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1.
Cochrane Database Syst Rev ; 4: CD013582, 2020 04 21.
Article in English | MEDLINE | ID: covidwho-1372688

ABSTRACT

BACKGROUND: This review is one of a series of rapid reviews that Cochrane contributors have prepared to inform the 2020 COVID-19 pandemic. When new respiratory infectious diseases become widespread, such as during the COVID-19 pandemic, healthcare workers' adherence to infection prevention and control (IPC) guidelines becomes even more important. Strategies in these guidelines include the use of personal protective equipment (PPE) such as masks, face shields, gloves and gowns; the separation of patients with respiratory infections from others; and stricter cleaning routines. These strategies can be difficult and time-consuming to adhere to in practice. Authorities and healthcare facilities therefore need to consider how best to support healthcare workers to implement them. OBJECTIVES: To identify barriers and facilitators to healthcare workers' adherence to IPC guidelines for respiratory infectious diseases. SEARCH METHODS: We searched OVID MEDLINE on 26 March 2020. As we searched only one database due to time constraints, we also undertook a rigorous and comprehensive scoping exercise and search of the reference lists of key papers. We did not apply any date limit or language limits. SELECTION CRITERIA: We included qualitative and mixed-methods studies (with a distinct qualitative component) that focused on the experiences and perceptions of healthcare workers towards factors that impact on their ability to adhere to IPC guidelines for respiratory infectious diseases. We included studies of any type of healthcare worker with responsibility for patient care. We included studies that focused on IPC guidelines (local, national or international) for respiratory infectious diseases in any healthcare setting. These selection criteria were framed by an understanding of the needs of health workers during the COVID-19 pandemic. DATA COLLECTION AND ANALYSIS: Four review authors independently assessed the titles, abstracts and full texts identified by our search. We used a prespecified sampling frame to sample from the eligible studies, aiming to capture a range of respiratory infectious disease types, geographical spread and data-rich studies. We extracted data using a data extraction form designed for this synthesis. We assessed methodological limitations using an adapted version of the Critical Skills Appraisal Programme (CASP) tool. We used a 'best fit framework approach' to analyse and synthesise the evidence. This provided upfront analytical categories, with scope for further thematic analysis. We used the GRADE-CERQual (Confidence in the Evidence from Reviews of Qualitative research) approach to assess our confidence in each finding. We examined each review finding to identify factors that may influence intervention implementation and developed implications for practice. MAIN RESULTS: We found 36 relevant studies and sampled 20 of these studies for our analysis. Ten of these studies were from Asia, four from Africa, four from Central and North America and two from Australia. The studies explored the views and experiences of nurses, doctors and other healthcare workers when dealing with severe acute respiratory syndrome (SARS), H1N1, MERS (Middle East respiratory syndrome), tuberculosis (TB), or seasonal influenza. Most of these healthcare workers worked in hospitals; others worked in primary and community care settings. Our review points to several barriers and facilitators that influenced healthcare workers' ability to adhere to IPC guidelines. The following factors are based on findings assessed as of moderate to high confidence. Healthcare workers felt unsure as to how to adhere to local guidelines when they were long and ambiguous or did not reflect national or international guidelines. They could feel overwhelmed because local guidelines were constantly changing. They also described how IPC strategies led to increased workloads and fatigue, for instance because they had to use PPE and take on additional cleaning. Healthcare workers described how their responses to IPC guidelines were influenced by the level of support they felt that they received from their management team. Clear communication about IPC guidelines was seen as vital. But healthcare workers pointed to a lack of training about the infection itself and about how to use PPE. They also thought it was a problem when training was not mandatory. Sufficient space to isolate patients was also seen as vital. A lack of isolation rooms, anterooms and shower facilities was a problem. Other important practical measures described by healthcare workers included minimising overcrowding, fast-tracking infected patients, restricting visitors, and providing easy access to handwashing facilities. A lack of PPE, and equipment that was of poor quality, was a serious concern for healthcare workers and managers. They also pointed to the need to adjust the volume of supplies as infection outbreaks continued. Healthcare workers believed that they followed IPC guidance more closely when they saw the value of it. Some healthcare workers felt motivated to follow the guidance because of fear of infecting themselves or their families, or because they felt responsible for their patients. Some healthcare workers found it difficult to use masks and other equipment when it made patients feel isolated, frightened or stigmatised. Healthcare workers also found masks and other equipment uncomfortable to use. The workplace culture could also influence whether healthcare workers followed IPC guidelines or not. Across many of the findings, healthcare workers pointed to the importance of including all staff, including cleaning staff, porters, kitchen staff and other support staff when implementing IPC guidelines. AUTHORS' CONCLUSIONS: Healthcare workers point to several factors that influence their ability and willingness to follow IPC guidelines when managing respiratory infectious diseases. These include factors tied to the guideline itself and how it is communicated, support from managers, workplace culture, training, physical space, access to and trust in personal protective equipment, and a desire to deliver good patient care. The review also highlights the importance of including all facility staff, including support staff, when implementing IPC guidelines.


Subject(s)
Coronavirus Infections , Cross Infection/prevention & control , Guideline Adherence , Health Personnel , Infection Control , Pandemics , Pneumonia, Viral , COVID-19 , Coronavirus Infections/prevention & control , Coronavirus Infections/transmission , Guideline Adherence/standards , Health Knowledge, Attitudes, Practice , Humans , Pandemics/prevention & control , Patient Isolation , Personal Protective Equipment , Pneumonia, Viral/prevention & control , Pneumonia, Viral/transmission , Practice Guidelines as Topic , Universal Precautions
6.
Pan Afr Med J ; 35(Suppl 2): 1, 2020.
Article in English | MEDLINE | ID: covidwho-1106450

ABSTRACT

The epidemic of Coronavirus disease 2019 (COVID-19) in China caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has become a global concern and subsequently labeled a pandemic by the World Health Organization on March 11th. As the world mobilizes to contain the COVID-19, scientists and public health experts are increasingly alarmed about the potentially catastrophic effects of an outbreak in Africa. The establishment of Africa Centres for Disease Control and Prevention by the Africa Union in 2017 was an unprecedented move toward strengthening national responses, so far enabling all fifty member states with confirmed cases of COVID-19 to adequately respond, break chains of transmission and effectively contain the spread of SARS-CoV-2. We enter an uncertain and challenging period that may severely test the preparedness, organizational resource and resilience of African states and the fabric of their societies. However, we speculate that the fear associated with COVID-19 may also lead to some of the long-standing messages about simple measures to reduce the spread, such as hand washing, finally becoming absorbed and more universally adopted by health workers and the public. Is it possible that regardless of the terrible threat posed by SARS-CoV-2, the increased adoption of these health protection measures may result in a reduction in the spread of other infectious diseases?


Subject(s)
Betacoronavirus , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Africa/epidemiology , COVID-19 , Coronavirus Infections/economics , Coronavirus Infections/mortality , Hand Disinfection , Hemorrhagic Fever, Ebola/epidemiology , Hemorrhagic Fever, Ebola/mortality , Humans , International Cooperation , Pandemics/economics , Pneumonia, Viral/economics , Pneumonia, Viral/mortality , SARS-CoV-2 , Universal Precautions
8.
Encephale ; 46(3S): S107-S113, 2020 Jun.
Article in French | MEDLINE | ID: covidwho-1065060

ABSTRACT

Emerging infectious diseases like Covid-19 cause a major threat to global health. When confronted with new pathogens, individuals generate several beliefs about the epidemic phenomenon. Many studies have shown that individual protective behaviors largely depend on these beliefs. Due to the absence of treatment and vaccine against these emerging pathogens, the relation between these beliefs and these behaviors represents a crucial issue for public health policies. In the premises of the Covid-19 pandemic, several preliminary studies have highlighted a delay in the perception of risk by individuals, which potentially holds back the implementing of the necessary precautionary measures: people underestimated the risks associated with the virus, and therefore also the importance of complying with sanitary guidelines. During the peak of the pandemic, the salience of the threat and of the risk of mortality could then have transformed the way people generate their beliefs. This potentially leads to upheavals in the way they understand the world. Here, we propose to explore the evolution of beliefs and behaviors during the Covid-19 crisis, using the theory of predictive coding and the theory of terror management, two influential frameworks in cognitive science and in social psychology.


Subject(s)
Betacoronavirus , Brain/physiology , Coronavirus Infections/psychology , Culture , Fear/psychology , Health Behavior , Pandemics , Pneumonia, Viral/psychology , Adaptation, Psychological , Attitude to Health , COVID-19 , Communicable Disease Control , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Denial, Psychological , Guideline Adherence , Guidelines as Topic , Health Risk Behaviors , Humans , Hygiene , Models, Psychological , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Protective Devices , Risk Management , Risk Reduction Behavior , SARS-CoV-2 , Universal Precautions
11.
Emerg Infect Dis ; 27(2): 404-410, 2021 02.
Article in English | MEDLINE | ID: covidwho-1006425

ABSTRACT

Switzerland began a national lockdown on March 16, 2020, in response to the rapid spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We assessed the prevalence of SARS-CoV-2 infection among patients admitted to 4 hospitals in the canton of Zurich, Switzerland, in April 2020. These 4 acute care hospitals screened 2,807 patients, including 2,278 (81.2%) who did not have symptoms of coronavirus disease (COVID-19). Overall, 529 (18.8%) persons had >1 symptom of COVID-19, of whom 60 (11.3%) tested positive for SARS-CoV-2. Eight asymptomatic persons (0.4%) also tested positive for SARS-CoV-2. Our findings indicate that screening on the basis of COVID-19 symptoms, regardless of clinical suspicion, can identify most SARS-CoV-2-positive persons in a low-prevalence setting.


Subject(s)
COVID-19 Testing/statistics & numerical data , COVID-19/diagnosis , Diagnostic Tests, Routine/statistics & numerical data , Patient Admission/statistics & numerical data , Universal Precautions/statistics & numerical data , Adult , Aged , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Testing/methods , Diagnostic Tests, Routine/methods , Female , Humans , Incidence , Male , Middle Aged , Prevalence , SARS-CoV-2 , Switzerland/epidemiology , Universal Precautions/methods
14.
Mayo Clin Proc ; 96(4): 912-920, 2021 04.
Article in English | MEDLINE | ID: covidwho-988749

ABSTRACT

OBJECTIVE: To assess the prevalence and characteristics of coronavirus disease 2019 (COVID-19) cases during the reopening period in older adults, given that little is known about the prevalence of COVID-19 after the stay-at-home order was lifted in the United States, nor the actual effects of adherence to recommended public health measures (RPHM) on the risk of COVID-19. PATIENTS AND METHODS: This was a cross-sectional study nested in a parent prospective cohort study, which followed a population-based sample of 2325 adults 50 years and older residing in southeast Minnesota to assess the incidence of viral infections. Participants were instructed to self-collect both nasal and oropharyngeal swabs, which were tested by reverse transcription polymerase chain reaction-based severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) assay between May 8, 2020, and June, 30, 2020. We assessed the prevalence of COVID-19 cases and characteristics of study subjects. RESULTS: A total of 1505 eligible subjects participated in the study whose mean age was 68 years, with 885 (59%) women, 32 (2%) racial/ethnic minorities, and 906 (60%) with high-risk conditions for influenza. The prevalence of other Coronaviridae (human coronavirus [HCoV]-229E, HCoV-NL63, and HCoV-OC43) during the 2019 to 2020 flu season was 109 (7%), and none tested positive for SARS-CoV-2. Almost all participants reported adhering to the RPHM (1,488 [99%] for social distancing, 1,438 [96%] for wearing mask in a public space, 1,476 [98%] for hand hygiene, and 1,441 (96%) for staying home mostly). Eighty-six percent of participants resided in a single-family home. CONCLUSION: We did not identify SARS-COV-2 infection in our study cohort. The combination of participants' behavior in following the RPHM and their living environment may considerably mitigate the risk of COVID-19.


Subject(s)
COVID-19 , Communicable Disease Control , Guideline Adherence/statistics & numerical data , Physical Distancing , Public Health , Aged , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/psychology , COVID-19 Testing/methods , COVID-19 Testing/statistics & numerical data , Communicable Disease Control/methods , Communicable Disease Control/organization & administration , Communicable Disease Control/statistics & numerical data , Cross-Sectional Studies , Disease Transmission, Infectious/prevention & control , Female , Humans , Male , Minnesota/epidemiology , Prevalence , Public Health/methods , Public Health/statistics & numerical data , Risk Reduction Behavior , Universal Precautions/methods , Universal Precautions/statistics & numerical data , Virology/methods
15.
Otolaryngol Head Neck Surg ; 162(6): 809-810, 2020 06.
Article in English | MEDLINE | ID: covidwho-913948

ABSTRACT

More than half of COVID-19 patients are afebrile early in the disease course, yet mildly ill or asymptomatic patients can still spread SARS-CoV-2 with high efficiency. Atypically presenting patients may be seen in noninfectious disease settings such as otolaryngology, which is a specialty prone to occupational exposure. Otolaryngologists have been infected with COVID-19 at higher rates than other specialties in China and other countries. Otolaryngology providers should maintain high clinical suspicion for mild and asymptomatic COVID-19 patients. Protective strategies should be implemented including preappointment screening, triaging, restriction of nonurgent visits and surgeries, telemedicine, and appropriate personal protective equipment use.


Subject(s)
Asymptomatic Diseases/therapy , Coronavirus Infections/prevention & control , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Occupational Health , Otolaryngology/organization & administration , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Asymptomatic Diseases/epidemiology , COVID-19 , Communicable Disease Control/organization & administration , Disease Management , Female , Global Health , Health Personnel/statistics & numerical data , Humans , Male , Otolaryngologists/statistics & numerical data , Pandemics/statistics & numerical data , Universal Precautions/methods
18.
Am J Infect Control ; 49(5): 653-654, 2021 05.
Article in English | MEDLINE | ID: covidwho-813429

ABSTRACT

This retrospective, cross-sectional study was conducted in four community hospitals in Los Angeles County, California. The assumption of this study was, coronavirus disease-19 (COVID-19) contributed to the increase in healthcare workers compliance with infection prevention measures. IP initiatives fostered among HCWs have increased awareness of effective hand washing, cleaning equipment after use and appropriate personal protective equipment use which has subsequently decreased healthcare acquired infections with multidrug-resistant organisms.


Subject(s)
COVID-19/prevention & control , Disease Transmission, Infectious/prevention & control , Guideline Adherence/statistics & numerical data , Hand Disinfection , Health Personnel/statistics & numerical data , Infection Control , Personal Protective Equipment , Practice Guidelines as Topic , Adult , COVID-19/epidemiology , COVID-19/transmission , Cross-Sectional Studies , Drug Resistance, Multiple, Bacterial , Female , Humans , Infection Control/methods , Infection Control/statistics & numerical data , Male , Middle Aged , Pandemics/prevention & control , Retrospective Studies , SARS-CoV-2 , Universal Precautions
19.
J Epidemiol Glob Health ; 11(1): 60-68, 2021 03.
Article in English | MEDLINE | ID: covidwho-789171

ABSTRACT

BACKGROUND AND OBJECTIVES: Corona Virus Disease 2019 (COVID-19) pandemic is a global health emergency. Health Care Workers (HCWs) with sound knowledge and practices can help curb the pandemic. This study aimed to assess the knowledge, attitude and practices of HCWs about COVID-19 and compare physicians and non-physicians in Saudi Arabia. METHODS: An online survey was conducted among HCWs in Saudi Arabia in March and April 2020. Data were collected using a structured questionnaire having four sections including; socio-demographic and professional profile, knowledge, attitude and practices regarding COVID-19. Questionnaire link was sent through social media. Descriptive analysis was used for assessment of knowledge, attitude and practice and Chi-square test was used for comparing physicians and non-physicians. Data were analyzed using SPSS version 21.0. RESULTS: A total of 398 HCWs completed the questionnaire. Only 45% of the participants had correct knowledge about the agent while about 97% knew that close contact with infected person is the most important risk factor. Only 63% had correct knowledge about the role of antibiotics in COVID-19 treatment. Majority of the HCWs were worried and most frequently reported worry was risk to family. Carrying infection to home was most commonly reported fear, 92%. Cleaning hands often or always was 11.5% and 87% respectively. About 71% wore mask during work. Knowledge was better among physicians compared to non-physicians while attitude and practices were comparable between the two groups. CONCLUSION: We found that there was poor knowledge about causative agent and role of antibiotics for COVID-19 but for mode of transmission and prevention there was good knowledge. There were widely prevalent worries and fears among the participants. Overall, there were good infection control practices among the HCWs. Interventions are needed to improve knowledge and address worries and fears of HCW.


Subject(s)
COVID-19 , Health Personnel , Infection Control/methods , Physicians , SARS-CoV-2/pathogenicity , Universal Precautions/methods , Adult , COVID-19/drug therapy , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/transmission , Cross-Sectional Studies , Demography , Female , Health Knowledge, Attitudes, Practice , Health Personnel/education , Health Personnel/psychology , Humans , Male , Needs Assessment , Physicians/psychology , Physicians/standards , Saudi Arabia/epidemiology , Sociological Factors , Surveys and Questionnaires
20.
Int J Environ Res Public Health ; 17(18)2020 09 08.
Article in English | MEDLINE | ID: covidwho-760919

ABSTRACT

As the novel coronavirus disease 2019 (COVID-19) pandemic continues, engaging the public in adherence to precautionary measures for preventing COVID-19 spread or infection becomes difficult. The present study aims to extend our understanding of how illness perceptions, coping, and self-efficacy affect adherence to precautionary measures among the public. An online survey was administered between April and June 2020 to a sample of 514 Hong Kong citizens. Variables considered were illness perceptions toward COVID-19, problem-solving, avoidance-based coping, self-efficacy, as well as adherence to precautionary measures including physical distancing, limiting unnecessary travelling, and washing hands regularly with soap and water. Adjusted structural equation model showed that illness perceptions toward COVID-19 had significant direct effect on their adherence to precautionary measures (unstandardized ß = 0.50, [95% CI, 0.28, 0.80], p = 0.001), and indirect effects through avoidance-based coping (ß = -0.10 [95% CI, -0.26, -0.01], p = 0.016) and self-efficacy (ß = -0.10, [95% CI, -0.18, -0.01], p = 0.025). These results imply that apart from emphasizing the health hazards of a novel infectious disease, an effective public health intervention and crisis communication should address avoidance-based coping and self-efficacy of the public in adherence to precautionary measures for COVID-19.


Subject(s)
Adaptation, Psychological , Coronavirus Infections/prevention & control , Coronavirus , Disease Transmission, Infectious/prevention & control , Guideline Adherence/statistics & numerical data , Pandemics , Pneumonia, Viral/prevention & control , Betacoronavirus , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/psychology , Hong Kong/epidemiology , Humans , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/psychology , SARS-CoV-2 , Self Efficacy , Universal Precautions
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