Early Stages Of COVID-19 Research Articles

SARS-CoV-2 viral load is linked to remdesivir efficacy in severe Covid-19 admitted to intensive care

Remdesivir therapy has been declared as efficient in the early stages of Covid-19. Of the 339 patients (males 55.8%, age 71(59;77) years) with a detectable viral load, 140 were treated with remdesivir (of those 103 in the ICU and 57 immunosuppressed) and retrospectively compared with 199 patients (of those 82 in the ICU and 28 immunosuppressed) who were denied therapy due to advanced Covid-19. The viral load was estimated by detecting nucleocapsid antigen in serum (n = 155, median 217(28;1524)pg/ml), antigen in sputum (n = 18, COI 18(4.6;32)), nasopharyngeal antigen (n = 44, COI 17(8;35)) and the real-time PCR (n = 122, Ct 21(18;27)). After adjustment for confounders, patients on remdesivir had better 12-month survival (HR 0.66 (0.44;0.98), p = 0.039), particularly when admitted to the ICU (HR 0.49 (0.29;0.81), p = 0.006). For the immunocompromised patients, the difference did not reach statistical significance (HR 0.55 (0.18;1.69), p = 0.3). The other most significant confounders were age, ICU admission, mechanical ventilation, leukocyte/lymphocyte ratio, admission creatinine and immunosuppression. The impact of monoclonal antibodies or previous vaccinations was not significant. Despite frequent immune suppression including haemato-oncology diseases, lymphopenia, and higher inflammatory markers in the remdesivir group, the results support remdesivir administration with respect to widely available estimates of viral load in patients with high illness severity.

Increased rate of surgery for loss of motion following anterior cruciate ligament reconstruction during COVID-19

ObjectivesTo investigate the incidence and risk factors associated with loss of motion after anterior cruciate ligament reconstruction (ACLR) during the coronavirus disease 2019 pandemic (COVID-19). MethodsA retrospective review of patients undergoing primary ACLR between March 2017 and November 2022 by a senior high-volume orthopaedic surgeon was performed. Exclusion criteria included revision ACLR, multiligamentous knee surgery, and age <14 years. The COVID-19 group was categorized according to the United States Centers for Disease Control Public Health Emergency declaration dates (January 31, 2020–May 11, 2023). To minimize confounding variables associated with the early stages of COVID-19, patients who underwent ACLR between December 1, 2019 and February 29, 2020 were excluded. Loss of motion was defined using the International Knee Documentation Committee criteria for loss of motion of the knee (i.e. an extension deficit >5° or flexion deficit >15° compared to the contralateral knee) 3–12 months after ACLR or as requiring surgery to restore motion within 12 months of ACLR. ResultsA total of 336 individuals who underwent 352 primary ACLRs (164 pre-COVID-19, 188 during COVID-19) were included (mean age: 25.2 ​± ​10.6 years, 44% female). The overall rate of postoperative loss of motion was 15% (n = 53), and 9% (n = 31) required surgery to restore motion within 12 months of ACLR. More patients underwent surgery for loss of motion during COVID-19 compared to pre-COVID-19, which was statistically significant (12% (n = 23) vs 5% (n = 8), respectively, P = 0.02). However, a statistically significant difference in the rate of loss of motion was not detected (18% (n = 33) vs 12% (n = 20), respectively, P = 0.16). A statistically significant increased median time from injury to ACLR was observed during COVID-19 compared to pre-COVID-19 (55 vs 37 days, P <0.01). More patients were unable to achieve terminal extension (0°) at minimum 9 months postoperatively during COVID-19 compared to pre-COVID-19 (10% vs 3%, P = 0.04) and motion was worse at this interval (0°–136° vs −2°–138°, P <0.01). ConclusionSurgery for loss of motion following ACLR was more common during COVID-19. Decreased access to elective medical care, changed activity level, psychological effects, or COVID-19 itself may explain the increased rate of surgery for loss of motion during COVID-19. Level of evidenceCase series; level IV.

PATHOGENESIS, DIAGNOSIS AND TREATMENT OF ACUTE RENAL INJURY IN PATIENTS WITH CORONAVIRUS INFECTION COVID-19

The review article presents an analysis of scientific articles indexed in the PubMed and Web of Science databases on the pathophysiological and clinical features of acute renal injury in patients with a new coronavirus infection. In addition to the direct damaging effects of the SARS-CoV-2 virus on the kidneys and the systemic consequence of viral infection, there are common damaging factors of acute renal injury for all critical conditions. Data on the direct damaging effects of the virus and the systemic consequence of viral infection are contradictory and require further research. Hypovolemia is common in the early stages of COVID-19, so emergency fluid administration is critical for the prevention and treatment of acute kidney injury in patients with novel coronavirus infection. Optimization of liquid volume in order to prevent and prevent the progression of AKI to a severe degree requiring renal replacement therapy is of particular importance when resources are limited in a pandemic.

Public Relations in Crisis Management: A Review and Analysis of Communicative Strategies During Early Stages of Covid-19

Public Relations in Crisis Management: A Review and Analysis of Communicative Strategies During Early Stages of Covid-19

Drinking While Stressed and Drinking to Cope Differentially Relate to Mental Health.

Excessive alcohol use, as well as drinking to manage distress, are known to undermine mental health. The current study examined the unique associations of simply consuming alcohol while stressed, versus using alcohol to cope with distress, with mental health during the early stages of COVID-19. Participants (N = 264) reported their alcohol use and use of alcohol/substances to cope with stress daily for 22 days and completed measures of mental health at baseline and every 7 days thereafter. Hierarchical regression models were tested to predict drinking while stressed, drinking to cope, and mental health. At baseline, drinking while stressed was not significantly associated with mental health when coping motives were accounted for. However, drinking to cope was significantly associated with greater stress, anxiety, depression, and loneliness. Drinking while stressed was significantly predicted by baseline stress and loneliness, while drinking to cope was significantly predicted by baseline anxiety. Drinking while stressed was not a significant predictor of change in mental health when coping motives were accounted for. Drinking to cope was a significant predictor of increases in depression but not of change in stress, anxiety, or loneliness. The motivation to manage distress appears to be driving the negative effects of alcohol use on mental health.

Longitudinal changes in anxiety and depression and their ameliorating lifestyle factors among community-dwelling older adults during the COVID-19 pandemic

BackgroundThe COVID-19 pandemic has affected the lifestyle and mental health of community-dwelling older adults. Physical activity and social interaction are healthy lifestyle factors that can reduce psychological distress among community-dwelling older adults, although their effect may vary by sex. However, it is unclear how the anxiety and depression of older adults living in the community changed when measures were implemented to limit social interactions to control infection, as in the early stages of COVID-19, and what lifestyle factors helped ameliorate psychological distress in each sex. MethodsThis study included 550 participants aged 65 and older, who visited a drug store in Daito, Osaka Prefecture, Japan. Baseline questionnaire surveys were conducted from January to April 2021. Follow-up surveys were conducted three months after the baseline survey. We collected data on participants’ anxiety and depression symptoms using the Kessler Psychological Distress Scale-6 (K6), as well as on their lifestyle factors that may have affected anxiety and depression symptoms. ResultsA total of 520 participants completed the baseline and follow-up surveys. K6 scores did not show a significant difference, while the frequency of social interactions with neighbors, family, and friends increased significantly between the two surveys. Among women participants, more frequent moderate-intensity exercise and family interactions were associated with improved K6 scores. ConclusionsWhen social interactions are restricted for infection control in community-dwelling older adults who are independent in activities of daily living including the ability to go out, social interactions recover over time, but anxiety and depressive symptoms persist. In women, lifestyle factors such as frequent moderate-intensity exercise may help reduce persisted anxiety and depression.

Framing Celebrity Scientists: How Chinese Media and Public Construct Celebrity-Based Risk Communication in Public Health Emergencies

ABSTRACT The impact of celebrities on public awareness in health communication has been proved to be significant, making it a possible approach for risk communication during public health emergencies. In the early stages of COVID-19, some Chinese medical experts engaged with the public and became “celebrity scientists.” It provides representative cases for studying celebrity-based risk communication approaches. With Dr. Wenhong Zhang as the primary case, this research investigates the construction process of celebrity scientists. Through semantic network analysis (SemNA) and other complementary methods, this study examines Dr. Zhang’s articles (n1 = 45), relevant news reports (n2 = 360), and public tweets (n3 = 12,933), in order to identify the main agendas of media, public and expert during the construction process of celebrity scientists, as well as their similarities and differences. The results reveal three categories in the narratives around the celebrity scientist, highlighting unbalanced focuses and preferences. Notably, the agendas of celebrity scientists, media outlets and the general public are more alike than different, and tend to converge over time. The simultaneous resonance of the media and public is also crucial in the construction of celebrity scientists, as well as specific incidents or turning points. These findings shed light on the application of celebrity-based risk communication approach in emergencies, providing guidance and discussion points for health messaging strategies as well.

COVID-19 vaccination, preventive behaviours and pro-social motivation: panel data analysis from Japan

The COVID-19 vaccine reduces infection risk; even if one contracts COVID-19, the probability of complications such as death or hospitalisation is lower. However, vaccination may prompt people to decrease preventive behaviours, such as staying home, washing hands, and wearing a mask. Therefore, if vaccinated people pursue only self-interest, the vaccine’s effect may be lower than expected. However, if vaccinated people are pro-social (motivated toward benefits for the whole society), they might maintain preventive behaviours to reduce the spread of infection. We conducted 26 surveys almost once a month from March 2020 (the early stage of COVID-19) to September 2022 in Japan. By corresponding with identical individuals, we independently constructed the original panel data (N = 70,908). Based on the data, we identified the timing of the second vaccine shot and compared preventive behaviours before and after vaccination. We investigated whether second-shot vaccination correlated with changes in preventive behaviours. Furthermore, we explored whether the vaccination effect differed between the older and younger groups. We then investigated the effect of pro-social motivation on preventive behaviours. Major findings are as follows: (1) Being vaccinated led people to increase preventive behaviours, such as mask-wearing by 1.04 (95% confidence intervals [Cis]: 0.96–1.11) points, and hand hygiene by 0.34 (95% CIs: 0.30–0.38) points on a 5-point scale. (2) Vaccinated people under 65 are less likely to stay home. (3) People with pro-social motivation to be vaccinated are more likely to maintain prevention than those not so motivated; on a 5-point scale, the difference is 0.08 (95% CIs: 0.01–0.15) points for mask-wearing and 0.05 (95% CIs: 0.001–0.10) points for hand hygiene. After vaccination, the opportunity cost of staying home outweighs its benefits, and people are less inclined to stay at home. This effect is lower in older people who are at a higher risk of serious illness. The opportunity cost of wearing masks and hand hygiene is lower than that of staying home, and the benefit persists after vaccination if people are motivated to maintain these behaviours for others’ well-being.

Investigating the spatiotemporal characteristics and medical response during the initial COVID-19 epidemic in six Chinese cities

In the future, novel and highly pathogenic viruses may re-emerge, leading to a surge in healthcare demand. It is essential for urban epidemic control to investigate different cities’ spatiotemporal spread characteristics and medical carrying capacity during the early stages of COVID-19. This study employed textual analysis, mathematical statistics, and spatial analysis methods to examine the situation in six highly affected Chinese cities. The findings reveal that these cities experienced three phases during the initial outbreak of COVID-19: “unknown-origin incubation”, “Wuhan-related outbreak”, and “local exposure outbreak”. Cities with a high number of confirmed cases exhibited a multicore pattern, while those with fewer cases displayed a single-core pattern. The cores were distributed hierarchically in the central built-up areas of cities’ economic, political, or transportation centers. The radii of these cores shrank as the central built-up area’s level decreased, indicating a hierarchical decay and a core–edge structure. It suggests that decentralized built environments (non-clustered economies and populations) are less likely to facilitate large-scale epidemic clusters. Additionally, the deployment of designated hospitals in these cities was consistent with the spatial distribution of the epidemic; however, their carrying capacity requires urgent improvement. Ultimately, the essence of prevention and control is the governance of human activities and the efficient management of limited resources about individuals, places, and materials through leveraging IT and GIS technologies to address supply–demand contradictions.

Efficiency of the Vitamin D Status Diagnosticator amongst Geriatric Patients with COVID-19.

The vitamin D status diagnosticator (VDSD), a 16-item tool, effectively identifies hypovitaminosis D in healthy older adults and can assist in determining the need for blood tests in this population. Assessing vitamin D levels is particularly crucial in the context of COVID-19. This study aimed to evaluate the VDSD's effectiveness in pinpointing hypovitaminosis D in older adults affected by COVID-19. The research involved 102 unsupplemented geriatric inpatients consecutively admitted to the acute geriatric division of Angers University Hospital, France, with an average age of 85.0 ± 5.9 years (47.1% women). The physician-administered VDSD was conducted simultaneously with the measurement of serum 25-hydroxyvitamin D (25(OH)D). Hypovitaminosis D was defined as a serum 25(OH)D concentration of ≤75 nmol/L for vitamin D insufficiency and ≤50 nmol/L for vitamin D deficiency. Results revealed that 87 participants (85.3%) had vitamin D insufficiency and 63 (61.8%) had vitamin D deficiency. The VDSD accurately identified vitamin D deficiency with an area under the curve (AUC) of 0.81 and an odds ratio (OR) of 40. However, its accuracy in identifying vitamin D insufficiency was lower (AUC = 0.57). In conclusion, the 16-item VDSD, a concise questionnaire, effectively identifies vitamin D deficiency in geriatric patients with COVID-19. This tool can be valuable in guiding the decision to administer vitamin D supplementation during the early stages of COVID-19.

Preventive health behaviour differences across racial groups during the early stages of COVID-19.

Throughout the COVID-19 pandemic, the practice of preventative health behaviours had been used disparately across different racial groups. This study seeks to identify any differences in preventative health behaviours across racial groups, controlling for other socio-demographic factors. A US national survey study was electronically conducted from July through November 2020, to measure racial/ethnic differences in health preventive behaviours about COVID-19. We performed 2-part regression models to assess whether preventive health behaviours differed by race and ethnicity. Specifically, we employed generalized logistic regressions for investigating the predictors of the use of complementary or alternative medicine (CAM), or stay-at-home strategy, then performed ordinal logistic regression to examine the predictors of social distancing, face mask wearing, and hand hygiene strategy practice. The results show that non-White respondents were more likely to practice social distancing, mask wearing, and hand hygiene strategy to prevent COVID-19, compared to their White counterparts. Additionally, the findings indicate that individuals who experienced COVID-19-related racial abuse or depression had a higher likelihood of practicing preventive health behaviours. We found ethnicity can be a predictor of health preventive behaviours, in accordance with previous research. The causes of these disparities will require further investigation in order to be addressed.

Families adapting to COVID-19 in urban Bangladesh: "It felt like the sky fell apart and we were in shock".

The COVID-19 epidemic has especially impacted the urban population in Bangladesh. Studies on COVID-19 have primarily focused on the patient's perspective. It is important to understand the experience of family members who adopt caregiving roles, as the experience of COVID-19 also impacts, and is impacted by, household members. This study aimed to explore the challenges, preventative practices, health-seeking behaviour, and perspectives of navigating the health care system from the perspective of family members of persons who had recovered from COVID-19 during its initial outbreak in Bangladesh. Participants of this qualitative study were family members (n = 7) of persons who had recovered from COVID-19 (either suspected or confirmed). Semi-structured in-depth interviews were conducted over telephone. Thematic analysis was used to analyse the data. Analysis revealed three key themes: changes in everyday practices and choice of health care, challenges and constraints, and unexpected positive outcomes. All the themes had temporal dimension to them with four distinct phases: early stage of COVID-19, strict lockdown phase, COVID-19 diagnosis and illness period and post COVID-19 recovery. The importance of maintaining social contact for psychological wellbeing during critical times was evident in the study. Online communication and social media enabled participants to remain 'socially connected' which further supported their mental health. Increased attention to hygiene practices both before, during and subsequent to COVID-19 infections within families was reported. Physical distancing in case of a suspected or confirmed COVID-19 case was found logistically and socially impractical in a densely populated city.

English learning behaviors in computer-mediated communication during COVID-19 in Thailand’s Deep South

ABSTRACT COVID-19 has transformed how teaching is organized, with computer-mediated communication (CMC) implemented to overcome physical constraints from social distancing. This study explored behaviors and approaches employed by 10 English teachers from three private schools to optimize ELT with CMC in southern Thai provinces. Data collection involved focus group discussions and semi-structured interviews with the participants. Findings revealed that the students had transformed their behaviors of learning English through CMC. Consequently, CMC was utilized in two ways, including as auxiliary and primary instruments. Firstly, CMC was employed to supplement synchronous learning in the early stages of COVID-19 with social media to assign and return completed tasks. Nevertheless, online classes saw low student participation, notable learning fatigue, limited English practice opportunities, and inadequate self-practicing for language development. Secondly, after CMC was utilized as a primary instrument; the students had a broader opportunity to study English; demonstrated a higher commitment to learning; and adopted autonomous learning, self-assessment, and digital skills. This study further found that CMC-ELT performance could be maximized by allowing students to actively design their online learning, using diverse applications to promote participation, introducing creative content to reduce limitations, increasing spaces for autonomous learning, and providing channels for publishing student outcomes.

HB-EGF Plasmatic Level Contributes to the Development of Early Risk Prediction Nomogram for Severe COVID-19 Cases.

(1) Background: Heparin-Binding Epidermal Growth Factor-like Growth Factor (HB-EGF) is involved in wound healing, cardiac hypertrophy, and heart development processes. Recently, circulant HB-EGF was reported upregulated in severely hospitalized COVID-19 patients. However, the clinical correlations of HB-EGF plasma levels with COVID-19 patients' characteristics have not been defined yet. In this study, we assessed the plasma HB-EGF correlations with the clinical and paraclinical patients' data, evaluated its predictive clinical value, and built a risk prediction model for severe COVID-19 cases based on the resulting significant prognostic markers. (2) Methods: Our retrospective study enrolled 75 COVID-19 patients and 17 control cases from May 2020 to September 2020. We quantified plasma HB-EGF levels using the sandwich ELISA technique. Correlations between HB-EGF plasma levels with clinical and paraclinical patients' data were calculated using two-tailed Spearman and Point-Biserial tests. Significantly upregulated parameters for severe COVID-19 cases were identified and selected to build a multivariate logistic regression prediction model. The clinical significance of the prediction model was assessed by risk prediction nomogram and decision curve analyses. (3) Results: HB-EGF plasma levels were significantly higher in the severe COVID-19 subgroup compared to the controls (p = 0.004) and moderate cases (p = 0.037). In the severe COVID-19 group, HB-EGF correlated with age (p = 0.028), pulse (p = 0.016), dyspnea (p = 0.014) and prothrombin time (PT) (p = 0.04). The multivariate risk prediction model built on seven identified risk parameters (age p = 0.043, HB-EGF p = 0.0374, Fibrinogen p = 0.009, PT p = 0.008, Creatinine p = 0.026, D-Dimers p = 0.024 and delta miR-195 p < 0.0001) identifies severe COVID-19 with AUC = 0.9556 (p < 0.0001). The decision curve analysis revealed that the nomogram model is clinically relevant throughout a wide threshold probability range. (4) Conclusions: Upregulated HB-EGF plasma levels might serve as a prognostic factor for severe COVID-19 and help build a reliable risk prediction nomogram that improves the identification of high-risk patients at an early stage of COVID-19.

Manifestations of Hope and Hopelessness in the Early Stages of COVID-19 in Africa

COVID-19 triggered significant emotions and imagination, if not panic, about health and life worldwide as people’s lives were suddenly uncertain. This scenario led some to assess their life circumstances as hopeless, while others continued to see hope on the horizon despite a dreadful disease, consequent lockdowns and especially social distancing. This paper explores African countries’ experiences of hope and hopelessness at the onset of the pandemic from the perspective of 12 PhD students in Hong Kong. The students narrated that despite being hit moderately, their countries sat far behind richer ones in terms of the capacity to handle the epidemic effectively – which somewhat signalled the hopelessness students felt and imagined for such countries. However, their narrations also showed that hope was consequential in people’s everyday responses to the socioeconomic effects of the virus. Their wishes, at the time, were that a vaccine would soon be found and extended to Africa, that Africans would realise the seriousness of the pandemic, and that they could be valuable sources of information and resources to their communities of upbringing.

Comparison of geological clusters between influenza and COVID-19 in Thailand with unsupervised clustering analysis.

The coronavirus disease (COVID-19) pandemic has considerably impacted public health, including the transmission patterns of other respiratory pathogens, such as the 2009 pandemic influenza (H1N1). COVID-19 and influenza are both respiratory infections that started with a lack of vaccination-based immunity in the population. However, vaccinations have been administered over time, resulting in a transition of the status of both diseases from a pandemic to an endemic. In this study, unsupervised clustering techniques were used to identify clusters of disease trends in Thailand. The analysis incorporated three distinct surveillance datasets: the pandemic influenza outbreak, influenza in the endemic stage, and the early stages of COVID-19. The analysis demonstrated a significant difference in the distribution of provinces between Cluster -1, representing those with unique transmission patterns, and the other clusters, indicating provinces with similar transmission patterns among their members. Specifically, for Pandemic Influenza, the ratio was 61:16, while for Pandemic COVID-19, it was 65:12. In contrast, Endemic Influenza exhibited a ratio of 46:31, with a notable emergence of more clustered provinces in the southern, western, and central regions. Furthermore, a pair of provinces with highly similar spreading patterns were identified during the pandemic stages of both influenza and COVID-19. Although the similarity decreased slightly for endemic influenza, they still belonged to the same cluster. Our objective was to identify the transmission patterns of influenza and COVID-19, with the aim of providing quantitative and spatial information to aid public health management in preparing for future pandemics or transitioning into an endemic phase.

Organizational resilience of audit firms – evidence from the outbreak of the COVID-19

PurposeThis paper examines the organizational resilience of audit firms during the early stages of COVID-19. The unexpected restrictions placed on travel and on-site working created unanticipated barriers for auditors in Hong Kong. The authors expect that auditors with greater organizational resilience can respond to unexpected situations and restore expected performance levels relatively quickly.Design/methodology/approachThe authors utilize a sample of 1,008 companies listed on Hong Kong Stock Exchange (HKEX) with a financial year-end of December 31. The authors identify five proxies contributing to organizational resilience: auditor size, industry specialization, diversity, geographic proximity to the client and auditing a new client. The authors use audit report timeliness as this study's main dependent variable.FindingsThis study's full-sample results suggest that larger auditors, industry specialists and auditors with closer relationships to clients issued more timely audit reports during the pandemic. The analysis of a subsample of companies that initially published unaudited financial statements reveals that industry expertise and longer auditor-client relationships significantly reduced the need for year-end audit adjustments. Finally, the authors find that larger auditors were more likely to offload clients, whereas industry specialists were more likely to retain clients.Research limitations/implicationsThe results of the paper suggests that audit firm characteristics associated cognitive abilities, behavioral characteristics and contextual conditions are associated with audit firm organizational resilience and, consequently, helps auditors respond unexpected changes in the audit environment.Practical implicationsThe findings of the paper are informative for those involved in audit firm management or auditor hiring and retention decisions.Originality/valueThis study is the first to link organizational resilience to the performance of audit firms in a time of unexpected events. The authors connect three auditor and two auditor-client dimensions to the organizational resilience of the audit firms.

The Optic Neuritis Developed During COVID-19 Infection - a Case Report

Background: COVID-19 affects all organ systems, including the visual organs. Clinical manifestations encompass all segments of the eye. Neuro-ophthalmic manifestations are rare and can occur during the acute phase of the illness, during recovery, or in the course of Long COVID. These clinical manifestations include optic neuritis and various forms of encephalomyelitis. Optic neuritis more commonly occurs during the recovery phase from the acute form or during Long COVID. Family physicians are in a position to first diagnose optic neuritis in the early stages. Objective: The aim of this paper is to present a case of optic neuritis occurring in the early stages of the disease, diagnosed in the prehospital period in a family medicine practice with consultations from ophthalmologists, infectologists, and neurologists. Such close collaboration enabled the early administration of corticosteroid therapy. Case report: A case of a 28-year-old woman is presented, who exhibited symptoms of COVID-19 with a confirmed positive antigen for the SARS-CoV-2 virus (PCR nasopharyngeal swab). On the fourth day of illness, sudden loss of vision in the right eye occurred along with headache. Early diagnosis and early administration of corticosteroid therapy led to significant improvement in vision. Conclusion: Clinical manifestations of eye diseases can occur in the early stages of COVID-19 as a direct consequence of viral infection. Ophthalmologist and neurologist examinations are necessary in the early stages of the disease for timely diagnosis of various ophthalmologic and neurologic disorders and adequate therapy.

The role of the social sciences and humanities in pandemic preparedness responses: insights gained from COVID-19, HIV and AIDS and related epidemics

The COVID-19 pandemic, particularly from 2020 to mid-2022, debilitated the management of the HIV epidemic in Africa. The multiple effects included well-documented HIV service interruptions, curtailment of HIV prevention programmes, the associated marked increase in both the risk for HIV infection among key populations and vulnerability of sub-populations (e.g. adolescent girls and young women) who are the focus of these programmes and — as importantly but less well-documented — the diverse negative socio-economic effects that accentuate HIV risk and vulnerability generally (e.g. loss of earnings, gender-based violence, stigma, police harassment of people during “lockdowns”). The global biomedical response to COVID-19 was necessary and remarkable for mitigating the bio-physical impacts of the pandemic (e.g. wide-spread surveillance coupled with rapid updates on the epidemiology of infections, rapid development of vaccines and revisions of treatment). However, drawing upon the widespread criticisms of state responses to the socio-economic effects of the COVID-19 pandemic and of “lockdowns” themselves, this article elaborates a core argument within those criticisms, namely that key lessons learnt during the HIV and AIDS and other pandemics were ignored, at least during the early stages of COVID-19. Our critique is that better integration of the social sciences and humanities in responses to pandemics can counter the reflex tendency to uncritically adopt a biomedical paradigm and, more importantly, to enable consideration of the social determinants of health in pandemic responses. At root, we re-assert a key value of ‘integrated’ interventions, namely the accommodation of context-sensitive considerations in the formulation of strategies, policies, plans and programme designs.

Opinions of emergency nurses in Turkey on their work environment during the COVID-19 pandemic and its relationship with their health: A qualitative study

IntroductionCOVID-19 patients being admitted to emergency service pose a high risk of exposure and infection to emergency nurses. Therefore, one of the primary responsibilities of hospital management is to provide an appropriate work environment for nurses. AimTo analyze the opinions of emergency nurses about their work environment, and to understand how the working environment is related to their health during the COVID-19 pandemic. MethodsThe study employed a qualitative descriptive research design and purposive sampling method. It was conducted in the emergency service of a state hospital in the central Anatolia region of Turkey, which was providing COVID-19 care at the time. The data were collected through semi-structured individual interviews held between January and February 2021. Each interview was conducted only once via WhatsApp video calls. Data collection was continued to reach data saturation (n:14). The data were analyzed using Colaizzi's seven-step content analysis. The Consolidated Criteria for Reporting Qualitative (COREQ) Studies checklist was followed in the study. ResultsThree themes emerged in the analysis of the data obtained from a total of 14 emergency nurses: (a) “Insufficient Physical Environment”; (b) “Inadequacies in Managerial Roles and Skills”; and (c) “The Effect of the Work Environment on Nurses' Health”. It was determined that the work environment of emergency nurses was inadequate in terms of resting areas, ventilation and separation of clean and infected areas, and they stated that they had not received adequate support from their managers and encountered difficulties due to equipment shortage, particularly in the early stages of COVID-19. It was also determined that the work environment caused psychological and ergonomic health issues. ConclusionsIt is important to provide adequate managerial support and to make arrangements that resolve the physical and mental obstacles in improving the work environment of emergency nurses.