Future Pandemics Research Articles

Examining moral distress and injury resulting from the COVID-19 pandemic: Insights from the Ghanaian radiography workforce

BackgroundMoral distress has been an issue under consideration in healthcare practice. The COVID-19 pandemic became a critical factor that contributed to heightened moral distress and injury among healthcare professionals, including radiographers. Despite the substantial engagement of radiographers in the management of COVID-19 patients, the consequent moral distress and injury states experienced by this critical frontline workforce have not been widely explored. This study investigated the level of moral distress and the coping mechanisms employed by radiographers in Ghana during the pandemic to provide valuable information to support radiographers and prepare the workforce better against any future pandemics. MethodsUtilising a cross-sectional design, a survey approach was employed for data collection between June 2023 and August 2023 from clinically-active radiographers who worked before and during the pandemic in Ghana. Both descriptive and inferential statistics were generated using Microsoft Excel 2019 and the Statistical Package for the Social Sciences (v.26). ResultsHundred (100) radiographers participated in the study. The result demonstrated that the COVID-19 pandemic escalated the risk of moral distress among radiographers from 22 % (n = 22) to 43 % (n = 43), with 33 % (n = 33) exhibiting signs of moral injury. This escalation impacted the mental health of 12 % (n = 12) of respondents and was reported as a contributor to career-changing decisions among radiographers. Notably, many of those affected did not seek formal support but relied on personal coping strategies and family support. Inadequate resources (69 %, n = 69), particularly regarding consumables, emerged as the primary cause of moral distress. The study underscored that the most effective means of mitigating moral distress in radiographers was through the provision of resources and additional staff support (66 %, n = 66). ConclusionThis study sheds light on the state of moral distress and injury among radiographers during the COVID-19 pandemic, impacting the mental health of a minority and contributing to career-changing decisions. The findings emphasise the importance for healthcare institutions to proactively implement systems, such as resource provision, improved staffing, and emotional support, now and during similar future pandemics. This is crucial to address moral distress and cater to the mental health needs of radiographers, ensuring a resilient clinical radiography workforce.

Predictors of the continuous use of an infectious disease self-management app for epidemiological investigations: a survey of young and middle-aged adults in South Korean citizens.

In the wake of the coronavirus disease-19 (COVID-19) pandemic, research on the difficulties faced by epidemiologists conducting epidemiological investigations has been progressing steadily. However, few studies have developed applications (apps) that can directly support epidemiological investigations via information and communication (ICT) technology, and conducted usability evaluations on them via user responses. This has caused difficulties when developing such technologies. We introduced and evaluated two mobile apps that support epidemiological investigations. This study attempted to identify the predictors affecting the acceptance of infectious disease self-management apps. We developed two infectious disease self-management smartphone apps for epidemiological investigations: KODARI (the Korean version) and MEDARI (in English version). We collected data from 248 users of KODARI by surveying Korean citizens. This study was conducted from November 15 to December 14, 2022. We used multiple regression analysis to identify the variables that affected continuous intention to use the KODARI app. We conducted two independent-samples t-tests to determine whether there were any differences in the perception of each variable in relation to demographic and COVID-19-related user characteristics. The factors that affected continuous intention to use the KODARI app, in order of relative importance, were: price value, satisfaction, performance expectancy, and facilitating conditions. Overall, male participants were more satisfied with the KODARI app than female ones, and more willing to continue using it. The male participants also evaluated facilitating conditions more positively than the female ones did. Married participants rated the app higher than single ones in terms of price value, performance expectancy, and continued intention to use. The study suggests factors that increase the use of health apps and suggests that use of these apps may increase further in the event of a future pandemics. These results are expected to help researchers study other infectious disease apps in the context of public health surveillance.

At risk but not adequately included: People with disabilities’ experience of COVID-19 in Zambia

Background: COVID-19 had an impact on all sections of society, including people with disabilities.Objectives: The authors aimed to explore the needs and experiences of people with disabilities in Zambia during the COVID-19 pandemic.Method: In this hermeneutic phenomenological study, we used a semi-structured interview guide to collect data from a purposive and snowball sample of 40 people with disabilities and their caregivers. The participants were from 11 districts in 6 provinces in Zambia. The in-depth interviews were done between July 2022 and November 2022. Data were managed in NVivo and analysed using reflexive thematic analysis.Results: The three themes included: (1) awareness and experience of public health measures on COVID-19 among people with disabilities; (2) experience of othering and stigmatisation as people with disability during the COVID-19 pandemic and (3) experience of COVID-19 symptoms and having COVID-19 among people with disabilities.Conclusion: Interventions were largely unresponsive to the needs of people with disabilities, exacerbating the risk of exposure to infection. In future, adaptations like emergency risk communication in braille, audio and sign language interpretation in adapted communication formats should be made. Further studies are needed to quantify the gaps in access to health, explore policies and strategies to improve health outcomes for people with disabilities in LMICs like Zambia.Contribution: The findings may contribute to the development and enhancement of policies and interventions responsive to the needs of people with disabilities in future pandemics in the Zambian context.

Canada needs a national COVID-19 inquiry now.

We are now in the fifth year of an ongoing pandemic, and Canada continues to experience significant surges of COVID-19 infections. In addition to the acute impacts of deaths and hospitalizations, there is growing awareness of an accumulation of organ damage and disability which is building a "health debt" that will affect Canadians for decades to come. Calls in 2023 for an inquiry into the handling of the COVID-19 pandemic went unheeded, despite relevant precedent. Canada urgently needs a comprehensive review of its successes and failures to chart a better response in the near- and long-term. While Canada fared better than many comparators in the early years of the COVID-19 pandemic, it is clearly still in a public health crisis. Infections are not only affecting Canadians' daily lives but also eroding healthcare capacity. Post-COVID condition is having accumulating and profound individual, social, and economic consequences. An inquiry is needed to understand the current evidence underlying policy choices, identify a better course of action on various fronts, and build resilience. More must be done to reduce transmission, including a serious public education campaign to better inform Canadians about COVID and effective mitigations, especially the benefits of respirator masks. We need a national standard for indoor air quality to make indoor public spaces safer, particularly schools. Data collection must be more robust, especially to understand and mitigate the disproportionate impacts on under-served communities and high-risk populations. General confidence in public health must be rebuilt, with a focus on communication and transparency. In particular, the wide variation in provincial policies has sown mistrust: evidence-based policy should be consistent. Finally, Canada's early success in vaccination has collapsed, and this development needs a careful post-mortem. A complete investigation of Canada's response to the pandemic is not yet possible because that response is still ongoing and, while we have learned much, there remain areas of dispute and uncertainty. However, an inquiry is needed to conduct a rapid assessment of the current evidence and policies and provide recommendations on how to improve in 2025 and beyond as well as guidance for future pandemics.

Socioeconomic status and adherence to COVID-19 preventative measures in Australia: A national cohort study.

The uptake of recommended preventative measures is a critical concern for protecting the public against COVID-19 outbreaks and future pandemics. However, it is unclear to what extent COVID-19 preventative measures were followed in Australia. This study aims to determine adherence level to COVID-19 preventative measures in 2021, and whether these were associated with socioeconomic status (SES). This was a national cross-sectional study using data from the Household Income and Labour Dynamics in Australia (HILDA) survey. This study included 15 457 community-dwelling adults (18 years or older) who participated in the 2021 wave of HILDA survey. SES was assessed by the Socio-Economic Index For Areas (SEIFA) score, split into quintiles. Outcomes included self-reported adherence to COVID-19 preventative measures (mask wearing, keeping distance, staying home; sum score range 3-15) and COVID-19 status (yes/no). Linear and logistic regression were used accordingly to assess the association between SES and the sum score of adherence to COVID-19 measures, and COVID-19 vaccination status. Adherence to COVID-19 preventative measures and uptake of COVID-19 vaccine in Australia in 2021 were moderate (between 60% and 70%). Regression models showed higher SES was associated with a slightly higher score of adherence (β = .08, 95% CI = .04-.12) and a higher likelihood of self-reporting receiving COVID-19 vaccination (OR 1.27, 95% CI = 1.23-1.31). SES was positively associated with the level of adherence to COVID-19 preventative measures and the probability of receiving COVID-19 vaccine. The findings of this study highlight the potential benefits of considering SES, particularly its impact on equity and access, when designing an educational program or awareness campaign in times of crisis. SO WHAT?: The findings of this study highlight the importance of considering SES when designing an educational program or an awareness campaign in times of crisis.

Measuring influencing factors affecting mortality rates during the COVID-19 pandemic

ABSTRACT Background The COVID-19 pandemic has revealed clear deficiencies in global public health policies and healthcare systems when confronted with the emergence of a novel and deadly infectious disease. Objectives With 4 years elapsed since the onset of the pandemic, ample data now exist to analyse the associations between the implementation of diverse public health policies, sociodemographic factors and COVID-19 mortality rates. Methods This study utilised the dataset compiled by ‘Our World in Data’ spanning the period of the COVID-19 pandemic from 2020 to 2022. Stochastic frontier analysis was employed to assess the influencing factors and their relationship with mortality rates resulting from COVID-19 infections across 156 countries or regions. Results This study yielded several key findings: (1) There remains a 33% margin for improvement in the global mortality rate concerning the COVID-19 pandemic; (2) During the initial stage of the pandemic, when an effective vaccine was not yet available, implementing public health control policies could reduce both the infection and mortality rates; (3) Areas characterised by higher population densities, a greater proportion of individuals aged 65 and over, and elevated prevalence rates of diabetes demonstrated higher mortality rates; and (4) Increasing vaccination coverage emerged as an effective strategy for reducing mortality rates. Conclusions As our understanding of the COVID-19 virus improves, global economies and social interactions have gradually returned to normality. It is anticipated that the findings of this study can serve as a valuable reference in combating potential future pandemics caused by unknown viruses.

Teaching infectious diseases during and in the aftermath of the COVID-19 pandemic – middle school teachers’ choice of content and instructional approaches

ABSTRACT The COVID-19 pandemic impacted immensely in schools worldwide, emphasising the pivotal importance of infectious diseases. This study aims to delineate the teaching of diseases in middle schools, investigating how content and instruction was influenced in the aftermath of the pandemic. Semi-structured individual interviews were conducted with teachers. The analytical method involved thematic analysis. The first analysis concerned teaching content was based on the framework of contagion literacy. The second analysis investigated the teaching approaches through an inductive analysis. The findings suggest that the pandemic had an impact on the biology teaching in relation to infectious diseases. During the pandemic, teaching largely revolved around student-initiated, question-driven discussions about current events related to societal health initiatives within schools, rather than expanding the planned biology curriculum. The main finding is that teachers focused on hygiene and to influence students’ behaviours interactively. The pandemic was not fully exploited by the participating teachers to develop more curriculum-based teaching including functional and critical health literacy perspectives. The study recommends that biology teachers collaborate with school health teams and engage in interdisciplinary work. We also suggest to amend primary science teacher education to meet the need to teach the young people in the event of future pandemics.

Can self-testing be enhanced to hasten safe return of healthcare workers in pandemics? Random order, open label trial using two manufacturers' SARS-CoV-2 lateral flow devices concurrently and nested viral culture study.

Covid-19 healthcare worker testing, isolation and quarantine policies had to balance risks to patients from the virus and from staff absence. The emergence of the Omicron variant led to dangerous levels of key-worker absence globally. We evaluated whether using two manufacturers' lateral flow tests (LFTs) concurrently improved SARS-CoV-2 Omicron detection significantly and was acceptable to hospital staff. In a nested study, to understand risks of return to work after a 5-day isolation/quarantine period, we examined virus culture 5-7 days after positive test or significant exposure. Fully-vaccinated Liverpool (UK) University Hospitals staff participated (February-May 2022) in a random-order, open-label trial testing whether dual LFTs improved SARS-CoV-2 detection, and whether dual swabbing was acceptable to users. Participants used nose-throat swab Innova and nose-only swab Orient Gene LFTs in daily randomised order for 10 days. A user-experience questionnaire was administered on exit. Selected participants gave swabs for viral culture on days 5-7 after symptom onset or first positive test. Cultures were considered positive if cytopathic effect was apparent or SARS-CoV-2 N gene sub-genomic RNA was detected. Two hundred and twenty-six individuals reported 1466 pairs of LFT results. Tests disagreed in 127 cases (8.7%). Orient Gene was more likely (78 cf. 49; OR: 2.1, 1.1-4.1; P = 0.03) to be positive. If Innova was swabbed second, it was less likely to agree with a positive Orient Gene result (OR: 2.7, 1.3-5.2; P = 0.005); swabbing first with Innova made no significant difference (OR: 1.1, 0.5-2.3; P = 0.85). Orient Gene positive Innova negative result-pairs became more frequent over time (OR: 1.2, 1.1-1.3; P < 0.001). Of individuals completing the exit questionnaire, 90.7% reported dual swabbing was easy, 57.1% said it was no barrier to their daily routine and 65.6% preferred dual testing. Respondents had more confidence in dual versus single test results. Viral cultures from days 5-7 were positive for 6/31 (19.4%, 7.5%-37.5%) and indeterminate for 11/31 (35.5%, 19.2%-54.6%) LFT-positive participants, indicating they were likely still infectious. Dual brand testing increased LFT detection of SARS-CoV-2 antigen by a small but meaningful margin and was acceptable to hospital workers. Viral cultures demonstrated that policies recommending safe return to work ~ 5 days after Omicron infection/exposure were flawed. Key-workers should be prepared for dynamic self-testing protocols in future pandemics. https://www.isrctn.com/ISRCTN47058442 (26 January 2022).

Modeling Of Mask Detection Systems, Distance Between Objects And Facial Recognition Using The Tiny-YOLOV4 Method, Convolutional Neural Network, And Viola Jones

The development of technology is currently increasing very rapidly, the latest technology such as Face Detection and Face Recognition in public facilities has been widely applied, such as cameras for attendance, facial detection devices as mobile phone security and various other new innovations in the field of technology. The purpose of creating this model is to determine the distance, and the use of masks in public places and to determine the performance when the two algorithms between Tiny-YOLOV4 and Viola Jones are combined. This method uses CPU testing with a clock speed of 2.9 GHz and GPU with a clock speed of 1590 MHz with an accuracy level of 92.6% for mask object detection and 90.67% for face recognition with a maximum distance in front of the camera for human detection is 830 centimeters, mask detection 730 centimeters, and face recognition 530 centimeters. The results of the study produced an accuracy of 92.6% for mask detection and an accuracy of 90.67% for face recognition at maximum distances of 730 cm and 530 cm respectively. The conclusion shows that this system is effective for detecting masks, faces, and distance, providing a significant tool for monitoring compliance in public spaces. Implementing this system can serve as a preventive measure for potential future pandemics

EPID-31. IMPACT OF THE COVID-19 PANDEMIC ON THE UTILIZATION OF STEREOTACTIC RADIOSURGERY AMONG RACIAL MINORITIES DIAGNOSED WITH BRAIN METASTASES

Abstract OBJECTIVES Brain metastases (BM) is the most common form of adult brain tumors and one of the devastating consequences of cancer. Stereotactic radiosurgery (SRS) is an established and effective treatment for oligometastatic BMs. We examined how COVID-19 pandemic impacted clinical utilization of SRS in BM treatment and generalize such impact to outpatient care for patients with all cancer types. METHODS Three national-scale datasets were used: National Cancer Database (NCDB,N=5,238), the National COVID Cohort Collaborative database (N3C, N=13,106 for BM, N=203,706 for all cancer types), and SEER. Multivariable logistic regression models were performed to determine whether the pandemic affected clinical utilization of SRS in BM treatment and chemotherapy initiation for all cancer types. RESULTS Prior to 2019 (pre-pandemic), we observed no racial disparity in the odds of receiving SRS between non-Hispanic white (NHWs) and non-Hispanic black (NHBs) BMs in both NCDB and N3C. Between 2020 and 2021 (pandemic), however, NHBs were significantly less likely to receive SRS comparing to NHWs in both NCDB (NHB:aOR-0.77,p=0.002) and N3C (NHB:aOR-0.78,p&amp;lt;0.001). In SEER, the age-adjusted incidence rate of BM remained unchanged when comparing pre- and post-pandemic periods. Further substantiating the impact of COVID-pandemic on racial disparity in outpatient care for all cancer patients, we showed that NHB patients were more likely to receive delayed chemotherapy (&amp;gt;60 days since diagnosis of cancer) compared to NHWs during the pandemic (aOR-1.10, p&amp;lt;0.001), but such association was not detected before pandemic. Ratio of odds ratio (ROR) analysis confirmed that NHB patients comparing to NHWs during pandemic experienced 1.11-fold difference in the odds of delayed chemotherapy between NHBs and NHWs before pandemic [ROR=1.11, p&amp;lt;0.001]. CONCLUSION Racial disparity in SRS-receipt for BM patients has been exacerbated during COVID-19 pandemic and such impact could be generalized to outpatient care for all cancer types. Understanding the determinants giving rise to this disparity should augment the readiness of our cancer care infrastructure in anticipation of future pandemics or other public health crises.

A Platinum-Graded Green Hospital Building in India during COVID-19 Pandemic: From Planning to Execution and Outcome

Background: A green hospital building has superior qualities over general hospital buildings in terms of energy conservation, use of natural resources, clean indoor air quality, green housekeeping, and other characteristics that improve patient outcomes. During the COVID-19 pandemic, healthcare organizations worldwide faced significant challenges and difficulties running hospitals. These challenges motivated the healthcare administration to find possible solutions for possible protocols for the functioning of the hospital. Methods: It was a prospective study conducted at a tertiary care hospital in north India from March 2020 to Feb 2022. After multiple changes in the fields of committee formation, human resource management, training, setting of the donning area and the doffing area, setting of the patient care areas and the infection control practices, equipment utilization, protocols for the support services, patient status updation to family members, and finally maintaining the patient data for the official purpose. Results: The hospital statistics showed a recovery rate of 81%, a mortality rate of 18%, and average length of stay of 8 days in COVID-19 patient care. Conclusion: The experiences, the challenges learned, and the solutions made to combat this pandemic will be the guide for future pandemics. The green hospital building proved its supremacy in patient outcomes and is recommended by hospital administrators as a future hospital building.

Critical roles of leadership and management to the suffocation of tertiary education sector during the Covid-19 pandemic: A critique of human migration

This research explores the coping mechanisms of the tertiary education sector during the Covid-19 pandemic from the point of view of the restricted human migration. The research is conceptual and empirical in nature within the qualitative research paradigm. Interviewing technique and narrative enquiry were employed to generate data pertaining to the restricted human mobility during the Covid-19 pandemic. Out of the population of 25 public higher education institutions, in South Africa, only 2 were conveniently sampled for intensive study on restricted human migration of their employees during the Covid-19 lockdown. This paper is therefore, a case study of 2 public higher education institutions. Research findings revealed that firstly, organisational efficacy took a nosedive during the Covid-19 pandemic. Secondly, there was a controversy of the mandatory immunizations within the migrants. Thirdly, the application of migration segregation aggravated the state of affairs. Fourthly, inhibition of the already planned face-to-face conference attendance crippled the education sector. Lastly, compromising of quality assessment practices particularly at institutions of higher learning was a disservice and disruptions to the education sector. Exemption of the education sector from the suffocation of restrictive health protocols in case of similar Covid-19 pandemics in future is recommended.

Migration, Urbanism and Health: Moving Toward Systems-Informed Policy and Practice

Migration and displacement are pivotal determinants of urban health, influencing both direct and indirect health outcomes. Migrants may face unique health risks, often exacerbated by economic, social, and environmental factors encountered during transit or upon resettlement. As migration patterns shift due to geopolitical, climatic, and economic pressures, they reshape the global and urban policy landscapes in unpredictable ways, presenting challenges that will continue to evolve in the coming decades. Current legal frameworks, in many cases, do not adequately account for migrant populations, hindering policy responses and complicating the protection of migrant health. Therefore, effective urban health interventions must be inclusive of migrant populations and expand beyond healthcare services. A systems-thinking approach that recognizes the broader determinants of health—including housing, employment, social services, and urban infrastructure—is essential to address the intersecting challenges migrants face. Despite these challenges, migration remains crucial to the functioning of urban environments. Migrant workers consistently contribute to the healthy operation of cities, underpinning key infrastructure and services. However, to optimize policy responses and improve urban health outcomes, more robust data and evidence on the health risks and outcomes of migrants, as well as the structural drivers of migration, are needed. Moreover, macro factors such as climate change, future pandemics, and geopolitical shifts are likely to influence both migration dynamics and migrant health. To anticipate and respond to these evolving challenges, a systems-informed and holistic vision of urban health is required—one that integrates migration into the broader urban policy and planning frameworks to foster healthier, more resilient cities.

Predictive biomarkers for severity of respiratory syndrome: the role of eGFR and hematological parameters in ICU patients

Introduction: Studying respiratory syndromes like COVID-19 is crucial for understanding viral-induced inflammatory responses and their impact on organ function. Insights from these studies are essential for managing current and future pandemics and improving patient outcomes in respiratory health crises. This study investigates the behavior of the estimated glomerular filtration rate (eGFR) and its correlation with hematological parameters in ICU patients with COVID-19. Objective: To assess eGFR behavior and its correlation with hematological parameters in respiratory syndromes ICU patients. Materials and Methods: 217 patient records were analyzed, with 144 discharged and 73 deaths. Patients were divided into discharge and death groups and laboratory parameters such as glomerular filtration rate and blood count were.evaluated at admission and outcome. Results and Discussion: There was a significant reduction in eGFR among patients in the death group at both admission and outcome. Significant correlations were observed between eGFR and hemoglobin (Hb), total neutrophils (N), and platelets (PLT) at the outcome. These findings suggest that the reduction in eGFR is a predictor of poor prognosis in COVID-19 ICU patients. Additionally, the significant correlations between eGFR and hematological parameters highlight their role in the inflammatory process and clinical deterioration. Conclusion: The reduction of eGFR is a significant predictor of poor prognosis in ICU patients with COVID-19. Significant correlations between eGFR and hematological parameters underscore their importance in the inflammatory process and disease progression. Studying respiratory syndromes like COVID-19 is crucial for understanding viral-induced inflammatory responses and improving critical care strategies for future respiratory health crises.

A rapid and versatile reverse genetic approach and visualization animal models for emerging zoonotic pseudorabies virus

Pseudorabies virus (PRV), a member of the Alphaherpesvirinae subfamily and a causative pathogen of Aujeszky's disease, has a broad host range including domestic and wild animals. PRV has been reported as a causative agent in patients with acute encephalitis in 2021, which suggests PRV might be a novel animal-origin virus in terms of zoonotic spillover and spread potential. To manage current PRV epidemics in pigs and prepare for future pandemics in other species including humans. Fundamental techniques essential for procuring such knowledge on prevention and therapy of PRV. Here, PRV CD22 strain was isolated and phylogenetic analysis showed that PRV CD22 belongs to the current epidemic strains in China. PRV CD22 was highly lethal to mice and piglets in vivo. Moreover, a rapid and efficient system to generate recombinant PRV was constructed based on PRV CD22 genomic DNA fosmid library. Using this system, a recombinant PRV strain expressing engineered labeling protein was rescued for visualization of viral infection in mouse model. Our study allows the generation of PRV that can be used for downstream treatment analyses. Once experimental or surveillance samples are obtained, PRV can be generated and treated efficiently based on our study.

Children and adolescents’ experiences of mandatory SARS-CoV-2 testing in schools: a cross-sectional survey

BackgroundPublic health measures during the COVID-19 pandemic had dramatic consequences for children and adolescents. However, policy-makers and healthcare researchers did not give sufficient weight to children’s perspectives. One common public...

The impact of COVID-19 on routine child immunisation in South Africa

BackgroundThe COVID-19 pandemic disrupted immunisation programs worldwide, reversing gains that had brought vaccine-preventable diseases largely under control. This study explored the impact of COVID-19 on the uptake of routine child immunisation services in South Africa.MethodsWe conducted qualitative research using in-depth interviews with 51 purposively selected parents/caregivers of children below the age of five who missed or delayed one or more scheduled immunisation doses in 2020–2022 and with 12 healthcare providers who provided public immunisation services during the pandemic.ResultsDuring the pandemic lockdowns, most caregivers perceived the risk of their child being infected with COVID-19 during a clinic visit as more salient than the risk of missing immunisation doses. Caregivers reported minimal exposure to routine immunisation communication, as well as shortages of routine vaccines for children at public health facilities, healthcare workers experienced anxiety and burnout. There was a post-pandemic shift to more active decision-making about immunisation, which had previously been an almost automatic behaviour, leading some caregivers to delay vaccinating their children. There was also evidence of a “bad vaccine” mental model among some caregivers regarding COVID vaccinations, which could lead to doubts about the safety of routine childhood vaccinations.DiscussionThe shift from default to active decision-making highlights a risk that routine immunisation will backslide in future pandemics. Governments should build resilient health systems at all levels and communicate clearly about the benefits and availability of RIs and the safety of vaccinations in general, alongside supply-side interventions.ConclusionRoutine immunisation is widely accepted in South Africa, driven by generational norms and provider recommendations. During the COVID-19 pandemic, many caregivers faced the dilemma of balancing COVID-19 exposure risk with the risk of their child developing a deadly VPD, leading to missed RI visits. This shift to active decision-making highlights a future pandemic risk. Governments should build resilient health systems and focus on understanding and engaging procrastinating and doubtful caregivers. Clear communication about RI benefits and vaccine safety is crucial, as misinformation can lead to distrust in new vaccines.

COVID 19 and the Mental Health of College Students

Background:The coronavirus disease 2019 (COVID-19) outbreak significantly impacted those across the United States. The COVID-19 pandemic has caused a mental health strain particularly among college students.Objective:This article examines the mental health of college students and the challenges they experience surrounding COVID-19.Methods:This literature reviews the on-campus infrastructure, resources, and support during the pandemic.Findings:The common theme in the findings throughout the literature is the increase and prevalence in stress, anxiety, and depression among college students with worsening results for students of color.Conclusion:The implications to practice, policy, and research are discussed to set future direction. Recommendations are provided to support the mental health of college students during future pandemics. Colleges and universities need to look to the schools of social work and social work educators for leadership and guidance in improving future outcomes.

Digital Contact Tracing Implementation Among Leaders and Health Care Workers in a Pediatric Hospital During the COVID-19 Pandemic: Qualitative Interview Study.

Health systems had to rapidly implement infection control strategies to sustain their workforces during the COVID-19 pandemic. Various outbreak response tools, such as digital contact tracing (DCT), have been developed to monitor exposures and symptoms of health care workers (HCWs). Limited research evidence exists on the experiences with these technologies and the impacts of DCT innovations from the perspective of stakeholders in health care environments. This study aims to identify the factors influencing the adoption of DCT, highlight variations in perspectives across 3 key stakeholder groups concerning the impact of DCT, and provide benchmarking evidence for future pandemic preparedness. Guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework, we conducted an exploratory qualitative study to investigate the implementation and impact of DCT at the Children's Hospital of Eastern Ontario between December 2022 and April 2023. We conducted 21 semistructured interviews with key stakeholders, including health care administrators (6/21, 29%), occupational health and safety specialists (8/21, 38%), and HCWs (7/21, 33%). Stakeholders were asked about the factors influencing engagement with the DCT tool, organizational-level uptake, the implementation process, long-term use and sustainability of DCT, and unintended consequences. Verbatim transcripts were subject to thematic analysis using NVivo (QSR International). The implementation of DCT was viable and well received. End users indicated that their engagement with the DCT tool was facilitated by its perceived ease of use and the ability to gain awareness of probable COVID-19 exposures; however, risk assessment consequences and access concerns were reported as barriers (reach). Participants commonly agreed that the DCT technology had a positive influence on the hospital's capacity to meet the demands of COVID-19 (effectiveness). Implementors and occupational specialists referred to negative staffing impacts and the loss of nuanced information as unintended consequences (effectiveness). Safety-focused communication strategies and having a DCT tool that was human-centered were crucial factors driving staff adoption of the technology. Conversely, adoption was challenged by the misaligned delivery of the DCT tool with HCWs' standard practices, alongside the evolving perceived threat of COVID-19. Stakeholders collectively agreed on the viability of DCT and its applicability to infectious disease practices (maintenance). Hospital stakeholders were highly satisfied with DCT technology and it was perceived as feasible, efficient, and having a positive impact on organizational safety. Challenges related to the alignment and delivery of DCT, alongside the evolving perspectives on COVID-19, posed obstacles to continued adoption by HCWs. Our findings contribute to evidence-based practices and present benchmarks that can inform preparedness for future pandemics and infectious disease outbreaks and help other organizations implement similar technologies.

Predictors for vaccine hesitancy among nursing students in Namibia

Background: Healthcare workers (HCWs) are a priority group targeted for vaccination because they are greatly exposed to infectious agents.Aim: To determine the prevalence of coronavirus disease 2019 (COVID-19) vaccination and associated risk factors for vaccine hesitancy to recommend vaccine uptake strategies among student nurses.Setting: The study was carried out at the University of Namibia, main campus in Windhoek.Methods: A cross-sectional study was undertaken using a proportionate stratified sampling method. The total sample for the study was 509 students. Statistical Package for the Social Sciences (SPSS) 29 was used to analyse data. Frequencies and proportions were calculated. Bivariate analysis and multiple logistic regression were conducted to pronounce the predictors for vaccine hesitancy.Results: Only 31.40% students were vaccinated against COVID-19. Out of the vaccinated, 41.80% (p 0.001) were previously infected with COVID-19. Participants who were not HCWs before nursing school were most likely not to be vaccinated (p 0.001). Most unvaccinated students were hesitant because of a lack of information about the COVID-19 vaccine’s side effects (50.36%) and not knowing its effectiveness (38.13%). A total 60.80% of the participants believed a vaccine was needed to overcome the pandemic.Conclusion: We recommend the creation of targeted awareness campaigns that shed more light on the benefits of vaccination and vaccine side effects.Contribution: The study identifies key factors that can be targeted to change student nurses’ behaviour towards vaccination and offers valuable data that can inform preparedness and response strategies for future pandemics in Namibia and similar regions.