Reactions to the media coverage during the first wave of COVID-19 in Bangladesh.

BACKGROUND: The news media play a critical role in disseminating accurate and reliable information during an outbreak like COVID-19, especially in LMICs. Studying how people react and reflect on the information provided and how it affects their trust in health systems is essential for effective risk communication. This study was undertaken to explore and analyse newspaper readers' reactions to the unfolding news of the COVID-19 outbreak in Bangladesh and how this affected and shaped their compliance with the mitigation measures advised by the Government. METHODS: We collected readers' comments on relevant news and features on the COVID-19 outbreak (n = 1,055) which were posted in the online versions of the four top circulating Bangla newspapers and one online news portal published during Jan.-Apr. 2020. A search protocol was developed and a team of three researchers searched and extracted data for content analysis according to some pre-determined study themes. RESULTS: Data analysis revealed several characteristics with implications for risk-communication: a faith-based and fatalistic attitude to the unfolding pandemic, a "denial" syndrome in the initial stage, a returning expatriate-bashing for specific countries, and a concern about the safety of the frontline health workers. The readers were resentful of the all-pervasive corruption in the health sector even in times of a pandemic and the Government's poorly coordinated, fragmented, and delayed COVID-19 response. The pandemic severely shook their trust in the already weak health system and perceived it to be incompetent, corrupt, and non-responsive. They had deplorable personal and family experiences while seeking treatment for COVID-19 patients. Expert committees were formed to advise the Government, but few recommendations were implemented on the ground. This helpless scenario made people sharply critical of the political leadership, especially for the failure of providing stewardship at the moment of crisis. CONCLUSIONS: The COVID-19 related information reaching the people, including misinformation, disinformation, and rumours was equivocal in the early months of the pandemic and failed to build the trust and transparency that is necessary for an inclusive response across constituencies. The Government should pay attention and weightage to people's perceptions about its COVID-19 response and take appropriate measures to re-build trust for implementing pandemic control measures.

Antibiotics in the Community During the COVID-19 Pandemic: A Qualitative Study to Understand Users' Perspectives of Antibiotic Seeking and Consumption Behaviors in Bangladesh.

INTRODUCTION: The COVID-19 pandemic is thought to have led to increased "inappropriate" or "unjustified" seeking and consumption of antibiotics by individuals in the community. However, little reference has been made to antibiotic seeking and using behaviors from the perspectives of users in Bangladesh during this health crisis. PURPOSE: This study seeks to document how antibiotic medicines are sought and used during a complex health crisis, and, within different contexts, what are the nuanced reasons why patients may utilize these medicines sub-optimally. METHODS: We used an exploratory, qualitative design. Forty semi-structured telephone interviews were conducted with people diagnosed with COVID-19 (n=20), who had symptoms suggestive of COVID-19 (n=20), and who had received care at home in two cities between May and June 2021 in Bangladesh. In this study, an inductive thematic analysis was performed. RESULTS: The analysis highlighted the interlinked relationships of antibiotic seeking and consumption behaviors with the diversity of information disseminated during a health crisis. Antibiotic-seeking behaviors are related to previous experience of use, perceived severity of illness, perceived vulnerability, risk of infection, management of an "unknown" illness and anxiety, distrust of expert advice, and intrinsic agency on antimicrobial resistance (AMR). Suboptimal adherence, such as modifying treatment regimes and using medication prescribed for others, were found to be part of care strategies used when proven therapeutics were unavailable to treat COVID-19. Early cessation of therapy was found to be a rational practice to avoid side effects and unknown risks. CONCLUSION: Based on the results, we highly recommend the take up of a pandemic specific antimicrobial stewardship (AMS) program in the community. To deliver better outcomes of AMS, incorporating users' perspectives could be a critical strategy. Therefore, a co-produced AMS intervention that is appropriate for a specific cultural context is an essential requirement to reduce the overuse of antibiotics during the COVID-19 pandemic and beyond.

Exploring the behavioral determinants of COVID-19 vaccine acceptance among an urban population in Bangladesh: Implications for behavior change interventions.

BACKGROUND: While vaccines ensure individual protection against COVID-19 infection, delay in receipt or refusal of vaccines will have both individual and community impacts. The behavioral factors of vaccine hesitancy or refusal are a crucial dimension that need to be understood in order to design appropriate interventions. The aim of this study was to explore the behavioral determinants of COVID-19 vaccine acceptance and to provide recommendations to increase the acceptance and uptake of COVID-19 vaccines in Bangladesh. METHODS: We employed a Barrier Analysis (BA) approach to examine twelve potential behavioral determinants (drawn from the Health Belief Model [HBM] and Theory of Reasoned Action [TRA]) of intended vaccine acceptance. We conducted 45 interviews with those who intended to take the vaccine (Acceptors) and another 45 interviews with those who did not have that intention (Non-acceptors). We performed data analysis to find statistically significant differences and to identify which beliefs were most highly associated with acceptance and non-acceptance with COVID-19 vaccines. RESULTS: The behavioral determinants associated with COVID-19 vaccine acceptance in Dhaka included perceived social norms, perceived safety of COVID-19 vaccines and trust in them, perceived risk/susceptibility, perceived self-efficacy, perceived positive and negative consequences, perceived action efficacy, perceived severity of COVID-19, access, and perceived divine will. In line with the HBM, beliefs about the disease itself were highly predictive of vaccine acceptance, and some of the strongest statistically-significant (p<0.001) predictors of vaccine acceptance in this population are beliefs around both injunctive and descriptive social norms. Specifically, Acceptors were 3.2 times more likely to say they would be very likely to get a COVID-19 vaccine if a doctor or nurse recommended it, twice as likely to say that most people they know will get a vaccine, and 1.3 times more likely to say that most close family and friends will get a vaccine. The perceived safety of vaccines was found to be important since Non-acceptors were 1.8 times more likely to say that COVID-19 vaccines are "not safe at all". Beliefs about one's risk of getting COVID-19 disease and the severity of it were predictive of being a vaccine acceptor: Acceptors were 1.4 times more likely to say that it was very likely that someone in their household would get COVID-19, 1.3 times more likely to say that they were very concerned about getting COVID-19, and 1.3 times more likely to say that it would be very serious if someone in their household contracted COVID-19. Other responses of Acceptors on what makes immunization easier may be helpful in programming to boost acceptance, such as providing vaccination through government health facilities, schools, and kiosks, and having vaccinators maintain proper COVID-19 health and safety protocols. CONCLUSION: An effective behavior change strategy for COVID-19 vaccines uptake will need to address multiple beliefs and behavioral determinants, reducing barriers and leveraging enablers identified in this study. National plans for promoting COVID-19 vaccination should address the barriers, enablers, and behavioral determinants found in this study in order to maximize the impact on COVID-19 vaccination acceptance.

Response to coronavirus disease 2019: Case study of one baking industry in Dhaka, Bangladesh.

The coronavirus disease 2019 (COVID-19) poses significant risks to health in the workplace for employees in the manufacturing sector of Bangladesh. A variety of preventive steps are being taken by many food industries to sustain their production during this period by ensuring food safety. In response to the current outbreak, early identification, preparedness for the growing threat, and employee well-being are of utmost importance. Food health is also a concern in this regard, as workers in the food industry remain close to food and packages. The risk of spreading the virus within the industry can be held to a minimum with timely action and concerted efforts. A study was carried out in one baking industry of Bangladesh to investigate their regular activities during the pandemic period. Until the writing of this report, there were no cases of COVID-19 among employees. Thus this case study shows how one baking industry in Bangladesh prepares and responds to the COVID 19 outbreak.