Coronavirus Disease 2019 Era Research Articles

Differences in Resumption of Orthopedic Surgery According to Characteristics of Surgery during COVID-19 Pandemic: National Registry Data.

Healthcare services have been restricted after the coronavirus disease 2019 (COVID-19) outbreak. With the pandemic still ongoing, the patterns of orthopedic surgery might have changed. The purpose of this study was to determine whether the reduced volumes of orthopedic surgery were recovered over time. Among the trauma and elective surgery, which accounted for most orthopedic surgical procedures, we also sought to elucidate whether the changes in the volumes of orthopedic surgery differed according to the type of surgery. The volumes of orthopedic surgery were analyzed using the Health Insurance Review and Assessment Service of Korea databases. The surgical procedure codes were categorized depending on the characteristics of the procedures. The actual volumes of surgery were compared with the expected volumes to elucidate the effect of COVID-19 on surgical volumes. The expected volumes of surgery were estimated using Poisson regression models. The reducing effect of COVID-19 on the volumes of orthopedic surgery weakened as COVID-19 continued. Although the total volumes of orthopedic surgery decreased by 8.5%-10.1% in the first wave, those recovered to a 2.2%-2.8% decrease from the expected volumes during the second and third waves. Among the trauma and elective surgery, open reduction and internal fixation and cruciate ligament reconstruction decreased as COVID-19 continued, while total knee arthroplasty recovered. However, the volumes of hemiarthroplasty of the hip did not decrease through the year. The number of orthopedic surgeries, which had decreased due to COVID-19, tended to recover over time, although the pandemic was still ongoing. However, the degree of resumption differed according to the characteristics of surgery. The findings of our study will be helpful to estimate the burden of orthopedic surgery in the era of persistent COVID-19.

Nutrition and health challenges among low-income families of young children in the post COVID-19 era: a qualitative study.

In the United States, one in every 5 children is obese with greater likelihood in low-income households. The coronavirus disease 2019 (COVID-19) pandemic may have accelerated disparities in child obesity risk factors, such as poor dietary intake and increased sedentary behaviors, among low-income families because of financial difficulties, social isolation and other struggles. This study reveals insights into nutrition and health challenges among low-income families of young children in West Texas to better understand needs and develop interventions. In-depth individual interviews were performed via Zoom among 11 families of children under the age of 3. A semi-structured interview guide was developed to explore 3 areas: changes in (1) dietary intake and (2) sedentary behaviors and (3) families' preferences regarding a parent nutrition education program. Each interview was audio-recorded, transcribed, and coded using MaxQDA software. Eating together as a family become challenging because of irregular work schedules during the COVID-19 pandemic. Most parents stated that their children's dietary habits shifted with an increased consumption of processed foods. Many parents are unable to afford healthful foods and have utilized food and nutrition assistance programs to help feed their families. All families reported that their children's screen time substantially increased compared to the pre-pandemic times. Moreover, the majority of parents did not associate child screen time with an obesity risk, so this area could be of particular interest for future interventions. Meal preparation ideas, remote modality, and early timing were identified as key intervention strategies. Online nutrition interventions that emphasize the guidelines for child screen time and regular meal routines will be effective and promising tools to reach low-income parents for early childhood health promotion and obesity prevention.

The COVID-19 Era Is Associated With Delays in Esophageal Cancer Diagnosis and Treatment

IntroductionThe coronavirus disease-2019 (COVID-19) pandemic has substantially affected the delivery of healthcare globally. The purpose of this study was to evaluate the association of this era with the timeline of care in esophageal cancer patients. MethodsWe performed a retrospective chart-review of patients presenting to a single high-volume tertiary care center with the diagnosis of esophageal cancer. COVID era was defined as March 2020-December 2020 and compared with the year before (3/2019-12/2019). ResultsIn total, 117 patients presented in the COVID-era versus 190 in pre-COVID. Stage 3 + 4 disease was found in 77.8% of the patients in the COVID-era compared to 68.9% in the pre-COVID era (P = 0.34). Diagnoses through emergency department admission were 35.5% in the COVID versus 26.7% in the pre-COVID group (P = 0.15). In the COVID era it took a median of 78 d to visit primary care provider (versus 52 d, P = 0.12 in pre-COVID), 45 d to endoscopy (versus 18 d, P = 0.004) and 38 d to treatment initiation (versus 36 d, P = 0.48). Thirty-five percent of the patients underwent esophagectomy compared to 26% in the pre-COVID-era. Median days of intensive-care-unit (ICU) (2 versus 3, P = 0.16) and hospital stay (14 versus 15, P = 0.28) were similar in both groups as well as postoperative 30-day morbidities (63 versus 63%, P = 0.48). One-year follow-up showed 83.7% (95% confidence interval [CI]: 73.8%-90.1%) survival in the COVID-group compared to 76.4% (95% CI: 66.9%-83.5%) in the pre-COVID-group (P = 0.58). Only three patients had a positive COVID result. ConclusionsOur institution treated fewer esophageal cancer patients during COVID-19 accompanied by a delay in endoscopic diagnosis. Postoperative outcomes and 1-year survival remained similar.

Electronic cigarettes use in COVID-19 era among students of a tertiary institution in Nigeria

Background: Electronic cigarette (e-cigarette) use is becoming popular among undergraduate students in Nigeria with a tendency for escalation because of the coronavirus disease 2019 (COVID-19) pandemic. Aim: The aim of this study was to assess electronic cigarette use in COVID-19 era among undergraduate students of a tertiary institution in Lagos state, Southwestern Nigeria. Setting: A tertiary institution in Southwestern Nigeria. Methods: The study design was a descriptive cross-sectional study with a pretested, structured, close- and open-ended self-administered questionnaire used for collection of data on knowledge, attitude and use of e-cigarettes. Results: Data from 183 respondents were analysed. The mean age of respondents was 24.8 ± 3.38 years, most (63%) of whom were males. The prevalence of ever-use of e-cigarettes was 15.3% of which 60.7% reported increased use of e-cigarettes since the COVID-19 pandemic. Age, education, tribe and religion ( p < 0.001) were significantly associated with higher odds of use of e-cigarettes. Conclusion: This study found an increase in the quantity of e-cigarettes used and online purchase of the same by respondents since the COVID-19 pandemic. Paying attention to the rate of use and having control measures in place for online purchase of e-cigarettes by youths in Nigeria may be necessary in the years to come. Contribution: This study addresses a gap in the availability of knowledge of use of e-cigarettes among a growing population of youths in Nigeria.

The Oral Cavity Potentially Serving as a Reservoir for SARS-CoV-2 but Not Necessarily Facilitating the Spread of COVID-19 in Dental Practice.

Intraoral tissues, secretions, and microenvironments may provide severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with the conditions necessary for viral cellular entry and inhabitation. The aim of the present study is to overview the oral cavity that potentially serves as a reservoir for SARS-CoV-2, and then discuss the possibility that such oral cavity facilitates the spread of coronavirus disease 2019 (COVID-19) in dental practice. Articles were retrieved from PubMed/Medline, LitCovid, ProQuest, Google Scholar, and preprint medRxiv databases. Results of the literature search indicated that SARS-CoV-2 host cell entry-relevant receptor and virus/cell membrane fusion mediators are expressed in major and minor salivary glands, tongue, taste bud, periodontal tissue, and dental pulp, which would be a target and reservoir for SARS-CoV-2. SARS-CoV-2 is present in saliva and gingival crevicular fluid of COVID-19 patients. These secretions would contaminate dental aerosol and droplet with SARS-CoV-2. SARS-CoV-2 inhabits periodontal pocket, gingival sulcus, and dental caries lesion, which could provide SARS-CoV-2 with a habitat. SARS-CoV-2 ribonucleic acid is preserved in dental calculus, which may inform of the previous infection with SARS-CoV-2. Despite involvement of the oral cavity in SARS-CoV-2 transmission and infection, to date, there have been no clusters of COVID-19 in dental practice. Dental settings are much less likely to facilitate the spread of COVID-19 compared with general medical settings, which may be explained by the situation of dentistry that the number of patients to visit dental offices/clinics was decreased during the COVID-19 pandemic, the characteristics of dentistry that dental professionals have maintained high awareness of viral infection prevention, adhered to a strict protocol for infection control, and been using personal protective equipment for a long time, the experimental results that dental devices generate only small amounts of aerosol responsible for the airborne viral transmission, irrigant from the dental unit contributes to the aerosol microbiota much rather than saliva, and the commonly used evacuation or suction system effectively reduces aerosol and droplet generation, and the possibility that human saliva exhibits the antiviral activity and the property to inhibit SARS-CoV-2 infection. It is considered that dental treatment and oral health care can be delivered safely in the COVID-19 era.

Fear of COVID-19 and social distancing on the health behavior of coronary heart disease patients

PurposeThis study aimed to provide basic data to improve the health behavior of patients diagnosed with coronary artery disease during pandemics such as that caused by coronavirus disease 2019 (COVID-19) by identifying the fear of COVID-19 and the degree of social distancing behavior of coronary patients. MethodsIn this study, 162 patients diagnosed with coronary artery disease who received follow-up care at the cardiovascular center of Dong-A University Hospital in Busan were selected. The variables examined in this study included subjects' general characteristics and disease-related characteristics, fear of COVID 19, social distancing behavior, and health behavior. Data were collected from June 8–25, 2021, and data analysis was performed using the IBM SPSS26.0 program. ResultsThe results showed that older participants, those who were religious, those with cohabitants, and those who showed better compliance with social distancing showed better health behavior practice. Factor with the greatest influence on the health behavior of patients with coronary artery disease was social distancing behavior (β = 0.299, p < .001). ConclusionAfter the COVID-19 pandemic, it is necessary to develop a health care program to promote the health behavior of high-risk patients, including coronary artery disease, in preparation for the COVID-19 era. The younger the patient, the fewer health activities are undertaken when living alone, so appropriate education and support for these individuals should increase the rate of implementation of health activities for coronary artery disease.

The importance of considering rhabdomyolysis as the underlying cause of myalgia in patients with COVID-19: A case report

Objective: Since the identification and spread of the novel coronavirus disease 2019 (COVID-19) in December 2019, respiratory presentations have been introduced as the main symptoms of this new type of viral disease; however, the extra-pulmonary features are raising awareness for researchers due to the vast diversity of vital organs affected by the virus. Among the wide range of clinical manifestations, limited data are available regarding rhabdomyolysis (RML) in COVID-19. Case Presentation: In this report, we present a 58-year-old woman with COVID-19 presenting with RML, with extremely elevated creatinine phosphokinase (CPK) and lactate dehydrogenase (LDH) levels (3283 and 1280 U/L, respectively) as the second sign of disease. Since the onset of the COVID-19 pandemic, several COVID-19 induced RML cases have been reported, and timely diagnosis and proper management are of paramount importance. Conclusion: Due to the findings that rhabdomyolysis can be a critical and missed cause of myalgia in COVID-19 patients, the importance of checking the serum level of CPK in patients with myalgia and fatigue in the era of COVID-19 upon their arrival will be highlighted.

Vaccine Mandates in the COVID-19 Era: Changing Paradigm or Public Health Opportunity? Comment on "Convergence on Coercion: Functional and Political Pressures as Drivers of Global Childhood Vaccine Mandates".

The debate around vaccine mandates has flourished over the last decade, with several countries introducing or extending mandatory childhood vaccinations. In a recent study, Attwell and Hannah explore how functional and political pressures added to public health threats in selected countries, motivating governments to increase the coerciveness of their childhood vaccine regimes. In this commentary, we reflect on whether such model applies to the coronavirus disease 2019 (COVID-19) case and how the pandemic has re-shuffled the deck around vaccine mandates. We identify COVID-19 immunisation policies' distinctive aspects as we make the case of countries implementing mass immunisation programmes while relying on digital COVID-19 certificates as an indirect form of mandate to increase vaccine uptake. We conclude by acknowledging that different forms of mandatory vaccination might serve as a shortcut to protect population health in times of emergency, underlining, however, that the ultimate public health goal is to promote voluntary, informed, and responsible adherence to preventive behaviours.

Pediatric asthma control in tertiary care setting using telemedicine during COVID-19 era.

During the coronavirus disease 2019 (COVID-19) pandemic, national measures have affected health care services. Children with asthma were a vulnerable population who were advised to avoid needless hospital visits. Telemedicine was utilized in this circumstance. However, data in Thailand is limited. This study aimed to evaluate asthma control in patients who were followed up by telemedicine compared with in-person visits at an outpatient clinic in Thailand's tertiary academic medical center. This was a retrospective study among pediatric patients with asthma who were followed up in the pediatric pulmonary and allergy clinic of Srinagarind Hospital from 1 January to 31 May 2021. We offered telemedicine (telephone visit) and in-person visits at the hospital by their willingness during this period. All patients were asked about asthma clinical control symptoms, medication compliance, exacerbation events, and hospital admissions by pediatric pulmonologists and allergists. Then, we decided to prescribe in controller medications. In the telemedicine groups, we used the postal service to deliver controller medicine to patients. Among 195 asthmatic children, 83 (42.56%) were followed up by telemedicine. Children who were followed up by telemedicine had more controlled symptoms than the in-person visit group [adjusted relative risk (aRR): 1.219; 95% confidence interval (CI): 1.062-1.400; P value =0.005]. In the in-person visit group, children had more asthma exacerbation events than telemedicine (5 vs. 0, respectively, P value =0.073). During the COVID-19 pandemic, telemedicine follow-up in asthmatic children resulted in well-controlled symptoms and few asthma exacerbation events.

Responses and strategies of Indonesian higher education during COVID-19 pandemic

&lt;span lang="EN-US"&gt;This study aimed to identify the responses and strategies of higher education in Indonesia in dealing with coronavirus disease 2019 (COVID-19). The data in this study came from several legal frameworks and news issued by relevant ministries as well as regulations and news released by universities which were analyzed to map how universities adapt to the COVID-19 situation. In addition, interview to faculty members, students and administrative staffs were also conducted. This study found that the relevant ministries responded no faster than the responses made by universities. The ministry has provided a series of regulations and also guidelines but unfortunately, the universities have published these things first. This research is an initial study to identify responses, obstacles to providing education, and research and community service in the COVID-19 era. This research is the first to investigate how universities conduct the three main tasks of the university in Indonesia investigating responses at the organizational and individual levels to identify responses and obstacles they find.&lt;/span&gt;

Insight into appropriate medication prescribing for elderly in the COVID-19 era.

Coronavirus disease 2019 (COVID-19) complicates clinical management in elderly population. There is an additional need to properly treat and monitor elderly COVID-19 patients. This paper discusses the inappropriate medication prescribing in the elderly and suggests an updated valid assessment tool considering COVID-19 and its treatment.

The effect of family structure on physical activity levels among children and adolescents in Western China in the era of COVID-19

PurposeThis study aimed to examine the levels of physical activity (PA) among children and adolescents in western China, and the influence of parents on their PA, in the era of coronavirus disease 2019 (COVID-19).MethodsThis cross-sectional study used a multistage questionnaire to evaluate 4800 children and adolescents of grades 4–12 (9–17 years old) from 48 primary and secondary schools across 16 districts and counties in western China. In addition to PA, questionnaires collected data on demography, family structure, and exercise habits. Data were assessed using the International Physical Activity Questionnaire-Short Form (IPAQ-SF) and analyzed using chi-square tests, t-tests, Spearman’s correlation, and logistic regression models in SPSS.ResultsIn this study, a minority (42.1%, n = 1553) of children and adolescents met the daily exercise target (60 min) recommended by the World Health Organization (WHO). Moderate- to vigorous-intensity physical activity (MVPA) level of boys was significantly higher than that of girls. Regardless of sex, children with the highest MVPA levels were those in grades 4–6, and PA levels decreased with increasing age. Furthermore, for every hour of increase in the daily MVPA of parents, the MVPA also increased by 6.1–13.9 min in children and adolescents. Moreover, areas of higher economic development were associated with lower levels of MVPA.ConclusionsOverall, this study found a low level of MVPA in children and adolescents of western China; both family structure and parental activity have a significant influence on the children's PA levels. Besides, the impact of COVID-19 on PA levels has not been entirely negative.

Bibliometric analysis of COVID-19 publications shows the importance of telemedicine and equitable access to the internet during the pandemic and beyond.

Pandemics highlight the increasing role of information and communications technology for improving access to health care. This study aimed to present a bibliometric analysis of the concept of digital divide reported in the published articles concerning the coronavirus disease 2019 (COVID-19) pandemic. To conduct this bibliometric analysis of research topics and trends, we used VOSviewer software. We developed a search strategy to retrieve peer-reviewed publications related to 'digital divide in the COVID-19 era' from the Scopus database. In total, 241 publications on the topic of digital divide and COVID-19 were retrieved from Scopus database between 2020 and 2021. The analysis of keywords co-occurrence of research topics revealed four main clusters including: 'telemedicine', 'Internet access and Internet use', 'e-learning' and 'epidemiology'. Seven characteristic categories were examined in these research topics, including: sociodemographic, economic, social, cultural, personal, material and motivational. 'Telemedicine' and 'Internet access and Internet use' as the largest clusters are connected to topics addressing inequalities in online health care access. Thus, policymakers should develop or modify policies in more egalitarian Internet access for all community members not only during a pandemic like the COVID-19 but also at regular times.

Relationship between nosocomial infections and coronavirus disease 2019 in the neurosurgery unit: clinical characteristics and outcomes from a Chinese Tertiary-Care Hospital

BackgroundThe COVID-19 pandemic has raised awareness of infection prevention and control. We found that the incidence of nosocomial infection in neurosurgery has changed. This study aimed to evaluate the impact of “coronavirus disease 2019 (COVID-19) prevention and control measures” on nosocomial infections in neurosurgery.MethodsTo explore changes in nosocomial infections in neurosurgery during the COVID-19 pandemic, the clinical data of inpatients undergoing neurosurgery at Taizhou Hospital of Zhejiang Province between January 1 and April 30, 2020 (COVID-19 era) were first analyzed and then compared with those from same period in 2019 (first pre-COVID-19 era). We also analyzed data between May 1 and December 31, 2020 (post-COVID-19 era) at the same time in 2019 (second pre-COVID-19 era).ResultsThe nosocomial infection rate was 7.85% (54/688) in the first pre-COVID-19 era and 4.30% (26/605) in the COVID-19 era (P = 0.01). The respiratory system infection rate between the first pre-COVID-19 and COVID-19 eras was 6.1% vs. 2.0% (P < 0.01), while the urinary system infection rate was 1.7% vs. 2.0% (P = 0.84). Between the first pre-COVID-19 and COVID-19 eras, respiratory system and urinary infections accounted for 77.78% (42/54) vs. 46.15% (12/26) and 22.22% (12/54) vs. 46.15% (12/26) of the total nosocomial infections, respectively (P < 0.01). Between the second pre-COVID-19 and post-COVID-19 eras, respiratory system and urinary accounted for 53.66% (44/82) vs. 40.63% (39/96) and 24.39% (20/82) vs. 40.63% (39/96) of the total nosocomial infections, respectively (P = 0.02).ConclusionsThe incidence of nosocomial infections in neurosurgery reduced during the COVID-19 pandemic. The reduction was primarily observed in respiratory infections, while the proportion of urinary infections increased significantly.

Surgical intervention for acute pancreatitis in the COVID-19 era.

Approximately 15%-19% of patients with severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infections develop gastrointestinal symptoms. Acute pancreatitis (AP) has been reported in 0.1% of patients with coronavirus disease 2019 (COVID-19). Biliary AP was most common (78.4%) before the COVID-19 pandemic; idiopathic AP is most common in patients with COVID-19 (up to 57.1%). The number of emergency department presentations decreased by 23.3% during the pandemic and many governments made national recommendations to delay nonurgent endoscopic procedures, leading to decrements of 22% in combined esophagogastroduodenoscopy (EGD) and colonoscopy and 20% in EGD after the COVID-19 pandemic. The symptoms and signs of COVID-19-related AP are fever (63%), abdominal pain (58%), respiratory symptoms (40%), nausea and vomiting (39%), and headache (4%). Approximately 5-10% of patients develop necrotizing or hemorrhagic AP, and patients who required surgical intervention had a higher mortality risk. Compared to 2019, the rates of elective surgery decreased by 41.8% in 2020; including cholecystectomy (40.1% decrease) and pancreas (111.1% decrease). Surgical volumes also decreased by 18.7% in 2020; device-assisted laparoscopic and robot-assisted procedures reduced by 45.4% and 61.9% during the COVID-19 Lockdown in 2020.

Emergency Medical Services Preparedness in Dual Disasters: War in the Era of COVID-19 in Armenia.

Emergency Medical Services (EMS) is a critical part of Disaster Medicine and has the ability to limit morbidity and mortality in a disaster event with sufficient training and experience. Emergency systems in Armenia are in an early stage of development and there is no Emergency Medicine residency training in the country. As a result, EMS physicians are trained in a variety of specialties.Armenia is also a country prone to disasters, and recently, the Armenian EMS system was challenged by two concurrent disasters when the 2020 Nagorno-Karabakh War broke out in the midst of the SARS-CoV-2/coronavirus disease 2019 (COVID-19) pandemic. This study aims to assess the current state of disaster preparedness of the Armenian EMS system and the effects of the simultaneous pandemic and war on EMS providers. This was a cross-sectional study conducted by anonymous survey distributed to physicians still working in the Yerevan EMS system who provided care to war casualties and COVID-19 patients. Survey response rate was 70.6%. Most participants had been a physician (52.1%) or EMS physician (66.7%) for three or less years. The majority were still in residency (64.6%). Experience in battlefield medicine was limited prior to the war, with the majority reporting no experience in treating mass casualties (52.1%), wounds from explosives (52.1%), or performing surgical procedures (52.1%), and many reporting minimal to no experience in treating gunshot wounds (62.5%), severe burns (64.6%), and severe orthopedic injuries (64.6%). Participants had moderate experience in humanitarian medicine prior to war. Greater experience in battlefield medicine was found in participants with more than three years of experience as a physician (z-score -3.26; P value <.01) or as an EMS physician (z-score -2.76; P value <.01) as well as being at least 30 years old (z-score -2.11; P value = .03). Most participants felt they were personally in danger during the war at least sometimes (89.6%). Prior to the COVID-19 pandemic and simultaneous 2020 Nagorno-Karabakh War, EMS physicians in Armenia had limited training and experience in Disaster Medicine. This system, and the frontline physicians on whom it relies, was strained by the dual disaster, highlighting the need for Disaster Medicine training in all prehospital medical providers.

Emerging Bacterial Pathogens in the COVID-19 Era: Chryseobacterium gleum -A Case in Point.

Introduction In the ongoing severe acute respiratory syndrome coronavirus 2 pandemic, a long hospital stay and empirical broad-spectrum antibiotics make the patients prone to acquire nosocomial infections especially with unconventional organisms, and Chryseobacterium gleum is one such rare nosocomial pathogen. Methods The given study is a case-series-based study conducted from September 2020 to April 2021 in which clinically suspected pneumonia patients who recovered from coronavirus disease 2019 (COVID-19) were included. Results Seventeen C. gleum isolates were obtained in pure culture from the tracheal aspirates of nine COVID-19 patients (including repeat samples to rule out colonization) within a period of eight months (September 2020-April 2021). Our records showed that there has been an increase in the number of isolates of C. gleum obtained in respiratory samples in 2020. We also did a review of literature of all the cases of C. gleum pneumonia reported till now. Conclusion To the best of our knowledge, this is the first study reporting the isolation of this rare pathogen from COVID-19 patients with clinical significance in a large cohort of patients. Therefore, it becomes important to consider this pathogen as a significant cause of respiratory infections, especially in patients recovered post COVID-19.

Elderly women and COVID-19 vaccination in the indigenous religio-culture of the Ndau of south-eastern Zimbabwe

Coronavirus disease 2019 (COVID-19) is steadily becoming a tameable, mild communicable disease globally. In the Western countries and some countries in Asia, such as China, for example, this milestone is owed to a high response to vaccination programmes. The same cannot be said of Africa, where the uptake of vaccines has not been encouraging. In Zimbabwe, for example, the government had intended to vaccinate at least 10 million of its estimated 16 million population in order to reach herd immunity. The figures are still very small, indicating vaccine hesitancy. In this article, it is contended that vaccination campaigns must be adapted to local religious culture and engage critically with the elderly women in particular. Indigenous religio-cultural beliefs and practices can either mobilise or immobilise individuals and communities in implementing the COVID-19 containment measures, depending on how they are approached. To this end, any response to the pandemic should never be exclusively unidirectional. This article employs cultural hermeneutics as its lens of analysis. It does not only seek to promote life-giving values associated with elderly women in African religio-cultures but also to interrogate negative practices driven by religio-culture that put their lives at risk in the era of COVID-19. Elderly women are at worst vulnerable to the disease, and at best they are the hub of communities’ health services. Packaging the vaccination campaigns in the religio-cultural and spiritual consciousness of a people has a potential to increase vaccine uptake in line with the spirit of Goal 3 of the United Nations Agenda 2030. This article is both theoretical and empirical. It uses the Ndau of south-eastern Zimbabwe to ascertain the meaning that they create about the elderly women’s interaction with the public health call for vaccination in the context of their religio-culture. The term ‘religio-culture’ has been used because throughout Africa, religion and culture are inseparably tied together. Data are generated through interviews with key informants.Contributions: Elderly women are vulnerable to COVID-19. Despite their vulnerability, Ndau elderly women find themselves compelled by their religio-culture to respond to the crisis in their communities. There is no literature that addresses the paradox and its attendant opportunities and challenges that characterise the circumstances of elderly women in the context of COVID-19 in the efforts to motivate vaccine uptake. The article shows that indigenous religio-cultural beliefs and practices can either mobilise or immobilise individuals and communities in taking the COVID-19 vaccines, depending on how they are approached.

Lockdown Amid COVID-19 Ascendancy over Ambient Particulate Matter Pollution Anomaly.

Air is a diverse mixture of gaseous and suspended solid particles. Several new substances are being added to the air daily, polluting it and causing human health effects. Particulate matter (PM) is the primary health concern among these air toxins. The World Health Organization (WHO) addressed the fact that particulate pollution affects human health more severely than other air pollutants. The spread of air pollution and viruses, two of our millennium’s most serious concerns, have been linked closely. Coronavirus disease 2019 (COVID-19) can spread through the air, and PM could act as a host to spread the virus beyond those in close contact. Studies on COVID-19 cover diverse environmental segments and become complicated with time. As PM pollution is related to everyday life, an essential awareness regarding PM-impacted COVID-19 among the masses is required, which can help researchers understand the various features of ambient particulate pollution, particularly in the era of COVID-19. Given this, the present work provides an overview of the recent developments in COVID-19 research linked to ambient particulate studies. This review summarizes the effect of the lockdown on the characteristics of ambient particulate matter pollution, the transmission mechanism of COVID-19, and the combined health repercussions of PM pollution. In addition to a comprehensive evaluation of the implementation of the lockdown, its rationales—based on topographic and socioeconomic dynamics—are also discussed in detail. The current review is expected to encourage and motivate academics to concentrate on improving air quality management and COVID-19 control.

Profit, cash flow, and leverage: the case of ASEAN stock market performance during the COVID-19 pandemic

PurposeThe coronavirus disease 2019 (COVID-19) outbreak in the first quarter of 2020 has caused a severe decline in stock markets worldwide. While prior studies in developed markets found that workplace closure can negatively impact the capital market (e.g. Ozili and Arun, 2020), lesser is known about how it impacts emerging capital markets, which may have different characteristics and behaviour (Harjoto et al., 2021). Hence, this study seeks to uncover stock performance around workplace closure dates of firms incorporated in ASEAN countries and investigates the role of accounting fundamentals in mitigating workplace closure policy's effects on stock performances.Design/methodology/approachUsing an event study methodology, the authors measure the cumulative abnormal returns (CARs) around workplace closure dates. The authors then use cross-sectional analysis to analyse whether the accounting fundamentals, specifically profitability, cash flow, and leverage, are associated with the CAR. This cross-sectional study involves 1,720 firms that are incorporated in the ASEAN countries.FindingsThis analysis indicates that, on average, ASEAN capital markets react negatively to workplace closure policies. The authors then find that the CARs around workplace closure dates are positively associated with the current ratios and are negatively associated with long-term debt ratios. This study’s results thus indicate that firms with a higher liquidity and a higher solvency experience a less adverse impact of the COVID-19 pandemic than other firms. The authors also find that the associations are more robust for (1) firms in industries more affected by COVID-19 and (2) firms located in countries with more severe cases. Additionally, contrary to this study’s expectation, the authors do not find meaningful associations between CARs around workplace closure dates and firms' cash flow from operation and profit respectively. This study’s results suggest that investors view prior performances related to firms' ability to generate operating cash flow and profit as less relevant to measure firm performance around the workplace closure event.Research limitations/implicationsThis study’s results contribute to studies examining fundamental accounting roles during the COVID-19 era, specifically in emerging economies. The findings are critical for investors in understanding the company fundamentals associated with stock price performance in emerging markets during the recent health-related crisis.Originality/valueMost studies analysing cross-sectional differences in stock returns during the COVID-19 era focus on industry-level differences and use observations from developed markets (Sinagl, 2020; Ramelli and Wagner, 2020). Studies using firm-level analysis in emerging markets are still limited. The authors expand prior studies by using firm-level analysis that spans six countries in ASEAN.