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The purpose of this study is to investigate the efficiency of the Iranian Red Crescent Society (IRCS) in managing their nonmonetary resources involved in coronavirus disease 2019 (COVID-19) response.
Methods:
For this purpose, the data envelopment analysis approach was used to measure the efficiency, considering the number of personnel and vehicles and screened passengers as the input and output parameters, respectively. It was examined the efficiency of 10 IRCS’s branches given 17 d of screening operation. For the analysis, the DEA SolverPro software 15a version was used.
Results:
The results show that only 1 branch had been fully efficient in using the resources, while 5 branches showed less than 50% efficiency. This study reveals that it is unnecessary to use a fixed number of volunteers at different stations with different passenger numbers.
Conclusions:
Using resources without efficient planning can lead to direct costs such as food, transportation, and maintenance, as well as indirect costs such as burnout, fatigue, and stress when responding to the COVID-19 pandemic. This analysis should support IRCS’s managers to move their valuable resources from inefficient to efficient centers to increase the screening rate and reduce the fatigue of aid workers for the next pandemic rounds.
The incidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exposure in shared patient rooms was low at our institution: 1.8 per 1,000 shared-room patient days. However, the secondary attack rate (21.6%) was comparable to that reported in household exposures. Lengthier exposures were associated with SARS-CoV-2 conversion. Hospitals should implement measures to decrease shared-room exposures.
Countries are trying several policy options for decreasing the incidence and burden of the coronavirus disease 2019 (COVID-19). One of these strategies is a lockdown, complete closure, to reduce the risk of distributing disease by means of social interactions. This study aimed to analyze the effect of a 3-week lockdown on the mortality and morbidity of COVID-19 in Iran.
Methods:
Official daily data on COVID-19 incidence and death reported by the World Health Organization (WHO) were extracted from September 1, 2020, to January 14, 2021. Data were analyzed using interrupted time series analysis by means of STATA 14 software.
Results:
Lockdown resulted in a significant reduction in the daily death from COVID-19 in the short-term (β = −139; P < 0.01) and in the long-term (β = −12; P < 0.01). Moreover, lockdown in the short-term insignificantly (β = −21.58; P = 0.969), and in the long-term significantly (β = −317.31; P < 0.01) reduced the COVID-19 daily incidence.
Conclusions:
The results showed that the lockdown has a significant effect on incidence and death numbers. Therefore, it could be a suitable short-term strategy for controlling the COVID-19 outbreak. On the other hand, its negative effects on households and businesses should be considered.
The aim of this study was to evaluate the management mode for the prevention and control of coronavirus disease 2019 (COVID-19) transmission used at a general hospital in Shenzhen, China, with the aim to maintain the normal operation of the hospital.
Methods:
From January 2, 2020, to April 23, 2020, Hong Kong–Shenzhen Hospital, a tertiary hospital in Shenzhen, has operated a special response protocol named comprehensive pandemic prevention and control model, which mainly includes 6 aspects: (1) human resource management; (2) equipment management; (3) logistics management; (4) cleaning, disinfection, and process reengineering; (5) environment layout; (6) and training and assessment. The detail of every aspect was described, and its efficiency was evaluated.
Results:
A total of 198,802 patients were received. Of those, 10,821 were hospitalized; 26,767 were received by the emergency department and fever clinics; 288 patients were admitted for observation with fever; and 324 were admitted as suspected cases for isolation. Under the protocol of comprehensive pandemic prevention and control model, no case of hospital-acquired infection with COVID-19 occurred among the inpatients or staff.
Conclusion:
The present comprehensive response model may be useful in large public health emergencies to ensure appropriate management and protect the health and life of individuals.
The coronavirus disease 2019 (COVID-19) has received various distinct perspectives and responses at the local as well as global levels. The current study pays attention to local perspectives, which have appeared in the Sindh Province of Pakistan.
Methods:
Given the constraints of the pandemic, and using convenience sampling, we conducted 10 online group discussions, 7 one-on-one interviews, and 30 cellphone discussions from a small town of Sindh Province. We made every effort to make our sampling inclusive in terms of decisive sociocultural factors: gender, religion, level of formal education, and occupation/job. We obtained data from women, men, Muslims and non-Muslims, the formally educated and noneducated, government employees, and daily wage laborers. Moreover, to perform content analysis, we used social media such as WhatsApp and Facebook.
Results and Discussions:
We have found that some people consider COVID-19 a “political” game, “supernatural test” or “Western plot”. The given perceptions then guide further actions: either ignore or adopt the preventive measures or take supernatural preventive measures. Considering it as a test of God, Muslims perform prayers, while the Bāgrrī community who practice Hinduism are taking cow urine to deal with the virus. This study brings these perspectives to the center stage; yet, the results cannot be generalized across the country, or within the province. Moreover, the study situates these perspectives within the global and socio-cultural, economic, and political contexts and invites more in-depth studies to inquire why such perspectives emerge.
Conclusions:
We discuss different narratives concerning COVID-19 in a small town of Sindh Province. We maintain that documenting these various perspectives and analyzing their impacts on the preparedness programs is essential, yet understanding the causes behind the stated standpoints is equally essential, if not more so.
The aim of this study was to assess variations in presentation and outcomes of coronavirus disease 2019 (COVID-19) across race/ethnicity at a large Texas metroplex hospital.
Methods:
A retrospective cohort study was performed.
Results:
Although COVID-19 patients demonstrated significant socioeconomic disparities, race/ethnicity was not a significant predictor of intensive care unit (ICU) admission (P = 0.067) or case fatality (P = 0.078). Hospital admission varied by month, with incidence among Black/African-American and Hispanic/Latino patients peaking earlier in the pandemic timeline (P < 0.001). Patients reporting Spanish as their primary language were significantly more likely to be admitted to the ICU (odds ratio, 1.75; P = 0.007).
Conclusions:
COVID-19 patients do not demonstrate significant racial/ethnic disparities in case fatality, suggesting that state-wide disparities in mortality rate are rooted in infection risk rather than hospital course. Variations in admission rates by race/ethnicity across the timeline and increased ICU admission among Spanish-speaking patients demonstrate the need to pursue tailored interventions on both a community and structural level to mitigate further health disparities throughout the pandemic and after.
Coronavirus disease 2019 (COVID-19) screening stations set up by Iranian Red Crescent Society have been available for 17 d with the aim of identifying and treating people with coronavirus, reducing road trips, and sensitizing people to the problem. This study aims to investigate the challenges of the procedure.
Methods:
A qualitative study was used to find the challenges of the COVID-19 screening centers. Volunteers, branch managers, and headquarter managers of the Iranian Red Crescent Society participated in this study applying snowball sampling. Data were collected by means of in-depth semi-structured telephone interviews in April 2020 after completion of the fever screening plan. All interviews were recorded and transcribed verbatim, always with prior permission of interviewees.
Results:
The interviews with 20 participants in the plan indicated 6 relevant challenges, including logistics, lack of planning, lack of coordination, legal challenges, mental health, and ethical challenges.
Conclusions:
The results indicated that, although establishing fever detection centers in Iran was a rapid response to COVID-19, it had significant flaws in the structure and adversely affected volunteers’ and staff’s health and financial resources. Therefore, well-structured protocols are required for similar responses in the future.
Recommendations for promoting mental health during the COVID-19 pandemic include maintaining social contact, through virtual rather than physical contact, moderating substance/alcohol use, and limiting news and media exposure. We seek to understand if these pandemic-related behaviors impact subsequent mental health.
Methods
Daily online survey data were collected on adults during May/June 2020. Measures were of daily physical and virtual (online) contact with others; substance and media use; and indices of psychological striving, struggling and COVID-related worry. Using random-intercept cross-lagged panel analysis, dynamic within-person cross-lagged effects were separated from more static individual differences.
Results
In total, 1148 participants completed daily surveys [657 (57.2%) females, 484 (42.1%) males; mean age 40.6 (s.d. 12.4) years]. Daily increases in news consumed increased COVID-related worrying the next day [cross-lagged estimate = 0.034 (95% CI 0.018–0.049), FDR-adjusted p = 0.00005] and vice versa [0.03 (0.012–0.048), FDR-adjusted p = 0.0017]. Increased media consumption also exacerbated subsequent psychological struggling [0.064 (0.03–0.098), FDR-adjusted p = 0.0005]. There were no significant cross-lagged effects of daily changes in social distancing or virtual contact on later mental health.
Conclusions
We delineate a cycle wherein a daily increase in media consumption results in a subsequent increase in COVID-related worries, which in turn increases daily media consumption. Moreover, the adverse impact of news extended to broader measures of psychological struggling. A similar dynamic did not unfold between the daily amount of physical or virtual contact and subsequent mental health. Findings are consistent with current recommendations to moderate news and media consumption in order to promote mental health.
The aim of this study was to analyze coronavirus disease 2019 (COVID-19) -related call data at Metro North Public Health Unit, Brisbane Australia, over the 2020 calendar year to assist surge preparedness.
Methods:
Call data were retrieved by call category or reference to “COVID” in summaries from the call management system at a large metropolitan public health service. Under a mixed-methods approach, qualitative data (caller, call purpose, and call outcome) were categorized with categories arising de novo. Resulting variables were numerically analyzed to identify trends by categories and time.
Results:
Of the 3468 calls retrieved, 160 duplicates and 26 irrelevant calls were excluded. Of 3282 included calls, general practitioners, followed by the public, contributed the greatest call volumes. Health-care–related callers and the public made 84.2% of calls. Calls most frequently related to patient testing (40.7%) and isolation/quarantine (23.2%). Education provision accounted for 29.4% of all outcomes. A total of 11.8% of all call outcomes involved applying relevant case definitions, and 49.1% of calls were identified as potentially preventable through effective emergency risk communication and targeted call-handling.
Conclusions:
This study identified key drivers of public health unit phone service use related to the COVID-19 pandemic throughout 2020. The results highlighted where risk perception influenced call volume and provided important insights for future public health preparedness.
This study sought to identify coronavirus disease 2019 (COVID-19) risk communication materials distributed in Jamaica to mitigate the effects of the disease outbreak. It also sought to explore the effects of health risk communication on vulnerable groups in the context of the pandemic.
Methods:
A qualitative study was conducted, including a content analysis of health risk communications and in-depth interviews with 35 purposively selected elderly, physically disabled, persons with mental health disorders, representatives of government agencies, advocacy and service groups, and caregivers of the vulnerable. Axial coding was applied to data from the interviews, and all data were analyzed using the constant comparison technique.
Results:
Twelve of the 141 COVID-19 risk communication messages directly targeted the vulnerable. All participants were aware of the relevant risk communication and largely complied. Barriers to messaging awareness and compliance included inappropriate message medium for the deaf and blind, rural location, lack of Internet service or digital devices, limited technology skills, and limited connection to agencies that serve the vulnerable.
Conclusion:
The vulnerable are at increased risk in times of crisis. Accessibility of targeted information was inadequate for universal access to health information and support for vulnerable persons regardless of location and vulnerability.
A variety of infectious diseases can cause outbreaks on board vessels, with both health and economic effects. Internationally, Coronavirus Disease 2019 (COVID-19) outbreaks have occurred on numerous cruise and cargo vessels and the containment measures, travel restrictions, and border closures continue to make it increasingly difficult for ship operators world-wide to be granted pratique, effect crew changes, and conduct trade. An effective outbreak management strategy is essential to achieve the outcome triad – healthy crew, clean vessel, and set departure date – while maintaining the safety of the on-shore workers and broader community and minimizing disruption to trade. This report describes the principles of COVID-19 outbreak responses on four cargo vessels, including the successful use of one vessel as a quarantine facility.
Methods:
Established principles of management and the experiences of COVID-19 outbreaks on cruise ships elsewhere informed a health-lead, multi-agency, strict 14-day quarantine (Q) regime based on: population density reduction on board; crew segregation; vessel cleaning and sanitation; infection risk zones, access, and control measures; health monitoring; case identification and management; food preparation and delivery; waste management control; communication; and welfare and security.
Findings:
Sixty-five crew were diagnosed with Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection (range 2-25; attack rate 10%-81%; 15 asymptomatic). No deaths were recorded, and only one crew was hospitalized for COVID-19-related symptoms but did not require intensive care support. Catering crew were among the cases on three vessels. All non-essential crew (n-EC) and most of the cases were disembarked. During the vessel’s Q period, no further cases were diagnosed on board, and no crew became symptomatic after completion of Q. The outbreak response duration was 15-17 days from initial decision.
No serious health issues were reported, no response staff became infected, and only two Q protocol breaches occurred among crew.
Interpretation:
Despite increasing risk of outbreaks on cargo vessels, maritime trade and crew exchanges must continue. The potential consequences of COVID-19 outbreaks to human life and to trade necessitate a balanced response. The principles described can offer health, financial, operational, and safety advantages.
This study aimed to investigate the characteristics of uncertainty in illness and the coping styles of patients with severe coronavirus 2019 (COVID-19) and to explore their relationship to provide effective guidance for clinical nursing. A cross-sectional survey was used to investigate 56 severe patients with COVID-19 in a designated hospital in Wuhan. A general information questionnaire, the Mishel Uncertainty in Illness Scale for Adults (MUIS-A) and the Medical Coping Modes Questionnaire (MCMQ) were used to collect the data. A statistical analysis was performed. The total score of the MUIS-A was a 66.29 ± 17.25 which was at a low level, while the total score of the MCMQ was 54.16 ± 6.39. The scores of facing and avoiding were significantly higher than those in the norm. The difference in the yielding dimension of patients with different family economic situations was statistically significant. The total score of MUIS-A correlated negatively with the coping style of facing and avoiding and positively correlated with the coping style of yielding. The coping style of patients was one of the factors influencing uncertainty in illness. Nursing staff need to pay close attention to the psychological state of their patients, understand their coping styles and actively correct negative coping styles to reduce the uncertainty in illness and promote physical as well as mental recovery.
To determine the utility of screening electrocardiograms after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among children in detecting myocarditis related to coronavirus disease 2019 (COVID-19).
Study Design:
A retrospective chart review was performed at a large paediatric academic institution to identify patients with prior SARS-CoV-2 infection who received a screening electrocardiogram by their primary care providers and were subsequently referred for outpatient cardiology consultation due to an abnormal electrocardiogram. The outcomes were the results from their cardiology evaluations, including testing and final diagnoses.
Results:
Among 46 patients, during their preceding COVID-19 illness, the majority had mild symptoms, 4 were asymptomatic, and 1 had moderate symptoms. The median length of time from positive SARS-CoV-2 test to screening electrocardiogram was 22 days, and many electrocardiogram findings that prompted cardiology consultation were normal variants in asymptomatic adolescent athletes. Patients underwent frequent additional testing at their cardiology appointments: repeat electrocardiogram (72%), echocardiogram (59%), Holter monitor (11%), exercise stress test (7%), and cardiac MRI (2%). Five patients were incidentally diagnosed with CHD or structural cardiac abnormalities, and three patients had conduction abnormalities (pre-mature atrial contractions, pre-mature ventricular contractions, borderline prolonged QTc), although potentially incidental to COVID-19. No patients were diagnosed with myocarditis or ventricular dysfunction.
Conclusion:
In a small cohort of children with prior COVID-19, who were primarily either asymptomatic or mildly symptomatic, subsequent screening electrocardiograms identified various potential abnormalities prompting cardiology consultation, but no patient was diagnosed with myocarditis. Larger multi-centre studies are necessary to confirm these results and to evaluate those with more severe disease.
Belgium is often seen as an outlier in the international experience with the coronavirus disease 2019. We summarize the unfolding of the pandemic in Belgium from February to December 2020, discuss the countermeasures that were implemented and provide some explanations why the numbers indicate a stronger pandemic in Belgium than in its neighbouring countries. To some extent, the seemingly poor performance of Belgium is a measurement artefact. Yet, there were indeed particular factors in Belgium that unnecessarily increased the toll of the pandemic. In the first wave insufficient priority was given to protect care homes. The second wave was larger than necessary due to a failure to timely implement restrictive measures. The latter can, at least partly, be explained by a unique political situation: a temporary, minority government in the middle of a major crisis.
Between 19 May and 12 June 2020, employees of the UZ Brussel were recruited in this study aiming to document the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroprevalence, to investigate the potential work-related risk factors for SARS-CoV-2 infection and to estimate the proportion of asymptomatic infections. In total, 2662 participants were included of whom 7.4% had immunoglobulin G antibodies against SARS-CoV-2. Of the participants reporting a positive polymerase chain reaction for SARS-CoV-2, 89% had antibodies at the time of blood sampling. Eleven per cent of the antibody positive participants reported no recent symptoms suggestive of coronavirus disease 2019 (COVID-19). Participants reporting fever, chest pain and/or anosmia/ageusia were significantly more frequently associated with the presence of antibodies against SARS-CoV-2. The presence of antibodies was highest in the group that had had contact with COVID-19-infected individuals outside the hospital with or without using appropriate personnel protective equipment (PPE) (P < 0.001). Inside the hospital, a statistically significant difference was observed for the employees considered as low-risk exposure compared to the intermediate-risk exposure group (P = 0.005) as well as the high-risk exposure group compared to the intermediate exposure risk group (P < 0.001). These findings highlight the importance of using correct PPE.
There is a paucity of evidence about the prevalence and risk factors for symptomatic infection among children. This study aimed to describe the prevalence of symptomatic coronavirus disease 2019 (COVID-19) and its risk factors in children and adolescents aged 0–18 years in Qatar. We conducted a cross-sectional study of all children aged 0–18 years diagnosed with COVID-19 using polymerase chain reaction in Qatar during the period 1st March to 31st July 2020. A generalised linear model with a binomial family and identity link was used to assess the association between selected factors and the prevalence of symptomatic infection. A total of 11 445 children with a median age of 8 years (interquartile range (IQR) 3–13 years) were included in this study. The prevalence of symptomatic COVID-19 was 36.6% (95% confidence interval (CI) 35.7–37.5), and it was similar between children aged <5 years (37.8%), 5–9 years (34.3%) and 10 + years (37.3%). The most frequently reported symptoms among the symptomatic group were fever (73.5%), cough (34.8%), headache (23.2%) and sore throat (23.2%). Fever (82.8%) was more common in symptomatic children aged <5 years, while cough (38.7%) was more prevalent in those aged 10 years or older, compared to other age groups. Variables associated with an increased risk of symptomatic infection were; contact with confirmed cases (RD 0.21; 95% CI 0.20–0.23; P = 0.001), having visited a health care facility (RD 0.54; 95% CI 0.45–0.62; P = 0.001), and children aged under 5 years (RD 0.05; 95% CI 0.02–0.07; P = 0.001) or aged 10 years or older (RD 0.04; 95% CI 0.02–0.06; P = 0.001). A third of the children with COVID-19 were symptomatic with a higher proportion of fever in very young children and a higher proportion of cough in those between 10 and 18 years of age.