COVID-19 vaccination campaigns for diverse language groups in Pennsylvania/USA and Western Cape/South Africa: Examples from national and sub-national levels

Decision letter: COVID-19 pandemic dynamics in South Africa and epidemiological characteristics of three variants of concern (Beta, Delta, and Omicron)

COVID-19 Pandemic and Diabetes Care.

BackgroundRisk factors for coronavirus disease 2019 (COVID-19) death in sub-Saharan Africa and the effects of human immunodeficiency virus (HIV) and tuberculosis on COVID-19 outcomes are unknown.MethodsWe conducted a population cohort study using linked data from adults attending public-sector health facilities in the Western Cape, South Africa. We used Cox proportional hazards models, adjusted for age, sex, location, and comorbidities, to examine the associations between HIV, tuberculosis, and COVID-19 death from 1 March to 9 June 2020 among (1) public-sector “active patients” (≥1 visit in the 3 years before March 2020); (2) laboratory-diagnosed COVID-19 cases; and (3) hospitalized COVID-19 cases. We calculated the standardized mortality ratio (SMR) for COVID-19, comparing adults living with and without HIV using modeled population estimates.ResultsAmong 3 460 932 patients (16% living with HIV), 22 308 were diagnosed with COVID-19, of whom 625 died. COVID-19 death was associated with male sex, increasing age, diabetes, hypertension, and chronic kidney disease. HIV was associated with COVID-19 mortality (adjusted hazard ratio [aHR], 2.14; 95% confidence interval [CI], 1.70–2.70), with similar risks across strata of viral loads and immunosuppression. Current and previous diagnoses of tuberculosis were associated with COVID-19 death (aHR, 2.70 [95% CI, 1.81–4.04] and 1.51 [95% CI, 1.18–1.93], respectively). The SMR for COVID-19 death associated with HIV was 2.39 (95% CI, 1.96–2.86); population attributable fraction 8.5% (95% CI, 6.1–11.1).ConclusionsWhile our findings may overestimate HIV- and tuberculosis-associated COVID-19 mortality risks due to residual confounding, both living with HIV and having current tuberculosis were independently associated with increased COVID-19 mortality. The associations between age, sex, and other comorbidities and COVID-19 mortality were similar to those in other settings.

Immunization Update 2021

Editorial: Coronavirus disease 2019 (COVID-19) - advances in epidemiology, diagnostics, treatments, host-directed therapies, pathogenesis, vaccines, and ongoing challenges.

Access to lifesaving medical resources for African countries: COVID-19 testing and response, ethics, and politics

Vaccination

Global coalition to accelerate COVID-19 clinical research in resource-limited settings

Is Africa prepared for tackling the COVID-19 (SARS-CoV-2) epidemic. Lessons from past outbreaks, ongoing pan-African public health efforts, and implications for the future

The Impact of COVID-19 on Health Care, Education, and Persons With Disabilities in Kenya

This commentary discusses the COVID-19 pandemic on the African continent. The authors describe why the international community should be hesitant in developing forecasts and prevention strategies for COVID-19 in the absence of integration of African data and leadership by African institutions.

BackgroundPrimary care nurses play a pivotal role in the response to disasters and pandemics. The coronavirus diseases 2019 (COVID-19) pandemic required preventative, diagnostic, and curative measures for persons presenting with symptoms of COVID-19 by healthcare providers, whilst continuing other essential services. We aimed to investigate the reorganisation of primary care services during COVID-19 from the perspectives of primary care nurses in the Western Cape province of South Africa.MethodsWe administered an online survey with closed and open-ended questions to professional nurses enrolled for a Postgraduate Diploma in Primary Care Nursing at Stellenbosch University (2020) and alumni (2017–2019) working in the Western Cape. Eighty-three participants completed the questionnaire.ResultsThe majority of the participants (74.4%) reported that they were reorganising services using a multitude of initiatives in response to the diverse infrastructure, logistics and services of the various healthcare facilities. Despite this, 48.2% of the participants expressed concerns, which mainly related to possible non-adherence of patients with chronic conditions, the lack of promotive and preventative services, challenges with facility infrastructure, and staff time devoted to triage and screening. More than half of the participants (57.8%) indicated that other services were affected by COVID-19, whilst 44.6% indicated that these services were worse than before.ConclusionOur findings suggest that the very necessary reorganisation of services that took place at the start of the COVID-19 pandemic in South Africa enabled effective management of patients infected with COVID-19. However, the reorganisation of services may have longer-term consequences for primary care services in terms of lack of care for patients with other conditions, as well as preventive and promotive care.

Background: Many small-, medium- and micro-sized enterprises (SMMEs) struggled for survival in South Africa during the coronavirus disease 2019 (COVID-19) pandemic. Unexpectedly, several SMMEs in the Western Cape province of South Africa not only survived but also thrived. Investigation was therefore needed to better understand how they survived to fill the knowledge gap.Aim: This research aimed at ascertaining the reasons why and how SMMEs survived a prolonged pandemic. It thereby investigated the possibilities of developing a framework for SMME survival during crises such as a prolonged pandemic.Setting: The study involved 16 different types of successful SMMEs, which operated in the Western Cape, South Africa, before, during and after the COVID-19 pandemic.Methods: The study employed semi-structured interviews with 16 participants as SMME owners, following a qualitative approach. Qualitative data were generated via snowball sampling following the COVID-19 pandemic and were analysed manually.Results: Study’s findings enabled the development of a proposed survival framework for SMMEs during times of crisis, such as a pandemic.Conclusion: The study succeeded in better understanding the challenges experienced by the SMMEs during the COVID-19 pandemic. It revealed several survival factors and actions, including the contribution of the Western Cape Government’s attempts towards an entrepreneurial ecosystem.Contribution: Drawing in part on resilience theory, a possible survival framework is proposed for entrepreneurs to consider whereby they may establish self-constructed support for the continuity of their SMMEs during prolonged times of crisis.

Baden LR, El Sahly HM, Essink B, et al. Efficacy and safety of the mRNA-1273 SARS-CoV-2 vaccine. N Engl J Med. 2021;384:403-16. 33378609.

COVID-19 and Autism Research: Perspectives from Around the Globe.