemorrhagic Fever and Kyasanur Forest Disease have been reported since a decade and now we are facing COVID-19 pandemic. One of the challenges in the prevention of these outbreaks is that as the cases decrease, the felt need declines, the public demand decreases and the mitigation responses get overshadowed by the need of emergency responses elsewhere. The One Health approach is a movement to promote alliance between medicine field, veterinary medicine and environmental sciences to upgrade the health of humans, animals, and ecosystem. The data in this article is compiled from different websites and publications of World Health Organization (WHO), Centre for Disease Control and Prevention (CDC), Integrated Disease Surveillance Programme (IDSP), grey literature and media. There is an urgent need for better surveillance and disease burden assessments in the country and to gain detailed insights into vector biology, factors of environment influencing the diseases, mapping of endemic areas, strengthen intersectoral coordination, infection control practices, and ensure use of Personal Protective Equipment's (PPE) and availability of drugs and vaccines to handle the outbreaks in a better way.


Subject(s)
COVID-19 , Hemorrhagic Fever, Crimean , Zika Virus Infection , Zika Virus , Animals , Disease Outbreaks/prevention & control , Ecosystem , Hemorrhagic Fever, Crimean/epidemiology , Humans , India/epidemiology , Pandemics , SARS-CoV-2
17.
J Infect Dev Ctries ; 15(11): 1593-1596, 2021 11 30.
Article in English | MEDLINE | ID: covidwho-1572710

ABSTRACT

COVID-19 outbreak has resulted in a substantial morbidity and mortality, and has put the health system under tremendous stress. A need for devising and adopting newer methods and techniques is being emphasized in the healthcare facilities to combat the effects of the SARS-CoV-2. Besides patient care, focus needs to be laid on the effective and dignified management of the deceased and medico-legal services provided by the hospitals and medical institutions during the COVID-19 pandemic. Considering the likelihood of forensic experts and autopsy personnel being exposed to SARS-CoV-2 inadvertently during the autopsy, it is recommended to resort to safer and minimally invasive techniques of postmortem examination of the dead. In this regard, employing radiological techniques for postmortem examination appears to be a promising option during the COVID-19 pandemic. An inherent advantage of postmortem radiography over conventional autopsies is the minimization of the risk of transmission of infection to the health care workers. Our correspondence highlights on the possibility of using radiological facilities as an effective replacement of high-risk conventional autopsy procedures during the COVID-19 pandemic.


Subject(s)
Autopsy , COVID-19/prevention & control , Health Facilities , Occupational Diseases/prevention & control , Radiology , SARS-CoV-2 , COVID-19/epidemiology , Humans , India/epidemiology , Occupational Diseases/epidemiology , Pandemics , Regional Health Planning
18.
Front Public Health ; 9: 787845, 2021.
Article in English | MEDLINE | ID: covidwho-1572345

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has caused phenomenal loss of lives and overburdened the health system in India. Low morale, fatigue, and inadequate knowledge among the healthcare workers (HCWs) are the perceived threats to pandemic control. We aimed to assess the COVID-19 related level of knowledge, attitude, and practices (KAP) among our HCWs. A cross-sectional, electronically distributed, questionnaire-based study was conducted which identified the demographics of HCWs and the current KAP related to coronavirus disease 2019 (COVID-19). The descriptive statistics were used to present the demographics of the participants and chi-square test was used to assess the differences in KAP among the participants. Of 1,429 total participants, 71.9% belonged to age group 21-40 years. Only 40.2% received any infection control training and 62.7% relied upon single source of information update. However, 82.9% of the participants had adequate knowledge. Being married, urban dwelling, and higher qualification were associated with knowledge adequacy (p < 0.001). Interestingly, the senior HCWs (age 41-50 years) were least likely to have adequate knowledge (74.1%). About 84% had positive attitude toward COVID-19, but 83.8% of the participants feared providing care to the patients with COVID-19. However, 93% of HCWs practiced safety precautions correctly most of the times and training had no influence on practice. In conclusion, more than 80% of HCWs in the study had adequate knowledge, positive attitude, and practiced safely most of the time. However, the pitfalls, such as poor training, knowledge uncertainties, and fear of disease acquisition among the HCWs need to be addressed.


Subject(s)
COVID-19 , Adult , Cross-Sectional Studies , Health Knowledge, Attitudes, Practice , Health Personnel , Hospitals , Humans , India/epidemiology , Middle Aged , Phobic Disorders , SARS-CoV-2 , Young Adult
20.
Asian Pac J Cancer Prev ; 22(S2): 51-57, 2021 Nov 01.
Article in English | MEDLINE | ID: covidwho-1559636

ABSTRACT

BACKGROUND: Sale of single cigarettes (also known as singles or loosies) is a key driver for early initiation of smoking and is a leading contributor to the smoking epidemic in India. Sale of singles additionally deter implementation of tobacco control strategies of pictorial health warnings including plain packaging and defeat effective taxation and promote illicit trade. We review India's tobacco control policy responses towards banning singles and other products sold as loose tobacco and identify opportunities for future policy intervention especially in the context of the ongoing COVID-19 pandemic. METHODS: Existing national and sub-national policy documents were analyzed for their content since the inception of the tobacco control laws in the country. RESULTS: There are no effective provisions at national level to ban loose tobacco products in India. However, the implementation of multiple legislative and regulatory measures (Acts/circulars/letters/notifications/orders/court judgements) in 16 Indian states and jurisdictions provide sufficient legal framework to substantiate its complete ban pan India. While the majority of state governments have adopted state level measures, Rajasthan had issued specific directive to all the 33 districts banning loose cigarettes and other tobacco products. Himachal Pradesh introduced the most unique and comprehensive legislation, for banning the sale of cigarettes and beedis (Dated November 7, 2016). The most recent notification in the state of Maharashtra (September 24, 2020) is the first to leverage powers using a mix of national and state legislations including the legislation addressing the rapidly emerging challenge of managing COVID-19. CONCLUSION: A robust national policy which supports strong provision to deter tobacco companies, their distribution network and vendors from selling singles or loose tobacco products is urgently needed. Such policy should be backed by cautionary messaging for consumers as well. Eliminating singles and loose tobacco sale will help in blunting tobacco use prevalence besides curbing spread of infectious diseases like COVID-19 pandemic.


Subject(s)
Public Policy/legislation & jurisprudence , Smoking Prevention/legislation & jurisprudence , Smoking/economics , Smoking/epidemiology , Tobacco Industry/economics , Tobacco Products/economics , COVID-19/epidemiology , Humans , India/epidemiology , Pandemics , SARS-CoV-2 , State Government , Taxes/legislation & jurisprudence , Tobacco Industry/legislation & jurisprudence
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