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1.
BMC Infect Dis ; 20(1): 745, 2020 Oct 12.
Article in English | MEDLINE | ID: covidwho-843296

ABSTRACT

BACKGROUND: Workers and residents in Care Homes are considered at special risk for the acquisition of SARS-CoV-2 infection, due to the infectivity and high mortality rate in the case of residents, compared to other containment areas. The role of presymptomatic people in transmission has been shown to be important and the early detection of these people is critical for the control of new outbreaks. Pooling strategies have proven to preserve SARS-CoV-2 testing resources. The aims of the present study, based in our local experience, were (a) to describe SARS-CoV-2 prevalence in institutionalized people in Galicia (Spain) during the Coronavirus pandemic and (b) to evaluate the expected performance of a pooling strategy using RT-PCR for the next rounds of screening of institutionalized people. METHODS: A total of 25,386 Nasopharyngeal swab samples from the total of the residents and workers at Care Homes in Galicia (March to May 2020) were individually tested using RT-PCR. Prevalence and quantification cycle (Cq) value distribution of positives was calculated. Besides, 26 pools of 20 samples and 14 pools of 5 samples were tested using RT-PCR as well (1 positive/pool). Pooling proof of concept was performed in two populations with 1.7 and 2% prevalence. RESULTS: Distribution of SARS-CoV-2 infection at Care Homes was uneven (0-60%). As the virus circulation global rate was low in our area (3.32%), the number of people at risk of acquiring the infection continues to be very high. In this work, we have successfully demonstrated that pooling of different groups of samples at low prevalence clusters, can be done with a small average delay on Cq values (5 and 2.85 cycles for pools of 20 and 5 samples, respectively). CONCLUSIONS: A new screening system with guaranteed protection is required for small clusters, previously covered with individual testing. Our proposal for Care Homes, once prevalence zero is achieved, would include successive rounds of testing using a pooling solution for transmission control preserving testing resources. Scale-up of this method may be of utility to confront larger clusters to avoid the viral circulation and keeping them operative.


Subject(s)
Betacoronavirus/genetics , Betacoronavirus/isolation & purification , Clinical Laboratory Techniques/methods , Coronavirus Infections/diagnosis , Coronavirus Infections/prevention & control , Nursing Homes/statistics & numerical data , Pandemics/prevention & control , Pneumonia, Viral/diagnosis , Pneumonia, Viral/prevention & control , Coronavirus Infections/transmission , Coronavirus Infections/virology , Disease Outbreaks/prevention & control , Disease Outbreaks/statistics & numerical data , Humans , Pneumonia, Viral/transmission , Pneumonia, Viral/virology , Reverse Transcriptase Polymerase Chain Reaction , Spain/epidemiology
3.
Nat Commun ; 11(1): 5009, 2020 10 06.
Article in English | MEDLINE | ID: covidwho-834902

ABSTRACT

Comorbid conditions appear to be common among individuals hospitalised with coronavirus disease 2019 (COVID-19) but estimates of prevalence vary and little is known about the prior medication use of patients. Here, we describe the characteristics of adults hospitalised with COVID-19 and compare them with influenza patients. We include 34,128 (US: 8362, South Korea: 7341, Spain: 18,425) COVID-19 patients, summarising between 4811 and 11,643 unique aggregate characteristics. COVID-19 patients have been majority male in the US and Spain, but predominantly female in South Korea. Age profiles vary across data sources. Compared to 84,585 individuals hospitalised with influenza in 2014-19, COVID-19 patients have more typically been male, younger, and with fewer comorbidities and lower medication use. While protecting groups vulnerable to influenza is likely a useful starting point in the response to COVID-19, strategies will likely need to be broadened to reflect the particular characteristics of individuals being hospitalised with COVID-19.


Subject(s)
Coronavirus Infections/epidemiology , Hospitalization , Influenza, Human/epidemiology , Pandemics , Pneumonia, Viral/epidemiology , Adult , Age Factors , Aged , Aged, 80 and over , Cohort Studies , Comorbidity , Coronavirus Infections/drug therapy , Female , Humans , Influenza, Human/drug therapy , Male , Middle Aged , Pneumonia, Viral/drug therapy , Prevalence , Republic of Korea/epidemiology , Sex Factors , Spain/epidemiology , United States/epidemiology , Young Adult
6.
J Med Internet Res ; 22(9): e19992, 2020 09 25.
Article in English | MEDLINE | ID: covidwho-803042

ABSTRACT

BACKGROUND: In the absence of a vaccine or effective treatment for COVID-19, countries have adopted nonpharmaceutical interventions (NPIs) such as social distancing and full lockdown. An objective and quantitative means of passively monitoring the impact and response of these interventions at a local level is needed. OBJECTIVE: We aim to explore the utility of the recently developed open-source mobile health platform Remote Assessment of Disease and Relapse (RADAR)-base as a toolbox to rapidly test the effect and response to NPIs intended to limit the spread of COVID-19. METHODS: We analyzed data extracted from smartphone and wearable devices, and managed by the RADAR-base from 1062 participants recruited in Italy, Spain, Denmark, the United Kingdom, and the Netherlands. We derived nine features on a daily basis including time spent at home, maximum distance travelled from home, the maximum number of Bluetooth-enabled nearby devices (as a proxy for physical distancing), step count, average heart rate, sleep duration, bedtime, phone unlock duration, and social app use duration. We performed Kruskal-Wallis tests followed by post hoc Dunn tests to assess differences in these features among baseline, prelockdown, and during lockdown periods. We also studied behavioral differences by age, gender, BMI, and educational background. RESULTS: We were able to quantify expected changes in time spent at home, distance travelled, and the number of nearby Bluetooth-enabled devices between prelockdown and during lockdown periods (P<.001 for all five countries). We saw reduced sociality as measured through mobility features and increased virtual sociality through phone use. People were more active on their phones (P<.001 for Italy, Spain, and the United Kingdom), spending more time using social media apps (P<.001 for Italy, Spain, the United Kingdom, and the Netherlands), particularly around major news events. Furthermore, participants had a lower heart rate (P<.001 for Italy and Spain; P=.02 for Denmark), went to bed later (P<.001 for Italy, Spain, the United Kingdom, and the Netherlands), and slept more (P<.001 for Italy, Spain, and the United Kingdom). We also found that young people had longer homestay than older people during the lockdown and fewer daily steps. Although there was no significant difference between the high and low BMI groups in time spent at home, the low BMI group walked more. CONCLUSIONS: RADAR-base, a freely deployable data collection platform leveraging data from wearables and mobile technologies, can be used to rapidly quantify and provide a holistic view of behavioral changes in response to public health interventions as a result of infectious outbreaks such as COVID-19. RADAR-base may be a viable approach to implementing an early warning system for passively assessing the local compliance to interventions in epidemics and pandemics, and could help countries ease out of lockdown.


Subject(s)
Coronavirus Infections/prevention & control , Coronavirus Infections/psychology , Data Collection , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Pneumonia, Viral/psychology , Smartphone , Social Isolation , Telemedicine , Wearable Electronic Devices , Adolescent , Adult , Aged , Aged, 80 and over , Body Mass Index , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Denmark/epidemiology , Female , Humans , Italy/epidemiology , Male , Middle Aged , Mobile Applications , Monitoring, Physiologic , Netherlands/epidemiology , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Social Media , Spain/epidemiology , United Kingdom/epidemiology , Young Adult
7.
Int J Environ Res Public Health ; 17(18)2020 09 19.
Article in English | MEDLINE | ID: covidwho-789454

ABSTRACT

Our objective was to compare clinical protocols for the treatment of the novel coronavirus disease 2019 (COVID-19) among different hospitals in Andalusia, Spain. We reviewed the current COVID-19 protocols of the 15 largest hospitals in Andalusia. Antiviral treatment, empirical antibacterial agents, adjunctive therapies, anticoagulant treatment, supportive care, hospital organization, and discharge recommendations were analyzed. All protocols included were the latest updates as of July 2020. Hydroxychloroquine in monotherapy was the most frequent antiviral drug recommended for mild respiratory illness with clinical risk factors (33.3%). Combined hydroxychloroquine with azithromycin or lopinavir/ritonavir was found in 40% of protocols. The recommended treatment for patients with mild and moderate pneumonias was different antiviral combinations including hydroxychloroquine plus azithromycin (93.3%) or hydroxychloroquine plus lopinavir/ritonavir (79.9%). Different combinations of hydroxychloroquine and lopinavir/ritonavir (46.7%) and triple therapy with hydroxychloroquine, azithromycin, and lopinavir/ritonavir (40%) were the most recommended treatments for patients with severe pneumonia. There were five corticosteroid regimens, which used dexamethasone, methylprednisolone, or prednisone, with different doses and treatment durations. Anakinra was included in seven protocols with six different regimens. All protocols included prophylactic heparin and therapeutic doses for thromboembolism. Higher prophylactic doses of heparin for high-risk patients and therapeutic doses for patients in critical condition were included in 53.3% and 33.3% of protocols, respectively. This study showed that COVID-19 protocols varied widely in several aspects (antiviral treatment, corticosteroids, anakinra, and anticoagulation for high risk of thrombosis or critical situation). Rigorous randomized clinical trials on the proposed treatments are needed to provide consistent evidence.


Subject(s)
Antiviral Agents/therapeutic use , Coronavirus Infections/drug therapy , Coronavirus , Pandemics , Pneumonia, Viral/drug therapy , Betacoronavirus , Clinical Protocols , Coronavirus/drug effects , Coronavirus/isolation & purification , Coronavirus Infections/epidemiology , Drug Combinations , Humans , Pneumonia, Viral/epidemiology , Spain/epidemiology , Treatment Outcome
8.
JMIR Public Health Surveill ; 6(3): e21653, 2020 09 21.
Article in English | MEDLINE | ID: covidwho-789092

ABSTRACT

BACKGROUND: Hospital workers have been the most frequently and severely affected professional group during the COVID-19 pandemic, and have a big impact on transmission. In this context, innovative tools are required to measure the symptoms compatible with COVID-19, the spread of infection, and testing capabilities within hospitals in real time. OBJECTIVE: We aimed to develop and test an effective and user-friendly tool to identify and track symptoms compatible with COVID-19 in hospital workers. METHODS: We developed and pilot tested Hospital Epidemics Tracker (HEpiTracker), a newly designed app to track the spread of COVID-19 among hospital workers. Hospital staff in 9 hospital centers across 5 Spanish regions (Andalusia, Balearics, Catalonia, Galicia, and Madrid) were invited to download the app on their phones and to register their daily body temperature, COVID-19-compatible symptoms, and general health score, as well as any polymerase chain reaction and serological test results. RESULTS: A total of 477 hospital staff participated in the study between April 8 and June 2, 2020. Of note, both health-related (n=329) and non-health-related (n=148) professionals participated in the study; over two-thirds of participants (68.8%) were health workers (43.4% physicians and 25.4% nurses), while the proportion of non-health-related workers by center ranged from 40% to 85%. Most participants were female (n=323, 67.5%), with a mean age of 45.4 years (SD 10.6). Regarding smoking habits, 13.0% and 34.2% of participants were current or former smokers, respectively. The daily reporting of symptoms was highly variable across participating hospitals; although we observed a decline in adherence after an initial participation peak in some hospitals, other sites were characterized by low participation rates throughout the study period. CONCLUSIONS: HEpiTracker is an already available tool to monitor COVID-19 and other infectious diseases in hospital workers. This tool has already been tested in real conditions. HEpiTracker is available in Spanish, Portuguese, and English. It has the potential to become a customized asset to be used in future COVID-19 pandemic waves and other environments. TRIAL REGISTRATION: ClinicalTrials.gov NCT04326400; https://clinicaltrials.gov/ct2/show/NCT04326400.


Subject(s)
Coronavirus Infections/epidemiology , Epidemics , Hospitals , Mass Screening/methods , Mobile Applications , Personnel, Hospital , Pneumonia, Viral/epidemiology , Population Surveillance/methods , Adult , Betacoronavirus , Body Temperature , Coronavirus Infections/complications , Coronavirus Infections/diagnosis , Coronavirus Infections/virology , Disclosure , Female , Health Status , Humans , Male , Middle Aged , Pandemics , Pilot Projects , Pneumonia, Viral/complications , Pneumonia, Viral/diagnosis , Pneumonia, Viral/virology , Spain/epidemiology , Telemedicine
9.
J Med Internet Res ; 22(9): e21319, 2020 09 10.
Article in English | MEDLINE | ID: covidwho-789086

ABSTRACT

BACKGROUND: Spain has been one of the countries most impacted by the COVID-19 pandemic. Since the first confirmed case was reported on January 31, 2020, there have been over 405,000 cases and 28,000 deaths in Spain. The economic and social impact is without precedent. Thus, it is important to quickly assess the situation and perception of the population. Large-scale online surveys have been shown to be an effective tool for this purpose. OBJECTIVE: We aim to assess the situation and perception of the Spanish population in four key areas related to the COVID-19 pandemic: social contact behavior during confinement, personal economic impact, labor situation, and health status. METHODS: We obtained a large sample using an online survey with 24 questions related to COVID-19 in the week of March 28-April 2, 2020, during the peak of the first wave of COVID-19 in Spain. The self-selection online survey method of nonprobability sampling was used to recruit 156,614 participants via social media posts that targeted the general adult population (age >18 years). Given such a large sample, the 95% CI was ±0.843 for all reported proportions. RESULTS: Regarding social behavior during confinement, participants mainly left their homes to satisfy basic needs. We found several statistically significant differences in social behavior across genders and age groups. The population's willingness to comply with the confinement measures is evident. From the survey answers, we identified a significant adverse economic impact of the pandemic on those working in small businesses and a negative correlation between economic damage and willingness to stay in confinement. The survey revealed that close contacts play an important role in the transmission of the disease, and 28% of the participants lacked the necessary resources to properly isolate themselves. We also identified a significant lack of testing, with only 1% of the population tested and 6% of respondents unable to be tested despite their doctor's recommendation. We developed a generalized linear model to identify the variables that were correlated with a positive SARS-CoV-2 test result. Using this model, we estimated an average of 5% for SARS-CoV-2 prevalence in the Spanish population during the time of the study. A seroprevalence study carried out later by the Spanish Ministry of Health reported a similar level of disease prevalence (5%). CONCLUSIONS: Large-scale online population surveys, distributed via social media and online messaging platforms, can be an effective, cheap, and fast tool to assess the impact and prevalence of an infectious disease in the context of a pandemic, particularly when there is a scarcity of official data and limited testing capacity.


Subject(s)
Betacoronavirus , Coronavirus Infections/epidemiology , Health Surveys/methods , Pandemics , Pneumonia, Viral/epidemiology , Social Media , Adult , Female , Humans , Male , Middle Aged , Prevalence , Self Report , Seroepidemiologic Studies , Social Behavior , Spain/epidemiology , Young Adult
11.
Rev Esp Salud Publica ; 942020 Sep 18.
Article in Spanish | MEDLINE | ID: covidwho-777060

ABSTRACT

OBJECTIVE: The Spanish registry of Covid-19 in Spanish pregnant women, made up of 100 centers, is created in response to the need to know the morbidity that Covid-19 generates in pregnant women and their newborns, to know the real incidence of the disease in this population group and to establish and monitor the package of measures to improve their care. The aim of this paper was the creation of a registry of pregnant women with Covid-19 infection in order to establish the interventions and measures necessary to improve the care of these patients during hospital admission. METHODS: To prepare the registry, the main researcher of each center collected weekly / biweekly the number of total pregnant women screened, as well as the total number of positive and negative, sending these data to the responsible researchers so that it could be available in real time of the percentage of infected asymptomatic pregnant population and the evolution by weeks in the centers of each participating province. The data were analyzed using the linear regression test and the Mantel test. RESULTS: As of May 31stsup> 2020, 16,308 screening tests were carried out in these hospitals, in which 338 pregnant women were positive, which translates into 2.07% (95% Confidence Interval: 1.86-2.30) of the asymptomatic pregnant women we attended in our centers were carriers of the virus and could develop the disease in subsequent days. CONCLUSIONS: The Spanish epidemiological registry allows us to know the incidence of infection in pregnant women attended in the Spanish delivery centers, as well as the weekly and / or fortnightly evolution of the same, observing a significant decrease in the proportion of positive pregnant women over the total of screenings throughout this period, with an average of 6.5% in early April 2020 to an average of 0.93% positive in late May 2020.


Subject(s)
Betacoronavirus , Clinical Laboratory Techniques , Coronavirus Infections/diagnosis , Mass Screening , Pneumonia, Viral/diagnosis , Pregnancy Complications, Infectious/diagnosis , Registries , Adult , Asymptomatic Diseases , Betacoronavirus/isolation & purification , Clinical Laboratory Techniques/methods , Clinical Laboratory Techniques/statistics & numerical data , Coronavirus Infections/epidemiology , Coronavirus Infections/therapy , Female , Humans , Incidence , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/therapy , Pregnancy , Pregnancy Complications, Infectious/epidemiology , Pregnancy Complications, Infectious/therapy , Spain/epidemiology
12.
Rev Esp Salud Publica ; 942020 09 16.
Article in Spanish | MEDLINE | ID: covidwho-774689

ABSTRACT

OBJECTIVE: Social determinants and health inequalities have a huge impact on health of populations. It is important to study their role in the management of the Covid-19 epidemic, especially in cities, as certain variables like the number of tests and the access to health system cannot be assumed as equal. The aim of this work was to determine the relation of social determinants in the incidence of Covid-19 in the city of Barcelona. METHODS: An observational retrospective ecological study was performed, with the neighbourhood as the population unit, based on data of cumulative incidence published at May 14th, 2020 by the Public Health Agency of Barcelona. Covid-19 incidence disparities depending on the income of the neighbourhoods, the Pearson linear correlation of the variables selected (age, sex, net density, immigrants, comorbidities, smokers, Body Mass Index [BMI] and Available Income per Family Index [AIFI]) with the incidence and the correlation with a multivariant Generalized Linear Model (GLM) were estimated. RESULTS: It was found that neighbourhoods belonging to the lowest quintile of income had a 42% more incidence than those belonging to the highest quintile: 942 cases per 100,000 inhabitants versus 545 per 100,000 inhabitants of the highest quintile. The Pearson correlation was statistically significative between the incidence of Covid-19 and the percentage of population over 75 (r=0.487), the percentage of immigration of the neighbourhood and the origin of the immigrants (r=-0.257), the AIFI (r=-0.462), the percentage of smokers (r=0.243) and the percentage of people with BMI over 25 (r=0.483). The GLM showed that the most correlated variables with the incidence are the percentage of people over 75 (Z-score=0.258), the percentage of people from Maghreb (Z-score=-0.206) and Latin America (Z-score=0.19) and the percentage of people with BMI over 25 (Z-score=0.334). The results of the GLM were significative. CONCLUSIONS: Social determinants are correlated with the modification of the incidence of Covid-19 in the neighbourhoods of Barcelona, with special relevance of the prevalence of BMI over 25 and the percentage of immigrants and its origin.


Subject(s)
Coronavirus Infections/epidemiology , Pneumonia, Viral/epidemiology , Social Determinants of Health , Adult , Betacoronavirus , Body Mass Index , Emigrants and Immigrants , Emigration and Immigration , Female , Health Services Accessibility , Health Status Disparities , Healthcare Disparities , Humans , Incidence , Male , Middle Aged , Pandemics , Residence Characteristics , Retrospective Studies , Smoking , Socioeconomic Factors , Spain/epidemiology
13.
AIDS ; 34(12): 1775-1780, 2020 10 01.
Article in English | MEDLINE | ID: covidwho-772521

ABSTRACT

BACKGROUND: It is unclear how characteristics, risk factors, and incidence of coronavirus disease 2019 (COVID-19) in people living with HIV (PLWH) differ from the general population. METHODS: Prospective observational single-center cohort study of adult PLWH reporting symptoms of COVID-19. We assessed clinical characteristics, risk factors for COVID-19 diagnosis and severity, and standardized incidence rate ratio for COVID-19 cases in PLWH cohort and in Barcelona. RESULTS: From 1 March 2020 to 10 May 2020, 53 out of 5683 (0.9% confidence interval 0.7-1.2%) PLWH were diagnosed with COVID-19. Median age was 44 years, CD4 T cells were 618/µl and CD4/CD8 was 0.90. All but two individuals were virologically suppressed. Cough (87%) and fever (82%) were the most common symptoms. Twenty-six (49%) were admitted, six (14%) had severe disease, four (8%) required ICU admission, and two (4%) died. Several laboratory markers (lower O2 saturation and platelets, and higher leukocytes, creatinine, lactate dehydrogenase, C reactive protein, procalcitonin, and ferritin) were associated with COVID-19 severity. No HIV or antiretroviral-related factors were associated with COVID-19 diagnosis or severity. Standardized incidence rate ratios of confirmed or confirmed/probable COVID-19 in PLWH were 38% (95% confidence interval 27-52%, P < 0.0001) and 33% (95% confidence interval 21-50%, P < 0.0001), respectively relative to the general population. CONCLUSION: PLWH with COVID-19 did not differ from the rest of the HIV cohort. Clinical presentation, severity rate, and mortality were not dependent on any HIV-related or antiretroviral-related factor. COVID-19 standardized incidence rate was lower in PLWH than in the general population. These findings should be confirmed in larger multicenter cohort studies.


Subject(s)
Coronavirus Infections/mortality , Coronavirus Infections/physiopathology , HIV Infections/complications , Pneumonia, Viral/mortality , Pneumonia, Viral/physiopathology , Adult , Anti-HIV Agents/therapeutic use , Betacoronavirus , CD4 Lymphocyte Count , Female , HIV Infections/drug therapy , Humans , Incidence , Male , Middle Aged , Pandemics , Prospective Studies , Risk Factors , Spain/epidemiology
14.
PLoS One ; 15(9): e0238682, 2020.
Article in English | MEDLINE | ID: covidwho-771788

ABSTRACT

The appearance of a new coronavirus (Covid-19) and its rapid expansion throughout the world has forced all countries to establish regulations based on social confinement. In the early days of a pandemic, the adherence to regulations is crucial to be able to block its spread. This research aims to analyse the relationship between motivational variables associated with physical distancing and self-interested consumption behaviours in the first 10 days of confinement in Spain. A total of 1,324 people participated throughout the country (mean age 28.92 years). Participants answered an online survey about socio-demographic, motivational variables, which included a) risk information seeking, b) confidence in self- and collective efficacy in coping with the pandemic, and c) the four higher-order personal values ‒conservation (security, conformity, and tradition), self-transcendence (universalism and benevolence), openness (self-direction actions and stimulation), and self-improvement (hedonism and power) ‒ and the aforementioned behaviours in coping with Covid-19. Results showed a positive association between self- and collective efficacy and both coping behaviours analysed: a protective role of conservation values on normative behaviours; and a negative relationship between self-transcendence values and self-interested consumption. Additionally, risk information seeking was positively associated with the development of physical distancing behaviour.


Subject(s)
Adaptation, Psychological , Betacoronavirus , Coronavirus Infections/psychology , Pandemics , Pneumonia, Viral/psychology , Self Efficacy , Social Values , Adolescent , Adult , Aged , Aged, 80 and over , Attitude to Health , Communicable Disease Control/legislation & jurisprudence , Communicable Disease Control/methods , Consumer Behavior , Coronavirus Infections/prevention & control , Humans , Middle Aged , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Spain/epidemiology , Young Adult
16.
Fam Process ; 59(3): 1060-1079, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-653144

ABSTRACT

During the recent COVID-19 outbreak in Spain, we explored the individual and relational well-being of people confined together with their partners and/or children during the first 3 weeks of state-regulated lockdown. Adults 18 years or older (N = 407) completed an online survey that included demographic, household, and employment information along with standardized measures of psychological distress (State-Trait Anxiety and Beck Depression) and relationship functioning-either the Dyadic Adjustment Scale if there were no children in the household or a Basic Family Relations Evaluation Questionnaire (CERFB) measuring conjugal, parental, and coparental functions. Qualitative analyses of responses to an open-ended question about perceived changes in couple or family dynamics during lockdown revealed nine specific themes comprising two overarching categories: relational improvement and deterioration. The overall prevalence of improvement themes (61.7%) exceeded deterioration themes (41.0%), with increased (re)connection and conflict atmosphere cited most often. Quantitative analyses found elevated levels of state anxiety but not trait anxiety or depression during lockdown. Consistent with the qualitative results, couples having no children at home reported high levels of dyadic adjustment, but with children present CERFB parental functioning exceeded conjugal functioning, a pattern sometimes associated with child triangulation into adult conflicts. Although correlates of psychological distress (e.g., unemployment, perceived economic risk) were relatively stable across subgroups, predictors of relationship functioning varied substantially with household/parental status (e.g., telecommuting and employment facilitated conjugal functioning only for couples with children).


Subject(s)
Coronavirus Infections/psychology , Parents/psychology , Pneumonia, Viral/psychology , Quarantine/psychology , Sexual Partners/psychology , Stress, Psychological/diagnosis , Adolescent , Adult , Betacoronavirus , Coronavirus Infections/prevention & control , Family Relations/psychology , Female , Humans , Male , Pandemics/prevention & control , Parenting/psychology , Pneumonia, Viral/prevention & control , Prevalence , Psychiatric Status Rating Scales , Qualitative Research , Spain/epidemiology , Stress, Psychological/epidemiology , Stress, Psychological/psychology , Young Adult
17.
Cuad Bioet ; 31(102): 183-202, 2020.
Article in Spanish | MEDLINE | ID: covidwho-761284

ABSTRACT

The article deals with the analysis of the criteria for the allocation of scarce health resources during the pandemic produced by the COVID 19 virus in Spain. It critically analyses the absence of a legal-constitutional perspective in the elaboration of such criteria and suggests the incorporation of the criterion of equity as a guarantee of the effective exercise of the constitutional right to health protection by vulnerable persons.


Subject(s)
Betacoronavirus , Health Resources/ethics , Pandemics/ethics , Resource Allocation/ethics , Constitution and Bylaws , Coronavirus Infections/prevention & control , Ethical Theory , Government Agencies , Health Priorities , Health Resources/legislation & jurisprudence , Health Resources/supply & distribution , Health Services Accessibility/ethics , Health Services Accessibility/legislation & jurisprudence , Human Rights/legislation & jurisprudence , Humans , Minority Groups , Pandemics/legislation & jurisprudence , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Publications , Resource Allocation/legislation & jurisprudence , Role , Social Justice , Societies, Medical , Spain/epidemiology , Triage/ethics , Vulnerable Populations
18.
Rev Esp Salud Publica ; 942020 Sep 07.
Article in Spanish | MEDLINE | ID: covidwho-746181

ABSTRACT

The SARS-CoV-2 pandemic (Covid-19) has had a major impact on residents of assisted-living facilities. While it is plausible that the characteristics of these patients and their special clinical fragility have contributed to their greater vulnerability to infection, other related factors cannot be ruled out, such as the quality of management at these centers and the lack of planning for actions taken before and during the health crisis. Both aspects pertain to the field of public health, where the ethics of the common good conflicts with the autonomy of the individual.


Subject(s)
Assisted Living Facilities/ethics , Community Health Planning/ethics , Coronavirus Infections/prevention & control , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Public Health/ethics , Betacoronavirus , Coronavirus Infections/epidemiology , Humans , Pneumonia, Viral/epidemiology , Risk Factors , Spain/epidemiology
19.
Euro Surveill ; 25(35)2020 09.
Article in English | MEDLINE | ID: covidwho-745113

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 community-wide transmission declined in Spain by early May 2020, being replaced by outbreaks and sporadic cases. From mid-June to 2 August, excluding single household outbreaks, 673 outbreaks were notified nationally, 551 active (>6,200 cases) at the time. More than half of these outbreaks and cases coincided with: (i) social (family/friends' gatherings or leisure venues) and (ii) occupational (mainly involving workers in vulnerable conditions) settings. Control measures were accordingly applied.


Subject(s)
Coronavirus Infections/transmission , Disease Outbreaks , Infection Control/methods , Pandemics/prevention & control , Pneumonia, Viral/transmission , Betacoronavirus , Coronavirus Infections/epidemiology , Disease Notification , Humans , Leisure Activities , Pandemics/statistics & numerical data , Pneumonia, Viral/epidemiology , Spain/epidemiology
20.
Rev Esp Salud Publica ; 942020 Sep 03.
Article in Spanish | MEDLINE | ID: covidwho-743521

ABSTRACT

OBJECTIVE: The Covid-19 pandemic is testing the resistance of health systems, the preservation of health professionals is a priority in processes of this type. The professionals' exposure to suspicious contacts often requires their confinement. The objective was to know the epidemiological characteristics of the primary care professionals who required confinement. METHODS: The research was carried out in the North Metropolitan Primary Care Area of Barcelona, from February 17 to May 3, 2020. 1,418 professionals who required confinement due to the epidemic by Covid-19 participated. The reasons for confinement, symptomatology, the confinement time and the results of PCR tests results were recorded. Univariate descriptive analysis was performed. RESULTS: 78.8% of the professionals were women and the mean age was 45.2 years. 67.8% were doctors and nurses, in the remaining 32.2% there were different healthcare and non-care professionals. 64.1% of the sample presented symptoms compatible with Covid-19. Participants described multiple symptoms during confinement. 1,050 diagnostic RT- PCR tests were performed, being positive in 323 cases, of which 33 were in asymptomatic people. CONCLUSIONS: The impact of the epidemic by Covid-19 is anticipated in health personnel compared to the general population. The distribution of symptoms in healthcare professionals is similar to that of other studies in the general population. Of the total number of professionals requiring isolation, 22.7% confirmed the diagnosis.


Subject(s)
Betacoronavirus , Coronavirus Infections/epidemiology , Health Personnel , Occupational Diseases/epidemiology , Pneumonia, Viral/epidemiology , Primary Health Care , Quarantine , Adult , Coronavirus Infections/diagnosis , Coronavirus Infections/prevention & control , Coronavirus Infections/transmission , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Occupational Diseases/diagnosis , Occupational Diseases/prevention & control , Pandemics/prevention & control , Pneumonia, Viral/diagnosis , Pneumonia, Viral/prevention & control , Pneumonia, Viral/transmission , Spain/epidemiology
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