Coronavirus Disease 2019 Precautions Research Articles

BC Cancer Radiation Therapists' perspective on the impact of COVID-19 precautions in clinical practice

IntroductionThere were many policy and procedure (P&P) changes implemented in health care facilities to combat the spread of the coronavirus disease 2019 (COVID-19). Common changes included an increase in personal protective equipment usage, room occupancy limits, limitations in visitors/family members and the absence of volunteers. This study evaluated the current views and opinions of Radiation Therapists (RTs) in British Columbia relating to how COVID-19 P&P changes have impacted their clinical practice. The goal was to identify gaps in the areas of RT practice, allow for self-reflection among RTs and potentially guide future P&Ps with patient-centred care at the forefront. MethodsA 24-item cross-sectional questionnaire was created and sent via e-mail to all RTs working across the province. Key sections explored in the questionnaire were: 1) patient care delivery, 2) staff-work environment, and 3) work satisfaction. Descriptive analysis was performed on the questionnaire responses. ResultsOf the approximate 300 invited participants, 107 responses were received from all areas of Radiation Therapy (Treatment units, CT simulation, Dosimetry, etc.) and from all cancer centres in the province. RT staff indicated that COVID-19 P&P negatively impacted patient care, including the ability to verbally and non-verbally communicate with patients (82 %), assess for side effects (85 %), and build rapport (62 %). A majority (79 %) of RT staff felt that communication with co-workers had been negatively impacted as well. When queried regarding the impact on staff environment, 51 % of RT staff agreed that the absence of volunteers increased their workload and the responses were polarized (46 % disagree, 35 % agree) when asked if RT staff have enough time for cleaning their clinical areas with new COVID-19 P&Ps in place. 78 % of RTs were aware of where to go with COVID-19 safety concerns and thought they received adequate education concerning COVID P&Ps. When asked to rank the factors that most impacted RT practice, RTs identified increased PPE usage (83 %), absence of volunteers (74 %), and room occupancy limits (70 %) as the leading P&P changes that negatively impacted their practice; while plexiglass barriers (39 %), re-arranged workspaces (37 %) and working remotely (12 %) were the least negatively impactful. ConclusionThe majority of RTs across BC Cancer responding to the questionnaire indicated that their ability to provide patient care and their staff-work environment were negatively impacted by implemented COVID-19 P&Ps. Views regarding COVID-19 P&P training/education was positive, yet there was no consensus regarding whether the changes were implemented smoothly. This study can facilitate reflection among both clinical leadership and RTs on how P&Ps can be implemented in the future and can encourage further retrospective analyses in aiding the development of P&Ps regarding future public health outbreaks.

COVID-19 Guidelines Adherence and Vaccine Acceptability Among Pregnant Women in Niger Foundation Hospital Enugu, South-Eastern Nigeria: A Mixed Method Study

Objectives: This study aimed to determine the acceptability of coronavirus disease 2019 (COVID-19) vaccines and adherence to the preventive protocol among pregnant antenatal attendees in Niger Foundations Hospital Enugu, South-Eastern Nigeria. Materials and Methods: Using a cross-sectional descriptive survey and in-depth interviews, we conducted a mixed method study from June to December 2021. We administered a structured questionnaire to 210 pregnant women to assess their knowledge and adherence to COVID-19 guidelines and interviewed 25 individuals. Quantitative and qualitative data were analyzed using SPSS v.28 and thematic analysis, respectively. Results: The participants’ age range was 20-43 years, with a mean of 29.9 (4.8) years. Most individuals (81.9%) had a university degree, 40.5% were skilled workers, and 73.3% had parity 0-1. They identified close contact (87.1%), respiratory distress (96.2%), and handwashing with soap (96.2%) as the commonest mode of transmission, symptom, and preventive strategy of COVID-19, respectively. Older women and individuals with higher parity had lower knowledge and adherence to COVID-19 precautions. Most participants rejected the vaccines due to fear of the side effects on themselves and the fetus. Conclusions: Although there was good adherence to COVID-19 protocols among the pregnant women in this study, vaccine acceptance/uptake rate was low. Education on vaccine advantages and correction of conspiracy theories are recommended.

Assessing the impact of COVID-19 pandemic on hazelnut production

This study examines the effects of the coronavirus disease 2019 (COVID-19) pandemic on hazelnut cultivation. Data are obtained from 196 hazelnut farmers in Turkey. Farmers’ socioeconomic characteristics and satisfaction with COVID-19 precautions are compared by geographical region. Exploratory factor analysis is used to examine the impact of COVID-19, with comparisons made before and during the pandemic via a paired-samples t-test. The results indicate that, though farmers in Ordu and Sakarya have similar socioeconomics and farm assets, they were affected differently by the COVID-19 pandemic. Fertilization costs increased by 60.5%, pesticide costs by 64.4%, and labor wages by 19.1% during the COVID-19 pandemic, whereas hazelnut sales prices only increased by 5.2%. Overall, the impact of COVID-19 can be explained across four dimensions: timing issues, increase in input prices, inability to access financial resources, and logistics issues. To generalize the results, it may be appropriate to select similar farmers in different regions and compare monetary values in real terms. In particular, farmers’ increased interest in digital resources due to the pandemic should be considered an opportunity for digital transformation in agricultural extension.

Impact of coronavirus disease 2019 (COVID-19) on antimicrobial resistance among major pathogens causing healthcare-associated infection

Coronavirus disease 2019 (COVID-19) has caused great impact on healthcare systems, including antibiotic usage and multi-drug resistant (MDR) bacterial infections at hospitals. We aim to investigate the trends of antimicrobial resistance among the major pathogens causing healthcare-associated infection (HAI) at intensive care units (ICU). The demographic characteristics of hospitalization, usage of antimicrobial agents, counted by half-an-year DID (defined daily dose per 1000 patient-days), and HAI density of five major MDR bacteria, including methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), carbapenem-resistant Acinetobacter baumannii (CRAB), carbapenem-resistant Klebsiella pneumoniae (CRKP), and carbapenem-resistant Pseudomonas aeruginosa (CRPA), of ICU patients at a medical center in Taiwan during January 2017 to December 2021 were collected and analyzed. The total antibiotic usage, counted by DID, had a significant increasing trend, before COVID-19 occurrence in 2017-2019, but no further increase during the pandemic period in 2020-2021. However, comparing the two time periods, antibiotics consumption was significantly increased during pandemic period. There was no significant change of HAI density in MRSA, VRE, CRAB, CRKP, and CRPA, comparing the pandemic to the pre-pandemic period. Although, CRKP and CRPA infection rates were increasing during the pre-pandemic period, there was no further increase of CRKP and CRPA HAI rates during the pandemic period. During COVID-19 pandemic, there was no significant increase in HAI density of five major MDR bacteria at ICU in Taiwan, despite increased antibiotic usage. Strict infection prevention measures for COVID-19 precautions and sustained antimicrobial stewardship probably bring these effects.

Lessons from the COVID-19 Pandemic: Strengthening our Commitment to Eye Care

Lessons from the COVID-19 Pandemic: Strengthening our Commitment to Eye Care

Kidney Transplant Practice in Pandemic Times: Lessons Learned for the Future.

Kidney Transplant Practice in Pandemic Times: Lessons Learned for the Future.

Trends of Animal Bite Cases and Comparison of Cases Reported during Pre-COVID-19 and COVID-19 Period in a Dedicated Anti-Rabies Clinic from a Tertiary Care Hospital, Hassan, Karnataka, India: A Retrospective Cohort Study

Introduction: Rabies causes 100% case fatality in animal bite victims if left untreated, and it ranks as the 10th leading cause of death due to infectious diseases worldwide. India alone reports 20,000 human rabies deaths annually, accounting for one-third of global mortalities related to the disease. However, rabies is 100% preventable. The nationwide lockdown imposed from March 25, 2020, to curb the spread of the Coronavirus Disease-2019 (COVID-19) disrupted various essential health services, including Post-Exposure Prophylaxis (PEP) for rabies. Aim: to describe the socio-demographic profile of animal bite cases and assess the burden of animal bites during the pre and post COVID-19 Pandemic, specifically in patients reporting to the dedicated Anti-Rabies Clinic (ARC) of a tertiary care hospital in Hassan, Karnataka, India. Materials and Methods: A retrospective record-based study was conducted from January 2019 to November 2021 among animal bite cases reporting to the ARC at Hassan Institute of Medical Sciences, Hassan, Karnataka, India. Data on age, gender, locality, and socio-economic status were collected from the records maintained at the ARC. All subjects with complete data in the records were included in the study. All animal bite cases were managed according to the World Health Organisation (WHO) guidelines, with necessary COVID-19 precautions taken. A total of 3,706, 3,303, and 2,144 subjects were considered for the years 2019, 2020, and 2021, respectively. Results: There was a decreasing trend in the reported cases during the pandemic. The proportion of animal bite cases among those less than 19 years old was 1,146 (30.9%), 1,124 (34.1%), and 711 (33.1%) in the years 2019, 2020, and 2021, respectively. The majority of animal bite victims were males: 2,489 (67.2%), 2,240 (67.8%), and 1,173 (54.7%) in the years 2019, 2020, and 2021, respectively. The majority belonged to the rural population, with 2,668 (72.0%), 1,057 (32%), and 1,586 (74%) in the years 2019, 2020, and 2021, respectively. However, there was an increase in the number of victims from the urban population in the year 2020, with nearly 2,246 (68%). Most of them, 2,299 (62%), 2,114 (64%), and 1,441 (67.2%) in the years 2019, 2020, and 2021, respectively, belonged to a lower socio-economic status. Category-III bites made up the majority representation in all the years 2019, 2020, and 2021. Conclusion: The number of animal bite cases reported during the pandemic was lower compared to the pre-pandemic phase. This highlights either missed reporting of cases or a reduction in exposure to animals, which decreased the risk of animal bites.

The Effect of COVID-19 on Maternal Mental Health and Medical Support

The Coronavirus disease 2019 (COVID-19) is a pandemic that affected the overall mental health of the population. As seen in previous situations, there seemed to be an extreme impact of disasters on the mental health of pregnant women and new mothers; therefore, we investigated the relationship between COVID-19 and maternal mental health. The pregnant subjects were identified during the study period through convenience sampling. The study received Institutional Review Board approval and online surveys were sent to subjects via email. The questions were focused on feelings about being pregnant and the influence of the practices during the pandemic. Fifty-one (51) pregnant patients were identified. Our study found that 92.3% of the participants felt negatively, as the COVID-19 precautions did not permit their significant other to attend their routine prenatal visits with them. 64.7% felt that the visits were less personal, 100% felt that they had to take more precautions. Only 42% of the doctors of the subjects discussed how COVID-19 could affect the pregnancy and the baby. Pregnant subjects all had negative feelings towards the pandemic, routine precautions, and the inability to include significant others in prenatal visits and delivery. The majority did not feel their medical teams discussed how COVID-19 could affect the baby.

COVID-19 Infection Risk Following Elective Arthroplasty and Surgical Complications in COVID-19-vaccinated Patients: A Multicenter Comparative Cohort Study.

BackgroundWe aimed to determine symptomatic Coronavirus disease 2019 (COVID-19) rates within 1 month of elective arthroplasty for vaccinated individuals and to determine whether vaccination guarantees protection against COVID-19 after arthroplasty (primary outcome). In addition, the 90-day surgical complications were compared to those of an unvaccinated group (secondary outcome).MethodsA prospective cohort study was conducted on elective joint arthroplasty patients at 3 tertiary hospitals in 2 major cities (Tehran and Isfahan) in our country (Iran). The outcomes of the COVID-19-vaccinated group were assessed between October 2021 and March 2022. Ninety-day surgical complications were compared with a historical cohort of unvaccinated patients treated earlier in the pandemic (April 2020-March 2021).ResultsThe study included 1717 consecutive patients: 962 vaccinated and 755 unvaccinated. In the vaccinated group, 38 patients (3.9%) contracted COVID-19, 4 (10.5%) were hospitalized again, and none required intensive care unit admission. The multivariate logistic regression analysis revealed that COVID-19-positive cases are more likely to be female (odds ratio [OR] = 12.5), to have visitors to their home (OR = 4.7), and to stay longer in the hospital (OR = 1.2) than COVID-19-negative cases. Compared to unvaccinated patients, the postoperative COVID-19 rate was not significantly different (3.9% vs 2.4%, P = .07). The incidence of surgical complications was similar between the 2 groups (P > .05).ConclusionsThe vaccination does not provide a guarantee that a patient will not contract COVID-19 following their arthroplasty surgery, especially in a region with a high rate of COVID-19. We believe reasonable perioperative COVID-19 precautions may be warranted even in vaccinated patients.

Surgical site infections during the COVID-19 era: A retrospective, multicenter analysis

BackgroundSurgical site infections (SSIs) are an undesired perioperative outcome. Recent studies have shown increases in hospital acquired infections during the coronavirus disease 2019 (COVID-19) pandemic. The objective of this study was to evaluate postoperative SSIs in the COVID-19-era compared to a historical cohort at a large, multicenter, academic institution.MethodsA retrospective review of all patients who underwent National Health and Safety Network (NHSN) inpatient surgical procedures between January 1, 2018 and December 31, 2020. Patients from the COVID-19-era (March-December 2020) were compared and matched 1:1 with historical controls (2018/2019) utilizing the standardized infection ratio (SIR) to detect difference.Results/DiscussionDuring the study period, 29,904 patients underwent NHSN procedures at our institution. When patients from the matched cohort (2018/2019) were compared to the COVID-19-era cohort (2020), a decreased risk of SSI was observed following colorectal surgery (RR = 0.94, 95% CI [0.65, 1.37], P = .76), hysterectomy (RR = 0.88, 95% CI [0.39, 1.99], P = .75), and knee prothesis surgery (RR = 0.95, 95% CI [0.52, 1.74], P = .88), though not statistically significant. An increased risk of SSI was observed following hip prosthesis surgery (RR 1.09, 95% CI [0.68, 1.75], P = .72), though not statistically significant.ConclusionsThe risk of SSI in patients who underwent NHSN inpatient surgical procedures in 2020 with perioperative COVID-19 precautions was not significantly different when compared to matched controls at our large, multicenter, academic institution.

'All of a sudden, you know, you can't go to these services, because of the risk of infection': Audiological service considerations at residential care homes for older persons during COVID-19.

BackgroundResidential care homes for older persons were especially affected during the coronavirus disease 2019 (COVID-19) pandemic lockdowns which resulted in limited social interactions and service provision. Communication became challenging due to the prophylactic use of masks and social distancing.ObjectivesThis qualitative research study set out to explore audiological service considerations in residential care homes for older persons during the COVID-19 restrictions.MethodThrough purposive sampling, nine managers from residential care homes for older persons in Johannesburg participated in semi-structured, online interviews. The transcriptions of these recorded interviews underwent thematic analysis.ResultsManagers employed various strategies to attend to residents’ audiological needs, audiological health, hearing aid use, and hearing aid provision. Furthermore, it transpired that other health related services were prioritised over audiological services in general, but especially during the pandemic lockdowns. Managers reported that staff had to use various communication strategies due to COVID-19 precautions and that masks and social distancing made communication more challenging for residents with hearing loss. Moreover, isolation and modified service provision were extremely taxing on residents.ConclusionThis study highlights the need for continued audiological services at residential care homes, but also the need to balance audiological needs with other health needs because these seem to be prioritised over hearing loss, especially in this population who may have limited agency and choice in the health care options available to them. Furthermore, adapted strategies need to be considered to support communication considering COVID-19 precautions so that communicative difficulties do not exacerbate lockdown isolation.

Mortality and Epidemiological Changes in Proximal Hip Fractures in the Course of a Pandemic.

Background: Coronavirus disease 2019 (COVID-19) has had an immense impact on the treatment protocols of orthopedic and trauma departments, yet its specific effect on mortality in patients with hip fractures due to possible surgical delays is still unclear. The purpose of this paper was to investigate whether the COVID-19 pandemic worsened the mortality rate of hip fracture patients. Patients and methods: This study comprised 175 prospectively included patients who (1) suffered from hip fractures, (2) presented during the Austrian state of emergency period from 15 March 2020 to 30 May 2021, and (3) were admitted to a level I trauma center. This cohort was compared with a retrospective control group of 339 patients admitted for hip fractures during the same timeframe in 2017, 2018, and 2019. Results: An admission reduction of 22% in the COVID period compared with the pre-COVID period was evident (p = 0.018). The 30-day mortality rate was 14.67% (pre-COVID) compared with 15.18% (p = 0.381). No differences in surgical complication rates or relationships between comorbidity burden and survival were observed. There were no significant changes in demographic variables, except for admission rate, gender (p = 0.013), and place of accident (p = 0.049). Conclusion: Surgeons should be reassured to take COVID-19 precautions, as this study did not show higher perioperative mortality due to COVID-19 measures. Under the current circumstances, with possibly reduced surgical and hospital bed capacities, it is expected that hip fractures may continue to require a high degree of resources.

A descriptive study on Bulgarian preclinical dental students' knowledge and attitude towards coronavirus disease 2019 precautions and cross-infection control practices

BACKGROUND AND AIM: One year after the novel coronavirus pandemic, there is a sustained risk of further global spread and most countries continue to impose preventive measures to mitigate the spread of coronavirus disease 2019 (COVID-19). The current situation outlined a specific reformulation of dental education in Medical University of Sofia, Sofia, Bulgaria - initial transition of face-to-face classes towards electronic learning (e-learning) processes, and subsequently, a transition from online teaching toward hybrid education. Therefore, the aim of the present study was to investigate preclinical dental students' knowledge and attitude towards COVID-19 precautions as well as crossinfection control strategies. METHODS: This descriptive cross-sectional study was conducted online on 258 out of 516 preclinical dental students at the School of Dental Medicine, Sofia, using a self-administered questionnaire. Survey items were grouped in 3 general sections: educational experiences, students' knowledge and perceptions of COVID-19 precautions and sources of relevant information as well as students' personal experiences during the current pandemic. RESULTS: A total of 169 students participated in the study (response rate: 65.5%). Of them, 98 (57.9%) were secondyear students, 42.6% were men, and their mean age was 21 +/- 1 years. Almost one-third of the participants indicated violation of disinfection and sterilization protocols (28.9%) and the presence of aerosol-generating procedures (27.2%) as the most important COVID-19 predisposing factors in dental practice. Vaccination was suggested as the most effective way of prevention against the COVID-19. Proposed infection control practices included strict cleaning, disinfection, and sterilization (87.6%), personal protective equipment (PPE) (85.8%), frequent ventilation (53.3%), and treatment after a negative polymerase chain reaction (PCR) (or other) test (46.2%). Social media was considered as the main source for pandemic-related information (68.0%). CONCLUSION: In the light of COVID-19, dental students demonstrated a satisfactory level of knowledge regarding standard precautions in dental practice;however, more attention should be paid to additional transmission-based precautions to ensure the safety of educational and working environment.

Primary Source of Information About COVID-19 as a Determinant of Perception of COVID-19 Severity and Vaccine Uptake : Source of Information and COVID-19.

BackgroundIdentifying the key determinants of vaccine uptake in the context of coronavirus disease 2019 (COVID-19) is critical to increasing vaccination rates, especially for Medicare beneficiaries.ObjectiveWe examined how the source of COVID-19 information shapes perceptions of COVID-19 severity and the likelihood of COVID-19 vaccine uptake among Medicare beneficiaries.Design, Setting, and ParticipantsWe included 6478 Medicare beneficiaries from the Fall 2020 Medicare Current Beneficiary Survey COVID-19 Supplement.Main MeasuresOur dependent variables were perception of COVID-19 severity and the likelihood of getting a COVID-19 vaccine. Our key independent variable was the beneficiaries’ primary source of information about COVID-19 and included six mutually exclusive categories: traditional news sources, guidance from government officials, social media, other webpages/Internet, friends or family members, or health care providers.Key ResultsCompared to those relying on traditional news sources or guidance from governmental officials, those relying on other sources had lower perceptions of COVID-19 severity and lower likelihood of getting a COVID-19 vaccine. Those relying on social media had the lowest levels in all measures (65.5% for those who agreed that COVID-19 is more contagious than the flu, 62.1% for those who agreed that COVID-19 is more deadly than the flu, 87.8% for those who agreed that all should take COVID-19 precautions, and 43.3% for those who answered that they would get a COVID-19 vaccine). The likelihood of COVID-19 vaccine uptake was also low among those relying on health care providers (55.5%). These findings remained similar even after adjusting for perceptions of COVID-19 severity in the relationship between the source of COVID-19 information and the likelihood of COVID-19 vaccine uptake.ConclusionsThe primary source of information that Medicare beneficiaries used to learn about COVID-19 may play a critical role in shaping perceptions of COVID-19 severity and attitudes toward getting a COVID-19 vaccine.

Effect of Using Personal Protective Equipment during the COVID-19 Pandemic on the Quality Indicators of Screening Colonoscopies.

Background Coronavirus Disease 2019 (COVID-19) has affected many facets of the practice of medicine including screening colonoscopies. Aims Our study looks to observe if there has been an effect on the quality of colonoscopies, as indicated by quality measures such as the cecal intubation rate (CIR), cecal intubation time (CIT), scope withdrawal time (SWT), and adenoma detection rate (ADR) with the adoption of standard COVID-19 precautions. Methods We conducted a retrospective chart review to analyze the effects of the COVID-19 pandemic on screening colonoscopies. The study utilized data on CIR, CIT, SWT, and ADR from outpatient, nonemergent procedures conducted at 3 endoscopy suites of St. Luke's University Health Network. All inpatient and emergent procedures were excluded. Results Our study demonstrated that the total number of screening colonoscopies was decreased between 2019 and 2020 (318 in 2019 vs. 157 in 2020, p = 0.005). CIT (320 ± 105 seconds in 2019 vs. 392 ± 107 seconds in 2020, p = 0.001) and SWT (706 ± 232 seconds in 2019 vs. 830 ± 241 seconds in 2020, p = 0.001) were increased while CIR (98.2% in 2019 vs. 96.6% in 2020, p = 0.04) was decreased between 2019 and 2020 likely due to PPE introduction. ADR was similar between the two groups (38.23 (12.50-66.66) in 2019 vs. 38.18 (16.66-66.00) in 2020, p = 0.8). Conclusion Our study showed that quality indices for screening colonoscopies like CIR, CIT, and SWT were negatively impacted during the COVID-19 time period. ADR, however, was similar. Thus, the efficiency of the procedures was affected by the use of PPE but it did not affect the colonoscopy's clinical benefit.

Guidelines for Mountain Rescue During the COVID-19 Pandemic: Official Guidelines of the International Commission for Alpine Rescue.

Roy, Steven, Inigo Soteras, Alison Sheets, Richard Price, Kazue Oshiro, Simon Rauch, Don McPhalen, Maria Antonia Nerin, Giacomo Strapazzon, Myron Allen, Alistair Read, and Peter Paal. Guidelines for mountain rescue during the COVID-19 pandemic: official guidelines of the International Commission for Alpine Rescue. High Alt Med Biol. 22: 128–141, 2021.Background: In mountain rescue, uncertainty exists on the best practice to prevent coronavirus disease 2019 (COVID-19) transmission. The aim of this work was to provide a state-of-the-art overview of the challenges caused by the COVID-19 pandemic in mountain rescue.Methods: Original articles or reviews, published until December 27, 2020 in Cochrane COVID-19 Study Register, EMBASE, PubMed, and Google Scholar were included. Articles were limited to English, French, German, or Spanish with the article topic COVID-19 or other epidemics, addressing transmission, transport, rescue, or cardiopulmonary resuscitation.Results: The literature search yielded 6,190 articles. A total of 952 were duplicates and 5,238 were unique results. After exclusion of duplicates and studies that were not relevant to this work, 249 articles were considered for this work. Finally, 72 articles and other sources were included.Conclusions: Recommendations are provided for protection of the rescuer (including screening, personal protective equipment [PPE], and vaccination), protection of the patient (including general masking if low risk, specific PPE if high risk), equipment hygiene (including disinfection after every mission), use of single-use products, training and medical measures under COVID-19 precautions, and psychological wellbeing of rescuers during the COVID-19 pandemic. Adapted COVID-19 precautions for low-and-medium-income countries are also discussed.

Internet Addiction and Stressors Causing Internet Addiction in Primary School Children during the COVID-19 Pandemic: A Descriptive and Cross-Sectional Study from Turkey

In this study, we aimed to examine the status of internet addiction in children and the stress factors causing it during the coronavirus disease 2019 (COVID-19) pandemic. This study was a descriptive and cross-sectional study. The study sample included 154 parents of 7- to 10-year-old students. Participant information form and the Family-Child Internet Addiction Scale were used as data collection tools. The data of the study were collected with a questionnaire (via Google Forms) between July 15 and December 15, 2020. Of the children participating in the study, 90.3% (n=139) showed no symptoms and 9.7% (n=15) showed limited symptoms in terms of internet addiction. The total mean score that the children obtained from the scale was found to be 24.6 +/- 16.9. It was observed that the frequency of a child playing games with parents, the parents watching news about COVID-19 with the child, and the child being frequently warned about the COVID-19 precautions increased the children's internet addiction scores (p<0.05). This study demonstrated that if the pandemic process was prolonged, internet addiction in children could be further triggered.

Impact of Coronavirus Disease 2019 Pandemic on Viral Hepatitis Elimination: What Is the Price?

In 2016, the World Health Organization developed a plan for viral hepatitis elimination by 2030. Globally, control of hepatitis B virus (HBV) and hepatitis C virus (HCV) are the most challenging aspects of viral hepatitis elimination. In many developed countries elimination of HBV could be targeted to special populations mostly immigrants from low resource settings. Elimination of HCV, however, remains a challenge globally. Barriers to HCV elimination include high cost of medications and the ability to engage specific at-risk populations as well as individuals who are out of medical care. In the context of the coronavirus disease 2019 (COVID-19) pandemic, treatment access and screening have been further negatively impacted by social distancing rules and COVID-19-related anxieties. This threatens to throw most countries off course in their elimination efforts. Before the pandemic, some states in the United States had scaled up their elimination efforts with plans to ramp up testing and treatment using Netflix-like payment models for HCV direct acting antiviral drugs. Most of these efforts have stalled on account of the health system's focus on COVID-19 control. To prevent further delays in achieving elimination targets, programs would need to explore new models of care that address COVID-19-related access hurdles. Systems that leverage technologies such as telemedicine and self-testing could help maintain treatment levels. Mathematical models estimate that COVID-19-related delays in 2020 could lead to 44,800 hepatocellular cancers and 72,300 liver-related deaths for the next decade.

COVID-19 pre-procedural testing strategy and early outcomes at a large tertiary care children's hospital.

PurposeWith the emergence of the coronavirus disease-2019 (COVID-19) pandemic, institutions were tasked with developing individualized pre-procedural testing strategies that allowed for re-initiation of elective procedures within national and state guidelines. This report describes the experience of a single US children’s hospital (Children’s Wisconsin, CW) in developing a universal pre-procedural COVID-19 testing protocol and reports early outcomes.MethodsThe CW pre-procedural COVID-19 response began with the creation of a multi-disciplinary taskforce that sought to develop a strategy for universal pre-procedural COVID-19 testing which (1) maximized patient safety, (2) prevented in-hospital viral transmission, (3) conserved resources, and (4) allowed for resumption of procedural care within institutional capacity.ResultsOf 11,209 general anesthetics performed at CW from March 16, 2020 to October 31, 2020, 11,150 patients (99.5%) underwent pre-procedural COVID-19 testing. Overall, 1.4% of pre-procedural patients tested positive for COVID-19. By June 2020, CW was operating at near-normal procedural volume and there were no documented cases of in-hospital viral transmission. Only 0.5% of procedures were performed under augmented COVID-19 precautions (negative pressure environment and highest-level personal protective equipment).ConclusionCW successfully developed a multi-disciplinary pre-procedural COVID-19 testing protocol that enabled resumption of near-normal procedural volume within three months while limiting in-hospital viral transmission and resource use.

Risk Factors for Reverse Transcriptase Polymerase Chain Reaction Positivity for SARS-CoV-2 among Health Care Workers in a Group of Tertiary Care Hospitals in Mumbai: A Cross-sectional Study

Introduction: Health Care Workers (HCWs) can acquire or transmit Corona Virus Disease 2019 (COVID-19) from and to patients respectively. There is limited data on risk factors for Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection among HCWs. Aim: To evaluate the risk factors for SARS-CoV-2 infection amongst HCWs of tertiary care hospitals in Mumbai, Maharashtra, India. Materials and Methods: A questionnaire based cross-sectional study was conducted among 801 HCWs from three tertiary care hospitals. Data regarding demography, co-morbidities (hypertension, diabetes, heart disease, cancer, immunosuppressive therapy, asthma), symptoms, contact with confirmed cases of COVID-19 and protective precautions at the work place was collected. Infection diagnosed by Respiratory Tract samples- Reverse Trancriptase Polymerase Chain Reaction (RT-PCR) test was correlated with the above factors. Results: Of the participants, 50.1% were working in designated COVID-19 area; 85.1% had no co-morbidity. A total of 62 of the 801 (7.75%) HCWs had a history of positive RT-PCR for SARS-CoV-2. Only asthma was associated with a significant higher in infection rate. Loss of taste/smell (30%), acute febrile illness (46.4%), acute respiratory illness (18.5%) were more common in persons with RT-PCR positivity (p&lt;0.05). Visit to fever clinic, positive household member, and a definite history of exposure to a COVID-19 positive patient, were significantly associated with higher risk of infection. Working in designated COVID-19 hospital was not a significant risk factor (8.5% vs 5.6%). HCWs on Hydroxychloroquine (HCQ) prophylaxis had significantly lower rate of infection. Conclusion: Rate of SARS-CoV-2 positivity among HCWs was 7.7%. Presence of symptoms, especially, loss of taste/smell, fever and respiratory symptoms are associated with high positive rates. Working in a designated COVID hospital was not a risk factor for increased rate of infection. HCQ prophylaxis is associated with reduced rate of COVID-19 among HCWs.