Community responses are important for the management of early-phase outbreaks of coronavirus disease 2019 (COVID-19). Perceived susceptibility and severity are considered key elements that motivate people to adopt nonpharmaceutical interventions. This study aimed to (i) explore perceived susceptibility and severity of the COVID-19 pandemic, (ii) examine the practice of nonpharmaceutical interventions, and (iii) assess the potential association of perceived COVID-19 susceptibility and severity with the practice of nonpharmaceutical interventions among people living in Afghanistan.

A cross-sectional design was used, using online surveys disseminated from April to May 2020. Convenience sampling was used to recruit the participants of this study. The previously developed scales were used to assess the participants’ demographic information, perceived risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, and perceived severity of COVID-19. Multivariate analyses were conducted to assess the potential association of perceived COVID-19 susceptibility and severity with the practice of nonpharmaceutical interventions.

The Internet was the main source for obtaining COVID-19 information among participants in this study. While 45.8% of the participants believed it was “very unlikely” for them to get infected with COVID-19, 76.7% perceived COVID-19 as a severe disease. Similarly, 37.5% believed the chance of being cured if infected with COVID-19 is “unlikely/very unlikely.” The majority of participants (95.6%) perceived their health to be in “good” and “very good” status. Overall, 74.2% mentioned that they stopped visiting public places, 49.7% started using gloves, and 70.4% started wearing a mask. Participants who believed they have a low probability of survival if infected with COVID-19 were more likely to wear masks and practice hand washing.

It appears that communities’ psychological and behavioral responses were affected by the early phase of the COVID-19 pandemic in Afghanistan, especially among young Internet users. The findings gained from a timely behavioral assessment of the community might be useful to develop interventions and risk communication strategies in epidemics within and beyond COVID-19.

The aim of this study was to test the appearance of negative dominance in coronavirus disease (COVID-19) vaccine-related information and activity online. We hypothesized that if negative dominance appeared, it would be a reflection of peaks in adverse events related to the vaccine, that negative content would attract more engagement on social media than other vaccine-related posts, and posts referencing adverse events related to COVID-19 vaccination would have a higher average toxicity score.

We collected data using Google Trends for search behavior, CrowdTangle for social media data, and Media Cloud for media stories, and compared them against the dates of key adverse events related to COVID-19. We used Communalytic to analyze the toxicity of social media posts by platform and topic.

While our first hypothesis was partially supported, with peaks in search behavior for image and YouTube videos driven by adverse events, we did not find negative dominance in other types of searches or patterns of attention by news media or on social media.

We did not find evidence in our data to prove the negative dominance of adverse events related to COVID-19 vaccination on social media. Future studies should corroborate these findings and, if consistent, focus on explaining why this may be the case.

Prior studies of universal masking have not measured face-mask compliance. We performed a quality improvement study to monitor and improve face-mask compliance among healthcare personnel (HCP) during the coronavirus disease 2019 (COVID-19) pandemic.

Mixed-methods study.

Tertiary-care center in West Haven, Connecticut.

HCP including physicians, nurses, and ancillary staff.

Face-mask compliance was measured through direct observations during a 4-week baseline period after universal masking was mandated. Frontline and management HCP completed semistructured interviews from which a multimodal intervention was developed. Direct observations were repeated during a 14-week period following implementation of the multimodal intervention. Differences between units were evaluated with χ2 testing using the Bonferroni correction. Face-mask compliance between baseline and intervention periods was compared using time-series regression.

Among 1,561 observations during the baseline period, median weekly face-mask compliance was 82.2% (range, 80.8%–84.4%). Semistructured interviews were performed with 16 HCP. Qualitative analysis informed the development of a multimodal intervention consisting of audit and passive feedback, active discussion, and increased communication from leadership. Among 2,651 observations during the intervention period, median weekly face-mask compliance was 92.6% (range, 84.6%–97.9%). There was no difference in weekly face-mask compliance between COVID-19 and non–COVID-19 units. The multimodal intervention was associated with an increase in face-mask compliance (β = 0.023; P = .002).

Face-mask compliance remained suboptimal among HCP despite a facility-wide mandate for universal masking. A multimodal intervention consisting of audit and passive feedback, active discussion, and increased communication from leadership was effective in increasing face-mask compliance among HCP.

The aim of this study was to evaluate the mortality rates of 566,602 patients with coronavirus disease (COVID-19) based on sex, age, and the presence or absence of underlying diseases and determine whether the underlying disease provides prognostic information specifically related to death.

The mortality rate was evaluated using conditional probability to identify the significant factors, and adjusted odds ratios (ORs) using a multivariable logistic regression analysis were estimated.

The mortality rate of patients with underlying health conditions was 12%, which was 4 times higher than that of patients without underlying health conditions. Furthermore, the mortality rates of women and men with underlying health conditions were 5.5 and 3.4 times higher than the mortality rates of patients without underlying health conditions, respectively. In a multivariable logistic regression analysis including sex, age, and underlying health conditions, male sex (OR: 1.83), age ≥ 41 y (ORs > 2.70), and underlying health conditions (OR: 2.20) were confirmed as risk factors for death.

More attention should be paid to older patients with underlying diseases and male patients with underlying diseases as the probability of death in this population was significantly higher.

The coronavirus disease (COVID-19) pandemic and associated social distancing increased stressors related to risk for domestic conflict, but increases in domestic conflict early in the pandemic have yet to be studied in community samples.

Increase in domestic conflict (verbal or physical fights) since the beginning of the pandemic was assessed in 1196 partnered and cohabitating respondents, drawn from a nationally representative sample, in May 2020. Chi-square tests and logistic regression analyses were used to estimate associations of demographic characteristics and financial worry with domestic conflict.

An increase in domestic conflict was reported by 10.6% (95% CI: 7.7-13.4) of the sample. Domestic conflict increase was significantly associated with younger age, lower education, and financial worry.

Increases in domestic conflict were seen in certain vulnerable groups and in those who report financial worry. Policies ensuring financial stability, particularly early in the disaster conditions, could reduce domestic conflict during continued COVID-19 conditions or other disasters.

This study aimed to determine whether COVID-19 is associated with a different presenting clinical picture or a more severe course of illness in people with a past history of chemical war injury.

This is a multicenter retrospective study in Fars Province, Iran, from August 22 to October 4, 2020. People with a past history of chemical war injury and COVID-19 were studied. Two age- and sex-matched control groups, double the size of the patient group each, from the same database of patients with COVID-19 who were hospitalized at the same time (ie, healthy controls and pseudocontrols).

A total of 46 people with a past history of chemical war injury, 92 healthy controls, and 92 pseudocontrols were studied. People with COVID-19 and a past history of chemical war injury had a significantly higher rate of chest pain compared with others. There were no other clinical differences between the groups. Mortality rate was 17.39%, 15.21%, and 27.17% in people with a past history of chemical war injury, the control group, and the pseudocontrol group, respectively.

A past history of a chemical war injury does not add to the risk of COVID-19 and does not significantly modify its clinical picture either.

To examine the associations between factors based on the social cognitive theory (SCT) and behavioral intention among doctors and nurses in China toward free and self-paid (600 RMB or US$91) severe acute respiratory coronavirus virus 2 (SARS-CoV-2) vaccination given 80% effectiveness and rare mild side effects.

Cross-sectional study.

Public hospitals.

The study included 362 doctors and 1,702 nurses in major departments of 5 hospitals of 3 Chinese provinces.

An anonymous online survey was conducted from October to November 2020, facilitated by hospital administrators through online WeChat/QQ working groups. Data on outcome expectations, self-efficacy, norms, and COVID-19–related work experiences were collected. Multivariate logistic regression models were used for data analyses.

The logistic regression analysis showed that physical (eg, protective effect of vaccination) and self-evaluative outcome expectations (eg, anticipated regret), self-efficacy, norms (eg, descriptive norm, subjective norm, professional norm, and moral norm), and job satisfaction were significantly and positively associated with the free and self-paid SARS-CoV-2 vaccination intention outcomes among doctors and nurses, adjusted for background variables. Doctors who had engaged in COVID-19–related work reported higher self-paid vaccination intention.

Health promotion is needed to improve the uptake of SARS-CoV-2 vaccination among healthcare workers. Such interventions may consider modifying the identified factors of vaccination intention, including strengthening perceived efficacy, positive feelings about vaccination, the need to avoid future regret, self-efficacy, and social norms. Future studies should examine the actual behavior patterns of SARS-CoV-2 vaccination, and the efficacy of promotion intervention should be tested in randomized controlled studies.

To determine the effect of 2 regulations issued by the Israel Ministry of Health on coronavirus disease 2019 (COVID-19) infections and quarantine among healthcare workers (HCWs) in general hospitals.

Before-and-after intervention study without a control group (interrupted time-series analysis).

All 29 Israeli general hospitals.

All HCWs.

Two national regulations were issued on March 25, 2020: one required universal masking of HCWs, patients, and visitors in general hospitals and the second defined what constitutes HCW exposure to severe acute respiratory coronavirus virus 2 (SARS-CoV-2) and when quarantine is required.

Overall, 283 HCWs were infected at work or from an unknown source. Before the intervention, the number of HCWs infected at work increased by 0.5 per day (95% confidence interval [CI], 0.2–0.7; P < .001), peaking at 16. After the intervention, new infections declined by 0.2 per day (95% CI, −0.3 to −0.1; P < .001). Before the intervention, the number of HCWs in quarantine or isolation increased by 97 per day (95% CI, 90–104; P < .001), peaking at 2,444. After the intervention, prevalence decreased by 59 per day (95% CI, −72 to −46; P < .001). Epidemiological investigations determined that the most common source of HCW infection (58%) was a coworker.

Universal masking in general hospitals reduced the risk of hospital-acquired COVID-19 among HCWs. Universal masking combined with uniform definitions of HCW exposure and criteria for quarantine limited the absence of HCWs from the workforce.