Asylum Seekers' Responses to Government COVID-19 Recommendations: A Cross-sectional Survey in a Swiss Canton.

Asylum seekers face multiple language, cultural and administrative barriers that could result in the inappropriate implementation of COVID-19 measures. This study aimed to explore their knowledge and attitudes to recommendations about COVID-19. We conducted a cross-sectional survey among asylum seekers living in the canton of Vaud, Switzerland. We used logistic regressions to analyze associations between knowledge about health recommendations, the experience of the pandemic and belief to rumors, and participant sociodemographic characteristics. In total, 242 people participated in the survey, with 63% of men (n = 150) and a median age of 30 years old (IQR 23-40). Low knowledge was associated with linguistic barriers (aOR 0.36, 95% CI 0.14-0.94, p = 0.028) and living in a community center (aOR 0.43, 95% CI 0.22-0.85, p = 0.014). Rejected asylum seekers were more likely to believe COVID-19 rumors (aOR 2.81, 95% CI 1.24-6.36, p = 0.013). This survey underlines the importance of tailoring health recommendations and interventions to reach asylum seekers, particularly those living in community centers or facing language barriers.

Expert guidance for COVID-19 vaccine deployment in Switzerland: a Delphi process.

BACKGROUND AND AIM: Vaccines providing protection against COVID-19 are a core tool for ending the pandemic. Though international organisations created guidance in 2020 for vaccine deployment, this had to be adapted for each country's situation and values. We aimed to assist public health decision makers by identifying areas of consensus among Swiss experts for the deployment of one or more novel COVID-19 vaccines. METHODS: An electronic, modified Delphi process between September and November 2020. We recruited a convenience sample of experts working in Switzerland from a variety of specialities, who completed two anonymous questionnaires. They voted on clarification questions and guidance statements from 0 (complete disagreement) to 10 (complete agreement). Responses for guidance statements with a median ≥8 and a lower inter-quartile range bound ≥7 were considered as reaching consensus. RESULTS: Sixty-five experts accepted (66% response rate), with 47 completing the first questionnaire (72%), and 48 the second (74%). Statements reaching consensus included: in the first phase we should vaccinate front-line healthcare professionals and people ≥65 years with risk factors; widespread vaccination of children and adolescents should not be an early priority; and vaccines should be provided free of charge in the setting of national or cantonal vaccination campaigns. Statements not reaching consensus included: early vaccination of people living with someone with risk factors who are not themselves at risk; vaccination of people with previous confirmed or suspected COVID-19; and whether vaccination should be mandatory for individuals with certain activities, such as front-line healthcare professionals. CONCLUSIONS: Experts reached consensus on several statements that were available for decision-makers when making key decisions for COVID-19 vaccine deployment in Switzerland. Statements without consensus highlighted areas requiring expert and public dialogue. The modified Delphi process allowed us to rapidly synthesise views from a broad panel of experts on sensitive topics, and could be considered for a broad range of issues during public health crises.

Performance du frottis nasopharyngé-PCR pour le diagnostic du Covid-19 - Recommandations pratiques sur la base des premières données scientifiques

The Covid-19 pandemic imposes new diagnostic strategies in order to optimize the medical care of our patients. The current biblio-graphy, although of low quality, shows a sensitivity of 56 to 83 % for the Covid-19 PCR. Even though one negative test can exclude a Covid-19 in the majority of cases, the NPV (Negative Predictive Value) decreases with increasing prevalence (pre-test probability). This finding suggests the need for strict auto-isolation of patients until the resolution of their symptoms. For patients that present with typical symptoms, who have a presumed Covid-19 prevalence of -40-50 %, a negative test should be interpreted with caution and a repeat test may be needed.

Citizen Responses to Government Restrictions in Switzerland During the COVID-19 Pandemic: Cross-Sectional Survey.

BACKGROUND: The success of government-recommended mitigation measures during the COVID-19 pandemic depends largely on information uptake and implementation by individual citizens. OBJECTIVE: Our aim was to assess citizens' knowledge and perceptions about COVID-19 recommendations in the Canton of Vaud, Switzerland. METHODS: A cross-sectional electronic survey with open and closed questions was disseminated by community-based partners prior to the relaxation of government restrictions. Outcomes included citizen knowledge (9-question measure) and worry about the virus, perception of government measures, and recommendations for improvements. Comparisons used linear regression, controlling for age, sex, education, and health literacy. Free-text answers were analyzed thematically. RESULTS: Of 807 people who accessed the survey, 684 (85%) completed all questions and 479 (60%) gave free-text recommendations. Overall, 75% were female, the mean age was 48 years, and 93% had high health literacy. Knowledge scores were high, with a median score of 8 out of 9. Mean levels of worry about the COVID-19 pandemic were higher in women than men (55/100 versus 44/100, P<.001), and in respondents with lower health literacy (57/100 versus 52/100, P=.03). Self-reported adherence to recommendations was high (85%) and increased with age and worry (both P<.001). Respondents rated their own adherence higher than others (85% versus 61%, P<.001). Moreover, 34% of respondents reported having self-quarantined; this rose to 52% for those aged ≥75 years. Those who had self-quarantined reported higher levels of fear. Nearly half (49%) of respondents felt the government response had been adequate, though younger age and higher levels of worry were associated with considering the response to be insufficient (both P<.001). Analysis of open-text answers revealed 4 major themes: access to and use of masks, gloves, and hand sanitizer; government messaging; lockdown and lockdown exit plan communication; and testing for COVID-19. CONCLUSIONS: Knowledge, adherence, and satisfaction regarding government recommendations and response were high in this sample, but many desired greater access to personal protective equipment. Those with lower health literacy and those who have been in self-isolation reported greater concerns about the pandemic.