COVID-19 Pandemic In Mexico Research Articles

Spatial epidemiological study of the distribution, clustering, and risk factors associated with early COVID-19 mortality in Mexico.

COVID-19 is a respiratory disease caused by SARS-CoV-2, which has significantly impacted economic and public healthcare systems worldwide. SARS-CoV-2 is highly lethal in older adults (>65 years old) and in cases with underlying medical conditions, including chronic respiratory diseases, immunosuppression, and cardio-metabolic diseases, including severe obesity, diabetes, and hypertension. The course of the COVID-19 pandemic in Mexico has led to many fatal cases in younger patients attributable to cardio-metabolic conditions. Thus, in the present study, we aimed to perform an early spatial epidemiological analysis for the COVID-19 outbreak in Mexico. Firstly, to evaluate how mortality risk from COVID-19 among tested individuals (MRt) is geographically distributed and secondly, to analyze the association of spatial predictors of MRt across different states in Mexico, controlling for the severity of the disease. Among health-related variables, diabetes and obesity were positively associated with COVID-19 fatality. When analyzing Mexico as a whole, we identified that both the percentages of external and internal migration had positive associations with early COVID-19 mortality risk with external migration having the second-highest positive association. As an indirect measure of urbanicity, population density, and overcrowding in households, the physicians-to-population ratio has the highest positive association with MRt. In contrast, the percentage of individuals in the age group between 10 to 39 years had a negative association with MRt. Geographically, Quintana Roo, Baja California, Chihuahua, and Tabasco (until April 2020) had higher MRt and standardized mortality ratios, suggesting that risks in these states were above what was nationally expected. Additionally, the strength of the association between some spatial predictors and the COVID-19 fatality risk varied by zone.

Transmission dynamics and forecasts of the COVID-19 pandemic in Mexico, March-December 2020.

Mexico has experienced one of the highest COVID-19 mortality rates in the world. A delayed implementation of social distancing interventions in late March 2020 and a phased reopening of the country in June 2020 has facilitated sustained disease transmission in the region. In this study we systematically generate and compare 30-day ahead forecasts using previously validated growth models based on mortality trends from the Institute for Health Metrics and Evaluation for Mexico and Mexico City in near real-time. Moreover, we estimate reproduction numbers for SARS-CoV-2 based on the methods that rely on genomic data as well as case incidence data. Subsequently, functional data analysis techniques are utilized to analyze the shapes of COVID-19 growth rate curves at the state level to characterize the spatiotemporal transmission patterns of SARS-CoV-2. The early estimates of the reproduction number for Mexico were estimated between Rt ~1.1–1.3 from the genomic and case incidence data. Moreover, the mean estimate of Rt has fluctuated around ~1.0 from late July till end of September 2020. The spatial analysis characterizes the state-level dynamics of COVID-19 into four groups with distinct epidemic trajectories based on epidemic growth rates. Our results show that the sequential mortality forecasts from the GLM and Richards model predict a downward trend in the number of deaths for all thirteen forecast periods for Mexico and Mexico City. However, the sub-epidemic and IHME models perform better predicting a more realistic stable trajectory of COVID-19 mortality trends for the last three forecast periods (09/21-10/21, 09/28-10/27, 09/28-10/27) for Mexico and Mexico City. Our findings indicate that phenomenological models are useful tools for short-term epidemic forecasting albeit forecasts need to be interpreted with caution given the dynamic implementation and lifting of social distancing measures.

Guidelines for refractive surgery with excimer and femtosecond lasers and for treatment with cross-linking during the COVID-19 pandemic in Mexico

The severe pandemic caused by the respiratory coronavirus SARS-CoV-2 (COVID-19) is currently a major problem in all elective surgery clinics, including those that perform refractive surgery, which has been rescheduling most of their procedures for a long time due to high morbidity and mortality. Currently, due to changes in the knowledge of the disease, as well as protective measures with barriers, many refractive surgery clinics have restarted their procedures without yet having a consensus about protection for doctors and patients. This work aims to adapt the international information of the existing guidelines, as well as to provide recommendations that can be applied and be useful for the practice of these procedures in Mexico.

Maternal mortality during the COVID-19 pandemic in Mexico: a preliminary analysis during the first year

BackgroundIn Mexico, the COVID-19 pandemic led to preventative measures such as confinement and social interaction limitations that paradoxically may have aggravated healthcare access disparities for pregnant women and accentuated health system weaknesses addressing high-risk patients’ pregnancies. Our objective is to estimate the maternal mortality ratio in 1 year and analyze the clinical course of pregnant women hospitalized due to acute respiratory distress syndrome and COVID-19.MethodsA retrospective surveillance study of the national maternal mortality was performed from February 2020–February 2021 in Mexico related to COVID-19 cases in pregnant women, including their outcomes. Comparisons were made between patients who died and those who survived to identify prognostic factors and underlying health conditions distribution.ResultsMaternal Mortality Ratio increased by 56.8% in the studied period, confirmed COVID-19 was the cause of 22.93% of cases. Additionally, unconfirmed cases represented 4.5% of all maternal deaths. Among hospitalized pregnant women with Acute Respiratory Distress Syndrome consistent with COVID-19, smoking and cardiovascular diseases were more common among patients who faced a fatal outcome. They were also more common in the age group of < 19 or > 38. In addition, pneumonia was associated with asthma and immune impairment, while diabetes and increased BMI increased the odds for death (Odds Ratio 2.30 and 1.70, respectively).ConclusionsMaternal Mortality Ratio in Mexico increased over 60% in 1 year during the pandemic; COVID-19 was linked to 25.4% of maternal deaths in the studied period. Lethality among pregnant women with a diagnosis of COVID-19 was 2.8%, and while asthma and immune impairment increased propensity for developing pneumonia, obesity and diabetes increased the odds for in-hospital death. Measures are needed to improve access to coordinated well-organized healthcare to reduce maternal deaths related to COVID-19 and pandemic collateral effects.

The partisan cues and perceived risks: the effect of partisan social media frames during the COVID-19 crisis in Mexico

ABSTRACT We present the results of a survey experiment designed to evaluate the effects of social media exposure on perceptions of personal health and job risks during the COVID-19 pandemic in Mexico. Our framing experiment treats respondents to positive and negative partisan messages from high-level politicians. Descriptive findings show divergent evaluations of how the government is addressing the crisis by supporters of the government and opposition parties. Results show that respondents are sensitive to negative frames regardless of the political color of the messenger. Further, supporters of the incumbent are more likely to deflect government’s responsibility when treated with a negative frame by a politician from the opposition.

Characterizing all-cause excess mortality patterns during COVID-19 pandemic in Mexico

BackgroundLow testing rates and delays in reporting hinder the estimation of the mortality burden associated with the COVID-19 pandemic. During a public health emergency, estimating all cause excess deaths above an expected level of death can provide a more reliable picture of the mortality burden. Here, we aim to estimate the absolute and relative mortality impact of COVID-19 pandemic in Mexico.MethodsWe obtained weekly mortality time series due to all causes for Mexico, and by gender, and geographic region from 2015 to 2020. We also compiled surveillance data on COVID-19 cases and deaths to assess the timing and intensity of the pandemic and assembled weekly series of the proportion of tweets about ‘death’ from Mexico to assess the correlation between people’s media interaction about ‘death’ and the rise in pandemic deaths. We estimated all-cause excess mortality rates and mortality rate ratio increase over baseline by fitting Serfling regression models and forecasted the total excess deaths for Mexico for the first 4 weeks of 2021 using the generalized logistic growth model.ResultsWe estimated the all-cause excess mortality rate associated with the COVID-19 pandemic in Mexico in 2020 at 26.10 per 10,000 population, which corresponds to 333,538 excess deaths. Males had about 2-fold higher excess mortality rate (33.99) compared to females (18.53). Mexico City reported the highest excess death rate (63.54) and RR (2.09) compared to rest of the country (excess rate = 23.25, RR = 1.62). While COVID-19 deaths accounted for only 38.64% of total excess deaths in Mexico, our forecast estimate that Mexico has accumulated a total of ~ 61,610 [95% PI: 60,003, 63,216] excess deaths in the first 4 weeks of 2021. Proportion of tweets was significantly correlated with the excess mortality (ρ = 0.508 [95% CI: 0.245, 0.701], p-value = 0.0004).ConclusionThe COVID-19 pandemic has heavily affected Mexico. The lab-confirmed COVID-19 deaths accounted for only 38.64% of total all cause excess deaths (333,538) in Mexico in 2020. This reflects either the effect of low testing rates in Mexico, or the surge in number of deaths due to other causes during the pandemic. A model-based forecast indicates that an average of 61,610 excess deaths have occurred in January 2021.

686 Sleep Education and Sleep Outcomes in the Time of Covid-19 in Mexico

IntroductionThis study examines computer-mediated sleep education for health providers enrolled in a certified diabetes educator program in November 2020 in Mexico.MethodsData derived from pre/post ratings assessed knowledge of obstructive sleep apnea (OSA), insomnia, restless legs syndrome (RLS), short sleep duration (SSD), circadian rhythm disorders (CRD), and drowsy driving (DD) on a 5-point Likert-like scale, and five true/false questions regarding misconceptions about sleep. Outcomes included self-reported sleep problems among providers since the onset of the March 2020 Covid-19 surge in Mexico. Pre/post means were compared with paired t-tests using SPSS (V25) with significance set at p<0.05.ResultsVolunteer participants (N=23; 83% women; 52% nutritionists; 48% health providers) were recruited from the fall semester 2020 diabetes educator certificate program. Means with standard deviations showed significant learning for all sleep disorders following the training (OSA: 3.1±1.0 to 4.4±0.78; Insomnia: 3.2±0.85 to 4.3±0.82; RLS: 2.1±1.2 to 4.2±0.95; SSD: 2.7 ±1.1 to 4.4±0.72; CRD: 2.6±1.2 to 4.4±0.73; DD: 2.6±1.1 to 4.4±0.78, all p<.0001). The total pre- to post-scores (Range=0 to 30) for sleep disorders moved from 16.3±5.7 to 26.3±4.4, p<.0001. Participants demonstrated improved, but borderline significant findings regarding misconceptions about sleep from pre-to post-testing, p=.07. Of the 23 respondents, 18 (78%) reported sleep problems specific to the onset of the Covid-19 pandemic in Mexico. Of the 18 providers, 13 reported insomnia symptoms, while five indicated short sleep due to double shift work, anxiety and depression, or poor sleep quality.ConclusionParticipants (78%) reported sleep problems; particularly insomnia associated with anxiety, depression, poor sleep quality and extended shift work since the onset of the Covid-19 pandemic. Findings are consistent with global studies of Covid-19 and sleep of health care workers. Online participants’ significant learning for all sleep disorders was coherent with in-class learners (N=173). Pre-to-post analyses of misconceptions about sleep, particularly sleep needs for adults and that daytime sleep can make up for lack of nighttime sleep, however, were not significant for these learners compared to the in-class learning groups.Support (if any)N/A

La construcción social del riesgo. Claves analíticas para comprender la pandemia de Covid-19 en México: el caso de la Jornada Nacional de Sana Distancia

&lt;p&gt;El objetivo de de este artículo es plantear claves analíticas de la sociología del riesgo para tratar de comprender el fenómeno de la pandemia por Covid-19 en México. Lo anterior se explica a través de la constitución de diferentes formas de asunción, apropiación y significación de la pandemia, a partir de visibilizar el carácter multidimensional de la construcción social del riesgo. En su sección teórica, se trazan los postulados de la sociología del riesgo, en sus “clásicos” y en sus perspectivas contemporáneas. En la sección analítica, se establecen modelos teóricos a partir de conceptos como “herramientas” para aproximarse a la pandemia por Covid-19. En la última sección, se propone operar analíticamente el caso de la Jornada Nacional de Sana Distancia en México, la cual evidencia formas de la construcción del riesgo. Este acontecimiento marca temporalidades y categorizaciones analíticas específicas que darán cuenta de la complejidad de la configuración del riesgo en la pandemia en México.&lt;/p&gt;

Medical Students’ Perception Towards the COVID-19 Pandemic in Mexico: Distance Learning, Assisting Hospitals, and Vaccination

Background: Mexico has been one of the most affected countries by the COVID-19 pandemic. Its health workers are playing a substantial role, but they are suffering from a high mortality rate, which highlights the need of vaccinating them before any other population. Medical interns have reduced their practices, some continue to assist clinical rotations without the protective equipment, and they are not being considered for vaccination. We wanted to determine the attitude of medical students and interns towards distance learning, assisting hospitals, and vaccination.&#x0D; Methods: We conducted a paired survey of a cohort of medical students who were evaluated twice, in June 2020 and in December 2020, using an online survey (32-online questions) to assess their perception of the pandemic.&#x0D; Results: We collected the response of 384 students in the summer period and 331 in the winter period; the majority were women from non-clinical semesters, and the median age of response was 21 years old (IQR 19 – 22). We found that the percentage of acceptance for vaccination was 95.6% in the summer and 93.7% in the winter, a remarkable acceptance in both periods. The percentage of students who manifested having someone close to them with symptoms suggestive of COVID-19 was 38.5% in the summer, showing an increase to 77.6% in the winter.&#x0D; Conclusion: We observed that medical students had a positive attitude towards vaccination and that the probable COVID-19 cases among them have increased in just a few months.

Population-Based COVID-19 Screening in Mexico: Assessment of Symptoms and Their Weighting in Predicting SARS-CoV-2 Infection.

Background and Objectives: Sentinel surveillance in the early stage of the COVID-19 pandemic in Mexico represented a significant cost reduction and was useful in estimating the population infected with SARS-CoV-2. However, it also implied that many patients were not screened and therefore had no accurate diagnosis. In this study, we carried out a population-based SARS-CoV-2 screening in Mexico to evaluate the COVID-19-related symptoms and their weighting in predicting SARS-CoV-2 infection. We also discuss this data in the context of the operational definition of suspected cases of COVID-19 established by the Mexican Health Authority’s consensus. Materials and Methods: One thousand two hundred seventy-nine subjects were included. They were screened for SARS-CoV-2 using RT-PCR. The weighting of COVID-19 symptoms in predicting SARS-CoV-2 infection was evaluated statistically. Results: Three hundred and twenty-five patients were positive for SARS-CoV-2 and 954 were negative. Fever, asthenia, dysgeusia, and oxygen saturation predicted SARS-CoV-2 infection (odds ratios ranged from 1.74 to 4.98; p < 0.05). The percentage of asymptomatic COVID-19 patients was 36% and only 38.15% met the Mexican operational definition. Cq-values for the gene N of SARS-CoV-2 were significantly higher in asymptomatic subjects than in the groups of COVID-19 patients with neurological, respiratory, and/or musculoskeletal manifestations (p < 0.05). Conclusions: Dysgeusia, fever, and asthenia increased the odds of a positive result for COVID-19 1.74–4.98-fold among the study population. Patients with neurological, respiratory, and/or musculoskeletal manifestations had higher viral loads at COVID-19 diagnosis than those observed in asymptomatic patients. A high percentage of the participants in the study (61.85%) did not meet the operational definition for a suspected case of COVID-19 established by the Mexican Health Authority’s consensus, representing a high percentage of the population that could have remained without a COVID-19 diagnosis, so becoming a potential source of virus spread.

Sleep and Mental Health Disturbances Due to Social Isolation during the COVID-19 Pandemic in Mexico.

The coronavirus disease (COVID-19) that broke out in China in December 2019 rapidly became a worldwide pandemic. In Mexico, the conditions requiring the declaration of a sanitary emergency were reached by the last week of March 2020, and health authorities’ limited mobility and imposed social isolation were the main strategies to keep the virus from spreading. Thus, daily living conditions changed drastically in a few days, generating a stressful situation characterized by an almost complete lack of mobility, social isolation, and forced full-time interactions with family members. Soon, complaints of sleep disturbances, anxiety, and symptoms of depression were reported. The present study reports the results of an online survey performed during the first two months of isolation. Questionnaires exploring sleep disturbances, anxiety, and depression were sent to people who responded to an open invitation. A total of 1230 participants filled out the sleep questionnaire, 812 responded to the anxiety questionnaire, and 814 responded to the depression questionnaire. Both men and women reported poor sleep quality, but women showed a higher proportion (79%) than men (60%); young women were more likely to be affected by social isolation. Concerning anxiety and depression, both sexes reported high similar symptoms. These data suggest that stressful conditions related to social isolation and the economic uncertainty caused by the pandemic may induce mental health disturbances, which may become worse with sleep restriction.

Ethnic disparities in COVID-19 mortality in Mexico: A cross-sectional study based on national data.

Across the world, the COVID-19 pandemic has disproportionately affected racial and ethnic minorities. How ethnicity affects Indigenous peoples in Mexico is unclear. The aim of this cross-sectional study was to determine the mortality associated with ethnicity, particularly of Indigenous peoples, in a large sample of patients with COVID-19 in Mexico. We used open access data from the Mexican Ministry of Health, which includes data of all confirmed COVID-19 cases in the country. We used descriptive statistics to compare differences among different groups of patients. Logistic regression was used to calculate odds ratios while adjusting for confounders. From February 28 to August 3, 2020, a total of 416546 adult patients were diagnosed with COVID-19. Among these, 4178 were Indigenous peoples. Among all patients with COVID-19, whether hospitalized or not, a higher proportion of Indigenous peoples died compared to non-Indigenous people (16.5% vs 11.1%, respectively). Among hospitalized patients, a higher proportion of Indigenous peoples died (37.1%) compared to non-Indigenous peoples (36.3%). Deaths outside the hospital were also higher among Indigenous peoples (3.7% vs 1.7%). A higher proportion of Indigenous peoples died in both the private and public health care sectors. The adjusted odds ratio for COVID-19 mortality among Indigenous peoples with COVID-19 was 1.13 (95% confidence interval 1.03 to 1.24). The adjusted odds ratio for COVID-19 mortality among Indigenous peoples with COVID-19 was higher among those who received only ambulatory care (1.55, 95% confidence interval 1.24 to 1.92). In this large sample of patients with COVID-19, the findings suggest that Indigenous peoples in Mexico have a higher risk of death from COVID-19, especially outside the hospital. These findings suggest Indigenous peoples lack access to care more so than non-Indigenous people during the COVID-19 pandemic in Mexico.

The Impact of Health Policies and Sociodemographic Factors on Doubling Time of the COVID-19 Pandemic in Mexico.

Background. The doubling time is the best indicator of the course of the current COVID-19 pandemic. The aim of the present investigation was to determine the impact of policies and several sociodemographic factors on the COVID-19 doubling time in Mexico. Methods. A retrospective longitudinal study was carried out across March–August, 2020. Policies issued by each of the 32 Mexican states during each week of this period were classified according to the University of Oxford Coronavirus Government Response Tracker (OxCGRT), and the doubling time of COVID-19 cases was calculated. Additionally, variables such as population size and density, poverty and mobility were included. A panel data model was applied to measure the effect of these variables on doubling time. Results. States with larger population sizes issued a larger number of policies. Delay in the issuance of policies was associated with accelerated propagation. The policy index (coefficient 0.60, p < 0.01) and the income per capita (coefficient 3.36, p < 0.01) had a positive effect on doubling time; by contrast, the population density (coefficient −0.012, p < 0.05), the mobility in parks (coefficient −1.10, p < 0.01) and the residential mobility (coefficient −4.14, p < 0.01) had a negative effect. Conclusions. Health policies had an effect on slowing the pandemic’s propagation, but population density and mobility played a fundamental role. Therefore, it is necessary to implement policies that consider these variables.

The implications of the Lack of Coordination and Self-Centered political Goals in Public Health: An insight into Mexico’s Response to COVID-19: A Case Study Report

This manuscript aims to explore the problems that the lack of coordination, inadequate management of the COVID-19 pandemic and insufficient health policies may represent to assertively face the COVID-19 pandemic in Mexico. As addressed by the recent Report “Mexico’s Response to COVID-19: A case Study” published by the Institute of Global Health Sciences at the University of California, San Francisco, so far Mexico has been struggling with systemic problems in the emergency response model that led to failures regarding the incorporation of relevant scientific evidence, implementation of a precautionary approach in the management of the pandemic, as well as prevalent coordination strategies that so far has had a result of high rates of COVID-19 transmission and an increasing number of death tolls, among other concerns. The situation of Mexico may offer some lessons on what should be avoided in dealing with public health emergency crisis, such as persuing political goals instead of focusing on public health objectives. For that matter, more than partisan purposes, it is significant to highlight the relevance of the national and international commitments with human rights that the Mexican State has assumed, as well as a dialogue among public, private and social sector that altogether may help to find optimal solutions aimed at tackling the problems that have aroused due to the COVID-19 pandemic.

Leadership, Public Health Messaging, and Containment of Mobility in Mexico During the COVID-19 Pandemic

The effectiveness of wide-spread policy measures in the midst of the COVID-19 pandemic hinges upon compliance with the ordinances. This study explores how leaders’ discourse relates to compliance with stay-at-home orders to mitigate the spread of the COVID-19 pandemic in Mexico. We use municipality-level mobility data from geolocation events of smartphone users and daily briefings from the President and Health Minister Dr. Hugo López-Gatell. Using quantile regressions, sentiment analysis and topic modelling, we shed light on the dynamics between political discourse and containment of mobility. We find discrepancies between the content and tone of the President and those of the COVID-19 czar. These contrasts translate into differences on the association between the content of the speeches and mobility patterns. Our findings, using a LASSO penalized quantile regression, indicate that when President AMLO's discourse is positive, mobility tends to decrease, but when the Health Minister's discourse is positive, mobility tends to increase. Across the distribution of mobility changes, those in the inter-quantile range are more responsive to the discourse. We also find that the discourse's association to mobility is mediated by awareness of COVID-related topics and by individuals’ political affiliation. Lastly, we show that mobility patterns prior to the conferences are not causing a change in discourse which clears concerns over reverse causality.

Epidemiological Characteristics of COVID-19 in Mexico and the Potential Impact of Lifting Confinement Across Regions

The novel coronavirus SARS-CoV-2 has paralyzed our societies, leading to self-isolation and quarantine for several days. As the 10th most populated country in the world, Mexico is on a major threat by COVID-19 due to the limitations of intensive care capacities, about 1.5 hospital beds for every 1,000 citizens. In this paper, we characterize the COVID-19 pandemic in Mexico and projected different scenarios to evaluate sharp or gradual quarantine lifting strategies. Mexican government relaxed strict social distancing regulations on June 1, 2020, deriving to pandemic data with large fluctuations and uncertainties of the tendency of the pandemic in Mexico. Our results suggest that lifting social confinement must be gradually sparse while maintaining a decentralized region strategy among the Mexican states. To substantially lower the number of infections, simulations highlight that a fraction of the population that represents the elderly should remain in social confinement (approximately 11.3% of the population); a fraction of the population that represents the confined working class (roughly 27% of the population) must gradually return in at least four parts in consecutive months; and to the last a fraction of the population that assumes the return of students to schools (about 21.7%). As the epidemic progresses, deconfinement strategies need to be continuously re-adjusting with the new pandemic data. All mathematical models, including ours, are only a possibility of many of the future, however, the different scenarios that were developed here highlight that a gradual decentralized region deconfinement with a significant increase in healthcare capacities is paramount to avoid a high death toll in Mexico.

Comunicación para la salud y pandemia. Modelos y analogías en la COVID-19 desde dos perspectivas en México

El propósito es aproximarnos a la comunicación oficial y al de la sociedad civil en la pandemia de COVID-19 en México, situándolo como otro síntoma de crisis ambiental y sanitaria. Es relevante el trabajo al utilizar herramientas de comunicación ambiental y para la salud, dar seguimiento a investigaciones de comunicación para el desarrollo, la salud y el ambiente tratando de integrarlas interdisciplinariamente. Se recuperan elementos contextuales que posibilitan estudiar las pandemias y detenernos en la del 2020. Teóricamente se toman las generaciones de modelos de salud que contrastamos con las metáforas de la pandemia, la forma comunicativa de la información oficial durante 120 días y la recuperación de algunas narrativas que publicó la prensa nacional. El eje central es trabajar con diferentes núcleos de la comunicación como son: la gubernamental, la social, ambiental y de salud. Uno de los principales hallazgos es que la comunicación oficial de los meses iniciales, respaldada con algunas políticas públicas, contuvieron el crecimiento acelerado del contagio masivo, pero fueron insuficientes según el relato de la gente.

Health-care guidelines and policies during the COVID-19 pandemic in Mexico: A case of health-inequalities

BackgroundHeterogeneous government responses have been reported in reaction to COVID-19. The aim of this study is to generate an exploratory review of healthcare policies published during COVID-19 by health-care institutions in Mexico. Analyzing policies within different health sub-systems becomes imperative in the Mexican case due to the longstanding fragmentation of the health-care system and health inequalities. Data and MethodsPolicies purposely included in the analysis were published by four public health institutions (IMSS, ISSSTE, SSA and PEMEX) during the COVID-19 epidemic in Mexico (from February 29th to June 15th, 2020) on official institutional websites. Researchers reviewed each document and classified them into seven policy categories set by the Rapid Research Evaluation and Appraisal Lab (RREAL): public health response, health-care delivery, human resources, health-system infrastructure and supplies, clinical response, health-care management, and epidemiological surveillance. ResultsPolicy types varied by health institution. The largest number of policies were aimed at public health responses followed by health-care delivery and human resources. Policies were mainly published during the community transmission phase. ConclusionsThe pandemic exposed underlying health-care system inequalities and a reactive rather than prepared response to the outbreak. Additionally, this study outlines potential policy gaps and delays in the response that could be avoided in the future.

Psychological impact of sociodemographic factors and medical conditions in older adults during the COVID-19 pandemic in Mexico

Introduction. Older adults are not only at a higher medical risk during the COVID-19 pandemic, but they may also be a group particularly vulnerable to mental health diminishing. Objective. To analyze the effect of some sociodemographic factors (sex and age) and medical conditions (diabetes and hypertension) on mental health and concerns about COVID-19 in a sample of older adults. Method. A non-probabilistic sample of 2,992 older adults (37.7% men and 62.3% women) was selected, with an average age of 70.45 years (SD = 7.31). Participants were given the Impact of Event Scale-6 (IES-6), the Patient Health Questionnaire (PHQ-9), the Generalized Anxiety Disorder-7 (GAD-7), a questionnaire of concerns about COVID-19, and a sociodemographic questionnaire. Participants’ answers were captured via Google Forms. Results. The results showed that women had greater concerns about COVID-19 than men. The findings in general showed significant effects, with women showing higher scores in depressive symptoms, anxiety, and greater stress generated in addition by the impact of the event. Differences concerning event-related stress and depression were found in relation to subgroups by age. Discussion and conclusion. These finding could serve for the planning and development of strategies that provide attention to the mental health of this population group.

The Impact of Environmental Factors on Academic Performance of University Students Taking Online Classes during the COVID-19 Pandemic in Mexico

The COVID-19 pandemic and the quarantine period determined that university students (human resource) in Mexico had adopted the online class modality, which required them to adapt themselves to new technologies and environmental conditions that are different from classrooms at their university. Specifically, these new environmental conditions can be uncomfortable and have an impact on the students’ academic performance. Consequently, the present study aims to determine the impact that the lighting, noise, and temperature levels (independent variables) have on academic performance (dependent variable) in university students during the COVID-19 pandemic. To do this, a questionnaire was developed, which was applied to 206 university students online, and a structural equation model was built that integrates the four variables through three hypotheses, which were statistically validated through the partial least squares method. Results showed that temperature, lighting, and noise have significant direct effects on university students’ academic performance. As a conclusion, it was obtained that the three independent variables have an impact in the sustainability of university students (human resource).