Early Phase Of COVID-19 Pandemic Research Articles

Awareness and Knowledge of COVID-19 Among Health Care Workers in Early Phase of COVID-19 Pandemic.

Objective The study aims to evaluate the awareness and knowledge of COVID-19 among healthcare workers.Material and MethodsA questionnaire was applied to healthcare workers working at Kocaeli University Faculty of Medicine and University of Kyrenia, Dr. Suat Günsel Hospital, to evaluate the coronavirus disease 2019 awareness and level of knowledge. ResultsA total of 598 healthcare workers participated in the study. Two-thirds of the respondents were from Turkey, while one-third were from the Turkish Republic of Northern Cyprus. The general symptoms of coronavirus disease 2019 were well known in the general population. Awareness of most symptoms was significantly lower in the Turkish Republic of Northern Cyprus group. It was well known that coronavirus disease 2019 can be asymptomatic in some patients and it can be contagious. The necessity of wearing surgical masks on sick individuals was less known in the Turkish Republic of Northern Cyprus group (96.6% vs 61.6%; P = .000). While handwashing was found similar in both groups for protection from coronavirus disease 2019 transmission, social distance and mask recommendations were lower in the Turkish Republic of Northern Cyprus group (P < .05). The concern about transmitting the virus to themselves and their relatives was more significant in the Turkish Republic of Northern Cyprus group than the Turkey group (84.4% vs 96.5%; P = .000). And 92.2% of the healthcare workers thought they should stay in an alternative place instead of their homes. ConclusionThe awareness and knowledge level of coronavirus disease 2019 is higher in Turkey than in Turkish Republic of Northern Cyprus related to the increased number of coronavirus disease 2019 cases in Turkey. Continuous education programs can contribute to improving the level of knowledge and reducing anxiety.

Compliance to infection prevention and control interventions for slowing down COVID-19 in early phase of disease transmission in Dar es Salaam, Tanzania.

Introductionon 16th March 2020, Tanzania announced its first COVID-19 case. The country had already developed a 72-hour response plan and had enacted three compulsory infection prevention and control interventions. Here, we describe public compliance to Infection Prevention and Control (IPC) public health measures in Dar es Salaam during the early COVID-19 response and testing of the feasibility of an observational method.Methodsa cross sectional study was conducted between April and May 2020 in Dar es Salaam City. At that time, Dar es Salaam was the epi centre of the epidemic. Respondents were randomly selected from defined population strata (high, medium and low). Data were collected using a structured questionnaire and through observations.Resultsa total of 390 subjects were interviewed, response rate was 388 (99.5%). Mean age of the respondents was 34.8 years and 168 (43.1%) had primary level education. Out of the 388 respondents, 384 (98.9%) reported to have heard about COVID-19 public health and social measures, 90.0% had heard from the television and 84.6% from the radio. Covering coughs and sneezes using a handkerchief was the most common behaviour observed among 320 (82.5%) respondents; followed by hand washing hygiene practice, 312 (80.4%) and wearing face masks, 240 (61.9%). Approximately 215 (55.4%) adhered to physical distancing guidance. Age and gender were associated with compliance to IPC measures (both, p<0.05).Conclusioncompliance to public health measures during the early phase of COVID-19 pandemic in this urban setting was encouraging. As the pandemic continues, it is critical to ensure compliance is sustained and capitalize on risk communication via television and radio.

Poor social distancing attitudes and practices may drive community transmission of COVID-19 – A Knowledge Attitude Practice study among the general population of Odisha, India

Background: Knowledge, attitude, and practice of the community can determine progress from localized to community transmission of COVID-19 in India. Aims and Objectives: To assess the knowledge, attitude and practice levels of the general population during the early phase of COVID-19 pandemic. Materials and Methods: A rapid cross-sectional survey was conducted among hospital visitors of a lead tertiary care hospital. Realtime data collection from 223 respondents was done and analyzed using Stata 12.1 SE. Results: Mean age was 38.2 ±13.5 years, 68.2% were males, mean education was 12.1 ± 3.7 years and 45.3% were gainfully employed. Almost all had heard about CORONA (221, 99.1%). Adequate knowledge was present on: a) mode of spread (48.0%); b) preventive measures (70.9%). Television (77.1%), social media (60.5%) and WhatsApp (44.0%) were sources of information. Positive attitude was seen for: a) wearing a mask (83.9%); b) health-seeking (85%) on presenting with symptoms; c) Self-isolation or home-quarantine (20%). Adequate knowledge towards the mode of spread, symptoms and control measures or positive attitudes for health-seeking were found to positively translate into correct practices (p?0.001). Conclusion: Attitudes and practices of social distancing, self-isolation or home-quarantine were not adequate to prevent the epidemic progress in India.

Modeling Early Phases of COVID-19 Pandemic in Northern Italy and Its Implication for Outbreak Diffusion.

The COVID-19 pandemic has sparked an intense debate about the hidden factors underlying the dynamics of the outbreak. Several computational models have been proposed to inform effective social and healthcare strategies. Crucially, the predictive validity of these models often depends upon incorporating behavioral and social responses to infection. Among these tools, the analytic framework known as “dynamic causal modeling” (DCM) has been applied to the COVID-19 pandemic, shedding new light on the factors underlying the dynamics of the outbreak. We have applied DCM to data from northern Italian regions, the first areas in Europe to contend with the outbreak, and analyzed the predictive validity of the model and also its suitability in highlighting the hidden factors governing the pandemic diffusion. By taking into account data from the beginning of the pandemic, the model could faithfully predict the dynamics of outbreak diffusion varying from region to region. The DCM appears to be a reliable tool to investigate the mechanisms governing the spread of the SARS-CoV-2 to identify the containment and control strategies that could efficiently be used to counteract further waves of infection.

Misinformation, Fears and Adherence to Preventive Measures during the Early Phase of COVID-19 Pandemic: A Cross-Sectional Study in Poland.

The response to the pandemic requires access to accurate information and public understanding and adherence to preventive measures. This online cross-sectional study of adult Poles (n = 1337) assessed the frequency of COVID-19 preventive behaviors, fears related to the COVID-19 pandemic, and beliefs in COVID-19-related conspiracy theories during the early phase of the COVID-19 pandemic when the nationwide lockdown was imposed (April 2020). As shown, 22% of surveyed admitted not to wash their hands frequently, while 12% did not use disinfectants. These two behaviors were also less frequent in individuals with medical education. The highest levels of pandemic-related fears were associated with health loss in relatives, pandemic-induced economic crisis, and government using a pandemic to control citizens by the state. A significant share of surveyed individuals believed that the pandemic was intentional action to weaken non-Chinese economies (32%) or was deliberately induced for profits from selling vaccines (27%). Men, individuals with no children, and subjects with lower education were significantly less likely to adhere to sanitary measures (handwashing, disinfection, avoiding face touching, changes in greeting etiquette, face-covering when coughing or sneezing), and were less concerned over self and relatives’ health. At the same time, men were less prone than women to the conspiracy theories related to the COVID-19 pandemic. The results indicate that adherence to sanitary measures during the pandemic can be a challenge also in developed countries, while misinformation campaigns (also concerning vaccines) have already affected the general public during the early phase of the epidemiological outbreak. The study provides observations that may be useful in the management of the public response to future epidemics.

The Determinants of Online Stock Investment in Malaysia: A Case in Early Phase of COVID-19 Pandemic

The purpose of this research is to determine the factors that affect the behavioral intention of Malaysians individuals to adopt online stock trading. The primary data is collected with the help of structured questionnaire from 285 participants in the study who are current or potential investors in the Malaysian stock market. The online surveys were distributed from the last quarter of 2019 to the first quarter of 2020. This study uses the structured and self-administered online questionnaire survey tool to collect the primary data from samples. Non-probability convenient sampling method was employed and Partial Least Squares Structural Equation Model (PLS-SEM) is adopted. The results indicate that all constructs, namely performance expectancy (PE), effort expectancy (EE), social influence (SI) and facilitating conditions (FC) have a direct significant positive relationship toward behavioral intention. In addition, the study shows that PE is the most important factor in determining individuals’ behavioral intention in adopting online stock trading. In conclusion, online stock trading system developer should focus on designing the additional useful features and ensuring the quality of the information to satisfy the demands and desires of the general public and to build features such as prompting traders to avoid the possibility of over trading or with feature enabling users to backtrack and test their trading strategies and to customize different types of analysis to help users making informed investment decisions.

Management of Early Breast Cancer at an Australian Cancer Centre During the Early Phase of COVID-19 Pandemic

Background: This study aimed to prospectively record changes to treatment for early breast cancer patients during the first wave of the COVID-19 pandemic in Australia. The purpose was to assess the impact on breast cancer outcomes and to determine the need for any mitigative actions. Methods: The study was conducted in the breast cancer unit of a tertiary referral hospital. Patients with early (non-metastatic) breast malignancy discussed in multidisciplinary team meetings between March and June 2020 were included. Patients were newly diagnosed, post-operative or post-neoadjuvant chemotherapy. Standard treatment was defined by Westmead Breast Cancer Institute protocols and any variations related to the pandemic were recorded. Results: In the study, 145 patients were included (median age 59 years). Pandemic-related changes to management were noted in 13 of 145 (9.0%) patients. Four patients experienced a delay to cancer treatments, four were not offered reconstructive/ symmetrisation surgical procedures, three had altered radiotherapy protocols and two patients were not offered enrolment to a clinical trial. These impacts affected the groups presenting with new cancers (n=7/86, 8.1%), post-operative cases (n=4/25, 16.0%) and post-neoadjuvant chemotherapy cases presenting for surgical planning (n=2/34, 5.9%). Conclusion: Most patients (91.0%) received standard treatment during the first wave of the pandemic. The minor variations from institutional protocols observed in this study are unlikely to affect local control or survival in this patient cohort, but close follow-up is required. Quality of life may have been affected for four patients who had downgraded or delayed reconstructive procedures.

Management of Early Breast Cancer at an Australian NSW Cancer Centre During the Early Phase of COVID-19 Pandemic

Background: This study aimed to prospectively record changes to treatment for early breast cancer patients during the first wave of the COVID-19 pandemic in Australia. The purpose was to assess the impact on breast cancer outcomes and to determine the need for any mitigative actions. Methods: The study was conducted in the breast cancer unit of a tertiary referral hospital. Consecutive patients with invasive cancer or ductal cancer in situ (DCIS) discussed in multidisciplinary team (MDT) meetings three times a week between March and June 2020 were included. Patients were newly diagnosed, post-operative or post-neoadjuvant chemotherapy. Standard treatment was defined by Westmead Breast Cancer Institute protocols and any variations related to the pandemic were recorded. Results:145 patients were included (median age 59 years). Pandemic related changes to management were noted in 13 of 145 (9·0%) patients discussed in the MDT meeting. Four patients experienced a delay to cancer treatments, four were not offered reconstructive/symmetrisation surgical procedures, three had altered radiotherapy protocols and two patients were not offered enrolment to a clinical trial. These impacts affected the groups presenting with new cancers (n=7/86, 8·1%), post-operative cases (n=4/25, 16·0%) and post-neoadjuvant chemotherapy cases presenting for surgical planning (n=2/34, 5·9%). Conclusion: Most patients (91·0%) received standard treatment during the first wave of the pandemic. Variations from institutional protocols are not expected to affect local control or survival in this patient cohort and no mitigative actions have been implemented. Quality of life may have been affected for four patients who had downgraded or delayed reconstructive procedures. Institutional strategies such as utilising telemedicine and COVID-free facilities were successfully implemented within the study period.Trial Registration: The study was registered with the Australian New Zealand Clinical Trials Registry(ACTRN12620000869976).Funding Statement: None.Declaration of Interests: RH has participated in advisory boards for AstraZeneca, Bristol Myers Squibb, Eli Lilly, Merck, Merck Sharp and Dohme, Novartis, Oncosec, Pfizer, Roche and Seagen; and has received speaker honoraria from Merck Sharp and Dohme, Novartis and Roche. EE has participated in advisory board for Merck Sharp and Dohme. There are no conflicts of interests to declare for the other authors.Ethics Approval Statement: Approval was obtained from the Sydney West Human Research EthicsCommittee (Project ID 2020/PID00900).

Implementation of a Vaccination Program Based on Epidemic Geospatial Attributes: COVID-19 Pandemic in Ohio as a Case Study and Proof of Concept

Geospatial vaccine uptake is a critical factor in designing strategies that maximize the population-level impact of a vaccination program. This study uses an innovative spatiotemporal model to assess the impact of vaccination distribution strategies based on disease geospatial attributes and population-level risk assessment. For proof of concept, we adapted a spatially explicit COVID-19 model to investigate a hypothetical geospatial targeting of COVID-19 vaccine rollout in Ohio, United States, at the early phase of COVID-19 pandemic. The population-level deterministic compartmental model, incorporating spatial-geographic components at the county level, was formulated using a set of differential equations stratifying the population according to vaccination status and disease epidemiological characteristics. Three different hypothetical scenarios focusing on geographical subpopulation targeting (areas with high versus low infection intensity) were investigated. Our results suggest that a vaccine program that distributes vaccines equally across the entire state effectively averts infections and hospitalizations (2954 and 165 cases, respectively). However, in a context with equitable vaccine allocation, the number of COVID-19 cases in high infection intensity areas will remain high; the cumulative number of cases remained >30,000 cases. A vaccine program that initially targets high infection intensity areas has the most significant impact in reducing new COVID-19 cases and infection-related hospitalizations (3756 and 213 infections, respectively). Our approach demonstrates the importance of factoring geospatial attributes to the design and implementation of vaccination programs in a context with limited resources during the early stage of the vaccine rollout.

Interventional cardiology's cross-departmental effort with production of reusable personal protective equipment during the early phase of COVID-19 pandemic.

Interventional cardiology's cross-departmental effort with production of reusable personal protective equipment during the early phase of COVID-19 pandemic.

Javanese-Mataraman Muslim Obedience towards Religious and State Leaders in Performing Friday Prayers during the COVID-19 Pandemic

The Javanese-Mataraman Muslims have an ambiguous attitude in responding to government policies and religious leaders in carrying out Friday prayers during the early phase of COVID-19 pandemic, symbolically obeying not to do it. However, in reality, they still carry out Friday prayers. This article aims to find out the attitude of the community in making decisions on Friday prayers. They usually have an accommodative attitude in responding to the pros and cons of life problems. This article uses mixed methods with a snowball sampling technique to make it easier to find out the community’s attitudes using the dramaturgy approach since it had information about the informants’ front stage and backstage. The results of this study explain that they have obedience in the front stage. In contrast to the backstage, they perform Friday prayers even though the state and religion prohibit it. The dramaturgy is related to the religious understanding of the Javanese-Mataraman community, hampered by the rigid interpretation of the fiqh of worship, not to the knowledge of maqāṣid al-sharī‘ah.

Registered Nurses' Experiences With Incivility During the Early Phase of COVID-19 Pandemic: Results of a Multi-State Survey.

Background:Incivility among workers in the health sector is recognized as an occupational hazard. The COVID-19 outbreak brought sudden and profound changes to many health care settings, many of which have been identified as antecedents to workplace incivility. The purpose of this retrospective study was to explore the experiences of registered nurses with workplace incivility, cyber-incivility, and incivility outside of work during the early phase of the COVID-19 pandemic.Methods:This mixed-methods study used convenience sampling. Data were collected from June to September 2020 via an online survey, which consisted of both closed- and open-ended questions. Participants were recruited from national nursing organizations and unions. Data were analyzed using descriptive statistics and thematic analysis for open-ended responses.Findings:A total of 526 nurses’ responses were included in the analysis. More than one third experienced greater incivility at work during the COVID-19 outbreak than before the pandemic (37.4%), and almost half (45.7%) said they witnessed more incivility than before the pandemic. Cyber-incivility and incivility outside of work were also issues. Qualitative results indicated that respondents felt they were on edge during this period. Other themes included leadership failure, fractured co-worker relationships, heightened incivility from patients and families, and hostility and ostracism from the general publicConclusion/Application to practice:Occupational health nurses, nursing leaders, and staff nurses need to work to restore relations that were fractured by incivility during the pandemic. In the future, improved preparedness, including establishing clear channels of communication, may lessen incivility by decreasing role stress and organizational chaos.

Mental Disorders Among Health Care Workers at the Early Phase of COVID-19 Pandemic in Kenya; Findings of an Online Descriptive Survey.

Background: Healthcare workers responding to the Corona Virus Pandemic (COVID-19) are at risk of mental illness. Data is scanty on the burden of mental disorders among Kenyan healthcare workers responding to the pandemic that can inform mental health and psychosocial support. The purpose of this study was to establish the frequency and associated factors of worry, generalized anxiety disorder, depression, posttraumatic stress disorder and poor quality of sleep among Kenyan health care workers at the beginning of COVID-19 pandemic.Methods: We conducted an online survey among 1,259 health care workers in Kenya. A researcher developed social demographic questionnaire and several standardized tools were used for data collection. Standardized tools were programmed into Redcap, (Research Electronic Data Capture) and data analysis was performed using R Core Team. In all analysis a p-value < 0.05 was considered significant.Results: 66% of the participants reported experiencing worry related to COVID-19. 32.1% had depression, 36% had generalized anxiety, 24.2% had insomnia and 64.7% scored positively for probable Post Traumatic Stress Disorder (PTSD). Depression was higher among females compared to men (36.5 vs. 26.9%, p = 0.003), workers <35 years old compared to older ones (38.1 vs. 26.4%, p < 0.001), and those who were not married compared to those who were married (40.6 vs. 27.6%, p < 0.001). Generalized anxiety was commoner among workers aged <35 years (43.5 vs. 29.3%, p < 0.001), females (41.7 vs. 29.2%, p < 0.001), those who mere not married compared to the married (45.2 vs. 31.2%, p < 0.001) and those with <10 years working experience (41.6 to 20.5%, p < 0.001). Younger health care professional had a higher proportion of insomnia compared to the older ones (30.3 vs. 18.6%, p < 0.001). Insomnia was higher among those with <10 years' experience compared to those with more than 20 years' experience(27.3 vs. 17.6%, p = 0.043)Conclusion: Many Kenyan healthcare workers in the early phase of COVID-19 pandemic suffered from various common mental disorders with young, female professionals who are not married bearing the bigger burden. This data is useful in informing interventions to promote mental and psychosocial wellbeing among Kenyan healthcare workers responding to the pandemic.

Knowledge, attitude and practice on COVID-19 among students during the early phase of pandemic in a university in Borneo, Malaysia.

Introduction: COVID-19 related knowledge, attitude and practice plays a major role in determining the readiness of the community to adopt the behavioural change towards recommended preventive measures outlined by public health officials. This study aims to assess the knowledge, attitude, and practice regarding COVID-19 among university students as well as its associated factors.Design and methods: This is a cross sectional study that was conducted among students in a public university during the early phase of COVID-19 pandemic in Malaysia. An online validated self-administered questionnaire was used to collect the data. Mann-Whitney U and Kruskal Wallis test was used to determine the association between independent variables with knowledge, attitude, and practice score.Results: Overall response rate of this study was 92.9 (n=524). Median score of knowledge domain was 78.0 (IQR= ±12.0), median attitude score of 49.0 (IQR= ±5.0), and median practice score of 80.0 (IQR= ±11.0). The mean knowledge, attitude and practice score were significantly higher among diploma holder (vs degree holder, p<0.05), residing in main Kota Kinabalu campus (vs non-KK campus, p<0.001), studying in medical faculty (vs non-medical faculty, p<0.001), and attended COVID-19 education (vs non-attendance; p<0.05).Conclusion: COVID-19 related knowledge and attitude were below satisfactory level during earlier phase of the pandemic. However, majority of respondents have positive behaviour towards COVID-19 prevention. This highlights the importance of accurate and tailored health education to improve the level of knowledge, attitude and practice of recommended measures to prevent COVID-19 spread. Significance for public health This study has important public health impact in relations to the current COVID-19 pandemic. It exhibits the importance of a tailored health education strategies to specific target groups. It also shows the lack of KAP at the early phase of pandemic which need to be addressed.

Genomic Evolution and Variation of SARS-CoV-2 in the Early Phase of COVID-19 Pandemic in Guangdong Province, China.

SummarySevere acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) with unknown origin spread rapidly to 222 countries, areas or territories. To investigate the genomic evolution and variation in the early phase of COVID-19 pandemic in Guangdong, 60 specimens of SARS-CoV-2 were used to perform whole genome sequencing, and genomics, amino acid variation and Spike protein structure modeling analyses. Phylogenetic analysis suggested that the early variation in the SARS-CoV-2 genome was still intra-species, with no evolution to other coronaviruses. There were one to seven nucleotide variations (SNVs) in each genome and all SNVs were distributed in various fragments of the genome. The Spike protein bound with human receptor, an amino acid salt bridge and a potential furin cleavage site were found in the SARS-CoV-2 using molecular modeling. Our study clarified the characteristics of SARS-CoV-2 genomic evolution, variation and Spike protein structure in the early phase of local cases in Guangdong, which provided reference for generating prevention and control strategies and tracing the source of new outbreaks.

Abstract P145: Who Are We Missing? False Call Rates Decline for Stroke Code Activations During Early Phase of Covid-19 Pandemic

Introduction: To slow the spread of the novel coronavirus (COVID-19), the Department of Homeland Security restricted access across the US-Mexico border in March 2020. During the same time period hospitals throughout the US began reporting declines in emergency department (ED) visits, especially related to stroke. As a stroke receiving center and largest hospital within a Southern California border county serving a binational population, we sought to understand the impact COVID-19 and closure of an international border might have on stroke code activations (SCA) and discharges at our facility. Methods: A retrospective analysis involving 417 cases presenting to a tertiary hospital consisting of two campuses near the US-Mexico border in Southern California was performed. Inclusion criteria: all cases with SCA in the ED arriving from March 1, 2020 to June 30, 2020 and March 1, 2019 to June 30, 2019. Exclusion criteria: cases arriving to the ED that did not have SCA and cases for which stroke codes were initiated after hospitalization. Results: Pedestrian and private auto passenger border crossings decreased by over 5 million people between April and May 2020 compared to the same period in 2019. From March to June 2020, there were 162 ED SCA compared to 255 during the same period in 2019; a 36.5% decrease in SCA in 2020. Additionally, there was a significant increase in the percentage of ED SCA resulting in actual stroke discharge diagnoses during this period. In early 2020, 68.5% of ED SCA were discharged with a stroke diagnosis compared to 60.4% in 2019, X 2 (1, N = 162) = 4.467, p &lt; .05. However, despite the increased true positive rate, there was an overall decrease in the total number of patients with SCA who were diagnosed with stroke (111 in 2020 vs 154 in 2019). Conclusion: As the overall number of SCA decreased during the early months of the COVID-19 pandemic, so did the total number of patients discharged with a stroke diagnosis. This suggests that fewer patients with acute stroke presented as a SCA during the early COVID-19 pandemic in comparison to the same time period in 2019. It is critically important as a stroke center serving a large, binational population to ensure the population we serve is seeking appropriate and timely care for serious and complex diseases.

Health inequality among different economies during early phase of COVID-19 pandemic

BackgroundThe new coronavirus outbreak originated in Wuhan, China, started in January 2020 is escalating as a pandemic across the globe in March 2020. It causes unprecedented morbidity and shocked health systems and the supply chains in new epicenters such as Italy, Spain, and the USA, claiming thousands of lives. Meanwhile, the pandemic is reaching swiftly and silently to low-income countries where international media cover less. How likely health outcomes among the countries with different economies may differ during the pandemic has not been reported yet. Methodologically, we conducted an analysis of COVID-19 deaths comparing case fatality rate (CFR) among countries with different income categories, applying COVID-19 global data from the European Centre for Disease Control including 199 countries’ data as of 31 March 2020, in the early phase of the pandemic. We categorized countries into high-income countries (HIC), upper-middle-income countries (UMIC), lower-middle-income countries (LMIC), and low-income countries (LIC) according to World Bank classification by income as of 2020.FindingStatistically, countries in different income groups are significantly different in terms of new cases identified in the last 2 weeks and the case fatality rate (MANOVA, P value < 0.001). New tests and detected case numbers shot up in HICs where CFR shot up in LMICs and LICs. The results of this analysis pointed out an important gap among countries with different economic status during the ongoing pandemic.ConclusionIn the HIC, contact tracing, testing capacity, and outbreak response, as well as clinical services, are strong. In the LICs, there is a low capacity of outbreak response which is reflected by the significantly lower number of diagnostic tests. Consequently, the reported number of COVID-19 cases in LICs may not reflect the actual burden of the pandemic. Without effective prevention, the pandemic can readily break into the weak health system and over-burden the hospitals and clinical services in poor countries.This finding is showing health inequality between the rich and the poor being amplified by the COVID-19 pandemic. Addressing such a gap through the local governance and integrated global responses will not only prevent unprecedented deaths, but also preserve the momentum towards Sustainable Development Goals (SDGs).

Percipirani stres i iskustva nastavnika u onlajn podučavanju tokom rane faze COVID-19 pandemije

Stress affects various aspects of human life and may also affect professional functioning of teachers. Research on attitudes towards digital/online teaching and learning has shown that the success of any online education depends upon the attitude of teachers towards online learning. Some studies before the pandemic showed that teachers, in comparison to other high-stress occupations, were reported as being the most stressed in regard to physical and psychological wellbeing. The aim of this pilot study is to investigate teachers' perceived stress and its relationship with attitudes towards online teaching and subjective online teaching overload during the early phase of COVID-19 pandemic. The online survey was performed during and immediately after the enforcement of lockdown measures in Vojvodina in spring 2020. The total sample included 64 teachers from primary and secondary schools (12.5% were class teachers), between 26 and 63 years of age. The subjective stress perception was measured using the Perceived Stress Scale, and a 19-item questionnaire was constructed for the assessment of attitudes towards online teaching. The perceived stress level was increased compared to the norms suggested by the scale author. Subjective overload with online teaching was significantly positively correlated with the perceived stress (r = .385, p &lt;.01). Teachers did not report extremely positive or negative attitudes towards online teaching. Still, the attitude towards online teaching was significantly negatively correlated with the subjective overload with online teaching (r = - .294, p &lt;.05). Results showed no significant correlation between the perceived stress and attitudes towards online teaching.

Point-of-care training program on COVID-19 infection prevention and control for pediatric healthcare workers: a multicenter, cross-sectional questionnaire survey in Shanghai, China.

BackgroundTo evaluate the effectiveness of training on knowledge and practice of infection prevention and control (IPC) among pediatric health care workers (HCW) in Shanghai, China, in the context of COVID-19 pandemic.MethodsAn online training program was designed by the Shanghai Pediatric Clinical Quality Control Center (SPQCC) during the early phase of COVID-19 pandemic on disease knowledge and practice of IPC. Training took place in the 81 partner hospitals affiliated with SPQCC. A multicenter, cross-sectional questionnaire survey was designed with a 25-item self-administered questionnaire to evaluate the knowledge gained from the training. Stratified-random sampling was used to select HCW according to three professionals (i.e., pediatricians, nurses and administrators) within each partner hospital. Awareness and knowledge of COVID-19 and its related infection control and practice were assessed by comparing survey results between different types of hospitals, professionals and professional ranks. A higher survey score meant that the respondent was more prepared and knowledgeable about COVID-19 and its infection control measures.ResultsCompleted questionnaires were returned from 1,062 subjects (385 pediatricians, 410 nurses, and 267 administrators), giving a response rate of 96.5%. Overall, awareness of clinical information related to COVID-19, importance of personal hygiene and isolation policy was high among the respondents. No statistical difference of scores on knowledge of COVID-19, IPC and relevant practice between the tertiary and peripheral hospitals. Among all respondents, middle-ranked health care personnel were most knowledgeable and achieved the highest score.ConclusionsMajority of pediatric HCW showed good recognition and practice in infection protection and control measures. The online training was able to achieve its aim to enhance knowledge and awareness and could have contributed to the zero infection rate among HCW caring for confirmed COVID-19 cases in Shanghai.

Personal protective equipment use by healthcare workers in intensive care unit during the early phase of COVID-19 pandemic in Italy: a secondary analysis of the PPE-SAFE survey.

Background:Italy was the first Western country to be heavily affected by COVID-19. Healthcare workers (HCWs) were exposed to a high risk of occupational infection, partially due to insufficient personal protective equipment (PPE) supplies. This study aimed to describe the practices, availability, training, confidence in PPE use and the adverse effects due to extended PPE use, as reported by HCWs in Italy. We also aimed to provide a comparison between Italian data and those from other countries.Methods:This study was a secondary analysis of a previously published international study, the PPE-SAFE Survey, conducted in April 2020. Data were analysed from the original study database.Results:We analysed the responses from 380 healthcare workers based in Italy, out of the 2711 respondents to the international survey. Among the Italian respondents, FFP2 and FFP3 respirators or equivalent were the most used masks for routine tasks (respectively 188/380, 50%; and 163/380, 43%). The median time of wearing PPE without taking a break was 5 h [interquartile range (IQR) 4–6], with statistically significant difference from other countries [median 4 h (IQR 2–5) p < 0.0001]. In Italy, 249 out of 380 (65%) HCWs had never performed a formal fit test for a N95 mask or equivalent and 91/380 (24%) never had a partner for donning and doffing procedures. Most of the respondents (299/380, 79%) had received formal training in PPE use at any time.Conclusion:Most of the surveyed Italian HCWs reported working at above usual capacity, long shifts with PPE without breaks and routine use in intensive care unit of aerosol protection (e.g. FFP2/FFP3), hazmat suits and face shields/visors. The correct adherence to safety procedures (e.g. donning/doffing in pairs, performing fit test) has substantial scope for improvement in the future.