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Residents of care homes across the globe are affected by the spread of SARS-CoV-2 as they have been identified as a high-risk group and because they experienced strict social isolation regulations during the first wave of the pandemic. Social isolation of older people with poor physical and mental health is strongly associated with mental health problems and decreased life expectancy. Other research has shown that older people managed to adapt to the changes brought about by the pandemic and have linked this to the concept of resilience. The aim of this research project was to investigate how this applied to residents in care home settings during the first phases of the contact ban in Germany from sociology, developmental psychology and environmental gerontology perspectives, and to gain in-depth understanding of residents’ experiences. This paper draws on structured interview data collected from residents in two care homes during early June 2020 in Frankfurt am Main, Germany. The findings show that their experiences were shaped by three factors: care home settings and the approach of staff to handling the contact ban; biographical sense of resilience; and a hierarchy of life issues. The findings highlight the importance of locally specific response mechanisms in care homes, agency and belonging of residents despite health-related limitations and the importance of a critical (gendered) lens on understanding their experiences.
The coronavirus disease 2019 (COVID-19) pandemic has caused the greatest global loss of life and economic impact due to a respiratory virus since the 1918 influenza pandemic. While health care systems around the world faced the enormous challenges of managing COVID-19 patients, health care workers in the Republic of Armenia were further tasked with caring for the surge of casualties from a concurrent, large-scale war. These compounding events put a much greater strain on the health care system, creating a complex humanitarian crisis that resulted in significant psychosocial consequences for health care workers in Armenia.
Nations throughout the world are imposing mandatory quarantine on those entering the country. Although such measures may be effective in reducing the importation of COVID-19, the mental health implications remain unclear.
Aims
This study sought to assess mental well-being and factors associated with changes in mental health in individuals subject to mandatory quarantine following travel.
Method
Travellers arriving at a large, urban international airport completed online questionnaires on arrival and days 7 and 14 of mandated quarantine. Questionnaire items, such as travel history, mental health, attitudes toward COVID-19, and protection behaviours, were drawn from the World Health Organization Survey Tool for COVID-19.
Results
There was a clinically significant decline in mental health over the course of quarantine among the 10 965 eligible participants. Poor mental health was reported by 5.1% of participants on arrival and 26% on day 7 of quarantine. Factors associated with a greater decline in mental health were younger age, female gender, negative views toward quarantine measures and engaging in fewer COVID-19 prevention behaviours. For instance, travellers who stated that they rarely wore masks had nearly three times higher odds of developing poor mental health.
Conclusions
Although the widespread use of quarantine may be effective in limiting the spread of COVID-19, the mental health implications are profound and have largely been ignored in policy decisions. Psychiatry has a role to play in contributing to the public policy debate to ensure that all aspects of health and well-being are reflected in decisions to isolate people from others.
Globally, health providers and patients alike have been forced to adapt rapidly to the use of telemedicine during the COVID-19 pandemic. Although telepsychiatry has been tested and found just as effective as face-to-face care, there still remains little uptake of this form of care provision in sub-Saharan Africa. This case study highlights the use of telepsychiatry in a previously telemedicine-naive private mental health facility in Kenya. We describe the challenges and lessons learned from the experience. We conclude on the need to test the effectiveness and acceptability of this mode of therapy in sub-Saharan Africa.
During COVID-19, the internet was a prime source for getting relevant updates on guidelines and desirable information. The objective of the present study was to determine the nutritional immunity information seeking behaviour during COVID-19 in India.
Design:
Google Trends (GTs) data on relevant COVID-19 and nutritional topics were systematically selected and retrieved. Data on newly reported COVID-19 cases were also examined on a daily basis. The cross-correlation method was used to determine the correlation coefficient between the selected terms and daily new COVID-19 cases, and the joint point regression models were utilised to measure monthly percent change in relative search volumes.
Setting:
Online.
Participants:
People using google search during period 01-01-2020 to 31-08-2020 in India.
Results:
The date of peak searches can be attributed to the COVID-19 guidelines announcement dates. All the nutritional terms showed a significant increase in average monthly percentage change. The higher than the average daily rise in COVID-19 cases leads to a higher than average increase in RSVs of nutritional terms with the greatest association after 14 to 27 days. The highest mean relative search volume for nutritional terms was from Southern India (49.34±7.43), and the lowest was from Western India (31.10±6.30).
Conclusion:
There was a significant rise in the google searches of nutritional immunity topics during COVID-19 in India. The local/regional terms can be considered for better outreach of public health guidelines or recommendations. Further automation of Google Trends using programming languages can help in real-time monitoring and planning various health/nutritional events.
Recognition of antibiotic stewardship programs (ASPs) as essential components of quality health care has dramatically increased in the past decade. The value of ASPs has been further reinforced during the coronavirus disease 2019 (COVID-19) pandemic because these programs were instrumental in monitoring antibiotic use, assessing emerging COVID-19 therapies, and coordinating implementation of monoclonal antibody infusions and vaccinations. ASPs are now required across hospital settings as a condition of participation for the Centers for Medicare and Medicaid Services and for accreditation by The Joint Commission. In the 2019 National Healthcare Safety Network annual survey, almost 89% of hospitals met the Seven Core Elements for ASPs defined by the Centers for Disease Control and Prevention. More than 61% of programs were co-led by physicians and pharmacists, evidence of the leadership role of both groups. ASPs employ many strategies to improve prescribing. Core interventions of preauthorization for targeted antibiotics, prospective audit and feedback, and development of local treatment guidelines have been supplemented with numerous emerging strategies. Diagnostic stewardship, optimizing duration of therapy, promoting appropriate conversion from intravenous to oral therapy, monitoring at transitions of care and hospital discharge, implementing stewardship initiatives in the outpatient setting, and increasing use of telemedicine are approaches being adopted across hospital settings. As a core function for medical facilities, ASP leaders must ensure that antibiotic use and ASP interventions promote optimal and equitable care. The urgency of success becomes progressively greater as complex patterns of antibiotic resistance continue to emerge, exacerbated by unpredictable factors such as a worldwide pandemic.
The COVID-19 pandemic has demonstrated that emergency departments (EDs) needed to reorganize their operations rapidly. This study investigated the impact of the pandemic on structural and logistical issues at EDs and measures taken. Belgian EDs were surveyed on the implemented changes at the start of the pandemic in relation to the four S’s in disaster medicine: Structure, Staff, Supplies and System. The study demonstrated that Belgian EDs felt largely unprepared for this pandemic, but nevertheless dynamically restructured their organization. A 46% increase in ED beds was created in different types of structures and more than half of all ED beds were reserved for COVID-19 care, but overall the number of patient presentations dropped by 29%. EDs deployed extra personnel, additional training and psychological support. More than half reported an acute shortage of personal protective equipment, several reported a shortage of ventilatory equipment and medications.
The study assessed the community preparedness to manage the COVID-19 and access to healthcare services during the lockdown of 2020 in a rural health block of northern India.
Methods
A cross-sectional study was conducted during June-July, 2020 in 25 villages and five wards of a rural administrative block of Haryana. A pre-tested, semi-structured investigator administered checklist was used to assess the community preparedness and practices for COVID-19 prevention/control and healthcare access through direct observations and interviewing community health workers and beneficiaries.
Results
Active surveillance for influenza-like illness was carried out in 86.7% of the study units, though the frequency was once a month. There was poor adherence (adherence: 0-3%) to COVID-19 infection prevention & control (IPC) measures such as physical distancing and use of face masks. Rural beneficiaries reported difficulty accessing essential healthcare services than their urban counterparts.
Conclusion
A qualitative study to understand the facilitators and barriers for the non-adherence to IPCs measures by the study population and formulating behaviour change communication strategies for improving the IPCs is needed. Repeat, cross-sectional surveys at regular intervals may be planned to gauge the change and effect of the interventions on the community preparedness and practices.
Healthcare workers (HCWs), are often seen as the most reliable source of vaccine-related information for their patients; nevertheless, various studies show that HCWs experience vaccine hesitation. In this study, the aim was to determine the reasons for vaccine hesitation among HCWs working in a large public hospital and its affiliated units in Istanbul.
Method:
A descriptive method for collecting qualitative data was designed for this study. The data of the HCWs was analyzed in line with the vaccine hesitancy factors put forward by the WHO.
Results:
The most important vaccine hesitancy theme that emerged was the fear and lack of confidence in the vaccines, which was expressed at a higher rate than any other theme in all HCWs. The most cited reason for fear/lack of confidence in the vaccine was the fear of its side effects. It was observed that the HCWs who reported hesitation about vaccination due to pregnancy and breastfeeding consisted of women. The second most common theme for vaccine hesitation was reported as an inconvenience in accessing the vaccines. Although HCWs have priority, they stated that their reason for vaccine hesitancy was due to heavy personal or workloads. The final theme was about complacency, or thinking they do not need the vaccine.
Conclusion:
Vaccine hesitation is a challenge that can be overcome with detailed monitoring and policy making. Although the vaccine seems to be more significant, we do not want to see vaccine hesitancy grow more than the vaccine itself.
Effective handwashing practices help prevent the spread of COVID-19. This study examined the knowledge, frequency, and characteristics of handwashing practices among Vietnamese university students.
Methods:
An analytic cross-sectional study was conducted on all students enrolling at Phenikaa University in Vietnam. A self-developed questionnaire was used to collect information on the participants’ knowledge regarding the effectiveness of handwashing as a COVID-19 preventive measure, the moments for hand hygiene, the most appropriate practices in different situations, and frequency.
Results:
Among 728 study participants, 460 (63.2%) were from health-related faculties. Almost (97.9%, 713/728) all participants knew that handwashing could protect against the spread of infection, but less than half performed handwashing often in a normal day (47.4%, 345/728), after sneezing or coughing (48.9%, 356/728), and 7.4% (54/728) only washed hands when hands are visibly dirty. Health students used alcohol-based handrub in all situations including those requiring handwashing with water and soap (P<0.05).
Conclusions:
The levels of knowledge regarding the effectiveness of handwashing among study participants are high, but actual practices of handwashing are suboptimal. It is crucial to improve community education to help reinforce correct hand hygiene behaviors including when to wash hands and which method should be used.
As of 25 July 2021, the Korea Disease Control and Prevention Agency reported 1,422 new COVID-19 cases, 188,848 total cases, and 2.073 total deaths (1.10% fatality rates). Since the first SARS-CoV-2 case was reported, efforts to find a treatment and vaccine against COVID-19 have been widespread. Four vaccines are on the WHO’s emergency use listing and are approved of their usage; BNT162b2, mRNA-1273, AZD1222, and Ad26.COV2.S. Vaccines against SARS-CoV-2 need at least 14 days to achieve effectiveness. Thus, people should abide by prevention and control measures, including wearing masks, washing hands, and social distancing. However, a lot of new cases were reported after vaccinations, as many people did not follow the prevention control measures before the end of the 14 days period. There is no doubt we need to break free from mask mandates. But let us not decide the timing in haste. Even if the mask mandates are eased, they should be changed depending on the number of reported cases, vaccinations, as well as prevention and control measures on how circumstances are changing under the influence of mutant coronavirus.
The coronavirus disease 2019 (COVID-19) global pandemic caused mental health services to be downscaled to abide by the public health restrictions issued.
Aims
The aim of this study was to investigate whether the pandemic and resultant restrictions had an impact on Malta's admissions to hospital for mental health issues by assessing the number and nature of psychiatric admissions to our only national mental health hospital.
Method
Data collection was carried out retrospectively for the 13-week period between 7 March 2020 and 4 June 2020, compared with the equivalent in 2019. Demographic data was obtained and descriptive statistical analysis through the use of the χ²-test, z-test and logistic regression model were used to compare both data-sets, using a P-value of 0.05.
Results
An overall reduction in admissions to hospital was noted in 2020 when compared with 2019, recorded to be lowest in March 2020 with a steady acceleration of admissions up until May 2020 (χ2(3) = 22.573, P < 0.001). This coincided with a decelerated rate of positive COVID-19 cases locally. In 2020, there were significantly higher female admissions (χ2(1) = 10.197, P < 0.001), increased presentations of self-harm/suicidal ideation (P < 0.001) and higher involuntary admissions using the Mental Health Act (χ2(1) = 4.904, P = 0.027). The logistic regression model identified total length of stay in hospital, primary mental health diagnosis, gender and month of admission as variables significantly associated with an admission.
Conclusions
Our first population-wide study confirms that the COVID-19 pandemic and subsequent public health restrictions had an impact on the population's hospital admissions for mental health issues.
To determine the case-fatality rate (CFR) of coronavirus disease 2019 (COVID-19) and its associated determinants in order to understand the true magnitude of the problem during ongoing conflict in Yemen.
Methods:
The CFR among confirmed COVID-19 cases in Yemen was calculated. The data was retrieved from national COVID-19 surveillance between April 10, when the first COVID-19 case reported, and May 31, 2020.
Results:
A total of 419 confirmed COVID-19 cases were reported. There were 14.1% and 5.7% of cases who required intensive care and mechanical ventilators, respectively. Out of total cases, 95 deaths were reported, giving CFR of 22.6% which is much higher compared to other countries. CFR was significantly higher among elderly compared to young adults and varied between governorates. Mortality was associated with preexisting hypertension (OR: 2.30; 95%CI: 1.58, 3.54) and diabetes (OR: 1.68; 95%CI: 1.08, 2.61).
Conclusions:
Elderly and those with comorbidities, in particular hypertension and diabetes, have higher risk for poor outcomes and therefore should receive more attention in the clinical setting. Preventive measures should also be prioritized to protect those groups in order to reduce the severe cases and deaths-associated COVID-19 in armed-conflict.
With the intention to try to contain the spread of the viral disease, several measures were taken in Argentina for long periods of time. The lack of labor activity, social constraints and a strong sense of helplessness, overimposed to a complex economic scenario with recesion, inflation and devaluation, led to the emergence of a dense climate of discontent. After a second wave hit the country, several measures were reinstalled. The Argentine society, polarized in many aspects, was further divided between those who supported the re-establishment of strict measures to help prevent further infections and those who desperately claimed for the urgent need to return to work to sustain their livings.
The preexisting problems to which developing countries are usually exposed have been sharpened over the last year, determining a very complex scenario where every decision is important for the country’s future. An updated report of the current situation and its management in different countries is of vital importance regarding global health issues and may serve for feedback and decision-making.