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1.
BMC Public Health ; 21(1): 1153, 2021 06 16.
Article in English | MEDLINE | ID: covidwho-1277929

ABSTRACT

BACKGROUND: Shielding of high-risk groups from coronavirus disease (COVID-19) has been suggested as a realistic alternative to severe movement restrictions during the COVID-19 epidemic in low-income countries. The intervention entails the establishment of 'green zones' for high-risk persons to live in, either within their homes or in communal structures, in a safe and dignified manner, for extended periods of time during the epidemic. To our knowledge, this concept has not been tested or evaluated in resource-poor settings. This study aimed to explore the acceptability and feasibility of strategies to shield persons at higher risk of severe COVID-19 outcomes, during the COVID-19 epidemic in six communities in Sudan. METHODS: We purposively sampled participants from six communities, illustrative of urban, rural and forcibly-displaced settings. In-depth telephone interviews were held with 59 members of households with one or more members at higher risk of severe COVID-19 outcomes. Follow-up interviews were held with 30 community members after movement restrictions were eased across the country. All interviews were audio-recorded, transcribed verbatim, and analysed using a two-stage deductive and inductive thematic analysis. RESULTS: Most participants were aware that some people are at higher risk of severe COVID-19 outcomes but were unaware of the concept of shielding. Most participants found shielding acceptable and consistent with cultural inclinations to respect elders and protect the vulnerable. However, extra-household shielding arrangements were mostly seen as socially unacceptable. Participants reported feasibility concerns related to the reduced socialisation of shielded persons and loss of income for shielding families. The acceptability and feasibility of shielding strategies were reduced after movement restrictions were eased, as participants reported lower perception of risk in their communities and increased pressure to comply with social commitments outside the house. CONCLUSION: Shielding is generally acceptable in the study communities. Acceptability is influenced by feasibility, and by contextual changes in the epidemic and associated policy response. The promotion of shielding should capitalise on the cultural and moral sense of duty towards elders and vulnerable groups. Communities and households should be provided with practical guidance to implement feasible shielding options. Households must be socially, psychologically and financially supported to adopt and sustain shielding effectively.


Subject(s)
COVID-19 , Aged , Disease Outbreaks , Feasibility Studies , Humans , SARS-CoV-2 , Sudan/epidemiology
2.
BMC Public Health ; 21(1): 1152, 2021 06 16.
Article in English | MEDLINE | ID: covidwho-1277925

ABSTRACT

BACKGROUND: Weight management is complex for people even in times of stability. Supporting individuals to develop strategies to maintain a healthier weight when there are additional life challenges may prevent relapse. This mixed-methods study describes the impact the COVID-19 restrictions had on adults engaged in weight management before and during the pandemic in order to determine helpful strategies. METHODS: Longitudinal data was captured from online surveys completed by Slimming World (SW) members 0-4 weeks after joining, October/November 2019, providing pre-joining and baseline (T0&T1), 3- (T2) and 6- month (T3-during COVID-19) data. Representatives from the general population, not attending a weight management service, completed the same questionnaires providing cross-sectional control data. All weights are self-reported. For this study, questions assessing the impact of the COVID-19 challenges on health-related behaviours and well-being are included comparing responses at T0/T1, T2 & T3. Longitudinal data were analysed using repeated measures ANOVA and cross-sectional data, one-way independent ANOVAs to compare means. Comparisons between SW members and controls were determined using z-proportion tests. Qualitative data generated was thematically analysed using a six-step approach to produce the key emerging themes. RESULTS: 222 SW members completed all three surveys, achieving a weight loss of 7.7 ± 7.5%. They maintained positive health-related behaviour changes made since joining, including increased fruit and vegetables (p < 0.001), fewer sugary drinks (p < 0.001), cooking from scratch (p < 0.001) and increased activity levels (p < 0.001). Despite COVID-19 restrictions, they were still reporting improvements in all behaviours and had healthier scores than the controls on all but alcohol intake, although still within guidelines. Qualitative data indicated that the situation created various challenges to managing weight with fresh foods harder to access, comfort eating, drinking more alcohol, eating more sugary foods and snacking through boredom. However, some reported having more free time enabling better planning, more time to cook from scratch and increased physical activity. CONCLUSIONS: The findings highlight the value of peer, group and online support and guidance for individuals to develop sustainable behaviour changes and a level of resilience. These strategies can then be drawn upon enabling maintenance of lifestyle changes and management of weight even in challenging times.


Subject(s)
COVID-19 , Adult , Cross-Sectional Studies , Health Behavior , Humans , Pandemics , SARS-CoV-2 , Surveys and Questionnaires
3.
BMC Health Serv Res ; 21(1): 579, 2021 Jun 16.
Article in English | MEDLINE | ID: covidwho-1270929

ABSTRACT

BACKGROUND: The COVID-19 pandemic has a significant impact on health care processes. Precautions such as restrictions imposed on visitors and social distancing have led to multiple challenges, particularly in terms of communication. Using the case of nursing, palliative and hospice care facilities in Germany and drawing on agenda-setting theory, the present study aims to shed light on how health care facilities use their websites to inform (potential) health care users about changes in regulations, new protective measures implemented and about recommendations in the context of the COVID-19 pandemic. METHODS: The websites of nursing, palliative and hospice care facilities in Germany were examined using qualitative document analysis and qualitative content analysis. A total of 138 websites was analysed in the study. The data gathered includes all information about COVID-19 on these websites published from the beginning of March until August 15, 2020. RESULTS: Facilities show similarities in adhering to the measures taken by the authorities to restrict the spread of SARS-CoV-2 and to protect vulnerable patients and employees. All facilities urged the public to avoid paying visits to patients in facilities unless there was an emergency; however, visiting procedures in practice varied by types of facilities. For optimal communication, telephone and especially video calls were the options preferred by health care providers and health care users. Facilities made great efforts to prevent emotional stress and to strengthen resilience among all stakeholders. Transparency was adopted by many facilities in order to build the public's trust. CONCLUSIONS: The agenda of health care facilities has been seriously affected by the COVID-19 pandemic. The study sheds light on the strategies developed by facilities, their efforts to increase emotional resilience among health care staff and health care users, the ethical guidelines they have adopted regarding privacy policies as well as how these themes are communicated via the facilities' websites. The results can inform other health care facilities about how websites can be used as essential communication tools in times of public health crises.


Subject(s)
COVID-19 , Hospice Care , Germany/epidemiology , Humans , Pandemics/prevention & control , SARS-CoV-2
4.
Front Public Health ; 9: 674035, 2021.
Article in English | MEDLINE | ID: covidwho-1268318

ABSTRACT

Research Objective: Initiatives to address social determinants of health (SDOH) and measure health-related social needs (HRSN) within clinic settings are increasing. However, few have focused on the specific needs of Asian Americans (AA). We examine the prevalence of HRSN during a period spanning the COVID-19 pandemic to inform strategies to improve cancer screening and primary care among AA patients. Methods: We implemented a self-administered HRSN screening tool in English and Chinese, traditional (T) or simplified (S) text, within a hospital-affiliated, outpatient primary care practice predominantly serving AA in New Jersey. HRSN items included food insecurity, transportation barriers, utility needs, interpersonal violence, housing instability, immigration history, and neighborhood perceptions on cohesion and trust. We conducted medical chart reviews for a subset of participants to explore the relationship between HRSN and history of cancer screening. Results: Among 236 participants, most were Asian (74%), non-US born (79%), and privately insured (57%). One-third responded in Chinese (37%). Half reported having ≥1 HRSN. Interpersonal violence was high across all participants. Transportation needs were highest among Chinese-T participants, while food insecurity and housing instability were higher among Chinese-S participants. Lower-income patients had higher odds of having ≥2 HRSN (OR:2.53, 95% CI: 1.12, 5.98). Older age and public insurance/uninsured were significantly associated with low neighborhood perceptions. Conclusions: We observed higher than anticipated reports of HRSN among primary care patients in a suburban, hospital-affiliated practice serving AA. Low neighborhood perceptions, particularly among Chinese-S participants, highlight the importance of addressing broader SDOH among insured, suburban AA patients. These study findings inform the need to augment HRSN identification to adequately address social needs that impact health outcomes and life course experiences for Asian patients. As HRSN measuring efforts continue, and COVID-19's impact on the health of minority communities emerge, it will be critical to develop community-specific referral pathways to connect AA to resources for HRSN and continue to address more upstream social determinants of health for those who are disproportionately impacted.


Subject(s)
COVID-19 , Neoplasms , Aged , Asian Americans , Early Detection of Cancer , Humans , Neoplasms/diagnosis , New Jersey , Pandemics , Primary Health Care , SARS-CoV-2
5.
J Cancer Surviv ; 2021 Jun 14.
Article in English | MEDLINE | ID: covidwho-1267510

ABSTRACT

PURPOSE: We explored adolescent and young adult cancer survivor (AYA) experiences with COVID-19 to understand the impact of living through a pandemic, unmet needs, and coping strategies. METHODS: AYAs were recruited nationally, completed an online survey, and attended one of six online focus groups. We used qualitative content analysis to analyze focus group data. RESULTS: Thirty-nine AYAs completed the survey, and 24 also participated in the focus groups. In the survey, AYAs responded that COVID-19 increased anxiety about their health or their family's health, feelings of isolation, and worries about job security. Overarching focus group themes included AYA behavioral responses to the pandemic similar to their peers, the added burden of cancer, and unexpected advantages of a cancer history. When discussing the added burden of cancer, subthemes included difficulties and delays in medical care, mental health stressors, and compounding uncertainty. Unexpected advantages of a cancer history included relying on coping strategies developed during active treatment and resiliency from practicing social distancing during treatment. CONCLUSIONS: AYAs have struggled in the early pandemic in ways similar to their peers but with compounding uncertainty regarding their unknown risk due to cancer history. Healthcare providers and systems can better support AYAs by providing additional psychosocial supports, developing strategies to triage good candidates for telehealth, and providing information about cancer survivor-specific risks for COVID-19. IMPLICATIONS FOR CANCER SURVIVORS: Our findings indicate a need for psychosocial supports that address managing anxiety and uncertainty. AYAs may be able to draw on their cancer experiences to navigate the COVID-19 pandemic.

6.
Front Pediatr ; 9: 638502, 2021.
Article in English | MEDLINE | ID: covidwho-1247888

ABSTRACT

Background: The contact tracing and isolation of contagious individuals are cornerstones in the control of the COVID-19 pandemic. Strategies to identify household contacts who should be isolated around index children that tested positive for SARS-CoV-2 remain to be clarified. We aimed to compare contact tracing strategies around an index child positive for SARS-CoV-2 using serological rapid diagnostic testing (RDT, chromatography immunoassay). Methods: We conducted a contact tracing study in households of index cases children in the Paris region, France, between May 8 and July 27, 2020. We compared two strategies, one using SARS-CoV-2 reverse transcriptase polymerase chain reaction (RT-PCR) and one combining RT-PCR and serological RDT, initiated once RDT was available. The contacts RT-PCR-/RDT+ were considered to have been previously infected and not requiring quarantine. The primary outcome was the proportion of contacts that could avoid quarantine with the two screening strategies. Results: We included 34 children as index cases. Median age was 7 years. They generated 184 contacts (111 adults, 73 children) tested by RT-PCR: 24/184 (13%) were positive. The strategy combining RDT and RT-PCR was performed in 120/184 contacts (77 adults, 43 children) of 26 index children: 16/120 (13%) were RT-PCR+ and 47/120 (39%) were RDT+. Among the 16 individuals who were RT-PCR+, 14 (87%) were also RDT+. Among the 104 individuals who were RT-PCR-, 33 were RDT+. Hence 33/120 (27%) individuals were not isolated. Conclusions: Following the diagnosis of SARS-CoV-2 infection in children, a strategy combining serological RDT and nasopharyngeal RT-PCR enabled us to identify around one fourth of contacts with past infection and avoid unnecessary quarantine of these individuals.

7.
BMC Public Health ; 21(1): 1020, 2021 05 30.
Article in English | MEDLINE | ID: covidwho-1247584

ABSTRACT

BACKGROUND: Cases of the Corona Virus Disease of 2019 (COVID-19) in Kenya have continued to increase rapidly, since the first case in the country was confirmed in March 2020. In the wake of the pandemic, the health and socio-economic challenges experienced by the youth in Kenya are likely to be elevated. We assessed knowledge, practices, perceived risk of infection, adoption of recommended behaviour and the effects of COVID-19 among the youth in Kenya. METHODS: A cross sectional descriptive study was conducted between April 30th to May 7th, 2020 through a combined online survey and phone interviews. A total of 2156 youth across all 47 counties in Kenya completed the responses to the study questions. All survey responses analyzed using Stata version 15 were tabulated by gender, age, and education level to generate basic descriptive tables and tested for differences by category using chi-square tests. Where applicable, linear and logistic regression analysis model was conducted using covariates such as employment status, gender, and education level. RESULTS: Knowledge on symptoms of COVID-19 was generally high. Female respondents were more likely to identify more symptoms correctly compared to men (p < 0.001). However, youth reported very low levels of anyone being at risk of infection (7.1%). Most youth have adopted behavior necessary to slow down the infection. There were generally very low reported levels of inability to access health services related to sexual and reproductive health. About 50.0% of respondents reported significant decline in income during the pandemic period, nearly a third reported living in fear while 26.5% reported feeling stressed. CONCLUSION: There was high knowledge of COVID-19 symptoms, preventive strategies, and high adoption of preventive practices. Strategies to sustain behaviors positively adopted among young people will be critical to reduce the spread of COVID-19. Despite the low reported rates of inability to access sexual and reproductive health, response measures should include strategies that facilitate continuity of services among young people. The reported social effects of the pandemic show the need for interventions to meet the health and socio-economic needs of the youth and minimize the long-term consequences of the pandemic.


Subject(s)
COVID-19 , Health Knowledge, Attitudes, Practice , Adolescent , Cross-Sectional Studies , Female , Humans , Kenya/epidemiology , Male , SARS-CoV-2
8.
Educ Inf Technol (Dordr) ; : 1-33, 2021 May 18.
Article in English | MEDLINE | ID: covidwho-1240016

ABSTRACT

The COVID-19 pandemic has disrupted many areas of the human and organizational ventures worldwide. This includes new innovative technologies and strategies being developed by educators to foster the rapid learning-recovery and reinstatement of the stakeholders (e.g., teachers and students). Indeed, the main challenge for educators has been on what appropriate steps should be taken to prevent learning loss for the students; ranging from how to provide efficient learning tools/curriculum that ensures continuity of learning, to provision of methods that incorporate coping mechanisms and acceleration of education in general. For several higher educational institutions (HEIs), technology-mediated education has become an integral part of the modern teaching/learning instruction amidst the Covid-19 pandemic, when digital technologies have consequently become an inevitable and indispensable part of learning. To this effect, this study defines a hybrid educational model (HyFlex + Tec) used to enable virtual and in-person education in the HEIs. Practically, the study utilized data usage report from Massive Open Online Courses (MOOCs) and Emotions and Experience Survey questionnaire in a higher education setting for its experiments. To this end, we applied an Exponential Linear trend model and Forecasting method to determine overall progress and statistics for the learners during the Covid-19 pandemic, and subsequently performed a Text Mining and Univariate Analysis of Variance (ANOVA) to determine effects and significant differences that the teaching-learning experiences for the teachers and students have on their energy (learning motivation) levels. From the results, we note that the hybrid learning model supports continuity of education/learning for teachers and students during the Covid-19 pandemic. The study also discusses its innovative importance for future monitoring (tracking) of learning experiences and emotional well-being for the stakeholders in leu (aftermath) of the Covid-19 pandemic.

9.
J Indian Inst Sci ; 100(4): 849-862, 2020.
Article in English | MEDLINE | ID: covidwho-1235812

ABSTRACT

Many countries have introduced Lockdowns to contain the COVID19 epidemic. Lockdowns, though an effective policy for containment, imposes a heavy cost on the economy as it enforces extreme social distancing measures on the whole population. The objective of this note is to study alternatives to Lockdown which are either more targeted or allows partial opening of the economy. Cities are often spatially organized into wards. We introduce Multi-lattice small world (MLSW)  network as a model of a city where each ward is represented by a 2D lattice and each vertex in the latex represents an agent endowed with SEIR dynamics. Through simulation studies on MLSW, we examine a variety of candidate suppression policies and find that restricting Lockdowns to infected wards can indeed out-perform global Lockdowns in both reducing the attack rate and also shortening the duration of the epidemic. Even policies such as partial opening of the economy, such as Two-Day Work Week, can be competitive if augmented with extensive Contact Tracing.

10.
Popul Health Manag ; 24(S1): S16-S25, 2021 02.
Article in English | MEDLINE | ID: covidwho-1236199

ABSTRACT

The coronavirus disease-2019 (COVID-19) pandemic is having a widespread impact on societies across the globe. As part of the effort to control transmission in the United States, many businesses either closed or instituted nonpharmaceutical control measures and allowed only essential workers on-site. During summer and fall of 2020, employers began formulating "return to work" strategies designed to mitigate the risk of transmission among employees. On a population level, several countries implemented national testing and surveillance strategies that proved effective in mitigating citizen-to-citizen transmission and contributed to suppressing COVID-19. A crucial component of many such strategies is population-based testing to identify and engage individuals with asymptomatic or presymptomatic infection, which also is relevant to return-to-work strategies. The authors describe an approach that multisite employers might use to help mitigate transmission of COVID-19 in the workplace. This approach leverages a bioinformatics platform informed by real-time PCR test data at the county and subcounty (eg, Public Use Microdata Area) level, allowing for population-based testing to be selectively targeted for employees in geographies with elevated SARS-CoV-2 positivity. A "Command Center" application integrates data from multiple sources (eg, local infection trends, employee symptom diaries, Bluetooth thermometers) in real time, which can be used to inform decisions regarding surveillance and employee self-isolation or quarantine; a mobile phone-based application provides for rapid, secure communication with employees. This overview is based on peer-reviewed literature and the early experience of a large employer with implementing bioinformatics tools to mitigate the impact of the pandemic on the workplace.


Subject(s)
COVID-19 , Models, Statistical , Occupational Health , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/transmission , COVID-19 Testing , Computational Biology , Humans , Pandemics , Public Health Surveillance , SARS-CoV-2 , United States , Workplace
11.
Am Surg ; : 31348211011125, 2021 May 19.
Article in English | MEDLINE | ID: covidwho-1234445

ABSTRACT

BACKGROUND: In response to the COVID-19 pandemic, children's hospitals across the country postponed elective surgery beginning in March 2020. As projective curves flattened, administrators and surgeons sought to develop strategies to safely resume non-emergent surgery. This article reviews challenges and solutions specific to a children's hospital related to the resumption of elective pediatric surgeries. We present our tiered reentry approach for pediatric surgery as well as report early data for surgical volume and tracking COVID-19 cases during reentry. METHODS: The experience of shutdown, protocol development, and early reentry of elective pediatric surgery are reported from Levine's Children's Hospital (LCH), a free-leaning children's hospital in Charlotte, North Carolina. Data reported were obtained from de-identified hospital databases. RESULTS: Pediatric surgery experienced a dramatic decrease in case volumes at LCH during the shutdown, variable by specialty. A tiered and balanced reentry strategy was implemented with steady resumption of elective surgery following strict pre-procedural screening and testing. Early outcomes showed a steady thorough fluctuating increase in elective case volumes without evidence of a surgery-associated positive spread through periprocedural tracking. CONCLUSION: Reentry of non-emergent pediatric surgical care requires unique considerations including the impact of COVID-19 on children, each children hospital structure and resources, and preventing undue delay in intervention for age- and disease-specific pediatric conditions. A carefully balanced strategy has been critical for safe reentry following the anticipated surge. Ongoing tracking of resource utilization, operative volumes, and testing results will remain vital as community spread continues to fluctuate across the country.

12.
Popul Health Manag ; 24(6): 675-680, 2021 12.
Article in English | MEDLINE | ID: covidwho-1228419

ABSTRACT

Health information technology (HIT) can enhance optimal health care access and utilization among individuals living with chronic diseases. This study aimed to provide population-level information on racial/ethnic disparities in HIT use and associated trends among those living with chronic diseases. The study sample consisted of adult respondents (≥18 years) of the 2011-2018 National Health Interview Survey living with at least 1 chronic condition. Binomial regression was used to analyze the association between race/ethnicity, year, and 4 measures of HIT use for patient-provider interaction. Regression parameter estimates were used to predict the trends in probability of the outcome variables across race/ethnicity. About 73% of the study sample were non-Hispanic Whites, 15% were non-Hispanic Blacks, and 13% were Hispanics. Compared to non-Hispanic Whites, there were decreased adjusted odds of any HIT use among non-Hispanic Blacks (OR = 0.72; 95% CI = 0.67, 0.76) and Hispanics (OR = 0.78; 95% CI = 0.72, 0.84). The likelihood of any HIT use increased with increasing year (OR: 1.16; 95% CI = 1.15, 1.18). Trends in racial/ethnic disparities were wider for email communication with provider and online prescription refill compared to online scheduling of appointment. The COVID-19 pandemic has led to accelerated adoption or expansion of HIT for patient care. Limited HIT use among non-Hispanic Blacks and Hispanics could worsen the disproportionate chronic disease burden, suboptimal clinical outcomes, and preventable health care costs experienced by this subpopulation. In conclusion, there is a need for intentional and strategic population-level interventions to increase HIT adoption and use among non-Hispanic Blacks and Hispanics living with chronic diseases.


Subject(s)
COVID-19 , Medical Informatics , Adult , Chronic Disease , Healthcare Disparities , Humans , Pandemics , SARS-CoV-2 , United States/epidemiology
13.
JAMA Netw Open ; 4(5): e2110071, 2021 05 03.
Article in English | MEDLINE | ID: covidwho-1227701

ABSTRACT

Importance: Nursing homes and other long-term care facilities have been disproportionately impacted by the COVID-19 pandemic. Strategies are urgently needed to reduce transmission in these high-risk populations. Objective: To evaluate COVID-19 transmission in nursing homes associated with contact-targeted interventions and testing. Design, Setting, and Participants: This decision analytical modeling study developed an agent-based susceptible-exposed-infectious (asymptomatic/symptomatic)-recovered model between July and September 2020 to examine SARS-CoV-2 transmission in nursing homes. Residents and staff of a simulated nursing home with 100 residents and 100 staff split among 3 shifts were modeled individually; residents were split into 2 cohorts based on COVID-19 diagnosis. Data were analyzed from September to October 2020. Exposures: In the resident cohorting intervention, residents who had recovered from COVID-19 were moved back from the COVID-19 (ie, infected with SARS-CoV-2) cohort to the non-COVID-19 (ie, susceptible and uninfected with SARS-CoV-2) cohort. In the immunity-based staffing intervention, staff who had recovered from COVID-19 were assumed to have protective immunity and were assigned to work in the non-COVID-19 cohort, while susceptible staff worked in the COVID-19 cohort and were assumed to have high levels of protection from personal protective equipment. These interventions aimed to reduce the fraction of people's contacts that were presumed susceptible (and therefore potentially infected) and replaced them with recovered (immune) contacts. A secondary aim of was to evaluate cumulative incidence of SARS-CoV-2 infections associated with 2 types of screening tests (ie, rapid antigen testing and polymerase chain reaction [PCR] testing) conducted with varying frequency. Main Outcomes and Measures: Estimated cumulative incidence proportion of SARS-CoV-2 infection after 3 months. Results: Among the simulated cohort of 100 residents and 100 staff members, frequency and type of testing were associated with smaller outbreaks than the cohorting and staffing interventions. The testing strategy associated with the greatest estimated reduction in infections was daily antigen testing, which reduced the mean cumulative incidence proportion by 49% in absence of contact-targeted interventions. Under all screening testing strategies, the resident cohorting intervention and the immunity-based staffing intervention were associated with reducing the final estimated size of the outbreak among residents, with the immunity-based staffing intervention reducing it more (eg, by 19% in the absence of testing) than the resident cohorting intervention (eg, by 8% in the absence of testing). The estimated reduction in transmission associated with these interventions among staff varied by testing strategy and community prevalence. Conclusions and Relevance: These findings suggest that increasing the frequency of screening testing of all residents and staff, or even staff alone, in nursing homes may reduce outbreaks in this high-risk setting. Immunity-based staffing may further reduce spread at little or no additional cost and becomes particularly important when daily testing is not feasible.


Subject(s)
COVID-19/prevention & control , COVID-19/transmission , Homes for the Aged , Nursing Homes , Personnel Staffing and Scheduling/organization & administration , Adaptive Immunity , Aged , COVID-19/diagnosis , COVID-19/virology , COVID-19 Nucleic Acid Testing , COVID-19 Serological Testing , Decision Support Techniques , Humans , Personal Protective Equipment , Viral Load , Vulnerable Populations
14.
Vaccines (Basel) ; 9(5)2021 May 13.
Article in English | MEDLINE | ID: covidwho-1227077

ABSTRACT

The pandemic of COVID-19 might be limited by vaccination. Society should be vaccinated to prevent the spread of coronavirus disease 2019 (COVID-19) and to protect persons who are at high risk for complications. In Poland, the National Vaccination Program has been introduced, which is a strategy for planning activities to ensure safe and effective vaccinations among Polish citizens. It includes not only the purchase of an appropriate number of vaccines, their distribution but also monitoring of the course and effectiveness of vaccination and the safety of Poles. The national COVID-19 immunization program has been divided into four stages. Stage 0 covers the healthcare workers to be vaccinated first, as they are most at risk of being infected with the coronavirus. The study aims to prove the thesis that GIS statistical data on the incidence of COVID-19 post-vaccination reactions should be verified, as patients do not report their occurrence through the procedure indicated by GIS. In March 2021, an anonymous questionnaire survey was conducted using an electronic questionnaire among persons belonging to group zero of the National Vaccination Program. The survey consisted of 19 short questions concerning, inter alia, getting COVID-19, post-vaccination reactions after receiving the first and second doses of the COVID-19 vaccine, and motivation to proceed with vaccination. A total of 1678 complete responses were received. It has been shown that only a small number of post-vaccination reactions are reported to the Sanitary Inspection, which makes GIS statistics on the incidence of post-vaccination reactions in COVID-19 unreliable. In addition, having earlier suffered from COVID-19 had an impact on the occurrence of more severe side effects after the first dose of the COVID-19 vaccine.

15.
Clin Pract Epidemiol Ment Health ; 17: 19-25, 2021.
Article in English | MEDLINE | ID: covidwho-1226930

ABSTRACT

BACKGROUND: The COVID-19 crisis is fuelling a state of fear among the human population at global level. Especially, those living in informal settlements and slums worldwide have been profoundly impacted by this pandemic. Individuals living in these places are already leading underprivileged lives. Thus, the economic and mental health problems caused by the COVID-19 crisis have further exacerbated their living standards, which has resulted, for instance, in tragedies such as suicides. OBJECTIVE: In this study, we have sought to identify those individuals most at risk of displaying high levels of fear of COVID-19 in an informal settlement located in the capital city of Peru. METHODS: A questionnaire was administered to 449 inhabitants living in the Carmen Alto informal settlement. The questionnaire was made up of two parts: the first one inquired about demographic data and the second part consisted of the Fear of COVID-19 Scale. RESULTS: The demographic variables of age, gender, marital status, educational level, occupation, whether a relative from the household was infected with COVID-19, and whether one of them died of this showed significant differences. It could be observed as well that the groups of females, stable workers, unemployed and those having completed a workforce education are at higher odds of displaying high levels of fear of COVID-19. As expected, the groups that had either a relative infected with COVID-19 or a relative death by this had the highest levels of fear towards the virus. CONCLUSION: The female participants are more likely to display higher levels of fear of COVID-19 due to the terrible effect that unfavorable events have on them. In the cases of the unemployed and stable workers, their proneness to show high levels of fear towards the virus is because they have lost their incomes, due to the loss of their jobs, and because of fear of infection, respectively. Hence, we hope that this work serves Peruvian (and other) health authorities to develop strategies that help individuals living in informal settlements and are in urgent need of mitigating mental health problems.

16.
Rev Bras Med Trab ; 19(1): 107-113, 2021 Apr 30.
Article in English | MEDLINE | ID: covidwho-1219744

ABSTRACT

Community healthcare agents are strategic professionals in delivery of Primary Healthcare activities. This article reflects on the role of continuing education in healthcare as a strategic element in ensuring the occupational health of community healthcare agents faced with combating and managing coronavirus 19 disease (COVID-19). In the current scenario, the work of community healthcare agents is undergoing daily reconstruction of professional practice in order to keep pace with the living territories to which they are assigned. Continuing education in healthcare enables construction of feasible scenarios that make problem solving possible, involving a constant reflective analytical perception of professional practices, permitting (re)construction of social skills such as the capacity to mobilize and motivate other actors to participate in political action. Through problematization, identification of needs, and questioning, continuing education in healthcare leads to (de)construction of the working practices of the very actors who are delivering care. Furthermore, continuing education in healthcare reaffirms the importance of the social, technical, and political training of community healthcare agents, thereby confirming their right to dignified and quality work. In a pandemic scenario, an agenda focused on continuing education in healthcare is essential to the continuity of care delivery to communities, facilitating expansion of access to the right to health.

17.
Aging Ment Health ; 26(5): 881-889, 2022 May.
Article in English | MEDLINE | ID: covidwho-1216544

ABSTRACT

OBJECTIVE: To identify factors associated with mental health of older adults during the pandemic and to provide strategies to mitigate their psychosocial impact in the elderly. METHOD: An integrative text mining analysis in Medline was performed to identify studies on the mental health of older adults during the pandemic. Subsequently, statistical topic modeling was performed to identify the most prevalent terms and topics discussed in included studies. RESULTS: A total of 29 studies were retrieved until July 1st 2020, including a majority of letters (12 studies) and commentaries (8 studies). The most frequent terms overall were: loneliness (n = 137), support (n = 132), home (n = 102), suicide (n = 96) and help (n = 94). The most prevalent terms were then divided in five topics: home (33%), suicide (32%), apps (15%), loneliness (12%) and physical activity (9%). Additionally, a section focused on low- and middle-income countries was included. A summary of strategies to mitigate the effects of pandemic in mental health of older adults was also provided. CONCLUSION: These factors demonstrate the importance of developing strategies for psychosocial support that take into consideration the particularities of the elderly. Different levels of care are immediately necessary to diminish the devastating impact of the pandemic in the mental health of older adults.


Subject(s)
COVID-19 , Pandemics , Aged , Aging , COVID-19/epidemiology , Data Mining , Humans , Social Stigma
18.
Front Psychol ; 12: 635816, 2021.
Article in English | MEDLINE | ID: covidwho-1211852

ABSTRACT

The global impact of Coronavirus Disease 2019 (COVID-19) is tremendous on human life, not only affecting the physical and mental health of population but also impacting the economic system of countries and individual itself. The present situation demands prompt response toward COVID-19 by equipping the humans with strategies to overcome the infection and stress associated with it. These strategies must not only be limited to preventive and therapeutic measures, but also aim at improving immunity and mental health. This can be achieved by yogic breathing techniques. In this perspective, we emphasize the importance of yogic breathing, Simha Kriya and Isha kriya, the simple yet effective breathing techniques.

19.
Semin Thromb Hemost ; 47(4): 362-371, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1203471

ABSTRACT

BACKGROUND: Venous thromboembolism (VTE) is a frequent complication of COVID-19, so that the importance of adequate in-hospital thromboprophylaxis in patients hospitalized with COVID-19 is well established. However, the incidence of VTE after discharge and whether postdischarge thromboprophylaxis is beneficial and safe are unclear. In this prospective observational single-center study, we report the incidence of VTE 6 weeks after hospitalization and the use of postdischarge thromboprophylaxis. METHODS: Patients hospitalized with confirmed COVID-19 were invited to a multidisciplinary follow-up clinic 6 weeks after discharge. D-dimer and C-reactive protein were measured, and all patients were screened for deep vein thrombosis with venous duplex-ultrasound. Additionally, selected high-risk patients received computed tomography pulmonary angiogram or ventilation-perfusion (V/Q) scan to screen for incidental pulmonary embolism. RESULTS: Of 485 consecutive patients hospitalized from March through June 2020, 146 patients were analyzed, of which 39% had been admitted to the intensive care unit (ICU). Postdischarge thromboprophylaxis was prescribed in 28% of patients, but was used more frequently after ICU stay (61%) and in patients with higher maximal D-dimer and C-reactive protein levels during hospitalization. Six weeks after discharge, elevated D-dimer values were present in 32% of ward and 42% of ICU patients. Only one asymptomatic deep vein thrombosis (0.7%) and one symptomatic pulmonary embolism (0.7%) were diagnosed with systematic screening. No bleedings were reported. CONCLUSION: In patients who had been hospitalized with COVID-19, systematic screening for VTE 6 weeks after discharge revealed a low incidence of VTE. A strategy of selectively providing postdischarge thromboprophylaxis in high-risk patients seems safe and potentially effective.


Subject(s)
C-Reactive Protein/metabolism , COVID-19 , Fibrin Fibrinogen Degradation Products/metabolism , Patient Discharge , SARS-CoV-2/metabolism , Venous Thromboembolism , COVID-19/blood , COVID-19/complications , COVID-19/mortality , COVID-19/therapy , Follow-Up Studies , Humans , Male , Middle Aged , Prospective Studies , Pulmonary Embolism/blood , Pulmonary Embolism/etiology , Pulmonary Embolism/mortality , Pulmonary Embolism/prevention & control , Venous Thromboembolism/blood , Venous Thromboembolism/etiology , Venous Thromboembolism/mortality , Venous Thromboembolism/prevention & control , Venous Thrombosis/blood , Venous Thrombosis/etiology , Venous Thrombosis/mortality , Venous Thrombosis/prevention & control
20.
Adv Radiat Oncol ; 6(4): 100626, 2021.
Article in English | MEDLINE | ID: covidwho-1202913

ABSTRACT

PURPOSE: The management of older patients in radiation therapy (RT) departments has been challenging in the context of the Coronavirus Disease 2019 (COVID-19) outbreak. We report our experience of RT adapted schedules or strategy changes in older patients during the COVID-19 pandemic. METHODS AND MATERIALS: Patients aged ≥75 years were recruited during weekly chart rounds. All were potentially eligible for a specific intervention to reduce the frequency of patients' visits to the hospital. The effect of deferring radiation and hypofractionation of RT schedules was assessed in terms of the number of courses initially planned and replanned during the lockdown. RESULTS: Twenty patients were identified during the official lockdown in France (March 17 to May 11). Median age was 78 years (75-95 years). Most patients were male (n = 12, 60%) being treated in the postoperative setting (n = 17, 85%). RT was delayed in 11 cases (55%) with hormonal therapy prescribed in 10 cases (50%). Altered RT fractionation was proposed for 5 cases (25%); combinations of altered fractionation and deferral of radiation were applied in 3 cases (15%). The number of radiation courses initially planned and replanned according to the pandemic context: 563 and 197, respectively (-62%; P < .001). None presented recurrence when RT was initiated, and no patient developed symptomatic COVID-19 infection. CONCLUSIONS: In the context of the COVID-19 outbreak, individual risk-based radiation therapy seems to be safe. Systematic screening of patients for COVID-19 before starting radiation therapy is mandatory. In our department the oncogeriatrics expertise availability for daily practice was of great use during the pandemic. Other prospective studies are needed to validate such strategies in case of resurgence of similar outbreaks.

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