Endemic Phase Research Articles

Factors Associated With Quality Of Life Among Students During the Transition from Pandemic to Endemic Phase

Factors Associated With Quality Of Life Among Students During the Transition from Pandemic to Endemic Phase

Association between Vaccination Status for COVID-19 and the Risk of Severe Symptoms during the Endemic Phase of the Disease.

The global health emergency caused by COVID-19 concluded in May 2023, marking the beginning of an endemic phase. This study aimed to evaluate the association between vaccination status and other patient characteristics and the risk of severe disease during this new endemic period. A nationwide cohort study was conducted in Mexico, where we analyzed data from 646 adults who had received positive confirmation of COVID-19 through PCR testing from May to August 2023. The overall risk of severe symptoms in the study sample was 5.3%. The average time elapsed from the last vaccine shot to symptom onset was over six months in all the immunized groups (1, 2 or 3 vaccine doses). Compared to unvaccinated patients, those with three vaccine doses showed an elevated risk of severe symptoms. Advancing age and various chronic comorbidities (specifically cardiovascular, kidney, and obstructive pulmonary conditions) were associated with a heightened risk of severe COVID-19 manifestations. These findings underscore the ongoing seriousness of COVID-19, even in an endemic phase, underscoring the urgent need for tailored interventions aimed at high-risk patients.

COVID-19 illness: Different comorbidities may require different immunological therapeutic targets.

The SARS-CoV-2 pandemic has led to more than 6,870.000 deaths worldwide. Despite recent therapeutic advances, deaths in Intensive Care Units still range between 34 and 72%, comprising substantial unmet need as we move to an endemic phase. The general agreement is that in the first few days of infection, antiviral drugs and neutralizing monoclonal antibodies should be adopted. When the patient is hospitalized and develops severe pneumonia, progressing to a systemic disease, immune modifying therapy with corticosteroids is indicated. Such interventions, however, are less effective in the context of comorbidities (e.g., diabetes, hypertension, heart failure, atrial fibrillation, obesity and central nervous system-CNS diseases) which are by themselves associated with poor outcomes. Such comorbidities comprise common and some distinct underlying inflammatory pathobiology regulated by differential cytokine taxonomy. Searching in the PubMed database, literature pertaining to the biology underlying the different comorbidities, and the data from the studies related to various immunological treatments for the Covid-19 disease were carefully analyzed. Several experimental and clinical data have demonstrated that hypertension and atrial fibrillation present an IL-6 dependent signature, whereas diabetes, obesity, heart failure and CNS diseases may exhibit an IL-1a/b predominant signature. Distinct selective cytokine targeting may offer advantage in treating severe COVID-19 illness based on single or multiple associated comorbidities. When the patient does not immediately respond, a broader target range through JAKs pathway inhibitors may be indicated. Herein, we discuss the biological background associated with distinct comorbidities which might impact the SARS-CoV-2 infection course and how these should to be addressed to improve the current therapeutic outcome.

Prognostic Performance of Inflammatory Biomarkers Based on Complete Blood Counts in COVID-19 Patients.

With the end of the pandemic, COVID-19 has entered an endemic phase with expected seasonal spikes. Consequently, the implementation of easily accessible prognostic biomarkers for patients with COVID-19 remains an important area of research. In this monocentric study at a German tertiary care hospital, we determined the prognostic performance of different clinical and blood-based parameters in 412 COVID-19 patients. We evaluated the neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), pan-immune-inflammation value (PIV), and absolute eosinopenia (AEP, 0/µL) of COVID-19 patients (n = 412). The Siddiqui and Mehra staging proposal, the WHO clinical progression scale, and COVID-19-associated death were used as COVID-19 outcome measures. With respect to Siddiqi and Mehra staging, patient age of older than 75 years, high C-reactive protein (CRP), absolute eosinopenia (AEP), cardiovascular comorbidities, and high ferritin were significant independent predictors for severe COVID-19. When outcome was determined according to the WHO clinical progression scale, patient age of older than 75 years, high CRP, high LDH, AEP, high neutrophil-to-lymphocyte ratio (NLR), and the presence of pulmonal comorbidities were significant independent predictors for severe COVID-19. Finally, COVID-19-associated death was predicted independently by patient age of older than 75 years, high LDH, high NLR, and AEP. Eosinopenia (< 40/µL) was observed in 74.5% of patients, and AEP in almost 45%. In conclusion, the present real-world data indicate that the NLR is superior to more complex systemic immune-inflammation biomarkers (e.g., SII and PIV) in COVID-19 prognostication. A decreased eosinophil count emerged as a potential hallmark of COVID-19 infection, whereas AEP turned out to be an accessible independent biomarker for COVID-19 severity and mortality.

Survival Analysis and Contributing Factors among PCR-Confirmed Adult Inpatients during the Endemic Phase of COVID-19.

In May 2023, the global health emergency status of COVID-19 concluded, marking the onset of an endemic era. This study assessed survival rates among PCR-confirmed adult inpatients during this phase and determined contributing factors. Employing a survival analysis approach, this investigation utilized a nationwide Mexican cohort encompassing 152 adult inpatients. Survival rates were computed using the Kaplan-Meier method, and a proportional Cox model identified mortality risk factors. Survival rates remained above 65% on day 14 after admission. Vaccination status, including the number of doses administered, was not significantly associated with fatal outcomes. Chronic kidney disease or a history of immunosuppression (due to any cause) increased mortality risk. Our findings underscore the persistent severity of COVID-19 beyond the global health emergency, emphasizing the necessity for tailored interventions for vulnerable patients.

COVID-19 endemic phase in Finland: An analysis of health policies and vaccination strategy

ObjectivesTo analyze how the vaccines and various measures to control the pandemic affected epidemiological, health and socioeconomic outcomes of COVID-19 in Finland. The focus of the analysis is on the endemic phase of the COVID-19 pandemic. MethodsThe paper provides an overview of Finland's healthcare system, trends in COVID-19 morbidity, mortality and vaccination coverage data, political considerations, interventions to control the pandemic, as well as the economic impact of the pandemic in the endemic phase. Data were collected from various sources, including previous studies, government reports, national statistics and registers and general media. ResultsIn Finland, the total number of COVID-19 infections increased significantly during 2022, but the number of serious forms of the disease decreased. The implementation of the vaccination strategy caused a diversity of opinions among authorities and experts. The governing of the pandemic was fully decentralized. Overall, there is a good vaccination coverage of the population. In the endemic phase society returned to live without restrictions. ConclusionsIt seems clear that vaccines played an important role in controlling the pandemic. Overall mortality increased substantially in 2022 causing life expectancy to fall. Moreover, different “excess death” indicators show an increase in 2021 and 2022, but the timing and magnitude of the effect varies. It is relatively safe to conclude that at least part of increase can be attributed to the pandemic, but a more exact conclusion calls for a comprehensive study. Similarly, understanding long covid and designing required intervention calls for more research.

The Next Generation COVID-19 Antiviral; Niclosamide-Based Inorganic Nanohybrid System Kills SARS-CoV-2.

The coronavirus disease 2019 (COVID-19) pandemic is a serious global threat with surging new variants of concern. Although global vaccinations have slowed the pandemic, their longevity is still unknown. Therefore, new orally administrable antiviral agents are highly demanded. Among various repurposed drugs, niclosamide (NIC) is the most potential one for various viral diseases such as COVID-19, SARS (severe acute respiratory syndrome), MERS (middle east respiratory syndrome), influenza, RSV (respiratory syncytial virus), etc. Since NIC cannot be effectively absorbed, a required plasma concentration for antiviral potency is hard to maintain, thereby restricting its entry into the infected cells. Such a 60-year-old bioavailability challenging issue has been overcome by engineering with MgO and hydroxypropyl methylcellulose (HPMC), forming hydrophilic NIC-MgO-HPMC, with improved intestinal permeability without altering NIC metabolism as confirmed by parallel artificial membrane permeability assay. The inhibitory effect on SARS-CoV-2 replication is confirmed in the Syrian hamster model to reduce lung injury. Clinical studies reveal that the bioavailability of NIC hybrid drug can go 4 times higher than the intact NIC. The phase II clinical trial shows a dose-dependent bioavailability of NIC from hybrid drug suggesting its potential applicability as a game changer in achieving the much-anticipated endemic phase.

Nonequilibrium phase transitions in metapopulation models of infectious diseases on heterogeneous networks

We study two meta-population models of infectious diseases in heterogeneous networks. We distinguish between asymptomatic and symptomatic infections and these two go through the different courses of infection and recovery. We consider that asymptomatic infections are described by an SIS model and symptomatic infections by an SIR or SIRS model depending on the immunity upon recovery. By introducing the probability of being infected asymptomatically, we combine an SIS model for asymptomatic infections with an SIR or SIRS model for symptomatic infections to obtain the SIS-SIR and SIS-SIRS models. We use a heterogeneous mean-field theory and Monte Carlo simulations to analyze two models and find that both models undergo nonequilibrium continuous phase transitions from the endemic phase to the disease-free phase at certain critical thresholds as we vary the proportion of asymptomatic infections. It suggests that it may be possible to maintain the population in the disease-free phase by controlling the proportion of asymptomatic infections. The SIS-SIRS model shows that asymptomatic infection drives symptomatic infection and vice versa. In addition, the spreading of infections eventually ceases as the population decreases even at a fixed proportion of asymptomatic infections corresponding to the endemic phase. The results provide a theoretical basis for understanding the epidemiological facts that social distancing and reducing asymptomatic infections are important factors in optimizing quarantine measures to prevent the epidemic outbreaks of infectious diseases.

Factors associated with COVID-19 booster vaccine hesitancy: a nationwide, cross-sectional survey in Japan

ObjectivesCOVID-19 vaccine hesitancy/fatigue is increasing as the pandemic enters the endemic phase. The present study aimed to explore current perceptions about COVID-19 booster vaccination among the Japanese public. Study designThis was a cross-sectional study. MethodsThis cross-sectional study used data from the Japan COVID-19 and Society Internet Survey conducted in September 2021 and September 2022. The public's perceptions of COVID-19 vaccination and factors associated with COVID-19 booster vaccine hesitancy were analyzed. ResultsIn total, 56,735 respondents were included. In the Japan COVID-19 and Society Internet Survey 2021, 75.1% of the participants (21,126/28,118) had completed the primary vaccination series. In the 2022 survey, 74.1% of the respondents (21,216/28,617) completed the primary series of vaccination with booster doses. The proportion of fear toward COVID-19 and obtaining information about COVID-19 has decreased from 2021 to 2022. Factors independently associated with booster vaccine hesitancy were young age (range: 18–29 years; adjusted odds ratio [aOR]: 6.56), history of COVID-19 (aOR: 1.82), distrust of the Japanese government's COVID-19 prevention measures (aOR: 1.55), lack of confidence in COVID-19 vaccine efficacy (aOR: 1.30), lack of confidence in COVID-19 vaccine safety (aOR: 1.62), low reliance on the COVID-19 vaccine (aOR: 1.92), and belief in COVID-19 conspiracy theories (aOR: 1.77). ConclusionsProviding clear and trustworthy information is critically important, especially targeted and tailored messages for the young generation, to promoting COVID-19 booster vaccination. Policymakers should therefore develop consistent and transparent communication strategies and the ability to respond promptly and flexibly to mitigate the negative impact of COVID-19 on the public while preparing for the next pandemic.

Development and validation of a hybrid deep learning–machine learning approach for severity assessment of COVID-19 and other pneumonias

The Coronavirus Disease 2019 (COVID-19) is transitioning into the endemic phase. Nonetheless, it is crucial to remain mindful that pandemics related to infectious respiratory diseases (IRDs) can emerge unpredictably. Therefore, we aimed to develop and validate a severity assessment model for IRDs, including COVID-19, influenza, and novel influenza, using CT images on a multi-centre data set. Of the 805 COVID-19 patients collected from a single centre, 649 were used for training and 156 were used for internal validation (D1). Additionally, three external validation sets were obtained from 7 cohorts: 1138 patients with COVID-19 (D2), and 233 patients with influenza and novel influenza (D3). A hybrid model, referred to as Hybrid-DDM, was constructed by combining two deep learning models and a machine learning model. Across datasets D1, D2, and D3, the Hybrid-DDM exhibited significantly improved performance compared to the baseline model. The areas under the receiver operating curves (AUCs) were 0.830 versus 0.767 (p = 0.036) in D1, 0.801 versus 0.753 (p < 0.001) in D2, and 0.774 versus 0.668 (p < 0.001) in D3. This study indicates that the Hybrid-DDM model, trained using COVID-19 patient data, is effective and can also be applicable to patients with other types of viral pneumonia.

COVID-19 in the Netherlands: A three-phase analysis

IntroductionThe COVID-19 pandemic has presented global challenges in the health, economy, society, and political sector for the past three years. For the Netherlands, the dynamic nature of the pandemic can be divided into three phases. The initial phase exclusively relied on non-pharmaceutical interventions (NPIs). The second phase was characterized by the introduction of vaccines alongside the continuation of stringent NPIs. Finally, the third phase marks the post-vaccine and booster stage, characterized by minimal or absent NPIs. This paper examines the interplay between the mitigation policies, the vaccination rollout, health outcomes, and economic indicators in the Netherlands in these three phases. MethodsThis analysis used national real-time data on COVID-19-related health outcomes, health service utilization, vaccination rollout, and economic indicators. Our descriptive analysis applied the “Categorising Policy & Technology Interventions (CPTI)” framework. ResultsThe number of daily deaths, hospital admission and ICU admission experienced the highest peak in the first phase, while the number of daily cases first spiked in the third phase. The containment measures reached a very significant level twice, resulting in a full lockdown twice. In the first two phases, the peak in stringency of the CPTI containment category was parallel with the peaks in health outcomes. Conversely, in the third phase, the containment measures were scaled down prior to the peak in daily cases. ConclusionsOur findings suggest that the Dutch three-phased COVID-19 mitigation strategy managed to fulfil its aim and protect vulnerable individuals, prevent healthcare institutions from overload, and move from the pandemic to the endemic phase.

Genomic Surveillance of SARS-CoV-2 in Malaysia during the Era of Endemic COVID-19.

On 5 May 2023, WHO declared the end of coronavirus disease 2019 (COVID-19) as a public health emergency of international concern. However, the risk of new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants causing rapid and high surges in cases and deaths remained. In Malaysia, five COVID-19 waves during the pandemic phase were well characterized, but similar studies focusing on the endemic phase were lacking. Hence, we retrieved 14,965 SARS-CoV-2 genomic sequences from the GISAID EpiCoV database for clade, lineage, and phylogenetic analysis in order to provide an insight into the population dynamics of SARS-CoV-2 that circulated in Malaysia from June 2022 to April 2023. The dominance of the Omicron variants was observed, and two new waves of infections driven by BA.5.2 and XBB.1, respectively, were detected. Data as of April 2023 also pointed to a possible eighth wave driven by XBB.1.9. Although new variants associated with higher transmissibility were behind the multiple surges, these subsequent waves had lower intensities as compared to the fourth and fifth waves. The on-going circulation and evolution of SARS-CoV-2 mean that COVID-19 still poses a serious threat, necessitating active genomic surveillance for early warning of potential new variants of concern.

Willingness to pay for an annual vaccine in an endemic COVID-19 scenario: a contingent valuation study in Metro Manila, Philippines

Using the Contingent Valuation Method, this paper estimated willingness to pay (WTP) for annual COVID-19 booster vaccines for the endemic phase of the disease. The study found that, on the average, Metro Manila households would be WTP PhP2,199.71–2,410.50 (US$42.71–46.81) for a one-dose vaccine with 90% efficacy for one year. This WTP estimate is a measure of the perceived benefits from preventing COVID-19 infection, suggesting the potential for private markets to cater to those who prefer to obtain the annual booster COVID-19 vaccine privately, while a public vaccination program that subsidizes partially or fully the cost of the vaccine for those with lower capacity to pay is likely to pass a social cost–benefit assessment. Consistent with economic theory, WTP was found to significantly decrease with vaccine price and increase with income. Further, the study found general acceptance (measured in terms of the Health Benefit Model constructs) of COVID-19 vaccines among Metro Manila households despite the dengue vaccine controversy in the country immediately prior to the COVID-19 pandemic.

Are we past the COVID-19 Pandemic? Insights from Singapore

ObjectiveThis study aims to examine the interplay between high policy stringency, vaccination rates and epidemiological outcomes to develop insights on COVID-19 policy transition in Singapore MethodsThe CPTI (Categorising Policy & Technology Interventions) framework was used to classify reported interventions from January 2021 to October 2022. To analyse the impact of vaccine measures, an additional category was created. The highest monthly proportion of de-escalated measures was used as a basis to define the periods that mark the policy transition in Singapore i.e. Phase 2 and 3. Proportions of significantly escalated measures were calculated and analysed against full and booster vaccination rates, alongside epidemiological indicators – monthly total number of infections and deaths, and monthly average active hospitalisation and ICU cases. ResultsImplementation of highly stringent policies were observed to have reduced in intensity as vaccination rates picked up from Phase 2 to 3. Containment measures were the most frequently and consistently adopted beside vaccine policies. Epidemiological indicators appeared to be generally lower in Phase 3 than Phase 2. Specifically, despite reduced intensity of stringent polices, hospitalisation and ICU cases were observed to remain relatively low when vaccination rates were correspondingly higher in Phase 3 compared to Phase 2. ConclusionThe descriptive analysis of COVID-19 policy shift in Singapore based on selected indicators preliminarily suggested its successful transition from the pandemic to endemic phase in its response strategies. A policy transition plan should consider the significance of vaccination rates in an exit strategy that protects the population against worse health outcomes.

Severity of Prior Coronavirus Disease 2019 is Associated With Postoperative Outcomes After Major Inpatient Surgery.

To determine how the severity of prior history (Hx) of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection influences postoperative outcomes after major elective inpatient surgery. Surgical guidelines instituted early in the coronavirus disease 2019 (COVID-19) pandemic recommended a delay in surgery of up to 8 weeks after an acute SARS-CoV-2 infection. This was based on the observation of elevated surgical risk after recovery from COVID-19 early in the pandemic. As the pandemic shifts to an endemic phase, it is unclear whether this association remains, especially for those recovering from asymptomatic or mildly symptomatic COVID-19. Utilizing the National COVID Cohort Collaborative, we assessed postoperative outcomes for adults with and without a Hx of COVID-19 who underwent major elective inpatient surgery between January 2020 and February 2023. COVID-19 severity and time from infection to surgery were each used as independent variables in multivariable logistic regression models. This study included 387,030 patients, of whom 37,354 (9.7%) were diagnosed with preoperative COVID-19. Hx of COVID-19 was found to be an independent risk factor for adverse postoperative outcomes even after a 12-week delay for patients with moderate and severe SARS-CoV-2 infection. Patients with mild COVID-19 did not have an increased risk of adverse postoperative outcomes at any time point. Vaccination decreased the odds of respiratory failure. Impact of COVID-19 on postoperative outcomes is dependent on the severity of illness, with only moderate and severe disease leading to a higher risk of adverse outcomes. Existing perioperative policies should be updated to include consideration of COVID-19 disease severity and vaccination status.

Can Pharmacists' Counseling Improve the Use of Inhalers and Quality of Life? A Prospective "Pre" and "Post" Education Analysis in Mardan, Pakistan.

Asthma is one of the common major non-communicable respiratory diseases, and is associated with a lower health-related quality of life (QOL). Poor inhalation is a significant contributing factor to poor control of asthma. Community pharmacist has a vital role to play in assisting patients and ultimately improving their asthma conditions through the use of inhalers. This study aimed to assess the effectiveness of "pre" and "post" educational intervention by a community pharmacist within a community pharmacy on asthma patients' QOL, inhaler technique, and adherence to therapy during the endemic phase of COVID-19. A "pre" and "post" interventional study was performed at a community pharmacy in the city of Mardan, Pakistan, in 2022 during the COVID-19 pandemic. Patients were divided into two groups, ie control and pharmacist-led education groups. After assigning patients to both groups, the baseline data were collected and followed for one month to compare the reduction in errors in the use of inhalers, QOL, and adherence to therapy. A paired sample t-test was performed, keeping a p-value <0.05 as statistical significance. A total of 60 patients were recruited, majority (58.3%) were females, and 28.3% were from the age group of 46-55 years old. A statistically significant difference was observed in the pre- and post-education QOL score among patients in the pharmacist-led education group, from a mean ± SD at pre-education of 40.23±10.03 to a mean±SD at post-education of 48.10±5.68. Similarly, a statistically significant difference was observed for the correct use of inhalers, ie MDIs and DPIs. Similarly, a statistically significant difference was observed in the adherence status between pre-education and post-education by pharmacists. The findings of the study revealed a positive impact of community pharmacist-led education on QOL, inhaler technique, and adherence to therapy among patients with asthma.

포스트 코로나 자치경찰의 치안활동 방향에 관한 연구

In 2020, the COVID-19 pandemic spread, and strong quarantine policies were implemented, which restricted social activities. As the lifestyle changed to a non-face-to-face-centered lifestyle, the crime pattern also changed. Crimes that could have occurred in daily life decreased, but non-face-to-face crimes and crimes committed at home showed an increasing trend. In the pandemic situation, not only the crime but also the police had a big change. In 2021, the autonomous police system was introduced and implemented, which led to various changes in the police's office area and activities. Since then, COVID-19 has changed to an Endemic of infectious diseases, and society is recovering from daily activities and the security environment is changing. In line with this situation, the police should develop policies and activities that reflect the changes in security activities.&#x0D; In this study, we analyze the changes in the public safety environment, focusing on Chungcheongnam-do, in the context of the COVID-19 pandemic and its transition to an endemic phase. Based on previous studies, we present the current issues within the police force and provide directions for public safety activities. Firstly, we propose strengthened responses and preventive measures against changes in crime and safety incidents resulting from the recovery of daily activities. Secondly, considering the continued economic downturn, we suggest preventive and responsive actions against financial and property crimes. Thirdly, we propose the formation of a security governance system, which includes welfare-oriented public safety activities tailored to specific crime types and targets.

Attitudinal analysis of vaccination effects to lead endemic phases

To achieve endemic phases, repeated vaccinations are necessary. However, individuals may grapple with whether to get vaccinated due to potential side effects. When an individual is already immune due to previous infections or vaccinations, the perceived risk from vaccination is often less than the risk of infection. Yet, repeated rounds of vaccination can lead to avoidance, impeding the establishment of endemic phases. We explore this phenomenon using an individual-based Monte Carlo simulation, validating our findings with game theory. The Nash equilibrium encapsulates individuals' non-cooperative behavior, while the system's optimal value represents the societal benefits of altruistic cooperation. We define the difference between these as the price of anarchy. Our simulations reveal that the price of anarchy must fall below a threshold of 12.47 for endemic phases to be achieved in a steady state. This suggests that for a basic reproduction number of 10, a consistent vaccination rate greater than 89% is required. These findings offer new insights into vaccination-related decision-making and can inform effective strategies to tackle infectious diseases.

Association of COVID-19 outcomes with diabetes in the Veneto region (north-east italy): Epidemiological insights for the endemic phase?

Background and aimsDiabetes mellitus is a prevalent chronic disease in patients who die of COVID-19. The aim of this study was to investigate the clinical and metabolic characteristics of diabetic patients with COVID-19 during the pre-vaccination phase. Methods and resultsA retrospective cohort study was conducted from February 2020 to February 2021 to examine the clinical and metabolic profiles of unvaccinated diabetic patients affected by COVID-19. Data were collected from claim databases, hospital discharge records, and clinical records within a healthcare district located in northeastern Italy with a population of 936,000. Potential prognostic indicators including sex, age, Body Mass Index (BMI), duration and type of diabetes, metabolic control, and the use of antidiabetic, antihypertensive, lipid-lowering, and antiplatelet therapies were investigated. For hospitalized patients, additional variables were recorded, such as length of hospital stay, blood pressure at admission, comorbidities, D-dimer levels, blood glucose (BG), in-hospital insulin and corticosteroid therapies, requirement for mechanical ventilation (i.e., orotracheal or tracheostomy), admission to the Intensive Care Unit (ICU), and mortality. Diabetic patients hospitalized for COVID-19 with a poorer prognosis were characterized by advanced age, longer diabetes duration, hypertension, higher usage of sulfonylureas, and lower usage of dietotherapy alone, metformin, Glucagon-Like Peptide-1 Receptor agonists (GLP1-Ra), and Renin-Angiotensin-Aldosterone System inhibitors (RAAS-i). ConclusionConsidering the potential for COVID-19 to become endemic, special care should be taken in managing older diabetic patients’ treatments.

Customer Satisfaction on How McDonald's Performs on Post-Pandemic

The Covid-19 has driven the entire planet to a dangerous tipping point, and no one is spared from this crisis, including our nation, Malaysia. Malaysia imposed the movement control order (MCO) on March 18, 2020, to blunt the exponential rise of Covid-19 cases and transition to the endemic phase of the Covid-19 pandemic on April 1, 2022. On account of that, this paper identifies customer satisfaction in the ways (social distancing, use of masks and hand sanitizers, contactless and cashless system, hygiene and cleanliness, and checking body temperature) McDonald’s adopted in Malaysia to surmount the outbreak of Covid-19. The researchers have collected primary data via Google Forms, with 150 participants partaking in this survey, and secondary data from different sources to conduct a deeper study on the research topic. Therein, this paper can enhance the understanding of how McDonald's performed post-pandemic. The researchers have used the IBM SPSS Statistic software to analyze the data collected. Overall, researchers find that most customers are satisfied with the measures taken by McDonald’s to combat Covid-19